International Leprosy Day

Fighting for a Just Cause
Sunday 31 January 2010

How would you respond if, because of a disease,
your family no longer wanted you to live at home?
How would you feel if, because of a disease,
your husband or wife wanted a divorce?
What would you say if you lost your job
because of an illness that had no impact on your ability to carry out your work?
What would you do if your children were no longer allowed to go to school
because of your ill health or disability?

These situations may sound remarkable, unbelievable even, and yet these are real situations, faced by real people everyday. They happen just because the person has leprosy.

TLM-UK: In 2010 The Leprosy Mission is focusing on Nepal to celebrate World Leprosy Day. At Anandaban hospital, patients not only receive medical care, but staff also help them begin the slow process of emotional healing and release. The hospital's projects include medical treatment and surgery, counselling, education support, housing support and small business loans.

Additional links:

http://www.leprosymission.org.uk/

http://www.who.int/lep/

http://news.bbc.co.uk/1/hi/health/medical_notes/166163.stm

Kiva: Money isn't everything, but it helps - especially in health

In health care we readily appreciate, but still need reminding of the link between wealth - health and poverty. The Black Report and the review some 25 years later is writ large in many student essays, reports and policy aspirations including the latest Labour government.

What we do forget is economics as a problem not just in peoples health, but in establishing a business. Despite the creativity and innovation an entrepreneur can demonstrate, venture capital companies will say "Great idea! Come back when you've got your first sales". This was noted on this week's The Bottom Line on BBC Radio 4.

If it's a real chicken and egg dilemma for innovators in the UK and developed nations, then imagine how difficult it is in countries like Somalia, Uganda, The Democratic Republic of the Congo, Tajikistan, Senegal, and Tanzania, ...?

For people with the aspirations of starting a business that initial, start-up finance is critical not to developing some 21st century technology prototype, but business ventures that we often take for granted in our developed towns and cities clothes, consmetics, food production and sales.

Kiva.org is a great idea. David my old boss brought them to my attention, but now it's time to hop on board.



UPrinting.com is an avid fan and lender on Kiva.org and they are having a blogathon end of January and so this is my effort. If you are new to Kiva there is a short video about how a small loan from people like us can help entrepreneurs gain an opportunity they might not otherwise have.

A Fistful Of Dollars: The Story of a Kiva.org Loan from Kieran Ball on Vimeo.

Kivaworld.com provides a world map so you can readily understand the scope of Kiva and the basics of the way it operates: fund raising, funded, in repayment, paid.

Health and medicine feature in the projects and in the groups of lending teams which you can also join. There are other agencies who ally microfinance with health protection. Health and microfinance already boast a prolonged debate and literature.

With the help of my sponsored links and partners here on W2tQ, I am joining the Kiva community this weekend. Microfinance can make a huge difference to individual lives and now Kiva and its worldwide supporters are creating their own records as revealed on the Kiva blog.

As UPrinting pointed out in announcing this event, your money is able to do good again and again. Sometimes it is not enough to just 'maintain a link' as always it's about making a difference. ...


Additional links:

Kiva Friends

Hodges' model: POLITICAL links (activism, democracy, development, economics, health policy, community informatics...)

http://ffhtechnical.org/services/scalable-delivery-models/microfinance-and-health-linkages

Matt Flannery, Kiva and the Birth of Person-to-Person Microfinance, Innovations, Winter/Spring 2007, 2, 1-2, 31-56. (doi:10.1162/itgg.2007.2.1-2.31).

http://www.mitpressjournals.org/loi/itgg

Nursing & Midwifery Council consultation on standards for pre-registration nursing education

This NMC consultation seeks your views on new standards for pre-registration nursing education programmes. These standards set out what nursing students must demonstrate to be fit for practice at the point of registration.

They will be used by Approved Education Institutions (AEIs) and their partners within the UK to design and develop education programmes.

The new standards

The proposed standards have been developed following a review of the existing Standards of proficiency for pre-registration nursing education (NMC 2004) [PDF]. They set out the requirements that all pre-registration nursing education programmes must meet.

They also set out guidance, which should be followed by AEIs and their partners. Finally, they offer advice, providing extra information and context to those who design and develop nurse education programmes.

There are two parts to the standards:

• Standards for competence the knowledge, skills and attitudes that all graduate nurses need to demonstrate at the point of registration with NMC. Generic competencies need to be met by all nurses. Field competencies relate to the four fields of adult, mental health, learning disabilities and children’s nursing.

• Standards for education the requirements all pre-registration nursing programmes have to meet, including those relating to the teaching, learning and assessment of nursing students. The standards for education have been developed to ensure students’ competence can be rigorously assessed and demonstrated. The standards must be robust enough to meet public expectations for safe and effective practice.

The standards for pre-registration nursing education will be published in the autumn of 2010. They will replace the existing Standards of proficiency for pre-registration nursing education. New education programmes, designed to meet the new standards, will be introduced from September 2011.

The consultation

This consultation gives us the opportunity to receive your feedback on the proposed new standards. We want to know:

• how effective you think they will be in enabling programme providers to develop nursing education programmes
• how they can be enhanced or improved
• whether you can see any barriers to their successful introduction
• whether they are clear and easy to use
• whether we should include anything else and
• whether they support and promote equality and diversity.

Some of the requirements and guidance in the proposed standards for pre-registration have been carried over from the current Standards of proficiency for pre-registration nursing education (NMC 2004). [PDF]

Most of the questions in this consultation will ask you about information that is new, or where there have been major changes to the existing requirements.

Get involved
Our online survey will run from 29 January to 5pm on 23 April 2010.
Link to survey page.

Attend a question and answer event

During February and March we will host five question and answer events across the UK.

If you are considering taking part in the consultation, this is an opportunity for you to ask NMC professional advisors who have been leading this review any questions you have about particular aspects of the consultation document or the new standards.

The events are designed to support you in completing the online survey - their purpose is not to receive feedback on the new standards.
To find out more go here.

My source NMC mail list:
Leila Harris-Ryberg
Communications Officer
Press and Public Relations
Communications and Stakeholder Relations
Nursing & Midwifery Council
23 Portland Place
London W1B 1PZ
www.nmc-uk.org

Hurricane Thyroid Disease and tips on how to treat

Description:
Thyroid storm is a life threatening condition that develops in cases of thyrotoxicosis (hyperthyroidism) are not treated.

Symptom
Symptoms are severe and may include:
- Agitation
- Changes in alertness (consciousness)
- Confusion
- Diarrhea
- Fever
- Heart beating (tachycardia)
- Fidget
- Trembling
- Sweating

Treatment
Thyroid storm can be overcome with medication, the other option is surgery to remove the thyroid gland or radioactive iodine administration.

