Monday, August 20, 2007

Why game creators need to open up their definition of games

Article from Ron Fahey on why the word game is likely to stay with the concept of interactivity.

This is not, before you roll your eyes and start skim-reading, about to turn into a lengthy argument for the dropping of the phrase "game" or "videogame" in favour of some new alternative which better describes the industry's products. Suggestions for a new, consumer-friendly name for interactive entertainment have been doing the rounds for over a decade, and they're all doomed to fail for one simple reason - everyone likes the word "game", even if it's not terribly accurate.

Besides, the accuracy doesn't matter; the word "game" is a label for interactivity, not a pigeon-hole which must be dispensed with because of its older connotations. After all, very few films are actually created using film any more, and there are a lot of novels which aren't exactly novel - the names remain, because they are intricately linked in people's minds with the class of entertainment they represent.

Click here for complete article

Friday, August 17, 2007

Saturday, August 11, 2007

Saturday, August 4, 2007

What You Will


Sent to you by Judi via Google Reader:


via IdeaFestival by Wayne Hall on Aug 03, 2007

We will draw the curtain and show you the picture. Twelfth Night, Act i. Scene 5.

At Functioning Form, Luke Wroblewski publishes his notes from a talk at Yahoo! Design Week given by IDEO general manager Tom Kelley on the importance of anthropology in business innovation.

Since I'm generally skeptical of efforts to pin down the bottom line value of design, I appreciate Kelley's emphasis on role playing - an idea that he develops in his book, Ten Faces of Innovation - and how anthropology, rather than metrics, might offer more to business creatives. There's even some evidence that the constant measuring itself can slow innovation.

So I'm with Kelley. Would-be innovators might want, instead, to take in Twelfth Night to understand how identity can be used to get somewhere.

Have a good weekend, all.



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Saturday, July 28, 2007

Today's Reason to Love the Web

WOW Amazing Constructions!!!! -

Ubiquitous computing and privacy: a design project

from ACM technews

Informatics Designs Tools to Promote Health Care,
Independent Living

Indiana University (07/19/07)
Researchers at the Indiana University School of Informatics will design tools that address the privacy concerns of the elderly, as information processing becomes more integrated in everyday devices around them. They
will build a "living lab," and volunteers from a Bloomington retirement community will participate in studies and provide feedback on how to improve designs and the design methodology. The digital toolkit could include a sensor that would be mounted to the kitchen counter for volunteers to place a finger before making breakfast, and a sensor embedded in a TV remote control that measures the participant's heart rate each time
it is used. "Our proposal addresses the acute privacy challenges of using ubiquitous computing in a home-based health care environment, where vulnerable populations risk enforced technology intimacy," says associate professor Jean Camp, who specializes in privacy issues and the impact of IT on society. They will concentrate on developing tools that will allow the volunteers and their caregivers to communicate their privacy concerns in the second year of the study, and in the third year the team will design a ubiquitous computing system for two households at the retirement community and study the interaction. The National Science Foundation is funding the project with a $821,000 grant.
Click Here to View Full Article
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Web support network

McGowan, Virginia (2003). "Net-working the Steps: Web-based Support for Women in Recovery from Problem Gambling." [review] EGambling: The Electronic Journal of Gambling Issues,. 8 (May).

Friday, July 27, 2007

HBS Cases: How Wikipedia Works (or Doesn't)



via HBS Working Knowledge on Jul 25, 2007

Published:July 23, 2007
Author:Sean Silverthorne

HBS professor Andy McAfee had his doubts about Wikipedia, the online encyclopedia created and maintained by volunteers. "I just didn't think it could yield a good outcome or a good encyclopedia. But I started consulting it and reading the entries, and I said, 'This is amazing.' "

So when the concept of "Enterprise 2.0"--a term coined by McAfee on the general idea of how Web 2.0 technologies can be used in business--popped up on Wikipedia, McAfee beamed. "I was bizarrely proud when my work rose to the level of inclusion in Wikipedia." Then, however, a turn of fortune took place. A "Wikipedian" nominated the article for deletion as unworthy of the encyclopedia's standards. McAfee thought, "It's not even good enough to get on Wikipedia?"

