I am a prime candidate for electronic health care record keeping because I am a patient and a wired one at that. The linked article below (PDF format) describes the lack of integration as a political and not technical matter. I can add to this where I have 3 different systems for keeping medical records, and none of them can talk to each other. That is unacceptable and must change if we are to fulfill the promise of the Affordable Care Act (ACA-Obamacare). All rights reserved to the Tech Republic author.
April 22, 2015 by Herbert H Dupree II · No Comments · Journal, Medical Transformations, Personal
January 2, 2015 by Herbert H Dupree II · No Comments · Education
For my first post of the new year, this lengthy article came in my RSS feed. As my formal educational portion of my learning career comes to a close, and my MA in Organizational Management has been earned, this essay is about changing to Pervasive Leadership, a term I frankly is not familiar with and wasn’t discussed in any of my major classes @ Ashford University. Not a knock on the school, but an interesting concept that if it were available then may provide an stimulating discussion from the instructor side.
December 2, 2014 by Herbert H Dupree II · No Comments · Transportation
Here is an article from one of the blogs I follow that could really work in my city.
The CATS system could use a concept of this by implementing 15-passenger vans (which I believe are not subject to CDLs) to improve neighborhood loop services and cross-county connectors. For example a route from UNCC to Concord Mills (Rider); Airport to Franklin Square in Gastonia (GT); I-485 transit station to Rock Hill; Northlake Mall to Huntersville &/or Mooresville. You can even contract it out to the service mentioned in the story and charge Express pricing for it ($3) with local service remaining $2.20 or $0.90 depending on distance. If the service takes off, then you can put larger neighborhood or standard buses on the route.
October 9, 2014 by Herbert H Dupree II · No Comments · Medical Transformations
I need to make known that I am not a huge fan of obvious advertorial content, in other words, sponsored content (“Tablets could ease health care workflows,” n.d.). Since the concept is not going away and is part of the fuel that drives the “free” as in cost web, my preference for it to be labeled as such. This linked story meets that requirement.
Having said this, I found this article to be fascinating as well as a “duh” moment for me in why is this not widespread. Whenever technology is introduced in a collaborative way to any field not friendly to it, there is lag, blowback, disdain, et cetera. I consider myself having a practical understanding of technology, albeit on a limited income. It has made my lifestyle for the better part of the last two decades and enabled my graduate studies and ePortfolio, linked elsewhere on this blog. Since tablets, slates, two-in-one devices are the modern Personal Digital Assistant (PDA), they can carry much more usefulness and information that can be hardened, accessible, monitored, and placed in the hands of medical professionals to remove some of the more mundane aspects of their jobs while letting the focus being patient care and medical decision-making (“Our Solutions – Greenway Medical Technologies,” n.d.). As a health consumer, the ability to communicate with the healthcare team in matters that are near real-time or quickly via e-mail is a shrewd operating state that allows for better diagnosis. It also allows less time going over the same thing at each doctor visit, thus saving the patient time and money, while maximizing the practitioner’s time by getting to the point of the visit. The article is one vendor’s vision to educate its market on their product and service offerings for this field. I am not actively in the field, so one can only guess how effective their pitch is, but it is a market too large to ignore, and will become more important over time as healthcare transitions to a single-payer model. IMHO, it is not if it will happen but when. The only reason it hasn’t happened to this point is partisan politics. Economics and demographics will force this shift among us, if not civil disobedience.
The barriers to deployment are less technical and more choice-based. The secure Electronic Health Records (EHR) marketplace is available, albeit not at an initial reasonable cost or an “open” system. One of the companies mentioned in the article just so happens to support an Auburn man on the PGA Tour, so the company can’t be all bad, and headquartered near my old stomping rounds in Carrollton, GA [~85 mi from where I grew up and about the same distance from my undergraduate education]. The Hippocratic Oath that medical doctors historically swear by has tenets that cover topics like this:
- To hold him who taught me this art equally dear to me as my parents…
- I will use those dietary regimens which will benefit my patients according to my greatest ability and judgment, and I will do no harm or injustice to them.
- In purity and according to divine law will I carry out my life and my art…
- Into whatever homes I go, I will enter them for the benefit of the sick…
The list continues (North, 2002).
Anything that enables a particular Greek historical admonishment, and can be interpreted in modern software and digital transmissions is a good thing in the end. A local hospital group, the “Purple” team, is running ads based on the ability to telemedicine your doctor with Skype™ style technology from anywhere or any time. A utopia based vision, for sure, but one that can and must happen in order for health outcomes to match the rest of the developed world.
North, Mi. (Trans.). (2002, September 16). Greek Medicine – The Hippocratic Oath [Exhibitions]. Retrieved from http://www.nlm.nih.gov/hmd/greek/greek_oath.html
Our Solutions – Greenway Medical Technologies. (n.d.). Retrieved from http://www.greenwayhealth.com/solutions/
Tablets could ease health care workflows. (n.d.). Retrieved from http://techpageone.dell.com/technology/tablets-could-ease-health-care-workflows/
Skype is a registered trademark of Microsoft Corporation.
