Inter-institutional cooperation among physicians becomes increasingly important. Yet, it is unrealistic to assume that cooperation can be supported via a homogeneous system that is pre-installed in every organization. Instead, physicians will typically have their own autonomous systems that support internal processes. Traditional activity-oriented workflow platforms do not resolve inter-institutional integration challenges. This paper presents an approach for distributed process management, which enables ad hoc cooperation via active electronic documents without the need to integrate local systems. A distributed case file is used to coordinate cooperating parties. Using this case file does not require any preinstalled system components, so genuine ad hoc information exchange is enabled.
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