He left the sidelines to join the online discussion about whether the article should be kept or jettisoned. It was also that moment that would eventually lead to an HBS case study, written with professor Karim R. Lakhani, on how Wikipedia governs itself and faces controversial challenges.

The case offers students a chance to understand issues such as how online cultures are made and maintained, the power of self-policing organizations, the question of whether the service is drifting from its core principles, and whether a Wikipedia-like concept can work in a business setting. (See related story below.)

The wisdom of crowds

Even by online phenomenon standards, Wikipedia is huge. Begun in 1999 by Jimmy Wales under the name Nupedia, the service today claims 1.8 million articles in English, 4.8 million registered users, and 1,200 volunteers who regularly edit Wikipedia articles.

Anyone can submit or edit an article, which is why Wikipedia has been lampooned for high-profile inaccuracies, such as a biography of journalist John Seigenthaler Sr., who, according to the anonymous contributor, "was thought to have been directly involved in the Kennedy assassinations of both John and his brother Bobby." Not so. A recent cartoon parodied, "Wikipedia: Celebrating 300 Years of American Independence!"

But Wikipedia also employs a series of consensus driven vetting processes that strive to ensure the information is accurate, is verifiable, is built on solid sources, and excludes personal opinion. Just as anyone can submit an article, anyone can also start an "Article for Deletion" (AfD) review process if they believe the piece does not live up to those standards. After online debate about the worthiness of the piece, a Wikipedia administrator reviews the arguments and decides the fate of the article.

The result has been a product that even academics regularly consult. In late 2005, the scientific journal Nature conducted a study comparing 42 science articles in Wikipedia with the online version of Encyclopaedia Britannica. The survey revealed that Encyclopaedia Britannica had 123 errors while Wikipedia had 162 (for averages of 2.9 and 3.9 errors per article, respectively.) For the editors at Britannica, that may be a little too close for comfort.

It's the kind of success that attracted McAfee, whose research centers on the use of technology in business, and Lakhani, an expert on distributed innovation.

"We had these completely overlapping interests, and we were kicking around the idea of how we were going to write a case on Wikipedia, what research could we do: What's the right way in on this phenomenon?" McAfee recalls. "And we just got very lucky with timing, in that this article appeared about my Enterprise 2.0 concept."

Into the thicket

In May 2006, someone unknown to McAfee, but who had read his seminal article "Enterprise 2.0: The Dawn of Emergent Collaboration" in the MIT Sloan Management Review, posted a 34-word Wikipedia "stub"--essentially a brief starting point for others to build on the concept. McAfee's article detailed how so-called Web 2.0 technologies such as blogs, wikis, and group messaging, employed in a business setting, could encourage more spontaneous, knowledge-based collaboration.

Shortly after the posting, however, Wikipedia user "Artw" recommended the article for deletion, characterizing the entry as "Neologism of dubious utility." An administrator eventually deleted the work, but Enterprise 2.0 was resurrected as a lengthier piece. An AfD was again tagged on the article. The debate was on.

"So we got to watch the governance process up close and personal on a topic that I cared a lot about," recalls McAfee. "I participated in the Article for Deletion process, and got to understand how Wikipedia works as a Wikipedian. At the end of all that we said, 'Well, regardless of what else we do at Wikipedia, we've got a really, really good teaching case right here.' "

Why Wikipedia works

From the outside, Wikipedia may look like chaos barely contained. "When people look at these sorts of phenomenon at Wikipedia, they misread the anarchy," Lakhani says. "All these people, thousands of people, there must be no rules! But there is a very ornate and well-defined structure of participation. One of our big learnings was to actually dive into the structure: What is the structure that enables these guys to produce this great resource?"

One element instilled by founder Wales is an ethic of self-governance and treating others with respect. In many online communities, personal insults fly freely, often fueled by youth and anonymity. Wikipedians, however, do not cotton to personal attacks. "The elbows are sharp on Wikipedia. It's not cuddly. But at the same time, I'm not entitled to call someone a bleep," says McAfee.

