On Wed, 29 Jun 2005, Greg Woodhouse wrote:

It's not too long, perhaps a bit confusing because I'm not familiar
with all the listed standards, but that's a different matter. I know
very well what is meant by the term "life cycle", and I should perhaps
clarify that when I speak of implementation, I am referring to
implementation of support tools.

I inserted that discussion because this dialog is applicable to a wider audience, one member of who I spoke with yesterday. Members of the full audience are not always familiar with many of the key concepts or the nature of aspects of the standards process but we need to reach them and I am pursuing this line of thought with Rick Marhall with respect to WV's activities. While that is going on we, here on the Hardhats forum need to get our collegues well oriented to the full field of discussion so that it can be carried forward into the various other forums that will reach the needed other participants. I think that the discussion of the application of RP (or its variants) or other LCMs to not only VistA projects but also those in other subject domains than healthcare where M may be used in concert with numerous other components of an enterprise information domain. We should envision the discussion at various levels as M programmers rapidly get into details that seem intuitively obvious but are not familiar to those outside that subject area. Its natural but the M Community is open and eager to relate its capabilites to other technolgies and components. I find the same propensity true of clinical laboratorians with respect to their discipline as it is just natural. but it does poiunt out how we must work at altering our horizon to get at the intrinsic problem domain.


From a modeling perspective, it does seem sensible, though, to inquire
as to what we mean by life cycle because it does directly influence how
we design tools, represent  concepts, and encode knowledge about a life
cycle model so that the tool can make use of that knowledge in a
meaningful way.

I would hope that WV will have a specific Project team on Infrastructure/Tools that can establish close liaison with the VA's groups working in this area. That could benefit both organizations and lead to an evolving tools library that could be easily applied to rapidly evolving conceptual content leading to truly effective and robust system behavior for end users. This tool set could enable the "HealthePeople" vision of Demetriades, Kolodner, and Christopherson in ways that perhaps they hadnt yet realized.


Are we talking past eachother?

Nope! As is natural, we each just have different perpsectives even though we have much common ground.

--- "A. Forrey" <[EMAIL PROTECTED]> wrote:

With respect to the term "Life Cycle Model" we must remember that we
are
speaking of the representation of the processes and activities that
will
lead, over the lifetime of the envisioned system, to the trajectory
of
system configurations. There will be the general form of processes
and
activities applicable to the general model, like "Rapid Prototyping"
(e.
g. as depicted in ASTM E-1340) to which will be added specific
details
related to the specific system and enterprise being considered. The
generalities for a system in the health information domain will have
concepts and functions that cross numerous specific enterprises and
specialty disciplines which will then be conditionmed by the detail
applicable to the individual enterprise. Much of this conceptual
detail
can be reflected in the conceptual content standards and referenced
in
the  Life Cycle Model documentation (e.g. IEEE 1362, 830, 1058) that
are
associated with the Zachman Framework concepts applied to the system
of
interest. For VistA, a general template document triad can be
prepared
that can be then tailored for the specific system and project of
interest
to a given health information architecture. In working with the
health
professional specialty disciplines, the "information system
engineers"
involved have the ability to convey to these specialties the
magnitude of
the effort involved (which may include "business process
re-engineering")
that is frequently not even comprehended; many may think the effort
is the
same as buying a computer box of the shelf from the local electronic
store. So the recognition of the Life Cycle Model and its
implications is
critical and something both the Infoirmation systems folks and the
health
specialty disciplines both need to know with lots of common ground.
RP LCM
is most useful to (but not unique to) healthcare because of the rapid

evolution of the underlying knowledge (e. g. Genomics, Proteomics,
Metabolomics), terms VistA is still trying to cath up with. For VistA

education in the "Common Ground" is key to how benefiiciary Acquirers
will
be able to work synergistically with the Suppliers who will enable
them
make it all work. Thus WorldVistA must have closely communicating
Project
teams and Educational Programs that will set the stage for what the
Supplier organizations (e.g. VSA) will do so that these organizations
can
realize their essential contribution to the System Life Cycle.

I hope that this wasnt too long.

