Introduction to CMMN
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The document introduces Case Management Model and Notation (CMMN) and provides examples from healthcare processes. It discusses how CMMN can be used to model a general clinical pathway process that is flexible enough to handle variability across different hospitals. While CMMN allows modeling of flexible processes, explicitly modeling roles, locations, and complexity requires expert knowledge and extending CMMN with domain-specific structures.
Introduction to CMMN
- 1. INTRODUCTION TO CMMN EXAMPLES FROM HEALTHCARE Nico Herzberg August 28, 2015
- 2. Structured/Unstructured Processes Nico Herzberg 2 Introduc=on to CMMN Strukturierung eines Prozesses Strukturiert Strukturiert mit Ad-‐Hoc-‐ Ausnahmen Unstrukturiert m. vordefinierten Fragmenten Unstrukturiert z.B. Kunden-‐registrierung, Rechnungsstellung z.B. Back-‐Office in Finanzdienstleistung z.B. Seefracht, Insolvenz, TV-‐Live-‐Show z.B. Feuerwehr-‐einsatz?, Forschung? Vorhersehbar Wiederholbar Variabel Einzigar=g Strukturierte Daten Daten/Dokumente/Unstrukturierte Daten Unstrukturierte Daten Steuerung Unterstützung BPMN BPMN CMMN/BPMN (CMMN?) Quelle: Sandy Kemsley, Case Management and BPM (White Paper)
- 3. Mo=va=on • Transferability and adop=on of a clinical pathway is not supported • Required flexibility cannot be expressed in BPMN models Nico Herzberg 3 Introduc=on to CMMN
- 4. Expressing Flexibility in BPMN? Ad-‐Hoc SubProcess Nico Herzberg 4 Introduc=on to CMMN • BPMN 2.0 OMG Specifica=on (2011): • Ac=vi=es with „no required sequence rela=onships“ • AdHocOrdering agribute: ac=vi=es performed in parallel or as sequence (default: parallel) • AdHocComple=onCondi=on: when does subprocess ends
- 5. BPMN-‐Example: Ad-‐Hoc Subprocess OMG (2011) Nico Herzberg 5 Introduc=on to CMMN
- 6. Scenario (I/II) Nico Herzberg 6 Introduc=on to CMMN
- 7. Scenario (II/II) Nico Herzberg 7 Introduc=on to CMMN • Ques=onnaire sent to all 14 liver transplanta=on centers in Germany • 10 of them answered • Results (example): • CT is done by all centers • MRI is done by 5 of 10
- 8. Case Modeling (I/II) Case Management Model and Nota=on 1.0 Nico Herzberg 8 Introduc=on to CMMN Note that the connection of the connector (i.e., onPart of the entry criterion Sentry of B of A visualizes the sentryRef of the onPart of the entry criterion Sentry of B (see 5.4 The construct in Figure 6.35 may be considered a “Stage transition,” triggered by a partic via its entry criterion (depicted on its boundary), the OnPart of which may specify as sta Stage A, given that it terminates based on the exit criterion (as depicted on its boundary) has an OnPart (not depicted as connector) that refers e.g., to the creation of a document when an instance of the document is created, Stage A terminates, and Stage B is enabled given that it terminates based on that document creation event. The following diagram illustrates a situation where Task A depends on the achievement Figure 6.35 - Using the Sentry-based connector to visualize dependency between a Task and a Milestone The following diagram illustrates a situation where Task A depends on a TimerEventLis Figure 6.36 - Using the Sentry-based connector to visualize dependency between a Task and a TimerEventListener The following diagram illustrates a situation where Task A depends on a CaseFileItem Milestone A ! Task A ! Task A Case Management Model and Notation, v1.0 45 The CMMN notation provides for the depiction of the behavioral model elements of a Case (i.e., elements of a Case's casePlanModel). As far as modeling of information is concerned, only the information model elements (i.e., CaseFileItems) that are involved in the behavior of the Case are depicted. In other words, the CMMN notation does not provide for the visual modeling of the information model elements of the Case. As with many other modeling languages, there are many different ways in which to model a Case using CMMN and its notation. It is left to the modeler to choose the best model to capture the essence of the situation at hand for the desired purpose. 