Plug & Play and IT Arms Races ... wither Patients, Persons...

On the internet, in journals and the conference circuit judging from various calls for papers and other announcements, you cannot move for innovation, creativity, biotech and change that is inevitably transformative. This is good don't get me wrong but in the push for plug and play ecosystems or calls for an IT arms race something(s) are repeatedly lost.

In the former its about consumers with a single diagrammatic mention of 'patient'. I looked for the person as in person-centered. I looked for the client. In the latter the arms race will be a mechanistic affair: a circuit that runs from finance to technology. I realise the agenda and audience for the articles is specific: IT is Healthcare IT News and a Consultancy Co. As previously noted here on W2tQ it's not just that I may be talking out of turn: I'm out of Continent too.

Reading these articles just convinces even more of the need for a conceptual grounding. We really should read:

 'plug and play' as mechanistic AND humanistic.

As for the IT arms race. Let's race by all means, that is what innovation and (rapid) progress is all about. But lets exercise our legs too and ensure that the data is not only stored holistically and distributed, but that this is the nature of its inclusive purpose and source.

Here and across the water they just don't get IT.

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Prompted by:

PwC Health Research Institute December 2015

HIMSS Time for a health IT arms race

Hodges' model: Combined Care Feature Capture - Black Box + White Box?

Nursing is, in theory and practice, far removed from multimedia; which in turn has changed markedly from when the poster quoted below was published in 1999. 

Nursing is 'multi-media' in the sense of combining several data sources across several domains of knowledge and from a range of media.

[From a conference poster no longer available:]

"Feature Detectors 

Feature detectors are used to build a semantically rich index entry for the original multimedia object. They do this on two different levels:

1. Blackbox detectors are implemented in a programming language to access the raw multimedia data and to derive the desired features from it. Example: the web_header detector sends a HTTP HEAD request to the specified HTTP server and extracts the content type from the response.
2. Whitebox detectors consist of queries over the already collected feature values. Example: the page_type detector uses the content type to determine if an object is a page.

In the general case blackbox detectors will derive low-level feature data, e.g., the color distribution of an image. But they can also be used for more complex tasks, like finding a face in an image. The function of whitebox detectors is to relate low-level features to concepts, e.g., an image is a portrait because its color distribution classifies it as a photo and it contains exactly one face."

Hodges' model is situated and in healthcare context is everything. Behind a hospital clinic or ward door we might expect certain features to be found. Out in the community following a referral again certain features will be found. The features take on a personalised nature as key features confirming a diagnosis, problem or care issue are presented by the patient (client) or their carer. I'm not sure whether this is useful or not, but the domains of Hodges' model suggests quite a few boxes are required to tick the box that is holistic - integrated care.

And that does not take account of exactly where the knowledge resides; that is another test.

M., A. Schmidt, M. Kersten. Acoi: A System for Indexing Multimedia Objects. In International Workshop on Information Integration and Web-based Applications & Services, Yogyakarta, Indonesia, November 1999. (n.b. The link in the poster is no longer valid.)

My original source:

ERCIM News No. 59 October 2004 Grammar Enables Effective Multimedia Search Queries. pp.63-64.

Hodges' model: A Black Box

"Globally, every theory of systems became a graph of either a simplex or a complex, all things being first of all situated in the depths of a black box." p.3.

Genesis: Michel Serres

"Who, in the end, and from the other side of the picture can boast of having conceived a general system, of projecting or constructing a general system of communication or relation, as a universal network? What would be conveyed by it? and how? What harmony, what cacophony would come of it? Do we have any sort of an ear for hearing that kind of thing?" p.4.

Michel Serres (1995). Genesis (Studies in Literature & Science). (Trans. Genevieve James, James Nielson) Ann Arbor: The University of Michigan Press.

1938 and counting... A Public (Mental) Health Odyssey? c/o Virginia Woolf

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"A deep concern with subjugated knowledges and with the arts of human communication expressed 50 years ago by Virginia Woolf in Three Guineas. Virginia Woolf, too, was concerned about how education contributed to ...