Gold rice best of vitamin A source

Rich golden rice containing beta-carotene is known to be transformed into vitamin A in the human body. Golden rice is effective for improving vitamin deficiencies such as poor communities.

Thus research in the Department of Pharmacy University of Baylor and Tufts, in his article that appeared in the latest issue of the column the American Journal of Clinical Nutrition.

Golden rice developed in the early 1990s with funding from the Rockefeller Foundation which aims to create rice that contains beta carotene, a precursor of vitamin A in rice grains. Recent data indicates that the Golden Rice contains 35 micrograms of beta carotene in each gram.

"We found that four units of beta carotene in Golden Rice will be converted into one unit of vitamin A in the human body," said Dr. Michael Grusak, professor of pediatrics associations Children Nutrition Research Center USDA / ARS at Texas Children's Hospital and BCM as reported from medicalnewstoday, Saturday (07/25/2009).

It is known after testing by feeding five healthy adults over a number of specific products labeled Golden Rice. In the test are then measured the amount of retinolnya, which is a form of vitamin A in the blood.

Vitamin A deficiency is common in some parts of the world where poor communities depend on rice as their staple food source. People who lack vitamin may be experiencing vision problems can even cause blindness.

"By entering into vitamin A in the staple food consumed by the public, we can make it more accessible to the general public in the area," said Grusak.

Further research is still necessary before the Golden Rice available commercially. The next step of the research to put technology into the rice grains are found in various regions and continue the conversion rate to human testing.

ERCIM News No. 80 published - Special Theme: "Digital Preservation"

Dear ERCIM News Reader,

ERCIM News No. 80 has just been published at http://ercim-news.ercim.eu/

Special Theme: "Digital Preservation"

- coordinated by Ingeborg Solvberg, Norwegian University of Science and Technology; and Andreas Rauber, Vienna Technical University

- featuring a keynote by Pat Manson, Head of Unit "Cultural Heritage & Technology Enhanced Learning"; European Commission Information Society and Media Directorate-General

Next issue: April 2010 - Special Theme:

"Computational Science/ Scientific Computing: Modelling and Simulation for Research and Industry"

(see call for articles)

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

Best regards,
Peter Kunz

This issue includes:

• The CARA Approach for Long-Term Preservation and Exploitation of Medical Images and Reports by Hanan Bouzid, et al..
• Designing a Trusted Distributed Long-Term Archive for Health Records by Frej Drejhammar
• Providing Web Accessibility for the Visually Impaired by Barbara Leporini, et al..
• ICASE Project: New Challenges in Computer-Based Assessment by Thibaud Latour and Sandrine Sarre.

ERCIM News
is published quarterly by ERCIM, the European Research Consortium for Informatics and Mathematics.
The printed edition will reach about 10,000 readers.
This email alert reaches over 5,000 subscribers.

---

Advertising in ERCIM News
By advertising in the ERCIM News printed edition, your company or institution will be able to speak to a highly qualified audience: You can reach over 10,000 researchers, scientists and decision makers in the field of information and communication technologies.
For rates and conditions, see http://ercim-news.ercim.eu/advertise

---

About ERCIM
ERCIM - the European Research Consortium for Informatics and Mathematics - aims to foster collaborative work within the European research community and to increase co-operation with European industry. Leading research institutes from twenty European countries are members of ERCIM. ERCIM is the European host of W3C.
http://www.ercim.eu/

Midwifery Materials for Haiti - in French/Creole - NEEDED

My source as posted to the GANM and on HIFA 2015 lists:

I am writing the (GANM) community to ask for assistance in gathering online midwifery and nursing materials - in the French or Creole language, for Haiti.

The National Nurse School University and Faculty of Medicine in Haiti has collapsed and they have lost most of their training materials. Dr. Larouche was killed in that collapse - he was teaching an OB course to the midwifery class at the time. I do not know the fate of the nursing/midwifery students, but one can imagine that the outcome is probably not a good one. Dr. Larouche was filling the void left by the untimely death of Madame G.Francoeur last year (she died in an auto accident).

Midwifery in Haiti was just recovering after the sadness of the loss of Mme Francoeur - and the earthquake has now destroyed most everything that they had.

Agnes Jacobs, UNFPA survived and has been emailing from Haiti. She and her colleagues are working to pick up the pieces and try to reconstruct materials for training midwives and nurses in life saving skills.

I am writing to members of the GANM asking for support in finding DIGITAL materials that we can provide to Agnes for the time being. It is VERY hard to get shipments of books and things to Haiti right now, but in the future, I suspect that Agnes will be able to use books, and guides, and computers to rebuild midwifery in Haiti. So eventually we will ask for books and things, but right now it is very hard to get these types of things to her. I know she is not alone, I know that COHI, PAHO, and many others are on the ground. I think the GANM can work with all these others to help in whatever way we can.

Johns Hopkins is sending a team to Haiti, including Dr. Beth Sloand who has been travelling to Haiti with students for over a decade. Beth does not have room to take printed materials, but she can maybe take a packed hard drive or CDs/DVDs that we load with teaching materials. Agnes does have a computer and internet (sporadically) - so I have been discussing with her the potential of sending digital materials which she can start to use right away until printed materials can be provided.

She welcomes health materials in French and or Creole primarily. They should be materials that can *instantly be used to teach midwives and community health workers* - so scientific articles that require interpretation and reconstruction into teaching materials are not what I am asking for at the moment. Right now there are no resources to turn scientific literature into teaching materials. Do you have teaching materials that you would be willing to share?

I would like to ask that people send either direct links to online resources that we can copy down to a CD or send useful teaching materials that we can put on a CD.

Please email them to the GANM or to me (pabbott2 @ son.jhmi.edu)

Regine Marton wrote already directing us to look at Hesperian and the WHO Reproductive Library (in French). We have the Hesperian material now. The WHO library is helpful.

If you have any quality materials for training of midwives that you would like to donate or direct us to find, please let us know. Please send scientifically sound materials - the last thing that Haiti needs are questionable methods or what we call in the US "hocus-pocus" (unproven claims or "magic").

I hope this makes sense and that the GANM community will come together to help Haiti in a “different” way. I think what we are doing is unique – while of course there are huge needs for emergency care and the like we are looking one step ahead to helping Haiti rebuild its educational infrastructure.

Best Regards,
Patti Abbott
GANM Moderator and "Electronic Midwife"

Call for case experiences on capacity development - final 2 weeks to enter

Dear Peter,

The Impact Alliance is working closely with the UNDP to gather capacity development experiences from around the world as part of the 'Capacity is Development' campaign. The members of our network have some amazing experiences to share, and this is a great opportunity to showcase your hard work, grow the knowledge base of what works and influence policy makers. We look forward to hearing from you!

