Nitpicker's Notes

 

My passion is to fix stuff.

Talk to me about

1. JustGo- An easy to learn and use method for navigating through lots of information.
2. VibrantHealth - Making HEALTH matter in our non-system
3. TheySaid

4. SmoothFlow - A system to eliminate unnecessary traffic jams.

I am an inveterate nitpicker. I correct the placement of garbage cans in my pod in the mobil home park where I live. I correct grammar and spelling on wikis and on Literotica sexy stories and anywhere else I can.

VibrantHealth - Fixing health care in America in three years.

Focus on OUTCOMES, not procedures. Health care reform for HEALTH

Dick Karpinski

"Health Care Reform Now ! " was written by George Halvorson, the CEO of Kaiser Health Plan. He undersstands the problems, especially where incentives to the health care providers encourage inefficient and ineffective care. He suggests a method for introducing another participant into the process between the payers and the providers to do two main things. They will insist on the providers using an electronic system to request payment, a single consistent system which creates an electronic medical record for each patient and records actual outcomes.

The outcome data is currently missing so neither providers nor patients nor even payers can compare the results obtained by different providers whether primary care doctors, specialists, hospitals, or health care plans. When we can tell what outcomes are achieved, everybody can make better choices and better outcomes will naturally follow. Evertybody will insist on it. When our hospital kills twice as many mothers in childbirth as the next one, we WILL want to change what we are doing in pre-natal care and deliveries. Count on it. The payers who reimburse the providerswill care. The companies who pay the premiums will care. The patients who use the services will care.

We are currently paying twice what other developed nations pay for health care, and yet we suffer much worse health care results. We require emergency rooms to take every desparately sick patient who shows up, but we do nothing to help that person avoid becoming desparately sick. Sometimes we do no prevention even when the patient is insured. There are no payment codes for providing a patient advice which will prevent a hospitalisation in the future. We don't pay for that, so we don't get that. When we eventually bring the uninsured into the system, and we repair the system so it encourages prevention, we will fix many problems. Our health will improve. Our costs will go down. We won't need so many clerks paid to deny claims.

TheySaid - A cheaper, faster way to learn what's in expensive academic journals.

Dick Karpinski

We have already many open source academic journals such as the Public Library of Science.. This is where original research is published so scientists around the world, and sometimes even in outer space, can learn what has been discovered lately. But many academic journals still print on paper and charge high prices for individual subscribers and very very high prices for libraries. This makes those journals unavailable to third world scientists and other people without the support of wealthy companies. Copyright interferes with open access, but the right approach avoids that problem entirely. Ideas are not copyrighted, only the words used to express them.

The articles in such journals are tightly written. It often takes half an hour or more PER PAGE to read an article carefully. Even textbooks, while designed for students to learn from, are still hard to read and often dull, besides. But there is a better way. One system I like is Compendium. It focuses on the questions being asked. Any answer must link directly to the question it answers. Of course there are often many competing answers to a single question, and each of them can be supported or challenged by arguments for and against them. The general class of such systems, including IBIS, the Issue Based Information System, and QuestMap, another commercial product no longer sold, is called Dialogue Mapping and is in turn supported by a book of that name by Jeff Conklin.

If some students, enthusiasts, and professional but poor scientists were to create dialog maps from the best journal articles, they could become articles in a wiki. Perhaps people would contribute their work along these lines in just the way that people contribute to Wikipedia. Of course, these are original research which is not supposed to show up in Wikipedia. Instead, this is the way scientists tell each other what they figured out, and why the other guy's experiments are silly and wrong. Scientists are supposed to fight with each other, though it must be admitted that sometimes it seems more like a teenage food fight than we might like.

Dialog Mapping lets the multiple viewpoints coexist in a single document. It even allows for alternative forms of the questions which might thereby elicit better answers than the original questions. "That is not the right question to ask! Instead, ask ...." And you don't even write the words, you just insert the alternative question with its own set of linked answers. This small amount of structure lets the questions form a natural index into the detailed dialog. You can find the part you want quite quickly. That is, if you like, this gives you an efficient way to ignore the parts you don't care about.

SmoothFlow - A system to eliminate unnecessary traffic jams.

 I was reading the stuff google showed me for "traffic waves", as suggested by a friend, and enjoying the truth of the effectiveness of anti-jam driving.

Then I thought that if we all (or actually even a small fraction of us) collaborated to do anti-jam driving we could improve gas milage and tempers for many many people.

Then I wanted the coordination communication to happen with auto-mesh WiFi in our auto-mobiles. I still can't see how to make this into a clear need for an auto-zooming UI. Damn. Well, take what you can get.

Then I wanted the WiFi device to speak to me while I was keeping my eyes on the road.

The radio speaks to me. And the TomTom GPS driving assistant speaks to me. Aha!

The TomTom is already intended to use sophisticated wireless (GPS) to help me drive better and save gas and reduce frayed nerves.

Just add 802.11S and a little software and 20% (or 10?, or 5?) of the drivers who respond appropriately to the spoken advice from their TomTom will save the highways from unnecessary traffic jams!

What an inexpensive fix to a widely distributed time, gas, and frustration wasting problem!

And a little step toward having the cars do the driving so we can enjoy the scenery and our cell phones and TVs and even our companions.

When we're ready, we can later add "cruise control" features to allow close spaced caravans, to reduce wind drag and improve lane capacity even more. Naturally it would auto-spread when zipper merges are needed.

Richard Karpinski, Nitpicker       dick@cfcl.com 

148 Sequoia Circle, Santa Rosa, CA 95401

Home +1 707-546-6760     Cell +1 707-228-9716

http://nitpicker.pbwiki.com

ps Put (or leave) "nitpicker" in the subject line to get past my spam filters.

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