Interactive Process Mining in Healthcare PDF
Preview Interactive Process Mining in Healthcare
Health Informatics Carlos Fernandez-Llatas Editor Interactive Process Mining in Healthcare Health Informatics This series is directed to healthcare professionals leading the transformation of healthcare by using information and knowledge. For over 20 years, Health Informatics has offered a broad range of titles: some address specific professions such as nursing, medicine, and health administration; others cover special areas of practice such as trauma and radiology; still other books in the series focus on interdisciplinaryissues,suchasthecomputerbasedpatientrecord,electronichealth records,andnetworkedhealthcaresystems.Editorsandauthors,eminentexpertsin their fields, offer their accounts of innovations in health informatics. Increasingly, theseaccountsgobeyondhardwareandsoftwaretoaddresstheroleofinformation ininfluencingthetransformationofhealthcaredeliverysystemsaroundtheworld. The series also increasingly focuses on the users of the information and systems: theorganizational,behavioral,andsocietalchangesthataccompanythediffusionof informationtechnologyinhealthservicesenvironments. Developmentsinhealthcaredeliveryareconstant;inrecentyears,bioinformatics hasemergedasanewfieldinhealthinformaticstosupportemergingandongoing developmentsinmolecularbiology.Atthesametime,furtherevolutionofthefield of health informatics is reflected in the introduction of concepts at the macro or health systems delivery level with major national initiatives related to electronic healthrecords(EHR),datastandards,andpublichealthinformatics. Thesechangeswillcontinuetoshapehealthservicesinthetwenty-firstcentury. By making full and creative use of the technology to tame data and to transform information, Health Informatics will foster the development and use of new knowledgeinhealthcare. Moreinformationaboutthisseriesathttp://www.springer.com/series/1114 Carlos Fernandez-Llatas Editor Interactive Process Mining in Healthcare Editor CarlosFernandez-Llatas ProcessMining4HealthLab–SABIEN– ITACAInstitute UniversitatPolitècnicadeValència Valencia Spain CLINTEC–KarolinskaInstitutet Sweden ISSN1431-1917 ISSN2197-3741 (electronic) HealthInformatics ISBN978-3-030-53992-4 ISBN978-3-030-53993-1 (eBook) https://doi.org/10.1007/978-3-030-53993-1 ©SpringerNatureSwitzerlandAG2021 Thisworkissubjecttocopyright.AllrightsarereservedbythePublisher,whetherthewholeorpartof thematerialisconcerned,specificallytherightsoftranslation,reprinting,reuseofillustrations,recitation, broadcasting,reproductiononmicrofilmsorinanyotherphysicalway,andtransmissionorinformation storageandretrieval,electronicadaptation,computersoftware,orbysimilarordissimilarmethodology nowknownorhereafterdeveloped. Theuseofgeneraldescriptivenames,registerednames,trademarks,servicemarks,etc.inthispublication doesnotimply,evenintheabsenceofaspecificstatement,thatsuchnamesareexemptfromtherelevant protectivelawsandregulationsandthereforefreeforgeneraluse. Thepublisher,theauthors,andtheeditorsaresafetoassumethattheadviceandinformationinthisbook arebelievedtobetrueandaccurateatthedateofpublication.Neitherthepublishernortheauthorsor theeditorsgiveawarranty,expressedorimplied,withrespecttothematerialcontainedhereinorforany errorsoromissionsthatmayhavebeenmade.Thepublisherremainsneutralwithregardtojurisdictional claimsinpublishedmapsandinstitutionalaffiliations. ThisSpringerimprintispublishedbytheregisteredcompanySpringerNatureSwitzerlandAG Theregisteredcompanyaddressis:Gewerbestrasse11,6330Cham,Switzerland Foreword It was on August 13, 2009, that I began my (virtual) relationship on Twitter with the SABIEN Group at ITACA Institute, Universitat Politècnica de València, in particularwithmygoodcolleagueVicenteTraver.Morerecently,Ihadthepleasure of meeting Carlos Fernandez-Llatas, who is the person responsible for putting togetheranumberofremarkablehealthprofessionalsandengineerstoproducethis bookontheuseofaninteractiveprocessminingparadigminthehealthcaredomain. Atthattime,Carlosand Vicentewerealready workingon waystoimprove the healthcare sector through the use of technology. In addition to writing hundreds of scientific publications, they started this line of work beginning in 1998 until their team was recognized as one of the most prestigious international research groupsintheapplicationofdigitalsolutionsinthehealthandwell-beingsector,with participation in several international research projects. Therefore, I have no doubt whatsoever that the content of this book, based on wide experience from different pointsofview,willmakeadifferenceintheworldofhealthcare. In 2009, I was a technical officer at the Ministry of Health and Consumer Affairs in Spain, where we were promoting the idea that the present and future of healthinformationisbasedondigitalsolutionsandknowledgemanagement.After