Electronic ego (EE) of a participant is the agent that represents her. In the EE approach, the participation of human experts and other individuals is represented as agents. EE contains both data and behavior of the participant. Behavior here refers to the collection of activities, and the precedence relationships that describe how the participant will accomplish the business outcome. For knowledge intensive processes, the behavior is usually not predefined. The behavior evolves as the human participants learn more about the business problem.
The concept of EE will be explained through an example from the healthcare domain. The advantages of this approach for performing process reengineering will be outlined.
Examples of such processes include: creation of proposal that involves a team of individuals with complementary skills; creation of a design of a complex artifact that involves experts from various fields; and evaluation of an investment proposal by a team of venture capitalists.
The proposed EE approach focuses on the participants, as opposed to the business artifacts. Each participant creates its EE and encodes (programming of the EE is done through a graphical user interface that replicates the environment that the participant is familiar with) in it the activities that she would like to perform in order to achieve the business outcome. In the beginning, when an EE is created, the collection and the order of activities encoded in the EE are generic and high level. As more information is gathered and the participant has a better understanding of the problem, the generic activities are specialized and details are added to the behavior of EE. This is done by the participant explicitly or done automatically by the EE itself based on context.
The objective of the EE approach is to have the participants be involved in only those activities in which their roles are indispensable, and have their EEs perform all the other activities for the participants. To illustrate this I will present in sequel a healthcare example.
Picture a Healthcare Information System (HIS) comprised of EEs of all the stakeholders--consumers, employers, insurance companies, government, all types of healthcare providers, and pharmacies. This new healthcare information system is essentially a manifestation of the emergent behavior of the interactions between agents that represent the self interest of their masters. Let me illustrate this briefly through the following example. Patient goes to a medical facility and swipes his medical card, and this creates patientØs EE (pEE) in the HIS. pEE now contains data (the medical ID of its master) and a program. The program mimics the activities that the patient will do or will be done to the patient. At the outset the program is a generic high-level process which includes check-in, scheduling of resources (nurse, labs, and physician), collection of information, diagnosis, treatment, and discharge.
The first interaction of pEE is with check-in's EE (cEE). cEE contains a program which executes the process: obtain medical ID from pEE; determine type of insurance; decide whether to accept the patient; if yes, then obtain the address of database that contains patientØs historical medical record and pass it on to pEE. Next the pEE interacts with the scheduler's EE (sEE). sEE takes information about resources to schedule for pEE and computes a schedule. This schedule is communicated to the pEE, which takes it to its master for review. After acceptance, the sEE informs the resources that pEEs master has been scheduled.
Lets skips some steps and join the patient by the patient's hospital bed side. The patient has been assigned a team that consists of a nurse, PCP, specialists, pharmacist and others. The team has an EE, and so do each of the other team members.
The patient is connected to several instruments that are monitoring the vital signs. All this information is sent to the pEE. The pEE has been programmed by the team to look for deviations from a band. Whenever there is a deviation, it alerts the team EE, which alerts an appropriate EE. Figure 1. Patient's electronic ego interacts with the healthcare team's EE (tEE), and the tEE is composed of various EEs.
Lets consider the following situation. The team meets once every day to discuss the status, progress, and changes to the planned treatment. Each EE is a manifestation of all the activities that it s master does, and how the master does them. The PCP discovers that the patient's treatment plan is not effective, so he requests the pcpEE to search through the medical literature and find similar cases, associated treatment plans and outcomes. After analyzing the information retrieved by the pcpEE, the PCP proposes that an experimental medication be tried. PCP enters this into his EE which communicates with the pharmacist's EE. The pharmacist takes note of this and asks its EE to compute any interactions the proposed medication will have with other medications that the patient is currently taking. In the meantime, the PCP an d the specialists are discussing recovery of the patient and conclude that the patient be discharged at a later date than planned. The scheduler's EE takes this information and modifies the room schedule, but discovers that the extension conflicts with PCPØs scheduled vacation.
Let me stop the example here and recap. EE based healthcare information system is patient focused. The complete historical medical record is in one place, and not distributed in various departments. Quality is improved because all the mundane tasks are taken care of by the EE, and the personalized EEs are programmed by participants to create an electronic environment that facilitates filtering and organization of information, and retrieval of knowledge. Costs are reduced because most of the administrative tasks have been eliminated or automated, duplicate tests and unnecessary treatment & medication are removed because the team works together and has the most updated information, and the team members spend more time improving the care provided to the patient and less time sifting through information or doing administrative tasks.
Examples of the functionality of EEs of other stakeholders include: healthcare provider's EEs manage functions like scheduling of resources, billing, check-in, and care paths; an insurance company's EEs manage functions like claims processing, monitoring performance of healthcare providers, and negotiating rates with employers.
The EE approach provides a natural method for modeling the complex interactions between stakeholders in the healthcare environment. We have built a demonstration prototype of clinical aspects of this healthcare example using Carnot's ESS and Rosette.
In knowledge intensive group processes, the EE approach allows each participant to automate all the mundane tasks, and focus only on the value-added tasks. In this approach each participant is assigned a role in the process, and how the participant chooses to accomplish the role is left up to her. This empowered environment relies on the creativity of the participants to improve the process. In the following paragraphs I will describe a specific method for implementing such an empowered environment.
Imagine a market-oriented model for compensating the participants. In such a model, there is a new participant--the process manager--in addition to all the participants described before. The process manager defines the process objectives. Getting back to the healthcare example, let me illustrate what a process manager would do in a hospital. Lets assume that the objectives are to minimize (a) time that a patient spends in the healthcare facility and (b) time to recovery of the patient. The first objective targets non-value added time, like waiting to register, waiting for a clinician, waiting for reports or X-rays to arrive, etc. The second objective targets effectiveness of care provided, in this example, measured by the speed of patient's recovery. Depending on the final diagnosis, the targets for the two time goals are defined. The scheduler is rewarded on how little time the patient had to wait during the entire encounter, the administrators will be rewarded based on how swiftly the administrative tasks were done, and the clinician's will be rewarded based on how fast the patient recovered.
The market-oriented approach combined with the EE based architecture empowers the participants to reengineer the process of accomplishing the business outcome.