Unleashing Innovation: HL7 AI Challenge Winners Transforming Healthcare with Standards-Based AI

At its core, BPM+ combines the strengths of the following open standards from the Object Management Group, Inc. (OMG®):

• BPMN™ (Business Process Model and Notation™) for structured workflows
• CMMN™ (Case Management Model and Notation™) for unstructured, event-driven cases
• DMN™ (Decision Model and Notation™) for business rules and decision logic
• SDMN™ (Shared Data Model and Notation™) for unified data definitions

Together, these standards form a cohesive modeling ecosystem that supports end-to-end business transformation, governance, and automation.

Why BPM+?

Most organizations rely on written documents to define processes and rules, but natural language often introduces ambiguity and inconsistency. BPM+ replaces this with precise, visual models that are easier to understand, validate, and automate.

Whether you’re managing a hospital, onboarding a customer, processing a loan, or running DevOps pipelines, BPM+ gives you:

• A blueprint for how your business operates
• A standardized input for workflow and decision orchestration
• A shared language for collaboration across teams

Key Benefits

• Eliminate ambiguity with readable, standardized diagrams
• Align stakeholders on scope, logic, and decision paths
• Enable automation directly from the models with no code translation needed
• Build reusable libraries of processes and decisions
• Improve agility by adapting quickly to regulatory or business changes

With BPM+, your models are more than just documentation, they are living assets that drive execution and transformation.

Who Uses BPM+?

BPM+ is widely adopted by organizations that operate in complex, regulated environments and require clarity, consistency, and automation across their decisions, processes, and data. It’s especially valuable for teams looking to align business operations with digital transformation goals while ensuring regulatory compliance.

Used Across Industries

BPM+ appeals to a diverse range of medium to large enterprises, particularly in sectors where auditability, standardization, and agility are critical:

• Healthcare: Hospitals and clinical organizations use BPM+ to model care pathways, enforce clinical best practices, and automate workflows at the point of care.
• Financial Services: Banks and lenders apply BPM+ to streamline loan origination, servicing, risk evaluation, and compliance with evolving regulations.
• Government: Public sector organizations modernize citizen-facing services and internal operations using BPM+ for greater transparency and efficiency.
• Telecommunications & Utilities: Use BPM+ to manage dynamic service delivery, customer care processes, and operational resilience.
• Technology & DevOps: Integrate BPM+ models with automation pipelines to orchestrate development, testing, deployment, and monitoring workflows.

Typical users include product owners, solution architects, business process teams, compliance departments, and low-code developers who need to orchestrate business decisions and workflows, manage cases, and standardize data.

Banks, insurers, investment firms, credit unions, and GSEs use BPM+ to manage critical functions like loan origination, customer onboarding, complaint resolution, and regulatory reporting. Financial institutions rely on BPM+ to model complex decision logic for credit scoring, fraud detection, and compliance, while maintaining the transparency required for audits and regulatory reviews. With BPMN and DMN, organizations codify risk and compliance rules; with CMMN, they manage investigative and exception-driven cases; and with SDMN, they standardize data definitions across processes. BPM+ helps ensure consistency, traceability, and agility, key to staying competitive and compliant in a fast-evolving financial landscape.

As the MISMO-approved standard for expressing business rules and decisions, DMN supports end-to-end lifecycle management, from authoring and validation, to execution and exchange, across systems and platforms.

MISMO®,
(Mortgage Industry Standards Maintenance Organization) a non-profit subsidiary of the Mortgage Bankers Association (MBA)

BPM+ is being used to document and automate hundreds of types of financial processes including:

• Risk assessment and mitigation processes
• Credit scoring processes
• Regulatory compliance processes
• Credit card processing
• EOD/EOM/EOQ/EOY closing processes
• Underwriting processes
• Anti-money laundering processes
• Loan origination processes
• Consumer protection processes
• Loan distribution processes
• Know your customer (KYC) processes
• Fraud detection processes
• Claims handling processes
• Loan servicing processes
• Complaint handling & mitigation processes
• Cross selling and up-selling processes
• Investment trade processes
• Trade review processes
• Marketing processes
• Sales forecasting processes

With BPM+, financial institutions can model and orchestrate business decisions, ensure auditability, and demonstrate governance across systems and geographies.

By integrating BPMN, CMMN, DMN, and SDMN standards, BPM+ supports both structured care protocols and dynamic case management, making it ideal for environments where patient care must be individualized yet evidence-based. Healthcare providers use BPM+ to improve care coordination, reduce administrative burdens, and enhance regulatory compliance. The result is greater operational efficiency, better patient outcomes, and a data-driven foundation for continuous improvement across the care continuum.

