research-article

POP-PL: a patient-oriented prescription programming language

Authors:

Spencer P. Florence,

Bruke Fetscher,

William H. Temps,

Tina Kiguradze,

Dennis P. West,

Charlotte Niznik,

Paul R. Yarnold,

Robert Bruce Findler,

Steven M. BelknapAuthors Info & Claims

GPCE 2015: Proceedings of the 2015 ACM SIGPLAN International Conference on Generative Programming: Concepts and Experiences

Pages 131 - 140

https://doi.org/10.1145/2814204.2814221

Published: 26 October 2015 Publication History

Abstract

Medical professionals have long used algorithmic thinking to describe and implement health care processes without the benefit of the conceptual framework provided by a programming language. Instead, medical algorithms are expressed using English, flowcharts, or data tables. This results in prescriptions that are difficult to understand, hard to debug, and awkward to reuse. This paper reports on the design and evaluation of a domain-specific programming language, POP-PL for expressing medical algorithms. The design draws on the experience of researchers in two disciplines, programming languages and medicine. The language is based around the idea that programs and humans have complementary strengths, that when combined can make for safer, more accurate performance of prescriptions. We implemented a prototype of our language and evaluated its design by writing prescriptions in the new language and administering a usability survey to medical professionals. This formative evaluation suggests that medical prescriptions can be conveyed by a programming language's mode of expression and provides useful information for refining the language. Analysis of the survey results suggests that medical professionals can understand and correctly modify programs in POP-PL.

References

[1]

Salman Ahmad, Alexis Battle, Zahman Malkani, and Sepandar D. Kamvar. The Jabberwocky programming environment for structured social computing. In Proc. User Interface Software and Technology (UIST), pp. 53–64, 2011.

Digital Library

[2]

Apple Computer, Inc. Hypercard Script Language Guide: The Hypertalk Language. Addison-Wesley, 1988.

Digital Library

[3]

Daniel W. Barowy, Charlie Curtsinger, Emery D. Berger, and Andrew McGregor. AUTOMAN: a platform for integrating human-based and digital computation. In Proc. Object-Oriented Programming, Systems, Languages & Applications (OOPSLA), pp. 639––654, 2012.

Digital Library

[4]

SM Belknap, H Moore, SA Lanzotti, PR Yarnold, M Getz, DL Deitrick, A Peterson, J Akeson, T Maurer, RC Soltysik, GA Storm, and I Brooks. Application of software design principles and debugging methods to an analgesia prescription reduces risk of severe injury from medical use of opioids. Nature: Clinical Pharmacology & Therapeutics 84(3), pp. 385––392, 2008.

[5]

Steven M. Belknap. The Chicago Kinetic Simulator. The Mathmatica Journal 1, pp. 68–86, 1991.

[6]

Chrisian J. Callsen and Gul Agha. Open heterogeneous computing in ActorSpace. Journal of Parallel and Distributed Computer 21, pp. 289– 300, 1994.

Digital Library

[7]

Committee on Identifying and Preventing Medication Errors. Preventing medication errors: Quality chasm series. National Academies Press, 2007.

[8]

Maria Cvach. Monitor alarm fatigue: An integrative review. Biomedical Instrumentation & Technology 46, pp. 268––277, 2012.

[9]

R Filik, K Purdy, A Gale, and D Gerret. Labeling of medicines and patient safety: evaluating methods of reducing drug name confusion. Human Factors 48(1), pp. 39–47, 2006.

[10]

Matthew Flatt and PLT. Reference: Racket. PLT, TR-1, 2010. http:// racket-lang.org/tr1/ David M. Gaba, Mary Maxwell, and Abe DeAnda. Anesthetic mishaps: breaking the chain of accident evolution. Anesthesiology 66(5), pp. 670– 676, 1987.

[11]

Patrice M. Healey and Edwin J. Jacobson. Common Medical Diagnoses: An Algorithmic Approach. Saunders, 1994.

