patient’s culture, learning style, value system, education, and life experience, remains beyond the current state of today’s science and would fit into Quadrant 4.

Other examples of technology-related research efforts in each of the four quadrants are provided below:

  • Quadrant 1 (General—applied efforts). Adaptation of existing IT and process solutions from other domains and industries, e.g., process and data integration technologies, human-computer interaction technologies, ubiquitous networking technologies, security, search, blogging, and social networking.

  • Quadrant 2 (Health care—applied efforts). Identification of the best examples of coupled health care improvement and health care IT that have been successfully deployed or prototyped, followed by wide deployment of those examples. Use of existing data and process standards to obtain low-hanging fruit, e.g., portals, electronic messaging, disease management dashboards, decision support and reminders, process automation, and so on.

  • Quadrant 3 (General—advanced efforts). Invention of new information technologies that are needed in health care, such as ontology management, systems that help to explain why decisions are made, large-scale machine learning, voice technologies, natural language processing, privacy management for access and data mining, and so on.

  • Quadrant 4 (Health care—advanced efforts). Specific advanced work on advanced ontologies and reasoning in the medical domain, modeling of the human body and the virtual patient, interpretation of medical information to different communities, approaches to learning and improving data quality, aggregation of patient health care information into a trustworthy database with explicit representation of uncertainty [C4O17, C5O23]), and so on.

5.1
AN OVERARCHING RESEARCH GRAND CHALLENGE: PATIENT-CENTERED COGNITIVE SUPPORT

Patient-centered cognitive support emerged as an overarching grand research challenge during the committee’s discussions. This section discusses how a research agenda might be assembled, together with representative research challenges, to illustrate the magnitude of the opportunity.

Much of health care is transactional—admitting a patient, encountering a patient at the bedside or clinic, ordering a drug, interpreting a report, or handing off a patient. Yet transactions are only the operational expression of an understanding of the patient and a set of goals and plans for that patient. Clinicians have a “virtual patient” in mind—a conceptual



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