A Process Modelling Framework Based on Point Interval Temporal Logic with an Application to Modelling Patient Flows

This thesis considers an application of a temporal theory to describe and model the patient journey in the hospital accident and emergency (A&E) department. The aim is to introduce a generic but dynamic method applied to any setting, including healthcare. Constructing a consistent process model can be instrumental in streamlining healthcare issues. Current process modelling techniques used in healthcare such as flowcharts, unified modelling language activity diagram (UML AD), and business process modelling notation (BPMN) are intuitive and imprecise. They cannot fully capture the complexities of the types of activities and the full extent of temporal constraints to an extent where one could reason about the flows. Formal approaches such as Petri have also been reviewed to investigate their applicability to the healthcare domain to model processes. Additionally, to schedule patient flows, current modelling standards do not offer any formal mechanism, so healthcare relies on critical path method (CPM) and program evaluation review technique (PERT), that also have limitations, i.e. finish-start barrier. It is imperative to specify the temporal constraints between the start and/or end of a process, e.g., the beginning of a process A precedes the start (or end) of a process B. However, these approaches failed to provide us with a mechanism for handling these temporal situations. If provided, a formal representation can assist in effective knowledge representation and quality enhancement concerning a process. Also, it would help in uncovering complexities of a system and assist in modelling it in a consistent way which is not possible with the existing modelling techniques. The above issues are addressed in this thesis by proposing a framework that would provide a knowledge base to model patient flows for accurate representation based on point interval temporal logic (PITL) that treats point and interval as primitives. These objects would constitute the knowledge base for the formal description of a system. With the aid of the inference mechanism of the temporal theory presented here, exhaustive temporal constraints derived from the proposed axiomatic system’ components serves as a knowledge base. The proposed methodological framework would adopt a model-theoretic approach in which a theory is developed and considered as a model while the corresponding instance is considered as its application. Using this approach would assist in identifying core components of the system and their precise operation representing a real-life domain deemed suitable to the process modelling issues specified in this thesis. Thus, I have evaluated the modelling standards for their most-used terminologies and constructs to identify their key components. It will also assist in the generalisation of the critical terms (of process modelling standards) based on their ontology. A set of generalised terms proposed would serve as an enumeration of the theory and subsume the core modelling elements of the process modelling standards. The catalogue presents a knowledge base for the business and healthcare domains, and its components are formally defined (semantics). Furthermore, a resolution theorem-proof is used to show the structural features of the theory (model) to establish it is sound and complete. After establishing that the theory is sound and complete, the next step is to provide the instantiation of the theory. This is achieved by mapping the core components of the theory to their corresponding instances. Additionally, a formal graphical tool termed as point graph (PG) is used to visualise the cases of the proposed axiomatic system. PG facilitates in modelling, and scheduling patient flows and enables analysing existing models for possible inaccuracies and inconsistencies supported by a reasoning mechanism based on PITL. Following that, a transformation is developed to map the core modelling components of the standards into the extended PG (PG*) based on the semantics presented by the axiomatic system. A real-life case (from the King’s College hospital accident and emergency (A&E) department’s trauma patient pathway) is considered to validate the framework. It is divided into three patient flows to depict the journey of a patient with significant trauma, arriving at A&E, undergoing a procedure and subsequently discharged. Their staff relied upon the UML-AD and BPMN to model the patient flows. An evaluation of their representation is presented to show the shortfalls of the modelling standards to model patient flows. The last step is to model these patient flows using the developed approach, which is supported by enhanced reasoning and scheduling

Computerization of workflows, guidelines and care pathways: a review of implementation challenges for process-oriented health information systems

There is a need to integrate the various theoretical frameworks and formalisms for modeling clinical guidelines, workflows, and pathways, in order to move beyond providing support for individual clinical decisions and toward the provision of process-oriented, patient-centered, health information systems (HIS). In this review, we analyze the challenges in developing process-oriented HIS that formally model guidelines, workflows, and care pathways. A qualitative meta-synthesis was performed on studies published in English between 1995 and 2010 that addressed the modeling process and reported the exposition of a new methodology, model, system implementation, or system architecture. Thematic analysis, principal component analysis (PCA) and data visualisation techniques were used to identify and cluster the underlying implementation ‘challenge’ themes. One hundred and eight relevant studies were selected for review. Twenty-five underlying ‘challenge’ themes were identified. These were clustered into 10 distinct groups, from which a conceptual model of the implementation process was developed. We found that the development of systems supporting individual clinical decisions is evolving toward the implementation of adaptable care pathways on the semantic web, incorporating formal, clinical, and organizational ontologies, and the use of workflow management systems. These architectures now need to be implemented and evaluated on a wider scale within clinical settings

