In order to create IT solutions that modify an existing reality, such as the work environment of a healthcare facility, so as to continuously improve the efficiency and quality of the environment, we need a new paradigm. Instead of building software that captures today's data and user scenarios, we need to build models of the information and processes of the real world, and deploy them within components of a platform ecosystem. We need to consider IT solution delivery as a continuous delivery modelling factory, run by domain experts, rather than a fixed-time, fixed-cost build by software developers.
The starting point for making computers understand any complex domain is to build formal descriptions of the problem space, the operational context, and to directly model the semantics of the new component. These models are maintained throughout development and are used to build software.
We use the paradigm of adaptive workflow in order to define clinical processes across performers, enterprises, and through time. In this view, decision support and workflow are intimately integrated within definitions of process aimed at generating outcomes for patients. A process engine is thus a navigation copilot.
We see information in healthcare in terms of a shared EHR, shared process definitions, and transactional interfaces. This requires various layers of formalisms and models, including APIs, all of which are openly published and shared. HIS products need to integrate with such platforms, rather than creating monolithic data siloes.