Date Presented 03/27/20 This study compares aggregate data from two cohorts of older adults moving into independent living at an LPC to determine differences in acuity levels. Scores from established measures of cognition and physical quality of life, percent needing hospitalization, and percent moving to a higher level of care were compared. Results show residents are moving in at higher levels of acuity, thus demonstrating a need for OT intervention with older adults for better transition to LPCs. Primary Author and Speaker: Jessica Meyer Additional Authors and Speakers: Chad Arnette, Linh Lam, Emily Schulz Contributing Authors: Mary Voytek, Marissa Bartosch, Jessica Selland, Madeline Thueson, Alice Kang, Elizabeth Brooks, Stephanie Hernreich

One of the key promises of IT strategic outsourcing is to deliver greater IT service management through lower cost. However, this raises a critical question: How can one predict the service delivery cost that will deliver the promised service level agreements (SLAs)? This is particularly challenging since such prediction is mostly needed during the service engagement phase where the SLAs and the delivery cost are negotiated, and the detailed service modeling data are not available. In this paper, we propose a modeling framework that uses queueing-model-based approaches to estimate the impact of SLAs on the delivery cost. We further propose a set of approximation techniques to address the complexity of service delivery and an optimization model to predict the delivery cost subject to service-level constraints and service stability conditions. We demonstrate the applicability of the proposed methodology using data from a large IT service delivery environment.

One of the key promises of IT strategic outsourcing is to deliver greater IT service management through lower cost. However, this raises a critical question on how to predict service delivery cost during the service engagement phase where nonstandard service level agreements (SLAs) are negotiated and detailed service modeling data are not available. In this paper we propose a modeling framework that uses queueing model based approaches to estimate the impact of SLAs on the delivery cost. We further propose a set of approximation techniques to address the complexity of service delivery and an optimization model to predict the delivery cost subject to service level constraints and service stability conditions. We demonstrate the applicability of the proposed methodology using data from a large IT service delivery environment.

During the customer engagement phase it is critical for the service providers to estimate the impact of service level constraints on service personnel needs. However, it is often difficult due to the implication from customer workload. In this paper we propose an SLA impact evaluation methodology that uses queueing models to quantitatively evaluate the impact of SLAs to the engagement cost model.

Workflow engines which require process instances to run to completion against their creation model are limited in their ability to adapt to model changes. The technique of process instance migration can be used to migrate instances to a new process model, but at any given time only a fraction of instances may be in a state which is compatible with the new model. We propose a continuous batch approach for migration which treats migration itself as a long running problem. The continuous migration approach schedules and orchestrates the evaluation and migration of long running processes over time, controlled by configurable policies while maintaining continuous process availability. We have built a long running process migration simulation to test our approach, looking at both migration success and cost. The simulation confirms the need for a long running migration approach and yields some interesting suggestions for tuning the configuration of the migration system.

Constant and rapid changes in the market place have inevitably brought changes to business process including the long running process. When changes are mandatory or require retroactive compliance, it may be necessary to migrate existing running process instances to a new version model. Current dynamic instance adaptation approach requires each instance to adapt to the changes individually. To support multiple instance migration across process models, we present an approach where we leverage model comparison technique; control and data flow analyses to identify data constraints for changed activities and identify potential migration points where we could migrate the instances. We then capture the migration point information in a migration plan which can later be used in the runtime environment to orchestrate the migration. We have implemented a prototype of our approach to demonstrate its applicability.

Web services have become important building blocks of distributed applications and have matured to the point where service lifecycle issues such as version management are now paramount. However, there is a lack of versioning support in relevant standards and tools. We present an approach which leverages the existing WSDL service definition model to build a versioned service hosting solution. We distinguish between a web service interface (published) version and its implementation version (private). We introduce the concept of a service interface proxy. This proxy, which can be generated automatically, implicitly defines the service interface version, and is published as the logical service endpoint. Client requests are routed dynamically by the proxy to appropriate implementation versions. We have implemented a prototype of our approach to demonstrate its applicability.