The United Nations Development Programme is pleased to announce the opening of the 'Capacity is Development' Knowledge Fair and invites you to share your experience. The knowledge fair seeks to collect experiences on policies, investments and programs that have proven successful in driving human and institutional capacity development in diverse settings around the world. These experiences will feed directly into the 'Capacity is Development' global event.

We invite you to submit an entry by Friday, 5 February, 2010.

Your entry can take the form of a short two-page case story, video or image.

The top five finalists will be awarded an expense paid trip to personally showcase their work at the 'Capacity is Development' global event in Marrakech, Morocco 17-19 March, 2010.

Entries should attempt to illuminate through words or images the impact of capacity development in practice. While diverse expressions of capacity development are welcomed, there is a special interest in gathering stories from three priority focal areas:

• Sub-national capacity development: local solutions, national strengths.
• Capacity development in post-conflict and transitional situations.
• Fostering the rise and resilience of middle-income countries.

For more detailed guidelines and online entry forms please visit:

www.capacityisdevelopment.org/knowledgefair or contact us at capacityisdevelopment@gmail.com for any questions or to simply alert us about an interesting experience.

Please forward this message to other networks and colleagues.

The UNDP Capacity Development Group is working in partnership with the Impact Alliance and LenCD - Learning Network on Capacity Development to implement this initiative.

(I am adding a link to this event at the POLITICAL domain resource page.)

Immune Hemolytic Anemia Diseases and tips on how to treat

Description:
Immune Hemolytic Anemia is a disorder that sign by damage to the immune system produces antibodies that attack red blood cells as if the substance is foreign to the body. These disorders often strike men than women. The exact cause of this disorder is unknown.

Symptom
This disease does not seem to show any symptoms because of the nature of the slow the growth. When it was worse then the patient will look like symptoms of anemia patients.

Treatment
If the symptoms of mild or if destruction of red blood cells themselves seem to be slowing, there is no maintenance required. If the destruction of red blood cells increases, corticosteroids such as prednisone is usually the first choice for treatment.

One More Chimpanzees with Human Similarity

Atlanta, No need to wonder if people like to imitate the behavior of celebrities, politicians or anyone else who is considered to have the position and higher social status. Because it turns out, distant relatives of the chimpanzee also have similar tendencies.

Previous allegations, imitating the nature of an idol is a typical behavior in humans. Surely it is surprising if it turns out that the primate species is said to have 98 percent similarity with human DNA that have similar behavior.

This was revealed in a joint investigation by a team from Emory University in Atlanta, the University of St. Andrews in Scotland, and Beloit College, Wisconsin. The findings were published in the journal PLoS One May 20th, 2010 edition.

Quoted from HealthDay, the researchers found that chimpanzees also knows what it called prestige (prestige). In her group, there specific figure chosen as role models.

This is observed when the researchers gave specific tasks to a group of chimpanzees for food. In performing these duties, observed a certain tendency in the group.

Chimpanzees who have a history of success and prestige higher gain will be much emulated by other chimpanzees. While chimps that failed, not much emulated.

More and more replicable means a chimpanzee get more prestige. This is according to the researchers affect the development of culture and behavior of chimpanzees, when it occurs in the wild.

The research team is currently planning further research. The goal was to observe the factors of age, dominance rank and experience in relation to the formation of prestige among chimpanzees.

Nursing and care homes: the new schools 4 basic nursing care?

I do not wish to denigrate the quality of care in nursing homes, as I've blogged previously there are others better placed to do that when needed. In some the nursing care is exemplary and this is evident not just in their inspection rating, but the morale of staff, the reports of relatives and local community plus other indicators - especially when you visit and use your senses. As a nurse you are duty bound to assess the quality of care wherever your practice takes you. In the homes where the care is very poor, there is no escape from that reality. The reality of poor care first hits visitors when they smell the home they have entered. If there is no escape for them - well what then of the residents and staff?

Now an extended and dedicated role for nursing home liaison within community mental health nursing has arrived* and taken root, this must say something about the quality of care in this sector (and not merely suggest a shortage of Consultant Psychiatrists)? Nurse, service managers and commissioners recognise that if they do not preempt the referral torrent (or trickle from some care homes!) then community teams will grind to a stand-still. Care homes need assistance even as private businesses in assuring their holistic competency.

If services do not stem that referral flow as a wave or otherwise, they will in turn become second rate first-aiders with no primary purpose. They will be forced to respond repeatedly to the same client RE-referrals, the same set of disjointed, fractured physical:mental:social health problems presenting in a series of unique individuals. And this is not person-centred care.

What the nursing home liaison role says is that here is one place we can locate the theory-practice gap, a skills gap and a lack of integrated, holistic person-centered care. Mash-ups may be desirable in the virtual world, but in care delivery - is that safe? Too frequently the mash-up of combined physical and mental health problems pass staff by. The problems go unrecognized, they are there: evident, but disguised; due to lack of comprehensive observation, life histories and despite the question and answer sessions at the gates (service interface). However it is described (e.g. single point), the specialisation of community mental health teams into memory assessment, intermediate, community mental health, ... depends on the vibrant management and quality of referrals.

Much is made of nursing homes registered as EMI (Elderly Mentally Ill) and their need for or access to a registered mental health nurse (RMN); but RMNs in turn rely on the ability of more junior staff to observe and accurately report the basic aspects of the resident's physical and mental state. If equity for older people in care is to be achieved, then although the care - nursing home sector is 'private' and a 'business' there must be an accommodation, a partnership when it comes to education and valuing time invested in these homes.

*Additional links:

http://www.careinfo.org/congress/pdf07/07par.1340q2-joannehirst.pdf

http://www.mentalhealthequalities.org.uk/our-work/later-life/communities-of-interest/care-homes-liaision-/hartlepool-care-home-liaison/

Image source: Neo - The Matrix http://www.dailygalaxy.com/my_weblog/psychology/

Hodges' model links in 3D with Topicscape

Roy Grubb (Hong Kong) got in touch recently regards his appreciation of the links resource I have compiled, organise and maintain using Hodges' model. Roy's intention to create a Topicscape in 3-D has now borne fruit. Unfortunately, on my Macbook Firefox fell over trying the link below. I then learned Topicscape runs on Windows PCs only. I look f/w to trying on my (aged) PC, but despite that limitation - this is a great development. Many thanks Roy!!

Here is Roy's post from his site (the larger image below with link is from his initial post):

I wrote about this a couple of weeks ago. Now that I have permission from Peter Jones to use the lists on his pages of links organized according to Hodges’ Health Career Model, I can announce that it is on-line and live in the form of a read-only Topicscape. You can search (just type) and visit the pages (links are in the details panel – just click). Links to the four main pages of links in the Hodges’ Health Career Model site are in the four main topic cones: Intrapersonal, Political, Science, Sociology.

