COVID-19 Bed Management Using a Two-Step Process Mining and Discrete-Event Simulation Approach

The sudden admission of many patients with similar needs caused by the COVID-19 (SARS-CoV-2) pandemic forced health care centers to temporarily transform units to respond to the crisis. This process greatly impacted the daily activities of the hospitals. In this paper, we propose a two-step approach based on process mining and discrete-event simulation for sizing a recovery unit dedicated to COVID-19 patients inside a hospital. A decision aid framework is proposed to help hospital managers make crucial decisions, such as hospitalization cancellation and resource sizing, taking into account all units of the hospital. Three sources of patients are considered: (i) planned admissions, (ii) emergent admissions representing day-to-day activities, and (iii) COVID-19 admissions. Hospitalization pathways have been modeled using process mining based on synthetic medico-administrative data, and a generic model of bed transfers between units is proposed as a basis to evaluate the impact of those moves using discrete-event simulation. A practical case study in collaboration with a local hospital is presented to assess the robustness of the approach. Note to Practitioners—In this paper we develop and test a new decision-aid tool dedicated to bed management, taking into account exceptional hospitalization pathways such as COVID-19 patients. The tool enables the creation of a dedicated COVID-19 intensive care unit with specific management rules that are fine-tuned by considering the characteristics of the pandemic. Health practitioners can automatically use medico-administrative data extracted from the information system of the hospital to feed the model. Two execution modes are proposed: (i) fine-tuning of the staffed beds assignment policies through a design of experiment and (ii) simulation of user-defined scenarios. A practical case study in collaboration with a local hospital is presented. The results show that our model was able to find the strategy to minimize the number of transfers and the number of cancellations while maximizing the number of COVID-19 patients taken into care was to transfer beds to the COVID-19 ICU in batches of 12 and to cancel appointed patients using ICU when the department hit a 90% occupation rate. IEEE

Process Modeling and Conformance Checking in Healthcare: A COVID-19 Case Study: Case Study

The discipline of process mining has a solid track record of successful applications to the healthcare domain. Within such research space, we conducted a case study related to the Intensive Care Unit (ICU) ward of the Uniklinik Aachen hospital in Germany. The aim of this work is twofold: developing a normative model representing the clinical guidelines for the treatment of COVID-19 patients, and analyzing the adherence of the observed behavior (recorded in the information system of the hospital) to such guidelines. We show that, through conformance checking techniques, it is possible to analyze the care process for COVID-19 patients, highlighting the main deviations from the clinical guidelines. The results provide physicians with useful indications for improving the process and ensuring service quality and patient satisfaction. We share the resulting model as an open-source BPMN file. © 2023, The Author(s).

Measuring the Impact of COVID-19 on Hospital Care Pathways

Care pathways in hospitals around the world reported significant disruption during the recent COVID-19 pandemic but measuring the actual impact is more problematic. Process mining can be useful for hospital management to measure the conformance of real-life care to what might be considered normal operations. In this study, we aim to demonstrate that process mining can be used to investigate process changes associated with complex disruptive events. We studied perturbations to accident and emergency (A &E) and maternity pathways in a UK public hospital during the COVID-19 pandemic. Co-incidentally the hospital had implemented a Command Centre approach for patient-flow management affording an opportunity to study both the planned improvement and the disruption due to the pandemic. Our study proposes and demonstrates a method for measuring and investigating the impact of such planned and unplanned disruptions affecting hospital care pathways. We found that during the pandemic, both A &E and maternity pathways had measurable reductions in the mean length of stay and a measurable drop in the percentage of pathways conforming to normative models. There were no distinctive patterns of monthly mean values of length of stay nor conformance throughout the phases of the installation of the hospital's new Command Centre approach. Due to a deficit in the available A &E data, the findings for A &E pathways could not be interpreted. © 2023, The Author(s).

