24 februari 2019 Process Mining in de Gezondheidszorg BPM round table session 11-06-2012 Dr.ir. Ronny Mans

Motivation Process flexibility is a key consideration Many healthcare processes in hospitals Intensive care Treatment of cancer Surgery … Process flexibility is a key consideration 24-2-2019

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 24-2-2019

Hospitals Pressures on healthcare providers High quality care Patient safety Cost reduction Increased demand for Streamlined processes 24-2-2019

Process Mining AND Wat is really going on? Suggestions for improvements Process improvement projects Time consuming to collect data 24-2-2019

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

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.

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 24-2-2019

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

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

azM hospital: Context 2009: coloncare nurse Care pathway: Patient guidance Appointment making Care pathway: Colorectal Cancer Rectal Cancer 24-2-2019

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? 24-2-2019

azM Hospital: Data Event Log: Patients: 260 Events: 37934 Gastero-Enterology, Surgery, Nursing Wards, Radiology, … 24-2-2019

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 24-2-2019

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! 24-2-2019

Diagnostic tests Emergency Admission to hospital Visits to OC Endoscopy 24-2-2019

Waiting Time ≈ 10 days Waiting Time > 10 days 24-2-2019

Rectal Cancer: 38 Patients Time between Last Consultation at Outpatient Clinic and Surgery Average: 17.5 days (stdev: 10.2 days) 24-2-2019

Rectal Cancer: Care Pathway Diagnosis Treatment Let’s Have a Closer Look! 24-2-2019

Rectal Cancer: Care Pathway Work UP Lab CT abdomen X-thorax MRI rectum Visit to OC Surgery Endoscopy Visit to OC Gastro-enterology 24-2-2019

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 24-2-2019

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 24-2-2019

azM Hospital More results have been obtained Interesting insights obtained Some results still need to be discussed 24-2-2019

DevTuHealthProc project 24-2-2019

Conclusion AND 24-2-2019

Questions? 24-2-2019