Another reason the governance structure works, adds Lakhani, is that it is transparent--everyone's edits can be read and commented upon by anyone else.

But the real basis of Wikipedia governance is a collection of policies and guidelines developed over the years that defines everything from article evaluation standards to the etiquette surrounding debate.

"When I got involved in this Article-for-Deletion process, they kept citing chapter and verse the policies and guidelines to me," McAfee says. "It really showed me how much Wikipedians rely on these--they really are the foundations that Wikipedia uses.

"So you've got a very clear set of criteria for telling your fellow Wikipedians, 'Here's my contribution, here's why it's valid and needs to be included,' " McAfee continues. "Now, you can argue about the wordsmithing and the structure of the article, but as far as the core question of what goes into an article, they've got that largely nailed."

Or was it Enterprise 2.0 that was getting nailed by the rules?

The endgame

McAfee thought the Enterprise 2.0 article did, in fact, live up to those standards. So why was it being considered for deletion? As the arguments dragged on, McAfee began to feel that the debate might be about something more than just the article.

"It seemed to me that some of the people arguing against it were entrenched, and they were using Wikipedia's policies as doors, as barriers, without being willing to engage in a real debate about them. So the policies had become for them a way to keep out articles they just personally didn't like."

And although Lakhani believes part of the entrenchment was because a Harvard professor was in the middle of the fray--"I think what happened was that people took even firmer stances"--Lakhani agrees that rules seemed to be used in an exclusionary way. "Now the question is, is what we saw just a tempest in a teapot, or does it tell us something interesting? I think it does tell us something interesting."

An ongoing tension within Wikipedia is characterized as the inclusionists versus the exclusionists. The inclusionists argue that one of Wikipedia's core values is that it should be open to all ideas, that truth emerges from a variety of directions. Better to include than exclude. The exclusionists see Wikipedia's utilitarianism diminished if too much froth clouds the valuable information inside.

"There is always a tendency in communities or in any social organization to have this boundary and say in or out," Lakhani says. "This might be happening in isolated places inside Wikipedia. The tension that they need to deal with is how to keep it as porous as possible."

Porous is good, says Lakhani, because most content on Wikipedia appears to originate at the fringes of the community from anonymous or infrequent contributors. (A central core of about 1,200 volunteers refines the pieces over time and generally tends the Wikipedia garden.) If exclusionists began to make it more difficult for outside contributions to populate Wikipedia, the product's secret sauce could be spoiled.

"That kind of ossification, if that happened, could be really dangerous," says McAfee. "But my feeling is this existential debate about the inclusionist versus the deletionist is not going to cripple Wikipedia. What's lost there, though, is that some people who have a lot of energy to bring--and I'm one of them--get turned off by these deletionists trying to slam doors in our faces."

But in its 8-year life in several forms, Wikipedia has shown institutionally that it is open to evolution of the rules. "They continuously keep tweaking the rules as they encounter new situations," Lakhani says.

Win some, lose some

In the end a Wikipedia administrator, serving as judge, reviewed the 17 pages of debate about deletion and decided Enterprise 2.0 should stay in. Victory was short lived.

"After that," McAfee says, "one of the people on the other side of the debate took it upon himself to truncate the article greatly and change the title of it. And I left him a message. I wrote, "Hey, did you not see that the result was 'Keep'?" And he replied, 'Look, Wikipedia is this very freeform environment. This is what I feel like doing. If you don't like it, feel free to change it.' Which left me a little unsatisfied, I have to say."

Q&A: Wikipedia in Pinstripes

Companies interested in tapping into the shared expertise of their workers--the wisdom of crowds writ for business--are looking towards models such as Wikipedia that encourage collaboration.

Can Wikipedia work in pinstripes? Harvard Business School professor Andy McAfee has his doubts that a corporate encyclopedia would have much value. But the underlying wiki technology--basically an electronic document and repository where participants can throw out ideas, comment on the work of others, and share documents--has more promise.

