Jeff Sutherland

“A revolution has got to leave the world with a totally different view of itself - its got to be a paradigm shift. When you’ve got a revolution like this, don’t think about applets. We’re talking about a situation where the whole content of your machine is going to have a totally different shape [to] it. As a result the whole society, the whole commercial environment around all software is going to look totally different. The rules we’re defining now the way you look at your system, the way you define protocols, the way objects talk to each other are defining what those possibilities will be.”1,2

Business Objects Standards and Architectures.- Business-Object Architectures and Standards.- The Object Technology Architecture: Business Objects for Corporate Information Systems.- The OMG Business Object Facility and the OMG Business Object.- An Architecture Framework: From Business Strategies to Implementation.- Object Oriented Technology and Interoperability.- An Architectural Framework for Semantic Inter-Operability in Distributed Object Systems.- Semantics: The Key to Interoperability.- Business Objects Applications.- Object Business Modelling, Requirements and Approach.- Implementing Business Objects: CORBA Interfaces for Legacy Systems.- Modeling Business Enterprises as Value-Added Process Hierarchies with Resource-Event-Agent Object Templates.- Managing Object Oriented Software Development Projects.- SCRUM Development Process.- Experiences with a Manufacturing Framework.- Business Application Components.- Author Index.

THIRTEEN PATIENTS WITH ADVANCED (STAGE III) malignant melanoma have been treated with high-dose chemotherapy (nitrogen mustard or a combination of BCNU and melphalan) combined with autologous, nonfrozen, bone marrow transplantation. Three patients (24%) achieved a complete remission and are currently alive and free of disease without further therapy at 26, 60, and 73 weeks. Five patients (38%) achieved partial remissions and five patients (38%) had no response. There was no difference in the response rate to nitrogen mustard and the BCNU-melphalan combination. Severe side effects to nitrogen mustard, however, precluded its further use in this study. The major cause of death in patients was intracerebral metastases, raising the question of prophylactic brain irradiation in future studies. Studies of the recovery rate of peripheral blood neutrophil, platelet, and peripheral blood and bone marrow CFU-C suggest that autologous bone marrow infusion may be of benefit in shortening hematopoietic recovery following intensive chemotherapy.

Patients, providers, payers, and government demand more effective and efficient healthcare services, and the healthcare industry needs innovative ways to re-invent core processes. Business process reengineering (BPR) showed adopting new hospital information systems can leverage this transformation and workflow management technologies can automate process management. Our research indicates workflow technologies in healthcare require real time patient monitoring, detection of adverse events, and adaptive responses to breakdown in normal processes. Adaptive workflow systems are rarely implemented making current workflow implementations inappropriate for healthcare. The advent of evidence based medicine, guideline based practice, and better understanding of cognitive workflow combined with novel technologies including Radio Frequency Identification (RFID), mobile/wireless technologies, internet workflow, intelligent agents, and Service Oriented Architectures (SOA) opens up new and exciting ways of automating business processes. Total situational awareness of events, timing, and location of healthcare activities can generate self-organizing change in behaviors of humans and machines. A test bed of a novel approach towards continuous process management was designed for the new Weinburg Surgery Building at the University of Maryland Medical. Early results based on clinical process mapping and analysis of patient flow bottlenecks demonstrated 100% improvement in delivery of supplies and instruments at surgery start time. This work has been directly applied to the design of the DARPA Trauma Pod research program where robotic surgery will be performed on wounded soldiers on the battlefield.

For many years, computers have supported complex clinical ancillary functions such as the laboratory, radiology, endoscopy, and others. Digital computers have been successfully incorporated into specialized clinical instruments to offer advanced digital devices such as fetal monitors, heart monitors, and imaging equipment. But these devices are often not fully integrated with clinical management and operational systems. Beyond ancillary department applications, the result of almost 30 years of trying to automate the clinical processes in healthcare is large investments in both computer systems and paper medical records that have resulted in paper-based, computer-assisted processes of care. This expensive combination of partial clinical automation and archaic paper-based support processes is a major obstacle to improvements in care delivery and management. The need to use software, informatics, and standards to help manage the operating room and perioperative processes of care is significant. The potential to reduce adverse events, cost of care, and to enhance the quality of care are real and worth attaining. This paper focuses on what medical informatics improvements are needed to support improvements in surgical care and to assist in the management of the highly complex operating room and perioperative care process, and proposes research priorities in these areas.

