Martin Burwitz

BPMN4CP: Design and implementation of a BPMN extension for clinical pathways

The Business Process Model and Notation (BPMN) is a standard for business process modeling that is very common in professional practice due to its expressiveness, the well defined meta model and the possibility of workflow integration. This research article aims to apply the BPMN for the representation of clinical pathways in order to utilize its benefits in the clinical context. BPMN provides a set of generic process modeling elements what makes it necessary to extend the language by domain-specific concepts from the field of clinical pathways (e.g., evidence indicators). Therefore, the extension method of Stroppi et al. (2011) was applied and extended in order to facilitate a systematic design and development. This research article provides the analysis of requirements and relevant concepts for modeling clinical pathways. Based on a domain ontology, need for extension is identified and the valid BPMN extension meta model is designed by the construction of a conceptional domain model and the corresponding BPMN extension model. The evolved extension ”BPMN4CP” is demonstrated by an example process of wisdom tooth treatment.

BPMN4CP Revised -- Extending BPMN for Multi-perspective Modeling of Clinical Pathways

Clinical Pathways (CPs) can be seen as business processes of hospitals or clinical institutions. Modeling these pathways is an emerging field of research, as it provides promising benefits for systems integration, quality management and documentation. The Business Process Model and Notation (BPMN) provides a range of process-related concepts but naturally lacks in representing specific aspects from the CP domain. Therefore, the BPMN extension BPMN4CP was designed in a previous research project. In accordance with research guidelines from Design Science, the extension ran through an iteration based on its practical application within a telemedical project. Based on several new requirements, the extension was revised regarding to the integration of resources, documents, objectives and quality indicators. These concepts were assigned to particular perspectives and diagrams in order to support model complexity management and provide appropriate diagrams for respective stakeholders. In order to provide a commonly usable extension, these enhancements were implemented as BPMN meta model extension.

Certification of Service-oriented eHealth Platforms

Certification of interoperability is an important quality measure, which can foster the success of eHealth projects. Often these projects test and certify interoperability for specific purposes. The achievement of long-term interoperability is often not in the scope of these projects. In this paper we describe the importance of expandability for the long-term interoperability. Further we show, how a structured criteria catalogue for the certification process can be derived for these two quality factors.

Clinical processes from various angles - amplifying BPMN for integrated hospital management

The design and management of information systems is driven by model-oriented approaches on different levels of abstraction. For instance, enterprise models link the organizational action system and corresponding information systems. Enterprise models are generally perceived as measures to close the gap between business and IT, as it is in the healthcare domain. Clinical Pathways (CPs) represent value-added processes of hospitals and are typically described by respective process modeling languages like BPMN. However, a solitary focus on processes is insufficient for utilizing the potential of the model. Instead, it is rather advisable to consider various perspectives in order to completely represent the organizational action system of a hospital. We therefore propose to extend clinical process models with accordingly required perspectives for the representation of satellite objects, e.g. medical resources. Based on previous work, this paper motivates the approach of (process-based) integrated hospital modeling and presents the architecture and design of a revised BPMN extension for multi-perspective modeling. The applicability of the proposed BPMN extension is demonstrated by modeling a CP part for the treatment of stroke patients, which explicitly integrates the process and resource perspective.

Conceptual Modeling for Cooperation-Based Evolution of Medical Treatment

Chronic diseases, cross-sectoral treatment chains, variations in lengths of stay and a multitude of treatment options along the treatment chain with significant economic and social impacts characterize the domain of psychological and psychosomatic treatment. This kind of treatment sector is facing major challenges like evaluating the treatments by economic criteria whilst ensuring at the same time a certain quality level, to facilitate coordinated cross-sectoral cooperation and to promote systematic exchange of knowledge. On the basis of analyses of structured interviews with different stakeholders of the psychological and psychosomatic sector, we designed a framework for the evolutionary development of Clinical Pathways. This framework covers a novel organizational paradigm derived from managerial theories and adapted for cooperative health care provision. Evolutionary reference models should serve as a means of organizational learning and should provide potential for improving both the quality of medical treatment and the cost-benefit ratio. The evolutionary approach contains a permanent generation of organizational experiences from daily care and using them for evaluation and improvement of standardized treatment modalities. Beyond the framework of evolutionary Clinical Pathways we discuss necessary adjustments of conventional modeling approaches applied within the health care sector.

Towards Adaptive Pathways: Reference Architecture for Personalized Dynamic Pathways

The usage of clinical pathways to describe and organize the treatment of patients in inter-sectoral care has been established through the last decade. In particular, engaging the patient in the treatment process has become more important. Adequate tools and concepts are needed to improve the integration of patients into inter-sectorial care processes. Personalized dynamic pathways form patient-specific extensions for clinical pathways as a flexible instrument that goes beyond traditional application of pathways. They support customizing care for patient-specific requirements as well as adding patient interaction to the care process. This paper adapts the concept of personalized dynamic pathways and proposes a reference architecture for integrating personalized dynamic pathways into existing inter-organizational healthcare information systems.

Nachhaltigkeit von E-Health-Projekten

Der Einsatz von Informations- und Kommunikationstechnik im Gesundheitswesen, kurz E-Health, wird schon langer als Moglichkeit gesehen, das Gesundheitswesen effektiver zu gestalten und dadurch Kosten zu sparen sowie die Qualitat der Versorgung zu verbessern. Die Verstetigung innovativer, auf modernen E-Health-Technologien basierender intersektoraler medizinischer Versorgung scheitert in Deutschland heute jedoch haufig an der fehlenden Verwertungsbasis und dem Pilotcharakter durchgefuhrter E-Health-Projekte, die wiederum als Negativbeispiel fur eine breitenwirksame Ubertragung von Losungen herangezogen werden.