Effective business process execution requires the integration of both process logic and business data. While recent approaches explore the potential of Large Language Models (LLMs) in automating process modeling, their applicability is limited in real-world scenarios where textual descriptions — often authored by non-experts — are complex or incomplete. Moreover, these works primarily focus on the control-flow perspective and overlook the critical role of data modeling and execution. In this paper, we propose a hybrid and decomposed approach to automatically generate executable process and data models from text using LLMs. Our method modularizes the task: the LLM clarifies and enriches the description, then extracts both process and data elements, which are combined into a unified model. Structured algorithms ensure robust and executable outputs. Evaluation results demonstrate that our approach improves model completeness, clarity, and efficiency compared to existing methods.

This paper addresses the problem of correcting medical coding errors with respect to some coding recommendations. The problem consists in clustering medical codings and determining for each cluster the set of features to correct in order to maximize the financial benefits subject to coding correction effort constraints. For this purpose, we model the coding recommendation as a disjunction of hypercubes and introduce the concept of correction sets. A mixed integer linear programming model is then proposed to assign medical codes to correction sets in order to maximize the financial benefits. The miscoding is then explained by characterizing optimal clusters with association rules and coding error distribution. A case study on patient stays associated with malnutrition-related ICD codes is presented, and the performance of the proposed methodology is assessed in regard to the current coding staff practice. A significant increase in health services reimbursement is achieved with a limited number of subjects’ features reviewed. Note to Practitioners—Medical miscoding has a significant negative impact on hospitals with a financial loss for under coding and a penalty for over coding. Whether a medical review is necessary for all descriptive features of a miscoded subject? Is it possible to reduce unnecessary medical reviews without compromising the goal of increasing hospital financial benefits? This article attempts to answer these questions with a data-driven optimization approach to determine a limited number of miscoding clusters and the set of features to review for each in order to best balance the financial benefits and the medical review workload. The application to a real-life case study leads to a significant increase in hospital fiscal revenue of nearly 6,992,489.69 €, while reviewing only a small number of descriptive features (5293 out of 22056 features, or 24% of features). Causes are also provided for each discovered coding error subtype to ameliorate medical coders’ coding practices. Furthermore, the proposed approach allows the decision-maker to balance the cost-benefit and the requirement of public health institutions (i.e., miscoding rate).

Process mining techniques can be used to analyse business processes using the data logged during their execution. These techniques are leveraged in a wide range of domains, including healthcare, where it focuses mainly on the analysis of diagnostic, treatment, and organisational processes. Despite the huge amount of data generated in hospitals by staff and machinery involved in healthcare processes, there is no evidence of a systematic uptake of process mining beyond targeted case studies in a research context. When developing and using process mining in healthcare, distinguishing characteristics of healthcare processes such as their variability and patient-centred focus require targeted attention. Against this background, the Process-Oriented Data Science in Healthcare Alliance has been established to propagate the research and application of techniques targeting the data-driven improvement of healthcare processes. This paper, an initiative of the alliance, presents the distinguishing characteristics of the healthcare domain that need to be considered to successfully use process mining, as well as open challenges that need to be addressed by the community in the future.

Medical test selection is a recurring problem in health prevention and consists of proposing a set of tests to each subject for diagnosis and treatment of pathologies. The problem is characterized by the unknown risk probability distribution across the population and two contradictory objectives: minimizing the number of tests and giving the medical test to all at-risk populations. This article sets this problem in a general framework of chance-constrained medical test rationing with unknown subject distribution over an attribute space and unknown risk probability but with a given sample population. A new approach combining decision-tree and Bayesian inference is proposed to allocate relevant medical tests according to the subjects’ profile. Case studies on screening of hypertension and diabetes are conducted, and the performance of the proposed approach is evaluated. Significant savings on unnecessary tests are achieved with limited numbers of subjects needing but not receiving necessary tests.Note to Practitioners—Whether a medical test is needed for all subjects in health prevention? Is it possible to reduce unnecessary tests without jeopardizing the goal of screening at-risk populations? This article attempts to answer these questions by proposing a data-driven approach combining decision trees for subject profiling, Bayesian inference for unknown probability distribution estimation, and combinatorial optimization for test allocation. The application of this approach to a real-case study reduces the number of electrocardiogram (ECG) tests by 90% while keeping the number of hypertensive subjects needing but not receiving ECG tests small (five out of 230). A significant cut of unnecessary tests is also achieved in a second case study of diabetes screening. This approach allows decision-makers to better balance the cost-saving and the level of public health objective. Furthermore, the combination with decision trees makes the practical implementation quite straightforward.

Discovering workflow patterns in event-logs is important for many organizations to understand and optimize organizational processes. Although numerous algorithms have been proposed in the literature to discover patterns in sequences of symbols, most of them are inadequate to discover patterns in rich event-log data. In this paper, motivated by the analysis of patient pathways in the health domain, a rich type of event logs, called activity-cost event logs, is considered where each event is associated with a cost. The paper formalizes the problem of mining interesting low-cost patterns in these logs by combining novel concepts of penalties (activity costs) and consistency of patterns, with traditional measures of confidence, length, and time. Furthermore, to extract these patterns efficiently from event logs, an algorithm named TWINCLE (Time-WINdow, Cost and LEngth constrained sequential rule mining) is proposed. Experiments carried out on benchmark datasets and real-life healthcare event logs show that proposed algorithm is efficient and can discover interesting patterns.

Process Mining aims to extract information from event logs to highlight the underlying business processes. It is useful in situations where there is no detailed and complete knowledge of how an overall system works, such as in a hospital where most processes are complex and ad-hoc. Many Process Mining discovery techniques have been proposed so far, but many challenges are still to be faced. Implicit dependencies are one of them. Choice-related phenomenon, implicit dependencies are not taken into account in most algorithms and graphical representations. In this paper, we propose the Implicit Dependencies Miner, a Process Tree based algorithm able to detect relevant dependencies.