Design and Execution of Integrated Clinical Pathway: A Simplified Meta-Model and Associated Methodology

Integrated clinical pathways (ICPs) are task-oriented care plans detailing the essential steps of the therapeutic pathway referring to a specific clinical problem with a patient’s expected clinical course. ICPs represent an effective tool for resource management in the public and private health doma...

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Main Authors: Carmelo Ardito, Danilo Caivano, Lucio Colizzi, Giovanni Dimauro, Loredana Verardi
Format: Article
Language:English
Published: MDPI AG 2020-07-01
Series:Information
Subjects:
Online Access:https://www.mdpi.com/2078-2489/11/7/362
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author Carmelo Ardito
Danilo Caivano
Lucio Colizzi
Giovanni Dimauro
Loredana Verardi
author_facet Carmelo Ardito
Danilo Caivano
Lucio Colizzi
Giovanni Dimauro
Loredana Verardi
author_sort Carmelo Ardito
collection DOAJ
description Integrated clinical pathways (ICPs) are task-oriented care plans detailing the essential steps of the therapeutic pathway referring to a specific clinical problem with a patient’s expected clinical course. ICPs represent an effective tool for resource management in the public and private health domains. To be automatically executed, the ICP process has to be described by means of complex general purpose description language (GPDL) formalisms. However, GPDLs make the process model difficult to grasp by a human. On the other hand, the adoption of a reduced set of graphical constructs prevents a fully automated process execution due to the lack of information required by a machine. Unfortunately, it is difficult to find a balance between modelling language expressiveness and the automated execution of the modelled processes. In this paper, we present a meta-model based on a GPDL to organize the ICP process knowledge. This meta-model allows the management of ICP information in a way that is independent from the graphic representation of the adopted modelling standard. We also propose a general framework and a methodology that aim to guarantee a high degree of automation in process execution. In particular, the corresponding execution engine is implemented as a chatbot (integrated with social media), which plays a two-fold role: during the actual execution of the entire ICP, it acts as a virtual assistant and gathers the patient’s health data. Tests performed on a real ICP showed that, thanks to the proposed solution, the chatbot engine is able to engage in a dialogue with the patient. We provide discussion about how the system could be extended and how it could be seen as an alternative to Artificial Intelligence (AI) and Natural Language Processing (NLP)-based approaches.
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spelling doaj.art-2c57d8402ae345fd86034f9d695cbb642023-11-20T06:35:29ZengMDPI AGInformation2078-24892020-07-0111736210.3390/info11070362Design and Execution of Integrated Clinical Pathway: A Simplified Meta-Model and Associated MethodologyCarmelo Ardito0Danilo Caivano1Lucio Colizzi2Giovanni Dimauro3Loredana Verardi4Dipartimento di Ingegneria Elettrica e dell’Informazione (DEI), Politecnico di Bari, Via Edoardo Orabona, 4, 70126 Bari, ItalyDipartimento di Informatica, University of Bari Aldo Moro, Via Edoardo Orabona, 4, 70125 Bari, ItalyDipartimento di Informatica, University of Bari Aldo Moro, Via Edoardo Orabona, 4, 70125 Bari, ItalyDipartimento di Informatica, University of Bari Aldo Moro, Via Edoardo Orabona, 4, 70125 Bari, ItalyDipartimento di Informatica, University of Bari Aldo Moro, Via Edoardo Orabona, 4, 70125 Bari, ItalyIntegrated clinical pathways (ICPs) are task-oriented care plans detailing the essential steps of the therapeutic pathway referring to a specific clinical problem with a patient’s expected clinical course. ICPs represent an effective tool for resource management in the public and private health domains. To be automatically executed, the ICP process has to be described by means of complex general purpose description language (GPDL) formalisms. However, GPDLs make the process model difficult to grasp by a human. On the other hand, the adoption of a reduced set of graphical constructs prevents a fully automated process execution due to the lack of information required by a machine. Unfortunately, it is difficult to find a balance between modelling language expressiveness and the automated execution of the modelled processes. In this paper, we present a meta-model based on a GPDL to organize the ICP process knowledge. This meta-model allows the management of ICP information in a way that is independent from the graphic representation of the adopted modelling standard. We also propose a general framework and a methodology that aim to guarantee a high degree of automation in process execution. In particular, the corresponding execution engine is implemented as a chatbot (integrated with social media), which plays a two-fold role: during the actual execution of the entire ICP, it acts as a virtual assistant and gathers the patient’s health data. Tests performed on a real ICP showed that, thanks to the proposed solution, the chatbot engine is able to engage in a dialogue with the patient. We provide discussion about how the system could be extended and how it could be seen as an alternative to Artificial Intelligence (AI) and Natural Language Processing (NLP)-based approaches.https://www.mdpi.com/2078-2489/11/7/362integrated clinical pathwayprocess designcase managementintegrated clinical pathway executionintelligent agentsprocess metamodel
spellingShingle Carmelo Ardito
Danilo Caivano
Lucio Colizzi
Giovanni Dimauro
Loredana Verardi
Design and Execution of Integrated Clinical Pathway: A Simplified Meta-Model and Associated Methodology
Information
integrated clinical pathway
process design
case management
integrated clinical pathway execution
intelligent agents
process metamodel
title Design and Execution of Integrated Clinical Pathway: A Simplified Meta-Model and Associated Methodology
title_full Design and Execution of Integrated Clinical Pathway: A Simplified Meta-Model and Associated Methodology
title_fullStr Design and Execution of Integrated Clinical Pathway: A Simplified Meta-Model and Associated Methodology
title_full_unstemmed Design and Execution of Integrated Clinical Pathway: A Simplified Meta-Model and Associated Methodology
title_short Design and Execution of Integrated Clinical Pathway: A Simplified Meta-Model and Associated Methodology
title_sort design and execution of integrated clinical pathway a simplified meta model and associated methodology
topic integrated clinical pathway
process design
case management
integrated clinical pathway execution
intelligent agents
process metamodel
url https://www.mdpi.com/2078-2489/11/7/362
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