Using BPMN for medical guidelines that integrate with FHIR-RDF

Medical guidelines are a core concept within evidence-based medicine and provide information on how patient treatment should be applied. The combination of medical guidelines, distributed Fast Healthcare Interoperability Resources (FHIR) resources describing available patient data, and related ontologies representing medical terminologies is substantial for an automated clinical decision support system to provide the most relevant information for the patient and the physician. In this work, we explore the integration of Business Process Modeling Notation (BPMN), FHIR, and Semantic Web technologies to achieve decision support for the medical use case. By using FHIR-RDF representation and SPARQL, we provide relevant information for the business process execution engine, which takes decisions and triggers feeds of new observations to an FHIR store for creating new patient-related data. The business process model describes which information is relevant for decision tasks. By extending the process engine's code, we were able to separate the high-level workflow from the technical tasks, such as querying for data or sending notifications. The application of medical guidelines is critical for patient care while technologies are emerging, and lots of information is available at different locations. With the relatively new standard FHIR, we can use discrete data, and by storing these data in RDF, we integrate with already existing medical ontologies that allow further inferences to process information about the patients.