Healthcare Process Support: Achievements, Challenges, Current Research

Healthcare organizations are facing the challenge of delivering high-quality services to their patients at affordable costs. To tackle this challenge, the Medical Informatics community targets at formalisms for developing decision-support systems (DSSs) based on clinical guidelines. At the same time, business process management (BPM) enables IT support for healthcare processes, e.g., based on workflow technology. By integrating aspects from these two fields, promising perspectives for achieving better healthcare process support arise. The perspectives and limitations of IT support for healthcare processes provided the focus of three Workshops on Process-oriented Information Systems (ProHealth). These were held in conjunction with the International Conference on Business Process Management in 2007-2009. The ProHealth workshops provided a forum wherein challenges, paradigms, and tools for optimized process support in healthcare were debated. Following the success of these workshops, this special issue on process support in healthcare provides extended papers by research groups who contributed multiple times to the ProHealth workshop series. These works address issues pertaining to healthcare process modeling, process-aware healthcare information system, workflow management in healthcare, IT support for guideline implementation and medical decision support, flexibility in healthcare processes, process interoperability in healthcare and healthcare standards, clinical semantics of healthcare processes, healthcare process patterns, best practices for designing healthcare processes, and healthcare process validation, verification, and evaluation

Using conceptual graphs for clinical guidelines representation and knowledge visualization

The intrinsic complexity of the medical domain requires the building of some tools to assist the clinician and improve the patient’s health care. Clinical practice guidelines and protocols (CGPs) are documents with the aim of guiding decisions and criteria in specific areas of healthcare and they have been represented using several languages, but these are difficult to understand without a formal background. This paper uses conceptual graph formalism to represent CGPs. The originality here is the use of a graph-based approach in which reasoning is based on graph-theory operations to support sound logical reasoning in a visual manner. It allows users to have a maximal understanding and control over each step of the knowledge reasoning process in the CGPs exploitation. The application example concentrates on a protocol for the management of adult patients with hyperosmolar hyperglycemic state in the Intensive Care Unit

Correctness of services and their composition

We study correctness of services and their composition and investigate how the design of correct service compositions can be systematically supported. We thereby focus on the communication protocol of the service and approach these questions using formal methods and make contributions to three scenarios of SOC.Wir studieren die Korrektheit von Services und Servicekompositionen und untersuchen, wie der Entwurf von korrekten Servicekompositionen systematisch unterstützt werden kann. Wir legen dabei den Fokus auf das Kommunikationsprotokoll der Services. Mithilfe von formalen Methoden tragen wir zu drei Szenarien von SOC bei

Correctness of services and their composition

We study correctness of services and their composition and investigate how the design of correct service compositions can be systematically supported. We thereby focus on the communication protocol of the service and approach these questions using formal methods and make contributions to three scenarios of SOC.Wir studieren die Korrektheit von Services und Servicekompositionen und untersuchen, wie der Entwurf von korrekten Servicekompositionen systematisch unterstützt werden kann. Wir legen dabei den Fokus auf das Kommunikationsprotokoll der Services. Mithilfe von formalen Methoden tragen wir zu drei Szenarien von SOC bei

Tackling Dierent Business Process Perspectives

Business Process Management (BPM) has emerged as a discipline to design, control, analyze, and optimize business operations. Conceptual models lie at the core of BPM. In particular, business process models have been taken up by organizations as a means to describe the main activities that are performed to achieve a specific business goal. Process models generally cover different perspectives that underlie separate yet interrelated representations for analyzing and presenting process information. Being primarily driven by process improvement objectives, traditional business process modeling languages focus on capturing the control flow perspective of business processes, that is, the temporal and logical coordination of activities. Such approaches are usually characterized as \u201cactivity-centric\u201d. Nowadays, activity-centric process modeling languages, such as the Business Process Model and Notation (BPMN) standard, are still the most used in practice and benefit from industrial tool support. Nevertheless, evidence shows that such process modeling languages still lack of support for modeling non-control-flow perspectives, such as the temporal, informational, and decision perspectives, among others. This thesis centres on the BPMN standard and addresses the modeling the temporal, informational, and decision perspectives of process models, with particular attention to processes enacted in healthcare domains. Despite being partially interrelated, the main contributions of this thesis may be partitioned according to the modeling perspective they concern. The temporal perspective deals with the specification, management, and formal verification of temporal constraints. In this thesis, we address the specification and run-time management of temporal constraints in BPMN, by taking advantage of process modularity and of event handling mechanisms included in the standard. Then, we propose three different mappings from BPMN to formal models, to validate the behavior of the proposed process models and to check whether they are dynamically controllable. The informational perspective represents the information entities consumed, produced or manipulated by a process. This thesis focuses on the conceptual connection between processes and data, borrowing concepts from the database domain to enable the representation of which part of a database schema is accessed by a certain process activity. This novel conceptual view is then employed to detect potential data inconsistencies arising when the same data are accessed erroneously by different process activities. The decision perspective encompasses the modeling of the decision-making related to a process, considering where decisions are made in the process and how decision outcomes affect process execution. In this thesis, we investigate the use of the Decision Model and Notation (DMN) standard in conjunction with BPMN starting from a pattern-based approach to ease the derivation of DMN decision models from the data represented in BPMN processes. Besides, we propose a methodology that focuses on the integrated use of BPMN and DMN for modeling decision-intensive care pathways in a real-world application domain