Process Mining Methodology for Health Process Tracking Using Real-Time Indoor Location Systems.

The definition of efficient and accurate health processes in hospitals is crucial for ensuring an adequate quality of service. Knowing and improving the behavior of the surgical processes in a hospital can improve the number of patients that can be operated on using the same resources. However, the measure of this process is usually made in an obtrusive way, forcing nurses to get information and time data, affecting the proper process and generating inaccurate data due to human errors during the stressful journey of health staff in the operating theater. The use of indoor location systems can take time information about the process in an unobtrusive way, freeing nurses, allowing them to engage in purely welfare work. However, it is necessary to present these data in a understandable way for health professionals, who cannot deal with large amounts of historical localization log data. The use of process mining techniques can deal with this problem, offering an easily understandable view of the process. In this paper, we present a tool and a process mining-based methodology that, using indoor location systems, enables health staff not only to represent the process, but to know precise information about the deployment of the process in an unobtrusive and transparent way. We have successfully tested this tool in a real surgical area with 3613 patients during February, March and April of 2015.

Process mining for individualized behavior modeling using wireless tracking in nursing homes.

The analysis of human behavior patterns is increasingly used for several research fields. The individualized modeling of behavior using classical techniques requires too much time and resources to be effective. A possible solution would be the use of pattern recognition techniques to automatically infer models to allow experts to understand individual behavior. However, traditional pattern recognition algorithms infer models that are not readily understood by human experts. This limits the capacity to benefit from the inferred models. Process mining technologies can infer models as workflows, specifically designed to be understood by experts, enabling them to detect specific behavior patterns in users. In this paper, the eMotiva process mining algorithms are presented. These algorithms filter, infer and visualize workflows. The workflows are inferred from the samples produced by an indoor location system that stores the location of a resident in a nursing home. The visualization tool is able to compare and highlight behavior patterns in order to facilitate expert understanding of human behavior. This tool was tested with nine real users that were monitored for a 25-week period. The results achieved suggest that the behavior of users is continuously evolving and changing and that this change can be measured, allowing for behavioral change detection.

Design of 1-year mortality forecast at hospital admission: A machine learning approach.

Palliative care is referred to a set of programs for patients that suffer life-limiting illnesses. These programs aim to maximize the quality of life (QoL) for the last stage of life. They are currently based on clinical evaluation of the risk of 1-year mortality. The main aim of this work is to develop and validate machine-learning-based models to predict the exitus of a patient within the next year using data gathered at hospital admission. Five machine-learning techniques were applied using a retrospective dataset. The evaluation was performed with five metrics computed by a resampling strategy: Accuracy, the area under the ROC curve, Specificity, Sensitivity, and the Balanced Error Rate. All models reported an AUC ROC from 0.857 to 0.91. Specifically, Gradient Boosting Classifier was the best model, producing an AUC ROC of 0.91, a sensitivity of 0.858, a specificity of 0.808, and a BER of 0.1687. Information from standard procedures at hospital admission combined with machine learning techniques produced models with competitive discriminative power. Our models reach the best results reported in the state of the art. These results demonstrate that they can be used as an accurate data-driven palliative care criteria inclusion.

Using process mining for automatic support of clinical pathways design.

The creation of tools supporting the automatization of the standardization and continuous control of healthcare processes can become a significant helping tool for clinical experts and healthcare systems willing to reduce variability in clinical practice. The reduction in the complexity of design and deployment of standard Clinical Pathways can enhance the possibilities for effective usage of computer assisted guidance systems for professionals and assure the quality of the provided care. Several technologies have been used in the past for trying to support these activities but they have not been able to generate the disruptive change required to foster the general adoption of standardization in this domain due to the high volume of work, resources, and knowledge required to adequately create practical protocols that can be used in practice. This chapter proposes the use of the PALIA algorithm, based in Activity-Based process mining techniques, as a new technology to infer the actual processes from the real execution logs to be used in the design and quality control of healthcare processes.

Diabetes care related process modelling using Process Mining techniques. Lessons learned in the application of Interactive Pattern Recognition: coping with the Spaghetti Effect.

Diabetes is one of the metabolic disorders with more growth expectations in next decades. The literature points to a correct self-management, to an appropriate treatment and to an adequate healthy lifestyle as a way to dramatically improve the quality of life of patients with diabetes. The implementation of a holistic diabetes care system, using rising information technologies for deploying cares based on the thesis of the Evidence-Based Medicine can be a effective solution to provide an adequate and continuous care to patients. However, the design and deployment of computer readable careflows is not a easy task. In this paper, we propose the use of Interactive Pattern Recognition techniques for the iterative design of those protocols and we analyze the problems of using Process Mining to infer careflows and how to how to cope with the resulting Spaghetti Effect.