BPM+ is being used to create healthcare process flows, manage cases and orchestrate DMN decision services in hundreds of ways. Here are some representative examples:

• Create/improve clinical guidelines
• Maintain EHR Systems
• Procurement
• Patient Admission and Discharge
• Care management
• Benefit Enrollment
• FHIR support
• Billings and payments
• Prior authorization
• Clinical decision support (CDS)
• Adding AI/Machine Learning into processes
• Insurance/claims processing
• Onboard and Offboard Employees & Patients
• Actuarial and risk management
• Manage the Staff Roster
• Automate FTP/SFTP/FTPS
• Call center scripting
• DevOps
• Accelerate Help Desk Response Time
• Fraud management
• HIPAA compliance
• Joint Commission standards reporting
• Risk Management
• CMS compliance

Trisotech: A Leader in BPM+

Trisotech is a global leader in business automation and a key contributor to all four BPM+ standards: DMN, BPMN, CMMN, and SDMN. Its tools, DMN Decision Modeler, BPMN Workflow Modeler, CMMN Case Modeler, and SDMN Shared Data Modeler are recognized as the reference implementations for these standards. Together, they form the foundation of the Trisotech Digital Enterprise Suite (DES), a definitive platform for standards-based business modeling and automation.

The suite offers a visual, browser-based environment for creating and deploying BPM+ models across public or private cloud infrastructures. It includes advanced capabilities such as AI and machine learning integration via Predictive Model Markup Language (PMML) and Clinical Quality Language (CQL), as well as Attended Tasks that support human-in-the-loop validation during automation. Additionally, Trisotech’s Knowledge Entity Modeler (KEM) allows organizations to manage business vocabularies and concept models based on the Semantics of Business Vocabulary and Business Rules™ (SVBR™) standard, supporting rich, domain-specific applications in industries like healthcare and finance.

Trisotech
in Financial Services:

• Provides Mortgage Feature Set (MFS) for Regulation Z, Fannie Mae, Freddie Mac, and MISMO standards
• Drag-and-drop support for MISMO data structures and business concepts
• Over 30 financial FEEL functions for BPM+ models

Trisotech
in Healthcare:

• Founding member of BPM + Health
• Healthcare Feature Set (HFS) with support for FHIR , SMART on FHIR, and CDS Hooks
• Over 1,000 pre-built clinical pathways and decision models
• Human-in-the-loop validation via Attended Tasks with the and the.

Why Choose Trisotech for BPM+?

Trisotech delivers a scalable, cloud-ready, standards-based automation platform trusted by enterprises and governments worldwide. With full support for BPM+, Trisotech enables:

• Rapid time-to-value through low-code modeling
• Seamless integration into any IT environment
• Reusable knowledge assets and accelerators
• Full compliance with industry-specific regulations
• Future-ready architecture for AI, APIs, and event-driven workflows

OMG®, BPMN™, (Business Process Model and Notation™), Decision Model and Notation™, (DMN™), CMMN™, (Case Management Model and Notation™), SDMN™, (Shared Data Model and Notation™), Semantics of Business Vocabulary and Business Rules™, (SVBR™), and BPM+ Health™ are either registered trademarks or trademarks of Object Management Group, Inc. in the United States and/or other countries. MISMO is a registered trademark of Mortgage Industry Standards Maintenance Organization, Inc. HomeReady® and Uniform Mortgage Data Program® (UMDP®) are registered trademarks of Federal National Mortgage Association (Fannie Mae).

What is Decision Intelligence?

Decision Intelligence (DI) is defined by Gartner as:

A practical discipline that advances decision making by explicitly understanding and engineering how decisions are made and how outcomes are evaluated, managed and improved via feedback.

It blends data science, AI, decision modeling, and domain expertise to support, augment, or automate business decisions. It treats decisions as strategic enterprise assets, ensuring that human expertise, business rules, AI insights, and organizational context are orchestrated into high-quality, auditable outcomes. Unlike traditional analytics, which stop at insight, DI connects the dots between data, rules, processes, and people, creating a closed-loop system where decisions are explicitly modeled, executed, monitored, and improved over time.

This decision-centric approach is rapidly gaining adoption across sectors, from finance and healthcare to government and public services.

How Trisotech Addresses
Decision Intelligence (DI)

Trisotech Digital Enterprise Suite (DES) is a cloud-native platform that treats decisions as first-class assets, combining decision models based on open-standards with AI and knowledge graphs to orchestrate processes, data, and human judgment. Business value is delivered by orchestrating decisions rather than just tasks or workflows. Every decision, process (workflow), case, or API is managed as a governed semantic asset, meaning it’s explainable and auditable. The platform is built on BPM+ standards (DMN for decisions, BPMN for processes, CMMN for cases, SDMN for data) to ensure model-driven interoperability and avoid vendor lock-in. A Digital Enterprise Graph (DEG) links these models with data and business vocabulary, providing rich context and reuse across the enterprise. Trisotech Decision Centric Orchestration (DCO) technology also emphasizes AI augmentation with governance: it can embed AI services (e.g. GenAI prompts, machine learning classifiers) directly into workflows while applying “TRUST” principles (Traceability, Reflectiveness, Understanding/Oversight, Separation of duty, Transparency) for safe, explainable AI use. In short, Trisotech DES is an integrated decision-centric platform combining decision automation, process orchestration, case management, and knowledge management with AI, all under strong governance. This comprehensive capability set aligns closely with Gartner’s vision of decision-centric solutions and Decision Intelligence Platforms (DIP).

