title: A Design Methodology for Medical Processes.
abstract: BACKGROUND
  Healthcare processes, especially those belonging to the clinical domain, are acknowledged as complex and characterized by the dynamic nature of the diagnosis, the variability of the decisions made by experts driven by their experiences, the local constraints, the patient's needs, the uncertainty of the patient's response, and the indeterminacy of patient's compliance to treatment. Also, the multiple actors involved in patient's care need clear and transparent communication to ensure care coordination.
  
  
  OBJECTIVE
  In this paper, we propose a methodology to model healthcare processes in order to break out complexity and provide transparency.
  
  
  METHODS
  The model is grounded on a set of requirements that make the healthcare domain unique with respect to other knowledge domains. The modeling methodology is based on three main phases: the study of the environmental context, the conceptual modeling, and the logical modeling.
  
  
  RESULTS
  The proposed methodology was validated by applying it to the case study of the rehabilitation process of stroke patients in the specific setting of a specialized rehabilitation center. The resulting model was used to define the specifications of a software artifact for the digital administration and collection of assessment tests that was also implemented.
  
  
  CONCLUSIONS
  Despite being only an example, our case study showed the ability of process modeling to answer the actual needs in healthcare practices. Independently from the medical domain in which the modeling effort is done, the proposed methodology is useful to create high-quality models, and to detect and take into account relevant and tricky situations that can occur during process execution.
authors.affiliation: Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano , Milano, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Ferrante
authors.affiliation: Health Informatics Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet , Stockholm, Sweden.
authors.forename: Stefano
authors.initials: S
authors.lastname: Bonacina
authors.affiliation: Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano , Milano, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pozzi
authors.affiliation: Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, Italy; Engineering in Health and Wellbeing Research Group at the National Research Council of Italy IEIIT - Istituto di Elettronica e di Ingegneria dell'Informazione e delle Telecomunicazioni, Trieste, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Pinciroli
authors.affiliation: Dipartimento di Ingegneria e Architettura, Università degli Studi di Trieste, Trieste, Italy; Clinical Center for Neurostimulation, Neurotechnology, and Movement Disorders Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milano, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Marceglia
mesh_terms: D003695:Delivery of Health Care; D006801:Humans; D008490:Medical Informatics / Q000379:methods*; D012984:Software; D000071939:Stroke Rehabilitation
keywords: Healthcare process modeling and design; computing methodologies; critical pathways; patient care management; patient-centered care