Another Genius

LONDON (Reuters) - Pop star George Michael admitted on Monday that his weekend arrest on suspicion of possessing drugs had been his "own stupid fault, as usual."

Really? I thought it was MY fault.

New meaning for the term "Ski Bum", or how many bad Bode jokes can YOU come up with?

Now that the Olympics are over and everyone has taken his shot at Bode Miller...

It's my turn.

Who would have thought that anyone could possibly make the snowboard crew look like serious athletes and zealous patriots? Just when we all thought that Lindsey Jacobellis' fall on the attempted Method Air near the finish of snowboardcross was the height of foolishness, we have the collective stupidity and crappy attitude of Bode Miller to contend with. Wonder if Nike is still so enamored of his "What the f---" attitude now? And if they were going to come out with a shoe named for him, it would be: The Bode - it fits you when it damn well wants to.

Now I'm all for living the moment, especially in a situation that might never recur such as the Olympics. However, that's also the very reason to make the most out of the opportunity - you may have only the one shot at the event, so why not try to excel? I'm not even saying that you have to have an unwavering focus on winning the gold medal - though one would think that's why the athletes are there, for the most part. There are MANY athletes that have no shot at the gold yet are thrilled - and rightly so - to represent their countries and compete amongst the best in the world. For them, the experience might be key. But for a Bode Miller, who clearly has the talent to win and has placed the expectations on himself (his protestations about being over marketed and not caring about winning ring a bit hollow - if so, then why be endorsed at all?), simply being there should not be enough.

I'm a "regional class" athlete - I compete often, I train very hard, and I love doing so. I totally cannot understand Miller's laissez-faire attitude, his seeming nonchalance about winning or even competing well. To say that he made the most out of his Olympic experience by going to a lot of parties? That's ridiculous. Stay home next time. We don't need you and neither does your team. Maybe if Miller was even a little bit disappointed in his performances, a BIT distraught that as a one time World Cup champion, he was probably not even fit enough to compete with the best even if he didn't straddle several gates, he would have come off better. But someone with his apparent talent and record should either go to the Games to compete and win - or stay home. Watching Bode Miller simply not care is infuriating to me.

Wozniak Blows a Gasket

Recently, Steve Wozniak, one of Apple's original garage-based founders, stated that he felt that Apple was "consorting with the enemy" by using Intel chips and that Apple should also sell off the iPod business as quickly as possible since Apple is supposed to be in the computer business, and the iPod is certainly no computer.

Brilliant inventor, maybe, but Steve, let's leave the business decisions to the adults, OK?

Obviously, Mr. Wozniak has failed to notice Apple's historical failure to win major market business for its computers - outside of education and creative types, that is. And while the iPod is not a computer in the traditional sense of the word, was the Mac? The Mac was revolutionary not only for its different look but for the audience to which it appealed. Similarly, the iPod makes technology "appealing" to millions of people that would never otherwise know or care what an MP3 is (to wit - my daughter, sitting next to me, states that "...iPods are cool. I don't care what an MP3 is [nor does she know...right, dear?]."

Let's check quickly. Apple sells off the iPod business and gets a boatload of cash. It kills its relationship with Intel and either has to manufacture chips itself (see Sun for the issues with this one) or get them from someone else. Either way, it's new architecture, manufacturing, possibly software, etc. Very simply, Apple dies. Perhaps Mr. Wozniak didn't notice what happened to Apple stock recently when there was even a small hint that iPod sales might not increase geometrically in the future. Apple without iPod these days is, unfortunately, not much.

Maybe the right thing to do for Apple to do is to sell the traditional computer business that Mr. Wozniak is so fond of and increase its focus on cool consumer electronics. Using its wizardry (small pun-like nod to Mr. Wozniak) in user interfaces and software, I'm sure it could cash in with other devices as well. Maybe Mr. Wozniak could take this divested entity over and make a success of it.

Perhaps not.

The Problem with Healthcare

First, two comic takes on the Cheney shotgun incident (by the way, can you believe Whittington apoligizing to Cheney and his family for being shot?):
- Cheney's motto: The buck(shot) stops here
- Fans of popular music a decade or so ago will appreciate thus: "Cheney's got a gun..."

And now back to our normally schedule blog. I've been spending the last week or so immersed in healthcare technologies. Specifically, these are what you might call the "back office" capabilities required for a doctor's office in private practice, or a group practice, a hospital, etc. Some of the technology is "middle office" - scheduling, calendaring, some diagnosis, etc. In short, there's a HUGE market out there of companies selling (or trying to sell) technology to the healthcare field...and this doesn't even take into account the technology used by pharmaceutical companies for R&D, marketing, etc.

The majority of the enthusiasm and unbridled capitalism in healthcare has been driven by a couple of initiatives: HIPAA, which basically wants your health information to be "portable" (the "P" in HIPAA) so that no matter where you might want to be treated, your information would be happily made available to the practitioner(s) you select. Of course, your information must also be secure, sealed away so tight that you yourself can barely understand it or grab it when you need it.

