Making it easier for hospitals to use data to help patients

Hospital 

Commodity data analytics for health care
[Via O'Reilly News and Commentary]

Analytics are expensive and labor intensive; we need them to be routine and ubiquitous. I complained earlier this year that analytics are hard for health care providers to muster because there’s a shortage of analysts and because every data-driven decision takes huge expertise.

Currently, only major health care institutions such as Geisinger, the Mayo Clinic, and Kaiser Permanente incorporate analytics into day-to-day decisions. Research facilities employ analytics teams for clinical research, but perhaps not so much for day-to-day operations. Large health care providers can afford departments of analysts, but most facilities — including those forming accountable care organizations — cannot.

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So, a hospital system that has put together a data analytics package that not only works for itself for day-to-day operations – for example, helping doctors determine if a patient is likely to be readmitted and knowing what to do to help – but is working to get other systems to use it.

It works no matter what the electronic health records software a hospital uses, analyzes data in ways different institutions need.

Will be interesting to see how this plays out. I’ve had a lot of interactions with a healthcare system that has moved to electronic records in a big way. And the speed of making decisions because the data are available has been amazing.

Things that might take a week and a couple of different visits can be done right there. Instead of hours spent trying to schedule an diagnostic procedure that needed to be done after hours, the office made the appointment at another facility within minutes.

Heck, I called my insurance company with a question. I was talking with a human being within 30 seconds who had answered my question within a minute and actually went on to check out some other things that they came up with themselves, just to check.

I do not expect things to be perfect but I can see glimpses of how much better the system can be.

UPDATED:Authority continues to do stupid things, as usual, by bullying people for not being racist

 Train wreck at Montparnasse 1895

Prosecute People for Not Being Racist Anymore
[Via First Draft]

Doc sent this along, and Jesus tits: 

The June issue of the paper went to print with the white space standing in for the letter, and without the word “Redskins” appearing anywhere. And this was when McGee decided to run around campus in his Quixotic attempt to collect all of the copies. This was also when the elder Pirritano made up his mind that the editors of the Playwickian should be prosecuted for their refusal to print his son’s letter.

“This in my opinion also reaches the level of a conspiracy, in any other context except a school environment it would be considered such,” Pirritano said in an email. “I see this as no different than if these students went into another students [sic] locker and stole their phone or any valuable. Theft is theft no matter how you look at it, and they admit conspiring to do such. My statement reflects that view and in my opinion a police investigation should have taken place. It also reflects my personal philosophy that taxpayers should not be on the hook for such acts and I made that known to the public that attended our meetings as well as received comments from the public that they supported such investigation.”

He’s arguing that the paper’s use of school funds is a misappropriation of tax dollars. One problem though: the final issue of the school year, historically, has been paid for by the students themselves. June 2014 was no different.

On July 2, Gayle Spoul, an attorney hired to represent the Playwickian‘s editors, wrote to Michael Levin, an attorney retained by the school district to sort out this issue: “It is inconceivable to me that the District would decide to expend time and ‘funds’ to ‘investigate’ and then potentially prosecute these students, who are simply attempting to stand up for the rights guaranteed them by the Constitution and Pennsylvania law.”

For more background see Doc’s post here

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UPDATE: The First Draft post is not the important point. Here is a direct link to the important article.

_________________________

I really hate this crap and wish that the authoritarian principal here, who has penalized teachers for doing the right thing when he asked them to do the wrong thing, would simply lose his job and have to work at minimum wage for the rest of his life. But I bet he gets a higher paying job in the administration. Because they, being hierarchical authoritarians themselves, have instituted restrictive polices forcing the editors to use words that they feel are racist.

Think about that? Would any school district force the editors of a school paper to use what the students view as racial epithets regarding a minority? Yet here we have a board bullying students to do just that.

And because of the board’s refusal to compromise, all the school district has really done is radicalize the students even more, while wasting a lot of taxpayers money. Last year it was 15-7 regarding the policy. This year the students editors are unanimous.

And expect the school district to pay a lot more as lawsuits are signed. Lawyers told the board to not make this move, explaining the long term legal effects.

Just stupid.

Authoritarians always end up losing against democracy. They always do stupid things by refusing to compromise, even a little. The British were stupid in the Revolution. The South was stupid in the Civil War. Simple, smart compromise would have been so much better.

But authority simply cannot compromise because it sees that as losing its authority. To many authoritarians only maintain their authority by the naked use of power. Which is why they do stupid things. And why they eventually loses when dealing with rapid change.

