OntologWiki: ConferenceCall 2005 11 03

[ontolog] Scheduled Discussion session - Nov. 3, 2005 (GPW)

Topic: "Healthcare Informatics Landscapes, Roadmaps, and Blueprints: Towards a Business Case Strategy for Large Scale Ontology Projects" - Discussion Session-II (GPX)

Moderator: BobSmith (GPY)

Panelists: (GPZ)
- BrandNiemann, MarcWine, MarkMusen, DavidWhitten, ChrisChute and ConradBock (GQ0)

Session Format: this will be a virtual session conducted over an augmented conference call using VNC "Virtual Network Computer" (a generic, open source, remote desktop web-conferencing utility). (H6Q)

First Hour: Briefly address the remaining questions from the first panel discussion 25 August 2005. (H6R)
- BobSmith's Welcome and Overview (HKA)
- MarkMusen's comments (HKB)
- Participant's Self-introduction and primary expectations for today's Forum (HKC)
- ChrisChute's presentation (HKD)
- ConradBock's presentation (HKE)
- MarcWine's presentation (HKF)
- DavidWhitten's comments (HKI)
- BrandNiemann's comments (HKQ)
- Discussion of the 4 open questions from last session (HKG)
- Additional Discussion (HKH)
Second Hour: Address at least one of the three selected issues from each of the three major constituencies our panelists represent: (H6S)
- International Healthcare Standards Organizations; (H6T)
  - Issues in focus: (HKK)
  - Discussions: ChrisChute, ConradBock (HKL)
- Inter-Governmental Groups seeking Interoperability; and, (H6U)
  - Issues in focus: (HKM)
  - Discussions: DavidWhitten, BrandNiemann, MarcWine (HKN)
- Open Discussion (HKO)
Summary and Next Steps: (HKP)

Take II: Beyond the Tipping Point: Can We Make Healthcare Standards Usable through Semantic Interoperability? (H6W)

History of this Series: (GQZ)
- topic proposed by RexBrooks during our 2005.07.07 conference call and further deliberated during our 2005.07.21 call. (GR2)
- a first panel discussion on this topic was held on Aug. 25, 2005. Refer to details at: ConferenceCall_2005_08_25 (GTM)
- this follow-up discussion session was brought up during the Ontolog conference call on 2005.09.01. (ref.) (H6P)

This session was proposed by RexBrooks, and organized by RexBrooks and BobSmith. (GR0)
- Unfortunately, RexBrooks who had planned to moderate today's session became hospitalized as of last Saturday (2005.10.29). We are sending Rex our "get well" wishes here; and, express our thanks to BobSmith who have gracious agreed to moderate the session on short notice. (HKV)

Follow-on Event: FCW Government Health IT Conference, Nov. 17~18, 2005, Washington D.C. (ref.) (GR1)

Conference Call Details (GQ1)

Date: Thursday, November 3, 2005 (GQ2)
Start Time: 10:30 AM Pacific Standard Time / 1:30 PM Eastern Standard Time / 18:30 UTC (see world clock for other time zones) (GQ3)
- Duration: 2.0 hours (GP3)
Dial-in Number: 1-702-851-3330 (Las Vegas, Nevada) (GP4)
- Participant Access Code: "686564#" (GP5)
Shared-screen support (VNC session) will be started 5 minutes before the call at: http://vnc2.cim3.net:5800/ (GP6)
- view-only password: "ontolog" (GP7)
- if you plan to be logging into this shared-screen option (which the speaker may be navigating), and you are not familiar with the process, please try to call in 5 minutes before the start of the session so that we can work out the connection logistics. Help on this will generally not be available once the presentation starts. (GP8)
- people behind corporate firewalls may have difficulty accessing this. If that is the case, please download the slides below and runing them locally. The speaker will prompt you to advance the slides during the talk. (GP9)

RSVP to peter.yim@cim3.com appreciated, to allow us to prepare enough conferencing resources. (GPA)

Information relating to this session is shared on this wiki page: http://ontolog.cim3.net/cgi-bin/wiki.pl?ConferenceCall_2005_11_03 (GPB)

For Virtual Speaker Session Tips and Ground Rules - see: VirtualSpeakerSessionTips (GPC)

Please note that this session will be recorded, and the audio archive is expected to be made available as open content to our community membership and the public at-large under our prevailing open IPR policy. (GPD)

Attendees (GPE)

Attended: (GPF)
- MarkMusen (H6I)
- BobSmith (H6F)
- ChrisChute (H6L)
- PeterYim (H6M)
- ConradBock (HHA)
- KurtConrad (HKW)
- Sathyaprasad Bandhuvula (NIST) (HKR)
- MarcWine (H6H)
- BrandNiemann (H6G)
- PatCassidy (HKX)
- Gary Vecellio (Mitre) (H9O)
- PatHeinig (HKU)
- Tim Cook (CHASE Health Informatics) (H6Y)
- DavidWhitten (H6K)

Expected (possibly joined us after the roll call): (GPG)
- BrettTrusko (H6J)
- PeterElkin (H6X)
- Richard Hennessy (IBM) (H9B)
- Itzhak Roth (Unicorn) (H9F)
- Gary Berg-Cross (EM&I) (H9Q)
- SusieStephens (HA7)
- Ann Wrightson (CSW Group, UK) (HA9)
- DuaneNickull (HAA)
- MonicaMartin (HAB)
- CarlReed (HHE)
- ...(to register for participation, please add your name here or e-mail <peter.yim@cim3.com> so that we can reserve enough resources to support the session.)... (GPH)

Regrets: (GQ4)
- BarrySmith (traveling) (H6N)
- JohnYoung (HAC)
- ElisaKendall (traveling, in UK) (HAU)
- JonathanCheyer (HAD)
- AsumanDogac (holiday in Turkey) (HAE)
- RexBrooks (hospitalized) (H6E)
- SteveRay (on travel) (HH9)
- DavidCMartin (IBM) (H72)
- PeterBrown (HKT)

Delayed Listeners: (H9C)
- EdDodds (H9D)

Agenda & Proceedings (GPI)

Discussion Topic: "Healthcare Informatics Landscapes, Roadmaps, and Blueprints: Towards a Business Case Strategy for Large Scale Ontology Projects" - Discussion Session-II (GPV)

Professor Bob Smith from California State University will be moderating this discussion session (GQ5)

Session Format (GPN)

Abstract (by Rex Brooks and Bob Smith): (GPJ)

Healthcare Informatics Landscapes, Roadmaps, and Blueprints: Towards a Business Case Strategy for Large Scale Ontology Projects - Discussion Session-II (GQK)

Moderated by: BobSmith, Professor Emeritus, California State University (GQL)

Panel Members: (GQM)
- BrandNiemann, EPA, chair of the federal Semantic Interoperability Community of Practice, CIO Council (GQO)
- MarcWine, GSA Office of Intergovernmental Solutions, Health IT Coordination (GQP)
- MarkMusen, Stanford University, Professor of Medicine and Computer Science, Director Stanford Medical Informatics, Director National Center for Ontological Research-Stanford (GQQ)
- ChristopherChute, Professor and Chairman, Biomedical Informatics, Mayo Foundation (GQR)
- DavidWhitten, WorldVistA, Co-founder; Public Domain Knowledge Bank (GQU)
- ConradBock, NIST (HHD)

1. Objectives: (GPO)

This series of Panel Discussions seeks to: (GR3)

identify the outlines and key landmarks of the current healthcare informatics landscape; (GR4)

clarify semantic interoperability issues between and amongst existing and planned standards, particularly between OMG-HL7 and OASIS initiatives; (GR5)

identify an appropriate Ontology Strategy and committment to business valuation; (GR6)

express key issues for Health Services(Sciences?) Domain Ontology organizational maturity and technology readiness levels; (GR7)

describe the Time dimension opportunities between remote organizational units. (GR8)

In addition to the previously iterated objectives of this series, BobSmith and RexBrooks have identified significant changes in the Healthcare Informatics Landscape which we believe should constitute a basis for specific discussions during the second half of this session: (H62)

