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Capturing Business Rules for Medical Treatment Recommendation

Our friend Jacob contributed a sample of medical rules to the DMN (Decision Model Notation) standardization effort at OMG.  He encouraged me to show how those business rules would look like in our Sparkling Logic SMARTS Decision Management tool.

In this demo, you will see how I created the entire project from scratch, in a business-user-friendly environment, leveraging heavily the use cases he gave me.


RedPenTM is a patent-pending approach to capturing and updating business rules in the context of data.  Graffiti on the use cases turn into business rules automagically!

Thanks again Jacob for allowing us to demo your project!

BBC 2011 – Business Rules for Cancer

healthcareAlthough Healthcare is a perfect fit for Business Rules technology, the providers have been late to adopt the technology.  We have seen many healthcare insurance companies use rules for eligibility or claims processing, but providers are lagging.  I was delighted to attend a session at BBC on Cancer Care.

Michael Katz, BS/MBA at International Myeloma Foundation, gave us a heartbreaking overview of the disease…  incurable but treatable.

The project focused on providing timely information to diagnosed patients healthcare providers.  The solution is available on the internet, with an iPad client available.

Michael shared a demo of the rules they created to detect anemia or bone issues for example.

The iPad application interprets the input data (gender, serotonin level, etc.) by invoking the rules running in a web service.

What’s next?

Nurses have written a 60-page survivor care plan, which they are translating into business rules now.

Similarly, they are translating a 10-step guide for the newly diagnosed (get the correct diagnosis, tests you really need, initial treatment options, supportive care…).

How Kaiser Innovates

A little while ago, I enjoyed reading the trip reports that both Jim Sinur and Elise Olding published on the Gartner blog about innovation at Kaiser Permanente.  Institutionalizing innovation?  This is just the kind of thing that picks my interest.  I could not pass on the opportunity to do that tour as well.  I signed Carlos and I up for a visit of the Sidney R. Garfield Health Care Innovation Center.

Kaiser Permanente - Garfield Healthcare Innovation CenterI also recommend the tour if you happen to be in California but plan ahead as they fill up very quickly.  Our guide was very knowledgeable as well and could give us some “techie” nuggets knowing we were on the IT side.  They combine 3 main aspects: Facilities, Patient Care and IT.  So you could request a guide with any of those specialties.  Isn’t that cool?

Jim described the process innovation that Kaiser implemented very successfully to reduce drug administration errors.  It is so ridiculously simple it is impressive.  It is often the case that the best solutions are actually very simple.  It was interesting that the environment allowed them to think outside the box and focus on the key issues to address.  With the in-situ brainstorming involving all stakeholders, they have been able to come up with an innovative solution to the problem and to test it.  They literally tested out several sashes once they settled on the idea.

I was intrigued by their robotic initiatives.  Having robots deliver bedding throughout the hospital feels a like Start-Trek-ish and cool.  The future is being tested over there though.  They finish the tour with the room of the future.  The trend to simplification continues there of course, bringing tablet-like devices at reach in replacement for many devices they use today.  With the Cloud and all the modern technology, it becomes less of a stretch to consider digital information exchange ver seamlessly from iPad to television to support interactive discussions between the healthcare provider and the patient.  Information will have to flow seamlessly to the home too, for better support and integration of wellness programs that lower “Back to the ER” statistics.

We only talked about Gamification in the context of nurse training, to simulate birth delivery, but you can tell from their website that Gamification is one important focus they experiment with.

My personal take-away was the impressive results they achieved by testing out their new processes or solutions in “reality”.  They have rooms that are designed exactly as real hospital rooms (although they felt much bigger than the room I was in for my son’s delivery).  They try, try and try again.  They iterate in the context of a real-life situation.  They observe; they measure; they assess.  With this use-case-driven approach, they have been able to correct or abandon ideas that looked perfect on paper — they call them their “successful failures”.  It saved them millions of dollars or more.  Our guide pointed out to a few architecture issues that may have been overlooked without the simulation.

That is an interesting parallel with the use-case-driven approach we are evangelizing.  In Decision Management, eliciting and refining business rules in the context of data leads to similar outcomes:

  • Detection of “successful failures”: decisioning that sounds good on paper but that leads to poor business results
  • Collaborative refinement: talking in the abstract can lead to misunderstanding and misalignment; when the discussion is concrete about a specific case, stakeholders can be more precise on their comments and contributions, accelerating the path to the “best” solution

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