On Treatment Patterns for Modeling Medical Treatment Processes in Clinical Practice Guidelines

Clinical practice guidelines(CPGs)contain evidence-based and economically reasonable medical treatment processes.Executable medical treatment processes in healthcare information systems can assist the treatment processes.To this end,business process modeling technologies have been exploited to model medical treatment processes.However,medical treatment processes are usually flexible and knowledge-intensive.To reduce the effort in modeling,we summarize several treatment patterns(i.e.,frequent behaviors in medical treatment processes in CPGs),and represent them by three process modeling languages(i.e.,BPMN,DMN,and CMMN).Based on the summarized treatment patterns,we propose a pattern-based integrated framework for modeling medical treatment processes.A modeling platform is implemented to support the use of treatment patterns,by which the feasibility of our approach is validated.An empirical analysis is discussed based on the coverage rates of treatment patterns.Feedback from interviewed physicians in a Chinese hospital shows that executable medical treatment processes of CPGs provide a convenient way to obtain guidance,thus assisting daily work for medical workers.

面向临床实践指南的诊疗模式建模与实现

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。