abstract: Background: Process mining (PM) using event log files is gaining popularity in healthcare to investigate clinical pathways. But it has many unique challenges. Clinical Pathways (CPs) are often complex and unstructured which results in spaghetti-like models. Moreover, the log files collected from the electronic health record (EHR) often contain noisy and incomplete data. Objective: Based on the traditional process mining technique of using event logs generated by an EHR, observational video data from rapid ethnography (RE) were combined to model, interpret, simplify and validate the perioperative (PeriOp) CPs. Method: The data collection and analysis pipeline consisted of the following steps: (1) Obtain RE data, (2) Obtain EHR event logs, (3) Generate CP from RE data, (4) Identify EHR interfaces and functionalities, (5) Analyze EHR functionalities to identify missing events, (6) Clean and preprocess event logs to remove noise, (7) Use PM to compute CP time metrics, (8) Further remove noise by removing outliers, (9) Mine CP from event logs and (10) Compare CPs resulting from RE and PM. Results: Four provider interviews and 1,917,059 event logs and 877 minutes of video ethnography recording EHRs interaction were collected. When mapping event logs to EHR functionalities, the intraoperative (IntraOp) event logs were more complete (45%) when compared with preoperative (35%) and postoperative (21.5%) event logs. After removing the noise (496 outliers) and calculating the duration of the PeriOp CP, the median was 189 minutes and the standard deviation was 291 minutes. Finally, RE data were analyzed to help identify most clinically relevant event logs and simplify spaghetti-like CPs resulting from PM. Conclusion: The study demonstrated the use of RE to help overcome challenges of automatic discovery of CPs. It also demonstrated that RE data could be used to identify relevant clinical tasks and incomplete data, remove noise (outliers), simplify CPs and validate mined CPs. / Dissertation/Thesis / Masters Thesis Computer Science 2020

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This Master's describes knownledge discovery from process logs by using process mining algorithms. Chosen algorithms are described in detail. These aim to create process model based on event log analysis. The goal is to design such components, which would be able to import the process and run the simulations. Results from components can be used for short term planning.

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / Process Mining is a discipline that recognizes three types of analysis: Discovery, monitoring, and process improvement. Organizations are focusing on redesigning and automating their major processes, according to a report published in 2018 [1]. In this way, a challenge n process mining is to show the results of the process analysis in a way that is understandable to non-expert users. Therefore, this research paper introduces a matrix of guidelines to guide process mining specialists/tool developers to improve the results of the analysis in process mining projects. This matrix is composed of 2 study fields that throughout the literature have been merging their virtues. First, process mining under 2 of its 3 types of projects: (1) based on objectives and (2) based on questions. The last type is based on data (exploratory analysis). Second, visualization of data with its techniques to represent data graphically. This research proposes a matrix of guidelines that integrates the discipline of process mining and the set of data visualization techniques based on the purpose of each graph (technique), the question / objective to be achieved and the importance that colors take in the analysis results in the process mining projects. / Revisión por pares

El presente trabajo propone un modelo para la evaluación de variables en el sector salud utilizando Process Mining y Data Visualization soportado por la herramienta Celonis. Esto surge ante la problemática orientada a la dificultad en la comprensión de las actividades que están involucradas en los procesos negocios y los resultados de este. El proyecto se centra en la investigación de dos disciplinas emergentes. Una de estas disciplinas es Process Mining y se enfoca principalmente en los procesos, en los datos por cada evento, esto con el fin de descubrir un modelo, ver conformidad de los procesos o mejorarlos (Process Mining: Una técnica innovadora para la mejora de los procesos, 2016). La segunda disciplina es Data Visualization, esta permite presentar los datos en un formato gráfico o pictórico ("Data Visualization: What it is and why it matters", 2016). El proyecto implica principalmente investigación, en primer lugar, se analizan las técnicas de Process Mining y Data Visualization. En segundo lugar, se separan las características y cualidades de las disciplinas, y se diseña un modelo para la evaluación de variables en el Sector Salud utilizando Process Mining y Data Visualization, generando un valor agregado, dado que al tener un formato gráfico o pictórico que representa adecuadamente los resultados de usar una técnica de minería de procesos, la comprensión y el análisis en la toma de decisiones es más precisa. En tercer lugar, se valida el modelo en una institución que brinda servicios en el Sector Salud, analizando uno de los procesos core. Finalmente, se elabora un plan de continuidad para que el modelo propuesto se aplique en técnicas de optimización de procesos en las organizaciones. / The present work proposes a model for the evaluation of variables in the health sector using Process Mining and Data Visualization supported by the Celonis tool. This arises from the problem oriented to the difficulty in understanding the activities that are involved in business processes and their results. The project focuses on the investigation of two emerging disciplines. One of these disciplines is Process Mining and it focuses mainly on the processes, on the data for each event, this in order to discover a model, see conformity of the processes or improve them (Process Mining: An innovative technique for the improvement of the processes, 2016). The second discipline is Data Visualization, this allows data to be presented in a graphic or pictorial format ("Data Visualization: What it is and why it matters", 2016). This project mainly involves research, first, Process Mining and Data Visualization techniques are analyzed. Second, the characteristics and qualities of the disciplines are separated, and a model is designed for the evaluation of variables in the Health Sector using Process Mining and Data Visualization, generating added value, given that by having a graphic or pictorial format that adequately represents the results of using a process mining technique, understanding and analysis in decision making is more accurate. Third, the model is validated in an institution that provides services in the Health Sector, analyzing one of the core processes. Finally, a continuity plan is drawn up so that the proposed model can be applied to process optimization techniques in organizations. / Tesis

