Separating Business Logic from Medical Knowledge in Digital Clinical Workflows Using Business Process Model and Notation and Arden Syntax

Stud Health Technol Inform. 2018:248:17-24.

Abstract

Background: Evidence-based clinical guidelines have a major positive effect on the physician's decision-making process. Computer-executable clinical guidelines allow for automated guideline marshalling during a clinical diagnostic process, thus improving the decision-making process.

Objectives: Implementation of a digital clinical guideline for the prevention of mother-to-child transmission of hepatitis B as a computerized workflow, thereby separating business logic from medical knowledge and decision-making.

Methods: We used the Business Process Model and Notation language system Activiti for business logic and workflow modeling. Medical decision-making was performed by an Arden-Syntax-based medical rule engine, which is part of the ARDENSUITE software.

Results: We succeeded in creating an electronic clinical workflow for the prevention of mother-to-child transmission of hepatitis B, where institution-specific medical decision-making processes could be adapted without modifying the workflow business logic.

Conclusion: Separation of business logic and medical decision-making results in more easily reusable electronic clinical workflows.

Keywords: Automatic Data Processing; Clinical; Decision Support Systems; Guideline Adherence; Hepatitis B; Hospital; Obstetrics and Gynecology Department.

MeSH terms

  • Clinical Decision-Making*
  • Humans
  • Logic*
  • Programming Languages
  • Software
  • Workflow*