1. 24 februari 2019
Process Mining in de Gezondheidszorg BPM round table session
Dr.ir. Ronny Mans

2. Motivation Process flexibility is a key consideration
Many healthcare processes in hospitals
Intensive care
Treatment of cancer
Surgery …
Process flexibility
is a key consideration

3. Healthcare Processes Process flexibility is a key consideration
But healthcare processes are
Distributed (involve multiple staff & departments)
Variable (similar diagnosis ≠ same treatment)
Dynamic (Adaptations needed for individual patients)
Process flexibility
is a key consideration

4. Hospitals Pressures on healthcare providers High quality care
Patient safety
Cost reduction
Increased demand for
Streamlined processes

5. Process Mining AND Wat is really going on?
Suggestions for improvements
Process improvement projects
Time consuming to collect data

6. Agenda Process Mining Application within azM Conclusions
24 februari 2019
Agenda
Process Mining
Application within azM
Conclusions

7. Process Mining Process discovery: "What is really happening?"
Conformance checking: "Do we do what was agreed upon?"
Performance analysis: "Where are the bottlenecks?"
Process prediction: "Will this case be late?"
Process improvement: "How to redesign this process?"
Etc.

8. Process Mining: Basic Idea
Case 1
Case 2
Case 3
Case
Activity 1
First visit 2
MRI
Lab test 3
Second visit
First visit
First visit
First visit
First visit
MRI
MRI
Lab test
MRI
Lab test
First visit
Lab test
Lab test
Secondvisit
Secondvisit
MRI
MRI
Secondvisit
Secondvisit
Secondvisit

9. Agenda Process Mining Application within azM Conclusions
24 februari 2019
Agenda
Process Mining
Application within azM
Conclusions

10. azM Hospital Gastro-enterology patients Coloncare Activities for:
24 februari 2019
azM Hospital
Gastro-enterology patients
Coloncare
Activities for:
Gastro-enterology
Surgery

11. azM hospital: Context 2009: coloncare nurse Care pathway:
Patient guidance
Appointment making
Care pathway:
Colorectal Cancer
Rectal Cancer

12. azM Hospital: Questions
Q1: What are Main Paths Followed?
Q2: Are There Long Waiting Times for Some Examinations?
Q3: Do We Adhere to the Care Pathway?

13. azM Hospital: Data Event Log: Patients: 260 Events: 37934
Gastero-Enterology, Surgery, Nursing Wards, Radiology, …

14. Rectal Cancer No radiotherapy (38 patients) Radiotherapy (25 patients)
Dotted Chart: Showing Events at a Glance
No radiotherapy
(38 patients)
Radiotherapy
(25 patients)
Complex cases
(9 patients)
Cases
Time
(relative)
Short cases
Long cases

15. Rectal Cancer 38 patients: Total time in between 30 and 60 days
Dotted Chart: Showing Events at a Glance
38 patients:
Total time in between 30 and 60 days
Let’s Look at the Process!

16. Diagnostic tests Emergency Admission to hospital Visits to OC
Endoscopy

17. Waiting Time
≈ 10 days
Waiting Time
> 10 days

18. Rectal Cancer: 38 Patients
Time between Last Consultation at Outpatient Clinic and Surgery
Average: 17.5 days (stdev: 10.2 days)

19. Rectal Cancer: Care Pathway
Diagnosis
Treatment
Let’s Have a Closer Look!

20. Rectal Cancer: Care Pathway
Work UP
Lab
CT abdomen
X-thorax
MRI rectum
Visit to OC Surgery
Endoscopy
Visit to OC
Gastro-enterology

21. Care Pathway Some Results: Work UP Lab CT abdomen X-thorax MRI rectum
31 patients
3 patients: No CT abdomen
2: CT liver and bile ducts
done instead
1: Not done
Work UP
Lab
CT abdomen
X-thorax
MRI rectum

22. Care Pathway Work UP Lab CT abdomen X-thorax MRI rectum 4 patients:
No CT abdomen,
No lab,
No MRI rectum,
No X-thorax
Perhaps done in other hospital
21 patients: X-thorax not done
Work UP
Lab
CT abdomen
X-thorax
MRI rectum

23. azM Hospital More results have been obtained
Interesting insights obtained
Some results still need to be discussed

24. DevTuHealthProc project

25. Conclusion
AND

26. Questions?