Systems thinking in the public sector

I'm reading Systems thinking in the public sector by John Seddon, and its a good read so far. The account of the DWP Verification Framework is new to me. Here's a quote:

If the Council Tax officers are working to service standards (very likely) they too will have learned that sendinging something somewhere (rather than actually completing the work) is often the best way to survive in this system.

Certainly true from the experience of a relative of mine recently.

Microshoft Mesh

Joel Spolsky: Architecture astronauts take over

Semantic search - killer app... or not?

Should the semantic web be able to improve search? Some say yes , some say no. It would be handy if it was, because then there would be a real world yardstick to measure the added value of semantic web technologies.

More on Healthspace

5.2.11. Against the above six criteria, HealthSpace scores somewhat differently:
a. The perceived relative advantage of HealthSpace is much lower than that of the
SCR (a common comment by patients and staff was “I can’t see the point of it”).
b. In its present iteration, HealthSpace is also complex – a feature largely
attributable to the tight security measures (which may be difficult to change).
c. It is not overly compatible with existing values and ways of working (but see
Discussion, paragraph 7.3.8.).
d. The observability of HealthSpace’s benefits remains to be demonstrated, since
this attribute concerns whether patients will perceive a worthwhile impact when
they use the technology themselves.
e. One strength of HealthSpace is that once registration hurdles are overcome, it is
easily trialable.
f. Another potential strength is that there are plans for patients to be able to
customise (‘reinvent’) HealthSpace to their own preferences and needs.

On Healthspace

Page 13 of the report:

We suggest that the NPfIT National Programme Board consider uncoupling
HealthSpace from the SCR programme. In the view of the evaluation team,
stakeholders in HealthSpace should prioritise optimising the design and use of this
technology in specific, clearly-defined use scenarios (e.g. supporting self-care in one
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or two chronic conditions) before attempting to offer it to NHS patients more
generally. To this end, partnerships with patient organisations and voluntary sector
groups (which are already in place and being further developed) are strongly
encouraged.

Evaluating NPfIT

Trish Greenhalgh on her experience of evaluating the NPfIT Summary Care Record:

An early finding of this evaluation was that many stakeholders tended to polarise
these tensions into simplistic and morally absolute dualisms (‘bad’ central control versus
‘good’ local emergence; ‘bad’ technical designers versus ‘good’ caring clinicians, and so on),
and demonise what they characterised as the ‘other side’. These entrenched positions
preclude effective dialogue. It is time to move on from them.

Report here

iGoogle in the University

Meeting with members of the computer science department of a leading university a few days ago. Most of them were using iGoogle and GMail as clients in preference to the university IT department supplied services.

Being Semantic

Tagging Goes Semantic With Zigtag - sounds interesting, a kind of hybrid folksonomy/taxonomy approach. What struck me though was the way in which the word semantic is a good thing to include in 2008. Perhaps publishers should start selling semantic dictionaries.

Semantic Interoperability for Electronic Health Records

John Halamka sets out the current state of semantic Interoperability for Electronic Health Records

ISO Fantasy

ongoing · ISO Fantasy: concerns Microsoft's now standard XML format for documents - the ISO Delta · "The important thing is this: The ISO Delta is completely irrelevant to the marketplace. It is not implemented in the shipping Microsoft products. Microsoft may choose to implement some portion of it in some future release of some product, or they may not. Given Office’s release and adoption cycle, it’s very unlikely that any pieces of the delta they decide to implement will be widely deployed in anything less than five years"

JAMA -- Preserving Confidentiality in the Peer Review Process, April 23/30, 2008, DeAngelis and Thornton 299 (16): 1956

JAMA -- Preserving Confidentiality in the Peer Review Process

The wisdom of patients

A new report from The California Healthcare Foundation, written by Jane Sarasohn-Kahn - The wisdom of patients: health care meets online social media (application/pdf Object) - is a useful overview of empowered health consumers and the choices open to them in 2008. It's interesting to reflect on the Health 2.0 phenomenon in relation to the current crisis in the US health system and especially in relation to Limits to Medicine