Applying evidence-based medicine in telehealth: an interactive pattern recognition approximation.

Born in the early nineteen nineties, evidence-based medicine (EBM) is a paradigm intended to promote the integration of biomedical evidence into the physicians daily practice. This paradigm requires the continuous study of diseases to provide the best scientific knowledge for supporting physicians in their diagnosis and treatments in a close way. Within this paradigm, usually, health experts create and publish clinical guidelines, which provide holistic guidance for the care for a certain disease. The creation of these clinical guidelines requires hard iterative processes in which each iteration supposes scientific progress in the knowledge of the disease. To perform this guidance through telehealth, the use of formal clinical guidelines will allow the building of care processes that can be interpreted and executed directly by computers. In addition, the formalization of clinical guidelines allows for the possibility to build automatic methods, using pattern recognition techniques, to estimate the proper models, as well as the mathematical models for optimizing the iterative cycle for the continuous improvement of the guidelines. However, to ensure the efficiency of the system, it is necessary to build a probabilistic model of the problem. In this paper, an interactive pattern recognition approach to support professionals in evidence-based medicine is formalized.

Behaviour patterns detection for persuasive design in Nursing Homes to help dementia patients.

Nursing homes usually host large accounts of persons with different levels of dementia. Detecting dementia process in early stages may allow the application of mechanisms to reduce or stop the cognitive impairment. Our ultimate objective is to demonstrate that the use of persuasive techniques may serve to motivate these subjects and induct re-learning mechanisms to stop mental impairment. Nevertheless, this requires the study of the behaviour of each patient individually in order to detect conduct disorders in their living ambient. This study presents a behavior pattern detection architecture based on the Ambient Assisted Living paradigm and Workflow Mining technology to enable re-learning mechanisms in dementia processes via providing tools to automate the conduct disorder detection. This architecture fosters the use of Workflows as representation languages to allow health professionals to represent persuasive motivation protocols in the AAL environment to react individually to dementia symptoms detected.

Activity-based process mining for clinical pathways computer aided design.

Current trends in health management improvement demand the standardization of care protocols to achieve better quality and efficiency. The use of Clinical Pathways is an emerging solution for that problem. However, current Clinical Pathways are big manuals written in natural language and highly affected by human subjectivity. These problems make the deployment and dissemination of them extremely difficult in real practice environments. In this work, a complete computer based architecture to help the representation and execution of Clinical Pathways is suggested. Furthermore, the difficulties inherent to the design of formal Clinical Pathways in this way requires new specific design tools to help making the system useful. Process Mining techniques can help to automatically infer processes definition from execution samples. Yet, the classical Process Mining paradigm is not totally compatible with the Clinical Pathways paradigm. In this paper, a pattern recognition algorithm based in an evolution of the Process Mining classical paradigm is presented and evaluated as a solution to this situation. The proposed algorithm is able to infer Clinical Pathways from execution logs to support the design of Clinical Pathways.

Corpus based learning of stochastic, context-free grammars combined with Hidden Markov Models for tRNA modelling.

In this paper, a new method for modelling tRNA secondary structures is presented. This method is based on the combination of stochastic context-free grammars (SCFG) and Hidden Markov Models (HMM). HMM are used to capture the local relations in the loops of the molecule (nonstructured regions) and SCFG are used to capture the long term relations between nucleotides of the arms (structured regions). Given annotated public databases, the HMM and SCFG models are learned by means of automatic inductive learning methods. Two SCFG learning methods have been explored. Both of them take advantage of the structural information associated with the training sequences: one of them is based on a stochastic version of the Sakakibara algorithm and the other one is based on a Corpus based algorithm. A final model is then obtained by merging of the HMM of the nonstructured regions and the SCFG of the structured regions. Finally, the performed experiments on the tRNA sequence corpus and the non-tRNA sequence corpus give significant results. Comparative experiments with another published method are also presented.

Corpus based learning of stochastic context-free grammar combined with hidden Markov models for tRNA modelling.

tRNA molecule has a well-known second structure in which it folds by pairing of far-off nucleotides. This paper shows a syntactic pattern recognition methodology for model tRNA second structure using stochastic context-free grammars. In order to learn models, structural regions (paired nucleotides) have been learned from categorized samples with full labelled tree with a Corpus based estimation algorithm. Nonstructural regions have been modelled by hidden Markov models and transformed to stochastic regular grammars to fusion together the structural regions. Test with positive samples and negative samples in comparison with Sakakibara achieved 1.81% in sequences error rate, 98.43% in precision and 100% in recall and 100% of SER in negative test. Corpus based algorithm is computational time efficient and required less training samples for converge to the correct model of the tRNA second structure.