Well I've been using dropbox and goodreader on the iPad and they work great however I only have 50GB on my drop box account. Since I have a server running 24/7 I though why not take out the middleman and access my WHS directly!
I noticed in the goodreader app on the iPad there was a webdav setting (follow the link if you want to know what webdav is), so I did a google search and came across a addin for WHS, that will enable webdav on WHS, aptly named WebFoldersForWHS.
1. Install and setup WebFoldersForWHS
Following the normal procedure for installing addins on WHS I quickly had the software installed. Now the tricky part I missed the first time around. Go to the Webfolders icon on WHS and right click to add the folders you want to share. To check and see if it works right click on a shared folder, click open, this should open a browser window, enter your credentials and you should see a list of your files. Make note of the URL you will need it when setting up GoodReader on your iOS device.
2. Install and set up GoodReader on your iOS device
Go to App Store and install Goodreader. It runs on iTouch, iPad, iPhone. Tap WebDownloads > Connect to Servers and (in the create new connection to section) tap Any WebDAV Server. You can put in any title and then put in the URL to you server, username and password.
Thats all there is to it enjoy!!
Monday, June 20, 2011
Wednesday, February 17, 2010
Tuesday, September 15, 2009
Tuesday, July 7, 2009
SonoSite News - SonoSite Introduces The 6 Lb. NanoMaxx - A Breakthrough Ultrasound Tool Aimed At Reducing Patient Safety Risks And Healthcare Delivery Costs
Friday, January 23, 2009
Happy Birthday Macintosh
Follow this link for a visual trip down memory lane and here for a history of the Mac.
Economic stimulus package FAQ
I received this (text) in a chain email pretty funny and I make no claims about the economic soundness of his theory. The original author is unknown to me:Sometime this year, taxpayers will receive an Economic Stimulus Payment. This is a very exciting new program that I will explain using the Q and A format:
Q. What is an Economic Stimulus Payment?
A. It is money that the federal government will send to taxpayers.
Q. Where will the government get this money?
A. From taxpayers.
Q. So the govern ment is giving me back my own money?
A. No, they are borrowing it from China. You children are expected to repay the Chinese.
Q. What is the purpose of this payment?
A. The plan is that you will use the money to purchase a high-definition TV set, thus stimulating the economy.
Q. But isn't that stimulating the economy of China?
A. Shut up.
Below is some information on consequences of spending your stimulus check and some helpf ul advice on how to best help the US economy by spending it wisely:
- If you spend that money at Wal-Mart, all the money will go to China
- If you spend it on gasoline it will go to Hugo Chavez and the middel east
- If you purchase a computer it will go to Taiwan
- If you purchase fruit and vegetables it will go to Mexico, Honduras, and Guatemala (unless you buy organic)
- If you buy a car it will go to Japan and Korea
- If you purchase prescription drugs it will go to India
- If you purchase heroin it will go to the Taliban in Afghanistan
- If you give it to a charitable cause, it will go to Nigeria
- And none of it will help the American economy
We need to keep that money here in America. You can keep the money in America by spending it at yard sales, going to a baseball game, drinking beer (domestic ONLY) or getting a tattoo; since those are the only businesses still in the US.
Thursday, January 22, 2009
Six Words You Should Drop from Your Resume [Resume]
Intersting post on LifeHacker. Very useful advice in these tough times with a saturated job market. In other words its not what you can do but what you have done.
Tuesday, January 20, 2009
Moonlight (Silverlight for Linux)
OK. For those of you who have been waiting to watch Netflix on Linux. This program is for you, eventually. Moonlight is an open source implementation of Microsoft Silverlight for Unix systems. It is installed just like any other Firefox plugin....Click the download link and install plugin. I tried it out hoping that it would work with NetFlix. Alas not yet it seems. Netflix supports Silverlight 2.0, so maybe when Moonlight is 2.0.