Because the power of democracy comes from its ability to adapt, to not be bound by the constraints of hierarchy and position, as it finds a wise answer to the damage done by uncompromising authority.

Just remember – any leader pushing a travel ban for Ebola does not really care abouut containment

Ebola Virus 

The evidence on travel bans for diseases like Ebola is clear: they don’t work
[Via Vox - All]

Welcome to Burden of Proof, a regular column in which Julia Belluz (a journalist) and Steven Hoffman (an academic) join forces to tackle the most pressing health issues of our time — especially bugs, drugs, and pseudoscience thugs — and uncover the best science behind them. Have suggestions or comments? Email Belluz and Hoffman or Tweet us @juliaoftoronto and @shoffmania. You can see previous columns here.


Travel restrictions to control the spread of disease have been tried since 1377, when the Mediterranean city of Dubrovnik — formerly known as Ragusa — imposed a 40-day isolation period on ships entering the city suspected of carrying the Black Death.

Calls for travel restrictions are revived with every pandemic threat, most recently Ebola. US politicians are now demanding a travel ban on West Africa in response to the Ebola outbreak.And, in the midst of ‘Ebolanoia,’ the idea is gaining traction.

But there’s a very clear problem with using a travel ban to stop Ebola: it renders useless the two best methods we have for stopping Ebola. Determined people will find ways to cross borders anyway, and if they don’t go through airports or they lie about where they came from, health officials can’t track their movements. And this is an important point because, to fight Ebola, we need to be able to follow up with the contacts of the infected. Getting aid and resources to the region to contain Ebola at the source would also become more challenging with travel restrictions.

This is why health officials unanimously agree that a travel ban is a bad idea. But don’t believe the experts: the best-available evidence also suggests travel restrictions, and even airport screening, don’t actually work. At best, they delay the spread of disease but they don’t impact the number of people who eventually get sick. They are expensive, resource-intensive, and potentially harmful to the countries involved. Here’s a guide to the research:

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We have used travel bans all the time previously. They simply do not work.

As it is, we can now track where everyone is, where they came from and where they went. This is critical for containment.

Instituting a ban from West Africa would not have stopped the first case in the US. He traveled to the US from Europe. So the ban would only work if every other country did the same thing.

And, as we have seen with people travleing for weddings or for cruises, people will do what they want to do and rationalize it away. So stop planes and they will take boats or cars or walk.

Then we have people who are just as dangerous as before (which is not much) but no way to track them at all. Which means disease spreads without our being aware or containing it.

We have had this conversation before. Travel bans do not work and make things worse.

Now, our leaders know all of this. So ask yourself why are some spreading this meme of travel bans? What do they have to gain by frightening people and offering ineffective solutions that will not work?

I can only call them sociopaths who lack a conscience and will drive the public to do unwise things purely for their own personal gain.

Look, you can only get Ebola if someone is showing symptoms. Now just using a fever as the criterion is mostly an abundance of caution. A fever will not make you contract the virus.

Contact with the blood  of a sick person will. And the main symptom of Ebola is not a fever. It is called a hemorrhagic disease for a reason. Meaning it produces a lot of external blood for others to infect themselves with.

The symptom to worry about is lots of infected blood. It is also very obvious when someone is displaying this symptom.

It is most likely that the people who became infected in Dallas did not get it the patient’s breathe or sweat or spit. They got it from blood particles or splatters that got on their protective clothing, followed by a poorly initiated removal of the clothing. (It is well know with anyone using protective gear – getting out of the gear is often the most dangerous time._

So, frankly, I would not be too worried about someone with Ebola who just had a fever. If they were coughing up blood, I would be very worried.

The new iMac is what the Mac Pro used to be

New iMac 

Apple’s matchless iMac with Retina 5K display is its most expensive ever
[Via MacDailyNews]

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“Apple yesterday launched its most expensive-ever iMac, the $2,499 iMac with Retina 5K display, a desktop that will appeal to not only professional creative customers but also well-heeled consumers who want the very best money can buy, analysts said,” Gregg Keizer reports for Computerworld. “‘Clearly, it’s a good machine for creative professionals,’ said Ezra Gottheil of Technology Business Research, in an interview yesterday. ‘But it’s also for those where money is no object, who want a very good PC.’”