this experience, I moved to the international health sector, working for the World Health Organization (WHO), the international agency that directs and coordinates internationalhealthwithintheUnitedNationssystem.Forthelast10years,Ihave had the opportunity and great honor to lead and contribute to several projects and initiatives related to digital health, data, and health information in the health and well-being area in more than 100 countries and territories. Carlos, Vicente, and I chosedifferentpaths-academiaversusgovernmentandpolicymaking-butweshared the same dream, to leverage the potential of data and digital solutions to improve populationhealth. Almost 11 years have passed since we met, and the world has dramatically changedsincethen.Now,welivelongerandhealthierlives,wearemoreconnected, and the spread and uptake of digital solutions are a reality. However, considerable challengesinthehealthandwell-beingsectorpersist,includingthelackofinvest- mentinthehealthsectorwhere,accordingtoWHO,thecurrenthealthexpenditure v vi Foreword (percentageofgrossdomesticproduct,GDP)hasonlyincreased0,06%since2009, representing nowadays less than 10% of global GDP spent on health. In addition, the coronavirus (COVID-19) pandemic, the most serious public health emergency in100years,threatenstodisruptalltheprogressachievedbycountriesinthesocial andeconomicsectorsthroughouttheseyears. If we want to overcome the present and future health challenges, we must act togethertoencouragecountriestowardsacoordinatedresponseandinvestmentwith thetargetofaglobalimpact.Hence,itisimperativeforeachcountrytostrengthen its data and healthcare systems so that data gaps can be closed and every country can generate and use timely, reliable, and actionable data to ensure that decisions aredata-driven. Asaresponsetothesechallenges,andinthemidstoftheseunprecedentedtimes, thisbookpresentsanopportunitytointroduceanewparadigmforintegratinghealth experts in the process of generating new evidence with a data-driven philosophy to enhance healthcare and overcome health threats through the use of interactive processmining. Recent experiences have shown that we cannot predict the future, but it is true thatitispossibletoinfernewknowledgefrompastactionsthroughacombination of process mining technologies using a new machine learning paradigm. As a result, this mixture can provide accurate and personalized knowledge for future decisionsandimprovepatienttreatmentandqualityoflife.Throughoutthisbook, theauthorsguideusthroughapathwaytodiscovernewwaystoprovideinformation tohealthcareprofessionalsbyinvolvingtheminthecomplexprocessofgenerating knowledgewiththeideaofreducingcostsandenhancingtheseprocesses.Aspartof thisworkflow,processminingalgorithmsareexecutedinahuman-understandable wayandhigh-qualitydataareneededtoleadtotherightdecisionsinthehealthcare domain. As a consequence, methods and techniques allow for the development of newmodelsfromreality,whileexpertshaveawaytovalidatethesemodelsthatcan beappliedtohumanbehavior. Atotalof33expertsfrom20differentinstitutionsaroundtheworldhaveagreed toguideusthroughthisjourneyacross17chapters,andIhopethatyouenjoythis tripasmuchasIhave. Wedonotknowwhatwillhappentomorrow,buttodayweknow,astheAmerican engineerandstatisticianWilliamEdwardsDemingsaid,“Withoutdata,you’rejust anotherpersonwithanopinion,”andthisbookwillhelpusfillthatgapwiththeuse ofinteractiveprocessmining. DavidNovillo-Ortiz Denmark, UnitHead,HealthInformation,MonitoringandAnalysis May2020 WorldHealthOrganization,RegionalOfficeforEurope The author is a staff member of the World Health Organization (WHO) and is solelyresponsiblefortheviewsexpressedintheforeword,whichdonotnecessarily representtheviews,decisions,orpoliciesoftheWHO. Preface Nowadays, writing a book about the use of artificial intelligence in the medical domainisachallenge.Numerousadvancesinthelastyearshaveresultedinalarge numberofworkinthisarea.Artificialintelligencetechnologieshaveprovenhighly successful in several scenarios. However, these have not yet solved some ethical andtechnicalissuesthatareraisinginevitablequestionsinthemedicalcommunity: Whatistheroleofthehealthprofessionalinthisscenario?Arethesesystemssafe? This is raising suspicion among certain professionals who feel these technologies can may lose control of healthcare. This mistrust is motivating the appearance of certain works in the literature that aid in understanding the results obtained by artificialintelligencealgorithms. This book attempts to go a step further by proposing technology that involves thehealthprofessionalintheprocessoflearning.Theaimofthisbookistopresent anddeepentheuseofInteractiveProcessMiningasanewparadigmforintegrating healthexpertsintheprocessofgeneratingnewevidence.Thisparadigmcombines the application of process mining technologies in healthcare using interactive