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35
As We May Work: An Approach Toward Collaboration on the
NII
Marjorie Greene
First Washington Associates
Abstract
An approach is introduced for information sharing and retrieval
on the national information infrastructure (NII) that focuses on
the communications paths between collaborative organizations in a
telecommunications network rather than upon the content of the
information that is stored in distributed databases. Direct
connections between domains of information are classified in the
form of trails through the network where they can be retrieved and
shared in natural language. An application of the approach in
shared health care systems is discussed.
The ability to connect to global networks and
communicate with millions of people has made every user a publisher
… but just as important, it has made every user an editor,
deciding what's important and real. In this medium, you get the
filter after the broadcast.
—Paul Saffo, Institute for the Future
Our technologies [will] become more a medium for
designing how we should work together, rather than merely designing
how we share our information.
—Michael Schrage
Statement of Problem
Contemporary organization theories have suggested that
interorganizational networks developed to coordinate activities
across organizational boundaries will become the "new institution"
of the future. Not only will these networks be important mechanisms
for providing superior economic performance and quality but they
will also survive, largely because of their "adaptive
efficiencies"—that is, because they have the ability to adjust
more rapibly to changing technology and market conditions, to
produce more creative solutions, and to develop new products and
services in a shorter period of time (Alter and Hage, 1993).
Public institutions such as schools, hospitals, libraries,
social service organizations and state and local governments are
also beginning to work together to provide their own services more
efficiently, and they view the NII as an important tool for
enhancing their efforts. These institutions will serve as catalysts
for further developing the NII and will ultimately create the
demands for the private sector's vision of an information
superhighway that offers more practical services that address a
growing and demographically shifting population.
There are, however, formidable barriers to the deployment of the
technologies used in collaborative networks. The recent White House
Mini-Conference on Aging highlighted a major problem when it
pointed out the need for "a standard protocol linking national,
local, 'on-line,' off-line, public, non-profit and private
databases" in delivering services to the elderly. "Differing
classification schemes, confusing terminology, and lack of
'info-glut' screening mechanisms" are limiting access to
information and preventing the effective delivery of integrated
care (''Accessing Eldercare via the Information Highway,"
1995).
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The vision of linkages between users of patient information
within communities in which each health care facility and
practitioner would connect to a network through an information
system is greatly hindered by the inability to create, store,
retrieve, transmit, and manipulate patients' health data in ways
that best support decision making about their care. This is the
problem that is addressed in this white paper. It is hoped that the
approach presented here for information classification and
retrieval through the NII will lead to further investigation of its
potential.
Related Initiatives
Community Networks
Several efforts are already under way to promote the widespread
use of advanced telecommunications and information technologies in
the public and nonprofit sectors, especially at the community
level. (See, for example, the U.S. Department of Commerce National
Telecommunications Information Administration/TIIAP initiatives.)
The private sector is also beginning to explore the use of
information technology in community networks, including those
designed to support and enhance collaboration among health and
human services providers (Greene, 1995). Eventually, a system of
"global, shared care" is expected to evolve in which the
coordinated activities of different people from different
institutions will apply different methods in different time frames,
all in a combined effort to aid patients medically,
psychologically, and socially in the most beneficial ways. Because
the ability to move data is considered fundamental to the process
of integrated care, attempts have been made to find cost-effective
ways to share data among the participants. However, this approach
has been fraught with difficulties that are largely unrelated to
the ability of the technology to provide solutions. Questions of
ownership, confidentiality, responsibility for health outcomes, and
semantics are paramount, and clinicians are themselves calling for
new solutions that do not require "knowledge" to be formalized,
structured, and put into coding schemes (Malmberg, 1993).
The European Approach
Many Europeans have also recognized that one of the major
problems in designing the shared care system is management of the
communications process among the different institutions and health
care professionals. They are taking a different approach and
conducting field studies to evaluate the feasibility of using
patient-owned, complete medical record cards, which patients would
carry with them and present to the institution carrying out the
treatment. Although they reconize the importance of natural
language processing and the potential of optical-storage technology
to reduce costs, they conclude that the technology will only be
available within the respective information systems that contain
medical records and that new solutions such as the chip card of the
hybrid card must be found in order to extend communication to all
health care providers (Ellsasser et al., 1995).
