Recent Projects


Overview of Research Topics

  • Development of an Information Access Control Model to Facilitate Team Coordination and Collaboration - A Case Study of the New York State HIV Clinical Education Initiative (CEI)

    To provide workflow support and to facilitate coordination and collaboration for complex clinical education programs that involve multiple institutions, we have enhanced the role-based access control model to include universal constraints on special training topics, geographical location of training events, and particular tasks in training workflow. We have successfully implemented an initial version of this model for the New York State HIV Clinical Education Initiative (CEI) to coordinate training activities among seven training centers. We have developed a prototype system based on this model, which has been effectively used to coordinate 210 collaborative HIV clinical education sessions in New York State for a ten month period. Additional model components and system features are under development, with the goal to design a generic information access control model to support workflow and to facilitate team coordination and collaboration for clinical education. more>>
  • Activity-Oriented Access Control (AOAC) Model

    In hospital information systems, protecting the confidentiality of health information, whilst at the same time allowing authorized physicians to access it conveniently, is a crucial requirement. The need to deliver health information at the point-of-care is a primary factor to increase healthcare quality and cost efficiency. However, current systems require considerable coordination effort of hospital professionals to locate relevant documents to support a specific activity. This study was to design and develop a flexible and dynamic access control model, Activity-Oriented Access Control (AOAC), which is based on user activity to authorize access permissions. A user is allowed to perform an activity if he/she holds a number of satisfactory attributes (i.e. roles, assignments, etc.) under a specified condition (e.g. time, location). Results of AOAC implementation in a realistic healthcare scenario have shown to meet two important requirements: protecting confidentiality of health information by denying an unauthorized access, and allowing physicians to conveniently browse medical data at the point-of-care. more>>
  • GLEE - A Model-Driven Execution System for Computer-Based Implementation of Clinical Practice Guidelines

    We have developed the GLEE system for execution of guidelines encoded in GLIF3 format. This system can be integrated with a local clinical information system through standard interfaces to EMRs and clinical applications. The execution model ofGLEE takes the "system suggests and user controls" approach. A tracing system is used to record the state ofguideline steps and their transitions. The GLEE system provides an internal event-driven execution model that can be hooked up with a clinical event monitor in the local environment. Potential use of the GLEE system includes clinical decision support, quality assurance, guideline development and medical education. more>>
  • GLIF: a representation format for sharable computer-interpretable clinical practice guidelines

    The Guideline Interchange Format (GLIF) is a model for representation of sharable computer-interpretable guidelines. The current version of GLIF (GLIF3) is a substantial update and enhancement of the model since the previous version (GLIF2). GLIF3 enables encoding of a guideline at three levels: a conceptual flowchart, a computable specification that can be verified for logical consistency and completeness, and an implementable specification that is intended to be incorporated into particular institutional information systems. The representation has been tested on a wide variety of guidelines that are typical of the range of guidelines in clinical use. It builds upon GLIF2 by adding several constructs that enable interpretation of encoded guidelines in computer-based decision-support systems. GLIF3 leverages standards being developed in Health Level 7 in order to allow integration of guidelines with clinical information systems. The GLIF3 specification consists of an extensible object-oriented model and a structured syntax based on the resource description framework (RDF). Empirical validation of the ability to generate appropriate recommendations using GLIF3 has been tested by executing encoded guidelines against actual patient data. GLIF3 is accordingly ready for broader experimentation and prototype use by organizations that wish to evaluate its ability to capture the logic of clinical guidelines, to implement them in clinical systems, and thereby to provide integrated decision support to assist clinicians. more>>
  • GESDOR - A Generic Execution Model for Sharing of Computer-Interpretable Clinical Practice Guidelines

    We developed the Guideline Execution by Semantic Decomposition of Representation (GESDOR) model to share guidelines encoded in different formats at the execution level. For this purpose, we extracted a set of generalized guideline execution tasks from the existing guideline representation models. We then created the mappings between specific guideline representation models and the set of the common guideline execution tasks. Finally, we developed a generic task-scheduling model to harmonize the existing approaches to guideline task scheduling. The evaluation has shown that the GESDOR model can be used for the effective execution of guidelines encoded in different formats, and thus realizes guideline sharing at the execution level. more>>
  • The InterMed Approach to Sharable Computer-interpretable Guidelines

    InterMed is a collaboration among research groups from Stanford, Harvard, and Columbia Universities. The primary goal of InterMed has been to develop a sharable language that could serve as a standard for modeling computer-interpretable guidelines (CIGs). This language, called GuideLine Interchange Format (GLIF), has been developed in a collaborative manner and in an open process that has welcomed input from the larger community. The goals and experiences of the InterMed project and lessons that the authors have learned may contribute to the work of other researchers who are developing medical knowledge-based tools. The lessons described include (1) a work process for multi-institutional research and development that considers different viewpoints, (2) an evolutionary lifecycle process for developing medical knowledge representation formats, (3) the role of cognitive methodology to evaluate and assist in the evolutionary development process, (4) development of an architecture and (5) design principles for sharable medical knowledge representation formats, and (6) a process for standardization of a CIG modeling language. more>>
  • Translating National Childhood Immunization Guidelines to a Computer-Based Reminder Recall System within an Immunization Registry

    To translate national childhood immunization guidelines to a computer-based reminder recall system, hierarchical system architecture design and combined approach of tabular and procedural knowledge representation are taken. Nested branches with hierarchical combinations of single antecedent variables are used to avoid logical incompleteness, redundancy and inconsistency. Mapping to the local electronic medical vocabulary is implemented to facilitate the integration with the local information system architecture. 26 second-level modules with 195 original branches and 121 final branches after pruning are encoded. 99.67% of the reminders are confirmed to be correct by SQL query. more>>
  • Model-Based Immunization Information Routing

    We have developed a model for clinical information routing within an immunization registry. Components in this model include partners, contents and mechanisms. Partners are classified into senders, receivers and intermediates. Contents are classified into core contents and management information. Mechanisms are classified into topological control, temporal control, process control and communication channel control. Immunization reminders, forecasts and recalls in email, fax and regular mail format are routed based on this model. Algorithms for deducing patient provider and patient clinical site relationships are developed to facilitate routing. A dummy provider within each site and a dummy site are created to manipulate routing for incomplete data. 46.63% of patients’ primary providers and 92.58% of patients' clinical sites are successfully identified. more>>

University of Rochester Medical Center
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