The other intitiative is also valiant effort by the Bush administration (currently) to playfully suggest that a nationwide network of interconnected healthcare providers (doctors, hospitals, dentists, psychologists, etc.), payers (insurance companies, HMOs, etc.), and patients (that's YOU) can all easily trade information around the horn, as it were, to ensure prompt and accurate care, service, and payment. This directive has been mandated and has begun to take shape in various forms, including critters called RHIOs (regional health information organizations) that will purport to do the nationwide job described above on a smaller regional scale.

Yeah, right. And Vice President Cheney will soon be joining the Olympic biathlon team.

There are a few problems with this. First and foremost is the level of technology adoption at most provider sites (if not payers, which move at a glacial pace but have gotten more high tech over the years). Providers are CHEAP. Like lawyers, they hate to spend their money on dopey stuff like computers and software. This is why you continue to see racks and shelves and rooms full of paper file folders in your neighborhood doctor's office. And face it - depsite the TONS of products and technologies out there, with more acronyms and specialty terminology than the armed forces could ever dream of (EMR, EHR, PMS [not that one], EDI, HL7, CPT, CCR, PHR, coding, revenue cycle management, transcription, code sets, etc.), when was the last time you saw ANY doctor you met with use technology to do ANYTHING short of viewing an X-ray (that's PACS technology, btw) or taking an ultrasound? Who's using this stuff? Has any doctor you've met with whipped out his ruggedized tablet computer and speedily entered your diagnosis, retrieved a course of treatment that agreed with his diagnosis, noted your allergy to a certain drug, and zapped the information to your insurance company? I think not.

The problem is one of expectation. You and I EXPECT the healthcare universe to be focused on - guess what - HEALTHCARE. Caring for the health of the patient. Making you better when you are sick or injured. However, it turns out that the vast majority of technology in healthcare - in the healthcare informatics space, as it's called - is focused on - guess what - PAYMENT. "Revenue cycle management", one of the hottest tech spaces in healthcare, is a euphemism for "make sure we get paid". Doctors spend a bunch of time in med school learning how to "code" - not as in code blue, as we all have seen in ER - but code as in make sure that they know what codes are entered for what they (1) diagnose and (2) treat (different codes, by the way) so that (3) they get paid quickly and accurately. And as more entities come between you, your doctor, and your wallet, guess what? It gets harder for the doctor to get paid. Surprisingly, the growth of HMOs, PPOs, etc. has made it harder, not easier, for doctors to be reimbursed; it's obviously easier for you to give the doctor cash or a check on treatment and he takes it to the bank, but the wonders of insurance that promise to reimburse you sort of gum up the works. The result? Bills that can barely be understood by smart people with 12+ years of post graduate schooling.

It is quite eye-opening that almost the entire emphasis of healthcare informatics - from practice management, to coding, to the electronic medical record (worth another few pages of type), to revenue collection, etc. - is advertised as a way to "optimize the revenue flow to the provider" and "capture all the payments to which the provider is entitled". You'd expect something more like "deliver swift, accurate care to the patient" or "reduce the possibility of errors in treatment", but those must be less noble goals.

I don't argue with providers being paid. But let's call a spade a spade and not fool ourselves that a nationally interconnected network of healthcare stuff will (1) work soon or (2) be focused on the needs of the patient, at least not at first. Indeed, the national health network is typically discussed in terms more relevant to homeland security than health and welfare (though staving off epidemics and pandemics seem to be at the heart of the directive as well). Even the concept of the RHIO noted above faces a significant stumbling block - who will pay for it? Articles about "best practices" invariably contain the mantra of "start small" and "organize appropriately to identify responsibility" and "figure out who's paying the check." I'm a technologist, and from a technology perspective, I think we can get there, but like many other ventures, this isn't so much about technology as it is about finance and priority. Until those fall in line and until our governments organize for this more effectively, the notion of interconnectivity, interoperability, and "easy to use" healthcare won't happen soon.

And the REAL terrorist is....?

President Bush yesterday saw fit to dribble out some additional information about what he categorized as foiled Al Qaeda plots that were planned after September 11, 2001. Though last year he had introduced the fact that there was actually a plot to hijack planes with shoe bombs and crash them, yesterday's revelation was that the target was the Liberty Tower in LA...OOPS - he meant to say the LIBRARY Tower in LA. Liberty, Library, whatever - those words with L, I, B, and Y in them can be rough and after all, this is heady stuff, this counterterrorism.

Methinks Mr. Bush is trying to justify the defense-hefty budget he introduced just the other day.