Discrete-event simulation (DES) is an invaluable tool which organizations can use to help better understand, diagnose, and optimize their operational processes. Studies have shown that for the typical DES exercise, the greatest amount of time is spent on developing an accurate model of the process that is to be studied. Process mining, a similar field of study, focuses on using historical data stored in software databases to accurate recreate and analyze business processes. Utilizing process mining techniques to help rapidly develop DES models can drastically reduce the amount of time spent building simulation models, which ultimately will enable organizations to more quickly identify and correct shortcomings in their operations. Although there have been significant advances in process mining research, there are still several issues with current process mining methods which prevent them from seeing widespread industry adoption. One such issue, which this study examines, is the lack of cross-compatibility between process mining tools and other process analysis tools. Specifically, this study develops and characterizes a method through which mined process models can be converted into discrete-event simulation models. The developed method utilizes a plugin written for the ProM Framework, an existing collection of process mining tools, which takes a mined process model as its input and outputs an Excel workbook which provides the process data in a format more easily read by DES packages. Two event logs which mimic real-world processes were used in the development and validation of the plugin. The developed plugin successfully extracted the critical process data from the mined process model and converted it into a format more easily utilized by DES packages. There are several limitations which will limit model accuracy, but the plugin developed by this study shows that the conversion of process models to basic simulation models is possible. Future research can focus on addressing the limitations to improve model accuracy.

This study intended to validate if clustering could be used to simplify models generated with process mining. The intention was also to see if these clusters could suggest anything about user efficiency. To that end a new metric where devised, average mean duration deviation. This metric aimed to show if a trace was more or less efficient than a comparative trace. Since the intent was to find traces with similar characteristics the clustering was done with characteristic features instead of time efficiency features. The aim was to find a correlation between efficiency after the fact. A correlation with efficiency could not be found.

Das stetige Wachstum von Datenmengen, besonders in Unternehmen, setzt die Neu- und Weiterentwicklung geeigneter datengetriebener Analysemethoden voraus, die die gesammelten Informationen in einen Kontext setzen und einen operativen Mehrwert für die Unternehmen erzeugen. Insbesondere die echtzeitnahe Analyse von Geschäftsprozessdaten, die in den Unternehmensinformationssystemen gespeichert werden, lassen sich mit Hilfe von Analysewerkzeugen, wie es das Process Mining zur Verfügung stellt, auswerten und generieren Einblicke in die Prozesse der Unternehmen. Für vertrauenswürdige Ergebnisse wird jedoch eine hohe Qualität der zu analysierenden Daten vorausgesetzt. Die vorliegende Arbeit befasst sich mit der Entwicklung eines Monitoring- und Klassifikationsverfahrens für Business Process Event-Streams zur Verwertung im Kontext des Online Process Mining. Zu den erarbeiteten Artefakten dieser Arbeit zählen ein auf den Bedarfen abzielender Anforderungskatalog, ein Konzept, das eine Streaming-Architektur, ein Klassifikationsmodell, eine rekonstruktionsbasierte Anomalieerkennung, einen Online Learning Workflow und Erklärungskomponenten umfasst sowie eine prototypische Umsetzung der Konzepte. Über technische Experimente auf Basis unterschiedlicher Datengrundlagen und optimierten Umgebungsparametern werden die Funktionsweise und Güte des erarbeiteten Monitoring- und Filterverfahrens überprüft. Durch die Einbettung des Event-Filters in eine Streaming-Architektur, die Kombination verschiedener Strukturen des maschinellen Lernens und der damit einhergehenden Generalisierungsfähigkeit des Modells sowie der Fähigkeit des Modells kontinuierlich zu Lernen gelingt es existierende Ansätze um Aspekte der echtzeitnahen Verarbeitung und dem Monitoring von Event-Streams zu erweitern und die Genauigkeit der Anomalieerkennung auf Event-Ebene zu verbessern. Durch Monitoring, Klassifikation und Filterung der eingehenden Event-Daten kann die Datenqualität für die Anwendung nachgelagerter Process Mining Aktivitäten erhöht werden.