Benefits and challenges of applying Semantic Web Services in the e-Government domain

Joining up services in e-Government usually implies governmental agencies acting in concert without a central control regime. This requires the sharing of scattered and heterogeneous data. Semantic Web Service (SWS) technology can help to integrate, mediate and reason between these datasets. However, since few real-world applications have been developed, it is still unclear which are the actual benefits and issues of adopting such a technology in the e-Government domain. In this paper, we contribute to raising awareness of the potential benefits in the e-Government community by analyzing motivations, requirements, and expected results, before proposing a reusable SWS-based framework. We demonstrate the application of this framework by a compelling use case: a GIS-based emergency planning system. We illustrate the obtained benefits and the key challenges which remain to be addressed

Ontology-based Classification and Analysis of non- emergency Smart-city Events

Several challenges are faced by citizens of urban centers while dealing with day-to-day events, and the absence of a centralised reporting mechanism makes event-reporting and redressal a daunting task. With the push on information technology to adapt to the needs of smart-cities and integrate urban civic services, the use of Open311 architecture presents an interesting solution. In this paper, we present a novel approach that uses an existing Open311 ontology to classify and report non-emergency city-events, as well as to guide the citizen to the points of redressal. The use of linked open data and the semantic model serves to provide contextual meaning and make vast amounts of content hyper-connected and easily-searchable. Such a one-size-fits-all model also ensures reusability and effective visualisation and analysis of data across several cities. By integrating urban services across various civic bodies, the proposed approach provides a single endpoint to the citizen, which is imperative for smooth functioning of smart cities

A Model of Workflow Composition for Emergency Management

AbstractThe common-used workflow technology is not flexible enough in dealing with concurrent emergency situations. The paper proposes a novel model for defining emergency plans, in which workflow segments appear as a constituent part. A formal abstraction, which contains four operations, is defined to compose workflow segments under constraint rule. The software system of the business process resources construction and composition is implemented and integrated into Emergency Plan Management Application System

Modeling an ontology on accessible evacuation routes for emergencies

Providing alert communication in emergency situations is vital to reduce the number of victims. However, this is a challenging goal for researchers and professionals due to the diverse pool of prospective users, e.g. people with disabilities as well as other vulnerable groups. Moreover, in the event of an emergency situation, many people could become vulnerable because of exceptional circumstances such as stress, an unknown environment or even visual impairment (e.g. fire causing smoke). Within this scope, a crucial activity is to notify affected people about safe places and available evacuation routes. In order to address this need, we propose to extend an ontology, called SEMA4A (Simple EMergency Alert 4 [for] All), developed in a previous work for managing knowledge about accessibility guidelines, emergency situations and communication technologies. In this paper, we introduce a semi-automatic technique for knowledge acquisition and modeling on accessible evacuation routes. We introduce a use case to show applications of the ontology and conclude with an evaluation involving several experts in evacuation procedures. © 2014 Elsevier Ltd. All rights reserved

Geospatial data integration with Semantic Web services: the eMerges approach

Geographic space still lacks the semantics allowing a unified view of spatial data. Indeed, as a unique but all encompassing domain, it presents specificities that geospatial applications are still unable to handle. Moreover, to be useful, new spatial applications need to match human cognitive abilities of spatial representation and reasoning. In this context, eMerges, an approach to geospatial data integration based on Semantic Web Services (SWS), allows the unified representation and manipulation of heterogeneous spatial data sources. eMerges provides this integration by mediating legacy spatial data sources to high-level spatial ontologies through SWS and by presenting for each object context dependent affordances. This generic approach is applied here in the context of an emergency management use case developed in collaboration with emergency planners of public agencies