On Wed, 29 Jun 2005, Gregory Woodhouse wrote:

I assume that by "ACT" you mean "activity"? This is interesting
because it's
a case in which I find my instinct and intuition at odds. My basic
instinct
as a developer is to break it up into a (possibly cyclic) sequence
of
(timed?) events. My intuition, on the other hand, is that on the
semantic (or
even ontological) level, it's a basic concept, and how I might
implement an
activity in a real system actual reflects my knowledge about
activities.

The Key is joint work of information systems engineers (ISE) with the
health
specialty disciplines (HSD)throughout the System Life Cycle (SLC).

And I have to ask: How do you see Deming's ideas  being applied to
medicine?

Deming's ideas affect both the conceptual content (HSD) and the
implemented content (ISE) that result in an effective system behavior
that
positively supports the measured outcome of the healthcare
enterprise.
Health service professional disciplines will be involved in the
measurement process. Thes esteps are all part of the healthcare
"business
process".


===
Gregory Woodhouse
[EMAIL PROTECTED]

"The policy of being too cautious is
the greatest risk of all."
--Jawaharlal Nehru


On Jun 28, 2005, at 6:37 PM, Thurman Pedigo wrote:

I have been watching this thread with a bit of nagging abstraction
- then
recognized it. Presented is a modified technique of W. Edwards
Deming - the
guy who taught the Japanese how to eat Detroit's lunch (in the
50's).
Shewhart was the originater in the 20's. A brief link:
http://www.balancedscorecard.org/bkgd/pdca.html
PLAN; DO; CHECK; ACT

And broken down:
PLAN:
  1. requirements analysis
  2. design
DO:
  3. coding
  4. documentation
CHECK:
  5. testing
ACT:
  6. maintenance
And the cycle restarts.

(Of course, this list could be elaborated/expanded.)


Perhaps the post industrial era adds new challenges. However, the
basic
concept of simplification and persistance have merits not met by
the "throw
this away and build anew" philosophy that seems to invade our
work.

Unfortunately, we failed to appropriately integrate Deming with
medicine.

thurman





-------------------------------------------------------
SF.Net email is sponsored by: Discover Easy Linux Migration
Strategies
from IBM. Find simple to follow Roadmaps, straightforward articles,
informative Webcasts and more! Get everything you need to get up to
speed, fast.
http://ads.osdn.com/?ad_id=7477&alloc_id=16492&op=click
_______________________________________________
Hardhats-members mailing list
Hardhats-members@lists.sourceforge.net
https://lists.sourceforge.net/lists/listinfo/hardhats-members



-------------------------------------------------------
SF.Net email is sponsored by: Discover Easy Linux Migration
Strategies
from IBM. Find simple to follow Roadmaps, straightforward articles,
informative Webcasts and more! Get everything you need to get up to
speed, fast. http://ads.osdn.com/?ad_id=7477&alloc_id=16492&op=click
_______________________________________________
Hardhats-members mailing list
Hardhats-members@lists.sourceforge.net
https://lists.sourceforge.net/lists/listinfo/hardhats-members




===
Gregory Woodhouse  <[EMAIL PROTECTED]>

"Design quality doesn't ensure success, but design failure can ensure failure."

--Kent Beck








-------------------------------------------------------
SF.Net email is sponsored by: Discover Easy Linux Migration Strategies
from IBM. Find simple to follow Roadmaps, straightforward articles,
informative Webcasts and more! Get everything you need to get up to
speed, fast. http://ads.osdn.com/?ad_id=7477&alloc_id=16492&op=click
_______________________________________________
Hardhats-members mailing list
Hardhats-members@lists.sourceforge.net
https://lists.sourceforge.net/lists/listinfo/hardhats-members



-------------------------------------------------------
SF.Net email is sponsored by: Discover Easy Linux Migration Strategies
from IBM. Find simple to follow Roadmaps, straightforward articles,
informative Webcasts and more! Get everything you need to get up to
speed, fast. http://ads.osdn.com/?ad_id=7477&alloc_id=16492&op=click
_______________________________________________
Hardhats-members mailing list
Hardhats-members@lists.sourceforge.net
https://lists.sourceforge.net/lists/listinfo/hardhats-members

Reply via email to