Ontolog Forum

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[ontolog] Scheduled Discussion session - August 25, 2005

  • Topic: "Healthcare Informatics Landscapes, Roadmaps, and Blueprints: Towards a Business Case Strategy for Large Scale Ontology Projects"

Conference Call Details

  • Date: Thursday, August 25, 2005
  • Start Time: 10:30 AM Pacific Daylight Time / 1:30 PM Eastern Daylight Time (see world clock for other time zones)
    • Duration: 2.0 hours
  • Dial-in Number: 1-702-851-3330 (Las Vegas, Nevada)
    • Participant Access Code: "686564#"
  • Shared-screen support (VNC session) will be started 5 minutes before the call at:
    • view-only password: "ontolog"
    • 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.
    • 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.
  • RSVP to appreciated, to allow us to prepare enough conferencing resources.
  • 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.


  • Expected also; likely particpated (since we stopped identifying participants once the recording of the session began):
    • Rachel Richesson
    • Susie Stephens
    • Charles Kelly (CEO, Medoctor Systems)
    • A. J. Schmitt (Medoctor Systems)
    • John Casillas
    • Russell Hamm (Mayo Clinic, Health Science Research, Biomedical Informatics)
    • Sylvia Candelaria de Ram (Cognizor, CO)
    • Bob Glushko (Center for Document Engineering, SIMS, UC Berkeley)
    • ...(to register for participation, please add your name here or e-mail <> so that we can reserve enough resources to support the session.)...
  • Regrets:
    • Greg Lewis, MD (MedOrder, Seattle, WA)
    • Ann Wrightson (CSW Group, UK)
    • John Young (AC/UNU Millennium Project)
    • Peter Brown
    • Sally St. Amand
    • EMichaelMaximilien

Agenda & Proceedings

  • Mr. Rex Brooks from will be moderating this discussion session
  • Abstract (by Rex Brooks and Bob Smith):

Healthcare Informatics Landscapes, Roadmaps, and Blueprints: Towards a Business Case Strategy for Large Scale Ontology Projects

Moderated by: Rex Brooks,

  • Panel Members:
    • Bob Smith, Professor Emeritus, California State University
    • Brand Niemann, EPA, chair of the federal Semantic Interoperability Community of Practice, CIO Council
    • David Whitten, WorldVistA, Co-founder; Public Domain Knowledge Bank
    • Marc Wine, GSA Office of Intergovernmental Solutions, Health IT Coordination
    • Mark Musen, Stanford University, Professor of Medicine and Computer Science, Director Stanford Medical Informatics
    • Ram D. Sriram, NIST, Manager, "Manufacturing Metrology and Standards for the Health Care Enterprise" program

1. Objectives

This Panel Discussion seeks to:

  • identify the outlines and key landmarks of the current healthcare informatics landscape;
  • clarify semantic interoperability issues between and amongst existing and planned standards, particularly between OMG-HL7 and OASIS initiatives;
  • identify an appropriate Ontology Strategy and committment to business valuation;
  • express key issues for Health Services(Sciences?) Domain Ontology organizational maturity and technology readiness levels;
  • describe the Time dimension opportunities between remote organizational units.

2. Background:

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 :

  • WorldVistA entitled: "The Importance of Dynamism in the OpenVistA Model" for an audience of communities seeking interoperability in Electronic Healthcare issues;
  • "Enhancing Business Processes Using Semantic Reasoning" for an audience of communities seeking interoperability in Business Processing;
  • "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.
  • 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.
    • 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.

3. Key assumptions and start of a framework for discussing large scale Healthcare ontology implementation strategies

  • 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]:
    • Place (geo-spatial zones ranging from a single ER episode thru Lab Tests and treatments on 3 or more continents);
    • Threat Level ( Benign friendly zone to potential risk to catastrophic mass casualties );
    • (Personal) Privacy & Security -- Security (A single individual to a family to a genetic type);
    • Time (Anticipated, Immediately Urgent, Ongoing Update, Summary Report, etc.)

3.1 Ontolog Health Informatics foundations

  • Prior presentations, for example Dr. Musen's Grass Roots presentation, illustrated the problems between the major Health Informatic groups (Philosophers, Knowledge Representation Specialists, and Life Science Specialists);
  • 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 Smith's timeline from 1980 initiatives with PROMIS and Alan Rector's analysis of past trends ]

3.2 Ontolog Health Informatics participation in USA's 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.

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.

3.3 Expansion of AHIC's 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 ]

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

  • 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.
    • (A recent study describes a $200 Billion "price tag" scenario)
    • Figure 1. HIMSS CCHIT model indicating important Relationships within the US Healthcare Systems

4. Pertinent Issues:

  • 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. Brailer's ONCHIT initiatives."

(Keeping in mind the primary vectors/axes of Time, Place, Threat Level, Personal / Group Privacy-Security)

    • 1.Is it now important to proseletyze the business value of ontology strategies more effectively?
    • 2.If so, what agenda items need to be identified and addressed?
    • 3.And what viewpoints and strategic assumptions need to be considered and honed?
    • 4.What models and "meta-models" are available to guide policy level debates in appropriate forums?
    • 5.Which turf battles should be considered or avoided?
    • 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.
    • 7.What constitutes appropriate maturity level for standards to be considered qualified for inclusion in these interoperable "Frameworks"?
    • 8.Can modeling and appropriate simplification of complicated relationships improve this short list of concerns?
    • 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?

Session Format: this is be a virtual session conducted over an augmented conference call

  • 1. we'll go around with a self-introduction of participants (10~15 minutes)
  • 2. Introduction of Moderator and Panelists
  • 3. Opening by Moderator
  • 4. 5-minute summary perspective by each panelist on the subject
  • 5. Open Discussion by all participants
  • 6. Summary / Conclusion / Follow-up (Moderator)

Moderator and Panelists' prepared slides or material (if there is any) can be accessed by pointing your web browsers to:

  • If you have questions for the presenter, we appreciate your posting them here: (please identify yourself)
    • ... (post you questions here, our moderator will be moderating the open discussion session) ...
    • Question: What is being done to add sensor information about the patient and their environment to the ontologies? - Michelle Raymond
    • 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? - Michelle Raymond
    • Question: Will business cases be targeted at vender's of systems as well as care systems? How? - Michelle Raymond
    • Question: How can private sector business best participate in these efforts (ontology and business cases)? - Michelle Raymond
  • For those who have further questions and discussion on this topic, please post them to the ontolog forum so that we can all benefit from the discourse.
  • Session ended 2005.08.25-12:50 pm PDT

Session Recording and Transcript of this Panel Discussion

(Thanks to Kurt Conrad and Peter P. Yim for their help with getting the session recorded. =ppy)

  • To download the audio recording of the entire discussion session, click here
    • the playback of the audio files require the proper setup, and an MP3 compatible player on your computer.
  • Conference Date and Time: Aug. 25, 2005 10:36am~12:49pm Pacific Daylight Time
  • Duration of Recording: 2 Hour 12.6 Minutes
  • Recording File Size: 46.7 MB (in mp3 format)
  • Telephone Playback Expiration Date: Sep. 4, 2005 1:11 PM Pacific Time
    • Prior to the above Expiration Date, one can call-in and hear the telephone playback of the session.
    • Playback Dial-in Number: 1-805-620-4002 (Ventura, CA)
    • Playback Access Code: 724931#
    • suggestion: best that you listen to the session while having the speakers' slide, or the above material opened in front of you. You'll be prompted to advance slides by the speaker.
  • The transcript of this session has been done and made available by Rex Brooks, (Thanks, Rex, and those who have sent in their edits!) see: