Analyzing conformance to clinical protocols involving advanced synchronizations

Clinical protocols are a popular instrument to document how clinicians are expected to behave under specific conditions. Protocols are typically based on internationally peer reviewed clinical guidelines as well as on hospital-local agreements. Existing techniques for monitoring protocol adherence only support protocol descriptions involving simple sequences and local decision rules. As care and cure processes are becoming increasingly complex, the need for more advanced techniques naturally emerges. In this paper we present a novel approach to defining and monitoring complex clinical protocols. By using BPMN to document protocols we enable the concise specification of protocols that involve multiple stakeholders that operate in parallel and under uncertainty. Uncertainty relates to the fact that protocols may involve complex loops and choices. While this specification style was becoming increasingly popular in the literature and practice of hospital management and operations management in general, corresponding conformance analysis techniques were still lacking. This paper contributes the first such technique and evaluate it on a complex compliance pattern from the cardiology domain.