McAfee and collaborator professor Karim R. Lakhani discuss their research into wikis and other collaboration tools for the enterprise.

Sean Silverthorne: Is Wikipedia a good model that transfers to a corporate environment?

Andy McAfee: No is the short answer here, simply because (a) how valuable is the corporate encyclopedia, and (b) how much enthusiasm or incentive do we have to contribute to the corporate encyclopedia? But an encyclopedia is only one of the things you can build with wiki technology.

Karim Lakhani: Wiki is another experiment in how to generate more collaboration inside companies, but I've seen mixed results. It can be as simple as "We're having an office party, please sign up on a wiki page, and tell us what you're going to bring," to "We're going to run this project, bring in all your knowledge assets together, and then we can self-organize."

What Wikipedia has shown is that self-selection is critical. Peer review is critical. So there is a challenge for firms that are used to managing employees and allocating the resources in a very top-down kind of way. Now we have a technology that enables self-selection, transparency, openness--how does a manager or management deal with the technology? Do they implement it in a way that's true to the spirit, or is it top-down? And, again, there are some very successful examples and some not so successful examples.

McAfee: There are a couple of things that explain a lot of the not so successful ones. There is the fact that this is a different technology, and you have to be, at this point, kind of a technology enthusiast or an early adopter. There's another problem, though, which is when you think about the percentage of Wikipedia users who have contributed anything to Wikipedia, it's got to be way less than 1 percent. Only a tiny, tiny fraction have done anything, but they have huge reach and huge impact. So the participation percentage is not big enough for this to spontaneously happen inside an organization. You've got to give it a push somehow. And management is my shorthand for where that push comes from. If you just say, "Employee base, here's a cool new technology, use it for your collaboration and coordination activities," you get back a big corporate blank stare.

Silverthorne: Wikis rely on the foundation of free expression. But can employees feel free to express their opinions to everyone in the company as Wikipedians do in their world? The CEO might be reading it, after all.

McAfee: You have to create an organization where you feel free to share your thoughts, and you don't care that your boss and the CEO can see it. And that's a much bigger challenge, I think. But then the benefits go up dramatically.

Silverthorne: Have you used wikis yourself?

McAfee: I can give you a couple of examples because I try to use wikis in a fair amount of my own work. I was organizing a 40-person conference of academics and needed to take care of all these administrative tasks that I really hate doing, like putting the schedule together. And I thought, "Ding, I'm going to outsource this to the people who are coming to the conference." So I put up a couple of initial wiki pages and e-mailed them to everyone. I said, "Here is the bare -bones schedule. You guys tell each other and tell all of us what you think we should do in each of these slots, and if you want to present in one of these 4 daily slots, just add your name to the list." And with very little pushback, the Web site for the conference self-assembled, and most people were quite happy with it. The amount of overhead went through the floor.

I also use them in my MBA course Managing in the Information Age. I tell my students that about half their grade will be based on wiki contributions. So I solve the incentive problem that way. And then I have to deal with all the problems of, "Well, what do you want us to do?" ("I'm not telling you.")

Lakhani: I think the other thing is that many companies are realizing that there's lots of knowledge in the outside world and are asking, "How do we enable the outside world to interact with us?" Many are thinking through wiki-like technologies that enable them to collaborate with outsiders and enable customers to give input.

Silverthorne: Will your students be using these tools and concepts when they leave HBS?

McAfee: I find it really hard to believe that all of my students are going to go out into the corporate world and never think about this category of tool. I don't buy it. When they get to their jobs, they're going to have collaboration, coordination, and knowledge -sharing challenges. Are they just going to send e-mails to each other? Darn, I hope not.

Lakhani: The new generation of students, the MySpace and Facebook generation, will be hitting the HBS campus soon; they are already here to some degree. They are so used to collaboration and sharing in a distributed fashion, for instance, going to a friend's page and leaving a note. They have these asynchronous ways of coordinating and collaborating.

