Appl Clin Inform 2019; 10(05): 935-943
DOI: 10.1055/s-0039-3400749
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Modeling a Clinical Pathway for Contraception

Letha J. Sooter
1   Department of Informatics and Networked Systems, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
Steve Hasley
2   American College of Obstetricians and Gynecologists, Washington, District of Columbia, United States
Robert Lario
3   Veterans Health Administration and University of Utah, Salt Lake City, Utah, United States
Kenneth S. Rubin
3   Veterans Health Administration and University of Utah, Salt Lake City, Utah, United States
Faruk Hasić
4   Research Centre for Information Systems Engineering, KU Leuven, Leuven, Belgium
› Author Affiliations
Further Information

Publication History

16 July 2019

21 October 2019

Publication Date:
11 December 2019 (online)


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.

Protection of Human and Animal Subjects

No human or animal subjects were included in this project.