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Explore the Therapy Orchestration Framework

Learning Objectives

After completing this unit, you’ll be able to:

  • Explain the main components and features of the Therapy Orchestration framework.
  • Describe the Advanced Therapy Management data model.

A Symphony of Coordination

In the previous unit, you established a basic foundation in Advanced Therapy Management, exploring its core features, advantages, and how it empowers life science organizations to deliver pioneering coactive treatments. Now, explore the framework that orchestrates this symphony of care: Therapy Orchestration.

Much like a conductor guiding a complex musical performance, Therapy Orchestration synchronizes the intricate processes involved in advanced therapies. It ensures that the appropriate user takes the necessary action at the optimal time, adapting to the unique challenges of each therapy, regional regulations, and site-specific variations.

With Therapy Orchestration, you design flexible workflows for complex therapies. Each workflow consists of interconnected subflows, representing the distinct stages of the therapy—from enrollment to infusion. Here’s a representative workflow for the apheresis stage of an advanced therapy divided into key components.

The division of stages, steps, and tasks using Apheresis stage.

To manage this complexity, a therapy workflow is divided into a clear hierarchy.

  • Stages (1): The major phases of the therapy, such as enrollment, scheduling, apheresis, manufacturing, and infusion.
  • Steps (2): The primary steps within each stage. For example, the apheresis stage can be divided into sequential steps such as pre-apheresis, before collection, during collection, and after collection.
  • Tasks (3): The specific activities that make up each step. For example, the pre-apheresis stage contains specific tasks such as submitting early serology reports, and picking and verifying apheresis kits.

Thanks to this hierarchical structure, you can set up workflows involving sequential and parallel processing, accommodating the real-world complexities of advanced therapies.

This framework optimizes team management and role assignment. You can configure care teams for each therapy and site. These teams can even span multiple sites, fostering collaboration and shared responsibility. You can assign each team member a role that translates into contextual activities within the therapy workflow. For instance, a nurse verifies patient identity during intake, while a lab technician prepares samples during apheresis. These users can visualize the therapy's progress and access relevant data within each stage, giving them the information necessary for effective task completion.

A Look Behind the Scenes

Advanced Therapy Management supports these intricate orchestrations with a robust, adaptable data model. By understanding the key records and relationships within this model, you learn how orchestration tools translate into real-world action. Explore this through the journey of Charles Green, who’s recently been diagnosed with a rare blood disease.

After his diagnosis, Charles’s oncologist recommends enrollment in Oncarta, a cutting-edge CAR T-cell therapy at StayHealthy Hospital. StayHealthy, with its network of apheresis centers, manufacturing labs, and infusion centers, has designed a comprehensive care program for patients such as Charles.

Take a look at the Advanced Therapy Management data model and how it maps the relationships within Charles’s therapeutic journey.

The objects mapped to different aspects of Charles Green’s Oncarta therapy.

Here’s a summary of the objects.

Object

Description

Scenario

Person Account (1)

A person account record combines information from the account and contact records of a patient.

Charles is referred to StayHealthy as a patient.

Care Program Enrollee (2)

Care Program (3)

A care program enrollee record stores information related to a patient in a care program.

A care program record represents a set of activities offered to patients.

Charles enrolls in the Oncarta Therapy care program.

Work Procedure (4)

A work procedure record stores information about a process or program, such as a therapy care program.

You can associate a specific flow orchestration with the work procedure.

StayHealthy Hospital offers an advanced therapy treatment called Oncarta, also known as CAR T-cell, Therapy.

Work Procedure Step (5)

A work procedure step record stores information about a work type that’s part of a work procedure.

The Oncarta procedure involves a series of stages, such as apheresis, manufacturing, and infusion.

Work Type (6)

A work type record represents a category of work. When associated with a work procedure, a work type is referred to as a work procedure step.

Apheresis, manufacturing, and infusion are work types.

Work Type Step (7)

Each work type step represents a specific step within a work type. Each step can be associated with an action plan template that contains specific tasks to complete within the overall step.

Before Collection is a work type step within the Apheresis work type.