McAfee: The distinction I draw is between channel technologies like e-mail and platform technologies that are universally visible and transparent and open to everybody. I think the communication bias of young people today has migrated from channel to platform.

Lakhani: They look at e-mail as being antiquated. And so I think that's eventually going to hit corporations.

Silverthorne: Are companies equipped to design these kinds of products?

McAfee: One of the things you learn is that designing a good user interface is really hard work. I know that companies like Google and Facebook have spent person-years just getting it to the point where it feels very intuitive and easy for us to use. It wasn't easy to get there. One of the things I worry about is that companies will go, "OK, we need an internal Facebook. Why don't we put a three-person coding team together, and we'll throw one of these things up there?" And it's just going to be an inferior product, and employees are going to vote with their feet.

Silverthorne: If you were to counsel companies that need more cross-collaboration and need to break down silos, what technologies would you recommend?

Lakhani: I would say technology's not the answer. It's the information and the flows of the information you've architected and the rules around flow of information that matter. If you look at open-source communities and what they're beginning to accomplish, they did that with some very rudimentary technology--e-mail lists and simple source code repositories. But the outcome has been incredible and is based on the architecture and rules of participation. If you bolt on wikis to an old set of rules, it would collapse and die.

McAfee: I'd say it a little bit differently. Wikis are about 10 years old, but there are modern wikis that are kind of corporate-ready--these are recent technologies. Tagging systems and a lot of other things are recently available technologies. But I agree that the technology toolkit is basically in place; that's a necessary condition, but it's completely insufficient alone. What I usually tell companies is, "Look, if you want to activate this Web 2.0-style energy inside your company, management is going to make all the difference. And if you manage it the old-fashioned way, or if you don't manage it and you just have the if-we-build-it-they-will-come philosophy, you're probably going to be disappointed."

You need to be actively involved--I'm going to fall back on buzzwords--in coaching to get desired behaviors and leading by example, and not shooting people when they step a little bit out of line. The organization is going to be watching what happens, and you're going to send very, very strong signals one way or another that are going to be picked up very quickly.


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Tuesday, July 24, 2007

Today's Reason to Love the Web

Today's Reason to Love the Web

High drama inside a cell, on


Sent to you by Judi via Google Reader:


via TED | TEDBlog by on Jul 24, 2007

David Bolinsky and his team at XVIVO illustrate scientific and medical concepts with high-drama animation. These animators are true auteurs, carefully scripting and editing the story of cellular processes to show everyone -- expert and amateur alike -- the truth and the beauty of our bodies. You've never seen the life of a cell quite like this. (Recorded March 2007 in Monterey, CA. Duration: 9:57.)

New: Download this talk in high resolution (480p)

Watch David Bolinsky's talk on, where you can download it, rate it, comment on it and find other talks and performances.

Read more about David Bolinsky on

Embed this video: Use this code to run the video on your own site:


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"Expressions of negative Clippy feelings"


Sent to you by Judi via Google Reader:


via Language Log by Mark Liberman on Jul 23, 2007

Michael Kaplan, who works on "internationalization and localization issues" for Microsoft, especially "collation and keyboard issues", recently posted some useful information about Clippy: I had a friend complain to me the other day (the way that all folks who have...


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I've been waiting for a paper like this


Sent to you by Judi via Google Reader:


via Marginal Revolution by Tyler Cowen on Jul 22, 2007

Steve Kaplan and Joshua Rauh write:

We consider how much of the top end of the income distribution can be attributed to four sectors -- top executives of non-financial firms (Main Street); financial service sector employees from investment banks, hedge funds, private equity funds, and mutual funds (Wall Street); corporate lawyers; and professional athletes and celebrities. Non-financial public company CEOs and top executives do not represent more than 6.5% of any of the top AGI brackets (the top 0.1%, 0.01%, 0.001%, and 0.0001%). Individuals in the Wall Street category comprise at least as high a percentage of the top AGI brackets as non-financial executives of public companies. While the representation of top executives in the top AGI brackets has increased from 1994 to 2004, the representation of Wall Street has likely increased even more. While the groups we study represent a substantial portion of the top income groups, they miss a large number of high-earning individuals. We conclude by considering how our results inform different explanations for the increased skewness at the top end of the distribution. We argue the evidence is most consistent with theories of superstars, skill biased technological change, greater scale and their interaction.

