DCCSS - A Meta-model for Dynamic Clinical Checklist Support Systems

Shan Nan, Pieter Van Gorp, Hendrikus H. M. Korsten, Uzay Kaymak, Richard Vdovjak, Xudong Lu, Huilong Duan


Clinical safety checklists receive much research attention since they can reduce medical errors and improve patient safety. Computerized checklist support systems are also being developed actively. Such systems should individualize checklists based on information from the patient’s medical record while also considering the context of the clinical workflows. Unfortunately, the form definitions, database queries and workflow definitions related to dynamic checklists are too often hard-coded in the source code of the support systems. This increases the cognitive effort for the clinical stakeholders in the design process, it complicates the sharing of dynamic checklist definitions as well as the interoperability with other information systems. In this paper, we address these issues by contributing the DCCSS meta-model which enables the model-based development of dynamic checklist support systems. DCCSS was designed as an incremental extension of standard meta-models, which enables the reuse of generic model editors in a novel setting. In particular, DCCSS integrates the Business Process Model and Notation (BPMN) and the Guideline Interchange Format (GLIF), which represent best of breed languages for clinical workflow modeling and clinical rule modeling respectively. We also demonstrate one of the use cases where DCCSS has already been applied in a clinical setting.


  1. Avrunin, G. S., Clarke, L. a., Osterweil, L. J., Goldman, J. M., and Rausch, T. (2012). Smart checklists for human-intensive medical systems. In IEEE/IFIP International Conference on Dependable Systems and Networks Workshops (DSN 2012), pages 1-6.
  2. Babayan, R. K. (2011). Effect of a comprehensive surgical safety system on patient outcomes. The Journal of urology, 185(4):1329-30.
  3. De Clercq, P. a., Blom, J. a., Korsten, H. H. M., and Hasman, A. (2004). Approaches for creating computerinterpretable guidelines that facilitate decision support. Artificial intelligence in medicine, 31(1):1-27.
  4. Färber, M., Jablonski, S., and Schneider, T. (2007). A comprehensive modeling language for clinical processes. In European Conference on eHealth 2007, GI, Oldenburg, Germany. Lecture Notes in Informatics (LNI), pages 77-88.
  5. Ko, R., Lee, S., and Lee, E. (2009). Business process management (BPM) standards: a survey. Business Process Management Journal, 15(5):744-791.
  6. Nan, S., Van Gorp, P., Korsten, H., Vdovjak, R., Kaymak, U., Lu, X., and Duan, H. (2014). Tracebook: A dynamic checklist support system. In Computer-Based Medical Systems (CBMS), 2014 IEEE 27th International Symposium on, pages 48-51.
  7. OASIS (2012). Web Services Human Task (WSHumanTask) Specification Version 1.1. [online] Available at: http://docs.oasis-open.org/ bpel4people/ws-humantask-1.1.html. [Accessed 09 September 2014].
  8. OMG (2011). BUSINESS PROCESS MODEL AND NOTATION (BPMN). [online] Available at: http:// www.omg.org/cgi-bin/doc?dtc/10-06-04.pdf. [Accessed 09 September 2014].
  9. OMG (2014). Case Management Model and Notation. [online] Available at: http://www.omg.org/spec/ CMMN/1.0/PDF/. [Accessed 09-September-2014.
  10. Peleg, M., Boxwala, A. A., Bernstam, E., Tu, S., Greenes, R. A., and Shortliffe, E. H. (2001). Sharable representation of clinical guidelines in glif: relationship to the arden syntax. Journal of biomedical informatics, 34(3):170-181.
  11. Scheuerlein, H., Rauchfuss, F., Dittmar, Y., Molle, R., Lehmann, T., Pienkos, N., and Settmacher, U. (2012). New methods for clinical pathwaysbusiness process modeling notation (bpmn) and tangible business process modeling (t. bpm). Langenbeck's Archives of Surgery, 397(5):755-761.
  12. Weiser, T. G., Haynes, A. B., Lashoher, A., Dziekan, G., Boorman, D. J., Berry, W. R., and Gawande, A. a. (2010). Perspectives in quality: designing the WHO Surgical Safety Checklist. International journal for quality in health care, 22(5):365-70.

Paper Citation

in Harvard Style

Nan S., Van Gorp P., H. M. Korsten H., Kaymak U., Vdovjak R., Lu X. and Duan H. (2015). DCCSS - A Meta-model for Dynamic Clinical Checklist Support Systems . In Proceedings of the 3rd International Conference on Model-Driven Engineering and Software Development - Volume 1: MODELSWARD, ISBN 978-989-758-083-3, pages 272-279. DOI: 10.5220/0005241902720279

in Bibtex Style

author={Shan Nan and Pieter Van Gorp and Hendrikus H. M. Korsten and Uzay Kaymak and Richard Vdovjak and Xudong Lu and Huilong Duan},
title={DCCSS - A Meta-model for Dynamic Clinical Checklist Support Systems},
booktitle={Proceedings of the 3rd International Conference on Model-Driven Engineering and Software Development - Volume 1: MODELSWARD,},

in EndNote Style

JO - Proceedings of the 3rd International Conference on Model-Driven Engineering and Software Development - Volume 1: MODELSWARD,
TI - DCCSS - A Meta-model for Dynamic Clinical Checklist Support Systems
SN - 978-989-758-083-3
AU - Nan S.
AU - Van Gorp P.
AU - H. M. Korsten H.
AU - Kaymak U.
AU - Vdovjak R.
AU - Lu X.
AU - Duan H.
PY - 2015
SP - 272
EP - 279
DO - 10.5220/0005241902720279