October 2001

    Ties Talk Archive Update | Information Management | Walk For the Wildwood / Oregon Vietnam Veterans Living Memorial | Electric Transformation | Tofu 101 | A Nobel Idea: Information Value | HIMSS Oregon Fall Conference: Patient Safety | Dine For America: Tony Roma's | County Cork Irish Pub | Nikkei Nexus Update | Sayonara Sayonara | Nikkei Netas Linkup | Public Health Informatics | Film: Tran's Mua he chieu thang dung (Vertical Ray of the Sun) | "The Keep" Debut | A Bitter Pill For eHealth | Health Informatics and Homeland Security | Film: Miike's Odishon (Audition) | The Oil's Third Jersey: Ho Hum | Online Music: The People Have Spoken

  • Online Music: The People Have Spoken
    Once-prominent Canadian music retailer Sam the Record Man has declared bankruptcy, throwing in the towel after a long battle against global competition and Internet downloading. This hits an emotional note for a lot of Canadians, who have fond memories of the flagship store on Yonge Street in Toronto ON. I bought my share (probably more) of CDs at Sam's, but the store where I bought my first LPs, A&A Records, went under long ago. It is a sign of changing times and new paradigms. Canadians were among the most active users of the free file swapping service Napster before it was shut down; no doubt they still use the clones that have taken its place. Sam's tried to implement an e-business answer to the Internet age, but it was too little, too late. Will the rest of the music industry take notice and adapt?

    Napster may seem like a villain to recording industry executives, but peer-to-peer technology has many useful applications in areas other than music. It may help medical informaticists achieve their "holy grail", a record of a different kind: the electronic patient record.

    (31 Oct 2001)
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  • The Oil's Third Jersey: Ho Hum
    The Edmonton Oilers debuted their third jersey at last night's game in the 'Chuck against the Vancouver Canucks. From the images I have seen on the Internet, I must say I am disappointed at how drab it is. As it is, the Oil's regular uniforms are among the most conservative in the NHL -- this would have been a chance to liven things up a bit. There had been much anticipation surrounding this project, given that the designer was Todd McFarlane, an Edmontonian who made his name and fortune as the creator of Spawn, one of the top five selling comic books in the U.S. Even though he is a part owner of the team, he had to answer to a committee that, from the sounds of it, didn't want anything too flashy.

    (28 Oct 2001)
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  • Odishon (Audition) (Japan 1999; Dir: MIIKE Takashi) ***
    Dorami-chan and I got an early Halowe'en scare from this film about a middle-aged widowed film producer who is convinced by his son to remarry. So far the scenario sounds like Sleepless in Seattle, right? Not for long! The first half is relatively normal -- relatively in that the producer uses an unconventional process to find a new wife: a bogus audition for a film that doesn't exist, but has a plot just like his life. One quiet young woman seems to meet all of his criteria, until he -- and we -- get to know her better. The gutwrenching latter half is a challenge to the senses, one which I withstood, thanks to the nature of my work.

    The Toronto International Film Festival used to (maybe still does) have "Midnite Madness", a series of midnight screenings devoted to the gruesome and macabre. It isn't surprising that this was where I saw another of director Miike's works in 1997, Gokudoh sengokushi: Fudoh (Fudoh: The New Generation). Koin Rokkaa Behbiizu (Coin Locker Babies), a 1980 novel (a "cyber-Bildungsroman" according to one review) by MURAKAMI Ryu was the source material for Odishon. The plot is mostly different, but the themes of abandonment, vengeance and mutilation remain. Murakami directed 1991's Topazu (Tokyo Decadence), another story of loneliness and alienation in modern Japan.

