Storyboards and Activty Diagrams

1. Storyboards and Activty Diagrams Dan Russler, M.D. July 19, 2005

2. Tutorial Objectives • Develop a strategy for building a communication bridge between domain experts and engineers • Define the borders between problem-space and solution space analysis • Introduce HL7 Storyboards • Introduce Unified Modeling Language (UML) Activity Diagrams

3. Tools for Requirements Analysis • Basic Modeling Environment • Pen • Paper • Intermediate Modeling Environment • Microsoft Word • Microsoft Visio • Microsoft Excel • High-end Modeling Environment • Rational Rose

4. Standardized Process Analysis (UML) Non-standard Graphics ad hoc Drawings Structured Documents Free-text Documents Discussions The Communication Pyramid ` ProblemSpace SolutionSpace Implementation-Independent Implementation-Specific Level of Abstraction Communication Models

5. Problem-Space Artifacts • Storyboard Text* • UML Storyboard Activity Diagram* • Domain Glossary • UML Domain Analysis Model • Static Model Cross-Reference (to HL7 RIM)

6. HL7 Reference Information ModelWhere does it fit into the process? Problem-Space Analysis Process (a la HDF) ProblemSpace SolutionSpace Level of Abstraction HL7 RIM Storyboards Message Artifacts

7. Why Storyboards? • Domain experts can usually write narrative, free-form descriptions of how the domain works • An inexpensive method for gathering requirements that documents the business process • Able to describe a series of actions/interactions between one or many persons and/or systems • Focuses on the problem space

8. Sample Storyboard • Precondition: Christine, age 46, was recently diagnosed with stage II breast cancer. She is scheduled to receive her first round of chemotherapy in a few days. Susan, an RN, is seeing Christine in the clinic. • Storyboard: Christine expresses concern about the nausea & vomiting in chemotherapy. Susan reviews Christine’s chart including the problem list, allergies, chemotherapy protocol, orders, results and the patient education plan. She schedules Christine for education on the disease and on the side effects of chemotherapy. • Postcondition: Christine is scheduled to receive education on side effects related to the chemotherapy and education on the disease.

9. Why Activity Diagrams? • Clarifies the roles of people and systems in the storyboard • Clarifies the names of the activities • Clarifies the sequence of activities • Clarifies the decision points • Identifies opportunities for messages • Clarifies the data communicated at each point • Clarifies the trigger events for specific processes

10. Sample Activity Diagram

11. Why Glossaries? • Domain experts don’t agree on the meaning of terms • Domain vocabularies and mappings often poorly understood, e.g. ICD, CPT, SNOMED • Engineers don’t understand domain terms • Multi-word terms not defined in dictionaries • Term meanings needed for later steps in analysis process

12. Sample Glossary

13. Why Domain Analysis Models?(A UML Class Model or Static Model or Information Model) • Each domain has evolved an independent “world view” • Domain experts can only validate what is familiar to them • Domains tend to see themselves as unique • Domain “world view” is filled with jargon • Domain “world view” (Information Model) • Best way to teach people about a domain • Best view of the requirements for a domain

14. Sample Domain Analysis Model Object of Action Provider Role -code -actsOn -name -vocabulary Finding includes the -role -vtext concepts of Goal and Recipient of Care -code -stext Outcome depending Action -vocabulary -hasRecipientOfCare -name on relationship timing +timing -vtext -role and other actions -code -code -vocabulary -vocabulary -hasSupply -vtext * -vtext -stext -hasSite -has Means Focus Finding OtherObjects -hasRoute -hasFocus -timing -Result -focusType Route Means Supply Site -code -code -code -code -vocabulary -vocabulary -vocabulary -vocabulary -has Judgement -vtext -vtext -vtext -vtext Judgement -stext -stext -stext -stext -degree Diagnosis -potentiality -hasSite -acuity -timing Subject of information focusType Value Set = Subject is coded for -code individual, family, -vocabulary • Patient Functioning • Environment or other physical entity -vtext -hasSubjec tOfInformation -stext • ICF and other similar • concepts in other • vocabularies

15. Why Cross-Reference to the RIM? • Domain analysis models support communication within a domain • Communications between domains requires an abstract, domain-independent model such as the HL7 RIM • Cross-reference tables build the mappings from the narrow world of the individual domain to the cross-domain interoperability supported by the HL7 RIM

16. Static Model Cross-Reference

17. Problem-Space Artifacts • Storyboard Text • UML Storyboard Activity Diagram • Domain Glossary • UML Domain Analysis Model • Static Model Cross-Reference (to HL7 RIM)

18. HL7 Reference Information ModelWhere does it fit into the process? Problem-Space Analysis Process (a la HDF) ProblemSpace SolutionSpace Level of Abstraction HL7 RIM Storyboards Message Artifacts

19. Let’s Take a Breather Any Questions?

20. StoryboardSkill-building

21. Sample Storyboard • Precondition: Christine, age 46, was recently diagnosed with stage II breast cancer. She is scheduled to receive her first round of chemotherapy in a few days. Susan, an RN, is seeing Christine in the clinic. • Storyboard: Christine expresses concern about the nausea & vomiting in chemotherapy. Susan reviews Christine’s chart including the problem list, allergies, chemotherapy protocol, orders, results and the patient education plan. She schedules Christine for education on the disease and on the side effects of chemotherapy. • Postcondition: Christine is scheduled to receive education on side effects related to the chemotherapy and education on the disease.

