Future of Health IT: Trends and Scenarios

Broken Is Fixed: Health informatics standards in light of Clay Shirky's "In Praise of Evolvable Systems"

I recently re-read an old essay by Clay Shirky (shirky.com) called In Praise of Evolvable Systems. It opens with a laughable description of designing a novelty protocol to slip past the IETF as a joke - however, the feature set described is an accurate description of the World Wide Web, as it existed when Shirky wrote the essay in the late 1990's. That lead-in ends with this:

HTTP and HTML are the Whoopee Cushion and Joy Buzzer of Internet protocols, only comprehensible as elaborate practical jokes. For anyone who has tried to accomplish anything serious on the Web, it's pretty obvious that of the various implementations of a worldwide hypertext protocol, we have the worst one possible.

Except, of course, for all the others...

It seems the WWW protocol family has turned out to be another example of "less is more", or more accurately, "broken is fixed".

More on data abundance, context rarity

Charlie Bess left a comment on my recent post that responded to his post in the EDS Fellows' Next Big Thing Blog regarding the abundance of data and the rarity of context. His comment needed a response, and my response got out of control, so it has turned into a post. His comment deserved wider visibility anyway, making a very good point, so I'm repeating it here. (Excuse me if I get tuna salad on your monitor; I'm writing this as I eat lunch.)

I think we do agree.

Physical proximity is the perfect example of meta data. This is data about the data we have on the word (or object if location is provided by RFID).

Although machines don’t have minds, they can have algorithms that handle “normal” situations, and should be able to recognize when it is not normal and bring this to people’s attention. People excel at pattern recognition and making decisions with insufficient information. So even if the system provides the context that it is not a normal situation and why, it should reduce the latency associated with the decision making process. Of course removing the noise of normal, should also be a tremendous benefit.

Charlie, I agree that we agree, with your clarification. My "disagreement" was only with the use of the term "metadata", which for many people is limited to explicit descriptions of the data, e.g., the data dictionary in a relational database; the title, description, keywords, and Dublin Core annotations found in HTML META tags; the DTD of an SGML or XML document (or XML Schema document in the latter case); or the WSDL and other descriptive annotations on Web Services. Your definition is clearly wider than that.

I think you have correctly stated what computers are good for at the moment, beyond numeric data processing and symbolic computation problems - to monitor aspects of the real world and to let us know when something is outside the bounds of normality. It made me wonder how far we can go in teaching computers how to become (or rather to simulate being) contextually aware. I think it's possible, and here's why.

$60 Gets You A New Medical Record And Free Foot Amputation

From TechDirt via KidneyNotes, an interesting story about the consequences of identity theft.

One 57-year-old Florida woman found that after her identity was stolen, the information was used to pay for a costly foot amputation. Worse, after heading in for a hysterectomy, she found that the scammer's medical history was now intertwined with her own -- the records suggesting she had magically acquired some of the scammer's medical conditions (like diabetes). Statistics show some 250,000 Americans had their medical information stolen and misused in recent years, with user records selling for around $60 a pop on the black market.

This is a great example of the problems I discussed in yesterday's posts about security of patient information (here and here).

Second Life and the Amish

My misgivings about Second Life expressed in the post Real Is Beautiful brought an email response from Paul Hartzog, a fellow grad student at Michigan and the a leading proponent of Panarchy, the most obviously sane, rational, and just form of government - therefore perhaps the one we are least likely to experience in our lifetimes. :-) Our brief exchange is reproduced here with permission. We ended up with him pointing me to a Wired article about technology and the Amish, which led me to look more deeply into the concerns I have.

More on the Linux Wearable Computer

(Click to enlarge)

Yesterday I put up a quickie about a post in The Positive Technology Journal regarding a wearable Linux computer targeted at the healthcare market. I took a look last night at the Web page describing this new toy, the Zypad WL 1000 from Parvus Corporation. I have mixed feelings about it - I love new gadgets as much as anyone, am enjoying learning to hack Linux, but feel like this may be a bit ahead of its time, at least in the healthcare market.

Living and Working in a Virtual World: New paradigms for human culture and application architectures

Recent posts in a number of blogs I follow have been converging on a vision of the future of global culture as shaped by information technology. Consider this from the blog of IBM executive Irving Wladawsky-Berger:

While it may be still too early to tell, I am beginning to sense the shape of the next major era of computing.  It feels much more ubiquitous and collaborative.  It also feels much more "intelligent," realistic and human.  I almost get the sense that we are creating a very rich virtual world that complements our physical world, with all kinds of capabilities to help us in our life and in our work.

SLFC: America's Youth

I found a very insightful study on the next generation, funded by the Student Loan Finance Corporation. You can read a summary at SLFC: America's Youth. From the health IT perspective, it is interesting mostly as a view into the population of up-and-comers in all three population segments that matter to us: future physicians, informaticians, and patients. The insights reveal some troubling facts about our educational system, especially at the primary and secondary levels. What this portends is a not-so-bright outlook for health IT and biomedical research in the US.

Understanding the importance of Net Neutrality

Imagine this, if you can: an issue in which the geek community, MoveOn.org, and the Gun Owners of America are on the same side.

I just got finished reading a post on the savetheinternet.com site called Lie Number 2, about why telcos are trying to quash the Net Neutrality movement and what the consequences are if they succeed. This has huge implications for biomedical research and healthcare IT in general. It's important we get involved in this fight.

Quickie: Software Development: Google's GWT Example: Interactive FIFA 2006 World Cup Application

There is a great blog post and sample application showing off Google's recently-announced Google Web toolkit or GWT. The post is at Jose Sandoval - Software Developer - Software Development: Google's GWT Example: Interactive FIFA 2006 World Cup Application.

Here's a quote to give you a taste of what's there:

The key feature of this API is that developers never code JavaScript to control the UI. Everything is coded in Java, and the provided compiler generates all the functionality in a language (HTML and JavaScript) that is understood by different web browsers.

The application works fine in IE6 on Windows XP, but some of the comments indicate that FireFox 1.5 isn't working.

Write Java, compile to a thin-client Web app: what could be tighter than this?

Mini-Clinic Review: Healia is Better

More Google Health whoop-de-doo - I found a reference in the Mini-Clinic Review blog an alternative to Google Health that works, better, at least for the moment, in Mini-Clinic Review: Healia is Better. The same blog has a longer post about Google Your Diagnosis with Google Health?, which talks about whether Google will make physicians obsolete. Interesting question...