[12]

Carl Hewitt, Peter Bishop, and Richard Steiger. A universal modular ACTOR formalism for artificial intelligence. In Proc. International Joint Conference on Artificial intelligence (IJCAI), pp. 235–245, 1973.

Digital Library

[13]

Richard Hillestad, James Bigelow, Anthony Bower, Federico Girosi, Robin Meili, Richard Scoville, and Roger Taylor. Can electronic medical record systems transform health care? potential health benefits, savings, and costs. Health Affairs 24(5), pp. 1103–1117, 2005.

[14]

John T. James. A new, evidence-based estimate of patient harms associated with hospital care. Journal of Patient Safety 8, pp. 122–128, 2013.

[15]

Jan Martin Jansen, Rinus Plasmeijer, Pieter Koopman, and Peter Achten. Embedding a web-based workflow management system in a functional language. In Proc. Language Descriptions, Tools and Applications (LDTA), 2010.

Digital Library

[16]

Spencer S. Jones, Robert S. Rudin, Tanja Perry, and Paul G. Shekelle. Health information technology: An updated systematic review with a focus on meaningful use. Annals of Internal Medicine 106(1), pp. 48– 54, 2014.

[17]

David A. Kindig. Some implications of patient-oriented health care. In Proc. Health Conference of the New York Academy of Medicine, 1971.

[18]

Ross Koppel, Metlay Cohen, Brian Abaluck, Russell Localio, Stephen E. Kimmel, and Brian L. Strom. Role of computerized physician order entry systems in facilitating medication errors. The Journal of the American Medical Association (JAMA) 293, pp. 1197–1203, 2005.

[19]

Christopher P. Landrigan, Gareth J. Parry, Catherine B. Bones, Andrew D. Hackbarth, Donald A. Goldmann, and Paul J. Sharek. Temporal trends in rates of patient harm resulting from medical care. New England Journal of Medicine 363, pp. 2124–2134, 2010.

[20]

Lucian L. Leape. Error in medicine. The Journal of the American Medical Association (JAMA) 272, pp. 1851–1857, 1994.

[21]

Bas Lijnse, Jan Martin Jansen, Ruud Nanne, and Rinus Plasmeijer. Capturing the netherlands coast guards SAR workflow with iTasks. In Proc. International Conference on Information Systems for Crisis Response and Management (ISCRAM), 2011.

[22]

Bas Lijnse, Jan Martin Jansen, and Rinus Plasmeijer. Incidone: A taskoriented incident coordination tool. In Proc. International Conference on Information Systems for Crisis Response and Management (ISCRAM), 2012.

[23]

Stuart B. Mushlin and Harry L. Greene II. Decision Making in Medicine (Third Edition). Mosby, 2010.

[24]

Mor Peleg, Aziz A. Boxwala, Omolola Ogunyemi, Qin Zeng, Samson Tu, Ronilda Lacson, Elmer Bernstam, Nachman Ash, Peter Mork, Lucila Ohno-Machado, Edward H. Shortliff, and Robert A. Greenes. GLIF3: The evolution of a guideline representation format. In Proc. American Medical Informatics Association (AMIA), pp. 645–649, 2000.

[25]

E. M. Schimmel. The hazards of hospitalization. Annals of Internal Medicine 60, pp. 58–63, 1964.

[26]

M Schubert, D Ausserhofer, M Desmedt, R Schwendimann, E Lesaffre, B Li, and S De Geest. Levels and correlates of implicit rationing of nursing care in Swiss acute care hospitals—a cross sectional study. International Journal of Nursing Studies 50, pp. 230–239, 2013.

[27]

Yuval Sharar, Silvia Miksch, and Peter Johnson. The Asgaard project: a task-specific framework for the application and critiquing of timeoriented clinical guidelines. Artificial Intelligence in Medicine 14, pp. 29–51, 1998.

[28]

Hardeep Singh, Shrinidi Mani, Donna Espadas, Nancy Petersen, Veronica Franklin, and Laura A. Petersen. Prescription errors and outcomes related to inconsistent information transmitted through computerized order entry: a prospective study. Archives of Internal Medicine 169, pp. 982–989, 2009.