... the barbarity of mechanised warfare.

Since 'the old education of the old colleges breeds neither a particular respect for liberty nor a particular hatred of war', she wrote, 'it is clear that you must build your colleges differently   (Woolf, 1977, p.39). Asking 'what should be taught in the new college, the poor college?', she replied thus:

Not the arts of dominating other people; not the arts of ruling, of killing, of acquiring land and capital. . . The poor college must teach only the arts can be taught cheaply and practised by poor people; such as medicine, mathematics, music, painting and literature. ... The aim of the new college, the cheap college, should be not to segregate and specialise, but to combine. It should explore the ways in which mind and body can be made to co-operate; discover what new combinations make good wholes in human life. (Ibid. pp.39-40)"

Virginia Woolf (1977). [1938] Three Guineas. Harmondsworth: Penguin.

Robins, K. and Webster, F. (1989). The Technical Fix: Education, Computers and Industry. Basingstoke: Macmillan. p. 275.

2001 and counting... A Public Health Odyssey c/o Rabbi Julia Neuberger

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Changes in the way that health professionals are being trained should help future doctors, nurses and others to think more holistically and to share more knowledge. p.77-78.

If a genuinely holistic approach is being taken, it is probable that several activities will be happening simultaneously to tackle any given problem, and that more than one measure of success would be appropriate. Collecting evidence to prove what works and what does not may also take a varied approach that mixes different methodologies and creates some new ones. p.77.

The growing understanding that health should be seen holistically - as being more about general wellbeing than the absence of disease - has not yet been equipped with evidence that policymakers and practitioners can respect. Throughout the history of the NHS, there has been a tension between the imperative to treat disease in the individual and the need to promote general good health in the population. p.77.

Tackling health inequalities has become a cornerstone* of British government policy. From the corridors of Whitehall to the local board meetings of primary care groups and trusts, the imperative to reduce the health gap between rich and poor is ubiquitous. Yet when action is proposed to turn the rhetoric into reality, particularly when significant investments are required, the cry of "not enough evidence" is invariably heard in opposition. p.77.

*Whatever the state of current Government policy, tackling health inequalities has been a 'cornerstone' within Hodges' model since the model was created in the 1980s. It remains so today in 2017.

Rabbi Julia Neuberger. Where's the Evidence? Making the Case for Public Health.
Source: Journal of Epidemiology and Community Health (1979-), Vol. 55, No. 2 (Feb., 2001), pp.
77-78.
Published by: BMJ
Stable URL: http://www.jstor.org/stable/25569362

Life - the (pen)ultimate choreographer...?

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Tolerance: Belgium Stamp

Women Children Disabled Unemployed Healthcare for All .... (Don't stamp here)

If the religious tolerance represented in the stamp above was the unequivocal reality across the whole of humanity that would be and will be an amazing step forward and a state of bliss. One day.  Progress is being made... Looking at the stamp, we realise that to be inclusive, life - the choreographer - is far more demanding.  The totality of equality and human rights requires the most complex of footwork and not just for the individual, but the many.... Women's March

Link and image:
European Diversity Belgium follows the model of Al Andaluz announcing a three-religion stamp

Hodges' model: Context in a Structure [Constructivism & Constructivists]

"First, we know that human memory for isolated facts is very limited. Knowledge is retained only when embedded in some organising structure. Thus, students who learn many separate facts are unlikely to retain their knowledge beyond the current period of test-taking - a much noticed, worrisome feature of the current educational system. Second, we now recognise that skills and knowledge are not independent of the contexts - mental, physical, and social - in which they are used. Instead, they are attuned to, even part of, the environments in which they are practised. A new challenge for instruction is to develop ways organising learning that permit skills to be practised in the environments in which they will be used (i.e. outside the classroom). Such contextualised practice is needed both to tune skills and knowledge to their environments of use and to provide motivation for practising abilities that in isolation might seem pointless or meaningless." p.22

Resnick, L. (ed.) (1989). Knowing, Learning and Instruction. Pittsburgh: Laurence Erlbaum Associates. p.3.