The Digital Library
Information sources accessed through the NII also represent
components of emerging universally accessible, digital libraries.
The National Science Foundation, in a joint initiative with the
Advanced Research Projects Agency and the National Aeronautics and
Space Administration, is supporting research and development
designed to explore the full benefits of these libraries, focusing
on achieving en economically feasible capability to both digitize
existing and new information from heterogeneous and distributed
sources of information and to find ways to store, search, process,
and retrieve this information in a user-friendly way (National
Science Foundation, 1994). It has been suggested, however, that
"for digital libraries to succeed, we must abandon the traditional
notion of 'library' altogether.… The digital library will be
a collection of information services; producers of material will
make it available, and consumers will find and use it" (Wilensky,
1995). New research is needed
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that is fundamental to the development of advanced software and
algorithms for searching, filtering, and summarizing large volumes
of data, imagery, and all kinds of information in an environment in
which users will be linked through interconnected communications
networks without the benefit of preestablished criteria for
arranging content.
Vannevar Bush and the New
Technologies
The concept of a dynamic, user-oriented information system was
introduced as early as 1945, when Vannevar Bush suggested that an
individual's personal information storage and selection system
could be based on direct connections between documents instead of
the usual connections between index terms and documents. These
direct connections were to be stored in the form of trails through
the literature. Then at any future time the individual or a friend
could retrieve this trail from document to document without the
necessity of describing each document with a set of descriptors or
tracing it down through a classification scheme (Bush, 1945).
In 1956, R.M. Fano suggested that a similar approach might prove
useful to a general library and proposed that documents be grouped
on the basis of use rather than content (Fano, 1956). This
suggestion was followed 10 years later by a pioneering contribution
of M.M. Kessler at the MIT Technical Information Project, who
developed a criterion for such grouping of technical and scientific
papers through "bibliographic coupling," in which two scientific
papers cite one or more of the same papers (Kessler, 1965). This
concept of bibliographic coupling has been extended to other types
of coupling and refined to the present day, largely through
computer-based techniques that identify sets of highly interrelated
documents through "co-citation clustering" (Garfield, 1983).
Although it was recognized that the model of "trails of
documents" as suggested by Dr. Bush 50 years ago had useful
features that the subsequent partitioning models did not offer,
research has not been conducted on its potential for classification
and retrieval in modern communications networks. Perhaps this would
be a good time to revisit the concept, especially as traditional
computer-based systems are merged with communications systems in a
network of networks such as the NII. And because citation
characteristics are an indication of how scientific doctrine is
"built," we might want to combine the idea of trails of documents
(represented as "communications paths") with sets of documents
(represented as "domains of information") into a more general model
that can be used for both classification and retrieval of
information. Such a model has been developed for military "command
and control'' and is presented here for further consideration by
the NII community.
Analysis
Message traffic among higher-echelon commands during the early
part of a crisis situation is extremely difficult to classify. This
is because such communications do not generally fall into
categories that deal with specific predetermined military tasks,
but instead are much less precisely defined, less routine, and
consist primarily of the exchanges of information along with
recommendations, advice, and other messages that are necessary
before any tactical systems can be put into effect. By the same
token, these communications are difficult to retrieve in any
formatted sense because the unexpected, evolving, and
interdependent nature of the information places an even greater
emphasis upon natural language communication.
In an attempt to avoid the inadequacies inherent in any
classification system while at the same time recognizing that as
the amount of available information grew there was a parallel need
for a more precise way to retrieve specific data, a technique was
developed for associating messages with each other that required no
interpretation of the subject content of the messages (Greene,
1967). This technique is based upon the thesis that if a message
referenced a previous message, the previous message must have
influenced that message in some way. For example, a message might
say, "This is in answer to your question in reference A." Often a
message referenced a previous message that referenced a yet earlier
message. Still other connections of messages through their
references are possible.
