面向临床实践指南的诊疗模式建模与实现

Modeling and Implementation of Treatment Patterns for Clinical Practice Guideline

对临床实践指南(Clinical Practice Guideline,CPG)中的诊疗过程进行数字化建模并使其被工作流引擎解释执行,可为医生提供针对性的临床建议,为指南的有效实施提供技术保障。由于诊疗过程的复杂业务规则和非结构化等特点,采用传统业务过程建模方法会导致模型难以理解、失去使用价值。而对于一些复杂而频繁的诊疗行为尚无可参考的有效建模方案。为此,该文从四种不同的CPG诊疗过程中提取出五个诊疗模式,并给出形式化定义和基于BPMN(Business Process Model and Notation)、DMN(Decision Management Notation)和CMMN(Case Management Model and Notation)的通用建模方法。诊疗模式的提出可为诊疗过程片段建模提供指导性建议和可复用的模板。在此基础上,对开源建模工具Camunda Modeler进行扩展,实现了支持诊疗模式的建模工具。通过配置诊疗模式,可快速得到诊疗过程片段模型,从而提高建模效率。通过对真实的CPG诊疗过程的建模和覆盖率分析验证了诊疗模式的可用性。

In order to ensure the effective implementation of clinical practice guidelines(CPGs),it is necessary to develop executable medical treatment process(MTP)models of CPGs,which can be executed by workflow engines.Because MTPs are usually rule-complicated and unstructured,traditional business process modeling method will lead to extremely complex MTP models that are unusable.There is no referable and effective modeling guidance for some complex and frequent medical treatment behaviors.To provide guidance and reusable templates for modeling MTP segments more easily,we extract five treatment patterns from four various CPGs and also elaborate their formal definitions and their general models based on BPMN,DMN and CMMN.A modeling platform is implemented to support the use of treatment patterns by extending the open-source modeling tool Camunda Modeler.MTP model segments can be quickly obtained by configuring treatment patterns,thus improving the modeling efficiency.A case study of MTP modeling for two real CPGs validates the usefulness of our treatment patterns.