Lack of physician automation in the US is equivalent to the situation in underdeveloped countries such as Croatia. In the emergency room, your medical record is your skin. US healthcare automation is roughly as eYcient as the Irish Post OYce was in the late 1980s. Thousands of clerks kept millions of slips of paper, some of which were more than 100 years old. Most of it was filed away in boxes that were inaccessible. The Irish Post OYce has made significant investment in automation during the last decade and now uses distributed object computing to seamlessly integrate thousands of oYces throughout the country. The UK, Denmark, Australia, Germany, and other countries are adopting the same post oYce technology. Meanwhile, the US healthcare industry has historically invested less than 2% of revenues in automation, compared to 7% in the typical US industry. The lack of ability to modify and automate business processes is crippling to both the healthcare system and its patients. Futures

Many organizations with investments in relational database management systems (RDBMS) want to build objectoriented applications supporting a graphical user interface without forcing programmers to deal with SQL and RDBMS limitations. This paper proposes a natural and relatively transparent coupling of object-oriented clients with relational database server technology for new applications. The specified architecture can concurrently deliver key features of both The ObjectOriented Database Manifesto and the Third Generation Database System Manifesto . The Hybrid ObjectRelational Architecture (HORA) is designed to: . support ANSI SQL III objectoriented functionality using currently available relational database systems . provide good server performance to both relational and object applications . provide full object storage support by the RDBMS . allow the specification of high-level referential integrity rules and userspecified constraints without SQL coding.

In recent months, a wide range of publications—Software Development, IEEE Software, Cutter IT Journal, Software Testing and Quality Engineering, and even The Economist— have published articles on agile software development methodologies, reflecting a growing interest in these new approaches to software development (Extreme Programming, Crystal Methodologies, SCRUM, Adaptive Software Development, Feature-Driven Development and Dynamic Systems Development Methodology among them). In addition to these "named" methodologies, scores of organizations have developed their own "lighter" approach to building software. The formation of the Agile Alliance by a group of expert consultants and authors on development process has fueled increasing interest in ways to deliver quality software in short, fixed delivery schedules, under severe time to market pressures (Fowler and Highsmith 2001).

Transitioning from a traditional project manager to Scrum is challenging. The PMI Project Manager manages the project by ensuring that intermediate deliverables are delivered at various stages of the project. Agile development emphasizes the need for producing tangible results as soon as possible and as often as possible. The resulting role of an Agile project manager is fundamentally different from a PMI Project Manager. We have provided a mapping between the PMI responsibilities to Scrum and show a project manager how to more easily make the transition to an agile practice

The patterns of the SCRUM development method are presented as an extension pattern language to the existing organizational pattern languages. In the last few years, the SCRUM development method has rapidly gained recognition as an effective tool to hyper-productive software development. However, when SCRUM patterns are combined with other existing organizational patterns, they lead to highly adaptive, yet well-structured software development organizations. Also, decomposing SCRUM into patterns can guide adoption of only those parts of SCRUM that are applicable to a specific situation. 1.

Concepts in Complex Adaptive Systems (cas) research are relevant to the development of enterprise business objects and component systems. Many mathematical and computing models have been developed for cas in recent years(Cowan, Pines et al. 1994) and much of this work can be applied conceptually to Business Object and Component Architectures now emerging as the mechanism of choice for building large distributed object systems. Holland creates a synthesis of seven basic cas concepts, four properties (aggregation, nonlinearity, flows, diversity) and three mechanisms (tags, internal models, building blocks) (Holland 1995). These concepts can organize our discussion of business object systems and inform our understanding of Enterprise Application Integration (EAI). Several examples of innovative approaches to EAI are provided: (1) an implementation of workflow, XML, and intelligent adapters to integrate disparate front and backend systems in an insurance company merger (Van den Enden, V...

