July 19, 2019

Traffic was moving slowly after breakfast with friends Friday Morning. I glanced around and noticed a rather dark, large smoke plume originating to my west.

While in traffic, my first thought was that the Sylvee had gone up in flames. The source turned out to be a Madison Gas & Electric substation. Fortunately, no one was injured. Curiously, I’ve seen no mention of this incident on their website.

I recorded a short video clip and captured a few images while moving slowly in Madison’s isthmus:

Madison Gas & Electric customers pay the highest rates in Wisconsin [https://www.zmetro.com/pdf/2019/wis_avg_res_electric_bill_2018_2019.xlsxxlsx comparison], up to 44% more than other Wisconsin utility customers. Why?

Madison Gas & Electric was embroiled in a lobbying scandal some years ago, sending money to a Kansas Democrat Party organ.

I recently compiled a bit of long term, personal medical history along with an image or two prior to meeting a new physician. I sought to share this digital information efficiently, and save everyone time, if not money.

However and unfortunately, Epic Systems’ My Chart app (Madison, WI based UW Health implementation) lacks the ability to ingest and share patient sourced images or documents…..

A few days later, in clinic, I used iOS’s AirDrop to share the text and graphics to the physician’s iPhone. While helpful, the lack of patient sharing tools meant that a clinic visit was required along with ever increasing deductibles.

Many healthcare providers share personal medical record data via the iPhone’s health app.

However and unfortunately, $3.65B UW Health’s Epic medical records cannot be shared to my iOS health app.

We continue to pay more for less.

The lack of interoperability is a reminder that US taxpayer’s now $40B back door electronic medical record subsidy has been a failure. Costs have exploded and we citizens lack data portability, despite the legislation’s requirement:

The HITECH Act set meaningful use of interoperable EHR adoption in the health care system as a critical national goal and incentivized EHR adoption.[7][8] The “goal is not adoption alone but ‘meaningful use’ of EHRs—that is, their use by providers to achieve significant improvements in care.”[9]

There are pockets of innovation. One Medical’s app supports video visits:

Thankfully, the visit was of no consequence, other than time and money.

Additional reading:

Death By 1,000 Clicks: Where Electronic Health Records Went Wrong

Madison’s Property Tax Base Growth; $38B+ Federal Taxpayer EMR Subsidy

Stillborn 2007 Wisconsin $30M EMR subsidy.

Cringely:

A reader asked me to write tonight about the Health Information Technology for Economic and Clinical Health Act, which is about as far from something I would like to write about as I can imagine, but this is a full service blog so what the heck. The idea behind the law is laudable — standardized and accessible electronic health records to allow any doctor to know what they need to know in order to treat you. There’s even money to pay for it — $30 billion from the 2009 economic stimulus that you’d think would have been spent back in 2009, right? Silly us. Now here’s the problem: we’re going to go through that $30 billion and end up with nothing useful. There has to be a better way. And I’m going to tell you what it is.

Russ Britt:

The costly flaws in U.S. digital health-data plan

Walking around SC Johnson’s impressive Racine campus recently, I turned a corner and this image lay in front of my camera.

Shift, focus, focus again – quickly as time is short – capture.

I found the fusion ideal: VW’s superb GTI and the Frank Lloyd Wright designed Research Tower are symbiotic.

To wit:

Wright called his design a “helio-lab,” or sun-lighted laboratory. At the building’s dedication, he said he hoped it would be a “flower among the weeds” of typical, “drab” structures built for business.

CAR magazine’s Good, Bad and Ugly on the GTI:

GTI is your dad when he was wild, young and free. After seven generations, VW has this hot-hatch thing nailed.

Pondering this random scene, my thoughts returned to driving some rental Toyota’s in Japan last year. Fine cars and well sorted interfaces with my iPhone, but, they were not a GTI. There may be hope, after President Akio Toyoda recently decreed “no more boring cars”.

VW appears to understand stimulants. Our youngest – no car fan – recently messaged me a link to “Hello Light”:

That said, she did speak well of a European VW Polo’s iPhone support during a recent rental.

Design, well done, adds incredible value to experiences and perceptions.

P.S. Wright’s impressive tower apparently cost four to five times the proposed budget. Wright and VW share tortured paths.

P.S2. I’ve owned a 2013 GTI since new. It is a (very) fun car to drive and has been more reliable than expected.

P.S3. SC Johnson’s (free!) architectural tour is rather impressive, from the knowledgeable guides to the visual stimulation. I find their approach to brand building quite interesting and, perhaps somewhat aligned, if not symbiotic, with Volkswagen’s.

P.S4. Mr. Toyoda has tapped into a fascinating and tension filled topic: Mission – let’s call it design – vs. Organization – let’s call it operations. The tension between mission and organization was recenlty exposed in several articles that discussed Jony Ive’s departure from Apple – and the quick reaction, which continues.

P.S5. For those unable to visit in person, the amuz app (amuzapp.com) features a number of Wright destinations, including SC Johnson’s headquarters and research building along with the nearby Wingspread estate.