Applying Business Process Modeling Notation (BPMN) In .

Applying Business Process ModelingNotation (BPMN) in HealthcareInternational Workshop on Ubiquitous Healthcareand Supporting Technologies 201031.5 – 2.6.2010 ShanghaiTimo Itälä M.Sc.Aalto University

About the presenter Aalto University School of Science and TechnologyDepartment of Computer Science and EngineeringSoftware Business and Engineering InstituteInformation Systems and Services EngineeringGroup The team here: Professor Matti Hämäläinen Researcher Timo Itälä Research Assistant Yong Han2

Content In this tutorial the concepts of business processes areexplained and business process modeling using theglobal standard notation BPMN (Business ProcessModeling Notation) is introduced. The approach on how to identify services and designbusiness processes based on Service OrientedArchitecture (SOA) is explained. Concepts of data modeling related to business processand service modeling are introduced. A practical case study related to health care processesand integration of hospital information systems is given.3

What is a Business Process?OrganizationOur organization producesproducts and services for ourcustomers.ResourcesCustomersSuppliersThe products and services areresults of our core businessprocesses.Support processes give support tothe core processes.Management processes governthe operation of the system.The processes need informationwhich can be processed by ourapplications which run on ourinfrastructure.Core Business ProcessesProducts andservicesSupport and Management ProcessesInformationApplications4Infrastructure

A definition of a Business Process A business process or businessmethod is a collection of related,structured activities or tasks thatproduce a specific service or product(serve a particular goal) for a particularcustomer or customers. It often can bevisualized with a flowchart as asequence of activities. (Wikipedia)5

Types of processes and flows Real process Flow of material, people, products,services etc. Financial process Flow of money Information flow Flow of data Business process Flow of tasks and messages6

Business processes within healthcare Clinical process How the patient is treatedDiagnosis – treatmentObservations, tests, operations, medicationExecuted by doctors: Give orders Nursing process How the patient is taken care Executed by nurses: Carry out orders Financial process Collection of payments The cashiers Scheduling process Scheduling appointments The assistants Patient record process Doctors, Patients, other staff7

Functions, processes and sVosInpatientwardArchiveLabRadiology Operating Maternity Pharmacy.theatreCarePatient Care ProcessPatient Admin:MUSTI, SenioriPatient Record:WebKert, SenioriSchedulingPersonnellMaterialResourcing ProcessManagement, Planning and Control ProcessReporting, MLIIWebLAbSambaQPAtiRaduTOTIWinRaduHAIKARAEtc.8

A Model and an Instance of a BusinessOrganizationProcessResourcesA Model of a business processdescribes how product and servicesare producedAn Instance of a business processproduces an uniquely identifiableproduct or service to an uniquelyidentifiable customerBusiness process modeling andinformation modeling go hand-inhandCustomersSuppliersCore Business ProcessesProducts andservicesSupport and Management ProcessesInformationApplications9Infrastructure

The practice of business processmodelingIf we want to improve how we do thingswe must first understand how we dothings today First we model as-is Then we look at the problems oropportunities for improvement Then we choose the most importantimprovements Then we model the to-be10

Representing business processesHow to model and representbusiness processes? Verbal, textual descriptions Visual diagrams Execution instructions1. Starting with a customer placing an order(the customer need)2. send IT-based information to the warehouse3. stock picking4. packing and recording5. sending the appropriate IT-basedinformation to the distribution hub6. sending IT-based information to theaccounts department7. generation of an invoice8. allocation and organisation of shipment forthe vehicle drivers9. delivery of the item and invoicing (thecustomer need fulfilled).11

Business Process Modeling Notation(BPMN) BPMN is a grphical representation for specifyingbusiness processes in a workflow BPMN was developed by Business ProcessManagement Initiative (BPMI) BPMN is currently maintained by the ObjectManagement Group (OMG) since 2005 BPMN 2.0 published recently Tool support: (62 listed) Drawing tools Repository based modeling tools12

Problems, SolutionsPools, Lanes,PartnersChoreographyProcesses, Services,OperationsData, MessagesLevel ofDetail?Business ProcessRedesignLevel 1: Conceptual,DescriptiveBPMN Effectiveness To do the right things EfficiencyLevel 2: Logical,Analytical, BPMN To do things rightLevel 3: EnterpriseArch/Zachman/zachman.jpg13

BPMN Elements14

Example: The patient visit in the“Happy Hospital”Business Process Steps Pay for the book, if you don t have one Pay for the visit Choose the department Wait in the line Meet the doctor Go to the lab Pay for the test Give the sample Get the results form Wait in the line Meet the doctor again The doctor writes the observations and the medication in the book Pay for the medicine Get the medicine15

Example: Hospital visit as a BPMNdiagram Flow objects: Events, Tasks, Gateways Connecting Objects: Sequence Flow, Annotation Data Objects: Data and Documents in the Process Hiding details: Sub-Process16

Hiding details: Sub-ProcessSub-Processes areused to hide andshow necessarylevel of detail17

Participants in the processesParticipants Organizations or departments The Hospital The Pharmacy Roles of persons The Patient The Doctor The Nurse The Receptionist How do we represent participants inthe processes?18

