Combining Process Mining and Simulation for Outpatient Pediatric Ophthalmology: A Case Study

Process mining (PM) and process simulation (PS) are key disciplines for analyzing, optimizing, and improving processes to support decision-making. In recent years, the healthcare sector has significantly increased the adoption of PM tools and has shown growing interest in integrating techniques from other disciplines, such as simulation. However, the literature shows that the combination of PM and PS in healthcare remains limited and is concentrated in a small number of medical specialties. This study aims to analyze and demonstrate the potential of combining PM and PS for healthcare process analysis. The study presents a case study illustrating the integration of PM and PS in the analysis of an outpatient consultation process at a pediatric hospital in Costa Rica. The analysis is based on a dataset of 1814 cases from 2022 and was conducted using the Celonis and Apromore tools, within the context of a specific clinical specialty. The results reveal complex process models, rework activities, bottlenecks, and cases with low levels of conformance, as well as a lack of communication among staff, while highlighting the involvement of domain experts throughout the research. The study designs three simulation scenarios to evaluate process behavior and identifies limitations in the application of the tools used, mainly related to the complexity and variability inherent in healthcare processes.