[29]

Ian G. Stiell, R. Douglas McKnight, Gary H. Greenberg, Ian McDowell, Rama C. Nair, George A. Wells, Cristine Johns, and James R. Worthington. Implementation of the ottawa ankle rules. The Journal of the American Medical Association (JAMA) 271, pp. 827–132, 1994.

[30]

Samson W. Tu and Mark A. Musen. A flexible approach to guideline modeling. In Proc. American Medical Informatics Association (AMIA), pp. 420–424, 1999.

[31]

Washington Adventist Hospital. Weight-Based beparin orders. 2009.

[32]

https://extranet.adventisthealthcare.com/ LinkClick.aspx?fileticket=rroECsjCLnY%3D&tabid= 649&mid=1813 Paul R. Yarnold. How to assess inter-observer reliability of ratings made on ordinal scales: Evaluating and comparing the Emergency Severity Index (Version 3) and Canadian Triage Acuity Scale. Optimal Data Analysis 3, pp. 42–49, 2014.

[33]

Paul R. Yarnold and Robert C. Soltysik. Optimal Data Analysis: A Guidebook With Software for Windows. APA Books, 2004.

Digital Library

Cited By

Florence SYou STov JFindler R(2019)A calculus for Esterel: if can, can. if no can, no can.Proceedings of the ACM on Programming Languages10.1145/32903743:POPL(1-29)Online publication date: 2-Jan-2019
https://dl.acm.org/doi/10.1145/3290374
Voelter MKolb BBirken KTomassetti FAlff PWiart LWortmann ANordmann A(2019)Using language workbenches and domain-specific languages for safety-critical software developmentSoftware and Systems Modeling (SoSyM)10.1007/s10270-018-0679-018:4(2507-2530)Online publication date: 1-Aug-2019
https://dl.acm.org/doi/10.1007/s10270-018-0679-0
Li XFlatt MCombemale BMernik MRumpe B(2017)Debugging with domain-specific events via macrosProceedings of the 10th ACM SIGPLAN International Conference on Software Language Engineering10.1145/3136014.3136019(91-102)Online publication date: 23-Oct-2017
https://dl.acm.org/doi/10.1145/3136014.3136019
Show More Cited By

Index Terms

POP-PL: a patient-oriented prescription programming language
1. Applied computing
  1. Life and medical sciences
2. Software and its engineering
  1. Software notations and tools
    1. General programming languages
      1. Language types

Recommendations

POP-PL: A Patient-Oriented Prescription Programming Language

A medical prescription is a set of health care instructions that govern the plan of care for an individual patient, which may include orders for drug therapy, diet, clinical assessment, and laboratory testing. Clinicians have long used algorithmic ...
POP-PL: a patient-oriented prescription programming language
GPCE '15

Medical professionals have long used algorithmic thinking to describe and implement health care processes without the benefit of the conceptual framework provided by a programming language. Instead, medical algorithms are expressed using English, ...
Designing language-oriented programming languages
OOPSLA '10: Proceedings of the ACM international conference companion on Object oriented programming systems languages and applications companion

Today, language-oriented programming (LOP) is realized by using either language workbenches or internal DSLs, each with their own advantages and disadvantages. In this work, we design a host language for DSLs with language workbench features, thereby ...

Comments

Information & Contributors

Information

Published In

cover image ACM Conferences

GPCE 2015: Proceedings of the 2015 ACM SIGPLAN International Conference on Generative Programming: Concepts and Experiences

October 2015

184 pages

ISBN:9781450336871

DOI:10.1145/2814204

General Chair:
Christian Kästner
Carnegie Mellon University, USA
,
Program Chair:
Anirüddhā Gokhālé
Vanderbilt University, USA

ACM SIGPLAN Notices Volume 51, Issue 3
GPCE '15
March 2016
184 pages
ISSN:0362-1340
EISSN:1558-1160
DOI:10.1145/2936314
Editor:
Andy Gill
University of Kansas, Lawrence, KS
Issue’s Table of Contents

Copyright © 2015 ACM.