Give it time to load the Topicscape software first time. Subsequent visits will be much quicker.

For you to fly around and explore this you will need a PC with 3D graphics hardware with an up-to-date graphics driver (requirements here).


There’s a wiki page with some helpful pictures that explain the few things you need to know to get you flying and zooming with the best of them. If you need any help, email me at r dot g at topicscape dot com.

Roy

Additional links:

The medical profession and mind maps – the quiet ones

Topicscape - Roy's initial post 'Hodges’ Health Career Model'

Science domain: H2CM (Visualization I & II, VR, Diagrams)

Putting 'care' in a holistic frame

How many frames do you need?

*infocare: care demographics, directories, media, literacies...

care communication, self care, care ethics, care philosophy, emotional care, pastoral (green) care, therapeutic care, care beliefs, interpersonal care, MENTAL HEALTH CARE cognitive care, holistic care, care responsibility, care ecology	emergency care, physical care, care model, theory, plan, care assessment, evaluation, care curricula, intervention, care process, evidenced care, BASIC NURSING CARE intensive care, coronary care, special care baby unit, *infocare, nursing care, medical care, health care, e-care, surgical care
collaborative care, child care, personal care, older adult care, informal care, SOCIAL CARE, family care, care education, community care, care community, residential care, care dependency, abusive care, care risks	duty of care, care policy, care provision, inspection, standards, care economics, care outcomes, care legislation, care home, care contract, care advocacy, care quality, CARE AID, care qualification, regulation, State care, private care, care insurance, CARE RIGHTS, care service engagement, prison care

Don't forget the 5th, virtual, spiritual frame?

Where is that?
It is wherever you need it to be. ...

Additional suggestions welcome: h2cmng at yahoo.co.uk

Currencies and travel in health and social care

Before the advent of the euro, holidays in Europe were that bit more exotic. Having to buy and adjust to another currency - and not just one - was part of the novelty and fascination of travel.

Health and social care have their own currencies (and yes, read that as there being integration here too!). Most of the currencies are national given the efforts to standardise, with examples such as, length of stay, referral to treatment and more recently in residential care and elsewhere continuing care and its occasionally truculent neighbour 1-to-1. Unfortunately, like land masses, these currencies can also suffer from continental drift.

Dissemination (use in the wild) lack of review and ongoing attention to standards, benchmarks and definitions can see a currency drift in its application and subsequent reporting (affecting perceived utility, value and impact). The value of a currency can be diminished over time as it no longer acts as a unit of difference.

So enjoy your travels, but beware the risks while you vive la difference, especially in your work!

Image source: http://www.artlebedev.com/mandership/77/

Marathon, half-marathons and other journeys

In 1984 a holiday in Athens brought with it the opportunity to visit Marathon. As a cross-country runner at school Marathon had always held a magical place in my mind. It did not disappoint either. Although I did not exactly follow in the footsteps of Pheidippides, the journey from Athens to Marathon was an experience in itself using the bus. And now - is it really 2,500 years since he made that journey?

Now there are many other marathons run the world over.

On the 21st March The Fresh Air Fund in NYC are having a half-marathon. As many of our readers are USA based and perhaps around NYC this may just be the spring well-being event for you?

Seriously, there are half-marathons the world over and Running Diary is one site that can help find one near you. Slightly closer to home for me the Alderney Half Marathon & 10 km Fun Run looks and sounds a great event. Walking or running wherever you are of course just getting out and about helps. In the meantime all the best to the Fresh Air Team, indeed all runners (and cyclists) everywhere!

Sahana OSS response in Haiti

My source: Community informatics list [ciresearchers]:

Sahana Software Foundation
Haiti Earthquake Response
Status Report #1
January 17, 2010 00:00 UTC

The Sahana Software Foundation and the Sahana community responded with a massive voluntary effort immediately following the earthquake that has devastated the poor country of Haiti. Working around the clock, we have set up a hosted instance of Sahana (the first deployment of SahanaPy following a disaster!) on a public website that is already filling gaps in the information management requirements of the massive relief operation.

Major Accomplishments

We have a Haiti 2010 Sahana Disaster Response Portal - a live and active website up at http://haiti.sahanafoundation.org which contains a feeds from many of the relief agencies and links to Sahana modules that are actively being used to help coordinate the relief effort.

We have a Sahana Haiti wiki page where we are tracking all of our and others' activites at: http://wiki.sahana.lk/doku.php/haiti:start

We have a requirements page where we record all the modification, configurations, and changes to Sahana based on the mission requirements at: http://wiki.sahana.lk/doku.php/haiti:requirements

The Haiti 2010 Sahana Disaster Response Portal provides the following functionality:

1. An Organization Registry - serves to track organizations and offices working on the ground in Haiti. Organizations are encouraged to self-register and report their office locations - alternatively, individual organization office or lists of offices can be e-mailed to haiti-orgs@googlegroups.com and we have volunteers to assist with data entry and to aggregate lists from other sources. We have entered data from pre-disaster lists of organizations working in Haiti available from UN OCHA. We can assume that these organizations will be working on the relief efforts, but expect that most of their office locations will be different as most organizations have been forced to move into tents given that few buildings remain standing and usable in the capital. We are working to validate these lists with the organizations directly.

The site serves up both KML for Google Earth users and GeoRSS for everyone else, and will generate reports of organization activities and the gaps (uncovered sectors by geographic location). This site will hopefully become the main resource for accurate information about the organizations working on the ground, where they are located, and what activities they are engaged in, and the resources in terms of staff and equipment that they have available to them. (Currently, data is admittedly sparse but we expect more details to become available as the coordination efforts take root on the ground). We are coordinating with UN OCHA, Google and others on sources of accurate lists and updates.

What are the gaps in our information collection? We have a large and we think accurate list of organizations, but not much office location information. Without this, it becomes hard to generate data that can be used as a layer in a GIS system. We are encouraging people to report this information - preferably by GPS coordinates, but any location information that we can use to manually geo-reference the office is valuable. We hope to be able to enhance our capabilities such that we can produce polygons showing organization's areas of coverage by sector. Please direct organizations working in Haiti to our site to register their offices and activities!

2. A Missing Persons Registry / Disaster Victim Identification (DVI) Registry - we are working with Google and others on an agreed common standard for the exchange of Missings Persons data using the PFIF standard. The Google site at http://haiticrisis.appspot.com/ is the main aggregator collecting all missing and found persons reports and we are encouraging all people to send data to that site. [We are struggling a little as Google's feed is not fully PFIF compliant and the lack of unique record identifiers makes it more complex to set up true synchronization without the creation of duplicate records. We continue to work with Google on this and hope to have a resolution and solution within the next few hours.] We will also be embedding Google's widget on our site for collecting missing person information. Google will be making their data available via a PFIF feed and we will be importing it into Sahana's Missing Persons registry. From there, Sahana can add value to the simple lists being collected.