Here is the link, here is the non-gated version. How about this bit from the text?:

...the top 25 hedge fund managers combined appear to have earned more than all 500 S&P 500 CEOs combined (both realized and estimated).

This is important too:

...we do not find that the top brackets are dominated by CEOs and top executives who arguably have the greatest influence over their own pay. In fact, on an ex ante basis, we find that the representation of CEOs and top executives in the top brackets has remained constant since 1994. Our evidence, therefore, suggests that poor corporate governance or managerial power over shareholders cannot be more than a small part of the picture of increasing income inequality, even at the very upper end of the distribution. We also discuss the claim that CEOs and top executives are not paid for performance relative to other groups. Contrary to this claim, we find that realized CEO pay is highly related to firm industry-adjusted stock performance. Our evidence also is hard to reconcile with the arguments in Piketty and Saez (2006a) and Levy and Temin (2007) that the increase in pay at the top is driven by the recent removal of social norms regarding pay inequality. Levy and Temin (2007) emphasize the importance of Federal government policies towards unions, income taxation and the minimum wage. While top executive pay has increased, so has the pay of other groups, particularly Wall Street groups, who are and have been less subject to disclosure and social norms over a long period of time. In addition, the compensation arrangements at hedge funds, VC funds, and PE funds have not changed much, if at all, in the last twenty-five or thirty years (see Sahlman (1990) and Metrick and Yasuda (2007)). Furthermore, it is not clear how greater unionization would have suppressed the pay of those on Wall Street. In other words, there is no evidence of a change in social norms on Wall Street. What has changed is the amount of money managed and the concomitant amount of pay.

There is a great deal of analysis and information (though to me, not many surprises) in this important paper. The authors also find no link between higher pay and the relation of a sector to international trade.


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Monday, July 23, 2007

Why Paperworks: All About Constraints


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via Common Craft - Social Design for the Web - by leelefever on Jun 24, 2007

Since our first couple of videos came out, I've been talking to a lot of people about what makes the Paperworks format work. Aside from the content/message, I often say that a set of constraints is what makes the format a great fit for our goals.

In this case, a "constraint" is a rule that we have decided not to break in making our videos.

Examples: We only use certain materials (paper, whiteboard, markers, string), we won't make a video over 4 minutes long, we only use our hands to tell the story and we don't use any external music (just humming, snaps, claps, etc.). Further, everything we make in the format is 100% copyright infringement free. These are the Paperworks constraints and they have a huge impact.

You might think that having constraints is limiting, but I think the opposite. Constraints are liberating. By narrowing the scope of possibilities down to only a few ways to present ideas, we can eliminate needless decision making and complexity.

Consider these examples:

Materials: By limiting ourselves to paper, markers and a whiteboard, we don't have to think about all the things we *could* do with flash animation, 3D, focus, perspective and the like. Our materials, while limited, keep us lightweight and simple.

Time: By limiting the video's possible length to 4 minutes, we limit ourselves to major points. We don't sweat the small stuff.

Hands: By using only our hands, we don't have to think about clothes, hair, make-up or even facial expressions.

Music: By not using external music, we don't have to pick the right song or worry about being sued.

The Lesson: The lesson is that constraints work to limit the number and depth of decisions we have to make. By eliminating the decisions about technology, presentation, music, etc. we have time to focus on the core of what makes Paperworks work: the ideas.

The essence of the Paperworks format is simplicity - bringing down the bar of technology and presentation to it's most basic level. By doing away with fancy graphic and soundtrack options, we can make room to think more deeply about the idea and concept that will convey the message in the simplest way we can. Further, it's a format almost everyone can use - it's not limited by complex technologies.

A Bit of Inspiration: If you haven't read The Paradox of Choice by Barry Schwartz, I recommend picking it up. It made me think about the hidden dangers of having too many options. Another inspiring book is Made To Stick by Chip and Dan Heath, which I reviewed briefly here.