Portable Application Suite on Thumb Drive
At my work all the computers have a standard software package and individual users cannot install additional software. I use Firefox, open office and putty on a regular basis on my personal computers and have things setup to get my work done efficiently. To my surprise, I found a "suite" that could be installed on a thumb drive (usb key) that would allow me to use my favorite applications in a portable fashion: PortableApps.com. From their website:
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Convenient
I installed the standard portable suite which is a complete collection of portable apps including a web browser, email client, office suite, calendar/scheduler, instant messaging client, antivirus, audio player, sudoku game, password manager, PDF reader, minesweeper clone, backup utility and integrated menu, all preconfigured to work portably.
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Convenient
Now you can carry your favorite computer programs along with all of your bookmarks, settings, email and more with you. Use them on any Windows computer. All without leaving any personal data behind.
Open
PortableApps.com provides a truly open platform that works with any hardware you like (USB flash drive, iPod, portable hard drive, etc). It's open source built around an open format that any hardware vendor or software developer can use.
Free
The PortableApps.com Suite and Platform is free. It contains no spyware. There are no advertisements. It isn't a limited or trial version. There is no additional hardware or software to buy. You don't even have to give out your email address. It's 100% free to use, free to copy and free to share.
--------------------------------------------------------------------------------------------I installed the standard portable suite which is a complete collection of portable apps including a web browser, email client, office suite, calendar/scheduler, instant messaging client, antivirus, audio player, sudoku game, password manager, PDF reader, minesweeper clone, backup utility and integrated menu, all preconfigured to work portably.
Sunday, January 18, 2009
Setup iTunes on Linux for syncing with AppleTV
Purpose
I have an AppleTV that has been modified to run boxee. However, I don't like how boxee handles music. I like how the native unmodified TV software syncs with iTunes and handles music.
The Problem
I have a very large music library (110GB, >20,000 songs). I have 2 Apple laptops that are not always connected to the network so I can't use those to sync with ATV, not to mention the hard drives on the laptops aren't large enough. I have a central server running Ubuntu 8.10 that works as my media server. Ideally I would like to have the AppleTV sync with my server. However, there is not linux version of iTunes and none of the other great linux audio software can be set up to sync with iTunes.
Failures
I first tried installing iTunes under Wine. It installed fine but bonjour could not. Apple uses Bonjour to announce the presence of all of their devices on the network. Without it none of the devices could find the shared library and the version of iTunes running on Ubuntu under wine could not see the AppleTV.
The Solution
Requirements: VirtualBox Software, Copy of Windows, iTunes 7 (I don't know if it will work with 8)
1. Download, install and setup the appropriate version of Virtual Box for your linux distribution.
2. Install w
indows on virtual box, I used Windows XP sp2. Make sure you install the windows guest additions provided with VBox.3. KEY STEP. Networking must be set up as "Host Interface Networking".
⁃ This allows the iTunes shared library to be seen from and by all the machines on the local network
4. Set up Host Interface Networking
⁃ “With Host Interface Networking, VirtualBox creates a new networking interface in software on the host computer. This new software interface will then exist in parallel to your regular interfaces (e.g., on a Linux host vbox0 will exist alongside eth0). When a guest is using such a new software interface, it looks to the host system as though the guest were physically connected to the interface using a network cable: the host can send data to the guest through that interface and receive data from it. This means that you can set up routing or bridging between the guest and the rest of your network.” from the Vbox User Manual
⁃ In order for HIN to work you must setup a Network Bridge for eth0
⁃ For Ubuntu I did this by: (Don't do remotely since your network has to be restarted)
⁃ Installing bridge utilities package
sudo apt-get install bridge-utils
⁃ Add an entry to the file /etc/network/interfaces to describe the bridge (br0)
sudo gedit /etc/network/interfaces
⁃ Paste
auto br0 iface br0 inet dhcp bridge_ports eth0
⁃ I left mine as DHCP and it seems to be working fine. However, you may want to assign a static IP address to the bridge. (Google is your friend)
⁃ Restart networking
sudo /etc/init.d/networking restart
⁃ Now every time you start your system a network bridge will be created
⁃ Now create a permanent host interface named vbox0
sudo VBoxAddIF vbox0
⁃ Replace
⁃ Now tell VirtualBox to use the interface
⁃ Select the Windows virtual machine you created earlier.