In particular, Sahana's Disaster Victims Identification registry - or DVI - which is used to management the handling and tracking and tracing of the deceased, dead bodies and their identification. There is currently no other known application for this and we hope that those working in this area will find Sahana extremely valuable. Sahana will have the ability to cross-reference missing persons information with the identified and unidentified deceased, thus facilitating reconciliation efforts. The Sahana Missing Persons registry has additional physical description information fields and we hope to be able to utilize some of the image matching capabilities available to extend these capabilities further. Organizations interested in utilizing these capabilities (which will not be made open for public use) should contact the Sahana team at
sahana-haiti@lists.launchpad.net.

Any updated missing persons status information will be pushed back to the main Google repository from Sahana.

3. Situation Mapping - Sahana's site is able to map all of the geo-referenced data within Sahana - primarily the organization data, but we have also manually entered a data layer of hospitals and medical facilities. Sahana has worked with members of the OSGeo community to obtain a fast tiled set of the current imagery being made available by Digital Globe. Sahana is also leveraging the constantly updated set of Open Street Map tiles. These are acting as backdrop for the offices that are being entered as part of the Organization Registry. Other data sources that are ready and available to be leveraged by Sahana and SahanaPy for other deployments include reports from Ushahidi, various point layers from Open Street Map, location names, USGS earthquakes, and locations from GeoNames. We will continue to build out these capabilities further as relevant layers are made available.

Capabilities we are working on:

The following capabilities are in the process of being developed and we expect will soon be available:

4. Request Management: We are working with the US State Department, Ushahidi and some other voluntary efforts on a project to process SMS messages with requests for assistance sent from survivors in Haiti. SMS text messages sent to a short code in Haiti will go into Ushahidi, who will have volunteer translators to add some structure to the message, identifying the sender's name, location (to the extent possible), and category of the message - a missing persons report, a request for assistance, etc. The message will go into a Ushahidi GeoRSS feed that will be captured by Sahana and fed into a simple Request Management system where the requests for assistance (such as "send water" to a certain village or neighborhood) can be made visible to relief organizations working on the ground. Organizations can fulfill or claim requests for handling and message the person back that assistance is coming. (Missing persons information will be captured by Google).

5. Translation: In addition, our translation project is now set up for Kreol and French translation and we may utilize a pool of Kreol-speaking volunteers being set up by the Service Employees International Union (SEIU) to help in these efforts. Interested translators should be directed initially to:
http://translate.hfoss.eu/wiki/Translation to become oriented in the process.

6. Shelter Registry and Disaster Victims Registry: In the coming days, we expect that there will be a requirement to start tracking the location of temporary shelters now being established, and possible registration of the survivors. We will prepare Sahana's existing registries for such purposes, which will produce further consumable data layers as well as additional missing persons reconciliation capabilities.

If you want to help:

We are using the IRC #sahana channel on freenode as our main coordination tool. Join the chat room to volunteer for tasks and someone from our core volunteer team will direct you - this room is actively staffed on a 24x7 basis.

But first, please check out the wiki pages to see what are the current requirements and areas of focus. We have a lot of volunteer Python and PHP programmers already working on the codebase, but we can probably use more. Please review the requirements page in particular to see where you might help.

We also have a large need for non-technical help - particularly for documentation support - user guidelines and instructions in particular - including some nice screenshots. See
http://trac.sahanapy.org/wiki/UserGuidelines to get started.

We also need help with Bug & Functionality testing. Please submit bug reports and feature request to: http://trac.sahanapy.org/newticket

For documentation and testing efforts - please use the development site at
http://haiti-orgsdev.sahanafoundation.org - NOT THE LIVE SITE PLEASE.

Finally, we could use help maintaining our own wiki - both the main page and requirements... much of this can be culled from the chat room logs - and helping to update some of the common public repositories of information about similar efforts, such as the crisis commons wiki at
http://crisiscommons.org/wiki/index.php?title=Haiti/2010_Earthquake, although they are doing a pretty good job at tracking us ourselves.

Remember to add yourself to the wiki as part of team, and what you are doing.

Acknowledgements

Personally, I have never been a part of such a collaborative and cooperative effort on the part of different organizations to come together and to help each other and to not replicate efforts. The Sahana community has worked closely and constantly with InSTEDD, Ushahidi, haitianquake.com, Google, the Crisis Camp participants, and others I apologize for not mentioning and we wouldn't have been able to accomplish all that we have without this, and for this I am very grateful.

The around the clock efforts of many of the Sahana community are too numerous to mention here, and at risk of leaving anyone out, I would just like to thank everyone for all that they have done and been able to do while juggling responsibilities such as full-time jobs and families.

This has been a new model for Sahana deployments - rather than waiting for a specific customer to come forward to take ownership of Sahana, we have self-deployed and I think this will be a likely successful model for the future. More and more, technology projects are stepping forward and doing good directly.

So go forth and do good.

Best regards,
Mark
==========
Mark Prutsalis
President & CEO
Sahana Software Foundation
Tel 860-499-0332
Fax 801-697-8731
mark at sahanafoundation.org
http://www.sahanafoundation.org

Compass-ion and care cartography

Are you a -

Care surveyor?
Care commissioner?
Care architect?
Care assessor?
Care appraiser?
Care philosopher?
Care manager?
Care publicist?
Care gatekeeper?
Care journalist? Care mentor? Care ecologist? Care informatician?
Care provider?
Care student?
Care planner?
Care archivist?
Care governor?
Care wright?
Care cartographer?
or is that - Care mapper?
....

or just a -

CAREr?

What c+mpass do you use to navigate the CARE -

curriculum
reflections
dialogues, records, policy, IT systems,
access
outcomes ...
?

Were you born in 1989? Join the EU "Generation '89" project!

Are you a citizen of Austria, Belgium, Bulgaria, the Czech Republic, Germany, Hungary, Poland, Romania or the UK?

Meet people from your generation!
Join the "Generation '89" project!

You have the chance to participate in one of the simultaneous meetings in Brussels, Bucharest, Prague or Warsaw, and to present the Declaration "Generation '89" to EU representatives in Brussels!

Application deadline: 31 January 2010 (10 February for Belgium and Poland)

More info at www.generation89.eu

With the support of the "Citizenship" Programme of the European Union.

GENERATION 89

The project "Generation 89" proposes to commemorate the fall of the communist systems in the European countries, through the lens of the young people born in 1989. The young people from Czech Republic, Romania, Poland, Belgium, UK, Germany, Hungary, Austria and Bulgaria and have had different historical context in which they lived their lives, and one of the objectives of this project is to bring together these youngsters and to offer a space where they can share experiences and expectations for the future. In order to attain this objective, 4 international meetings will be organised in Prague, Bucharest, Warsaw, and Brussels, where for two days the participants will have a various programme focused on two themes: national past and European future.

