Healthcare Business Process Management, Adaptive Case Management & Process-Aware EHR & Health IT Systems

Interoperability: BPM’s “Spider In The Web”

Slide22

Interoperability. Will van der Aalst, who I already mentioned, top BPM researcher in the Netherlands. He calls BPM the "spider in the web." When he says spider in the web, he means the business process management model with all its adapters and the flexibility of the workflow representations and the way the engines can be monitored, things happen automatically, can be a kind of glue between disparate technologies and disparate systems. And healthcare is full of disparate technologies and disparate systems that need to be glued together to create the ACO.

A major focus in healthcare has been on syntactic and semantic interoperability. By syntactic, there are little characters, [pipes and hats 00:24:33], HL7, and they allow you to get the message from one system to another. From the pharmacy to... from the practice to the pharmacy or from the hospital to the practice.

Semantic interoperability. There are all these codes, these alphanumeric codes, and they stand for drugs or diseases or procedures. You send them to the payer to get paid. Does that code mean the same thing in both systems? That's semantic interoperability.

You never hear about what the academicians call "pragmatic interoperability." Pragmatics is also from linguistics, just like syntax and semantics. Pragmatics means using language to achieve goals. Can you pass the salt? Literally you would say yes, but that may not achieve my goal.

I also call it workflow interoperability. Workflow interoperability is the degree to which the message effect matches your intended effect. That is, when I send a message from this organization to that organization, I sent it for a reason. Does it achieve that goal?

If I'm a primary care practice and I send a referral to a sub-specialist and I don't hear anything back, after awhile you want to say, "Hey, did you get it? Do you still have it? Are you still working on it? What's the status?" Or, you get it back and it doesn't make any sense in the context. "Why am I getting a lab result here? I sent you, I'm expecting an image."

So, there's a conversation that has to happen between systems to clarify, to check assumptions, to catch things from falling between the gaps. Workflow technology is really good at that, but syntactic and semantic is really a tactical level. You can compensate somewhat by gluing these systems together, and at the workflow level, saying, "Wait a minute, does this match what I expected?" And close the loop.

June 16th "BPM & Case Management: US Healthcare Needs You!"
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