T. S. Raghu

A business process context for Knowledge Management

Knowledge and management of it emphasize and expect interactions between aspects of business processes including workflow execution, information processing, decision making and motivational structure. As such production and consumption of knowledge occur within these aspects of business processes. Therefore, a business process context provides the justification and rationale for organizing Knowledge Management efforts that address knowledge storage and retrieval, knowledge sharing and knowledge synthesis. Exemplar projects are used to illustrate potential approaches and associated research challenges to addressing Knowledge Management efforts within a business process context.

Adopting ontology to facilitate knowledge sharing

Ontology-enabled knowledge management experiences derived from a domain ontology development project at Intel Corporation are described and assessed.

Collaborative Decision Making: A Connectionist Paradigm for Dialectical Support

The facilitation and analytical support of argumentation-based collaborative decision making is the focus of this research. We model collaborative decision making as an argumentation process. We develop a connectionist modeling framework, a network representation formalism for argument structures, connectionist network mechanisms, and their models of computations to extract the behavior of argument structures. We use two examples from the case study literature to illustrate the concepts. Several interesting properties of the connectionist network models are observed from our computational results. We find that although the length of the computation is affected by parametric values, the final activation levels of the units are largely unaffected. We observe that the initial activation levels of the defeasible units seem to have no effect on their final activation levels. The proposed modeling approach generates valuable insights into the characteristics of specific argumentative discussions. While the intention of this work is not to introduce the connectionist paradigm as a means to bring arguments to a closure (resolution), we show that certain resolution mechanisms can be easily implemented under the connectionist framework.

Addressing the homeland security problem: A collaborative decision-making framework

A majority of critical decisions requires collaborative efforts among analysts to build situation awareness. Teams of decision makers frequently have to react to incoming facts and developing events in a timely fashion such that the consequences of the decisions made largely have a positive impact on a developing situation. This problem is further exacerbated due to the multitude of agencies involved in the decision-making process. Thus, the decision-making processes faced by the intelligence agencies are characterized by group deliberations that are highly ill structured and yield limited analytical tractability. In this context, a collaborative approach to providing cognitive support to decision makers using a connectionist modeling approach is proposed. The connectionist modeling of such decision scenarios offers several unique and significant advantages in developing systems to support collaborative discussions. Several inference rules for augmenting the argument network and to capture implicit notions in arguments are proposed. We further explore the effects of incorporating notions of information source reliability within arguments and the effects thereof.

Associating consumer perceived value with business models for digital services

As digital services increasingly deal with commodity offerings (i.e., digital content and features that are similar between service providers), service providers are seeking to differentiate themselves with variations in their digital service business models. Research, though, has yet to consider the association of consumer perceived value with digital service business models underlying technological innovations. We seek to demonstrate that consumer value for digital service business models may be quite different even when consumers have similar preferences for standard technology characteristics. In the context of this paper, we specifically consider consumer perceived value associated with Personal Health Records (PHRs) and PHR digital business models, through the use of an integrated latent variable and choice empirical model. We find that although consumer perceived value for PHRs is generally high, when offered a choice between three competing PHR business models, consumers state high value for only two of the business models in the choice set: PHRs offered directly by groups of medical providers and Integrated PHRs. These findings suggest that while perceived value may be high for generally considered digital services, variations in the underlying digital service business models are likely to have significant impacts on consumer valuations of digital services.

Impact of CPOE Usage on Medication Management Process Costs and Quality Outcomes

We assess the impact of computerized physician order entry (CPOE) systems usage on cost and process quality in the medication management process. Data are compiled from 1,014 U.S. acute-care hospitals that have already implemented CPOE. Data sources include the American Hospital Association, HIMSS Analytics, and the Centers for Medicare and Medicaid Services. We examine the association of CPOE usage with nursing and pharmacy salary costs, and evidence-based medication process compliance. Empirical findings controlling for endogeneity in usage show that benefits accrue even when 100 percent usage is not achieved. We demonstrate that the relationship of CPOE usage with cost and compliance is non-linear.

Next steps for mobile entertainment portals

Mobile entertainment portals are already appearing, but game designers lack tools for designing content and services. One approach is to use argumentation for hypothesizing the consequences of actions and interactions in a game world.

Using secure messaging to update medications list in ambulatory care setting

UNLABELLED This study analyzed patient adoption of secure messaging to update medication list in an ambulatory care setting. The objective was to establish demographic differences between users and non-users of secure messaging for medications list update. Efficiency of secure messaging for the updates was compared to fax and telephone based updates. METHODS The study used a retrospective, cross-sectional study of patient medical records and pharmacy call logs at Mayo Clinic, Arizona from December 2012 to May 2013, approximately one year after organizing a pharmacy call center for medication updates. A subgroup analysis during a 2-week period was used to measure time to complete update. MAIN MEASURES Main dependent variable is the frequency of medication list updates over the study duration. Technician time required for the update was also utilized. RESULTS A total of 22,495 outpatient visits were drawn and 18,702 unique patients were included in the primary analysis. A total of 402 unique patients were included in sub-group analysis. Secure message response rate (49.5%) was statistically significantly lower than that for phone calls (54.8%, p<0.001). Time to complete the update was significantly higher for faxed medication lists (Wilcoxon rank-sum tests, p<0.001) when compared to those for secure message or phone. CONCLUSIONS Around 50% of the patients respond to medication update requests before office visit when contacted using phone calls and secure messages. Given the demographic differences between users and non-users of patient portal, mixed mode communication with patients is likely to be the norm for the foreseeable future in outpatient settings.

When traditionally inseparable services are separated by technology: the case of patient portal features offered by primary care providers

Health-care services have traditionally been provided and consumed simultaneously, as exemplified by in-person patient visits to primary care providers (PCPs), where clinical assessment and treatment are provided and consumed face-to-face. Technological intermediation is changing this traditional assumption, however, as patient-centric technologies, such as patient portals, are creating service separation opportunities. While service separation facilitated by patient portals may bring welcome changes to access, efficiency, and clinical outcomes, usage of patient portals by health-care consumers remains low. Suboptimal demand-side usage of patient portals, especially at the primary care level, could have significant negative implications for patient-centered policy initiatives predicated on patient empowerment and engagement. This paper contributes to this important policy context by reporting findings from a study designed to assess patient perceptions associated with hypothetical patient portal features offered by PCPs and potential subsequent impacts to PCP loyalty and switching propensity. We find that patient portal features focused on back-office (clinical) self-service capabilities (such viewing health records or summaries from prior visits) are perceived positively by consumers, but, interestingly, clinical digital communication and collaboration features (such as online video consultations with physicians) do not have significant perception impacts. These findings suggest that patient portals may act as a complement to health-care service delivery, while substitution for clinical in-person interactions may not be viewed positively.

Measures of satisfaction for providers and patients using same day teledermoscopy consultation

We aimed to determine whether patients and providers were satisfied with teledermoscopy consultation for skin lesions.