Toward an interoperable, intraoperative situation recognition system via process modeling, execution, and control using the standards BPMN and CMMN

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Denise Junger - , Reutlingen University (Author)
  • Elisaveta Just - , Reutlingen University (Author)
  • Johanna M. Brandenburg - , Heidelberg University , German Cancer Research Center (DKFZ) (Author)
  • Martin Wagner - , Clusters of Excellence CeTI: Centre for Tactile Internet, University Hospital Heidelberg, National Center for Tumor Diseases (NCT) Heidelberg (Author)
  • Katharina Schaumann - , University Hospital Duesseldorf (Author)
  • Thomas Klenzner - , University Hospital Duesseldorf (Author)
  • Oliver Burgert - , Reutlingen University (Author)

Abstract

Purpose: For the modeling, execution, and control of complex, non-standardized intraoperative processes, a modeling language is needed that reflects the variability of interventions. As the established Business Process Model and Notation (BPMN) reaches its limits in terms of flexibility, the Case Management Model and Notation (CMMN) was considered as it addresses weakly structured processes. Methods: To analyze the suitability of the modeling languages, BPMN and CMMN models of a Robot-Assisted Minimally Invasive Esophagectomy and Cochlea Implantation were derived and integrated into a situation recognition workflow. Test cases were used to contrast the differences and compare the advantages and disadvantages of the models concerning modeling, execution, and control. Furthermore, the impact on transferability was investigated. Results: Compared to BPMN, CMMN allows flexibility for modeling intraoperative processes while remaining understandable. Although more effort and process knowledge are needed for execution and control within a situation recognition system, CMMN enables better transferability of the models and therefore the system. Concluding, CMMN should be chosen as a supplement to BPMN for flexible process parts that can only be covered insufficiently by BPMN, or otherwise as a replacement for the entire process. Conclusion: CMMN offers the flexibility for variable, weakly structured process parts, and is thus suitable for surgical interventions. A combination of both notations could allow optimal use of their advantages and support the transferability of the situation recognition system.

Details

Original languageEnglish
Pages (from-to)69-82
Number of pages14
JournalInternational journal of computer assisted radiology and surgery
Volume19
Issue number1
Publication statusPublished - Jan 2024
Peer-reviewedYes

External IDs

PubMed 37620748

Keywords

Keywords

  • BPMN, CMMN, Intraoperative area, Situation recognition, Surgical process modeling, Case Management, Humans, Workflow