"Interactions among EHR workflow systems, explicitly defined internal and cross-EHR workflows, hierarchies of automated and human handlers, and rules and schedules for escalation and expiration will be necessary to achieve seamless coordination among EHR workflow systems. In other words, we need workflow management system technology to enable self-repairing conversations among EHR and other health IT systems. This is pragmatic interoperability. By the way, some early workflow systems were explicitly based on speech act theory, an area of pragmatics."
Well, Chuck cited this text in support of his argument for "pragmatic interoperability," so let's start there. "Pragmatic," in this rather erudite ("graduate level") academic context, doesn't denote (nor connote) "pragmatism" in the casual conversational sense -- i.e., "practical, workable, expedient, etc" It's about the importance of, well, uh -- context in communications for accuracy of information exchange and subsequent mutual understanding.
A scene-setting sample:
What did they mean by that? it’s a relatively common question, and it’s precisely the subject of the field of pragmatics. In order to know what someone meant by what they said, it’s not enough to know the meanings of the words (semantics) and how they had been strung together into a sentence (syntax); we also need to know who uttered the sentence and in what context, and be able to make inferences regarding why they said it and what they intended us to understand. There's one piece of pizza left can be understood as an offer (“would you like it?”) Or a warning (“it’s mine!”) Or a scolding (“you didn’t finish your dinner”), depending on the situation, even if the follow-up comments in parenthesis are never uttered. People commonly mean quite a lot more than they say explicitly, and it’s up to their addressees to figure out what additional meaning they might have intended. A psychiatrist asking a patient can you express deep grief? Would not be taken to be asking the patient to engage in such a display immediately, but a movie director speaking to an actor might well mean exactly that. The literal meaning is a question about an ability (“are you able to do so?”); the additional meaning is a request (“please do so”) that may be inferred in some contexts but not others. The literal meaning is the domain of semantics; the “additional meaning” is the domain of pragmatics.
Pragmatics and natural language: Introduction and preliminary definitions
Linguistics is the scientific study of language, and the study of linguistics typically includes, among other things, the study of our knowledge of sound systems (phonology), word structure (morphology), and sentence structure (syntax). It is also commonly pointed out that there is an important distinction to be made between our competence and our performance. Our competence is our (in principle flawless) knowledge of the rules of our own idiolect — our own individual internalized system of language that has a great deal in common with the idiolects of other speakers in our community but almost certainly is not identical to any of them. (For example, it’s unlikely that any two speakers share the same set of lexical items.) Our performance, on the other hand, is what we actually do linguistically — including all of our hems and haws, false starts, interrupted sentences, and speech errors, as well as are frequently imperfect comprehension: linguists commonly point to sentences like the horse raced past the barn fell as cases in which our competence allows us — eventually — to recognize the sentence as grammatical (having the same structure as the men injured on the battlefield died), even though our imperfect performance in this instance initially caused us to mis-parse the sentence. (Such sentences are known as "garden path" sentences, since we are led "down the garden path” toward an incorrect interpretation and have to retrace our steps in order to get to the right one. [emphasis mine -BG])
Pragmatics may be roughly defined as the study of language use in context — as compared with semantics, which is the study of literal meaning independent of context ( although these definitions will be revised below). If I’m having a hard day, I may tell you that my day has been a nightmare — but of course I don’t intend you to take that literally; that is, the day hasn’t in fact been something I’ve had a bad dream about. In this case the mid-semantic meaning of “nightmare” (a bad dream) differs from its pragmatic meaning — that is, the meaning I intended in the context of my utterance. Given this difference, It might appear at first glance as those semantic meaning is a matter of competence, while pragmatic meaning is a matter of performance. However our knowledge of semantics, like all of our linguistic knowledge, is rule governed … Because speakers within a language community share these pragmatic principles concerning language production and interpretation in context, they constitute part of our linguistic competence, not merely matters of performance. That is to say, pragmatic knowledge is part of our knowledge of how to use language appropriately. And as with other areas of linguistic competence are pragmatic competence is generally implicit — known at some level but not usually available for explicit examination…
Pragmatics, then, has to do with it rather slippery type of meaning, one that isn’t found in dictionaries and which may vary from context to context. The same utterance will mean different things in different contexts, and will even mean different things to different people…
Situating pragmatics within the discipline of linguisticsGot all that? Looks like a great text. Way too expensive at $35.99 Kindle edition. Though, I may well buy it anyway at some point as a nicely-written refresher, after I digest a couple of other more important eBooks for me in the same price range. The Amazon 1-Click Cognitive Crack Pipe is killin' me.
Language use involves a relationship between form and meaning. As noted above, the study of linguistic form involves the study of a number of different levels of linguistic units: phonetics deals with individual speech sounds, phonology deals with how the sounds pattern systematically within a language, morphology deals with the structure of words, and syntax deals with the structure of sentences. At each level these forms may be correlated with meaning. At the phonetic/phonological level, individual sounds are not typically meaningful in themselves. However international contours are associated with certain meanings; these associations are the subject of the study of prosody. At the morphological level, individual words and morphemes are conventionally associated with meanings; this is the purview of the lexical semantics and lexical pragmatics. And at the sentence level, certain structures are conventionally associated with certain meanings (e.g., when two sentences are joined by and, as in I like pizza and IE did frequently, we take the resulting conjunction to be true as well); this is the purview of sentential semantics. Above the level of the sentence, we are dealing with pragmatics, including meaning that is inferred based on contextual factors rather than being conventionally associated with a particular utterance.
Pragmatics is closely related to the field of discourse analysis. Whereas morphology restricts its purview to the individual word, and syntax focuses on individual sentences, discourse analysis studies strings of sentences produced in a connected discourse. Because pragmatics concentrates on the use of language in context, and the surrounding discourse is part of the context, the concerns of the two fields overlap significantly. Broadly speaking, however, the two differ in focus: pragmatics uses discourse as data and seeks to draw generalizations that have predictive power concerning our linguistic competence, whereas discourse analysis focuses on the individual discourse, using the findings of pragmatic theory to shed light on how particular set of interlocutors use and interpret language in a specific context.
I used my Mac Dragon Dictate to talk this stuff in, reading in split windows from the Amazon "Look Inside" preview, just for y'all.
"retrace our steps in order to get to the right [interpretation]."Yeah. In ordinary Great Unwashed Lean-speak, we're simply talking about process errors, "defects," - MIS-communication. (More precisely, failures of intended communication.)
At its most banal, clinical miscommunication (failure of "communication") is merely an exasperating waste of resources. At its most consequential, patients die.
My sub-Pragmatics, more fundamental (though linguistically valid) rant on "Interop" here.
More to come...