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Graphical Summary of Patient Status


Sent to you by Judi via Google Reader:


via On Informatics by David Dorr on Jul 21, 2006

Recently, I (re)discovered this gem of an article:

Powsner SM, Tufte ER. Related Articles, Links
No abstract Graphical summary of patient status.
Lancet. 1994 Aug 6;344(8919):386-9. No abstract available.
PMID: 7914312 [PubMed - indexed for MEDLINE]

Graphical summary of patient statusOne enormous difficulty in the care of complex patients - in this case, hospitalized patients - is the sheer volume of information that is generated over relatively short amounts of time. One of the key requests seen by EHR developers in these settings (whether 'home-grown' or vended) is to better summarize the data. This has led to many different solutions in the area, from flexible flowsheets (think excel worksheets) to 'rounds reports' (single page summaries of key information usable as the health care team goes on rounds) to snapshots (special pages in the EHR that attempt to summarize various aspects of health or care).

For those familiar with the use of EHRs, all of the above examples likely ring a bell. In my experience, these components are often the value-added aspects of the EHR for resident physicians and students in academic centers - the ability to have, easily at hand, a wealth of knowledge about patient status. Interestingly (and, I admit, anecdotally), these summaries are often printed. We created such a summary sheet (available for view here) and found use was higher when printed and placed on the door prior to a visit. The physician or nurse, typing madly into the EHR, would refer to various aspects when making orders or creating notes, alleviating the need to ask the system to flip back and forth between old data and new entries. The sheet provided a lot of pertinent information about specific aspects of a patient's health in a simple format. The major complaint was still the amount of data one needed to sift through.

Tufte and Powsner take this to the next level, by summarizing dozens of variables, adding important context (what matters often is not an absolute level but recent trends and long-term status - what is normal for this patient), and leaving the text at the side. A few groups attempted to take this concept and move forward with it, but they aren't in wide use. It seems like a gem of an idea. Patient records should be easily carried with the team, contain a wealth of information very simply presented, and remove all of the distracting numbers in favor of relative thresholds. Especially interesting is the summary variable for psychosis - quantitative measures for most mental illnesses have been developed but, again, slow to catch on.

Although I have an idea why we haven't implemented these functions broadly (I am being overly positive about the idea on purpose), I'd be interested in the now and future readers' comments. Does this concept work? How could we improve upon it? If you think it can't be successful, why? What other methods appeal to you?


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Google as Diagnostic Aid


Sent to you by Judi via Google Reader:


via On Informatics by Alexis Turner on Dec 05, 2006

I was recently alerted by another member of the department to an article right up my alley - it reports the results of a recent study on using the Internet (Google, specifically) to assist doctors in making diagnoses.

Before we go any further, let's just be clear that the article doesn't suggest Google should replace doctors in the decision-making process; in fact, it makes it quite clear that a doctor's specialized knowledge is necessary to form the search query well in the first place, as well as to sift through the results when they are returned. In this sense, Google's usefulness to decision support is really as something of a brainstorming tool - it allows a trained physician to consider possibilities, sometimes unusual, that may not have been at the forefront of their thoughts.

I found the editorial even more interesting than the results of the study itself, if that is possible. In particular, the editorial points out a significant difficulty with using the web to generate these sorts of results - namely, its anarchy. Because web pages are created using a variety of formats and formatting (HTML, CSS, PDF, DOC, XML, etc.), it makes it very difficult to understand the data itself. Computers do not speak or understand the way we do, they simply index. Something like HTML only tells the computer how to display information, but it doesn't impart anything about what the information means (this is one reason why search engines often return bizarre results, incidentally - because they currently have no way of knowing better).

To deal with this difficulty, there has been an ongoing push (15+ years) by the founder of the web (Tim Berners Lee) and others to move to what they have dubbed "The Semantic Web." In short, this effort is intended to embed all web documents with hidden information that actually indicates what each piece of information means, as well as what type of information it is. As an imaginary example, take this text:

'Googling for a diagnosis--use of Google as a diagnostic aid: internet based study,' Tang and Ng.

