Multi-level process mining methodology for exploring disease-specific care processes

Abstract

Background: Public healthcare is a complex domain with many actors and highly variable protocols, which makes traditional process mining tools less effective and calls for specialized methods.

Aim: The objective of the work was to develop a generally applicable process mining methodology to explore care processes related to diseases.

Methods: The proposed methodology called Process Mining Methodology for Exploring Disease-specific Care Processes (MEDCP) is based on a systematic, step-wise refinement of the raw event logs by using such a multi-level expert taxonomy of events that encapsulates the professional concepts of the analysis. A treatment process is defined according to domain-specific rules to identify the starting (index) and closing events. Concepts from various levels of the taxonomy support the final process definition for an analysis that can deliver meaningful conclusions for domain experts.

Results: The applicability of the methodology was demonstrated on two case studies in the cardiological and oncological care domains, in the public health care system in Hungary over a period of ten years. Thanks to the multi-level taxonomy, these studies successfully identified the most important high-level event sequence patterns and some key anomalies in the national care system, such as the significantly different behavior of low-volume vs. high volume care providers in the oncology study or the geographically connected, homogeneous clusters of providers with similar care spectra in the cardiology study.

Discussion: As the case studies showed, the proposed methodology can improve the efficiency of standard process mining methods, and deliver high level conclusions that are easy to interpret by domain experts. System-level insight into health care processes can serve as a basis for the optimisation and long-term planning of the whole care system.

Keywords: Cardiology; Clinical pathway; Healthcare treatment sequence; Multi-level analysis; Oncology; Process mining.