From: Abbott, J. and Ryan, T. (2000) The Unfinished Revolution: Learning, Human Behaviour, Community and Political Paradox. Stafford: Network. p.22.

Framing a Life Animated

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(mental) Life	Animated
communication  meaning singing  dialogue family friends relationships	documentary activism awareness

My source: Whitworth, D. (2016)  The autistic boy whose life was unlocked by Disney, Arts, The Times, 13 December. p.8-9.

Person & Sense of Place: A River runs through it.....

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Personhood Personality Identity Philosophy Ethics Panpsychism	Whanganui River Nature Environment Human Ecology
History - Heritage Indigenous Peoples	Legal personhood Rights of Nature

My source: Moses, K. (2017) New Zealand River Granted Legal Personhood, Resurgence & Ecologist, Jan / Feb 2017. Issue 300: p.5.

NZHerald Agreement entitles Whanganui River to legal identity http://nzh.tw/10830586 via @nzherald

The Rights of Nature

Comment: From universal health coverage to right care for health - The Lancet

"What is right care? In its simplest definition it is care that weighs up benefits and harms, is patient-centred (taking individual circumstances, values, and wishes into account), and is informed by evidence, including cost-effectiveness." p.1.

Kleinert, S. & Horton, R. (2016). From universal health coverage to right care for health. The Lancet. Published Online January 8, 2017 http://dx.doi.org/10.1016/S0140-6736(16)32588-0

How can we reflect upon universal health coverage and 'right care'?

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harm to the individual wishes values patient (person) centered	information resources harm - benefit ratios unnecessary care over diagnosis
beliefs community leaders harm to the community social benefits human relationships	Universal health coverage cost   finances organisations power policy

My source: Twitter greg fell

Perceptive Movement (Fifteen Points in 1 of 4)

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My source:
A presentation at Conceptual Spaces at Work 2012
& Brilliant Ideas, Bloomberg, Random International

'Person re-identification': In Camera In Care...? [ Ack: ERCIM 108 ]

From: Identifying Persons of Interest in CCtV Camera Networks by Furqan M. Khan and Francois Bremond (Inria) in ERCIM News 108

"Person re-identification is a challenging task because individuals move in all directions, including away from the camera and across the field of view (see Figure 1). Therefore, biometric cues such as face or iris cannot be reliably extracted. Instead, holistic appearance of the person (clothing) or gait is used, which is inherently not as discriminative. Furthermore, due to low resolution, subtleties in gait are difficult to measure. In addition, a person’s appearance in a video is susceptible to illumination, occlusion, camera properties and viewing angle. Finally, for a fully automated system, individuals must be localised using a person detection and tracking algorithm before building their appearance models." p.35.

The above text prompted the musings below as per Hodges' model and a nursing - healthcare context:

Patient (Person) re-identification is a challenging task because patients move through the health and social care systems in many directions, routes and disciplines, including away from the humanistic values that should (must) inform practice for comprehensive assessment (see Figure 1 - Hodges' model). Therefore, mechanistic (that includes biometric) cues AND humanistic perspectives cannot be reliably extracted and integrated. Instead, holistic appearance of the person across four care or knowledge domains can be used. This is inherently not as discriminative as it starts with a blank (neutral) conceptual framework. Furthermore, emergency situations (hopefully) excepted, staffing pressures and time constraints create low resolution accounts and records in terms of person-centeredness and so subtleties in a variety of care strengths and needs (including gait) may be difficult to discern and measure. In addition, a person’s representation in a care episode or encounter is susceptible to communication problems (noise), lack of access to records, whether paper or computer-based, all aggravated by a viewing angle that is still service-centered. Finally, a system that can facilitate holistic, person centered and integrated care for individuals must be self-referential in that it facilitates definition of health and what care (by self, other person [or thing - robot]) encompasses. The system will encourage reflection and critical thinking helping to assure person-centered skills in staff ('person' detection) and continuity of care (tracking algorithm) before building the appearance model: their health career.

