The Tallis Toolset

Software and training materials (documentation, tutorials, samples) to create, publish and enact clinical knowledge applications over the web.

Note: These pages on Tallis are in draft form are are gradually being re-edited and corrected.

Modern clinical practice is fast becoming, as Alan Rector of Manchester University has said, a humanly impossible task. As the knowledge base of medicine continues to grow the demands on those who are required to deliver consistent, high quality, safe and accountable care is effectively impossible to satisfy unaided. Among the most promising new developments that may help to address this challenge and reduce the burdens on clinical and other healthcare professionals are point of care information and decision support systems.

The Tallis toolset developed at the Advanced Computation Laboratory (ACL) of Cancer Research UK is a suite of software tools to support authoring, publishing and enacting of clinical knowledge applications over the web – applications designed to support the management of medical procedures and clinical decision making at the point of care. The Tallis Composer is a graphical editor that supports the authoring process. The resulting clinical knowledge application can then be tested in the Tallis Tester. Finally, the Tallis Engine enables the execution of the clinical application over the web.

Tallis is built on the PROforma language for modelling clinical processes. PROforma is a knowledge composition language that provides an expressive but precise formalism for capturing medical expertise. It offers both a strong underlying clinical performance model to guide the application developer and the declarative properties that are needed for effective and safe dissemination of expertise.

See http://www.openclinical.org/gmm_proforma.html for information about clinical PROforma applications in use and in development.

Musical Notation: A Revolution in the Capturing & Dissemination of Knowledge

At the turn of the millennium the repertoire of all singers and instrumentalists was disseminated entirely through live performance. This naturally resulted in variation from one performance to another, with pieces forgotten, or added, or adapted as it pleased the artist. Consistency and quality were variable as a result. These shortcomings inspired Guido d’Arezzo to develop the basic concepts of modern musical notation.

Like other kinds of mathematical notation, musical notation is clear and precise; it has both a procedural interpretation and a declarative aspect. It made possible a clear record of the composer’s intentions for the performers, and led to the very concept of music publishing and the whole of the modern music industry.

As in music the "repertoire" of skilled clinicians is learned through a combination of observation of other experienced doctors and private study. As in early music, therefore, it is inevitable that errors and differences of interpretation creep in to clinical practice. PROforma is a notation analogous to the musical stave: it provides a standard way of writing down and implementing the basic clinical process while facilitating discussion and debate and permitting differences of interpretation.

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