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In Figure 1, if each number represents a message and if an arrow
from 2 to 1 means 2 referenced 1, then we can interpret Figure 1 as
follows: message 2 references message 1, message 4 references
message 2 but also references message 3, and message 5 is another
message that references message 3. Thus, we can speak of a
"reference-connected" set of messages S = (1, 2, 3, 4, 5)—that
is, a set of messages that are connected in any way through their
references. (This concept is analogous to the one of "joining" in
directed graph theory.)
Figure 1
A reference-connected
set of messages.
It is noted that in Figure 1, messages 4 and 5 are
"bibliographically coupled." Another type of coupling occurs if two
papers are cited by one or more of the same papers (e.g., 2 and 3).
And finally, there is the simple citation relationship between 1
and 2, 2 and 4, 3 and 4, and 3 and 5. These three basic types of
reference connectivity have been used as separate partitioning
criteria for retrieval systems in the past. However, they have not
been combined into a single dynamic system for both classification
and retrieval, nor have they been used to link databases for
interorganizational collaboration, as this white paper
suggests.
It was found that during the early part of a crisis situation
when messages throughout the command structure and in different
locations were put into reference-connected sets, these sets in
most cases uniquely identified particular events during the crisis.
For example, one set that was constructed from crisis-related
message traffic found in files at three command headquarters
contained 105 distinct messages that dealt with the preparations
for landing airborne troops. Other sets of messages represented the
communications related to other events such as the provision of
medical supplies, the preparation of evacuation lists, and sending
surgical teams. All of these events were represented by unique
message sets in the investigated files of crisis-related
traffic.
Reference-connected sets proved to be valuable tools in analyses
of command information flow as well as of the operations they
describe. Deficiencies in flows and use of information were much
more easily identified when focus was placed upon a specific event
represented by communications throughout an entire command
structure. The natural application of these sets to information
retrieval was also noted because it was possible to file messages
automatically into appropriate message sets by noting only the
references that were given. These sets then represented events
during a crisis and were available for answering queries regarding
their status. Predetermined subject categories were not required,
nor were any restrictions placed upon the format of the messages.
The method simply provided a way of quickly locating a message that
had the information (as it was expressed in natural language) that
was necessary to make a decision.
Automatic Classification
A simple filing method was used in the analysis for
automatically classifying messages into reference-connected sets.
If a message referenced a previous message, it was put into the
file of the previous message. So, for example, in Figure 2, message
2 would be filed with message 1 because it referenced message 1.
Message 3 does not reference a previous message and would thus
begin a new file 2. However, message 4 referenced messages in both
files and therefore connected the two. Two subsets were identified
in this way. One subset (assigned the number 1) contained messages
1, 2, and 4. The other subset (assigned the number 2) contained
messages 3, 4, and 5. Message 4 is the link between them and, in
the language of directed graph theory, may be considered to be a
linking point between two maximal paths in the semipath from
message 1 to message 5.
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Figure 2
Automatic classification of a reference-connected set.
The structure of a reference-connected set identifies subsets
(as in the preceding section) that can be interpreted in a number
of ways. For example, it is noted that a subset will occur only if
there is a message within the set (such as 3 in Figure 2) that does
not reference a previous message but that is eventually linked to
the set. Such a message may begin a "new" event that eventually
becomes related in some way to the earlier event initiated by
message 1. However, the structure of a reference-connected message
set is also a function of another important factor—the
organizational chain-of-command and the distribution of information
throughout this chain. For a message cannot reference a previous
message unless its author is cognizant of the previous message.
Consequently, the paths in a reference-connected set (and thus the
corresponding subsets) will often reflect the information flow
between specific commands although the event is essentially the
same.
It is easily seen that this model can be extended and adapted to
other interorganizational networks in which information is
exchanged to meet a common goal, such as provision of health care.
The application of the model also becomes more complex as
additional nodes are included and multiple addressees are allowed.