Since our first panel, the American Health Information Community (AHIC) 17-member commission has been empaneled and the first three of four contracts related to the Office of the National Coordinator for Health Information Technology have been granted by the Dept. of Health and Human Services http://www.hhs.gov/news/press/2005pres/20051006a.html These contracts are aimed to Advance Nationwide Interoperable Health Information Technology and will report to the AHIC. (H63)

Because this group of panelists includes the variety of viewpoints necessary we propose that: (H64)
- Dr. Christopher Chute, representing HL7, Rex Brooks and Brett Trusko, representing OASIS and the International Health Continuum TC in particular, suggest one to three topics related to International Healthcare Standards; (H66)
- David Whitten, Brand Niemann and Marc Wine, representing Governmental and Inter-Governmental Groups, ranging from local and state to federal jurisdictions, including VistA and Marc Wine's Health Information Technology Ontology Project (HITOP), as well as the Semantic Interoperability Community of Practice (SICoP) which Brand chairs, suggest one to three topics from this arena; (H68)
- Mark Musen and Bob Smith representing Academic Institutions, and Post Doctoral Research in particular contribute one to three suggested topics from this perspective. (H6A)

2. Background: (GPP)

Prior Ontolog Discussion Forums have focused upon topics such as Services Sciences and Ontologies and Tagging for an increasingly focused audience of interdisciplinary experts and cross-disciplinary practitioners, while recent Ontolog Speaker Forums have examined topics of : (GR9)

WorldVistA entitled: "The Importance of Dynamism in the OpenVistA Model" for an audience of communities seeking interoperability in Electronic Healthcare issues; (GRA)

"Enhancing Business Processes Using Semantic Reasoning" for an audience of communities seeking interoperability in Business Processing; (GRB)

"The Maturity of Business Ontologies and Rate of Adoption - examples and challenges from the domain of eCommerce and electronic business collaborations" for an audience of communities interested in examining the issues of Semantic Web development in the business domain. (GRC)

We wish to engage thought leaders on healthcare informatic frontiers because there are many converging efforts heading in similar directions for standardizing the range of business functions that support healthcare delivery. (GRD)
- In other words, the timing is ripe and right for the development of a new ontological viewpoint to guide this committment and inform a strategy to harmonize these converging efforts seamlessly and without a wasteful conflict of competing organizations trying to achieve the same goal. (GRE)

3. Key Assumptions and skeleton of framework to discuss large scale Healthcare ontology implementation strategies: (GPQ)

This topic concerns stategies to share formal and informal ontologies (vocabulary/datamodel standards) for medicine regardless of context [Contexts range along at least four dimensions]: (GRF)
- Place (geo-spatial zones ranging from a single ER episode thru Lab Tests and treatments on 3 or more continents); (GRG)
- Threat Level ( Benign friendly zone to potential risk to catastrophic mass casualties ); (GRH)
- (Personal) Privacy & Security -- Security (A single individual to a family to a genetic type); (GRI)
- Time (Anticipated, Immediately Urgent, Ongoing Update, Summary Report, etc.) (GRJ)

3.1 Ontolog Health Informatics foundations (GRK)

Prior presentations, for example Dr. Musens Grass Roots presentation, illustrated the problems between the major Health Informatic groups (Philosophers, Knowledge Representation Specialists, and Life Science Specialists); (GRL)
The Ontolog Forum at the 7th Protege Conference at Bethesda included presentations examining the 25 years of promising IT solutions to health care data requirements [ Bob Smiths timeline from 1980 initiatives with PROMIS and Alan Rectors analysis of past trends ] (GRM)

3.2 Ontolog Health Informatics participation in USAs SICoP and ONC RFI-summary (The Prelude to the 4 RFPs and the AHIC Charter) Today, as a cumulative result of trends and events, Canada, the UK, New Zealand, and the United States have launched significant HIT projects. (GRN)

