Abstract
Background The Centers for Disease Control and Prevention (CDC) produced a 72-page document
titled “U.S. Selective Practice Recommendations for Contraceptive Use” in 2016. This
document contains the medical eligibility criteria (MEC) for contraceptive initiation
or continuation based on a patient's current health status. Notations such as Business
Process Model and Notation (BPMN) and Decision Model and Notation (DMN) might be useful
to model such recommendations.
Objective Our objective was to use BPMN and DMN to model and standardize the processes and
decisions involved in initiating birth control according to the CDC's MEC for birth
control initiation. This model could then be incorporated into an electronic health
records system or other digital platform.
Methods Medical terminology, processes, and decisions were modeled in coordination with the
CDC to ensure correctness. Challenges in terminology bindings were identified and
categorized.
Results A model was successfully produced. Integration of clearly defined data elements proved
to be the biggest challenge.
Conclusion BPMN and DMN have strengths and weaknesses when modeling medical processes; however,
they can be used to successfully create models for clinical pathways.
Keywords
business process model and notation - decision model and notation - contraception
- medical eligibility criteria - clinical pathway - clinical guideline