The programme will comprise movie screenings and debates on the events from 1989, as their parents' generation lived and storied them, informational session regarding the EU policies in the matter of youth and young professionals, workshops focused in drafting a Declaration upon how they perceive their future in EU, a documentary visit to a local organisation with activity in the field of communist systems studies, sightseeing and international night. A second meeting in Brussels of a delegation of the young representatives will be organised with the EU representatives, in order to present the Declaration "Generation 89" and the young people opinion on the future of Europe and their future as citizens of EU. With the support of the "Citizenship" Programme of the European Union.

www.generation89.eu

Image source: Globe - Europe Registrarism

Folliculitis disease and tips to treat

Description
Folliculitis is the inflammation of hair follicles one or better. This condition can occur on skin anywhere.

Folliculitis begins when hair follicles damaged by friction from clothing, blockage of the follicle, or shaving. In most cases of folliculitis, damaged follicles are then infected with the bacteria staphylococcus (staph).

Symptom
- Rash (reddened skin area)
- Acne or pustules located around hair follicles
- Itchy skin

Prevention
To prevent further damage to hair follicles and infection of action that needs to be done among other things:
- Minimize the friction of clothes.
- Avoid shaving in areas that often arise itching (if it must be shaved, use a clean new razor blade or electric razor).
- Maintain cleanliness of the area that itches.

Incontinentia pigmenti disease and tips on how to treat

Description
Incontinentia pigmenti (IP) is a skin condition which is derived through families that causes unusual bright color and skin color changes. IP is caused by abnormal genes. In many cases, there is a problem with one of the genes located on the X chromosome. This condition most often occurs in women.

Most babies born with a skin color change IP in the first two weeks. Discolored skin occurs when a substance called melanin that accumulate under the skin. Melanin gives skin color.

Symptom
Babies born with the IP spot on the skin. When the patches that turn into lumps disappear. and after the lump disappeared replaced their dark skin, called hyperpigmentation. After several years, the skin returns to normal.

IP associated with central nervous system problems, including: growth delay, paralysis, muscle spasms. People with IP also has the possibility of abnormal teeth, hair loss, and visual problems.

Treatment
There is no specific treatment for IP. Treatment is aimed at individual symptoms. For example, glasses may be needed to improve eyesight. Drugs can be prescribed to help control seizures or muscle spasms.

Rickettsialpox disease and tips on how to treat

Description:
Rickettsialpox is an infection transmitted to humans by the bite of rat fleas home.

Rickettsia Akari is an organism that causes rickettsialpox. A person can contract the disease when infected fleas bite infected rats. Long incubation, from flea bites until the first symptoms for 7 to 14 days. This disease usually goes away by itself. Just knowledge, some countries such as Russia, Korea, and South Africa became a county spread of this disease.

Symptom
Rickettsialpox main symptoms are:
- rash
- fever
- chills
- muscle aches

Treatment
Antibiotics such as tetracycline, doxycycline, and chloramphenicol can be used to treat rickettsialpox.

'situated' in Hodges' model #2

So, Hodges' model is person-centred and situated
- a conceptual springboard for all.

In the 1970-80s the nursing process challenged task-based care.

Ever since we have stressed individualised, personalised care and now today self-care.

Interpersonal and communication skills are central to nursing theory,
practice, management and informatics.

In Hodges' model the individual is the primary focus*.

The science and art of nursing
is predicated upon the
nurse - patient
relationship.

Situated = 'Its a duet' (anagram)

*Inclusion of the 'group' in the model also facilitates
consideration of relatives, parent-child, family, community and populations.

Short Bowel Syndrome Disease and tips on how to treat

Description:
Short Bowel Syndrome is a condition in which the nutrients are not absorbed properly (malabsorption) due to a severe intestinal disease or surgical removal of most of the small intestine. When most of the small intestine surgically removed, or because of defects that occur before birth (congenital defect), the possibility of intestinal surface is not large enough to absorb food nutrition.

This condition may develop when one-half or more of the intestine removed during surgery. Risk factors include the small bowel disease that may require surgery, such as Crohn's disease. While infants are usually the cause Necrotizing enterocolitis.

Symptom
* Diarrhea
* Fatigue
* Pale
* Swelling (edema), especially of the legs
* Very smelly
* Weight loss decreases

Treatment
Treatment aims to relieve symptoms, and can include:
* High-calorie foods that supply vitamins and minerals, and other types of carbohydrates, proteins, and certain fat
* Some vitamins and minerals may be given by injection
* Treatment for anemia with vitamin B12, folic acid, and increased dietary iron
* Drugs to slow the normal movement of the intestine (nutrients extend the time spent in the small intestine)
* Tube of food through the veins (parenteral nutrition), when normal eating is not giving enough nutrients (sometimes a patient can eat normally again after they have been stable)

Food in Hospital Patients Not Create a spirit of Eating

Patients who were treated at the hospital often complained about the food in the hospital were less tasteful. In Japan even 50 percent of hospital food wasted in the UK and raise about USD 800 billion wasted because hospital food is not finished.

Why is hospital food does not make a patient's spirit?

As quoted by the Guardian, Thursday (5/20/2010), no public funds for hospital care of about 50 million pounds (about USD 750 billion) is wasted because of food policy at the hospital to make patients who do not spend a lot of food.

Foods that are expected to be a patient's recovery process seems to fail because the food is given a bad mood that actually causes the patient no appetite.

"The government should be responsible for improving the quality of food served in hospitals so that all patients believed that the food consumed can come to recover the disease," said researchers at the Centre for Food Policy at City University.

While the discovery made by Japanese researchers in 2008, found the hospital food did not make the patient less excited because it tastes good.

Just so you know, hospitals are reducing the use of salt or flavor in his food dish. Though the flavor of salt and this is one that makes food tasty and can increase appetite.

Researchers have found exactly the use of glutamate can increase appetite, especially for elderly patients. Free glutamate can be found in cheese sauce, oyster, crab, chicken, beef, white shrimp, tomatoes and others. While glutamate is bound to be found in the flavor.

"Based on this research, the proper utilization of glutamate for nutritional care of elderly patients would be useful to improve the quality of life because the patient had an appetite so that white blood cells increased, the sound clearer and more cheerful face," said researchers from Seinan Toyama K Jo Gakuin University

'situated' in Hodges' model #1

I'm not exactly sure how many times I've cut and pasted the paragraphs that introduce Hodges' model as person-centered and situated. Quite a few!

