Discovering care pathways for multi-morbid patients using event graphs

Abstract

Patients suffering from multiple diseases (multi-morbid patients) often have complex clinical pathways. They are diagnosed and treated by different specialties and undergo other clinical actions related to various diagnoses. Coordination of care for these patients is often challenging, and it would be of great benefit to get better insight into how the clinical pathways develop in reality. Discovering these pathways using traditional process mining techniques and standard event logs may be difficult because the patient is involved in several highly independent clinical processes. Our objective is to explore the potential of analyzing these pathways using an event log representation reflecting the independent clinical processes. Our main research question is: How can we identify valuable insights by using a multi-entity event data representation for clinical pathways of multi-morbid patients? Our method was built on the idea to represent multiple entities in event logs as event graphs. The MIMIC-III dataset was used to evaluate the feasibility of this approach. Several clinical entities were identified and then mapped into an event graph. Finally, multi-entity directly follows graphs were discovered by querying the event graph visualizing them. Our result shows that paths involving multiple entities include traditional process mining concepts not for one clinical process but all involved processes. In addition, the relationship between activities of different clinical processes, which was not recognizable in traditional models, is visible in the event graph representation.