What are Decision Intelligence Platforms (DIPs)?

A Decision Intelligence Platform (DIP) is a software environment that empowers organizations to model, automate, monitor, and optimize complex decisions. According to Gartner a DIP must support capabilities such as decision modeling, orchestration, composability, collaboration, execution, governance, and learning from outcomes.

Unlike standalone AI or analytics tools, a DIP delivers an end-to-end lifecycle:

• Model decisions using standard notations.
• Execute them via orchestration engines.
• Monitor outcomes and compliance.
• Analyze the quality and outcomes of those decisions.

This unified approach accelerates agility and ensures trust, transparency, and accountability in automated decisions.

How Trisotech Addresses
Decision Intelligence Platform (DIP)

Trisotech Decision-Centric Orchestration (DCO) technology aligns strongly with Gartner’s criteria for Decision Intelligence Platforms (DIPs) by offering explicit decision modeling and orchestration through BPM+ standards (DMN, BPMN, CMMN, SDMN). In fact, Trisotech is recognized by Gartner as a representative vendor in the DIP category. Trisotech modular, API-driven architecture supports composability and microservice deployment, while its cloud-native execution environment enables governed, traceable decision services at scale. The platform fosters collaboration among business and technical stakeholders and integrates human oversight into AI-augmented decisions via its TRUST (Traceability, Reflectiveness, Understanding, Separation, Transparency) framework. Trisotech also emphasizes governance, policy enforcement, and real-time observability to meet strict monitoring and compliance demands. Through modeling and continuous monitoring, it supports decision refinement and learning over time. Conceptually, Trisotech neuro-symbolic approach, combining business rules, knowledge graphs, and AI, embodies the principles of decision intelligence, positioning it as a fully realized and future-ready DIP.

In short, the Trisotech Digital Enterprise (DES) Suite offers:

• Full decision modeling and orchestration via DMN, BPMN, CMMN and SDMN.
• Composability through a low-code environment and open APIs.
• Governed execution with explainability and observability at every step.
• Collaboration across business and technical roles via shared semantic assets.
• Analysis of decision performance for improvement insights.

By treating decisions as governed, repeatable assets, financial institutions can:

• Standardize regulatory and credit decisions.
• Automate case-based operations (e.g., KYC, loan approvals).
• Embed explainable AI in decision workflows.
• Ensure full traceability for audits and regulatory reviews.

Decision Intelligence in financial services improves “decision quality and explainability while reducing time-to-insight and operational costs”.

How Trisotech Addresses
Decision Intelligence in Financial Services

Trisotech for Financial Services enables institutions to:

• Model compliance, risk, and eligibility decisions using DMN with a business vocabulary.
• Orchestrate workflows involving human approvals and AI components.
• Embed auditability and compliance at the core of decision execution.
• Deploy modular decision services that are scalable and policy-controlled.

Through semantic modeling and governed orchestration, Trisotech helps financial organizations operationalize DI to accelerate innovation while maintaining compliance and trust.

DI enables:

• Standardization of clinical decision support (CDS).
• Real-time orchestration of care pathways and prior authorization.
• Transparent, auditable AI augmentation in clinical workflows.
• Interoperability via standards like FHIR and BPM+ Health.

Decision intelligence in healthcare is entering the early mainstream and is key for next-generation care orchestration and utilization management.

How Trisotech Addresses
Decision Intelligence in Healthcare

Trisotech for Healthcare provides:

• End-to-end support for BPM+ Health modeling (DMN, BPMN, CMMN, SDMN).
• Seamless integration with FHIR APIs.
• Orchestration of AI-assisted decisions with human oversight (e.g., infection control, remote monitoring).
• Compliance with data privacy, consent, and auditability standards through its governance-first architecture.

By embedding decision intelligence into clinical and operational pathways, Trisotech empowers health systems to improve outcomes and reduce variability, all while maintaining transparency and trust.

Conclusion

Decision Intelligence is more than a buzzword; it’s the future of responsible automation. Whether in finance, healthcare, or any data-driven industry, the ability to model, govern, and optimize decisions is the key to agility and trust.

Trisotech leads this transformation with its Decision-Centric Orchestration (DCO) technology: a complete decision intelligence platform rooted in open standards, AI augmentation, and human-AI collaboration. It’s not just automation; it’s orchestration of intelligence. A statement that could serve as a manifesto for decision intelligence.

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