⁃ Configure one of its network adapters to use Host Interface Networking (using “Settings”, “Network”, “Attached to”) and enter vbox0 into the “Interface name” field.
5. If your windows system is firewalled, then ports 3689 and 5353 must be open for itunes to work.
6. Install iTunes, add your music library folder (see vbox instructions for sharing folders) and enable music sharing in iTunes.
7. Voila this virtual machine is now serving up your virtual library. Now go to the ATV and enable syncing with this iTunes library. A 4 or 5 digit code will be displayed on the ATV this must be entered on iTunes after clicking on the ATV in the left hand pane.
8. Now should be all synced up.
Thursday, January 15, 2009
Hey baby its cold outside
Local Weatherman throws a glass of hot water in the air and turns it into a cloud of ice. Boy I wish I was in Mexico on the beach..........
Star Wars Trilogy as told by someone who has never seen it.
Star Wars: Retold (by someone who hasn't seen it) from Joe Nicolosi on Vimeo.
I can't believe she got so much of it right, without ever seeing the movies. Pretty funny
How to stay alive in frigid weather
1/14/2009 7:55:01 PM
By Jeff Hansel
Post-Bulletin, Rochester MN
Don't kid yourself.
You really can die in just a few minutes in the kind of weather Minnesota is experiencing this week.
Current weather conditions can produce hypothermia within roughly 15 minutes, and death within 45 minutes, said Dr. Christopher Russi, an emergency physician at Mayo Clinic's Saint Marys Hospital in Rochester.
So it's essential for everyone to dress as if they're going to be outside a couple of hours -- even if they just plan to step out for a few seconds.
The National Weather Service in La Crosse, Wis., issued a wind-chill warning covering the entire three-state area of Minnesota, Wisconsin and Iowa Wednesday, saying that "dangerously cold wind chills will persist into midday Friday with significant threat of frostbite."
Wind chills of 30 below zero to 40 below, with actual air temperatures as low as 20 below zero or colder, are expected. Russi warned residents to:
• Dress warmly in layers.
• Keep your feet, hands and head covered.
• Watch neighbors, and check on the elderly.
• Dress to stay outside long-term, even if you're only going for the mail.
"That's typically where people get in trouble is just throwing shoes and a light jacket on to run out and get the mail," said Tom Beniak, assistant coach of ambulance operations for Gold Cross Ambulance Service, which covers the Austin and Rochester regions.
A fall on the ice can mean getting stuck outside with potentially disastrous results. Plummeting body temperatures and hypothermia can lead to death when cold air combines with dangerous wind.
"It doesn't take long, and that's why we really encourage people to stay warm, dress in layers and avoid alcohol," Russi said.
Alcoholic beverages can make you feel warmer than you are, he said. People at greatest risk during subzero temperatures are those with neuropathy who might not feel their extremities getting dangerously cold; this group includes diabetics and vulnerable adults, including the elderly, Russi said.
Gold Cross Ambulance crews see cold-temperature effects first-hand, although they've no frostbite yet.
"What we have seen is some patients that may have fallen outside have become hypothermic rather quickly," Beniak said.
Victims of auto crashes are especially at risk, as are those whose cars stall. Keep an extra pair of warm boots in the car, along with a blanket or sleeping bag and food. Also, Russi said, make sure you've got a well-charged cell phone with you if you're going to be driving.
If you're injured in a car accident, stay with the vehicle, Russi said.
If you find someone who's in trouble because of the cold, call 911 first. Then, do what you can to start the warming process.
"If you live near, or if you know somebody who's at high risk or vulnerable, checking on them is always a good idea," Russi said.
Reporter Jeff Hansel covers health for the Post-Bulletin. Read his blog, Pulse on Health, at Postbulletin.com.
