Digest 2014-10-01

Welcome to the Federated Wiki video chat for October 1, 2014 On today's call: <ul class="bullet"><li>Ward Cunningham</li><li>David Ing</li><li>Paul Rodwell</li><li>Jack Park</li><li>Tom Munnecke</li><li>Allen Byerly (occasionally)</li></ul> Tom:  understanding flow, immutable past <ul class="bullet"><li>Understanding acceleration and deceleration of heart, going up and down stairs</li><li>Average heart rate:  young person can spike, but young person can't</li><li>Lose the average metric, when taking snapshots</li><li>Looking for language constructs to express healthcare</li><li>The patient getting own health world or health space ... where you might be</li><li>Branching logic, directions, Markov chains, one most likely, would like to go</li></ul> Ward used to wear a heart rate monitor on a bicycle <ul class="bullet"><li>Got to a point where knew what the heart monitor would say, before looking down at it</li><li>Long climb, then let off a bit, when could see the top of the hill, heart rate would plummet</li><li>Heart would respond to brain, to let off a little<ul class="bullet"><li>Heart rate as anticipatory</li></ul></li></ul> These are things that healthcare is ignoring <ul class="bullet"><li>Doctor, first of Olympic cardiologies</li><li>Aschemic conditioning, when heart couldn't get out of it, it would kill them</li><li>Sense of resilience, adaptability</li><li>Taking derivative of heart rate, rather than the heart rate itself</li></ul> David Ing:  <ul class="bullet"><li>Chinese medicing uses indicators that western meds actively ignore</li></ul>     Bill Moyers: Healing and the Mind (DVD & Book) <ul class="bullet"><li><a href="http://www.amazon.com/s/?ie=UTF8&keywords=healing+and+the+mind+dvd&tag=googhydr-20&index=aps&hvadid=28632878367&hvpos=1t1&hvexid=&hvnetw=g&hvrand=17476565235277510065&hvpone=&hvptwo=&hvqmt=b&hvdev=c&ref=pd_sl_2hxkzz2lz7_b">http://www.amazon.com/s/?ie=UTF8&keywords=healing+and+the+mind+dvd&tag=googhydr-20&index=aps&hvadid=28632878367&hvpos=1t1&hvexid=&hvnetw=g&hvrand=17476565235277510065&hvpone=&hvptwo=&hvqmt=b&hvdev=c&ref=pd_sl_2hxkzz2lz7_b</a></li></ul> Tom:  nothing is missing, recognized by Japanese <ul class="bullet"><li>Now looking for nothing is missing for talk in China</li><li>What is more effective for pain, depends on the patient's belief system</li><li>Western medicine based on reductionistic science: medicine by body part doesn't allow the explanation</li></ul> Wiki as reductionist? David: C. West Churchman Design of Inquiring Systems <ul class="bullet"><li><a href="http://coevolving.com/blogs/index.php/archive/the-meta-design-of-dialogues-as-inquiring-systems/">http://coevolving.com/blogs/index.php/archive/the-meta-design-of-dialogues-as-inquiring-systems/</a></li></ul> Each patient having his own world, reflected in a federated wiki <ul class="bullet"><li>No universal state</li><li>Linking blood pressure from Kaiser to Walmart to your home is difficult</li><li>Universal federation?  Open and universal?</li></ul> Locked into 3 panels may not be sufficient for health care? <ul class="bullet"><li>Federation is a good direction</li><li>Graceful specificity</li></ul> If had a wiki for own health, going to western hospital could be lifted out of medical guide, reviewed by doctor, and then ported into record <ul class="bullet"><li>Then visit to Chinese doctor could also be put into record</li></ul> Workflow or flow? <ul class="bullet"><li>Pre-set with things to make observations</li><li>Template</li></ul> Holy grail:  universal health record that would be accessible to institutions <ul class="bullet"><li>A map that travels with you, or connects you</li><li>When you go into a hospital, they know about you</li></ul> <a href="http://munnecke.com/papers/healthepeoplechap1.rtf">http://munnecke.com/papers/healthepeoplechap1.rtf</a> How to get to universal, when there are intersecting universes? Start with universal, then break into enterprise <ul class="bullet"><li>Was pushing for patient-centric information model</li><li>Equivalent to pushing to wikipedia, and hiring the encyclopedia people as consultants, and then having a community so that people don't pay too much</li><li>Now trying to go back to patient-centric</li><li>If doctor doesn't look at blood pressure, know that</li></ul> Wiki model came out of grassroots, need to take a similar approach to healthcare <ul class="bullet"><li>Failure to communicate</li><li>Records now take 25% of doctor's time</li></ul> Who is the centre of the universe?  Enterprise, physician or patient? <ul class="bullet"><li>Now, centering on billing</li></ul> Vista was a social system for healthcare, got corrupted into a billing system Federation, as no center of the universe? Like the web, no center of the web <ul class="bullet"><li>Many centers, and many scales</li><li>e.g. Africa, U.S. community</li><li>Different time frames, differnt scales of operating</li><li>How does a gene related to family health?  etc.</li><li>Family history flows into children's history</li></ul> Flow not as workflow, but longitudinal meaning? <ul class="bullet"><li>What does measurement mean in accumulated fact?</li></ul> Not deterministic, Newtonian <ul class="bullet"><li>Chinese medicine see flow in a different way:  being poked with needles</li><li>If Middle Eastern, have a different skin chemistry</li><li>Statefulness:  flow as a transformation, and work in the community is the ensemble</li><li>Put these all into a space</li><li>Could be a community:  different groups of people focusing on different goals</li><li>Yes, longitudinal</li><li>Has some workflow</li></ul> Workflow tends to be a control thing <ul class="bullet"><li>How to move information into an organization that is expeditious</li><li>Most form-based systems require entering a lot of things that don't have to be said, and then not entering things that should be said</li></ul> Conversation around flow <ul class="bullet"><li>Would enhance the capability to become a full conversation</li><li>A story</li></ul> Wikipedia was innovative in creating the talk page <ul class="bullet"><li>But then it ended up being another wiki page</li><li>Need a chat session ... but people are used to writing wiki pages, so then people hate it</li></ul> In Vista, did a mailman, threaded respoonse, based on what they had done for the Well <ul class="bullet"><li>Confer2</li><li>Programming an internal version, called it mailman rather than threaded</li><li>Emsembles and transformations are a generalization of that learned in mailman</li><li>Working on blood pressure story, what's the history of that?