Computerworld reports on an extensive new Harvard Medical School study, appearing in the American Journal of Medicine, that paints a stark and troubling picture of the essential worthlessness of many of the computer systems that hospitals have invested in over the last few years. The researchers, led by Harvard’s David Himmelstein, begin their report by sketching out the hype that now surrounds health care automation:
Enthusiasm for health information technology spans the political spectrum, from Barack Obama to Newt Gingrich. Congress is pouring $19 billion into it. Health reformers of many stripes see computerization as a painless solution to the most vexing health policy problems, allowing simultaneous quality improvement and cost reduction …
In 2005, one team of analysts projected annual savings of $77.8 billion, whereas another foresaw more than $81 billion in savings plus substantial health gains from the nationwide adoption of optimal computerization. Today, the federal government’s health information technology website states (without reference) that “Broad use of health IT will: improve health care quality; prevent medical errors; reduce health care costs; increase administrative efficiencies; decrease paperwork; and expand access to affordable care.
Category: Technology
‘Puzzlers’ reassemble shredded Stasi files, bit by bit
East German documents provide a crucial piece of history, supporters of the project say, but putting them back together could take hundreds of years. A computerized system would help, but it’s costly.
Reporting from Berlin and Zirndorf, Germany, – Martina Metzler peers at the piles of paper strips spread across four desks in her office. Seeing two jagged edges that match, her eyes light up and she tapes them together.
“Another join, another small success,” she says with a wry smile — even though at least two-thirds of the sheet is still missing.
Metzler, 45, is a “puzzler,” one of a team of eight government workers that has attempted for the last 14 years to manually restore documents hurriedly shredded by East Germany’s secret police, or Stasi, in the dying days of one of the Soviet bloc’s most repressive regimes.
Two decades after the heady days when crowds danced atop the Berlin Wall, Germany has reunited and many of its people have moved on. But historians say it is important to establish the truth of the Communist era, and the work of the puzzlers has unmasked prominent figures in the former East Germany as Stasi agents. In addition, about 100,000 people annually apply to see their own files.
The Inside Story of Wal-Mart’s Hacker Attack
Wal-Mart was the victim of a serious security breach in 2005 and 2006 in which hackers targeted the development team in charge of the chain’s point-of-sale system and siphoned source code and other sensitive data to a computer in Eastern Europe, Wired.com has learned.
Internal documents reveal for the first time that the nation’s largest retailer was among the earliest targets of a wave of cyberattacks that went after the bank-card processing systems of brick-and-mortar stores around the United States beginning in 2005. The details of the breach, and the company’s challenges in reconstructing what happened, shed new light on the vulnerable state of retail security at the time, despite card-processing security standards that had been in place since 2001.
In response to inquiries from Wired.com, the company acknowledged the hack attack, which it calls an “internal issue.” Because no sensitive customer data was stolen, Wal-Mart had no obligation to disclose the breach publicly.
Wal-Mart had a number of security vulnerabilities at the time of the attack, according to internal security assessments seen by Wired.com, and acknowledged as genuine by Wal-Mart. For example, at least four years’ worth of customer purchasing data, including names, card numbers and expiration dates, were housed on company networks in unencrypted form. Wal-Mart says it was in the process of dramatically improving the security of its transaction data, and in 2006 began encrypting the credit card numbers and other customer information, and making other important security changes.
“Wal-Mart … really made every effort to segregate the data, to make separate networks, to encrypt it fully from start to finish through the transmission, ” says Wal-Mart’s Chief Privacy Officer Zoe Strickland. “And not just in one area but across the different uses of credit card systems.”
Wal-Mart uncovered the breach in November 2006, after a fortuitous server crash led administrators to a password-cracking tool that had been surreptitiously installed on one of its servers. Wal-Mart’s initial probe traced the intrusion to a compromised VPN account, and from there to a computer in Minsk, Belarus.
Madison Unified Fiber Network, Madison Broadband Initiative
Details appear on the next Madison School Board meeting agenda [PDF].
Good news, if it happens. The Madison lags other parts of the country and world in fiber deployment.
