“Towards A Universal Name Space” – Dec 6, 2013 Workshop at MIT 

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We will be meeting at the offices of the W3C at MIT.

The success of the World Wide Web was due to an amazingly simple set of initial conditions.  In Weaving the Web Tim Berners-Lee wrote,

What was often difficult for people to understand about the
design of the web was that there was nothing else beyond URLs, HTTP, and
HTML.  There was no central computer “controlling” the web, no single
network on which these protocols worked, not even an organization anywhere
that “ran” the Web. The web was not a physical “thing” that existed
in a certain “place.” It was a “space” in which information could exist.”
Today’s health IT landscape has taken a wildly different approach.  The HITECH funding supported a top-down, “Castles and Drawbridges” approach, focusing on enterprise-centric information systems that are then supposed to be interfaced.  Whereas Google has given us immense power to find information quickly and in context, healthcare has stuck with primitive categorization scheme akin to libraries using card catalogs organized by card catalogs using the Dewey Decimal System, everything in its place and a place for everything.  At it’s root, medical nomenclature is based on assumptions of Aristotle’s law of the excluded middle – things can be either A or Not A, but not both.  We roll these assumptions up in to Boolean Lattices, layer upon layer of hierarchical decomposition which appear to give us precision and consistency. In reality, however are being dragged into a morass of exploding complexity, and our attempts to improve the situation are like trying to get out of a hole by digging it deeper. The hospital, Peter Drucker said, is the most complex organization in our society.  Over and above the complexities of modern medicine and discoveries in the life sciences, we have overlaid immense technical, economic, and political complexities in recent years.
It is questionable, whether we have the intellectual paraphernalia to deal with this level of complexity.
Taking lessons learned from the web, this invitation-only workshop will look at alternatives technology to get out out of the complexity morass.  We will examine Linked Data, using RDF and Semantic Web technology to provide a flexible model for linking health information at the patient level.  Rather than locking patient information into information “castles” and trying to establish a network of “drawbridges” to interface everything, an alternative approach would be to look at Health IT as creating an “information space” within which health information could exist.  This would become a large-scale, fine-grained network of information, giving us great freedom to rethink privacy, security, and provenance, in addition to supporting hierarchical structures as appropriate. (Here is a conversation between Ward Cunningham, creator of the Wiki, and Tom Munnecke, one of the architects of the VA VistA EHR system, comparing how their designs started from simple initial conditions.
A critical first step in this architecture is to define a URI (Universal Resource Identifier) or similar framework that is capable of naming all health information at .  What would this URI look like, and how could it facilitate advanced health IT?
This workshop is a continuation of one at MIT in April, 2013, as well as “RDF as A Universal Health Exchange Language” in Encinitas, CA. June 2013.
We will be meeting at MIT, courtesy of W3C, at Stata Center,  Friday, Dec 6 from 10AM to 2 PM
We are looking for “unencumbered thinkers” to participate in this workshop.  If you are interested in attending, please email munnecke@gmail.com