A Before Collection action plan template is associated with the record and contains a series of tasks for specific users to complete.

Service Territory (8)

Service Territory (9)

A service territory record set up as a child territory represents a site or location where a work type is performed.

A service territory record set up as a parent territory represents a site that groups all the child service territories where the work types are performed.

Each step occurs at a different site. A parent site, StayHealthy Hospital, groups these sites.

In addition to these objects, which primarily define the setup construct for an advanced therapy workflow, there are additional objects representing the real-time constructs for each patient.

Examine the distinction between these two constructs.

  • Setup Construct: This construct involves configuring the foundational elements of the therapy workflow before it's executed for any specific patient.
  • Run-Time Construct: This construct involves Salesforce generating real-time records to track a patient's treatment journey after the setup is complete.

Review the table to see how different workflow phases correspond to setup and run-time constructs.

Workflow Component

Setup Construct (For Each Workflow)

Run-time Construct (For Each Patient)

Example

Workflow

Care Program, Work Procedure

Not applicable

StayHealthy Oncarta Therapy

Stage

Work Procedure Step, Work Type

Care Program Enrollee Work Order

Enrollment

Step

Work Type Step, Action Plan Template

Care Program Enrollee Work Order Step

Patient Consent

Task

Tasks in Action Plan Template with assigned roles by user or user group

Tasks Flow and Component Tasks

Request Patient Consent, Confirm Consent Receival

Understanding the distinction between setup and run-time constructs is key to implementing workflows that meet the needs of the general therapy and specific patient. For a complete view of the Advanced Therapy Management data model and detailed object descriptions, see the Health Cloud Developer Guide.

An Orchestration in Action

With the orchestration framework and data model established, follow Charles Green’s journey through the initial stages of his therapy to see the orchestration in motion.

Anita Mandal, the treatment center coordinator, logs in to the Advanced Therapy Management app. This streamlined interface offers easy access to essential features such as Care Programs, Multi-Step Scheduling, and Therapy Orchestration without overwhelming users with unnecessary complexity. From the app, Anita accesses Charles’s Care Program Enrollee record, the central hub for orchestrating his entire treatment journey.

Charles Green’s care program enrollee record page at the enrollment stage with initial tasks.

The task pane displays the initial steps for the enrollment stage: obtaining patient consent and initiating the cell order. Each step contains tasks tailored to Anita’s role, ensuring she focuses on her specific responsibilities.

When you click a task, it launches a guided workflow that the therapy provider’s administrators have configured. After you complete the tasks, the orchestration seamlessly transitions to the next step.

For example, after Anita completes the consent tasks, the orchestration then moves to the cell order intake step.

The My Tasks pane presenting Create Cell Order as the next step.

Next, Anita initiates the Create Cell Order task, which launches a workflow for initiating the therapy purchase details for the treatment.

The Create Cell Order window with fields filled in for Charles’s therapy order.

After Anita completes the cell order, the gene therapy coordinator receives a notification. The coordinator’s view of the patient's record presents only the tasks assigned to them. In this case, they review and approve the cell order.

The assigned tasks for the gene therapy coordinator with a single task for enrollment.

Upon approval, the patient's record advances to the Scheduling stage. Anita now sees new scheduling steps and tasks. Charles's care program enrollee record at the scheduling stage, showing new steps and tasks in the task pane.

The first step in this stage is aptly named Book Slots, and it’s here that Anita begins the intricate process of coordinating Charles’s treatment timeline. She schedules his apheresis, manufacturing, and infusion appointments, each carefully placed to ensure a seamless and timely therapy journey.

Therapy Orchestration doesn’t just manage complex therapy workflows; it transforms the entire treatment experience. By optimizing workflows and fostering collaboration, it creates a harmonious symphony of care that benefits patients and providers alike.

In this unit, you explored how Therapy Orchestration synchronizes complex therapy workflows, ensuring that each team member performs the necessary task at the optimal time. You also learned how the orchestration framework and data model work together to create a harmonious treatment experience for patients and providers alike.

In the next unit, you discover how Multi-Step Scheduling simplifies the coordination of appointments and lead times across the entire therapy journey.

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