September 29, 2014 by Herbert H Dupree II · No Comments · Academicstan, Education
Those two words at times do not seem to be living in the same area code, much less be present in a classroom (I have teachers in my family and this is what is being told to me, the local school system frowns on outsiders observing their classrooms). Here is a technology based article that attempts and most succeeds on documenting the gulf between the two words in the title.
September 25, 2014 by Herbert H Dupree II · No Comments · Journal, Personal
As I, get older and my “formal” schooling career winds down, my thoughts have turned to how I want to spend the rest of my time here on earth. My current decision is to become more of a creative type of person. It has been said that I have a way with words, in some cases too much of said way. The written word, multimedia, graphics, artwork, photograph manipulation, and even a bit of computer code as an adjunct to the written word are personally excitable subject areas worth pursuing. As in any journey in life, the routes taken have much to do with factors beyond your control, but it remains imperative to enjoy the ride. To some, this latest scribe could be described as TMI (Too Much Information); however, this is what is part of my Fertile Mind, and parcel to the creation of this blog beyond school requirements.
July 16, 2014 by Herbert H Dupree II · No Comments · Personal, Seasoned Stafffers
dis·pos·a·ble adjective—designed for or capable of being thrown away after being used or used up: (“the definition of disposable,” n.d.). This came from Dictionary.com based on Random House. At that website, there are two other definitions, but the relevance for this essay. A bit of backgrounder for why this subject becomes personal. This author is 49 years old at composition time; having been out of the workforce for over 5 years now after Transportation series of jobs, (it would be generous to call it a career after only 5 years). The trucking business is notorious for being difficult on one’s health; it certainly was on mine. One of the big issues in the business is a lack of consistent sleep, which leads to many diseased problems down the road.
Driving performance unswervingly worsens in sleep-loss states and is influenced by circadian rhythm and time on task. Maintenance of lane position, reaction time, steering, and speed deviation all worsen in sleep-loss states. The prevalence of obstructive sleep apnea among longhaul truck drivers varies from 28-78% of the trucker brotherhood, much higher than the prevalence rate of 2% to 4%reported in the general population studies (Heaton & Rayens, 2010, p. 137).
I had a rollover accident in March 2008 in Wayne County IN. It was a snowy night and the load started in Indianapolis, picked up in Hartford City IN, and scheduled to deliver in Columbus OH the next day 104 miles away from where it all essentially ended. Once you roll a truck over, that is the end of your primary driving career. While the facts weren’t known, sleep apnea played a major role as I was fighting sleep during the whole episode, and was trying to get to the Love’s Truck Stop in Richmond to end the night. Passing a Wal-Mart Supercenter and a small truck stop in Lynn, IN. There ended up three different stints with trucking companies that were unfulfilling and didn’t last. The Department Of Transportation requires a level of fitness to drive that involves blood pressure, sugar levels, vision, et cetera. I did manage with medicines to stay legal and fit for the road; this hid some disturbing medical issues I am dealing with today. Morbid obesity has been an issue for at least the past 10 years. When I started, my weight was about 283 lbs. and I’m 5’7” which equates to a Body Mass Index of 40, where 30 is considered Obese. The last scale weight was 415 lbs. or BMI of 59. Contrary to popular belief and legend, I did not spend my nights at truck stop buffets on a regular basis; in fact, it was maybe once a month. Truck stop/travel center buffets are generally outdated limited to the TA and Petro chains and scattered independents nationwide. However, you are still eating out nightly and healthy choices were not as widespread then as they are now. I have most of the symptoms of Type 2 Diabetes, such as excess thirst, frequent urination, and constant hunger (“Diabetes mellitus type 2,” 2014). In addition, my eyesight has gotten worse, have leg ulcers, constant headaches, general fatigue, and major foot maladies. According to all of my doctors, I am considered Disabled. The local transit authority and state of North Carolina DMV concurs. The tragedy here is that the Federal Government, using North Carolina as its agent, decided on two occasions that I was not disabled, therefore ineligible for healthcare, funds, and other services. I personally know people who have received Disability for lesser symptoms and much less, drama was involved, but North Carolina is one of the 25 states that did not take the expanded Medicaid for political (Republican) reasons. For me to get Medicaid and help that the rest of the civilized America gets, I would have to move 250 miles to West Virginia of all places, 450 miles to Maryland or Kentucky, or 600 miles to Arkansas as the closest locales. NC and every state that touches it is under the same Republican grip of denying benefits to citizens because of who the president is or another reason they will proclaim which flies in the face of reality.