“‘It’s both a niche product and a premium mass-market product,’ said Patrick Moorhead, principal analyst at Moor Insights & Strategy. ‘It’s for professionals who don’t need the absolute best, like a Mac Pro, but also for prosumers who just want the best,’” Keizer reports. “Not surprisingly, Apple spent much of the iMac’s time in the spotlight yesterday touting the display, which offers 5120-by-2880-pixel resolution. ‘This is the world’s highest-resolution display,’ boasted Philip Schiller, Apple’s top marketing executive, who presented the 5K Retina iMac at Thursday’s event.”

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I’m in the market for a new computer. While still very productive with my early 2008 Mac Pro, it  is beginning to slow down some. I looked at the new Mac Pro, because that is what I have always used for work – that is, the top of the line Macs with respect to speed, etc.

The current Mac Pro is just way too much muscle for me and way too expensive.

So I looked at the new iMac. And it fits exactly what I need. At close to the price I have always paid. 

Now when to pull the trigger?

The insanity of GM – the invisible hand of capitalism should destroy this company

GM’s hit and run: How a lawyer, mechanic, and engineer blew open the worst auto scandal in history
[Via PandoDaily]

gmstory1

As the sun was setting on a stormy Georgia day, Brooke Melton was 30 miles outside of Atlanta in her Chevy Cobalt. It was March 10, 2010, her birthday, and the 29-year-old pediatric nurse was on her way to her boyfriend’s to celebrate.

Melton had purchased the white GM Cobalt in 2005, the year the four-cylinder compact first rolled out of factories, and lately it had been giving her trouble. A week earlier the engine had unexpectedly shut off. Melton managed to pull over to the side of the road and restart it, but the incident shook her. She phoned her father, who advised her to bring the car in to the local dealership. So she wouldn’t forget, Melton scribbled a list of the problems in a notebook: “Key locking in the ignition,” she wrote. “Suddenly shutting off while driving and unable to turn vehicle.” Under “strange knocking sound” she underlined “ignition problems.” Mechanics at the dealership assured her nothing was wrong, and after cleaning the fuel injection gave Melton back her car a few days later with a clean bill of health.

As dusk bled into darkness early the next evening, she was driving north over a stick-straight section of Highway 9 at 58 mph when it happened again. The Cobalt’s engine shut off and the lights inside and outside the car dimmed. Melton hit the brakes, but no power from the engine meant no anti-lock brakes and no power steering. The car fell into a skid. Tires squealing, the Cobalt’s back end fishtailed, coming up on her left. Melton instinctively spun the wheel counterclockwise.

Three and a half seconds after the engine quit, Melton was the reluctant driver’s seat passenger of a car hydroplaning sideways across the centerline. In the southbound late, bearing down at highway speed, was a gray Ford Focus driven by a 26-year-old man from nearby Acworth, GA, his two-year-old daughter strapped in the back.

The Focus plowed into the passenger side of Melton’s Cobalt: 3,000 pounds of steel, glass, plastic, and human smashing into three 3,000 pounds of steel, glass, plastic, and human. While Brooke’s lap belt glued her waist to the seat, her shoulder harness went slack the instant the engine shut off. As the side of her car caved in, Melton’s torso, neck, and head whipped violently to the right, the force equivalent to falling from the 16th floor of a building. The Cobalt spun around and was heaved 15 feet down a hill, ending up backward in a creek swollen with rainwater. Rescuers found Melton slumped over the steering wheel, her body submerged up to her shoulders.

Brooke Melton was not the first to crash her GM car after the engine stalled. Over the course of a decade, dozens of people died and scores more were injured on American roads. Four months earlier, Hasaya Chansuthus was heading home to Nashville in her 2006 Cobalt when she sideswiped another car, her engine shut off and the Cobalt raced off the highway. She was killed when her head struck the steering wheel. In 2009, an 11-month old baby was paralyzed and his grandmother and aunt were killed in Pennsylvania after the Cobalt’s engine turned off without warning and was hit by another car. Earlier that year, 81-year-old Marie Sachse lost control of her 2004 Saturn Ion outside of St. Louis and died eight hours later from internal injuries. In 2006, 18-year-old Natasha Weigel was a few miles from home in eastern Wisconsin when the engine quit and the Cobalt shot off the highway, killing Weigel and another teenager.

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The article is long and it will make you cry (if you are human) And it will make you so mad at the socicopaths allowed to run things, make millions and kill the rest of us.

People at GM switched the switches without telling anyone. No process was in places to prevent them from doing this  and even when notified, management chose cost over safety. Switches that killed people. Replacing them with new ones that had the same part number. 

But apparently  no one at GM knows why. So this was not a mistake but a coverup.

