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Problem

In general, decision models and (business) processes can be combined in complex ways. From a DMN perspective, dependencies between Decisions imply that a sub-decision may be used to better inform a parent decision. DMN does not specify when (or even whether) a sub-decision should be made. A business process can be used to orchestrate the temporal ordering between decisions, possibly interleaving them with tasks other than decision tasks.

It is important to remember that decisions can be made (i.e., DMN models can be evaluated) at any point in time. Until the decision outcome is committed to and actions are performed, one can further distinguish between actions that have no material consequence, actions that can be undone, actions that can be compensated, and ones that are irreversible. Factors to take into account are the actual cognitive/computational cost to evaluate a decision, and how relevant it is to (try to) make a decision at a certain point in time. Making an unnecessary decision may distract a clinician from taking active care of the patient and making an important decision at an untimely moment may require the decision to be revisited (e.g., when new information becomes available).

Applicability

·       Multiple Decisions with mutual dependencies

·       Workflow influences the timeliness of the Decision-making

·       Workflow tasks gather/produce information required for decision making

Specific Example

In the full PE guideline, the RGS-based diagnostic choice is one of the early decisions. As data from labs and imaging is gathered, further testing may be required, ultimately leading to the decision on whether to treat or not. The interleaved Process (BPMN) and the Decision (DMN) components are shown in Figure 1 and Figure 2  below.

Figure 1 – Interleaved BPMN & Decision

 

Figure 2 – Interleaved DRD 

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