An approach based on process mining to assess the quarantine strategies' effect in reducing the COVID-19 spread

PurposeThe feasibility of process mining combined with simulation techniques in estimating the effectiveness of COVID-19 prevention strategies on infection and mortality trends to determine best practices is assessed in this study. The quarantine event log is built from the CUSP (the COVID-19 US State Policy) database, where the dates of implemented social policies in the USA to respond to the COVID-19 pandemic are documented.Design/methodology/approachCOVID-19 is a highly infectious disease leading to a very high death toll worldwide. In most countries, the governments have resorted to a series of drastic strategies to prevent the outbreak by restricting the activities and movement among their population for a predefined time. Heretofore, different approaches have been published to estimate quarantine strategies and the majority signify the positive effect on managing this pandemic. Notably, the process perspective of COVID-19 datasets is of less concern among researchers. The purpose of this paper is to exploit the process mining techniques to model and analyze the quarantine implementation processes.FindingsThe discovered process model has 51 process variants for 51 cases (states), which indicate the quarantine activities were executed in different orders and periods during the pandemic. The time interval analysis between activities reveals the states with the most extended quarantine periods. These primary process mining insights are applied to define scenarios and variables of an agent-based model. The simulation findings indicate a meaningful relation between enforcing quarantine strategies and a declining trend of infection by 90% in the case of following strict quarantine and mask mandates. It is observed that in the post-quarantine period, the disease repeats its ascending trend unless implementation of different intervention strategies likes vaccination.Originality/valueThis study is the first in introducing process mining techniques in analyzing the COVID-19 quarantine strategies impact. The findings provide valuable insights for policymakers to proper control strategies and the process mining research community in expanding more process-related analysis on this pandemic. Also, the results have broad implications for research in other fields like information science to estimate the impact of quarantine strategies on process patterns in library systems.

Personalised Geriatric Health Monitoring: The Need for Process Mining Approach

It is common for an elder person to live alone in today's environment, away from family care, especially during the movement control order due to the COVID-19 pandemic since 2020. This has brought to the concern of this study to justify the need for personalised geriatric health monitoring that adopts the process mining approach. Constant monitoring is deemed required in order to reduce the risk of sudden illness among the elders, as well as to reduce the need to be treated at the hospital when the capacity could be limited during critical time. As part of the findings, this paper presents the process flow of data capture on one of the four vital signs, showing the significance of time, frequency and duration in reading the data for further analysis to understand the pattern in health monitoring. The importance of process mining approach is amplified in terms of the context of time in health monitoring, and the context of personalisation due to the veracity across ageing population. This paper proposes the concept of health monitoring process model, which is produced by collectively analysing the process models of the vital signs. © 2022 IEEE.

Erratum: A differential process mining analysis of COVID-19 management for cancer patients.

[This corrects the article DOI: 10.3389/fonc.2022.1043675.].

PROMPT: Process Mining and Paravector Tensor-Based Physical Health Monitoring Framework

The provision of physical healthcare services during the isolation phase is one of the major challenges associated with the current COVID-19 pandemic. Smart healthcare services face a major challenge in the form of human behavior, which is based on human activities, complex patterns, and subjective nature. Although the advancement in portable sensors and artificial intelligence has led to unobtrusive activity recognition systems, very few studies deal with behavior tracking for addressing the problem of variability and behavior dynamics. In this regard, we propose the fusion of PRocess mining and Paravector Tensor (PROMPT)-based physical health monitoring framework that not only tracks subjective human behavior, but also deals with the intensity variations associated with inertial measurement units. Our experimental analysis of a publicly available dataset shows that the proposed method achieves 14.56% better accuracy in comparison to existing works. We also propose a generalized framework for healthcare applications using wearable sensors and the PROMPT method for its triage with physical health monitoring systems in the real world. © 2001-2012 IEEE.

The Impacts of the COVID-19 Pandemic on an Educational Institution's Administrative Process, a Process Mining Approach

The COVID-19 pandemic has affected virtually every human activity over the past 2 years. This paper examines how the COVID-19 pandemic interfered with the business processes in Brazil's public vocational and higher education institution. Throughout the pandemic, the Organization forced the enactment of the paper-recorded processes in a virtual implementation. To unveil how the referred paper-recorded processes subset got executed during the pandemic, we conduct a process mining on the company's information system. The process mining data shows various indications of task merging, precluding, and duration modifications. The analysis of 4231 instances of administrative processes between 2019 and 2021 showed a reduction in duration times and the number of tasks. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

A differential process mining analysis of COVID-19 management for cancer patients.

