Updated: Aug 26, 1998
This is the most recent structured information on this project. Complementary data can be found on previous documents
HC-REMA Healthcare Resource Management

Overview

Containing costs and allocating funds is a complex task requiring the input of various fields of expertise. Sometimes the choices to be faced are straightforward, but usually they are complicated and difficult to comprehend. Nevertheless, the problems will have to be resolved. Decisions can be made implicitly, e.g., by having a consensus meeting and using the experience and knowledge available to establish the best option. Or, decisions can be made explicitly, incorporating and weighing all relevant issues.

The latter requires some form of decision modelling.

Purpose and objectives

The resource management decision support system is based on sharing common models and knowledge from health economics, decision analysis, probability theory, epidemiology, and clinical praxis, all formalised through a set of common ontologies organised in a medical, cost, and organisational ontology.

The HC-REMA toolset allows the user to substitute general decision models for resource management with application specific data in order to get an application tailored model to be used in the user’s own domain, whether it is adaptions to different sites and countries or to different application area. The toolset also provides the users with instruments to browse and edit ontologies and to share the knowledge in a collaborative way. By using the web technology, the tools are platform independent and are available internationally through the Internet.

The project focuses on applications such as therapy assessment, trail and screening scheduling, and instrument purchase. Several user settings are anticipated such as bedside planning, strategic planners and academic knowledge accumulation.

The HC-REMA tools are designed to show the following characteristics:

1. Support of "dynamic" economic evaluation, i.e. decision-support models will be able to "learn and adapt themselves" through the appropriate links to distributed databases.
2. Support of a model-based approach to the development of knowledge-intensive applications for economic evaluation: generic problem solving models and ontologies for economic evaluation will be operationalised by instantiating them with domain-specific knowledge and, if needed, interfaced to additional, application-specific software components.
3. Support for the development of multi-agent applications, enabling different classes of health professionals to share knowledge and produce economic evaluation collaboratively.
4. Facilitate interpretation and transfer of the result of economic evaluation to different settings, with every developed model built on top of a common ontology.

Results

1. The project has established a set of general ontologies, a medical, a cost and an organizational ontology as a common framework for the HC-REMA tools. For some of the selected applications the mapping between the general ontologies and the domain specific ontology has been established.
2. The architecture of WebOnto, a Web-based collaborative environment for browsing and editing ontological and cost-effectiveness (CE) models has been specified and the first versions have been implemented and tested in a limited environment. This tool focuses on the first two characteristics.
3. The implementation of WebEET, an Economic Evaluation Tool, which has been designed as a "service" delivered through the internet able to provide a decision support to different health care decision makers in building meta-model-based decision support systems. This tool focuses on the three first characteristics.
4. The project has designed an interface for handling synchronous and asynchronous dialogues over the web, Tadzebao, (which means "Big Character Poster" in Chinese). The Java client for this tool has been constructed. The implementation work is in progress. These tools focus on the last two characteristics.
5. Test sites and applications have been identified. Complex application specific prototypes for the decision support systems being tested have been compared with the generic decision models supported by the HC-REMA team. The cost-effectiveness components seem to map sufficiently in the case of TREAT, a system for antibiotic therapy.

List of deliverables

Year 1

• D 3: Functional Specifications (delivered month 7 - public)
• D 2 HC-REMA Final Conference notes

Year 2

• D 4 Economic Evaluation Tool
• D 5 Cost Evaluation Tool Design
• D 6 Knowledge Acquisition and Visualization Tool
• D 7 Demonstration Phase Results
• D 8 Exploitation Plan

List of participants

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