Monday, January 5, 2009
How to roll your own Mac for under 240$
I'm been looking for a way to play digital media (music, media) in the living room. It should be inexpensive and easy for the family (wife) to use. I would like for it to serve upiTunes music library and dvd library, play internet video (cbs, hulu, joost) AND record over the air TV. I am currently using boxee on a hacked AppleTV. It works OK for serving up movies. Not so good at music, although the built in frontrow software does a good job for music. It can't do PVR at all. I would rather use a mac mini but they are too expensive and I would also have to get a PVR card and would have to switch between boxee and PVR software. I might have to try this hardware seems pretty inexpensive maybe I could install mythbuntu and have boxee scan the mythbuntu folder tag it, and serve it up all in the boxee interface. Then could use as a media player and PVR.....hmmm??
Monday, December 29, 2008
Lung Cancer: Still the Biggest Cancer Killer, by Far
By Dennis Thompson
HealthDay Reporter
Sunday, December 28, 2008; 12:00 AM
SATURDAY, Dec. 27 (HealthDay News) -- It's the leading cause of cancer death in the United States, killing more people each year than breast, prostate, colon, liver, kidney and melanoma cancers combined.
It's typically discovered too late to be treated successfully, with about 85 percent of victims dead within five years of diagnosis.
And nine out of 10 cases of the disease are tied to a single behavior -- smoking.
Lung cancer killed 160,390 people in 2007, according to the Lung Cancer Alliance. That's an average of 439 people a day.
And tobacco caused 90 percent of those deaths, according to the U.S. National Cancer Institute. "Smoking is the most lethal legal activity in our society," said Dr. James Mulshine, a professor of internal medicine and associate provost for research at Rush University Medical Center in Chicago.
Researchers are trying to find better ways to detect lung cancer and to find genetic warning signs, or markers, that could predict who might be at increased risk.
But doctors say anti-smoking measures have proven the only effective weapon against the disease. "At this point, the progress in decreasing lung cancer death rates is due solely to men quitting smoking since the early 1990s," said Dr. Michael Thun, vice president of epidemiology and surveillance research for the American Cancer Society.
The death rate for men fell from 90.6 deaths per 100,000 people in 1990 to 69.4 deaths per 100,000 in 2005, Thun said. But the death rate for women peaked in 1998 at 41 deaths per 100,000 and has remained in that range ever since, he said. "Lung cancer rates have been falling in men since 1991, since men began to quit smoking," Thun said. "They have leveled off in women, but are not declining. Women started smoking later than men in our society and are having more trouble quitting."
For some time, it was thought that women might be more susceptible to tobacco-related lung cancers than men. However, recent research from the National Cancer Institute has disproved that notion. "It looks like the effect of tobacco is the same for women as it is for men," said Dr. Tim Byers, deputy director of the University of Colorado Cancer Center and a professor with the university's department of preventive medicine and biometrics.
Other recent research has discovered a genetic variant tied to lung cancer risk. Doctors earlier this year found a 70 percent increased risk of the disease among carriers of a deficient gene called Alpha 1-antitrypsin. But given that smoking is the cause of nearly all lung cancers, doctors aren't sure that knowledge of a genetic link will prove useful in the near term. "There's nothing that can be done about this genetic variant," Thun said.
The most promising area of new research involves early detection of lung cancer through the use of spiral CT scans.
Currently, when lung cancer is detected, the disease has already spread outside the lung in 15 percent to 30 percent of cases, according to the National Cancer Institute. That's because chest X-rays can only detect larger tumors of 1 centimeter or more.
Currently, when lung cancer is detected, the disease has already spread outside the lung in 15 percent to 30 percent of cases, according to the National Cancer Institute. That's because chest X-rays can only detect larger tumors of 1 centimeter or more.
But spiral CT, a technology introduced in the 1990s, can pick up tumors well under 1 centimeter.
About 50,000 current or former smokers are participating in the National Lung Screening Trial, a study that hopes to determine in the near future whether CT scans can allow early intervention that would save a person's life.
"We all have our fingers crossed that the trial will show there is a screening procedure that will make a difference," Byers said. "We're probably about two to three years away from knowing the results of that trial."
In the meantime, doctors say the best way to save lives from lung cancer is to throw more energy into measures that will prevent smoking.