During the acute phase of the COVID-19 pandemic, hospitals faced a challenge to manage patients, especially those with other comorbidities and medical needs, such as cancer patients. Here, we use Process Mining to analyze real-world therapeutic pathways in a cohort of 1182 cancer patients of the Lausanne University Hospital following COVID-19 infection. The algorithm builds trees representing sequences of coarse-grained events such as Home, Hospitalization, Intensive Care and Death. The same trees can also show probability of death or time-to-event statistics in each node. We introduce a new tool, called Differential Process Mining, which enables comparison of two patient strata in each node of the tree, in terms of hits and death rate, together with a statistical significance test. We thus compare management of COVID-19 patients with an active cancer in the first vs. second COVID-19 waves to quantify hospital adaptation to the pandemic. We also compare patients having undergone systemic therapy within 1 year to the rest of the cohort to understand the impact of an active cancer and/or its treatment on COVID-19 outcome. This study demonstrates the value of Process Mining to analyze complex event-based real-world data and generate hypotheses on hospital resource management or on clinical patient care.

Detecting Context-Aware Deviations in Process Executions

A deviation detection aims to detect deviating process instances, e.g., patients in the healthcare process and products in the manufacturing process. A business process of an organization is executed in various contextual situations, e.g., a COVID-19 pandemic in the case of hospitals and a lack of semiconductor chip shortage in the case of automobile companies. Thus, context-aware deviation detection is essential to provide relevant insights. However, existing work 1) does not provide a systematic way of incorporating various contexts, 2) is tailored to a specific approach without using an extensive pool of existing deviation detection techniques, and 3) does not distinguish positive and negative contexts that justify and refute deviation, respectively. In this work, we provide a framework to bridge the aforementioned gaps. We have implemented the proposed framework as a web service that can be extended to various contexts and deviation detection methods. We have evaluated the effectiveness of the proposed framework by conducting experiments using 255 different contextual scenarios. © 2022, Springer Nature Switzerland AG.

PROMPT: PROcess Mining and Paravector Tensor based Physical Health Monitoring Framework

The provision of physical healthcare services during the isolation phase is one of the major challenges associated with the current COVID-19 pandemic. Smart healthcare services face a major challenge in the form of human behavior, which is based on human activities, complex patterns, and subjective nature. Although the advancement in portable sensors and artificial intelligence has led to unobtrusive activity recognition systems but very few studies deal with behavior tracking for addressing the problem of variability and behavior dynamics. In this regard, we propose the fusion of PRocess mining and Paravector Tensor (PROMPT) based physical health monitoring framework that not only tracks subjective human behavior, but also deals with the intensity variations associated with inertial measurement units. Our experimental analysis on a publicly available dataset shows that the proposed method achieves 14.56% better accuracy in comparison to existing works. We also propose a generalized framework for healthcare applications using wearable sensors and the PROMPT method for its triage with physical health monitoring systems in the real world. IEEE

A process mining- deep learning approach to predict survival in a cohort of hospitalized COVID-19 patients.

BACKGROUND: Various machine learning and artificial intelligence methods have been used to predict outcomes of hospitalized COVID-19 patients. However, process mining has not yet been used for COVID-19 prediction. We developed a process mining/deep learning approach to predict mortality among COVID-19 patients and updated the prediction in 6-h intervals during the first 72 h after hospital admission. METHODS: The process mining/deep learning model produced temporal information related to the variables and incorporated demographic and clinical data to predict mortality. The mortality prediction was updated in 6-h intervals during the first 72 h after hospital admission. Moreover, the performance of the model was compared with published and self-developed traditional machine learning models that did not use time as a variable. The performance was compared using the Area Under the Receiver Operator Curve (AUROC), accuracy, sensitivity, and specificity. RESULTS: The proposed process mining/deep learning model outperformed the comparison models in almost all time intervals with a robust AUROC above 80% on a dataset that was imbalanced. CONCLUSIONS: Our proposed process mining/deep learning model performed significantly better than commonly used machine learning approaches that ignore time information. Thus, time information should be incorporated in models to predict outcomes more accurately.

