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Intermed. Function type. Distributed research center. Distributed research center. Harvard B&W Decision Systems. McGill. Harvard Mass General. Stanford Medical Informatics. Columbia U. Columbia Presbyterian. University of Utah. Resource diagram. InterMed history.
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Function type • Distributed research center
Distributed research center Harvard B&W Decision Systems McGill Harvard Mass General Stanford Medical Informatics Columbia U Columbia Presbyterian University of Utah
InterMed history • NIH experiment in distant collaboration • Prior work by all PI’s • Initial funding 1994-1997 • Outside evaluator brought in 1995 • Follow-ups funded by the Army AHRQ and NLM
Alternative history • Confusion • Frustration • Focusing • Productivity • (Question for discussants: Was the confusion/ frustration part a necessary phase?)
Scientific Products • Initial goals were broad • Make progress in the field of medical decision support • Improve standardization between regions • Needed credibility of multiple sites
Disparate goals (incentives) • Clinicians wanted to efficiently develop something that would be useful in the field • Researchers each wanted to ‘push the envelope’ in their area of interest. Would this project focus on… • CPSC research? • AI research? • Medical research? • Differences in goals between locations
Could these challenges negotiated? • Collaboration readiness? • Technology readiness?
Collaboration readiness? • Barriers of distance, discipline, institution • All PI’s had a ‘family’ connection to Octo Barnett’s lab
Technology used • Email, email lists • Teleconferencing • Timbuktu application sharing (for tele-presentation) • Ontolingua controlled vocabulary system
Strategic use of technology • Conference calls • FTF meetings
Conference calls • PI-only calls were negotiation methods of last resort • Efficiency of conference calls improved significantly over time • Email used to prepare for conference calls • Email used to prepare for and offload content from conference calls • Role specialization was a key to increased productivity later in the collaboratory
FTF meetings • Noted increased productivity of conference calls after FTF meetings
GLIF • Post-1996: Coordinated effort to develop a machine-readable system for describing clinical decisions • Settled on GLIF Guideline Interchange Format
Example GLIF for cough treatment REPLACE WITH CHRONIC COUGH
Challenges still remained… • Communication gaps • Example of unstated background knowledge by clinicians