Studies have shown that raising the price of cigarettes through taxation, clean air laws that prohibit smoking in public places, and counter-advertising have all helped reduce smoking rates in the United States, Thun said.
"We know those tactics work, but, for political reasons, they're not being fully applied," he said.
Quitting smoking also will allow people to avoid the host of other health problems that come with it, most notably cardiovascular disease.
"If you avoid smoking, you have avoided the Mount Everest of avoidable health hazards," Thun said.
More information
To learn more, visit the
SOURCES: James Mulshine, M.D., professor of internal medicine and associate provost for research, Rush University Medical Center, Chicago; Michael Thun, M.D., M.S., vice president of epidemiology and surveillance research, American Cancer Society, Atlanta; Tim Byers, M.D., M.P.H., deputy director of the University of Colorado Cancer Center, and professor, Department of Preventive Medicine and Biometrics; Lung Cancer Alliance; U.S. National Cancer Institute
© 2008 Scout News LLC. All rights reserved.
Saturday, December 13, 2008
The Mayo Plan
By Dan Beckham
The revered clinic takes its “patient first” model of health care to a national insurance proposal.
A single black-and-white photo demonstrates that Mayo Clinic had become a national treasure by 1935. It shows Franklin D. Roosevelt smiling broadly as he sat in the backseat of a convertible between Will and Charlie Mayo. The clinic had become worthy of the patronage of American presidents as well as the loyalty of hundreds of thousands of less illustrious patients.
Since then, Mayo’s reputation has only grown. That reputation has meant an obligation to use its influence to address what was ailing American medicine. As Will Mayo observed in 1921, “The medical profession can be the greatest factor for good in America. The greatest asset of a nation is the health of its people.... Medicine’s place is fixed by its service to mankind; if we fail to measure up to our opportunity, it means state medicine, political control, mediocrity and loss of professional ideals.”
Integration
What has always made Mayo different is its lack of walls. Mayo’s mission statement indicates that it “will provide the best care to every patient every day through integrated clinical practice, education and research.” The distinguishing word here is integrated. When Will and Charlie conceived of Mayo Clinic, they imagined something much different from the health care of their day. Rather than individual physicians proudly entrenched in their own practice and specialty holes beholden to no one, they saw physicians of many specialties working collaboratively with only the interests of their patients to consider.
Supporting the physicians on this team were lay administrators who were afforded the greatest respect by their physician colleagues. Physicians and administrators were, in turn, supported by a uniquely integrated infrastructure that dramatically increased the efficacy, efficiency and responsiveness of care. This distinctive medical model and the passionate commitment of its advocates explain how one of the world’s great organizational and technological enterprises came to rise like Oz’s Emerald City among the rolling hills of southeast Minnesota.
It was across these same hills that Will Mayo took long motorcar rides with the clinic’s first administrator, Harry Harwick. At the time, Will feared he was dying. So he felt compelled to share in detail his dreams for Mayo Clinic with the man he was confident could provide the management discipline necessary to bring them to fruition. There was no line between medicine and management in that car on those country drives. Medicine and management were all one thing, and so they’ve remained at Mayo Clinic to this day.
The Necessity of Cooperation
Just as Harwick sat next to Will Mayo, today Bob Smoldt sits in the office next to Denis Cortese, M.D., Mayo’s physician CEO. Smoldt is the latest in a revered line of top administrators at Mayo. He is the embodiment of a rich legacy of “professional management.” Cortese, a pulmonologist, represents a tradition of “physician leadership” that reaches back to Will and Charlie Mayo. Cortese is responsible for a $5 billion enterprise, but he still sees patients and teaches, like all his CEO predecessors. Together, Cortese and Smoldt are what Mayo has been from its beginnings--medicine and management--unified around the patient.
As Mayo’s leaders have consistently emphasized, Mayo is “physician led and professionally managed.” While it is not unusual for other health care organizations to declare they intend to “emulate Mayo,” they rarely appreciate what this aspiration entails. Many hospital administrators choose to ignore the “physician led” part. Many physicians ignore the fundamental importance of “professional management.” Very few recognize the depth of collegial partnership that characterizes the relationship between physicians and administrators at Mayo Clinic.