    Quotes, Cultural Notes and Links

    • "Japan is finished."
    • "Japan is full of lonely people."
    • "Words create lies. Pain can be trusted."
    • The producer, Shigehiko, and his son, Shigeharu, share the same first kanji (Chinese character) in their given names, a tradition also observed by my father's family.
    • Shigeharu is a dinosaur buff and uses the Internet to search for the latest information on a new discovery in Australia -- in English, just like the subjects in my J-MeSH research project.
    • Steve Erickson Meets Ryu MURAKAMI
      1997 Interview with MURAKAMI Ryu
    • Japan's Lost Generation
      In a world filled with virtual reality, the country's youth can't deal with the real thing (Essay)
    • Miike scores double bill at 2001 Tokyo film festival
      Latest offerings:Katakurike no shiawase (The Happiness of the Katakuris) and Araburu tamashiitachi (Agitator)

    (27 Oct 2001)
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  • Health Informatics and Homeland Security
    Today on HealthLeaders.com there is an interesting opinion piece by a healthcare technology consultant who is described as "a frustrated patient and a willing participant in the process of change in the delivery of care." He argues that health informatics -- in the form of the Health Insurance Portability and Accountability Act of 1996 -- is a key part of homeland security.

    HIPAA is aimed at administrative simplification (read: "cutting out red tape") in healthcare business transactions by making business practices (billing, claims, computer systems and communication) uniform across the industry. Presently an average of 26 cents of each healthcare dollar is spent on administrative overhead!

    When the final HIPAA rules were published in 2000 and set a compliance deadline for 2002, the implied widespread need for information technology upgrades was thought to virtually guarantee employment for us health informatics students. But heels have been dragged, largely due to the anticipated cost, and now some involved parties want the deadline pushed back.

    The author makes the valid point that HIPAA is not just about adhering to a government guideline. HIPAA is about making a better healthcare enterprise, which impacts on the entire continuum of care -- and homeland security.

    (24 Oct 2001)
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  • A Bitter Pill For eHealth
    Here is a recent CNET.com special report on problems getting informatics done in the healthcare industry:

    • A Bitter Pill: Online medical industry tries to cheat death
      Health informatics promises to revolutionize the way patients, doctors, drug manufacturers and insurance carriers do business. But in the past five or so years, little has changed. Ambitions have been stymied by a wide range of problems that include offline competition, the New Economy bust, opposition by physicians, and daunting obstacles of integrating the massively outdated technologies used to run the medical business.

    Despite these problems, the good news is that the people quoted in the articles all talk about the inevitability of an informatics transformation in healthcare -- it just may take a generation or so to get there.

    (23 Oct 2001)
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  • "The Keep" Debut
    In response to a visitor's request, I have posted some more morgue images, of a different, very necessary part of the facility: "The Keep".

    (22 Oct 2001)
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  • Mua he chieu thang dung (Vertical Ray of the Sun) (Vietnam 2000; Dir: TRAN Anh Hung) ***
    A languorous look at the lives and loves of three Vietnamese sisters in modern-day Hanoi. You will enjoy this film as long as you are not in a hurry to go anywhere and don't expect much to happen. Each scene features beautiful cinematography. I could relate to the sequence in which the author husband battles writer's block! The camera lingers the longest on the youngest sister, 20-something Lien -- understandable once you realize she is played by the director's wife, TRAN Nu Yen-Khe, who also appeared in his 1993 debut Mui du du xanh (The Scent of Green Papaya). Also prominent are food and Vietnamese songs (it would have been nice to have subtitles for the lyrics).

    (21 Oct 2001)
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  • Public Health Informatics
    One application of health informatics is using the Internet to collect and distribute public health information -- this was the topic of the AMIA 2001 Spring Congress earlier this year. As you can see from the lengthy "To Do List" generated from the meeting, there remains a great deal of basic infrastructure work to be done in this area.