6.3 Case Plan Models The complete behavior model of a Case is captured in a casePlanModel. A casePlanModel is depicted using a “Folder” shape that consists of a rectangle with an upper left smaller rectangle attached to it. The name of the Case can be enclosed into the upper left rectangle. Figure 6.1 - CasePlanModel Shape The various elements of a casePlanModel are depicted within the boundary of the casePlanModel shape. Note that the casePlanModel is the outermost Stage that can be defined for a Case. The following diagram shows an example of a Case’s casePlanModel. Although incomplete, this diagram exemplifies the basis of Case modeling using the CMMN notation. <CaseName> Figure 6.4 - Collapsed Stage and Expanded Stage Shapes A Stage may be discretionary (i.e., used as DiscretionaryItem that is contained in a PlanningTable). A discretionary Stage has the shape of a rectangle with short dashed lines and angled corners and a marker in the form of a “+” sign in a small box at its bottom center, while a discretionary expanded Stage has the shape of a rectangle with short dashed lines and angled corners and a marker in the form of a “-” sign in a small box at its bottom center. Figure 6.5 - Discretionary Collapsed Stage and Discretionary Expanded Stage Shapes When a Stage is expanded, elements that are contained in it become visible. 6.6 Entry and Exit Criterion PlanItems may have associated Sentries. When a Sentry is used as an entry criterion it is depicted by a shallow “Diamond” shape. Figure 6.6 - EntryCriterion Shape When a Sentry is used as an exit criterion it is depicted by a solid “Diamond” shape. ! ! Figure 6.4 - Collapsed Stage and Expanded Stage Shapes A Stage may be discretionary (i.e., used as DiscretionaryItem that is contained in a PlanningTable). A discretionary Stage has the shape of a rectangle with short dashed lines and angled corners and a marker in the form of a “+” sign in a small box at its bottom center, while a discretionary expanded Stage has the shape of a rectangle with short dashed lines and angled corners and a marker in the form of a “-” sign in a small box at its bottom center. ! Figure 6.10 - Task Shape A Task may be discretionary (i.e., used as DiscretionaryItem contained in a Plann is depicted by a rectangle shape with dashed lines and rounded corners. Figure 6.11 - Discretionary Task A Task may be associated with one or more entry criteria Sentries and one or more The following example illustrates a Task with one entry criterion and one exit criterio Figure 6.10 - Task Shape A Task may be discretionary (i.e., used as DiscretionaryItem contained in a Plan is depicted by a rectangle shape with dashed lines and rounded corners. Figure 6.11 - Discretionary Task A Task may be associated with one or more entry criteria Sentries and one or mor The following example illustrates a Task with one entry criterion and one exit criteri Figure 6.12 - Task with one entry criterion and one exit criterion 6.8.1 Human Task A HumanTask has two possible depictions. If the HumanTask is non-blocking (i.e., i depicted by a rectangle with rounded corners and a “Hand” symbol in the upper left co Figure 6.24 - Milestone Shape A Milestone may have zero or more ent Figure 6.25 - Milestone with one entry cri 6.10 EventListeners An EventListener is depicted by a dou to indicate variations of an EventListen Figure 6.26 - EventListener Shape A TimerEventListener is depicted by Figure 6.27 - TimerEventListener Shap A UserEventListener is depicted b Figure 6.28 - UserEventListener Shap 6.11 Connectors Case Plan Model Stages Milestone and Task Task with Sentries Event Listener Figure 6.14 - Blocking HumanTask Sh A HumanTask may be discretionary (i HumanTask is depicted by a rectangle depending if it is blocking or not. Figure 6.15 - Non-Blocking and Block 6.8.2 Case Task A CaseTask is depicted by rectangle Figure 6.16 - CaseTask Shape A CaseTask may be discretionary (i.e CaseTask is depicted by a dash lined Figure 6.18 - Alternative CaseT A discretionary CaseTask can a the upper left corner, a collapse Figure 6.19 - Alternative Discre 6.8.3 Process Task A ProcessTask is depicted by Figure 6.20 - ProcessTask Shap A ProcessTask may be discret discretionary ProcessTask is d upper left corner. Case/Process Task 46 Figure 6.2 - CasePlanMode CMMN is declarative by n 6.4 Case File It A CaseFileItem is depict Figure 6.3 - CaseFileItem S 6.5 Stages A Stage is depicted by a r bottom center. When the St form of a “-” sign in a sma Case File Item