In most commercial electronic contract management applications available today, different customized code base has to be developed, deployed and operated to support each tenant. Few advanced commercial electronic contract management applications use a single code base with configuration options to support multi-tenants. However, a separate instance of the code base still has to be deployed and operated for each tenant even in these applications. The business model of having to support a single application instance for each tenant makes an electronic contract management application and other critical business applications out of reach for most small and medium businesses (SMBs), in particular, the very small businesses (SVBs) because of its high development and maintenance cost. Recently, a new business model of a single application instance supporting multi-tenancy based on software as a service (SaaS) has emerged making expensive business applications more affordable for SMBs and SVBs for multi-tenancy [1]. In this paper, we present the first of a kind multi-tenancy SaaS electronic contract management application. We also describe several novel methods used in the metadata, security and shared services, as well as customization and tenant extensions modules to support multi-tenancy SaaS in this application. This multi-tenancy SaaS application has shown to benefit both the application service providers as well as their tenants. This new multi-tenancy SaaS model can reduce the application hosting cost and make the application more affordable to the tenants because of its capabilities in customization and scalability while continuing to support an increasing number of tenants. It furthers benefits tenants by saving their money and time with immediate access to the latest IT innovations and infrastructure improvements on a single application code base. Most end users of tenants have found their productivities increased, the contract transaction time accelerated, contractual errors reduced in using this multi-tenancy SaaS electronic contract management application as demonstrated in several ongoing IBM pilot programs serving more than ten tenants with over 3000 end users.

Rapidly changing market conditions and IT systems are forcing companies to adapt their business processes more dynamically than in the past. Most current commercial BPMS products lack the full capability to support changing processes. To address this challenge, we discuss three aspects of dynamic adaptation in a BPM system: model-level, instance-level, and runtime environment changes. We focus on analyzing the patterns of the instance-level navigation changes, including the preconditions, actions and consequences of each change. Based on this analysis, we propose a system design for the runtime environment to support dynamic instance-level changes. We have implemented a prototype of such a system with the motivating scenarios to demonstrate the usefulness of our proposal.

With the growing adoption of service oriented computing, web services are becoming important building blocks of distributed applications. As these services inevitably evolve and change, service version management will increasingly become a key part of the service lifecycle. To address this versioning requirement from the service provider's point of view, we propose two key concepts. The first is to draw a distinction between a service's interface version and its implementation version. The second is to employ a tiered hosting model which echoes this structure, by introducing a version routing point in front of the actual service implementation versions. This version routing, point routes versioned requests to the appropriate implementation versions. We have implemented a prototype of our approach on IBM's WebSphere Process Server and WebSphere Enterprise Service Bus. We show our results with a versioned test service, to demonstrate the capabilities of our proposal.

Study Objectives. To characterize the safety of concomitant aspirin, clopidogrel, and warfarin therapy after percutaneous coronary intervention (PCI), and to identify patient characteristics that increase the risk of hemorrhage.Design. Retrospective, matched cohort studySetting. Academic medical center and affiliated outpatient offices.Patients. The active group consisted of 97 patients who underwent PCI from January 1, 2000-September 30, 2005, and received warfarin, aspirin, and clopidogrel; the control group consisted of 97 patients who were individually matched to patients in the active group by procedure type, procedure year, age, and sex. Control patients received aspirin and clopidogrel.Measurements and Main Results. Clinical data were collected from inpatient records, outpatient physician office records, and telephone surveys administered to patients or caregivers. The primary end point was major bleeding. The median duration of follow-up after index procedure was 182 days (range 0-191 days) in the active group and 182 days (range 0-213 days) in the control group. Fifty-seven (59%) of the 97 patients in the active group received warfarin for atrial fibrillation. There were 14 major bleeds in the active group (including 1 death) and 3 major bleeds in the control group during the study period. Mean international normalized ratio at the time of bleeding was 3.4. Hazard ratio for major bleeding was 5.0 in patients receiving warfarin therapy (95% confidence interval 1.4-17.8, p=0.012). Aspirin dose, age, sex, body mass index, history of hypertension, diabetes mellitus, intraprocedural glycoprotein IIb-IIIa or anticoagulant type, and postprocedural anticoagulant use did not have a significant effect on the risk of major bleeding.Conclusion. Warfarin was an independent predictor of major bleeding after PCI in patients receiving dual antiplatelet therapy. Prospective data to further characterize the safety of concomitant warfarin and dual antiplatelet therapy after PCI are needed.