What better way to do this than, under the guise of Homeland Security and ongoing diligence, to keep reminding us just how evil and crafy those nasty Al Qaeda folks are. I don't doubt that, but I think it isn't quite sporting to surface every now and then with "new information" that hits home regarding potential terrorist activity. Besides, there was a FANTASTIC opportunity yesterday as well which seems to have disappeared suddenly from the news. Late last night, news reports came out about the evacuation of a Senate building (if memory serves) due to sensors that are supposed to register nerve agents sounding off. However, it turned out that this was a false positive and that the only nerve agent was likely to be some gas dispensed by an overfed burrito eating government official. Talk about being ever vigilant, though! "Not only are we abreast of all shoe bomb activities, but we are also keenly aware of F-bombs as well!", Mr. Bush could have told us.

He might also have to rework his usage of the following titles:
Life, Library, and the Pursuit of Happiness
"Give me library or give me death"
The statue of library
The New York Public Liberty

At least he didn't say "nucular" (again).

Emeril Was Right - Pork Fat Rules!

Just when we all thought we'd figured out some of the basics of health(ier) eating, the results of an epic survey were just released noting that apparently, all the attention paid to following a low fat diet turns out to be hogwash. A long term study of 49,000 women revealed basically that there was ultimately no health difference in terms of cancer, heart disease, etc. among those that followed low fat diets and those that ate normally.

This is bad.

I remember during the hayday of Aktins dieting, people were filling their plates with fatty meats, eggs, etc. because they were told to avoid carbohydrates. They weren't told to go hog wild on bacon, steak, etc., but they often did. I wonder what their arteries will ultimately look like? But this study's results have the potential to do the same thing: persuade a relatively unsophisticated public that they can eat whatever they want and keep on truckin'.

Of course, this is totally the wrong way to think, especially given the sedentary nature of many adults and children. However, I can see the buttery popcorn, cheese fries, and chicken fried steaks piling up on the plates of Americans everywhere.

Also: Another reason to like Janet Jones
She's good looking, she's married to the greatest hockey player ever invented, and now this - she's part of a football gambling ring operating out of New Jersey!!! What next - she can cook chicken fried steak?

Cartoons vs. APLs

It's been a bad month for cartoons. Surely, Charles Schultz in his best days could not have foreseen the shitstorm that a few cartoons have caused. Whether it's lampooning our government's treatment of disabled veterans insensitively, the Danes blaspheming the Prophet Muhammed, or more recently, Iran seeking New York magazine-like contest entries for Holocaust-oriented yuks, it's clear that cartoons have become no laughing matter.

Perhaps if we go back to Krazy Kat and Ignatz mouse, we'd find violence in our cartoons that could be similar to the reactions occurring today. However, like the Three Stooges, the old cartoons were oriented toward slapstick and physical humor, not provoking attacks with pointed sticks and physical violence like those of today. Where has everyone's sense of humor gone?

Imagine if all cartoons were taken literally - or better yet, if the special interest groups corresponding to some of the cartoons took public offense to their depictions in them. Bald children the world over would see Charlie Brown shut down permanently; cavemen would lash out at the horrors in every B.C cartoon. Should parents revolt when their entire value systems are laid to waste by the cruel humor in each Family Circus panel? What about the awful characterization of our military through Beetle Bailey?

When last I checked, cartoons were meant to deliver truth through satire and irony, allowing people the flexibility to laugh at situations that had real life truths but may not often be seen clearly. Cartoons allow a view from another angle, exposing reality from the alternative side of humor, dark as it may sometimes be. However, I suppose there are those who believe that they or their beliefs are beyond laughter and, concomitantly, beyond reproach.

A co-worker said yesterday that those that were burning buildings and violently protesting the "bomb-turban" cartoon were proving the artist/author right, and so they are. While there are certainly limits to free speech (an envelope that the Enquirer, Star, etc. push every week, for example), expression of one's viewpoints should not only be permissible, it's healthy. Through exploration, perhaps we can all come to a general understanding of how we are perceived in the world and repair those elements that offend or frighten others - or better yet, if they are misunderstood, those can be corrected as well. Maybe some things are sacred and some sensitivity training is in order for a few things, but violent reactions to cartoons that shed a different light on circumstances seems to me to be a poor way to demonstrate that an inaccuracy has been portrayed.

"Many a truth is said in jest."

Post Super Bowl Musings

I'm not sure what is more ironic (or perhaps moronic):
- the fact that the Rolling Stones were viewed as "safe" entertainment for the Super Bowl half time when perhaps 30-40 years ago (?) they were part of the counter-culture.
- the fact that ABC censored the Stones' lyrics (and they agreed), cutting out the line "You make a dead man come" from Start Me Up. That lyric, unlike Janet Jackson's breast, has been out in the general public for quite a long time. I wonder if the three (two?) people that MIGHT have heard it or understood it could have complained enough to get ABC in trouble?

Either Joe Jurevicius can take a hit or some of the Steelers can't tackle. Anybody see that play very late in the game? He took a head on shot and bounced off and around the tackler.

Good call on the gadget play by Madden and Michaels. 1 series prior, I think, Madden noted that they'd likely to a gadget play, that Randle El would be in it and Ward would be the recipient.

Pretty weak post, but the best I can do for now.