An approach based on process mining to assess the quarantine strategies' effect in reducing the COVID-19 spread

Purpose The feasibility of process mining combined with simulation techniques in estimating the effectiveness of COVID-19 prevention strategies on infection and mortality trends to determine best practices is assessed in this study. The quarantine event log is built from the CUSP (the COVID-19 US State Policy) database, where the dates of implemented social policies in the USA to respond to the COVID-19 pandemic are documented. Design/methodology/approach COVID-19 is a highly infectious disease leading to a very high death toll worldwide. In most countries, the governments have resorted to a series of drastic strategies to prevent the outbreak by restricting the activities and movement among their population for a predefined time. Heretofore, different approaches have been published to estimate quarantine strategies and the majority signify the positive effect on managing this pandemic. Notably, the process perspective of COVID-19 datasets is of less concern among researchers. The purpose of this paper is to exploit the process mining techniques to model and analyze the quarantine implementation processes. Findings The discovered process model has 51 process variants for 51 cases (states), which indicate the quarantine activities were executed in different orders and periods during the pandemic. The time interval analysis between activities reveals the states with the most extended quarantine periods. These primary process mining insights are applied to define scenarios and variables of an agent-based model. The simulation findings indicate a meaningful relation between enforcing quarantine strategies and a declining trend of infection by 90% in the case of following strict quarantine and mask mandates. It is observed that in the post-quarantine period, the disease repeats its ascending trend unless implementation of different intervention strategies likes vaccination. Originality/value This study is the first in introducing process mining techniques in analyzing the COVID-19 quarantine strategies impact. The findings provide valuable insights for policymakers to proper control strategies and the process mining research community in expanding more process-related analysis on this pandemic. Also, the results have broad implications for research in other fields like information science to estimate the impact of quarantine strategies on process patterns in library systems.

A Process Mining Pipeline to Characterize COVID-19 Patients' Trajectories and Identify Relevant Temporal Phenotypes From EHR Data.

The impact of the COVID-19 pandemic involved the disruption of the processes of care and the need for immediately effective re-organizational procedures. In the context of digital health, it is of paramount importance to determine how a specific patients' population reflects into the healthcare dynamics of the hospital, to investigate how patients' sub-group/strata respond to the different care processes, in order to generate novel hypotheses regarding the most effective healthcare strategies. We present an analysis pipeline based on the heterogeneous collected data aimed at identifying the most frequent healthcare processes patterns, jointly analyzing them with demographic and physiological disease trajectories, and stratify the observed cohort on the basis of the mined patterns. This is a process-oriented pipeline which integrates process mining algorithms, and trajectory mining by topological data analyses and pseudo time approaches. Data was collected for 1,179 COVID-19 positive patients, hospitalized at the Italian Hospital "Istituti Clinici Salvatore Maugeri" in Lombardy, integrating different sources including text admission letters, EHR and hospital infrastructure data. We identified five temporal phenotypes, from laboratory values trajectories, which are characterized by statistically significant different death risk estimates. The process mining algorithms allowed splitting the data in sub-cohorts as function of the pandemic waves and of the temporal trajectories showing statistically significant differences in terms of events characteristics.

Building Process-Oriented Data Science Solutions for Real-World Healthcare.

The COVID-19 pandemic has highlighted some of the opportunities, problems and barriers facing the application of Artificial Intelligence to the medical domain. It is becoming increasingly important to determine how Artificial Intelligence will help healthcare providers understand and improve the daily practice of medicine. As a part of the Artificial Intelligence research field, the Process-Oriented Data Science community has been active in the analysis of this situation and in identifying current challenges and available solutions. We have identified a need to integrate the best efforts made by the community to ensure that promised improvements to care processes can be achieved in real healthcare. In this paper, we argue that it is necessary to provide appropriate tools to support medical experts and that frequent, interactive communication between medical experts and data miners is needed to co-create solutions. Process-Oriented Data Science, and specifically concrete techniques such as Process Mining, can offer an easy to manage set of tools for developing understandable and explainable Artificial Intelligence solutions. Process Mining offers tools, methods and a data driven approach that can involve medical experts in the process of co-discovering real-world evidence in an interactive way. It is time for Process-Oriented Data scientists to collaborate more closely with healthcare professionals to provide and build useful, understandable solutions that answer practical questions in daily practice. With a shared vision, we should be better prepared to meet the complex challenges that will shape the future of healthcare.