These individual projects involve implicit ontology strategies impacting many different domains. More specifically, these domains include the financial, geopolitical governmental (legal, law enforcement, military, overlapping municipal, county-borough, regional, state-province jurisdictional) and related business/commerical information networks and matrices. Not surprisingly, the apparent complexity of programs and resource dependencies requires increasingly sophisticated tools such as Protege and other alternatives to simple spreadsheets or word processing tools, and training-indoctrination and education of new skills. (GRO)

3.3 Expansion of AHICs impacts upon standards bodies and opportunity for the business case arguments/committments [ Layers, Levels, Points of View / Viewpoints, Goals-Means Chains; Rules, and Rules for Rulemaking Policies; Domain ecology ] (GRP)

3.4 Service Domain Systems and Service-Oriented Architectures provide means for maintaining EHR-States (Updates and Acknowledgements of State Change) (GRQ)

Dr. Brailer's extensive and public discussion of required Health IT System changes and value propositions have elicited partial cost and/or benefit scenarios for debate. (GRR)
- (A recent study describes a $200 Billion "price tag" scenario) (GRS)
- Figure 1. HIMSS CCHIT model indicating important Relationships within the US Healthcare Systems (GRT)

4. Pertinent Issues discussed previous and issues to be discussed at this session: (GPR)

Panel Discussion: General Initial orienting questions around the proposition: "We have reached a tipping point because of the change in the focus of large organizations' attention now achieved by Dr. Brailers ONCHIT initiatives." (Keeping in mind the primary vectors/axes of Time, Place, Threat Level, Personal / Group Privacy-Security) (GS4)

Previously discussed Issues: (GRV)
- 1.Is it now important to proseletyze the business value of ontology strategies more effectively? (GS5)
- 2.If so, what agenda items need to be identified and addressed? (GS6)
- 3.And what viewpoints and strategic assumptions need to be considered and honed? (GS7)
- 4.What models and meta-models are available to guide policy level debates in appropriate forums? (GS8)

Issues remaining from previous session: (GRX)
- 5.Which turf battles should be considered or avoided? (GS9)
- 6.Can and should we seek a set of primary policy concerns to develop a coordinated [ choreographed ] global system for sharing interoperable Frameworks in a specified timeframe that produces results with minimal disruptive conflict among interdependent communities. (GSA)
- 7.What constitutes appropriate maturity level for standards to be considered qualified for inclusion in these interoperable "Frameworks"? (GSB)
- 8.Can modeling and appropriate simplification of complicated relationships improve this short list of concerns? (GSC)
- 9.Should Enterprise Business Models be considered at this point, given that Enterprise Architecture and Service-Oriented Architecture are gaining greater traction and it is of the utmost importance to simplify physical workflows, financial flows and associated knowledge flows within an enterprise and between levels? (GSD)

Questions from audience of previous session: (GS1)
- Question: What is being done to add sensor information about the patient and their environment to the ontologies? - MichelleRaymond (GSE)
- Question: Does the Informatics of Medicine Ontology work stretch from wellness care, to home care, to out-patient, to in hospital, to support facilities, etc...? If not where is the focus? How can we pull this together? - MichelleRaymond (GSF)
- Question: Will business cases be targeted at vender's of systems as well as care systems? How? - MichelleRaymond (GSG)
- Question: How can private sector business best participate in these efforts (ontology and business cases)? - MichelleRaymond (GSH)

5. Panelists prepared material: (GPS)

Prepared Material & Resources (GSP)
- combined slide deck from the 2005.08.25 panel, with RexBrooks' opening (GSP)
- Individual panelists slides: (GSQ)

links to additional relevant resources: (GSX)
- ONCHIT Announcement - http://ontolog.cim3.net/file/resource/discussion/healthcare-informatics-landscape_20050825/FederalRegister--ONCHIT_20050819.pdf (GSY)
- HIMSS National Preparedness Response Listing - http://ontolog.cim3.net/file/resource/discussion/healthcare-informatics-landscape_20050825/NationalPreparednessResponse-Listings--HIMSS_20030814.pdf (GSZ)
- A Compilation of selected Healthcare Standards Organizations - http://ontolog.cim3.net/file/resource/discussion/healthcare-informatics-landscape_20050825/HealthStandardsOrgs--AHRQ-MichaelFitzmaurice_Jun-2004.doc (GT0)

