Extending BPMN 2.0 for intraoperative workflow modeling with IEEE 11073 SDC for description and orchestration of interoperable, networked medical devices

  • Juliane NeumannEmail author
  • Stefan Franke
  • Max Rockstroh
  • Martin Kasparick
  • Thomas Neumuth
Original Article



Surgical workflow management in integrated operating rooms (ORs) enables the implementation of novel computer-aided surgical assistance and new applications in process automation, situation awareness, and decision support. The context-sensitive configuration and orchestration of interoperable, networked medical devices is a prerequisite for an effective reduction in the surgeons’ workload, by providing the right service and right information at the right time. The information about the surgical situation must be described as surgical process models and distributed to the medical devices and IT systems in the OR. Available modeling languages are not capable of describing surgical processes for this application.


In this work, the BPMNSIX modeling language for intraoperative processes is technically enhanced and implemented for workflow build-time and run-time. Therefore, particular attention is given to the integration of the recently published IEEE 11073 SDC standard family for a service-oriented architecture of networked medical devices. In addition, interaction patterns for context-aware configuration and device orchestration were presented.


The identified interaction patterns were implemented in BPMNSIX for an ophthalmologic use case. Therefore, the examples of the process-driven incorporation and control of device services could be demonstrated.


The modeling of surgical procedures with BPMNSIX allows the implementation of context-sensitive surgical assistance functionalities and enables flexibility in terms of the orchestration of dynamically changing device ensembles and integration of unknown devices in the surgical workflow management.


Business Process Model and Notation IEEE 11073 SDC Integrated OR Medical device interoperability Process modeling Surgical workflow 



The work has been partially funded by the German Federal Ministry of Education and Research (Bundesministerium für Bildung und Foschung (BMBF)) under Reference No. 03VNE1036 as part of the MoVE project.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Ethical standards

All procedures involving human participants have been approved and performed in accordance with ethical standards.


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Copyright information

© CARS 2019

Authors and Affiliations

  1. 1.Innovation Center Computer Assisted Surgery (ICCAS)Leipzig UniversityLeipzigGermany
  2. 2.Institute of Applied Microelectronics and Computer EngineeringUniversity of RostockRostockGermany

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