Updating Prediction Models for Predictive Process Monitoring

Predictive monitoring is a key activity in some Process-Aware Information Systems (PAIS) such as information systems for operational management support. Unforeseen circumstances like COVID can introduce changes in human behaviour, processes, or computing resources, which lead the owner of the process or information system to consider whether the quality of the predictions made by the system (e.g., mean time to solution) is still good enough, and if not, which amount of data and how often the system should be trained to maintain the quality of the predictions. To answer these questions, we propose, compare, and evaluate different strategies for selecting the amount of information required to update the predictive model in a context of offline learning. We performed an empirical evaluation using three real-world datasets that span between 2 and 13 years to validate the different strategies which show a significant enhancement in the prediction accuracy with respect to a non-update strategy. © 2022, Springer Nature Switzerland AG.

SUPPLY CHAIN RESILIENCE MANAGEMENT USING PROCESS MINING

Recent events such as the Coronavirus Pandemic or the disruption of the Suez Canal have shown how vulnerable supply chains can be and have led to an increased focus on resilience analysis by companies. We believe that all the data needed to understand the resilience status of a supply chain and identify opportunities for improvement already exist within companies. Therefore, we provide an approach to guide decision makers in this regard. We propose to first perform a rough resilience analysis using a limited set of transactional data. This analysis is based on key resilience areas to identify vulnerable elements of the supply chain that should be further investigated in terms of specific entities, transport relations, and materials. Based on these elements, process mining becomes a promising approach to understand the underlying actions, problems, and possible bottlenecks and to reveal improvement strategies. © ECMS Ibrahim A. Hameed, Agus Hasan

Analysis of Stroke Assistance in Covid-19 Pandemic by Process Mining Techniques.

Medical assistance to stroke patients must start as early as possible; however, several changes have impacted healthcare services during the Covid-19 pandemic. This research aimed to identify the stroke onset-to-door time during the Covid-19 pandemic considering the different paths a patient can take until receiving specialized care. It is a retrospective study based on process mining (PM) techniques applied to 221 electronic healthcare records of stroke patients during the pandemic. The results are two process models representing the patient's path and performance, from the onset of the first symptoms to admission to specialized care. PM techniques have discovered the patient journey in providing fast stroke assistance.

Analyzing Medical Data with Process Mining: A COVID-19 Case Study

The recent increase in the availability of medical data, possible through automation and digitization of medical equipment, has enabled more accurate and complete analysis on patients’ medical data through many branches of data science. In particular, medical records that include timestamps showing the history of a patient have enabled the representation of medical information as sequences of events, effectively allowing to perform process mining analyses. In this paper, we will present some preliminary findings obtained with established process mining techniques in regard of the medical data of patients of the Uniklinik Aachen hospital affected by the recent epidemic of COVID-19. We show that process mining techniques are able to reconstruct a model of the ICU treatments for COVID patients. © 2022, Springer Nature Switzerland AG.

Process mining-driven analysis of COVID-19's impact on vaccination patterns.

Process mining is a discipline sitting between data mining and process science, whose goal is to provide theoretical methods and software tools to analyse process execution data, known as event logs. Although process mining was originally conceived to facilitate business process management activities, research studies have shown the benefit of leveraging process mining in healthcare contexts. However, applying process mining tools to analyse healthcare process execution data is not straightforward. In this paper, we show a methodology to: i) prepare general practice healthcare process data for conducting a process mining analysis; ii) select and apply suitable process mining solutions for successfully executing the analysis; and iii) extract valuable insights from the obtained results, alongside leads for traditional data mining analysis. By doing so, we identified two major challenges when using process mining solutions for analysing healthcare process data, and highlighted benefits and limitations of the state-of-the-art process mining techniques when dealing with highly variable processes and large data-sets. While we provide solutions to the identified challenges, the overarching goal of this study was to detect differences between the patients' health services utilization pattern observed in 2020-during the COVID-19 pandemic and mandatory lock-downs -and the one observed in the prior four years, 2016 to 2019. By using a combination of process mining techniques and traditional data mining, we were able to demonstrate that vaccinations in Victoria did not drop drastically-as other interactions did. On the contrary, we observed a surge of influenza and pneumococcus vaccinations in 2020, as opposed to other research findings of similar studies conducted in different geographical areas.