- 9. Case Modeling (II/II) Nico Herzberg 9 Introduc=on to CMMN Case Modeling (II/II) Nico Herzberg 9 Modeling and Monitoring Variability in Hospital Treatments -‐ A Scenario using CMMN
- 10. Tooling Nico Herzberg 10 Introduc=on to CMMN Trisotech CMMN Modeler: hgp://cmmnwebmodeler.com/
- 11. Discussion (I/II) • Modeling a general process valid for several hospitals • Yes, it is possible • Expressing mandatory tasks in one hospital is difficult à expert knowledge required • Explicit modeling of roles not supported • Role assignment to cases and human tasks • Not expressed explicitly in the model Nico Herzberg 11 Introduc=on to CMMN
- 12. Discussion (II/II) • Explicit modeling of loca=ons not supported • Could be expressed by structuring, e.g. stages • How to deal with complexity? • Structuring • How to use case plan models? • CMMN + hospital specific best prac=ces • CMMN as template à adop=on by each hospital • CMMN as inspira=on for a more concrete model Nico Herzberg 12 Introduc=on to CMMN
- 13. Future Work • Is CMMN the right choice for modeling clinical pathways? • How to deal with the weaknesses? • Extensions required? • Evalua=on of CMMN in hospitals • Best prac=ces for using CMMN in healthcare Nico Herzberg 13 Introduc=on to CMMN
- 14. Evalua=on of CMMN in hospitals Diagnose bei Verdacht auf Leberzellkrebs Nico Herzberg 14 Introduc=on to CMMN
- 15. Evalua=on of CMMN in hospitals Diagnose bei Verdacht auf Leberzellkrebs Nico Herzberg 15 Introduc=on to CMMN
- 16. Evalua=on of CMMN in hospitals Ambulante Nachsorge für einen Empfänger einer Leber Nico Herzberg 16 Introduc=on to CMMN
- 17. Evalua=on of CMMN in hospitals Ambulante Nachsorge für einen Empfänger einer Leber Nico Herzberg 17 Introduc=on to CMMN
- 18. Evalua=on of CMMN in hospitals Tägliche Visite für einen Leberlebendspender Nico Herzberg 18 Introduc=on to CMMN
- 19. Evalua=on of CMMN in hospitals Tägliche Visite für einen Leberlebendspender Nico Herzberg 19 Introduc=on to CMMN
- 20. Evalua=on of CMMN in hospitals Rekonvaleszenz eines Leberlebendspenders Nico Herzberg 20 Introduc=on to CMMN
- 21. Evalua=on of CMMN in hospitals Rekonvaleszenz eines Leberlebendspenders Nico Herzberg 21 Introduc=on to CMMN
- 22. Conclusion Case Management Model and Nota=on 1.0 Nico Herzberg 22 Introduc=on to CMMN Note that the connection of the connector (i.e., onPart of the entry criterion Sentry of B of A visualizes the sentryRef of the onPart of the entry criterion Sentry of B (see 5.4 The construct in Figure 6.35 may be considered a “Stage transition,” triggered by a partic via its entry criterion (depicted on its boundary), the OnPart of which may specify as sta Stage A, given that it terminates based on the exit criterion (as depicted on its boundary) has an OnPart (not depicted as connector) that refers e.g., to the creation of a document when an instance of the document is created, Stage A terminates, and Stage B is enabled given that it terminates based on that document creation event. The following diagram illustrates a situation where Task A depends on the achievement Figure 6.35 - Using the Sentry-based connector to visualize dependency between a Task and a Milestone The following diagram illustrates a situation where Task A depends on a TimerEventLis Figure 6.36 - Using the Sentry-based connector to visualize dependency between a Task and a TimerEventListener The following diagram illustrates a situation where Task A depends on a CaseFileItem Milestone A ! Task A ! Task A Case Management Model and Notation, v1.0 45 The CMMN notation provides for the depiction of the behavioral model elements of a Case (i.e., elements of a Case's casePlanModel). As far as modeling of information is concerned, only the information model elements (i.e., CaseFileItems) that are involved in the behavior of the Case are depicted. In other words, the CMMN notation does not provide for the visual modeling of the information model elements of the Case. As with many other modeling languages, there are many different ways in which to model a Case using CMMN and its notation. It is left to the modeler to choose the best model to capture the essence of the situation at hand for the desired purpose. 