An important part of healthcare decision making is to understand how certain actions relate to desired and undesired outcomes. One key challenge is to deal with confounding variables, i.e., variables that influence the relation between actions and outcomes. Existing techniques aim to uncover the underlying statistical relations between actions and outcomes, but either do not account for confounding variables or only consider the process or case level instead of the event level. Therefore, this paper proposes a novel relation mining approach for healthcare processes that 1) explicitly accounts for confounding variables at the event level, and 2) transparently communicates the effect of the confounding variables to the user. We demonstrate the applicability and importance of our approach using two evaluation experiments. We use a real-world healthcare dataset to show that the identified relations indeed provide important input for decision making in healthcare processes. We use a synthetic dataset to illustrate the importance of our approach in the general setting of causal model estimation.

Process mining techniques are valuable to gain insights into and help improve (work) processes. Many of these techniques focus on the sequential order in which activities are performed. Few of these techniques consider the statistical relations within processes. In particular, existing techniques do not allow insights into how responses to an event (action) result in desired or undesired outcomes (effects). We propose and formalize the ARE miner, a novel technique that allows us to analyze and understand these action-response-effect patterns. We take a statistical approach to uncover potential dependency relations in these patterns. The goal of this research is to generate processes that are: (1) appropriately represented, and (2) effectively filtered to show meaningful relations. We evaluate the ARE miner in two ways. First, we use an artificial data set to demonstrate the effectiveness of the ARE miner compared to two traditional process-oriented approaches. Second, we apply the ARE miner to a real-world data set from a Dutch healthcare institution. We show that the ARE miner generates comprehensible representations that lead to informative insights into statistical relations between actions, responses, and effects.

Before the findings of a process mining project can be turned into actionable insights or recommendations, it is essential to make sure that the findings are actually valid. Therefore, the evaluation of the findings is a crucial part of a successful process mining project. Current process mining methodologies, however, fall short in providing actionable support to perform such an evaluation. This is especially true when domain experts are involved. To close this gap, we performed a literature study considering all process mining case studies published in the last two decades. In total, we identified 244 candidate papers of which we analyzed 80 in depth. Based on this literature study, we found a need for a more systematic approach for qualitative evaluations in process mining projects where domain experts are involved. Therefore, we build on these results to propose six validation strategies, which originate from qualitative research. We believe that this proposal for more rigor in the evaluation phase of process mining projects helps to move the discipline forward.