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CCS SFM Rejecting BPM and Deferring CMMN

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Revision as of 19:39, 18 March 2013 by Enrique Meneses (talk | contribs)
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Standard BPMN 2.0 applies well for automation of well defined and rigid processes where it is important to enforce consistency from the workforce. Good applications in health care are patient administration functions.

Dynamic BMPM which some individuals refer to as adaptive case management applies to the unpredictable flow of "knowledge workers". In this usage the process is emergent or unfolding based on expert evaluation and decision making. This is more common to providers in patient care where there are so many degrees of freedom of action which depend on the individual conditions.

CMMN is more on the "dynamic BPMN" parading. As a notation it may more accurately express the dynamic nature of coordination of dare processes than BPMN. A challenge, will be tool support for the annotation. A start may be to simply extend the meaning of the BPMN metamodel and redefine some of the constructs through specialization of the UML metamodel constructs so reflect it's dynamic nature.

The flow of coordination of care is guided by care team participants. At the moment (3/17) CCS does not seek to automate coordination of care activities but instead it seeks to support collaborative interactions.

The Execution Support functional profile and its operations to not attempt to provide rigorous process control support, because the CP-DAM project team has chosen to not model to that depth in that area. This is largely because the team has focused on its core need to assemble disjoint plans and to harmonize their respective goals and interventions. As described in earlier, there is tremendous pressure to solve those specific problems. The teams made a conscious decision to not be distracted by topics that are in their view both less urgent and less important. The teams did, however, include basic predecessor-successor relationships among actions as well as action nesting. There is a distinct danger that as the CCS project moves to the OMG stage of specification work, the CCS team could get bogged down in fascinating workflow integration discussions and compromise its success with the CCS primary scenarios.

The CP-DAM and CCS project teams note that in the CCS context, if a CDS Agent is available to the CCS server implementation, then perhaps that agent could be watch for start conditions and decision points and suggest process control actions. Most notably, the CP-DAM and CCS do not include constructs for complex decision points (“gates”). Such are represented in the HL7 GLIF and Arden Syntax standards, and in the OMG Case Management Modeling and Notation (CMMN) standards. The CP DAM and CCS project teams chose to not pursue their level of detail as regards process control.

The CMMN specification mentioned above merits more investigation in the OMG “implementable specification phase of this project, to discover its potential role as an optional environmental conformance profile. For example, if CP-DAM constructs and CCS execution support functions are mapped to CMMN constructs and operations, then the resulting implementation could support the both the rich CP-DAM plan structure that the professional care manager needs as well as rigorous runtime process controls including mandatory decision points.

Due to the prevalence of patient-specific factors and the constant need for special actions that occurs in the field of medicine, classical business process management (BPM) process definitions have been deemed by the CP-DAM and CCS project teams to be entirely unacceptable due to their rigidity. However, the CMMN specification has taken this need for dynamic planning into account, and actually provides constructs for dynamic (re) planning.

In summary, some consideration to CMMN may be given during the OMG phase of the CCS project, but it must not be allowed to substantially delay the standardization of the primary CCS profiles.