Transcript 25 Years of PROMISES

25 Years of PROMISES: Lessons
Learned from Modeling Professional
Practices
Extending Medical Enterprise
Ontologies: Levels; Limits; and
Tensions
Draft 3
1
7th International Protégé Conference
July 6, 2004
• Bob Smith, Ph.D. Tall Tree Labs
– [email protected]
• Bill Elliott, Internal Medical Labs
– [email protected]
• Christian Fillies, SemTalk
– [email protected] www.sentalk.com
• Gay Woods-Albrecht
– www.bpmsolutionsgroup.com
Draft 3
2
Outline: 25 Years of PROMISES
Draft 3
3
Problem Oriented Medical
Records and Guidance:
Draft 3
4
Draft 3
5
What happened to our
Guidance expectations of 1980?
Draft 3
6
Effective Supply and Demand
Draft 3
7
Comprehensive Computer
Supported Medical Decision
Support Systems?
• Comprehensive: Intelligent, Robust, Adaptive?
• Computer Supported: Knowledge, Model Driven, and Data
(Factual) Informed?
• Medical: Ecology: Public and Private Health Care and “caring
systems”
• Decision Support: NOT Professional Automation but
Professional Reasoning Enhancements
• Systems: Social components, technical components, cultural
components with explicit guidance “rules for rule making in informed
communities”
Draft 3
8
Draft 3
9
OMB’s US Statistical Abstract-XML Altova Project and Practices
Draft 3
10
JIT Process Knowledge
Integration
Draft 3
11
BPMN.Org Perspectives on Liaison
Options – June, 2004
Draft 3
13
Swim lanes Level 7 to Level 1(?)
1. De Facto Standards (Current Practice Tensions between
competing evolving-emergent standards: Knowledge Management,
Process Management, Standards Management; Business Strategist’s
Strategy (HBR))
2. Standard Abstractions (MS, IBM, SUN: WS-I)
3. Regulatory Guidance Clusters (NIST, NIH, W3C, etc.)
4. CEO-Supply Chain Integration (Health Care
Infrastructure and Payment Systems)
5. Medical Practitioners (Internal Medicine Associates, Inc.)
6. Technical Staff (IT-Lab Techs)
7. Patients with medical problem(s) and paper
Med Records (Brave Dave with High PSA Radical
Surgery)
Draft 3
16
This Protégé Conference
demonstrates top down strategies
• Vast changes in the supply of technical
capability with ontologies, semantic web
services standards, tools, vendors: with
obvious economic and social ripple
effects;
• Vast changes in the demographics of
demand for effective and efficient
integrated and orchestrated medical
practice
Draft 3
17
Bottom Up Strategy
• Size distribution of medical practice and
associated IT and Process maturity
– How and where do most patients receive
medical care?
• Garfield model: Distributed health delivery areas
– Scenario: You are the technology
“gatekeeper” for an 8 physician practice with a
Stat Lab (Statistics go here…)
Draft 3
18
Dialectics from HBR?
• Harvard Business Review June 2004
article by Michael Porter challenging
current assumptions of US Health Care
Competitive Strategies
• Can the Porter-Teisberg policy changes be
modeled? With Ontology and Process
Management-Knowledge Management
simulators?
Draft 3
19
Coherent Architectural Plans?
• What kind of a roadmap would you sketch
for yourself, today, in thinking about the
real needs of these physicians in your
organization?
• How might you arrange to brainstorm the
options using available process modeling
and simulation tools to position Protégé
and SAGE Projects in context?
Draft 3
21
Application Development
Options (Architect Needed)
•
•
•
•
•
Protégé?
SemTalk2 ?
MS_DotNET?
Hybrid?
See link:
..\Sacramento_Wk\101MSDCF\LabPicsJune
04a.htm
Draft 3
22
Protege – Sage Project
Architecture
• Sharable Active Guidance Environment
Draft 3
23
Draft 3
24
Process Model: AS IS
• Describe current workflow
Draft 3
26
Draft 3
28
References
Draft 3
31
Alan Rector: Where are we going?
• Citation: Rector, AL (2001) AIM: A personal view of
where I have been and where we might be going.
Artificial Intelligence in Medicine 23:111-127
• “My own career in Medical Informatics and AI in
Medicine has oscillated between
– concerns with medical records and
– concerns with knowledge representation with decision support
as a pivotal integrating issue.
• It has focused on using AI to organize information and
reduce ‘muddle’ and
• improve the user interfaces to produce ‘useful and
usable systems’ to help doctors with a ‘humanly
impossible task’. “
Draft 3
41
25 Years of PROMISES
Draft 3
47
Reference Domains
1.
2.
3.
4.
5.
6.
7.
Protégé/Sage Project/CoP linkages
Ontology Management of OE
Health Care Technology Trends (Cladistics)
Strategy and Policy (Direction and Guidance)
Business Semantic Primes
Knowledge Flow Metrics
Process Knowledge Management
Draft 3
48