gfn healthcare, inc.
P.O. Box 90363
Pittsburgh, PA 15224-0863 USA
v: (412) 362 1334
f: (412) 36F-ELIX
Health care/health services
Innovative or improved ways of doing things; More equitable access to technology or electronic information; Local commitment to network- based activities; Partnerships between public and private sector
Supporting Documentation (contact author for more information):
Video; Software; Documentation
Internet Applications to Health Care Quality and Efficiency The FELIX Tool for Business Re-engineering
Business process re-engineering has yet to attack problems in the health care industry. Key among the many reasons why this is true is the nature of hospitals, which were built from a collection of independent clinical specialists. Frequently, these independent entities create a duplicity of process and collision of information which interferes with the quality and efficiency of the care of the patient.
Health care reform (true reform, not political reform), involves the shift from practice-oriented clinical practice to community-oriented health care. Many hospitals have yet to recognize that this profound change in health care emphasis must occur. Many others have comprehended, but are stuck with a management and information infrastructure which is incapable of managing the necessary changes to produce a lean organization tuned to health care community. Key to the management of patients is the management of information flows and processes which characterize the patient care environment.
FELIX was born out of this environment of chaos and change. Designed by a team of clinicians, administrators, information scientists, and industrial engineers, FELIX evolved from its roots as a patient management system into a tool to promote controlled organizational change.
What is FELIX?
FELIX is multimedia information authoring and management tool designed to facilitate the sharing of complex patient and process information across networks. Using the X windowing system, a high- level application scripting language, and standards for networked information interchange, FELIX provides an electronic bridge to sources of information distributed over many sites on a network. Unlike typical network browsers and wide area information systems, FELIX allows the user to integrate these sources into a single, coherent, framework for presentation and manipulation based on the concept of a virtual structured document.
FELIX is not just a technology. Instead, it is the articulation of many real- world social constructs into an electronic representation that allows the user to visualize the relationships between information and information sources. Through FELIX, the user can discover not only information, but also the process by which this information was created. This facilitates organizational self-discovery, one of the first steps toward empowering users to contribute meaningful changes to the organization.
Implementation of FELIX was begun following frustrated attempts to begin business process re-engineering using discussion groups and the Delphi method. It was found, by the FELIX developers, that while most members of the clinical community were open to change and learning, organizations provided little incentive for them to undertake this arduous process.
FELIX is the carrot and the stick to just such organizations. By providing interactive graphical metaphors coupled to standard business applications such as calendar management and scheduling, electronic mail and messaging, and document creation and management, we were able to enlist the support of the organization in a process which was, otherwise, regarded as tedious and of a low priority.
FELIX was influenced by many practical demonstrations of social computing, including the Andrew system at Carnegie Mellon University, the World Wide Web, WAIS, and the University of Minnesota Gopher, USENET news and the Multipart Internet Mail Extensions (MIME).
The FELIX user interface was based on work done at the Software Engineering Institute (CMU Serpent), the University of California at Berkeley (TCL), Brown University (FIELD and Intermedia), the University of New Mexico (KHOROS), and Stanford University (Interviews). The information browser combines visual programming metaphors (a la KHOROS and NeXTStep) with a semantic network which describes the organizations functional areas, processes, and the interconnectedness of these to the outside world.
The original work on FELIX was begun at the University of Pittsburgh Medical Center, continued at Carnegie Mellon University, but was first realized at Shadyside Hospital, a 474-bed academic urban referral center. Continued work on FELIX is being done at Duquesne University (Pittsburgh) and by gfn healthcare, inc., a not-for-profit partnership. Wide area information sharing using FELIX and the Internet was the motivation for the establishment of the Pittsburgh community-oriented SMDS trial network which involved CMU, the University of Pittsburgh, Shadyside Hospital, the Pittsburgh Supercomputer Center, and IBM. This trial was the first of its kind in the United States as it involved inter- rather than intra-agency networking.
FELIX is standards-based, and designed to be affordable and portable. It is designed for network operation using the Internet as a model for global networking. FELIX is scalable, so that the same metaphors can be used in a system at home or in the private office as in the large hospital. Problem tracking and trouble shooting in FELIX is accomplished by advanced messaging services between the client user and a system architect connected via the Internet.
Who developed FELIX?
FELIX was developed in an academic urban referral hospital by a team of people described in the introductory paragraphs. Although it is a system still in development, FELIX is not an experimental architecture or a model. It was designed to manage real patient care processes and real clinical process information. The FELIX design team includes Charles W. Webster, MD, Xiofeng Wang, MS, Andrew K. Pople, Roseanne K. Silva, MSIN, and Sean McLinden, MD.