Participants: Swimlanes, Pools andLanes A Pool represents a process ofone participant A Pool can contain subpartitions to show differentroles within a participant Possible roles The Pharmacy The Office The Cashier The Assistant19

Processes within Pools A Business Process isalways within one Pool The Patient Pool:White-Box pool The Hospital Pool:Black-Box Pool Participants and theirprocesses cancollaborate with eachother. How?20

Collaboration with messages betweenprocesses The participant sprocesses cancollaborate usingmessages Message flow alwaysbetween pools Sequence flow alwayswithin a pool21

The Core Process of an organizationCore Process characteristics The doctor s process gives aservice to the patient Volumes in Happy Hospital 1000 visits/day 600 beds 10 000 employees What could be other coreprocesses?22

Business Process Modeling Methodsteps1.2.3.4.5.Define Process ScopeCreate the Top Level diagram for the Happy PathAdd top-level exception pathsExpand sub-processes to show detail at child levelAdd intermediate message flows to external pools23

Discovering the processes What are the core processes? What are the support processes? Service orientation Support processes give services to thecore processes24

What to improve? Process Orientation Clinical Process? Scheduling Process? Financial Process? Pharmacy Process? Other Processes? Health Record Management Process? As-Is: Health Records are written in the book owned by thepatient Problems: A book can be in one place only. Other problems.25

How to improve? Service Orientation Business Processes are composed of business services Examples: Payment service, Patient record service Business Services are reusable components which canbe used in many business processess Business Services can be implemented using softwarecomponents, often web services The Benefits of using reusable components Cost savings: Build once, use many times Time savings: Use ready components instead of building fromscratch Risk management: Using ready components helps to control therisks26

Discovering y and getthe medicineSub-processserviceThomas Erl:Service-OrientedArchitectureProcessMake theLaboratorytestsA service can be a task, a sub-process or a process27

From As-Is to To-Be process Discussion about services How to identify services SOA Principles How the processes and services could be identified Data oriented services (patient record) Function oriented services (laboratory) Process oriented services (the doctors workstation) Notification oriented services (do we have any?.) Who is asking for the service, who is delivering theservice?28

The Patient and the Doctor The doctor gives aservice to a patient The result of thatservice is betterhealth for thepatient The documentationof the service is thebook which containsthe patient record29

Laboratory included as a businessservice The laboratory gives aservice to the doctor The Laboratory ordersand results are on aseparate paper form The doctor receivesthe results The patient pays forthe laboratory andreceives the results30

Ideas for improvement regarding PatientHealth Record Electronic Health Record? Discussion and collection of improvement ideas What problems it could solve? The patient could forget the paper book at home or lose it The doctor has a bad handwriting The laboratory results and other documents are on separate papers What other opportunities EHR would give The hospitals could share the patient records Other requirements Privacy, Confidentiality, Authenticity and other security aspects Support to other processes: Scheduling, Financial, etc. Availability, Usability, Performance31

Electronic Health Record as a service EHR could store all the doctorsnotes in a similar way as thepatient record book It could store also the labresults and other information It could be accessible for thedoctor and other professionalswhen needed It could also be accessiblewithin the hospital and alsooutside the hospital likeregional level It must guarantee theprivacy, confidentialityand authenticity of thenotes32

How EHR service could be used? The doctor would startlooking at the patient sEHR The lab results would becollected into the EHR The doctor would writeall notes into the EHR The patient would get apaper copy or could alsolook at the EHR33

How EHR could be implemented?EHROption 1Stand alone system34

How EHR could be implemented?Option 2An applicationservice whichwould offerservices to otherapplicationsEHRDoctor sSystemLIS35

Identifying Application Services EHR Patient recordmanagement LIS Laboratory order entryEHRand results rdelivery Pharmacy system Delivery of the medicine Doctor s systems Coordination of theDoctor sSystemcollaboration The Patient Collaboration with theprofessionalsLIS36

Implementing services as web services A service consists of one or multiple operations A Message Exchange Pattern (MEP) is related to an operation Request-Response operation A service receives a request message and sends a reply message Solicit-Response operation A service sends a request message andwaits for a reply message One-way operation A service receives a message Notification operation A service sends a message A fault message can be replied (Fault) Applies to any programming language Services are synchronous orasynchronous37

Implementing services as web servicesService: Electronic Patient Record Operations and messages EPRQuery In: EPR-QueryMessage Out: EPR-ReplyMessage EPRStore In: EPR-StoreMessage Web services are defined usingweb services definitionlanguage (WSDL)38

The data model for the messages How do we define the messages inWSDL documents? We need a data model Transactional data What happened Encounter and Notes. Master Data The “static data” that is referencedfrom the transactional data thatdescribes business events Hospital, Department, Doctor,Patient, Encounter Type.WSDLWSDLWSDL39

Healthcare Information Model HL7 RIM RIM (Reference InformationModel) is a generic healthcare data model HL7 CDA (Clinical DocumentMaster DataTransactional DataWhoWhereWhatBusinessEventsArchitecture) is a RIM basedstandard for exchange ofclinical recordsEntities and theirattributesStructuresVocabularies and codesReference DataInstances ofBusiness ProcessesBusiness ServicesWhat40