Introduction

Wise Knowledge Systems, Inc. (WKS) has produced the Knowledge-based Expert Systems (KBES) application as an advanced modeling and simulation/decision discovery and support tool. KBES keys on continual input from whole communities of domain experts to evaluate situations and decisions and produce information on optimized strategic actions. This cumulative knowledge continually refines the KBES output resulting in a very current and very accurate contribution to actionable knowledge.

KBES is a learning tool that continually evolves via the use of the experts.

KBES is accurate at a minimum of 95%, and has received important validation and praise from mathematicians at major universities, the Office of the Chief of Naval Operations, juried scientific journals, the Smithsonian Institute where it is part of their collection, and, in the private sector. KBES has been successfully deployed in both private sector operations, and in active military operations.

The production of  the dynamic assessment of medical readiness for the Navy produced highly accurate and user friendly information on current and future state of medical readiness with modeling and simulation to produce optimized strategies for medical readiness.

The architecture of all KBES models and applications supports the interchange of values for “triggers” that can open new pathways and establish a different or new decision and optimized strategic interventions. All of the KBES analytical engines are modular and can be used individually or in tandem.

The four KBES analysis engines work both individually and in combination. The output of these analyses is actionable action based on the sum of the knowledge of the domain experts using the application. In certain cases, the analyses can produce a decision or suggest and action that is not part of the typical responses and thereby improve the final outcome.

Excerpts, reviews and deployment details for all WKS KBES models, technology, and applications are available both on request and at the WKS web site: wiseknowledgesystems.com.

Precise dates and times and full transcripts of meetings and conversations are available on request.

The following is a very small sample of the documents, and communications for WKS and the VA since 2004.

Overview

10/15/2007

Dr. Wise met in Washington with Dr. Paul Tibbits. Dr Tibbits says he is aware of WKS’ KBES as successfully applied to the Navy Shipboard Medical Administrative Readiness Tool (SMART). Dr. Tibbits says he wishes to identify the best application of the KBES technology for the VA.

Wise Knowledge Systems, Inc. has received positive praise following analysis of KBES technology by:

Paul Tibbits, M.D.—Veterans Administration
Roy Pratt- HP
Joe Goodin- Office of the Chief of Naval Operations
The Smithsonian Institute
Dr. John Sharp- UMKC School of Medicine
Frank Sisti- Software Engineering Institute
Dr. Dale Alverson- Telemedicine Director , University of New Mexico
Ciro Rodriquez- U.S. Congress, House of Representatives
W.C. Vanderwagen, M.D.- Indian Health Service
Wendell Porth- St. Lukes Lutheran Hospital
Richard A. Cooper- Trinity University, Department of Mathematics
Bill Silva- Dyncorp
Wise Knowledge Systems, Inc. clients,  since 1985

Although WKS continued to provide the full information/material to Dr. Tibbits since our initial meeting with him, the following individuals have, in meeting with WKS, said initially that they have either not received any information from Dr. Tibbits, and/or, they have not reviewed the material. Following their review with Dr. Wise each said that the KBES application would support the VA/VHA health mission with veterans. Other than Ms. Lloyd, VHA, and Ms. McCutcheon, VA OAL, each said that they would recommend a pilot KBS project for VA to Dr. Tibbits. Importantly, Dr. Tibbits wrote the most positive evaluation of KBES for the VA, yet he failed to put KBES on the “list” for prioritization for acquisition. Other than Ms. McCutcheon, each of these individuals said they would not acquire KBES because: ” the VA is broken, nobody here wants to work/it is hard to find anybody at the VA who wants to work, and the VA is not mature to use this technology”.

This response may be seen as rather extraordinary when one reviews the assessment give by Dr. Tibbits himself, and by Joe Goodin of the Office of The Chief of Naval Operations.

The following is the SPAWAR evaluation as edited by Dr. Paul Tibbits.

POINT PAPER

10 Sept 2009

Subj:    Use of modeling and expert system to strengthen system development lifecycle (SDLC), as related to IT systems capacity planning.

BACKGROUND 

On an enterprise level, the SDLC processes present at the VA are still too fragmented, with multiple opportunities for improvement in process documentation, modeling, and standardization, as well as accuracy of capacity forecasting and adherence to software efficiency constraints.

If applied properly, the use of the modeling and exper systems approach has the potential to provide significant value to the SDLC processes by:

• Facilitating process and data discussions with stakeholders; 
• Modeling transaction volumes based on actual vs paper based processes and “what if” variations in between;
• Aligning SDLC processes and organizations;
• Identifying potential root cause issues based on similar process data;
• Supporting change and communications.
• Deploying in a modular, flexible, and secure manner with lowest possible risk of poor systems performance.

The implementation of modeling and expert systems methodology could yield early benefits in facilitation and communications while benefits surrounding toolsets and data modeling would be limited until process alignment has been achieved and initial data is available for use in the models.

ANALYSIS 

Modeling and Expert Systems Methodology

There are a variety of commercial approaches to use of modeling and expert systems which approach process modeling, knowledge management, and data analysis in a proprietary manner.

Value in process modeling, knowledge management, and data analysis are typically seen in 3 discrete areas:  Communications facilitated by the knowledge, data gathering, modeling process; the extensibility of the models themselves; and the potential for root cause analysis and process improvement based on data and structural analysis.