The Truth About the TATA Nano
hy is a soon-to-be success story gathering dust at TATA dealers across India? Much like the initial growing pains of the Ford Model T, the $2000 Nano currently lies on waiting list. Given the lopsided supply/demand and construction conflagrations with the government, I reckon enterprising Indians are flipping the Nanos living in parking lot limbo for profit. Still, my precious few moments sitting in somebody’s dusty Nano left me impressed. Not because it was a perfect machine: I saw automotive history in the making.
Rarely in America is a car designed around a vision: witness the overweight performance icons clawing for yesteryear’s glory, car based trucks and globally designed, badge engineered atrocities. Not with the TATA Nano: behold the homegrown hero.
The Nano is born from an undying need for affordable transportation in a country with a growing but repressed middle class. This group needs a family vehicle superior to tube frame rickshaws and 150cc motorcycles carrying four or more people. Yes, really: I saw a family of four riding a motorcycle through the congested, fast paced, life threatening streets of Bangalore. Make no mistake: a car at this price and size is the automotive embodiment of “If you Build It, They Will Come.”
It’s all about the lakhs; the Nano is designed around a price befitting the Indian working class. One look around the beast shows the good, bad and ugly of the situation.
Exterior fit and finish is respectable, until you spot the unfinished rear hatchback seams, hurriedly painted over. That stylish rear hatch is glued shut, so cargo is only accessible from the rear seat. And the list of price-conscious ideas doesn’t stop: three-lug wheels, single arm wiper blade and an adorable looking center exit exhaust.
Medical Tourism Takes Flight
A growing number of U.S. insurers are paying for patients to have medical procedures performed more cheaply overseas. And that’s raising the profile of a few companies you’ve probably never heard of. Video: Bangkok Bypass Surgery
IN THE PAST THREE MONTHS, THE CREAKY Barron’s staff has replaced a hip, two knees and undergone various nips and tucks. Based on average prices, these cost a total of at least $100,000. But abroad, say in Singapore, the tab would have been about $50,000, including stays in a private room, airfare and a vacation for the patients and their companions. Elsewhere in Asia, medical care is even cheaper. That’s why more U.S. insurers are considering financing treatment for Americans willing to travel abroad. In fact, “medical tourism” could help rein in the health-care costs that devour 16% of America’s gross domestic product.
That possibility is raising the profile of a few publicly traded companies you’ve probably never heard of: Thailand’s Bumrungrad Hospital (ticker: BH.Thailand) and Bangkok Dusit Medical Services (BGH.Thailand), Singapore’s Parkway Holdings (PWAY.Singapore) and Raffles Medical (RFMD.Singapore), and India’s Apollo Hospitals (APHS.India). Says Prathap Reddy, the U.S.-trained cardiologist who founded Apollo in 1983 and is its chairman: “We bring excellent care at a cost benefit. If the U.S. were to cover all its people, there would be a demand/supply gap. India can step in with equivalent care at one-fifth the cost.”
Paranoid Survivor: Andrew Grove
EARLIER this year Andrew Grove taught a class at Stanford Business School. As a living legend in Silicon Valley and a former boss of Intel, the world’s leading chipmaker, Dr Grove could have simply used the opportunity to blow his own trumpet. Instead he started by displaying a headline from the Wall Street Journal heralding the recent takeover of General Motors by the American government as the start of “a new era”. He gave a potted history of his own industry’s spectacular rise, pointing out that plenty of venerable firms—with names like Digital, Wang and IBM—were nearly or completely wiped out along the way.
Then, to put a sting in his Schumpeterian tale, he displayed a fabricated headline from that same newspaper, this one supposedly drawn from a couple of decades ago: “Presidential Action Saves Computer Industry”. A fake article beneath it describes government intervention to prop up the ailing mainframe industry. It sounds ridiculous, of course. Computer firms come and go all the time, such is the pace of innovation in the industry. Yet for some reason this healthy attitude towards creative destruction is not shared by other industries. This is just one of the ways in which Dr Grove believes that his business can teach other industries a thing or two. He thinks fields such as energy and health care could be transformed if they were run more like the computer industry—and made greater use of its products.