Additional Resources-Updates: (GTL)
- (please post any additional resources here) (GT1)

6. Questions, Answers & Discourse: (GPT)

If you have questions for the panel, we appreciate your posting them as instructed below: (please identify yourself) (GTN)
- experimental: try using the queue management chat tool at: at: http://webconf.soaphub.org/conf/room/ontolog_20051103 (GTO)
  - instructions: once you got access to the page, click on the "settings" button, and identify yourself (by modifying the Name field). You can indicate that you want to ask a question verbally by clicking on the "hand" button, and wait for the moderator to call on you; or, type and send your question into the chat window at the bottom of the screen. (GTP)
- ... (you may also post you questions below, the moderator & panel will be fielding them during the open discussion) ... (GTQ)
- For those who have further questions or remarks on the topic, please post them to the [health-ont] project discussion space on the ontolog forum so that we can all benefit from the discourse. (GTS)

new Questions (this session) (GTT)
- ...(insert content here) ... (GTR)

Discourse (this session) (GTU)
- MarkMusen: {nid HKY} (HL1)
  - Need to build up critical mass among ontologists, who are highly specialized, most of the time (HL2)
  - announcing the establishment of National Cneter for Ontological Research (NCOR) - see: http://ncor.us (HKZ)
  - announcing the establishment and funding by NIH of the National Center for Biomedical Ontology (cBio) - see: http://www.bioontology.org/ (HL0)
  - outreach activities to come (e.g. May 21~24, 2006 in German) (HL3)
  - soliciting collaborators - there is a mechanism in place now (see NIH solicitations at: http://www.bioontology.org/collaborators.html) (HL4)
- Tensions identified: (HL8)
  - (ConradBock) Subject Matter Experts (SME) vs. Computer Scientists (CS) (HL9)
  - (ConradBock) Logician vs. Engineering discipline and practice (HLA)
  - (MarcWine, PatCassidy, DavidWhitten & ChrisChute) Tools vs. Content (HLB)
- DavidWhitten (HLC)
  - "until you understand your audience, one cannot establish good communications" (HLD)
  - the need for an understanding of how granular do we need in a particular context {nid HLE} (HLG)
  - there is a need to be able to handle ad hoc categorization (DavidWhitten, ChrisChute) (HLH)
- Resounding the need for an interlingua, generalized (upper) ontology, common semantic model (ConradBock, DavidWhitten, PatCassidy, ...) (HLF)
- BrandNiemann: One Slide Summary (HL7)
- PeterYim: hope this community would help disambiguate, and bring clarity and integrity to ontological work, as Ontological Engineering and Semantic Technology seem to be turning the corner and getting wider awareness and possibly gaining adoption. (HLI)

The session was adjourned at 2005.11.03 12:35 pm PST (H6O)

Session Recordings of this Panel Discussion (GPU)

 (Thanks to KurtConrad and PeterYim for their help with getting the session recorded.  =ppy)    (GT5)

To view the transcript of this session, please see HealthcareInformaticsSession2Transcript (I7I)
To download the November 3, 2005 audio recording of the entire discussion session, click here (GT6)
- the playback of the audio files require the proper setup, and an MP3 compatible player on your computer. (GT7)
- Conference Date and Time: Nov. 3, 2005 10:37am~12:35pm Pacific Standard Time (GT8)
- Duration of Recording: 1 Hour 58 Minutes (GT9)
- Recording File Size: 41 MB (in mp3 format) (GTA)
- Telephone Playback Expiration Date: Nov. 13, 2005 11:56 AM Pacific Time (GTB)
- Prior to the above Expiration Date, one can call-in and hear the telephone playback of the session. (GTC)
- Playback Dial-in Number: 1-805-620-4002 (Ventura, CA) (GTD)
- Playback Access Code: 496088# (GTE)
- suggestion: best that you listen to the session while having the above prepared slides opened in front of you. You'll be prompted to advance slides by the speaker. (GTF)

ConferenceCall 2005 11 03