The Mayo brothers did not create their clinic alone. The groundwork was laid by their father, William Worrall Mayo, who drilled into them the necessity of cooperation, suggesting that “no one is big enough to be independent of others.” Harwick designed the clinic’s business and administrative practices. Mother Alfred Moes, through her sheer determination, built St. Mary’s Hospital, where the Mayos would rely on the sisters’ assistance as they perfected their surgical skills. But when it came to inventing the organization that would knock the walls out of Mayo, much of the credit goes to Henry Plummer, M.D.
Early Harbinger of EMR
Plummer was a gifted physician. His work with hormonal disorders led to numerous advances. He was also an exceptional engineer of both tangible and intangible things.
Plummer designed the clinic’s extraordinary patient record system. Referred to within Mayo as the “unit medical record,” it was a dossier that contained both inpatient and outpatient data in one file linked to a unique Mayo Clinic identification number and stored in a central repository. This single dossier preceded the patient wherever he or she went in the clinic, thus providing the appropriate physician with the benefit of an integrated perspective. It brought patient, physician, laboratory tests, radiology reports and medical record into one room at the same time.
Without Plummer’s system, it would not have been possible for Mayo to offer patients timely and coordinated consults with the appropriate mix of specialists or to provide the option of next-day surgery. Although Plummer launched this innovation in 1907, outside of Mayo most patient records remain scattered throughout the offices of multiple independent physicians and hospitals. Mayo converted Plummer’s paper system to an electronic version in the mid-1990s. Its ability to produce an up-to-date, integrated medical record on every Mayo Clinic patient remains one of its hallmarks.
It was Plummer, too, who designed the network of conveyor belts, drop slots and phone lines that helped make the integration of care possible at Mayo. When representatives of the phone company told Plummer that the kind of internal communications system he envisioned for the clinic was not feasible, he showed them how to make it work. And when the clinic outgrew its facilities, Plummer designed and oversaw the construction of new buildings that represented a revolution in the way medicine was organized and delivered. Like Mayo’s medical record, waiting areas, exam rooms and offices were standardized with a careful eye to the needs of the patient.
Embracing the Mayo Way
When Mayo Clinic built its revolutionary clinic in Minnesota, it also created a revolution in American medicine. That many Americans came to embrace the Mayo way is well represented by the thousands who arrived without an appointment and waited hopefully at its doorstep. But to health care providers satisfied to work without the benefit of teamwork and infrastructure, Mayo was a threat.
The Mayo way was denigrated and resisted by many for decades. Many physicians simply dismissed it as socialized medicine. Despite this, the Mayos felt a responsibility to carry beyond Rochester, Minn., what they deeply believed to be a superior approach. They were tenacious in their quiet Midwestern manner, and their way spread. Clinics based on the Mayo model sprung up and grew on varied terrain--not only in rural locales like Marshfield, Wis., and Sayre, Pa., but also in cities like Cleveland, Boston, Houston and New Orleans.
Beyond Clinic Walls
Over the past few years, Cortese, Smoldt and many of their colleagues have worked diligently to use the strength of Mayo’s reputation as a catalyst for significant reform. The preponderance of the quality, cost and access problems facing health care today are piled at the bottom of the organizational walls built between specialists, departments, payers and providers, as well as between medicine and management. Mayo is a proven example of the power of knocking down walls.
Mayo Clinic is doing well enough in the current health care system. It is internationally respected, growing and financially viable. Why should it dedicate itself to health care reform? Smoldt put it simply, echoing Will Mayo’s concerns: “We need to be involved in national health care reform because we believe the needs of the patient come first.”
In early 2006, Cortese and Smoldt co-authored an article outlining their ideas for creating substantial reform in health care by 2011. In it, they saw the engineering legacy of Henry Plummer renewed and expanded to significantly improve processes of care. They envisioned that all the information about patients be immediately available with a click of a computer key anywhere in the world.