Who is going to hire that person, even if he has an Einstein type brain? I am not implying that I am even close to his level, just making a statement. There are laws against age and health discrimination; if a company doesn’t want to hire you, a reason will be made up of thin air and can get around all of this, NC is an at-will state, therefore, hiring and firing decisions can be made with or without a reason unless under contract. Werner Enterprises in Georgia decided that I was not worthy of their company by crating bogus medical claims for denying fitness that local doctors couldn’t see. In trucking, you can have a valid license and medical card (now combined in most states), but each company will insist on their own medical exam (only 2 of the 9 companies that I went to orientation used existing medical cards) and use it as a Weed Out process, nothing to do with drug tests which are automatic and lawful. The next plan was to increase my educational footprint. I earned a Bachelor’s Degree in Hotel and Restaurant Management from Auburn University many moons ago and decided that an MBA was the new BS degree in the marketplace. Found a way to attend school and not deal with the Graduate Management Admission Test that traditional schools, including Auburn and UNC Charlotte, require to get into their graduate MBA programs. In October 2011, I achieved my Masters of Business Administration w an Information Systems specialty from Ashford University. That went nowhere, so further schooling ensued with the last of these courses ending in June of this year. Altogether, I have three graduate degrees and no job, career, or hope of that fact changing. The legality of employment deserts for 40 something and beyond is such that only first-person narratives exist in the wild. Reaching out to “experts” that can get you a job in this economy, well all these people want to do is sell you their manuals that are ideal, but do not really work. Wouldn’t it be refreshing if someone in Human Resources would come right out and say, you are unemployable, and here are the reasons why? That person would be sued out of existence for being honest; grown adults such as me can take it.
Franklin Delano Roosevelt was one of our country’s greatest presidents and certainly before my time on earth. He has many quotes attributed to him that stand the test of time, here is one: True individual freedom cannot exist without economic security and independence. People who are hungry and out of a job are the stuff of which dictatorships are made (“Franklin D. Roosevelt Quotes at BrainyQuote.com,” n.d.). Some factions of the populace are more than content to command total control over other people’s livelihoods, and by making older workers who can still get the job done equivalent to soiled toilet paper serves their ends.
Full circle has arrived and a return to the definition of Disposable by reminder: designed for or capable of being thrown away after being used or used up: (“the definition of disposable,” n.d.). Could it be that The Powers That Be / 1% have no more use for anyone over 40 that manage to lose their job, regardless of fault? Cast aside a whole generation of late Baby Boomers/early Baby Bust like Kitty Litter as a means of creating a docile permanent underclass? Ignore the rule of law for corporate personhood, oh wait, we already have that (“Corporate personhood,” 2014)? Even levels of government enter this Matrix by only playing lip service to Citizen Services, denying Medicaid because it can, or because of conflict of interest with medical personnel who will say whatever the person that pays them want to hear.
Corporate personhood. (2014, July 13). In Wikipedia, the free encyclopedia. Retrieved from http://en.wikipedia.org/w/index.php?title=Corporate_personhood&oldid=616377824
the definition of disposable. (n.d.). Dictionary.com. Retrieved from http://dictionary.reference.com/browse/disposable?s=t
Diabetes mellitus type 2. (2014, July 13). In Wikipedia, the free encyclopedia. Retrieved from https://en.wikipedia.org/w/index.php?title=Diabetes_mellitus_type_2&oldid=614674578
Franklin D. Roosevelt Quotes at BrainyQuote.com. (n.d.). BrainyQuote. Retrieved from http://www.brainyquote.com/quotes/quotes/f/franklind134721.html
Heaton, K., & Rayens, M. (2010). Feedback actigraphy and sleep among long-haul truck drivers. AAOHN Journal, 58(4), 137–145. doi:10.3928/08910162-20100329-01
July 6, 2014 by Herbert H Dupree II · No Comments · Journal
Finally, some encouraging news to those of us of a certain age who are felt to be disposable, unemployable, and just discarded with the trash, because we are not corporate people. PS, I do have a comment on this story
Tags: Anti unemployable
June 30, 2014 by Herbert H Dupree II · No Comments · Interesting Tech, Multimedia
3D movies has been kinda pushed down our throats a bit by Hollywood with tepid success. Reminds me of the whole Blu-Ray thing. A great technology that never really took off, and digital downloads will replace it when most of us get serious broadband (ala Fiber To The Home). This development of a 4K camera cannot be a bad thing.
June 26, 2014 by Herbert H Dupree II · No Comments · Journal
I saw an article about changing the map of the United States to have only 38 states. It got me to thinking, since school is out and waiting on the “decision”, I would make a few changes to the United States map that make sense, at least in my head.
- Combine the Dakotas and allow 4 senators for 6 yrs. then down to 2.
- Split California into 2 states @ Kern, San Luis Obispo, San Bernardino counties southward.
- Create the state of Columbia/Anacostia/Georgetown/etc. that covers the DC, Prince Georges, Montgomery Counties in Maryland, and independent cities of Arlington and Alexandria, counties of Fairfax, Loudon, and Stafford in Virginia.
- Combine Wyoming and Montana and allow 4 senators for 6 yrs. then down to 2.
- Escambia, Santa Rosa, and Okaloosa Florida counties move to Alabama.
- El Paso and Hudspeth counties Texas move to New Mexico and Mountain Time Zone.
- Lake and Porter counties Indiana move to Illinois.
- Place Alabama and Middle Tennessee in the Eastern Time Zone.
- Separate New York City, Long Island, and Westchester County from the rest of New York for its own state.
- Combine Connecticut and Rhode Island and allow 4 senators for 6 yrs. then down to 2.
When all is said and done, I still have 50 states.