Nevertheless, two important characteristics should be noted that
illustrate this model's potential in supporting the collaborative
process:
•
The subsets of a reference-connected set often
correspond operationally to the sets of messages received at
various nodes for the same event and therefore define "domains of
information" stored and processed at each node in the network for
that event or, in the case of health care, patient episode. (This
concept can be pursued further in order to address concerns about
excessive centralization in integrated systems, to protect patient
privacy, and to measure the benefits of collaboration—i.e.,
health outcomes—in terms of the costs assumed by individual
participants. These are all potential advantages of this approach
when applied to health information networks.)
•
Rules of referencing could be established that
would guarantee that certain sets and subsets would appear. For
example, if each node in the network has a record (through the
references) of all previous communications dealing with an event,
all of the messages would automatically form a reference-connected
set at each node even though all of the messages were not processed
at every node. (Again, there are advantages here for social service
agencies that would like to "track" clients without sacrificing
client confidentiality or losing control over their own
administrative processes.)
Conclusion and Recommendations
In a medium in which "the filter comes after the broadcast" and
in which users everywhere have direct access to the full contents
of all available material, finding information will be a key
problem. How can a classification system be developed for a
communications-based system in which the unexpected, evolving, and
interdependent nature of the information places even greater
emphasis on natural language? New approaches will have to be found
that avoid both the problem of describing the content of
information and the problem of integrating new information into a
predetermined classification code. The collaborative networks of
the future will focus on information flows. They will lead to
dynamic user-oriented information retrieval systems that are
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based on communications paths and direct connections between
distributed information sources rather than upon technologies that
mechanically or electronically select information from a store. New
paradigms of interaction appropriate for multimedia distributed
systems will be the focus of new technologies, and automated,
intelligent search agents will be found that help consumers as well
as providers to find and use what is important and real.
New technologies, combined with the concept of
reference-connected sets, may offer another potential solution to
the management of the communications process among different
institutions in collaborative networks. Future research on
community networks should be focused on the operational level
rather than the administrative level by linking users of
information from the "bottom up" and by searching through
communications paths rather than through the content of the
information that is stored in distributed databases. This would
give communities an opportunity to assess the role of the NII
without large investments in technology and would allow
participating organizations to gain the economic benefits of the
network only in so far as there is a need to collaborate.
An approach is presented here that does not attempt to guide
users through the vast domains of information that will be
available through the NII. Instead, it helps them to find quickly
the others user within their community of interest that may have
the information they are seeking. This approach could provide the
protocol needed to link national, local, "on-line," off-line,
public, nonprofit, and private databases for increased access to
collaborative networks. It could also enable providers of health
and human services to work together to aid patients medically,
psychologically, and socially in the most beneficial ways. It is a
tempting approach
References
"Accessing Eldercare via the Information
Highway: Possibilities and Pitfalls," a 1995 White House
Mini-Conference on Aging, March.
Alter, C., and J. Hage. 1993.
Organizations Working Together. Sage
Bush, Vannevar. 1945. "As We May Think,"
Atlantic Monthly 176(1):101–108.
Ellsasser, K-H., Nkobi, J., and Kohler,
C.O. 1995. "Distributing Databases: A Model for Global, Shared
Care," Healthcare Informatics, January.
Fano, R.M. 1956. Documentation in Action,
Chapter XIV-e, pp. 238–244, Reinhold Publishing Corporation,
New York.
Garfield, E. 1983. Citation
Indexing—Its Theory and Application in Science, Technology,
and Humanities. ISI Press, Philadelphia.
Greene, M.J. 1967. "A Reference-Connecting
Technique for Automatic Information Classification and Retrieval,"
Research Contribution No. 77, Operations Evaluation Group, Center
for Naval Analyses, The Franklin Institute, March.
Greene, M.J. 1995. "Assessing the
Effectiveness of Community Services Networks in the Delivery of
Health and Human Services: An Economic Analysis Model," research
conducted under HRSA Contract No. 94-544 (P), March.
Kessler, M.M. 1965. "Bibliographic
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Malmberg, Carl. 1993. "The Role of
Telematics in Improving the Links Between Primary Health Care
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National Science Foundation, Digital
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Representative terms from entire chapter:
natural language