    Electronic interchange of data about reportable diseases would help healthcare institutions, insurers and government policymakers do more effective and efficient work on an everyday, routine basis. But the speed and accuracy afforded by online data transactions becomes even more important in evolving crisis situations, when response time is crucial. It might be premature to call the current anthrax scare a crisis, nevertheless it warrants close monitoring. The Internet is also a useful way to provide the public with up-to-date information: today, the National Library of Medicine released this new consumer health information website about anthrax:

    (18 Oct 2001)
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  • Nikkei Netas Linkup
    Almost half the people of Japanese ancestry outside of Japan live in South and Central America, mainly Brazil, Peru and Argentina. Today the Runker Room linked up with the Nikkei Netas Group, a trilingual Peruvian website with the motto "Uniendo a la communidad Nikkei del Mundo / Unindo ao communidad Nikkei do mundo / Uniting the Nikkei community of the World". Hopefully my listing under "Paginas Personales" in their Links directory will encourage web traffic from Central and South America to find out about Nikkei-jin in North America. You can explore the Netas links to learn about their lives, as well as brush up on your Spanish and Portugese.

    (15 Oct 2001)
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  • Sayonara Sayonara
    This evening I went with Dorami-chan to a farewell potluck dinner for one of her fellow volunteers with the Moshi Moshi Project, who is returning to Japan now that her visa is about to expire. Moshi Moshi is Portland Public Schools' distance learning program for the Japanese language, broadcast on local television. The on-screen teachers Reiko-sensei and Toyo-sensei and volunteer coordinator Michiyo-sensei were also there -- it was a bit like encountering celebrities! Moshi Moshi is meant for children, but it seems adults watch, too -- at a Mariners baseball game in Seattle a few months ago, Toyo-sensei was recognized by a man who said, "I like your show!" The same might happen if he ever goes to Okinawa, where Moshi Moshi is also shown. The production team worked hard over the summer to select and edit excerpts from their taped broadcasts, which are now available for sale as Moshi Moshi On Video (I am partial to Song Video #1, featuring Yasai Rokku (Vegetable Rock)!).

    (13 Oct 2001)
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  • Nikkei Nexus Update
    There is an update at Nikkei Nexus.

    (12 Oct 2001)
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  • County Cork Irish Pub
    This evening I went along as Audio Technical Assistant to Dorami-chan for a taped interview she conducted for her PSU Cultural Awareness course. The purpose of the exercise was to discover another person's culture through their personal stories and memories. She chose to speak with a Filipino woman we know, who chose to meet at this neighbourhood pub in northeast Portland. I set up the lapel microphones, checked the recording level, got the tape rolling, then settled back to listen and learn while enjoying some full-flavoured Arrogant Bastard Ale from San Diego and delicious pub fare. The ambience is so-so (the single, large, high-ceilinged, open room isn't very cosy; attempts at atmosphere consist of a few scattered Irish artifacts), but place is smoke-free and only open until midnight, better for your health on both counts. We got a over an hour of conversation recorded, then quit when the live guitar trio started playing some pleasant laid back tunes.
    County Cork, 1329 NE Fremont Street, Portland, OR, 503-284-4805

    (12 Oct 2001)
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  • Dine For America
    One month has passed since the terrorist attacks in the eastern United States. To remember 11 September 2001 and to assist those in need as a result of those events, the Oregon Restaurant Association organized Dine For America, a day when revenue from participating restaurants all over Oregon was donated to the American Red Cross Disaster Relief Fund. We were glad to help out by doing something we enjoy -- eating!

    We are mostly vegetarian at home (see Tofu 101), but Dorami-chan had a hankering for meat, ribs in particular. Where else to go but Tony Roma's Famous Ribs? This company grew from a little restaurant in North Miami FL to a worldwide chain (there is even a franchise in Tokyo JP!). They had an all-you-can-eat special tonight. Friends will attest that I was good at this sort of thing in my younger days, but this time I maxxed out at 2 rounds of 8 ribs each, far short of the house record of 8 rounds of 12 ribs each!