This book is dedicated to the Godfathers of Scrum, Takeuchi and Nonaka [1], who gave Scrum its name and helped created a global transformation of software development. In 2021 Scrum is used in over 77% of Agile transformations worldwide. Many others have contributed to the creation of Scrum:
• Jim Coplien and the ATT Bell Labs Pasteur Project  for the paper on the most productive software development team ever documented – the Borland Quattro Pro Project [2]. The first Scrum team implemented the Scrum daily meeting after reading this paper.
• Nobel Laureates Muhammad Yunus and the Grameen Bank for originating microenterprise development and the Accion International President’s Advisory Board, responsible for much of microenterprise development in the western hemisphere. As a member of the Accion advisory board, Jeff Sutherland noticed the strategy for bootstrapping the poor out of poverty is a model for freeing hundreds of thousands of software developers from developer abuse caused by poor management practices.
• Alan Kay and his team at Xerox Parc [3] for inventing Smalltalk, the mouse, the graphical user interface, the personal computer, the Ethernet, and the laser printer. Listening to his insights on innovation inspired the first Scrum team to go from “good” to “great” [4].
• Professor Rodney Brooks for launching the startup iRobot in space leased from Jeff Sutherland. He taught us the subsumption architecture [5], how to create simple rules to produce highly intelligent performance from complex adaptive systems.
• Christopher Langton of Los Alamos Labs and the Sante Fe Institute for coining the term “artificial life” and showing that increasing degrees of freedom up to the edge of chaotic behavior accelerated their evolution [6]. Scrum feels “chaotic” by intent, so as to accelerate software evolution.
• The French object-database developers working near the MIT campus at Graphael (later Object Databases, then Matisse Software) for demonstrating first in Lisp and then in C++ the Agile patterns of pair programming, radical refactoring, continuous integration, common ownership of code, world class user interface design, and other tips and tricks which Kent Bent used to create eXtreme Programming a decade later. These were all incorporated into the first Scrum.
• The Creative Initiative Foundation for their work with Silicon Valley volunteers to help make the world a better place, the underlying motivation driving the founders of Scrum. This connected the Co-Creators of Scrum with the early systems thinking of MIT Professor Peter Senge who later wrote “The Fifth Discipline.”
• Capers Jones and his productivity experts at Software Productivity Research who analyzed and reanalyzed the output of early Scrum teams, as well as many of the software products built with Scrum during 1994-2000 [7]. These analyses allowed us to provide a money back guarantee that users would double productivity during the first month using tools created by the first Scrum.
• The first Scrum team – John Scumniotales (Scrum Master), Don Roedner (Product Owner), Jeff McKenna (Senior Consultant), Joe Kinsella (object-relational mapping), Laurel Ginder (QA), and three Danish developers - Grzegorz Ciepiel, Bent Illum, and John Lindgreen. They endured repeated failure, depressing analysis of these failures in front of their technical peers from other companies, and transcendence of their missteps. They were the first Scrum team to achieve the hyperproductive state for which Scrum was designed and their product, Object Studio, was reported as industry leader by computer trade journals. Little did they know that Scrum would be their greatest contribution, although Object Studio still lives on as a successful product almost 20 years later.
• PatientKeeper, Inc., the first company to fully implement an “All at Once” or Type C Scrum involving the entire company in Scrum practice. This innovation in process design has been documented by Mary and Tom Poppendieck in their book on Lean Software Development [8]. “I find that the vast majority of organizations are still trying to do too much stuff, and thus find themselves thrashing.  The only organization I know of which has really solved this is Patient Keeper [9].” PatientKeeper was the first company to achieve a hyperproductive revenue state driven by Scrum in 2007. Revenue quadrupled from 13M to 50M in one year.
• Jim Johnson, CEO of the Standish Group, continuously shared data on over 500,000 project sets, each with 8-25 projects over the years since Scrum began. These data continually showed that while Agile projects (77% Scrum) were more successful than traditional projects, 58% of Agile projects fail to deliver. The data in the 2018 Chaos Report – Decision Latency Theory: It’s All About the Interval [10] showed clearly that Scrum success was primarily driven by shortening decision time.
• Last, but not least, many Scrum practitioners experience the quality without a name (QWAN) - a phrase used by Christopher Alexander in his book “The Timeless Way of Building” [11]. Alexander describes a certain quality that we seek, but which cannot be named. This may be the most important feature of Scrum and can only be spoken of as a set of core values - openness, focus, commitment, courage, and respect. It could be viewed as the “speed of trust” or one of the sources of “ba” often seen on Scrum teams. Ba is the Japanese term for  the creative flow of innovation described by Takeuchi and Nonaka [12].