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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
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Visual Modeling Languages in Patient Pathways: Scoping Review.

Binyam Bogale1, Märt Vesinurm2, Paul Lillrank2

  • 1Department of Neurology, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

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|November 15, 2024
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Summary

This review categorizes visual modeling languages for patient pathways (PPs), finding diverse approaches from general-purpose to domain-specific languages. Understanding these categories aids in selecting appropriate modeling tools for healthcare communication.

Keywords:
BPMNUMLbusiness process model and notationdomain-specific modeling languagespatient pathwaysscoping reviewunified modeling languagevisual modeling languages

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Area of Science:

  • Health Informatics
  • Systems Engineering
  • Healthcare Management

Background:

  • Patient pathways (PPs) are crucial for health system enhancement but require clear description and communication.
  • Modeling is vital for PPs to improve communication, understanding, and process streamlining.
  • A knowledge gap exists regarding the diverse visual modeling languages used for PPs.

Purpose of the Study:

  • To compile and categorize visual modeling languages used for representing patient pathways (PPs).
  • To identify the justifications and contexts for adopting, adapting, combining, or developing these modeling languages.
  • To address the need for consolidated knowledge on visual modeling in PP representation.

Main Methods:

  • A comprehensive search strategy was developed and refined across major databases and gray literature.
  • Two independent reviewers screened articles based on inclusion criteria, with a third reviewer resolving disagreements.
  • Data charting and descriptive/thematic summaries were conducted using Covidence software.

Main Results:

  • 22 articles met the inclusion criteria from 1838 retrieved, with 'clinical pathway' being the most common term for PPs.
  • Visual modeling languages were categorized into five types: adopted general-purpose (GPML), extended GPML, combined languages, domain-specific (DSML), and ontological languages.
  • Justifications for language use included versatility, expressiveness, tool support, domain needs, integration, and simplification.

Conclusions:

  • Various visual modeling languages exist for PPs, offering different levels of abstraction and granularity.
  • The developed categorization aids in understanding the complex interplay between PPs and modeling languages.
  • Standardized GPMLs are common, while DSMLs are less frequent due to development costs; future research should evaluate language effectiveness for stakeholder communication.