[pt] Business Process Management é a ciência de observar como o trabalho é realizado em determinada organização garantindo produtos consistentes e se aproveitando de oportunidades de melhoria. Atualmente, boa parte dos processos são realizados em frameworks, muitos com armazenamento de arquivos de log, no qual é disponibilizada uma grande quantidade de informação que pode ser explorada de diferentes formas e com diferentes objetivos, área denominada como Mineração de Processos. Apesar de muitos desses dados contemplarem o modo como os recursos são alocados para cada atividade, o foco maior dos trabalhos nessa área é na descoberta do processo e na verificação de conformidade do mesmo. Nesta dissertação é proposto um modelo em petri net que incorpora a alocação de recurso, de forma a poder explorar as propriedades deste tipo de modelagem, como por exemplo a definição de todos os estados possíveis. Como aplicação do modelo, realizou-se um estudo comparativo entre duas políticas, uma mais especialista, de alocação de recurso, e outra mais generalista usando simulações de Monte Carlo com distribuição de probabilidade exponencial para o início de novos casos do processo e para estimação do tempo de execução do par recurso atividade. Sendo assim, para avaliação de cada política foi usado um sistema de pontuação que considera o andamento do processo e o tempo total de execução do mesmo. / [en] Business Process Management is the science of observing how the work is performed in a given organization ensuring consistent products and seeking opportunities for improvement. Currently, most of the processes are performed in frameworks, many with log files, in which a large amount of data is available. These data can be explored in different ways and with different objectives, giving rise to the Process Mining area. Although many of these data informs how resources are allocated for each activity, the major focus of previous work is on the discovery process techniques and process compliance. In this thesis a petri net model that incorporates resource allocation is proposed exploring the properties of this type of modeling, such as the definition of all possible states. As a model validation, it is applied in a comparative study between two resource allocation policies, one considering the expertise of each resource and other with a more generalist allocation. The arrival of new cases and the resource-activity pair execution time were estimated by Monte Carlo simulations with exponential probability distribution. Thus, for the evaluation of each policy a scoring system was used considering the progress of the process and the total execution time.

[pt] A sepse é a principal causa de morte em unidades de terapia intensiva (UTIs) no mundo. No Brasil, a taxa de mortalidade nas UTIs atinge 65 por cento. Este estudo teve como objetivo avaliar o comportamento dos processos de atendimento a pacientes com sepse em unidades de terapia intensiva do Beth Israel Deaconess Medical Center, Boston-EUA, a partir da base de dados MIMIC-IV. Esta base de dados está disponível publicamente e contém dados de mais de 200.000 pacientes registrados entre 2008 e 2019. Após aplicação dos critérios de inclusão 7.790 casos foram estudados. Usando técnicas de mineração de processos foi analisada a conformidade das execuções de tratamento com as recomendações terapêuticas e, em seguida, foi realizada uma análise de comparação dos desfechos em relação ao atendimento do protocolo de sepse. Os resultados mostraram uma média geral de 92 por cento de conformidade. O LOS observado foi menor que o LOS esperado e a taxa de mortalidade foi maior que a mortalidade esperada. Uma análise sobre indicadores SMR e SRU confirmou a variação em relação aos valores esperados, sugerindo que o processo de tratamento de sepse desta unidade precisa de algumas adequações e que a análise de conformidade pode não ser a melhor forma de avaliar este tipo de processo. / [en] Sepsis is the leading cause of death in intensive care units (ICUs) worldwide. In Brazil, the mortality rate in ICUs reaches 65 percent. This study evaluated the behavior of the care pathways for patients with sepsis and in a critical status of the Beth Israel Deaconess Medical Center, Boston-USA intensive care units, from the MIMIC-IV database. This available database contains data from more than 200,000 patients registered between 2008 and 2019. After applying the selection criteria, 7,790 cases were studied. Using process mining techniques, the conformance of treatment executions with therapeutic recommendations was analyzed, followed by a comparative analysis of outcomes concerning the adherence to the sepsis protocol. The results showed an overall average compliance of 92 percent. The observed LOS was less than the expected LOS, and the mortality rate was higher than the expected mortality rate. An analysis of SMR and SRU indicators confirmed the variation from expected values, suggesting that the sepsis treatment process in this unit requires some adjustments and that compliance analysis may not be the best way to evaluate this type of process.