Re-ordered fuzzy conformance checking for uncertain clinical records.

Modern hospitals implement clinical pathways to standardize patients' treatments. Conformance checking techniques provide an automated tool to assess whether the actual executions of clinical processes comply with the corresponding clinical pathways. However, clinical processes are typically characterized by a high degree of uncertainty, both in their execution and recording. This paper focuses on uncertainty related to logging clinical processes. The logging of the activities executed during a clinical process in the hospital information system is often performed manually by the involved actors (e.g., the nurses). However, such logging can occur at a different time than the actual execution time, which hampers the reliability of the diagnostics provided by conformance checking techniques. To address this issue, we propose a novel conformance checking algorithm that leverages principles of fuzzy set theory to incorporate experts' knowledge when generating conformance diagnostics. We exploit this knowledge to define a fuzzy tolerance in a time window, which is then used to assess the magnitude of timestamp violations of the recorded activities when evaluating the overall process execution compliance. Experiments conducted on a real-life case study in a Dutch hospital show that the proposed method obtains more accurate diagnostics than the state-of-the-art approaches. We also consider how our diagnostics can be used to stimulate discussion with domain experts on possible strategies to mitigate logging uncertainty in the clinical practice.

Using openEHR's Guideline Definition Language for Representing Percutaneous Coronary Intervention Patient Safety Rules in a Dynamic Checklist System.

openEHR's Guideline Definition Language is designed for standardizing clinical decision support systems. In this study, we use Guideline Definition Language to represent patient safety rules in pre-operation of Percutaneous Coronary Intervention for the dynamic checklist system. After using Guideline Definition Language in this case, we had some results about its expression adaptability to requirements of patient safety rules.

Identify Facilitators and Challenges in Computerized Checklist Implementation.

Safety checklists have been considered as a promising tool for improving patient safety for decades. Computerized checklists have better performance compared with paper-based checklists, though there are barriers to their adoption. Given previous literature, it is still unclear what assists implementations and their challenges. To address this issue, this paper summarizes the implementation of two successful computerized checklist implementations in two countries for two different clinical scenarios and analyzes their facilitators and challenges.