• Communications facilitation value is typically measured as “soft” returns.  Benefits can be seen in training/mentoring, team building, and other areas of organizational and individual development. 
• Model extensibility value can be measured by perceived benefits to functionally related processes which allow for value to be replicated with less cost and/or as ongoing management tools such as dashboards and training toolsets.
• Root cause analysis can be an outcome of both modeling and data analysis.
  
  • Value in data analysis is dependent on the amount and type of data available.  Detailed data modeling implies sufficient data to make it useful for achieving buy in on outcomes
  • Benefits of data analysis are limited typically by confidence in models and quality of data.  The confidence in the model is based on the transparency of the modeling process and the facilitation approach.  The quality of data is often in question when processes are not standardized or if stakeholders are not involved in developing underlying assumptions.

Modeling and Expert Systems

• Are flexible and modular.
• Have been deployed on a number of databases and operating environments.
• Can receive either “stand alone,” “batch,” or “real-time” data inputs based on standard data base sharing techniques.
• Have been accredited and deployed in DoD environments.
• Can be a reasonable methodology for leveraging benefits in a secure and flexible manner.

Ms. McCutcheon simply said “I see no value in it. You (WKS) can start over with the VA!”

These individuals are:

Navy Captain Christine Boltz
Greg Donham—VA
Navy Commander Margret Beaubein
Dr. Julius Chou
Ms. Susan Lloyd—VHA
Dr. Michael
Valivullah—VA
Dr. Pat Pearcy—SPAWAR
Ms. Wendy McCutcheon—VA  OAL

Dr. Tibbits says his efforts and funds are spent to “support the status quo” at the      VA. Dr. Tibbits says “I will just go down the hall and get the money from my boss”. Dr. Tibbits said that Ms. McCutcheon was now the sole authority for acquisition for the VA for health and medical applications and that the first people   funded by her office were “raving” about her performance.

Dr. Tibbits and Ms. McCutcheon say that, though they know WKS is a Veteran owned small business,  they will not consider Wise Knowledge Systems, Inc. using the GSA, because the “GSA is not helping us (VA)”.

Cathy Weblimo of Chairman Filner’s office reports she has heard/seen nothing in response to Chairman Filner’s request to the Secretary of the VA  for the       Secretary’s office to “provide the Committee with evaluation and feedback of SMART. Please respond by November 16, 2007”, Ms. Weblimo has said there remains no response by the Office of the Secretary of the VA to this request by Chairman Filner.

Following a conversation with Chairman Filner’s staff, Chairman Filner and I spoke and he invited me to testify at this hearing.

Summary

Since 2004, WKS has been in communication with leadership at the VA to develop an understanding of a potentially important, potentially life saving, resource allocation technology to the VA. This is WKS Knowledge-Based Expert System (KBES) technology. KBES has received very positive technical reviews as an advanced modeling and simulation decision, support technology from every point of assessment to which it has been assigned by both the Navy and the VA, and in the private sector. The critical health area of CRTBI and the fundamental nature of SDLC development for the VA make positive movement on these topics significant to the mission of the VA. There is clearly an important ethical issue of the VA being enabled to keep its promise and deliver its mission to American veterans.

Once a technology has been tested, evaluated, praised, and successfully focused on an emergent health issues or in support of technology that supports health; non-response is an unacceptable option. The leadership at the VA, their staff and colleagues all seem to agree that the KBES technology could be very good for the VA, but some persons of authority have decided that they will not attempt to acquire or apply KBES because the VA is” not mature, is broken, and that the people at the VA do not want to work”. These individuals at VA seem to be defaulting the responsibility for a decision. Failing that they simply do not respond.

It is an unfortunate part of our American history that treaties (contracts) were made with the American Indian tribes to remove them as an obstacle to what was called progress. These treaties or agreements were made by our government knowing they would not be kept. The explanation for this fraudulent manipulation was often that “Indians are not people/they are not human beings”. One wonders if the individuals mentioned above at the VA, in maintaining the “status Quo”, failing to provide state-of-the-art- medical and health care to our young people enlisting in the service, while referring to  the VA as “immature, broken and not willing to work”, also considers these young Americans as “not human beings”.

This arrogant and non-productive behavior is not appropriate when the health and lives of American Veterans, and their families are at risk.

While it is clear that the vast majority of individuals at the VA are sincerely dedicated to American veterans and do want to work for the mission of the VA, there remains a few in leadership positions who frustrate the evolution of the medical responses and capabilities now available to the VA. WKS recommends installing and supporting qualified individuals in these important positions who have the experience and expertise to follow up on positive evaluations, and acquire state-of-the- art advanced medical and healthcare technology, like KBES. Saying that “the VA is broken and nobody here wants to work” as the rationale for non-acquisition of proven technologies does not support the critical mission of the VA, nor does it compliment those at the VA who work hard and are not broken and give much more than for hollow lip service for American veterans. We all look forward to a more positive approach to acquisition for the future of the VA and American veterans. Do the right thing. Honor the contract with American veterans.

I want to thank the Committee and in particular Chairman Dr. Bob Filner for giving our experience a voice. I will try to answer any questions you may have now.

Respectfully presented.

Jay Wise

Wise Knowledge Systems