Thanks to the HIFA-2015 list I realised last week that there is no tag for 'situated' on W2tQ. Well, this post corrects that omission, but what does situated mean in Hodges' model?

Here is a definition c/o Google:

• situated/s'ɪtʃueɪtɪd/
  Synonyms:

  • adjective: located
  • If something is situated in a particular place or position, it is in that place or position. ADJ adv ADJ v-link ADJ prep
    ...
    

Related phrases

• situate
  If you situate something such as an idea or fact in a particular context, you relate it to that context, especially in order to understand it better.
  ...

Hodges' model is based on the belief that health and social care are multicontextual. Without wishing to substitute one term for another context and situation are inter-related and bear closer examination here on W2tQ.

Hodges' model prompts the user to consider that the person (-at-the-center) of care is simultaneously residing within four primary situations or contexts (five - if we include the spiritual aspects). Veterans and new recruits appreciate from the dizzy heights of the model, how quickly we find complexity in the multiple contexts that exist in health and social care. The many perspectives and views that must be taken into account to achieve safe, integrated and holistic care. Together with the above there are other definitions of relevance to scholars, champions and users of Hodges' model:

located: situated in a particular spot or position; "valuable centrally located urban land"; "strategically placed artillery"; "a house set on a ...
wordnetweb.princeton.edu/perl/webwn

In artificial intelligence and cognitive science, the term situated refers to an agent which is embedded in an environment. ...
en.wikipedia.org/wiki/Situated

Located in a specific place; Supplied with money or means
en.wiktionary.org/wiki/situated

The first definition about location is important as Hodges' model puts the person at the center. It is from there that the care domains are considered in turn and revisited as required. Hodges' model provides a locus around which care activities can be placed. Usually we view self-centeredness in a pejorative way. When you think about it though this is precisely what is needed to achieve person-centered care. In this case we need something that constantly re-centers - reorientates the subject(s) and agent(s) of care.

The second definition which looks to A.I. for inspiration is relevant as the concept of embodiment, embeddedness already has academic form* as a means to explore self-centeredness. Not only is the individual embedded in a (the) situation, but the carer (formal - informal) must also reside there and share to an extent the experience, if empathy, rapport and communication are to arise.

That final definition can be utilised due to the inclusion of means. People have skills, strengths and coping strategies and this sense of situated rings very true at present, with the emphasis on recovery, staying well, relapse prevention and adjusting to what may be permanent change. People also need knowledge as a means to maximise their health and well-being, which takes me back where I started with Health Information for All by 2015.

So, amid all the complexity, over-arching infrastructures, policies,
debate (and definitions!) it is refreshing that as I revel in the
scope of Hodges' model - two axes, four domains,
its holistic bandwidth... I can find the
word 'situated' planted
firmly
at the model's
center.

* Ref:
Paley, J. (2004) Clinical cognition and embodiment, International Journal of Nursing Studies, Volume 41, Issue 1, Pages 1-13.

Image source - with thanks: Ariel Bravy - http://www.arielbravy.com/photoblog/
http://www.arielbravy.com/photoblog/images/20060719214447_glenn%20x%20millenium%20park.jpg

Pregnancy sickness Through Time and tips to treat

Description
Called the pregnancy if the pregnancy is overdue past 294 days or 42 weeks. Possible reasons for lack of amniotic fluid, placenta infusiensi, or stress.

Symptom
Fetal movements are rare. In infants who are born there are signs such as fragile skin, dry, and easy to peel, the skin looked green, yellowish on the nails, skin, and umbilical cord.

Treatment
Labor induction or delay of termination of pregnancy during the week to assess fetal movement.

Ticks in boxes and triplicate thinking

Having things in triplicate may be reassuring from an admin perspective. ...

That said, 1st year learners on wards can relax to focus on learning, not having to worry (too much) about the administration - the running of the ward 24/7.

Very soon though years 2... 3 come knocking and they must consider due process, they have to question and get to grips with the established routine that sets and keeps several plates spinning.

Of course IT has by and large (?!) removed the need for paper carbon copies (although those three copies should have three distinct purposes).

Despite that an obsession with ticks in just three boxes may not be enough when it comes to high quality multidisciplinary, holistic and integrated care - it's ticks in the mind and attitude that count.

Additional links:
Records Management Society

The Productive Ward

Image source:
Triplicate Girl - http://upload.wikimedia.org/wikipedia/en/6/63/Triplicate_Girl_LSH3.jpg

Vitiligo Disease and tips on how to treat

Description:
Vitiligo is a skin condition where there is no berpigment skin areas. The exact cause of vitiligo is not known with certainty. Vitiligo associated with malignant diseases such as anemia, hyperthyroidisme, and Addison's disease.

Symptom
There are white patches that contrast with the original skin.

Treatment
Vitiligo difficult to cure. early treatment including light therapies, treatment with trimethylsoralen.

Aspirin overdose and tips on how to treat

Description:
If someone accidentally or intentionally consume high doses of aspirin at one time, it is called an acute overdose. If normal doses of aspirin, aspirin accumulate in the body from time to time and cause symptoms, it is called chronic aspirin overdose. This can occur if the kidneys are not working correctly or if a person is dehydrated. chronic aspirin overdoses typically occur in patients older ages when the weather is hot.

Symptoms:
Symptoms of acute overdose may include:
- Stomach pain and stomach pain
- Nausea
- Vomiting - may cause an ulcer or irritation of the stomach known as gastritis

Symptoms of chronic overdose may include:
- Fatigue
- Low grade fever
- Confusion
- The heart beats faster
- Breath uncontrolled

Treatment:
Treatment depends on the amount of aspirin consumed when you swallow and the overall condition of incoming patients keteika emergency treatment room.

IgA nephropathy disease and tips on how to treat

Description:
IgA nephropathy is chronic kidney disease lasting 10-20 years. This is caused by deposits of protein immunoglobulin A (IgA) in glomeruli (filters) in the kidney. These glomeruli normally functions as a filter waste and excess water from the blood and sends it to the bladder as urine. However, the IgA protein prevents this filtering process. This can lead to blood and protein in the urine and swelling in the hands and feet. It is unknown what causes IgA deposits are.

Symptom
The most common symptom is blood in the urine. Symptoms until the disease is necessary for many years and causing complications such as swelling, upper respiratory tract infection recurring, or intestinal disease.

Treatment
Specific treatment for IgA nephropathy will be determined by your doctor based on age, health condition of patients, medical history, the impact of the disease. Treatment includes:
diet, cholesterol reduction, medication, stop smoking, exercise and maintaining normal body weight and blood pressure control.