machine learning for supporting health professionals in inferring new knowledge from past actions and providing accurate and personalized knowledge for future decisionsandimprovepatients’treatmentsandqualityoflife. Thisbookhasaneminentpracticalfocusprovidingnotonlymethodologiesand technologies for the application of interactive process mining paradigm, but an importantpartofthebookisalsodedicatedtopresentingexamplesofrealusescases wherethisparadigmhasbeensuccessfullyappliedindifferentmedicaldomainslike surgery,emergency,obesitybehavior,diabetes,andhumanbehaviormodelling. Although, inevitably, making a practical book requires tools for supporting the proposed techniques, the objective of this book is not to be tool-specific. The aim is to provide solutions, by explaining the real concepts and the engineering behind the solution, and not the tools used in detail, keeping the content timeless and independent of the tools used. The book is intended to provide a common view between health professionals and data scientists in a general way. The deep analysis of the techniques that are used is out of the scope of this book. To make it accessible for a wider audience, we have skipped the more technical parts and vii viii Preface Fig.1 Bookchapters have focused on philosophical and organizational aspects. That means, the what andthehowInteractiveProcessMiningTechniquescansupportprofessionalsinthe improvementofhealthprocesses. Figure 1 shows the relation of chapters that are included in the book. The remainderofthebookisthefollowing: Thefirstchapterintroducestheproblemandexplainsthemainconceptsthatwill berevisitedlaterinthebookinmoredetail.Apartfromthisintroduction,thebook is organized into three parts and a final chapter discussing the challenges we are facingintheapplicationofInteractiveProcessMininginthemedicaldomain. The first part revisits the basic aspects and the current medical background. Chapter2,analyzetheeffectsthatareproducingtheHealthDigitalTransformation in the medical domain and shows the aspects in the appearance of Value-Based Medicine Paradigm. Chapter 3 provides an introductory background to medical processes and what approaches exist for their design and automation. Chapter 4 Preface ix introduces Process Mining focused on their application in the healthcare domain, highlighting the differences, singularities, and barriers in their application in real medical environments. Chapter 5 goes deeper into the problem of Data Quality, specificallyinthecaseofProcessMining.ToclosethispartChap.6showstheuse ofsemanticsforabetterwaytodefineprocessesusingProcessMiningandHealth DataStandards. The second part of this book is focused on the presentation of the Interactive Process Mining Paradigm in the healthcare domain. Chapter 7 explains what is the Interactive Process Mining paradigm, presenting its singular advantages for applicationinthemedicaldomain.Chapter8deepensthemethodologicalaspectsof InteractiveProcessMining,revisitingtheconceptofDataRodeosforsupportingthe deploymentofInteractiveProcessMininginhealth.Finally,Chap.9introducesthe conceptofInteractiveProcessIndicator(IPI)asanewwaytoprovideinformation tothedoctortoachievebetterknowledgeinmedicalprocessesandsupportingthem intakingbetterdecisions. The third part of the book is a selection of real cases for illustrating the application of Interactive Process Mining in the healthcare domain. Chapters 10, 11,12,13,14,and15presentrealcasesinrealscenarioswhereInteractiveProcess Mining is being applied, highlighting specific aspects, advantages, and barriers of thismethodology.Thecaseshavebeenselectedcoveringdifferentfieldsinsidethe medical domain. Chapters are talking about applying this technology in hospitals with the existing information in medical databases, as well as enriched with Real- Time Location Systems, and supporting medical education. But we also have selected cases analyzing the patient process in chronic diseases, discovering its dynamicalprocessesandanalyzingthedatathatcomesfromtheInternetofThings fordiscoveringthepatient’sindividualbehavior. Chapter16introducestheapplicationoforganizationaltechniques,likeChange Management, proposing techniques for improving the success probability in the applicationofInteractiveProcessMininginasingularcase,likeitisinhealthcare domain.Thelastchaptersummarizesnewchallengesthathavetobeaddressesinthe comingyearsinordertosuccessfullyapplythismethodologyinhealthcaredomains. Thisbookisthehumbleresultofmorethan15yearsofresearchinthemedical informatics field, looking for the best ways to support the decisions of health professionals,increasethequalityofcare,andachievebetterpatientexperiencevia continuousimprovementinmedicalprocesses. Apartofmylifeisinthisbook.Ihopeyouenjoyreading. Valencia,Spain CarlosFernandez-Llatas May2020
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