Dr Grove may be 73 and coping with Parkinson’s disease, but his wit is still barbed and his desire to provoke remains as strong as ever. Rather than slipping off to a gilded retirement of golf or gallivanting, as many other accomplished men of his age do, he is still spoiling for a fight.
Britain’s National Medical Records Project – “No money spent on training”…
“If you live in Birmingham,” declared Tony Blair when he was UK prime minister, “and you have an accident while you are, for example, in Bradford, it should be possible for your records to be instantly available to the doctors treating you.”
Not any more. Or not, at least, if the Conservatives win the next general election. For the Tories have pledged to scrap the country-wide version of the National Health Service’s electronic patient record.
Back in 2002, the idea of a full patient record, available anywhere in an emergency, was the principal political selling point for what was billed as “the biggest civilian computer project in the world”: the drive to give all 50m or so patients in England (the rest of the UK has its own arrangements) an all-singing, all-dancing electronic record. Roll-out was meant to start in 2005 and be completed by 2010.
Under a Conservative government, development of the local record – exchangeable between primary care physicians and their local hospitals – would continue. Nationally, clinicians would still be able to seek access to it when needed from the doctors who would hold it locally. But the idea of a national database of patients’ records, instantly available in an emergency from anywhere in the country, would disappear.
This may or may not matter, depending on your point of view. For many clinicians, the idea of an instantly available national record was always something of a diversion. It is access to a comprehensive record locally that is crucial for day-to-day care.
Nonetheless, the Conservatives’ decision to scrap the central database is a symbolic moment for a £12bn ($20bn, €14bn) programme that has struggled to deliver from day one. It is currently running at least four years late – and there looks to be no chance in the foreseeable future of its delivering quite what was promised.
…..On top of that, while there was a £6bn budget for the 10-year central contracts, no money was earmarked for training, in spite of the lesson, from the relatively few successful installations of electronic records in US hospitals, that at least as much has to be spent on changing the way staff work as is spent on the systems themselves.
Flickr vs. Free Speech
One thing I’ve learned over the years is this – screwing over your users while yelling “the lawyers made me do it!” rarely ends well. Particularly when the lawyers are just being lazy, and free speech rights are at stake.
Flickr really stepped in it this time. And they’ve sparked a free speech and copyright fascism debate that is unlikely to cool down any time soon.
Sometime last week they took down a photoshopped image of President Obama that makes him look like the Heath Ledger (Joker) character from The Dark Knight. The image was created and uploaded to Flickr by 20 year old college student Firas Alkhateeb while “bored over winter school break.” It was also later altered yet again by someone else and used to create anti-obama posters that went up in Los Angeles.
Thomas Hawk has a good overview of some of the other details, but the short version is the image was removed by Flickr sometime last week due to “due to copyright-infringement concerns.”
People are angry over the takedown. There are lots of pictures mocking President Bush on a Time Magazine cover on Flickr that haven’t been removed. And of the Heath Ledger Joker character.
Airbus A380 in Oshkosh!
Of all the planes to touch down in Oshkosh this week, one towers above all others. That’s the Airbus A380.
We’ve written about the 380 before, and it’s tough to call a plane that’s already in service at three different airlines experimental, but today Airbus gave us – and the rest of the crowd here – something much cooler than your typical commercial jet landing. Flying in from Toulouse (via Milwaukee) under the command of test pilot Terry Lutz, the 380 did multiple flybys over the airfield, showing off for the thousands of assembled plane watchers before touching down at 3:15 local time.
As the plane rolled to a stop, it’s four engines still roaring, we couldn’t help but be awed all over again by its sheer size: 239 feet long, 79 feet high, with a wingspan of almost 80 269 feet and weighing in at 610,000 pounds. Seeing the plane in the company of so many other things with wings (some of them not so small themselves) puts those numbers in perspective. And while it might seem silly to call an aircraft the size of the A380 graceful, there’s no other way to describe the way it gently turned and banked as it circled the airfield before making its final approach. We’ve made it clear from the start that we love this plane, and today in Oshkosh we found a reason to love it a little bit more.