    (11 Oct 2001)
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  • HIMSS Oregon Fall Conference: Patient Safety
    Today I attended the fall meeting of the local chapter of the Healthcare Information Management Systems Society, an organization of healthcare information and management systems professionals. Several representatives from local healthcare organizations spoke on the topic of how information systems can contribute to patient safety by reducing medical errors. Informaticists face technical issues to achieve this, such as developing error reporting and documentation applications that do not add to caregivers' already heavy workload. But the most daunting challenge relates to human factors -- changing the workplace's Culture of Blame (witch hunt) to a Culture of Accountability ("Why?" hunt -- system analysis), as the airline industry has successfully done.

    I got a solid grounding in this area last year at the 2000 AMIA Spring Congress, which took place shortly after the Institute of Medicine released its report To Err Is Human: Building a Safer Health System. I looked at this HIMSS meeting as an opportunity to network with working informaticists, and maybe get some leads on employment possibilities. It was a bit disturbing to find out that of the other people at my table, 40% had recently been laid off! I hope the economy turns around by the time I graduate in June 2002 ...

    (11 Oct 2001)
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  • A Nobel Idea: Information Value
    Today it was announced that The 2001 Nobel Prize in Economic Sciences has been awarded to American economists George Akerlof (Berkeley), Michael Spence (Stanford), and Joseph Stiglitz (Columbia), "for their analyses of markets with asymmetric information". Markets with asymmetric information occur when one side of the market has much better information than those on the other. Tenants know more than landlords about their ability to make rent payments, corporate executives know more than shareholders about a firm's profitability, and prospective policy holders know more than insurance companies about their accident risk. During the 1970s, these Nobel Laureates laid the foundation of modern information economics.

    One reason why medicine has been so slow to join the information revolution is that healthcare executives have until recently viewed medical information systems as cost centers, with no return on investment (ROI). While clinicians and other caregivers intuitively know that information helps them function, to date medical informaticists have been unable to demonstrate the economic value of systems that provide information. A topic I initially considered for my medical informatics Master's thesis was the measurement of information value in heathcare environments. I should have stuck with it -- there might have been a Nobel prize to win!

    (10 Oct 2001)
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  • Tofu 101
    We were out of tofu, and I happened to be on an errand near Uwajimaya, one of Portland's Asian food stores, so I bought some. Apparently I got the right kind, kinugoshi-dofu, but an inferior-tasting brand -- this is the peril of having so many choices! (Uwajimaya carries tofu from more than 5 makers.) Most North Americans would say, "Huh? Tofu has flavour?" Dorami-chan was not amused -- her father's family in Japan is in the tofu-making business, so she knows what of she speaks. She went to the store herself the next day and bought her preferred brand, and to prove her point, she served the two kinds tonight as hiya-yakko (raw tofu) in a blind taste test. They were different, but to me more in texture than taste.

    (08 Oct 2001)
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  • Electric Transformation
    This afternoon Oregon Public Broadcasting showed Electric Money, a 2-part series it produced for PBS-TV, which explores the digital revolution in the financial services business. The lessons learned are useful to those of us in health informatics:

    • What might have been the first Internet were carrier pigeons that Paul Julius Reuter used to send stock prices between Brussels and Aachen in the 1800s. (The medical information systems of some healthcare organizations today aren't much better than this!)
    • Senior stock traders did not perceive any benefit in computerization, so the first computers were put on the desks of the most junior traders. Computers only started to gain acceptance as those junior traders got promoted, which happened rapidly because they parlayed their access to electronic information into superior trading performance. (Informaticists call generational change "progress by obituary".)
    • The CEO of Citibank believed in the potential of electronic banking, and used his company as a proving ground for many of the computer applications we now take for granted. As a result, Citibank gained a competitive advantage and a dominant market position. (Informaticists know that executive sponsorship is vital for the success of any program that involves significant organizational change. Some healthcare organization executives are just beginning to realize that information systems are mission critical.)
    • Today handheld computers are used to send messages across the floor of the New York Stock Exchange, reducing transaction lag time and error, and increasing accuracy and efficiency. (Getting information to the point of use is important for doctors and nurses constantly on the move.)
    • Traders at LIFFE, an exchange in London, experienced radical changes when trading went electronic. The physical trading floor, no longer needed, was torn down. Today they sit in front of computers all day, working in a virtual trading floor. (Don't expect hospitals and healthcare to look the same after informatics is through with them.)
    • Packard and Farmer, two physicists who laid the groundwork for chaos theory, founded The Prediction Company, which uses math and statistics to drive fully automated stock trading systems. (Some aspects of disease may prove to be mathematically predictable once genetic and environmental influences are known)
    • Digital technology has made available electronic information that has democratized stock trading. More people than ever are following stocks and trading. (Online health information has empowered patients, who often arrive at the doctor's office knowing more about the latest on their condition than the doctor.)