6.3 Case Plan Models The complete behavior model of a Case is captured in a casePlanModel. A casePlanModel is depicted using a “Folder” shape that consists of a rectangle with an upper left smaller rectangle attached to it. The name of the Case can be enclosed into the upper left rectangle. Figure 6.1 - CasePlanModel Shape The various elements of a casePlanModel are depicted within the boundary of the casePlanModel shape. Note that the casePlanModel is the outermost Stage that can be defined for a Case. The following diagram shows an example of a Case’s casePlanModel. Although incomplete, this diagram exemplifies the basis of Case modeling using the CMMN notation. <CaseName> Figure 6.4 - Collapsed Stage and Expanded Stage Shapes A Stage may be discretionary (i.e., used as DiscretionaryItem that is contained in a PlanningTable). A discretionary Stage has the shape of a rectangle with short dashed lines and angled corners and a marker in the form of a “+” sign in a small box at its bottom center, while a discretionary expanded Stage has the shape of a rectangle with short dashed lines and angled corners and a marker in the form of a “-” sign in a small box at its bottom center. Figure 6.5 - Discretionary Collapsed Stage and Discretionary Expanded Stage Shapes When a Stage is expanded, elements that are contained in it become visible. 6.6 Entry and Exit Criterion PlanItems may have associated Sentries. When a Sentry is used as an entry criterion it is depicted by a shallow “Diamond” shape. Figure 6.6 - EntryCriterion Shape When a Sentry is used as an exit criterion it is depicted by a solid “Diamond” shape. ! ! Figure 6.4 - Collapsed Stage and Expanded Stage Shapes A Stage may be discretionary (i.e., used as DiscretionaryItem that is contained in a PlanningTable). A discretionary Stage has the shape of a rectangle with short dashed lines and angled corners and a marker in the form of a “+” sign in a small box at its bottom center, while a discretionary expanded Stage has the shape of a rectangle with short dashed lines and angled corners and a marker in the form of a “-” sign in a small box at its bottom center. ! Figure 6.10 - Task Shape A Task may be discretionary (i.e., used as DiscretionaryItem contained in a Plann is depicted by a rectangle shape with dashed lines and rounded corners. Figure 6.11 - Discretionary Task A Task may be associated with one or more entry criteria Sentries and one or more The following example illustrates a Task with one entry criterion and one exit criterio Figure 6.10 - Task Shape A Task may be discretionary (i.e., used as DiscretionaryItem contained in a Plan is depicted by a rectangle shape with dashed lines and rounded corners. Figure 6.11 - Discretionary Task A Task may be associated with one or more entry criteria Sentries and one or mor The following example illustrates a Task with one entry criterion and one exit criteri Figure 6.12 - Task with one entry criterion and one exit criterion 6.8.1 Human Task A HumanTask has two possible depictions. If the HumanTask is non-blocking (i.e., i depicted by a rectangle with rounded corners and a “Hand” symbol in the upper left co Figure 6.24 - Milestone Shape A Milestone may have zero or more ent Figure 6.25 - Milestone with one entry cri 6.10 EventListeners An EventListener is depicted by a dou to indicate variations of an EventListen Figure 6.26 - EventListener Shape A TimerEventListener is depicted by Figure 6.27 - TimerEventListener Shap A UserEventListener is depicted b Figure 6.28 - UserEventListener Shap 6.11 Connectors Case Plan Model Stages Milestone and Task Task with Sentries Event Listener Figure 6.14 - Blocking HumanTask Sh A HumanTask may be discretionary (i HumanTask is depicted by a rectangle depending if it is blocking or not. Figure 6.15 - Non-Blocking and Block 6.8.2 Case Task A CaseTask is depicted by rectangle Figure 6.16 - CaseTask Shape A CaseTask may be discretionary (i.e CaseTask is depicted by a dash lined Figure 6.18 - Alternative CaseT A discretionary CaseTask can a the upper left corner, a collapse Figure 6.19 - Alternative Discre 6.8.3 Process Task A ProcessTask is depicted by Figure 6.20 - ProcessTask Shap A ProcessTask may be discret discretionary ProcessTask is d upper left corner. Case/Process Task 46 Figure 6.2 - CasePlanMode CMMN is declarative by n 6.4 Case File It A CaseFileItem is depict Figure 6.3 - CaseFileItem S 6.5 Stages A Stage is depicted by a r bottom center. When the St form of a “-” sign in a sma Case File Item