And they prescribed a new era of professionalism characterized by perpetual learning. Learning would be encouraged not only within organizations but also between them, so that new ideas would be quickly shared. Such intraorganizational sharing and transparency would provide a rising tide to lift all ships.
Universal health care would be provided by removing government from its role as insurer and replacing it with a market-based model that allows consumers to choose providers on the basis of performance. Government would turn its attention to supporting innovation, facilitating the setting of standards as well as financing and coordinating coverage for Americans unable to afford insurance. Insurers would compete based on their ability to improve the health of their enrollees.
Sharing Systems and Protocols
Having articulated Mayo’s view of desirable health reform, Cortese and Smoldt launched an ambitious effort to generate input from leaders in academia, business, government and health care. A national symposium held in May of 2006 in Rochester was the first step. This interactive exchange of ideas focused on identifying innovative solutions while keeping the discussion centered on the needs of the patient.
Additional national symposia are planned. Recommendations emerging from the symposia will be shared in national policy forums where they will be honed into actionable plans. A third element of the effort will be leadership summits to inform, educate and build consensus for change among leaders positioned to influence health care reform.
Results of Mayo’s first national symposium emphasized the importance of building a public and business mandate for significant change. Cornerstones of that mandate include transparency among hospitals and physician practices to allow caregivers and consumers to learn from each other. Another cornerstone is the fostering of increased integration in health care through new organizational structures, shared clinical and management protocols, as well as linked information systems. Finally, the symposium members recommended payment systems that reward patients, health plans and providers based on performance consistent with high quality.
In reaching outside Mayo Clinic to a wide range of experts and organizations, Cortese and Smoldt reflected an important variation of William Worrall Mayo’s original assertion that “no one is big enough to be independent of others.”They were demonstrating that “no organization is big enough to be independent of others.”
Data Warehouse
Of course, Mayo’s leadership on issues related to health reform could hardly be expected to resonate if the clinic itself did not reflect what it was advocating for others. One effect of Plummer’s patient record system was to create a storehouse of a century’s worth of data that could be integrated to a degree impossible in any other health care organization in the world, then or now. Today, a Mayo-IBM collaborative is leveraging the integration that Plummer put into place more than a century ago.
While researchers at Mayo were always able to pull patient records and look across them for relationships and patterns, their power was limited by sheer volume as well as their inherent lack of ready interconnection and correlation.
The problem with these records gave new meaning to Will Mayo’s reflection on an interchange he once had with a colleague: “A prominent specialist in gastrointestinal diseases once asked, ‘How is it possible that you, a general surgeon, see so many of these cases while I, who am devoting all my time to this work, see so few?’ I could only answer, ‘The thickness of the abdominal wall prevents you from seeing them.’” In this instance, it was the thickness of a paper file that kept the Mayo Clinic from seeing the meaning buried in its patient data.
Economist Kenneth Arrow once described a firm as an “incompletely connected network of information flows.” Cortese and Smoldt saw the power of freeing up the flow of information so it makes its way more easily to those most likely to put it to good use. As Cortese observed, “The clinic was among the world’s pioneers in systematically keeping patient records and then using them in treatment. For years, Mayo has employed researchers it calls ‘abstractors’ who comb through paper records looking for patterns of disease and treatments to help doctors. Now, we’re envisioning doing all this electronically so the information systems of Mayo and perhaps the whole country will be a repository of all knowable information about how to care for a patient.”
Mining the Data
A first step in the collaborative involved scanning the medical histories of more than 6 million of Mayo’s past patients, including their X-rays, cardiograms and lab tests, as well as more esoteric data related to genetic and protein makeup. To this massive database, IBM is applying data mining and pattern recognition technology already used by financial institutions to spot fraud and by marketers to target their campaigns. IBM is also using artificial intelligence to “cleanse” data that might compromise patient identities.
The data mining extends beyond Mayo patient records and incorporates public databases such as those maintained by the National Cancer Institute. The result will be an integration of data that allows scientists, researchers and practitioners at Mayo to better see patterns related to disease and treatment.
