基于规则引擎的临床诊疗流程建模技术研究

Medical negligence has been a key focus in healthcare. To normalize the clinical process, The National Institute Institutes of Health publishes a serials of clincal pathway. But it is not successful because of its complexity and papery. This project try to introduce the idea of Business Process Management(BPM) into the clinical process management. As clincal process been the objective, the main idea of this project is to put forward a kind of process modeling method accroding to clinical pathway. Because of the complexity and diversity of clinical proceses, as well as the flexibility of chinical rules, this project tries to separate a clincal process into three parts- - -clincal knowledge, rules and processes. Thus to implement the independence among these three parts while modeling and the dynamica connection when process running througn the rule engine. This work can make the clinical process model to be scalable and reuseable more easily. The more concrete research content are followings. First, to study the acquisition and representation method of clinical knowledge by analysis on and extraction from clincal pathways. Then to construct the model of clinincal knowledge. Second, to research on the extraction method of clinical ruels and design the dynamic rule description language. Then to design a database of clincal rules. Third, give an visual process defintion method and build a database of clinical process models. Fourth, analyze the rule interpretation algorithms and dynamic relationship among clinical knowledge, rules, processes. Finally, design and implement the rule engine.

针对目前我国医疗信息化水平较低、诊疗流程不规范、临床路径贯彻实施效果不佳的现状，借鉴已在传统行业中取得较大成效的业务流程管理（Business Process Management，BPM）的思想，本项目以临床诊疗流程为研究对象，以临床路径为理论指导，针对临床诊疗流程的复杂性、多样性以及诊疗规则的灵活性，提出了将临床路径分解为知识、规则和流程三部分，实现静态时对三者独立建模，动态时（即流程运行时）通过规则引擎实现知识与流程的动态关联的建模思想，使其具有更好地扩充性和可重用性。具体的研究内容包括：分析、提取临床路径中包含的临床诊疗知识，研究其获取方法和表达方法，建立诊疗知识模型；研究诊疗规则的抽取方法，设计描述诊疗规则的动态描述语言；设计临床诊疗规则库；研究临床诊疗流程的可视化定义机制，建立诊疗流程模型库；研究诊疗规则的解析算法，研究知识规、规则与流程的动态关联机制，设计并实现规则解析引擎。

针对目前我国医疗信息化水平较低、诊疗流程不规范、临床路径贯彻实施效果不佳的现状，借鉴已在传统行业中取得较大成效的业务流程管理（Business Process Management，BPM）的思想，以临床诊疗流程为研究对象，以临床路径为理论指导，针对临床诊疗流程的复杂性、多样性以及诊疗规则的灵活性，研究了一种基于规则引擎的开放式临床诊疗流程建模环境，实现了相应的运行支撑平台，开发了一套建模工具集，并通过临床仿真系统进行了验证测试，完成本项目预定目标。本项目在如下方面开展了研究并取得成果：1)提出了一种基于规则引擎的开放式临床诊疗流程建模环境，设计了诊疗流程建模环境支撑平台框架，并实现了临床诊疗流程建模环境的支撑平台，开发了一套建模工具，支持医学知识、临床路径及诊疗规则的可视化建模与更新。2)设计了医学知识本体模型和基于XML的知识描述语言，研制了专家知识建模工具，为领域专家提供了一种可视化的描述与扩展医学知识库的手段。3)设计并实现了基于行为网络的临床路径工作流模型建模方法，给出了基于XML语言的工作流模型定义文件；研制了临床路径工作流解析引擎，完成了在流程运行阶段对临床路径工作流模型的解释执行；研制了临床路径工作流建模工具，提供不同种类疾病的临床路径的图形化建模手段。4)定义了基于产生式的规则描述语言，设计并实现了基于该规则描述语言的诊疗规则设计工具，实现了规则解析引擎，并在规则解析过程中引入了“置信度”的概念来提高规则匹配的准确度。本项目相关研究成果在国内外核心期刊和国际会议上共发表（含收录）学术论文6篇，申请国家发明专利5项，获得软件著作权6项，累计培养研究生9名。