Comment on Paul Roemer's "EHR market is ripe for the taking by Google, Microsoft, Oracle"

I read with great interest Paul Roemer's post last month -

EHR market is ripe for the taking
by Google, Microsoft, Oracle

I've a lot of respect for the people working at that other sharp end of health. There are times when they are where I would like to be: not the bleeding edge, but the business edge:

Paul is a healthcare strategist and the managing partner of Healthcare IT Strategy, which helps health care providers solve business problems using EHR, workflow improvement, and change management.

Mr Roemer is out there among the corporations, the deals, the the media frenzy and the stock market's take on health care AND health IT. He is addressing specific audiences and over here in the UK we can hear the debate raging. My problem is that working for the NHS all my career I have been and am cocooned. Even though I try to venture out and get involved, this is the very powerful criticism of long-term public sector employees. While far from totally sheltered from economical and political climate change, we are protected from the worst of the business elements. Despite this, seeing the title of Paul's post and his two rules:

Rule No. 1: Content is king. In cable, it is channels such as HBO and Discovery. In healthcare it is data--patient data, effectiveness data, disease data.

Rule No. 2: The cable/telco model values the businesses based on the number of assets (subscribers--you and me). Each body adds somewhere between $5,000 and $10,000 to the valuation model of a Comcast or a Verizon. Downstream, some valuation will be placed on each PHR subscriber.

- two additional rules sprang instantly to mind. ...

Rule 3: Beware low hanging fruit

I posted in April 2009 Data sharing, privacy, health, citizenry.... "Database State" expressing concern that the sanctity of personal data is being eroded bit-by-bit in the mind of the general public by the media and the sheer ubiquity of information and technology. Peaches, plums, pears are delicious when ripe, but as such they need to be handled very carefully. So too does the Personalised health record amid a variety of threats - the worst of which are often internal. In health care the patient data that Paul identifies in his Rule 1 is central, and a key issue is the demarcation of individual and anonymised aggregated data. Hence, Paul quite rightly points to a regulated market. Personal data can be far more valuable in terms of direct marketing and so the temptations for misuse are profound.

In the UK an NHS consultation has addressed the additional uses of patient data. This concerned the research capability programme and provision of a health research support service; with events to present proposals and debate the various issues that include information governance. The report of that consultation is provided below (care of the NHS-HE Connectivity Project list):

http://www.dh.gov.uk/en/Consultations/Responsestoconsultations/DH_109310

Information governance is not fixed, nor should it ever be.

In Paul's rule 1 content is king and content=data - in this case:

• patient data;
• effectiveness data;
• disease data.

This list of data would surely qualify as being 'broad spectrum' in nature. If its circulation is not very tightly controlled it can damage the (care) environment. If not managed effectively across multifold 'borders' - national, regional/state, corporate, systems, organisations, users, testing, interfaces, legislative, public bodies - this data can mutate markedly despite the insistence upon standards. You see although Google, Microsoft and Oracle may take that ripe fruit, as they pick it they come across -

Rule 4: Whenever and wherever picked,
fruit can be tainted

This might include the odd bug, or one or two tainted fruit items perhaps? It could be problems in the form of parts of the EHR that are difficult to incorporate, with questions of shared access and ownership? (If the fruit is indeed pristine, no blemish, no chemicals, no truly-devoted-insect-kisses: what are the overheads - especially those in the form of corporate responsibility?)

Now don't mistake me: I'm also sick to the gums of flannel and people talking jargon. I've seen medics, nurses and nurse managers waving their arms around stressing the importance of their profession, this action followed by that and pointing to the shrouds (my right index finger twitches as I write). But if Google, Microsoft and Oracle believe they can do an Indiana Jones and just shoot to solve the problem because - as Paul suggests - they have the 'numerics' in the cable/telco model, then they need to take care (even if only improvising).

Microsoft, CSC and many other corporations already know of the complexity that reigns (pours in fact!) from their experience in health IT. Paul highlights Google as a new kid in town. Maybe acquisition does obviate the need to learn quickly (let others learn the lessons). But whatever the point of entry: health care remains a cussed business. And the future mix demands (begs!) the integrated addition of social care, but how and to what level?

It is not enough to counter "let's attack this complexity with simplicity." Health and social care are metronomic. They alternate between complex - simple descriptions (one of which is re-organisation). Plus, that metronome may as well be in a closed box:

Schrodinger's. Care to gamble?

Paul's choice of 'downstream' referring to the eventual valuation of PHR subscribers does lessen the mechanistic clang-clang as the subscription counter falls. There is a space for the person - for the humanistic aspects to shine through. Paul's post is also fascinating since such numbers do count and speak volumes (sorry - but they really do). They will not only reach shareholder's ears, but the general public's too helping erode the cherished sanctity of my personal data. So am I saying that some of the giants of corporative intelligence turn and run screaming, arms raised like surprised Martians in alien territory? No.

Maybe, as I have found -

the real low hanging fruit is the m+del.

Is it as ripe and appropriate in this market as it seems?

Or is it past its sell by date?

Time as ever will tell.

Additional links:

NHS data breaches: the 'cogeography' of who and where?

EHR market is ripe for the taking by Google, Microsoft, Oracle

Paul Roemer (twitter)

Image source:
LowHangFruit.com

=============== Paul's Post Follows ==============

December 17th, 2009

by Paul Roemer
The national EHR market is ripe for the taking by a big three like Microsoft, Google and Oracle. Heck, I'll even go so far as to suggest that when the dust settles in about five or seven years, the National Health Information Network will be a regulated combination of a handful of those firms.

As for the other firms offering or planning to offer PHRs, permit me to suggest the following scenario: Let's say I am in charge of Google's somewhat non-existent healthcare line of business. One of my goals would be to have more users of my PHR than any other firm.

Why does this model make sense? Two ways, both of which come from the cable/telco business model.

Rule No. 1: Content is king. In cable, it is channels such as HBO and Discovery. In healthcare it is data--patient data, effectiveness data, disease data.

Rule No. 2: The cable/telco model values the businesses based on the number of assets (subscribers--you and me). Each body adds somewhere between $5,000 and $10,000 to the valuation model of a Comcast or a Verizon. Downstream, some valuation will be placed on each PHR subscriber.

So, back to the example of me running Google's healthcare offering. (If you don't like Google as an example, insert your favorite firm.) If I'm Google, am I troubled by the fact that other firms are building their own solutions? No, because the difficult part of the business model is adding users, adding subscribers. Why not let a bunch of firms do the business development work for me, do the dirty work to get the users, and then just devour those firms? Once I own them, I convert them to my platform. Do I then get some 'ownership' or right to use the data? That would certainly be the business goal.

One million users valued at $5,000 adds $5 billion in valuation. Ten million adds $50 billion. Ten billion is about 2.5 percent of the U.S. market. Do I stop at the border? Of course not.

By the way, while all this is going on, Google, Microsoft, or some other company will also be creating standards and building or buying up EHR firms.