ERCIM News No. 108 Special theme: "Computational Imaging"

Dear ERCIM News Reader,

ERCIM News No. 108 has just been published at http://ercim-news.ercim.eu/en108

This issue features:

ERCIM News 108

• A Special Theme "Computational Imaging" with 21 articles providing an insight in the many complex facets of computational imaging, coordinated by the guest editors Joost Batenburg (CWI) and Tamas Sziranyi (MTA SZTAKI) .
• Keynote "Imaging as a Ubiquitous Technique: New and Old Challenges" by Andy Götz, Head of Software at European Synchrotron Radiation Facility and Armando Solé, Head of Data Analysis at European Synchrotron Radiation Facility
• A "Research and Innovation" section with news about research activities and innovative developments from European research institutions

This issue is also available for download in pdf and ePUB

Thank you for your interest in ERCIM News. Feel free to forward this message to others who might be interested.

Next issue: No. 109, April 2017 Special Theme: "Autonomous Vehicles"

Best regards,
Peter Kunz
ERCIM News editor in chief

Learning Health Systems (LHS) Call and 1st Issue

Learning Health Systems

Learning Health Systems (LHS) is an international, open access, peer-reviewed journal published in collaboration with the University of Michigan. With a goal of advancing the interdisciplinary area of learning health systems, the journal promotes research, scholarship, and dialogue focused on theory, complex issues, conceptual syntheses, education models and more. LHS seeks to achieve continuous rapid improvement in health and healthcare and to transform organizational practice. The journal includes research reports, experience reports, briefs and commentaries.


Learning Health Systems is now accepting submissions for its first issue.

Reasons to publish:

• Topics of international importance 
• Immediately open access, freely available to read, download and share 
• Distinguished editorial board 
• High standard, rigorous peer review 
• Quality and reputation, supported by the University of Michigan and Wiley 
• Authors retain copyright 
• Compliance with institutional and funder mandates

Early view.

My source:
Kathleen Young via GANM:  http://knowledge-gateway.org/ganm/

Book: Start the New Year as you mean to go on... It's SimPol

The SimPol Solution

“It’s ambitious and provocative. Can it work? Certainly worth a serious try” – Noam Chomsky

“I nodded until I got a crick in my neck. I haven’t read a book for years that I agreed with so deeply and so consistently – nor felt so keenly that these are messages the world needs to hear. The clarity, simplicity and profound importance of this book are beyond question. Please read it, and please encourage others to do the same.” - Prof. Simon Anholt, Founder, the Good Country Index

Humanity is failing to tackle urgent global problems like climate change, tax havens, mass migration and wealth inequality. Meanwhile, voters are rebelling in the form of Brexit, Trump and the rise of the Far-Right. The SIMPOL SOLUTION reasons that there is just one barrier that prevents all governments from taking action: the fear that it would make their national economies uncompetitive. No nation can move first for fear of losing jobs and investment to others.

The SIMPOL SOLUTION identifies this as ‘Destructive Global Competition’, a global vicious circle in which we’re all caught. It’s not that governments don’t want to act, but that they can’t. Blaming governments or corporations, even protesting against social injustices, simply continues a ‘them-and-us' polarised politics that goes nowhere.

To find a way out, this book proposes an inner revolution in the way we think about and understand the world, a new more complex level of thinking that the authors call ‘world-centric’. They outline the necessary psychological steps needed to achieve this before introducing the SIMPOL SOLUTION – a simple but effective way for citizens to democratically impel governments to cooperatively solve multiple global problems, so opening the way to a just and sustainable future.

Published by Peter Owen Ltd. Due out February 2017. Pre-order NOW on Amazon, from the publisher, or from the authors direct, at http://www.simpol.org/index.php?id=545

Happy New Year!

My source: John Bunzl  jbunzl AT simpol.org