22. Sources • Interviews with domain experts!!!! • Watching people work • Case studies • In healthcare, chart reviews • Literature reviews

23. How do you write a Storyboard? • Determine and Narrow the Topic • Identify the Precondition • Setting • Roles of the participants/actors • Name the characters • Sequence of Events • Write the story • Simple sentences: subject, verb, object and linear • Describe interactions with systems (if part of story) • Check the flow of the story • Send out for review and validation by domain experts • Iterative process with other problem-space artifacts • Declare Postcondition

24. Advantages • Facilitates validation with domain experts • Lack of formal structure • Domain experts can easily read, write and edit • Knowledge transfer

25. Storyboard Exercise • Precondition: Christine, age 46, was recently diagnosed with stage II breast cancer. She is scheduled to receive her first round of chemotherapy in a few days. Susan, an RN, is seeing Christine in the clinic. • Storyboard: Christine expresses concern about the nausea & vomiting in chemotherapy. Susan reviews Christine’s chart including the problem list, allergies, chemotherapy protocol, orders, results and the patient education plan. She schedules Christine for education on the disease and on the side effects of chemotherapy. • Postcondition: Christine is scheduled to receive education on side effects related to the chemotherapy and education on the disease.

26. Storyboard Exercise #2 • Precondition: I’m need to log into e-mail from the hotel…. • Storyboard: • Postcondition:

27. UML Activity DiagramsSkill-building

28. Activity Diagram Dynamic View Activity Diagram Visualizing the activities and flow of a healthcare business process

29. Activity Diagram 9 Components • Swim Lane • Partitions activities according to the responsible party or entity associated with the activity • Activity State • Action (single step in a process or procedure) • Transition • Way to sequentially link actions • Data Object • Activities operate on and by objects that serve as inputs or output to a specific activity • Become datagrams transmitted in messages

30. Iteration #1 Storyboard • Precondition: Christine, age 46, was recently diagnosed with stage II breast cancer. She is scheduled to receive her first round of chemotherapy in a few days. Susan, an RN, is seeing Christine in the clinic. • Storyboard: Christine expresses concern about the nausea & vomiting in chemotherapy. Susan reviews Christine’s chart including the problem list, allergies, chemotherapy protocol, orders, results and the patient education plan. She schedules Christine for education on the disease and on the side effects of chemotherapy. • Postcondition: Christine is scheduled to receive education on side effects related to the chemotherapy and education on the disease.

31. 1st Iteration Activity Diagram

32. 1st Iteration Activity Diagram ?

33. Activity Diagram 9 Components Decision Point • Point where decision is make and flow is directed based on that decision Guard • Way to control the flow once a transition has started • Evaluates a true/false once associated with a specific transition or decision point

34. 2nd Iteration Activity Diagram

35. Iteration #2 Storyboard • Precondition: Christine, age 46, was recently diagnosed with stage II breast cancer. She is scheduled to receive her first round of chemotherapy in a few days. Susan, an RN, is seeing Christine in the clinic. • Storyboard: Christine expresses concern about the nausea & vomiting in chemotherapy. Susan reviews Christine’s chart including the problem list, allergies, chemotherapy protocol, orders, results and the patient education plan and decides she needs additional education. She schedules Christine for education on the disease and on the side effects of chemotherapy. • Alt Flow: Susan educates patient immediately >>P.C. Christine waits for chemotherapy • Postcondition: Christine is scheduled to receive education on side effects related to the chemotherapy and education on the disease.

36. 2nd Iteration Activity Diagram

37. 2nd Iteration Activity Diagram ?

38. 3rd Iteration Activity Diagram

39. Iteration #3 Storyboard • Precondition: Christine, age 46, was recently diagnosed with stage II breast cancer. She is scheduled to receive her first round of chemotherapy in a few days. Susan, an RN, is seeing Christine in the clinic. • Storyboard: Christine expresses concern about the nausea & vomiting in chemotherapy. Susan reviews Christine’s chart including the problem list, allergies, chemotherapy protocol, orders, results and the patient education plan and decides she needs additional education. She schedules requests an appointment for Christine for education on the disease and on the side effects of chemotherapy. Scheduling responds with an appointment, and Susan gives Christine directions and other appointment information. • Alt Flow: Susan educates patient immediately >>P.C. Christine waits for chemotherapy • Postcondition: Christine is scheduled to receive education on side effects related to the chemotherapy and education on the disease.

40. Activity Diagram Take-Home • “The process of storyboard refinement and activity diagram definition is iterative”

41. Activity Diagram 9 Components Fork • Allows activities to spawn into two or more threads Join • Allows synchronization of the forks to arrive at a common point Signal Receipt / Signal Send (not illustrated) • Specific information associated with a transition

42. Parallel Flow Control Obstetrician Cardiologist Lab Evaluate Patient Request Service Lab Form--CBC & Protime Perform Lab Consult Order Form Schedule Patient Routine Ob Care Payor Authorization Evaluate Patient Set Protime Goal Protime Goal Protime Result Ob Care with Calculation Goal Variance [Protime In Range] [Protime High] [Protime Low] Increase Coumadin Reduce Coumadin Continue Ob Care

43. Activity Diagram Exercise • What are the swimlane titles for your e-mail storyboard?

44. That’s All, Y’AllAnd Thanks! Any Remaining Questions?