Why Johnny Can't Reengineer Health Care Processes  
with Information Technology 

Charles Webster, MD, MSIE, MSIS, Sean McLinden, MD, and Kathleen Begler, RRA 

Department of Health Information Sciences*, Duquesne University, Pittsburgh, Pennsylvania 15282, USA 

*Renamed Health Management Systems in 1995. 

Presented at MEDINFO'95 and published in MEDINFO'95 Proceedings. 
R.A.Greenes et al. (editors), pp1283-1287. 

Many educational institutions are developing curricula that integrate computer and business knowledge and skills concerning a specific industry, such as banking or health care.We have developed a curriculum that emphasizes, equally, medical, computer, and business management concepts. Along the way we confronted a formidable obstacle, namely the domain specificity of the reference disciplines. Knowledge within each domain is sufficiently different from other domains that it reduces the leverage of building on preexisting knowledge and skills. We review this problem from the point of view of cognitive science(in particular, knowledge representation and machine learning) to suggest strategies for coping with incommensurate domain ontologies. These strategies include reflective judgment, implicit learning, abstraction, generalization, analogy, multiple inheritance, project-orientation, selectivity, goal- and failure-driven learning, and case- and story-based learning.

Survey of Medical, Computer, and Business Subdomains 
that led to Health Management Systems Curriculum
(Adapted from Figure 1)

Health Management Systems Curricular Architecture
Combining Subdisciplines and Depicting Pathways
(Adapted from Figure 2)