The collaborative relies on one of the most powerful supercomputers in the world--IBM’s Blue Gene. According to Cortese, “We are at a point with standards in technology and new genomic-based analytic techniques where we can achieve more in the next 10 years than we’ve achieved in the last 100, and we see in IBM a partner with unique capacity to deliver expertise and innovation.”
Yielding Answers
IBM’s Blue Gene provides real-time access to specialized algorithms for molecular modeling. By better understanding protein structure and function, it will become possible to prescribe with much greater precision, customizing treatments to the makeup of individual patients rather than simply using the blunt instrument of protocols generalized from large patient populations.
Hugh Smith, M.D., a cardiologist and a past chair of the board of governors at Mayo Clinic Rochester, speculated on the possibilities: “Wouldn’t it be marvelous if a doctor knew not just the exact location of the patient’s cancer but its gene characteristics and the outcomes of therapy in the last 500 patients with cancer in that identical location and with those identical genetic characteristics? To do this, there needs to be a consistent way to link these kinds of data, not just in a single hospital, but regionally, nationally and globally.”
Nina Schwenk, M.D., a Mayo specialist in internal medicine who has worked on the IBM collaboration emphasizes: “The goal is to allow a doctor examining a patient to ask an online computer system how the last 100 Mayo clinic patients with the same gender, age and medical history responded to particular treatments. You’ll be able to pull all the charts, see what treatments patients got and how they responded.”
Already, screening and recruiting of candidates for Mayo research studies that once took 13 months to complete can now be done in 16 seconds. Mayo researchers recently reached the surprising conclusion that many patients diagnosed with multiple sclerosis (MS) don’t get worse. The researchers collected patient records on 162 MS patients in southern Minnesota who were treated at Mayo in 1991. Then they tracked down all but one of them and concluded that less than half the patients developed worsening disabilities within 10 years, and only 20 percent had moved into wheelchairs.
The Importance of Connectivity
Cortese echoes Mayo’s founders, as well as the input of the national health care symposium Mayo sponsored, as he puts the IBM partnership in context: “Because science and medicine are becoming ever more complex, it’s increasingly unlikely that we can rely only on our own discoveries, so we have to be connected to a degree we haven’t been in the past. If there’s a big difference in how we are today and how we have to be in the future, it has to do with relationships.”
By serving as a catalyst for health reform and by putting its reputation, resources and passion behind what it advocates, Mayo is helping invent the future its founders envisioned and its patients hoped for: a system without walls, where care is connected and whole. And a place where the patient’s interest is the only interest.
Dan Beckham is president of The Beckham Company, a strategic consulting firm based in Bluffton, S.C. He is also a regular contributor to H&HN OnLine.
Tuesday, December 9, 2008
2008-09 College Football Bowl Schedule and Payout
Wow! Whoever said college football is not a business is sadly mistaken. I just ran across the payouts for the bowl games this year. Can you believe the BCS bowls pay $17,000,000. I don't know if this is per team or split between the two, still its a lot of money. I reformatted and put the info into a spreadsheet.
Monday, November 3, 2008
Mac Mini, iMac updates coming next week?
URL: http://news.cnet.com/8301-13579_3-10081129-37.html?part=rss&subj=News-Apple
Apple could be getting ready to make some tweaks to its desktop Macs next week, adding to the new touches unveiled last month with its new MacBooks. Anticipated refreshes of the iMac and Mac mini could happen as early as next week, according to anonymous sources. Described only as "persistent," the sources say that an announcement is scheduled for November 10th, rather than Macworld, Apple's next confirmed publicity event in January. The primary reasoning is said to be Mac Pro, which is also due for an update, but which may not have enough chips ready for mass production. The Pro will instead take the place of the iMac and Mini at Macworld, two of the sources suggest, in exchange providing more holiday sales of the latter systems.
Specifications for the new computers are unknown, but the systems would likely be updated to use modern Intel and NVIDIA platforms, in keeping with the changes made to MacBooks in October. The Mini in particular is believed to be in dire need of an update, having last been changed in August of 2007
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