Google does not understand that 'Googling for a diagnosis...' is the title, nor does it understand Tang and Ng to be authors. Using semantic web principles, however, one would simply code the page to be something like this:

title 'Googling for a diagnosis--use of Google as a diagnostic aid: internet based study,' /title author Tang /author and author Ng /author .

The person viewing the page, though, would not see all of this information, they would see things as in the first example.

It seems easy enough, but in fact making such a large scale switch is extremely difficult. Among other things, how does one identify which standardized words to use? OWL (Web Ontology Language) is part of the semantic web effort to devise a consistent way of naming individual pieces of information. It couples with RDF (Resource Description Framework), which contains hidden information about the nature of an overall document, to paint a more precise picture of a web page for search engines and other tools.

Although the theories are good, they have taken a long time to catch on, not least because it is so difficult to change the fundamental nature of a system as vast and varied as the web. Proponents point out that, if all the information on the web is consistently presented, individual pages and even pieces of information from within a page can be shared across pages (in other words, rather than linking to an outside page, information can be pulled into an existing page to create a new page that is a mix of many) and applications - databases, for instance, could be built simply by plucking data from multiple sources in real time. Detractors point out that such a requirement goes against the nature of the web by requiring severe rigidity in the ways the pages are structured, and that such rigidity could possibly inhibit new developments. They also express unease at the idea that it would make the web easier to index not only by beneficial entities (Google), but also by hostile ones (government censors).

It's an extremely interesting discussion with implications and applications for several branches of informatics (text mining, information retrieval, and decision support...among others), as well as for the very nature of the web itself.
Googling for a diagnosis--use of Google as a diagnostic aid: internet based study


Semantic Web

[ links suggested by Sarah Lopez ]


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Sunday, July 22, 2007

CEOs must be designers, not just hire them. "Design is...


Sent to you by Judi via Google Reader:


via on Jul 03, 2007

CEOs must be designers, not just hire them. "Design is no longer just about form anymore but is a method of thinking that can let you to see around corners. And the high tech breakthroughs that do count today are not about speed and performance but about collaboration, conversation and co-creation." (link)


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You Know the Blogosphere Is Real When ...


Sent to you by Judi via Google Reader:


via Freakonomics Blog by Stephen J. Dubner on Jul 17, 2007

shhh.jpgAlthough I've been writing journalism in one form or another for a long time, I would like to think that I am not the kind of journalist who makes friends or family uncomfortable about saying something casually that that they don't want known publicly. That said, it does happen that someone will mention something over dinner, e.g., and then quickly say "Now, that's off the record" or "That's not for public attribution." I'm pretty sure I've never violated that trust, and I hope I never do.

Something along these lines happened yesterday -- three separate times, to my amazement -- but, even more to my amazement was the twist that accompanied the request for retroactive off-the-record status. On three separate occasions, involving three different people in three different locations, someone said something interesting to me yesterday and then quickly followed with: "Now, that's not for the blog, please."

The blog? This little thing?

I didn't even know that these three people read the blog. I was, of course, happy to honor their request. (Even though the three pieces of information were in fact pretty juicy, none of them were really appropriate for this blog anyway -- well, maybe one of them was, but since that discussion was also governed by an NDA, it was very, deeply off-limits.) The biggest takeaway for me was this: the blogosphere is real in a way that none of us, journalists or economists or parents or cops, could have imagined a few years ago.

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Better Than a Video Resume...



via Freakonomics Blog by Steven D. Levitt on Jul 20, 2007

A few weeks back Dubner blogged about the video resume. Far more effective, it turns out, is the front-page resume.

I have a good friend named Sally. Last week she won a $25,000 prize as "Nurse of the Year." This week she got laid off!

That made for a great story in the Chicago Sun-Times today.

The new job offers are already pouring in.

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Monday, July 16, 2007

Creative Common Flash animation

A great explanation of Creative commons build in flash