Can process mining automatically describe care pathways of patients with long-term conditions in UK primary care? A study protocol

Introduction In the UK, primary care is seen as the optimal context for delivering care to an ageing population with a growing number of long-term conditions. However, if it is to meet these demands effectively and efficiently, a more precise understanding of existing care processes is required to ensure their configuration is based on robust evidence. This need to understand and optimise organisational performance is not unique to healthcare, and in industries such as telecommunications or finance, a methodology known as ‘process mining’ has become an established and successful method to identify how an organisation can best deploy resources to meet the needs of its clients and customers. Here and for the first time in the UK, we will apply it to primary care settings to gain a greater understanding of how patients with two of the most common chronic conditions are managed. Methods and analysis The study will be conducted in three phases; first, we will apply process mining algorithms to the data held on the clinical management system of four practices of varying characteristics in the West Midlands to determine how each interacts with patients with hypertension or type 2 diabetes. Second, we will use traditional process mapping exercises at each practice to manually produce maps of care processes for the selected condition. Third, with the aid of staff and patients at each practice, we will compare and contrast the process models produced by process mining with the process maps produced via manual techniques, review differences and similarities between them and the relative importance of each. The first pilot study will be on hypertension and the second for patients diagnosed with type 2 diabetes

Process Mining Contributions to Discrete-event Simulation Modelling

Background: Over the last 20 years, process mining has become a vibrant research area due to the advances in data management technologies and techniques and the advent of new process mining tools. Recently, the links between process mining and simulation modelling have become an area of interest. Objectives: The objective of the paper was to demonstrate and assess the role of process mining results as an input for discrete-event simulation modelling, using two different datasets, one of which is considered data-poor while the other one data-rich. Methods/Approach: Statistical calculations and process maps were prepared and presented based on the event log data from two case studies (smart mobility and higher education) using a process mining tool. Then, the implications of the results across the building blocks (entities, activities, control-flows, and resources) of simulation modelling are discussed. Results: Apart from providing a rationale and the framework for simulation that is more efficient modelling based on process mining results, the paper provides contributions in the two case studies by deliberating and identifying potential research topics that could be tackled and supported by the new combined approach. Conclusions: Event logs and process mining provide valuable information and techniques that could be a useful input for simulation modelling, especially in the first steps of building discrete-event models, but also for validation purposes

Enhancing discrete-event simulation with big data analytics: a review

This article presents a literature review of the use of the OR technique of discrete-event simulation (DES) in conjunction with the big data analytics (BDA) approaches of data mining, machine learning, data farming, visual analytics, and process mining. The two areas are quite distinct. DES represents a mature OR tool using a graphical interface to produce an industry strength process modelling capability. The review reflects this and covers commercial off-the-shelf DES software used in an organisational setting. On the contrary the analytics techniques considered are in the domain of the data scientist and usually involve coding of algorithms to provide outputs derived from big data. Despite this divergence the review identifies a small but emerging literature of use-cases and from this a framework is derived for a DES development methodology that incorporates the use of these analytics techniques. The review finds scope for two new categories of simulation and analytics use: an enhanced capability for DES from the use of BDA at the main stages of the DES methodology as well as the use of DES in a data farming role to drive BDA techniques

The application of process mining to care pathway analysis in the NHS

Background: Prostate cancer is the most common cancer in men in the UK and the sixth-fastest increasing cancer in males. Within England survival rates are improving, however, these are comparatively poorer than other countries. Currently, information available on outcomes of care is scant and there is an urgent need for techniques to improve healthcare systems and processes. Aims: To provide prostate cancer pathway analysis, by applying concepts of process mining and visualisation and comparing the performance metrics against the standard pathway laid out by national guidelines. Methods: A systematic review was conducted to see how process mining has been used in healthcare. Appropriate datasets for prostate cancer were identified within Imperial College Healthcare NHS Trust London. A process model was constructed by linking and transforming cohort data from six distinct database sources. The cohort dataset was filtered to include patients who had a PSA from 2010-2015, and validated by comparing the medical patient records against a Case-note audit. Process mining techniques were applied to the data to analyse performance and conformance of the prostate cancer pathway metrics to national guideline metrics. These techniques were evaluated with stakeholders to ascertain its impact on user experience. Results: Case note audit revealed 90% match against patients found in medical records. Application of process mining techniques showed massive heterogeneity as compared to the homogenous path laid out by national guidelines. This also gave insight into bottlenecks and deviations in the pathway. Evaluation with stakeholders showed that the visualisation and technology was well accepted, high quality and recommended to be used in healthcare decision making. Conclusion: Process mining is a promising technique used to give insight into complex and flexible healthcare processes. It can map the patient journey at a local level and audit it against explicit standards of good clinical practice, which will enable us to intervene at the individual and system level to improve care.Open Acces