Even when GM did know, they took 5 months before recalling all the cars. And then did not have the parts needed. People continue to die after the recall.

And this was only discovered  because a woman wrote a note before she died. Otherwise, people would still continue to die (perhaps 165 so far), others put in prison or bankrupted.

We have allowed our lives to be put in the hands of people with no morals, no ethics and no humanity. “GM nod?” Put them all in prison.

Make an example of them. I am so glad I have never owned a GM car. I never will. Screw them. So should the marketplace.

How distributed democracy permitted a team to play top flight soccer

 Soccer 286

Meet the smallest team ever to play in elite European soccer
[Via Quartz]

Barcelona’s soccer team later today will host a match in its legendary stadium, Camp Nou, where the club regularly plays in front of 98,000. Barcelona has won La Liga 22 times and the European Cup four times. Its opponents are much less renowned, though, in their own way, no less remarkable.

The club from Eibar, a small town in the Basque country, is playing in Spain’s top division for the first time ever. Last year, its budget was €3.2 million ($4.1 million), which wouldn’t cover the annual salary of Lionel Messi, Barcelona’s star player. The team’s stadium holds 5,200 and average attendance last year was 2,900—which makes Eibar the smallest team ever in the history of La Liga. It is quite likely that that it is the smallest team ever to play in any of the top divisions of the major European leagues of England, Spain, Italy, and Germany. For example, in England, you have to go two divisions below teams like Manchester United and Chelsea to get to attendances below Eibar’s.

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They qualified for the top division but did not have the money. After osing in court, they needed several million dollars to play.

Luckily for them, we now have to the tools for people around the world to support organizations that they like – the team crowdfunded the money.

The plucky team had the lowest budget of the 80 teams in the second division. They have no debt.They are a great example of how to succeed without  needing to spend huge amounts of money.

Yet they won enough games to be promoted up to the top league. So they used that same attitude to ask people from around the world to help.

And they did.

A 90-year-old who has been a member since 1945 bought the share that let the team reach its goal. Now all the names of the shareholders are on a wall in the Eibar stadium, primarily featuring locals but—in a sign of how much this plucky team caught the imagination of soccer fans everywhere—also people from more than 50 countries.

This is how distributed approaches can overcome obstacles to achieve success. we continue to see more of this every day.

Left/right is not as important today as authority/democracy

How Far Conservatism Has Changed
[Via Contrary Brin]

All right, it is an important U.S. political season.  As a registered Republican and a frequent speaker at libertarian gatherings, I remain hopeful that this will be the year that several million temperamentally conservative-but-calmly-rational Americans will wake up to the way their movement and the GOP have been hijacked. And that only a shattering drubbing at the polls will send the American right back to the drawing boards — learning to do politics again. Including negotiation about real problems. 

Oh, but it will be so hard! 
The oligarchs who have done the hijacking have ordered up so many narratives, from “birther” paranoia to climate denialism, from preaching “oligarchy is gooood for you” to utter lies about U.S. history. I will explicate the best and most hilariously most damning example below — the George Soros Effect.  
thats-not-austinBut first — In That’s Not What They Meant!: Reclaiming the Founding Fathers from America’s Right WingProfessor Michael Austin examines dozens of books, articles, speeches, and radio broadcasts by such figures as Glenn Beck, Mark Levin, Sean Hannity, Larry Schweikart, and David Barton to expose the deep historical flaws in their use of America’s founding history. In contrast to their misleading method of citing proof texts to serve a narrow agenda, Austin allows the Founding Fathers to speak for themselves, situating all quotations in the proper historical context. 
What emerges is a true historical picture of men who often disagreed with one another on such crucial issues as federal power, judicial review, and the separation of church and state. As Austin — whom I met last week, at Newman University, in Kansas — shows, the real legacy of the Founding Fathers to us is a political process: a system of disagreement, debate, and compromise that has kept democracy vibrant in America for more than two hundred years, but that regularly comes under attack. How extreme has been the veer off any path of sane conservatism?  

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I feel that the real battle is not between left/right economic divides but between hierarchical authoritarian/distributed democracy. The GOP may have a preponderance of the former but there are quite a lot in the leadership of the Dems. We are out of balance, but luckily have very strong tools now to leverage distributed approaches to regain our footing.

The Founding Fathers had to deal with exactly the same imbalances. We saw liberals and conservatives then come together to develop an entirely new set of tools to deal with the imbalance.

I am confident we will again. 

The question is how long it will take to regain the balance, how much it will be delayed by the authoritarians and how many millions die in the meantime

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