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CONTINUOUS CLINICAL PATHWAYS EVALUATION BY USING AUTOMATIC LEARNING ALGORITHMS
 

CONTINUOUS CLINICAL PATHWAYS EVALUATION BY USING AUTOMATIC LEARNING ALGORITHMS

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Presentation carried out in Rome the 26th January, 2011 during HEALTHINF-BIOSTEC 2011 about CONTINUOUS CLINICAL PATHWAYS EVALUATION BY USING AUTOMATIC LEARNING ALGORITHMS...

Presentation carried out in Rome the 26th January, 2011 during HEALTHINF-BIOSTEC 2011 about CONTINUOUS CLINICAL PATHWAYS EVALUATION BY USING AUTOMATIC LEARNING ALGORITHMS
Authors: Carlos Fernández-Llatas, Teresa Meneu, Jose Miguel Benedí and Vicente Traver

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    CONTINUOUS CLINICAL PATHWAYS EVALUATION BY USING AUTOMATIC LEARNING ALGORITHMS CONTINUOUS CLINICAL PATHWAYS EVALUATION BY USING AUTOMATIC LEARNING ALGORITHMS Presentation Transcript

    • CONTINUOUS CLINICAL PATHWAYS EVALUATION BY USING AUTOMATIC LEARNING ALGORITHMS
      Carlos Fernández-Llatas, Teresa Meneu, Jose Miguel Benedí andVicente Traver
      vtraver@itaca.upv.es
    • Introduction
      Using Clinical Pathways for Health Care standardization
      Workflow Technology
      Activity-Based Process Mining for Clinical Pathways automatic Learning
      Clinical Pathways Process Miner
      Conclusions and Future Work
      Index
    • Clinical pathways
      Formal care protocols
      Efficient and coordinated use of resources
      From the evidence based medicine approach
      Advantages
      Facilitate the praxis of health professionals
      Improvement of quality of care
      Unify criteria
      Help the administrative management of clinical processes
      Using Clinical Pathways for Health Care standardization
    • Using Clinical Pathways for Health Care standardization
      • Problems
      • Complexity
      • Subjectivity
      • Adaptation needed
      • Bureaucratized execution
      • Without adequate ICT support
    • Workflow Technology
      Workflow
      Theautomation of a business process, in whole or part, during which documents, information or tasks are passed from one participant to another for action, according to a set of procedural rules
      Workflow Management Coalition Glossary
    • Workflow Technology
      Workflow
      Formal description of a process designed to be automated
      Readable by experts
      Can be automatically executed by using workflow engines
      Workflows can help Clinical Pathways Standardization
    • Workflow Technology
      Difficulties in the process design
      Complete and explicit definition needed
      Differences between actual and perceived process
      Large time process design
      High knowledge of representation language needed
    • Process Mining
      Process Mining
      Obtain a model from the execution logs
      Corpus
      Set of workflow execution logs used to train the model
      Can be used in an iterative way to refine continuously clinical pathways
      Evaluation of deployed Clinical Guidelines
      Human readable and modifiable inferred model
    • Workflow Technology
      Event Based Process Mining
      Inference from system events
      Insufficient for clinical pathways inference
      Gettemperature
      Medicate
      Yes
      Fever
      No
      Do nothing
    • Activity-Based Process Mining
      for Clinical Pathways automatic Learning
      Activity Based Process Mining
      Inference from Activities
      Corpus with information of start, duration and result of actions
      07/05/2010 10:22:59 => i:1 BeginAction: Admission
      07/05/2010 10:34:01 => i:1 EndAction: Admission Res: OK
      07/05/2010 10:35:03 => i:1 BeginAction: Triage
      07/05/2010 10:46:06 => i:1 EndAction: Triage Res: InHospital
      07/05/2010 10:56:07 => i:1 BeginAction: TNS
      07/05/2010 10:56:08 => i:1 BeginAction: TMP
      07/05/2010 11:23:10 => i:1 EndAction: TNS Res: OK
      07/05/2010 11:33:12 => i:1 EndAction: TMP Res: Fever
      07/05/2010 11:43:19 => i:1 BeginAction: TMP
      07/05/2010 11:50:19 => i:1 EndAction: TMP Res: OK
      07/05/2010 11:51:24 => i:1 BeginAction: QualityTest
      07/05/2010 12:00:28 => i:1 EndAction: QualityTestRes: OK
      07/05/2010 12:15:29 => i:1 BeginAction: Discharge
      07/05/2010 12:20:30 => i:1 EndAction: DischargeRes: OK
    • Activity-Based Process Mining
      for Clinical Pathways automatic Learning
      • PALIA (Parallel Activity-based Log Inference Algorithm)
      • Input: Activity based log samples
      • Output: TPA (Timed Parallel Automaton)
      • 4 Subalgorithms
      • Parallel prefix aceptor tree
      • Parallel Merge
      • Onward Merge
      • Elimination of repeated transitions and not useful states
      Algorithmdesignedwithin Carlos Fernandez’ thesis
    • TPA (Timed Parallel Automaton)
      Based on parallel finite automaton approach
      Alphabet enriched with discrete temporal labels
      Able to describe complex transitions
      Description of parallelism and synchronization patterns
      Double function of transition:
      g: N+ N+
      d: Q  Q
      where: Q is a set of nodes N
      Activity-Based Process Mining
      for Clinical Pathways automatic Learning
    • Activity-Based Process Mining
      for Clinical Pathways automatic Learning
      • Parallelprefix aceptor tree
    • Activity-Based Process Mining
      for Clinical Pathways automatic Learning
      • ParallelMerge
    • Activity-Based Process Mining
      for Clinical Pathways automatic Learning
      • OnwardMerge
    • Activity-Based Process Mining
      for Clinical Pathways automatic Learning
      • Eliminate repeated transitions and not useful states
    • Clinical Pathways Process Miner
      Tool for Process Mining over deployed Clinical Pathways
      Analysis of deviations on Clinical Pathways executions
      Comparison between real execution and designed pathway
      Discovery of new Clinical Pathways patterns
      Analysis of Costs produced of Clinical Pathways deviations
      Cost evaluation of inefficient cases
      Bottle-necks detection.
      Currently testing with experts in Heart Cycle project
      Clinical Pathways Process Miner
    • ClinicalPathwaysProcessMining Demo
    • Process Mining Techniques can be used to help in the Clinical Pathways design process
      A Clinical Pathway can be approached in an iterative way
      Errors and new patterns can be detected and corrected in each iteration
      The process can be continuously improved designing more and more cost-efficient Clinical Pathways
      Conclusions
    • CONTINUOUS CLINICAL PATHWAYS EVALUATION BY USING AUTOMATIC LEARNING ALGORITHMS
      Carlos Fernández-Llatas, Teresa Meneu, Jose Miguel Benedí andVicente Traver
      vtraver@itaca.upv.es