OBJECTIVE: Process Mining (PM) is an established discipline with increasing adoption in the clinical domain. In this context, PM seeks to infer clinical processes from healthcare data collected in the Electronic Health Record. However, the particularities of clinical practice cause that, in most cases, the processes obtained result in an intricate network that hardly corresponds to clinical algorithms and, thus, are difficult to understand for clinical and IT personnel. To address these problems, our aim is to incorporate specialized clinical knowledge into the PM discovery algorithm. METHODS: We propose a declarative approach to interactive process discovery in the clinical domain. Concretely, we present a set of declarative techniques that allows clinicians to incorporate their knowledge in the process, based on the Declare formalism. RESULTS: The results of this work encompass both the declarative interactive approach and its implementation in the I-PALIA PM discovery algorithm, as well as an application to a use case for the treatment of prostate cancer. This application demonstrates that the implemented techniques are useful in managing typical problems that arise when applying PM methods to the clinical domain. CONCLUSION: This work proposes a novel approach with techniques for interactive process discovery in the clinical domain. This approach not only allows the clinical expert to interactively incorporate specialized knowledge into the PM algorithm, but also serves to obtain process models that are more comprehensible and better resemble treatment procedures.

Clinical Practice Guidelines (CPGs) include recommendations aimed at optimising patient care, informed by a review of the available clinical evidence. To achieve their potential benefits, CPG should be readily available at the point of care. This can be done by translating CPG recommendations into one of the languages for Computer-Interpretable Guidelines (CIGs). This is a difficult task for which the collaboration of clinical and technical staff is crucial. However, in general CIG languages are not accessible to non-technical staff. We propose to support the modelling of CPG processes (and hence the authoring of CIGs) based on a transformation, from a preliminary specification in a more accessible language into an implementation in a CIG language. In this paper, we approach this transformation following the Model-Driven Development (MDD) paradigm, in which models and transformations are key elements for software development. To demonstrate the approach, we implemented and tested an algorithm for the transformation from the BPMN language for business processes to the PROforma CIG language. This implementation uses transformations defined in the ATLAS Transformation Language. Additionally, we conducted a small experiment to assess the hypothesis that a language such as BPMN can facilitate the modelling of CPG processes by clinical and technical staff.

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.

Ponència presentada al 16th International Conference on Software Technologies (ICSOFT 2021), el 6 de juliol de 2021