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Toward an interoperable, intraoperative situation recognition system via process modeling, execution, and control
Denise Junger1, Elisaveta Just2, Johanna M Brandenburg3,4
1School of Informatics, Research Group Computer Assisted Medicine (CaMed), Reutlingen University, Reutlingen, Germany. denise.junger@reutlingen-university.de.
International Journal of Computer Assisted Radiology and Surgery
|August 24, 2023
Summary
Case Management Model and Notation (CMMN) offers greater flexibility for modeling complex surgical processes than Business Process Model and Notation (BPMN). CMMN enhances model transferability in situation recognition systems.
Area of Science:
- Medical Informatics
- Process Modeling
- Surgical Workflow Analysis
Background:
- Standardized process modeling languages like Business Process Model and Notation (BPMN) have limitations in capturing the variability of complex, non-standardized intraoperative surgical procedures.
- Case Management Model and Notation (CMMN) is designed to address weakly structured and variable processes, making it a potential alternative or supplement to BPMN.
Purpose of the Study:
- To evaluate the suitability of CMMN compared to BPMN for modeling, executing, and controlling complex intraoperative surgical processes.
- To assess the impact of using CMMN on the transferability of situation recognition systems in surgical contexts.
Main Methods:
- Developed and integrated models of Robot-Assisted Minimally Invasive Esophagectomy and Cochlea Implantation using both BPMN and CMMN.
- Utilized test cases to compare the advantages and disadvantages of BPMN and CMMN in terms of modeling, execution, and control within a situation recognition workflow.
- Investigated the influence of each modeling language on the transferability of the developed system.
Main Results:
- CMMN provides superior flexibility for modeling intraoperative processes while maintaining understandability compared to BPMN.
- While CMMN requires more effort and process knowledge for execution and control in situation recognition systems, it significantly improves model and system transferability.
- CMMN is recommended as a supplement to BPMN for highly variable process segments or as a complete replacement for BPMN in certain scenarios.
Conclusions:
- CMMN is well-suited for modeling variable and weakly structured surgical interventions due to its inherent flexibility.
- Combining BPMN and CMMN can optimize the utilization of their respective strengths, enhancing the overall effectiveness and transferability of situation recognition systems in surgery.
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