Abstract:
|
Healthcare
is
seen
as
an
essential
matter
in
developed
societies,
and
providing
patients
with
an
outstanding
quality
service
has
been
the
main
core
objective
of
healthcare
organizations
for
decades.
However,
the
use
of
the
very
best
and
new
techniques
to
provide
this
high
quality
service
made
the
cost
of
the
patient’s
cares
dramatically
increase.
Nonetheless,
this
tendency
is
starting
to
change
due
to,
among
other
factors,
the
recent
push
for
healthcare
changes
that
governments
and
health
insurance
companies
are
introducing.
This
is
the
reason
why
medical
institutions
have
lately
been
facing
huge
pressure
in
order
to
streamline
their
resources,
so
they
can
be
able
to
care
for
more
patients,
attending
the
increasing
demand
for
healthcare,
and
reduce
costs
while
still
delivering
a
high
quality
service
[Anyanwu
et
al.,
2003;
Mans
et
al.,
2009].
High
amounts
of
data
are
stored
in
these
organizations,
normally
for
financial
administration.
However,
until
recently
they
were
barely
used
to
optimize
the
processes.
This
is
why
the
medical
environment
is
told
to
be
“Information
Rich
and
Knowledge
Poor”
[Kaur
and
Wasan,
2006].
A
study
from
the
Institute
of
Medicine
(IOM)
of
the
National
Academies
stated
that
there
is
a
real
lack
of
progress
in
the
use
of
Information
Technology
(IT)
to
improve
administrative
and
clinical
processes.
However,
this
scenario
is
starting
to
change
with
the
extended
use
of
Information
Systems
in
modern
organizations,
as
well
as
hospitals.
One
of
the
different
ways
hospitals
can
optimize
their
processes
is
by
using
this
valuable
data
in
order
to
create
standardized
procedures
or
paths
via
process
modeling.
Normally,
care
paths
are
based
on
the
expertise
of
the
doctors,
but
finding
the
correct
model
to
predict
the
way
a
doctor
will
react
to
specific
cases
would
be
outstanding.
We
want
to
discover
the
best
outcome;
however,
this
does
not
mean
that
it
has
to
be
the
most
dominant.
By
having
standardized
processes,
every
patient
will
no
longer
be
seen
as
a
completely
different
and
unique
case.
Patients
with
common
characteristics
can
be
cared
for
in
a
similar
way.
The
procedures
in
an
operation
room,
even
though
they
may
vary,
can
be
seen
as
more
uniform
and
process
oriented
than
other
healthcare
techniques.
Achieving
these
standardized
paths
is
not
a
trivial
issue.
First,
one
will
have
to
decide
which
specific
techniques
to
apply.
Healthcare
processes
have
to
deal
with
an
extraordinary
uncertainty
and
healthcare
organizations,
because
of
their
processes,
are
seen
as
highly
dynamic,
complex,
ad
hoc,
and
multi-‐disciplinary
[Rebuge
&
Ferreira,
2012].
That
is
why
mining
techniques
will
be
the
best
option.
However,
these
techniques
are
usually
not
meant
for
the
medical
environment,
they
are
more
likely
to
be
used
in
business
processes,
so
searching
for
the
most
suitable
procedure
will
be
key.
To
carry
out
the
study,
two
databases
of
the
anesthesia
care
of
ERCP
(Endoscopic
Retrograde
Cholangio
Pancreatography)
will
be
used.
The
Beth
Israel
Deaconess
Medical
Centre
in
Boston
will
provide
both
datasets.
First,
we
started
the
study
with
a
small
dataset
of
33
patients,
while
we
were
waiting
for
the
large
dataset,
which
contained
848
patients.Many
different
paths
can
be
found
using
process
mining
techniques.
Usually,
to
make
business
decisions
while
mining,
the
decision
is
based
in
the
cost
influence,
the
revenue
and
the
operational
efficiency
maintaining
the
level
of
care
[Silver
et
al,
2001].
Nevertheless,
in
this
study,
the
most
prominent
factor
will
be
to
find
a
standard
path,
so
the
variance
should
be
reduced
as
much
as
possible.
Searching
for
a
standardized
path
does
not
mean
that
we
are
searching
for
the
dominant
one,
but
the
goal
will
be
to
discover
the
best
outcome
for
each
situation.
If
a
path
has
got
a
high
variance,
it
will
probably
not
be
worth
to
implement
it
due
to
inefficiency
and
higher
costs.
Applying
pre-‐processing
techniques
such
as
clustering
can
reduce
some
of
the
variability.
Other
factors
to
take
into
account
are
the
simplicity
of
the
path,
the
medical
correctness
and
the
reduction
of
the
risk
for
the
patient.
Nonetheless,
the
main
problem
we
will
face
is
to
find
models
that
are
medically
correct.
Previous
studies
failed
to
achieve
these
good
models
while
applying
process
mining
techniques
to
describe
process
models
related
to
healthcare.
Hence,
the
challenge
of
this
study
is
to
demonstrate
that
these
medical
processes
can
be
analyzed
after
process
mining
techniques
are
applied
to
a
dataset. |