Permission to make digital or hard copies of all or part of this work for personal or classroom use is granted without fee provided that copies are not made or distributed for profit or commercial advantage and that copies bear this notice and the full citation on the first page. Copyrights for components of this work owned by others than the author(s) must be honored. Abstracting with credit is permitted. To copy otherwise, or republish, to post on servers or to redistribute to lists, requires prior specific permission and/or a fee. Request permissions from [email protected].

Sponsors

SIGPLAN: ACM Special Interest Group on Programming Languages

Publisher

Association for Computing Machinery

New York, NY, United States

Publication History

Published: 26 October 2015

Permissions

Request permissions for this article.

Request Permissions

Check for updates

Author Tags

Qualifiers

Research-article

Conference

GPCE'15

Sponsor:

SIGPLAN

GPCE'15: Generative Programming: Concepts and Experiences

October 26 - 27, 2015

PA, Pittsburgh, USA

Acceptance Rates

Overall Acceptance Rate 56 of 180 submissions, 31%

Contributors

Other Metrics

View Article Metrics

Bibliometrics & Citations

Bibliometrics

Article Metrics

7
Total Citations
View Citations
163
Total Downloads

Downloads (Last 12 months)6
Downloads (Last 6 weeks)0

Reflects downloads up to 01 Mar 2025

Other Metrics

View Author Metrics

Citations

Cited By

Florence SYou STov JFindler R(2019)A calculus for Esterel: if can, can. if no can, no can.Proceedings of the ACM on Programming Languages10.1145/32903743:POPL(1-29)Online publication date: 2-Jan-2019
https://dl.acm.org/doi/10.1145/3290374
Voelter MKolb BBirken KTomassetti FAlff PWiart LWortmann ANordmann A(2019)Using language workbenches and domain-specific languages for safety-critical software developmentSoftware and Systems Modeling (SoSyM)10.1007/s10270-018-0679-018:4(2507-2530)Online publication date: 1-Aug-2019
https://dl.acm.org/doi/10.1007/s10270-018-0679-0
Li XFlatt MCombemale BMernik MRumpe B(2017)Debugging with domain-specific events via macrosProceedings of the 10th ACM SIGPLAN International Conference on Software Language Engineering10.1145/3136014.3136019(91-102)Online publication date: 23-Oct-2017
https://dl.acm.org/doi/10.1145/3136014.3136019
St-Amour VFeltey DFlorence SYou SFindler R(2017)Herbarium Racketensis: a stroll through the woods (functional pearl)Proceedings of the ACM on Programming Languages10.1145/31102451:ICFP(1-15)Online publication date: 29-Aug-2017
https://dl.acm.org/doi/10.1145/3110245
Voelter MKoščejev SRiedel MDeitsch AHinkelmann A(2021)A Domain-Specific Language for Payroll Calculations: An Experience Report from DATEVDomain-Specific Languages in Practice10.1007/978-3-030-73758-0_4(93-130)Online publication date: 15-Apr-2021
https://doi.org/10.1007/978-3-030-73758-0_4
Osial PKauranen KKim A(2019)Prescriptive Grammar for Clinical Prescribing WorkflowInternational Journal of Extreme Automation and Connectivity in Healthcare10.4018/IJEACH.20190101091:1(96-110)Online publication date: 1-Jan-2019
https://dl.acm.org/doi/10.4018/IJEACH.2019010109
Voelter MKolb BBirken KTomassetti FAlff PWiart LWortmann ANordmann A(2019)Using language workbenches and domain-specific languages for safety-critical software developmentSoftware and Systems Modeling (SoSyM)10.1007/s10270-018-0679-018:4(2507-2530)Online publication date: 1-Aug-2019
https://dl.acm.org/doi/10.1007/s10270-018-0679-0

View Options

Login options

Check if you have access through your login credentials or your institution to get full access on this article.

Full Access

Get this Publication

View options

PDF

View or Download as a PDF file.

eReader

View online with eReader.

Figures

Tables

Media

View Table of Conten