The 2P-K Framework: A Personal Knowledge Measurement Framework for the Pharmaceutical Industry

Knowledge is a dynamic human process to justify our personal belief in pursuit of the truth. The intellectual output of any organisation is reliant upon the individual people within that organisation. Despite the eminent role of personal knowledge in organisations, personal knowledge management and measurement have received little attention, particularly in pharmaceutical manufacturing. The pharmaceutical industry is one of the pillars of the global economy and a knowledge-intensive sector where knowledge is described as the second product after medicines. The need of measurement to achieve effective management is not a new concept in management literature. This study offers an explanatory framework for personal knowledge, its underlying constructs and observed measures in the pharmaceutical manufacturing context. Following a sequential mixed method research (MMR) design, the researcher developed a measurement framework based on the thematic analysis of fifteen semi-structured interviews with industry experts and considering the extant academic and regulatory literature. A survey of 190 practitioners from the pharmaceutical manufacturing sector enabled quantitative testing and validation of the proposed models utilising confirmatory factor analysis. The pharmaceutical personal knowledge framework was the fruit of a comprehensive study to explain and measure the manifestations of personal knowledge in pharmaceutical organisations. The proposed framework identifies 41 personal knowledge measures reflecting six latent factors and the underlying personal knowledge. The hypothesised factors include: regulatory awareness, performance, wisdom, organisational understanding, mastership of product and process besides communication and networking skills. In order to enhance the applicability and flexibility of the measurement framework, an abbreviated 15-item form of the original framework was developed. The abbreviated pharmaceutical personal knowledge (2P-K) framework demonstrated superior model fit, better accuracy and reliability. The research results reveal that over 80% of the participant pharmaceutical organisations had a form of structured KM system. However, less than 30% integrated KM with corporate strategies suggesting that KM is still in the early stages of development in the pharmaceutical industry. Also, personal knowledge measurement is still a subjective practice and predominately an informal process. The 2P-K framework offers researchers and scholars a theoretically grounded original model for measuring personal knowledge. Also, it offers a basis for a personal knowledge measurement scale (2P-K-S) in the pharmaceutical manufacturing context. Finally, the study had some limitations. The framework survey relied on self-ratings. This might pose a risk of social desirability bias and Dunning–Kruger effect. Consequently, a 360- degree survey was suggested to achieve accurate assessments. Also, the model was developed and tested in an industry-specific context. A comparative study in similar manufacturing industries (e.g. chemical industries) is recommended to assess the validity of the current model or a modified version of it in other industries

Exploring the use of routine healthcare data through process mining to inform the management of musculoskeletal diseases

Healthcare informatics can help address some of the challenges faced by both healthcare providers and patients. The medical domain is characterised by inherently complex and intricate issues, data can often be of poor quality and novel techniques are required. Process mining is a discipline that uses techniques to extract insights from event data, generated during the execution of processes. It has had good results in various branches of medical science but applications to musculoskeletal diseases remain largely unexplored. This research commenced with a review of the healthcare and technical literature and applied a variety of process mining techniques in order to investigate approaches to the healthcare plans of patients with musculoskeletal conditions. The analysis involved three datasets from: 1) a private hospital in Boston, US, where data was used to create disease trajectory models. Results suggest the method may be of interest to healthcare researchers, as it enables a more rapid modelling and visualisation; 2) a mobile healthcare application for patients receiving physiotherapy in Sheffield, UK, where data was used to identify possible indicators for health outcomes. After evaluation of the results, it was found that the indicators identified may be down to chance; and 3) the population of Wales to explore knee pain surgery pathways. Results suggest that process mining is an effective technique. This work demonstrates how routine healthcare data can be analysed using process mining techniques to provide insights that may benefit patients suffering with musculoskeletal conditions. This thesis explores how strict criteria for analysis can be performed. The work is intended to expand the breadth of process mining methods available to the data science community and has contributed by making recommendations for service utilisation within physiotherapy at Sheffield Hospital and helped to define a roadmap for a leading healthcare software company