    Information technology has completely transformed virtually every sort of financial activity, but it took fifty years to happen. Hopefully it won't take as long in healthcare!

    (07 Oct 2001)
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  • Walk For the Wildwood
    Dorami-chan wanted to get me out from in front of my computer, so she entered us in this 4-mile charity walk in support of the Wildwood Trail, a hiker-only, 27-mile woodland path that runs the length of Portland's Forest Park, the largest forested city park in America.

    The forested hills called the Tualatin Mountains by local Native Americans were seen as a potential park from the time Portland was founded in the 1800s. Trails were built through the hills for farmers to bring their wheat to the Willamette River for shipping. In 1915, developers built the 11-mile Leif Erikson Drive with the intention of building subdivisions, but the realtors' plans were defeated by the Great Depression. After World War Two, the Mazamas hiking club began a tree planting and trail building campaign, and in 1948, Forest Park was dedicated. Today, it is a 4,800-acre swath of urban wilderness with a 50-mile trail system: a cool, shady haven on hot days and a leafy umbrella on rainy ones.

    The weather for this morning's walk was overcast but warm. The route began at the southern end of the Wildwood Trail, the parking lot of the Oregon Zoo and Hoyt Arboretum ("arboretum" means "tree museum"). There wasn't a formal start -- once you picked up your T-shirt and number you could start walking -- so the path wasn't too congested. We came across dog walkers and joggers who must have been surprised to have so much company on their usual route. At a healthy pace, the hills and switchbacks made for a good workout.

    Oregon Vietnam Veterans Living Memorial
    Also at the start/finish of the walk route was this a tribute to Oregonians who served in the Vietnam War. The Washington DC monument to the same war takes the visitor deeper and deeper into the ground, paralleling America's experience in Southeast Asia. The Portland memorial takes the form of an ascending spiral, symbolizing growth, healing, and ascension from a material world to beyond. Along the way, there is a stone alcove for each year of military involvement, listing the names of the 571 Oregon casualites, including 3 with recognizably Japanese surnames. Also listed, in stark contrast, are local civilian happenings for each year, such as festivals and county fairs.

    "So long as we are not forgotten we do not die."
    Inscription at memorial entrance

    The images from the links below show the memorial with its original gravel pathway, which has since been replaced by brick pavement. This has made the site wheelchair accessible, but it has also made it attractive to skateboarders. While we were there, two teenagers -- possibly of draft age -- came rumbling down. With America on the verge of a similar conflict, I wonder if the memorial means anything to them other than a cool spiral ride?

    (06 Oct 2001)
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  • Information Management
    "Health informatics." This answer to the question, "What are you studying?" is a real conversation stopper -- the term is almost never heard outside of the field. At least with pathology, most people have a vague (if incomplete) idea of what the work involves. Simply put, health informatics is information management for the healthcare industry. If you are asking, "What is information management?" you can find out from the Financial Post's online series FPMastering: Information Management, a primer on the management of information and the technology that captures, stores, distributes and processes data. Businesses now know that information management is critical for success. Healthcare organizations are slowwwly coming around to the same realization.

    (04 Oct 2001)
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  • Ties Talk Archive Update
    There is an update at the Ties Talk Archive. The new pages are linked up to the Runker Room Discussion Board, if you want to put in your two cents' worth without subscribing to the e-mail list.

    (02 Oct 2001)
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