Managing Socio-technical Interactions in Healthcare SystemsIntroductionThe Architectural ApproachArchitectural Primitives for Causal InteractionsArchitectural Primitives for Biddable InteractionsModeling Reconfiguration OperationsModeling Configuration GraphsModeling Reconfiguration Rules Using Graph TransformationsConcluding RemarksReferencesA. ter Hofstede, B. Benatallah, and H.-Y. Paik (Eds.): BPM 2007 Workshops, LNCS 4928, pp. 347–358, 2008. © Springer-Verlag Berlin Heidelberg 2008 Managing Socio-technical Interactions in Healthcare Systems Osama El-Hassan, José Luiz Fiadeiro, and Reiko Heckel Dept. of Computer Science, University of Leicester, University Road Leicester, LE1 7RH, United Kingdom {oehe1, jose, reiko}@mcs.le.ac.uk Abstract. We put forward an architectural framework that promotes the exter-nalisation of the social dimension that arises in software-intensive systems which, like in healthcare, exhibit interactions between humans (social compo-nents) and technical components (devices, computer-based systems, and so on) that are critical for the domain in which they operate. Our framework is based on a new class of architectural connectors (social laws) that provide mecha-nisms through which the biddability of human interactions can be taken into ac-count and the sub-ideal situations that result from the violation of organisational norms can be modelled and acted upon by reconfiguring the socio-technical systems. Our approach is based on formal, algebraic graph-based representa-tions and transformations. 1 Introduction One of the main sources of difficulties in healthcare oriented process management is the fact that staff may deviate from prescribed medical or organisational workflows. Such deviations are not “errors” but, rather, result from the fact that situations may arise in which humans may need to interact with machines in “sub-ideal” states [17]: “Medical personnel must be free to react and is trained to do so. There-fore, in addition to the customization of a pathway schema at instance creation time, it must be possible to dynamically adapt in-progress treatment cases (i.e., process instances) during runtime. […] As a con-sequence the actual patient treatment process may deviate from the original treatment plan and the related medical pathway respectively. However, such deviations from the pre-planned process must not lead to errors or inconsistencies”. Freedom to (re)act matches perfectly the characteristics of biddable domains as identified by Jackson [16]: “[people] can be joined to adhere to certain behaviour, but may or may not obey the injunction”. The problem, as highlighted in the quote above, is to endow systems with the degree of flexibility that allows them to adapt dynamically to changes from ideal to sub-ideal states. In this paper, we explore the use of architectural modelling techniques for making systems adaptable through dynamic reconfiguration [2]. Such techniques rely on the348 O. El-Hassan, J.L. Fiadeiro, and R. Heckel externalisation of the coordination of the interactions among components of the sys-tem in explicit connectors [1]. One can then reconfigure the system by changing the connectors without changing the components themselves. However, in order to be able to address interactions in which some of the components are human, as is the case in healthcare, we need new modelling primitives that extend the notion of con-nector. For instance, we should be able to model the interactions that, in a healthcare system, are associated with the roles performed by medical staff when engaging with fellow staff, software applications or machines. Our approach addresses what are sometimes called “socio-technical systems”: sys-tems that include a “social dimension” in the sense that people (or groups of people) need to be considered not as external users but as another class of components that, together with software and devices, perform roles that are vital for the “good” behav-iour of the system. In order to bring human interaction within the boundaries of sys-tems, we need to be able to refer to normative concepts like permissions, obligations and power, and to model the violations that can take place so that processes and un-derlying software can be reconfigured to react to non-normative situations in ways that ensure agreed, possibly minimal, levels of service. In this paper, we are particu-larly interested in capturing sub-ideal situations that are caused by violating an obliga-tion or a permission to perform a certain action or activity. From this discussion, it should be obvious that our approach differs from the per-spective on human interaction taken in HCI (Human-Computer Interactions), which addresses user interface issues, or CSCW (Computer Supported Cooperative Work) [], which tackles person-to-person computer-mediated collaborations. Our focus is not on user interaction but on peer-to-peer interactions. Our starting point is a combi-nation of recent work on software architecture [2] and the knowledge that has been accumulated in multidisciplinary areas of research such as deontic logic [22], multi-agent systems [10], role-based access control [21] and other social studies. In [8], we made a preliminary proposal for a new class of architectural primitives and formal configuration modelling techniques based on [24]. These configuration primitives allow us to specify when and how to reconfigure the software architecture, at runtime, in a way that reflects the normative positions of humans as engaged in interactions within organisational settings. In this paper, we provide an overview of this work as applied to healthcare and develop in more detail the semantics of the reconfiguration operations. Section 2 constitutes a brief discussion of the architectural modelling approach and addresses the new primitives, through which biddable interactions can be coordinated, then after. Section 3 provides a mathematical semantics over graph-based representa-tions and transformations followed by an example. 2 The Architectural Approach 2.1 Architectural Primitives for Causal Interactions Our architectural framework is based on the CCC architectural approach [2, 3], which includes a business micro-architecture to support engineers and system specifiers to model and implement evolving component-base systems. Architectural primitivesManaging Socio-technical Interactions in Healthcare