</li><li>Blood rate related</li><li>Communication process</li></ul> Well predated wiki, started in 1985 - <a href="http://www.well.com/">http://www.well.com/</a> Well was exceptional in tracking responses <ul class="bullet"><li>So, could follow Ward's Monday morning</li><li>Others could, e.g. create on astronomy</li></ul> Sense of room, and people in the room? Proximity, neighbourhood <ul class="bullet"><li>Not a fan of physical graphs</li></ul> At a conference, chit-chat, talk about what's new <ul class="bullet"><li>An ability to talk with each other, based on history</li><li>Then a third person walks up, and it changest he conversation</li><li>Now trying to make it easy for the third person, but guessing terminology</li></ul> There was some research in IBM on Babble: <a href="http://www.pliant.org/personal/Tom_Erickson/AdoptionOfBabble.html">http://www.pliant.org/personal/Tom_Erickson/AdoptionOfBabble.html</a> Neighbourhood on shared language <ul class="bullet"><li>Was ICB9, now ICB10 -- eras</li><li>For longitudinal data, put interpreters in the longitudinal record to interpret the workflow</li></ul> Changes at the moment, could have 40 years, with some changes Floppy disk era, couldn't make sense of the bits today <ul class="bullet"><li>Longitudinal need an interpreter, or a virtual machine, to do semantics</li></ul> Old Mac documents:  text and images <ul class="bullet"><li>But then when lost Mac Write, couldn't get either</li><li>Web working well, now with SVGs and canvasses</li><li>Want to have the bulk of text so it's hard to go bad:  plain text</li><li>But then if want image, or visualization, have something else</li><li>They'll have shorter eras than the text era</li><li>ASCII, Unicode ... but pretty much still plain text</li></ul> Chinese characters?  What does it mean to be international? <ul class="bullet"><li>A question from OpenShift</li><li>A person from France said Welcome Visitors is in English</li></ul> Wikipedia is trying to get over languages, with more numbers, e.g. Abraham Lincoln's birthday Cardiologist versus sports medicine, might have different glossaries or foundational concepts <ul class="bullet"><li>Health record for Chinese medicine should talk about meridians, acupuncture points</li><li>Not part of the ICB10 vocabulary</li></ul> Programming, in so many different languages every day <ul class="bullet"><li>Used to just do it cold, when worked in one language</li><li>Now, use Google, e.g. enumerate keys in a hash</li><li>We shouldn't train people in programming languages anymore, we should train them in names of snippets of code</li></ul> Next generation language?  More flexible? <ul class="bullet"><li>PL/1 as the language to end all languages?</li></ul> Pulling semantics from the outside into the inside <ul class="bullet"><li>Region, community, ..., population health</li><li>Ensemble, or central neighbourhood, has range and scale</li><li>Not sure like semantics over that</li><li>In universal space, trying</li><li>Intrinsics, things that happen across spaces, e.g. genetic level, immune level</li><li>Scale-independent properties?</li><li>One intrinsic is identity:  boundariness, what's inside, what's outside?</li><li>Didn't have language to talk about the intrinsics of a fractal</li><li>Living instrinsics of health</li></ul> In engineered systems, can assign numbers to things, e.g. domain name, array position <ul class="bullet"><li>A key outside the thing</li><li>More matching than addressing</li><li>Matching transcends scale, just as addressing transcends scale</li><li>When look at a form, e.g. form 610 as an external identifier of the information, and it's convenient to say 610, but it's now how I made my money</li></ul> Question:  Trying to figure out language for longitudinal <ul class="bullet"><li>Are there high-level languages or extractions?</li><li>Representing, self-describing, managing state, and then branching</li></ul> Category theory? Web programming:  reactive programming <ul class="bullet"><li>Instead of thinking about data, thinking about a stream of data</li><li>Events</li><li>Vocabulary of inventing, emerging, using of web streams</li><li>Gibberish on Wikipedia, but there is a good article</li><li>Contemporary, or something renewed?</li><li>Linda had these notions?</li><li>Functional reactive programming?</li></ul> Gelernter's Linda?  Not that's not it Combinatorial logic? <ul class="bullet"><li>Like functional programming, so Scala or Pascal</li></ul> Clojure community Is related to David Gelernter's work on Mirror Worlds, a while ago Executable pattern language in health <ul class="bullet"><li>Programmers deal with state all of the time, but something that lasts past program execution</li></ul> Guardian Angel, from MIT: <ul class="bullet"><li>At birth, someone would get a process</li><li>An agent, acting for the patient</li></ul> Electric Imp? <ul class="bullet"><li>Processor, wifi</li><li>Program it with smartphone, link to internet</li><li>Connected to an agent</li><li>Could solder on a thermometer</li><li>When you register, the agent cooperates with the microcomputer</li><li>Having an agent track your healthcare, and act as a mediator</li></ul> At U. of Warwick, Hub of All Things <a href="http://hubofallthings.com/">http://hubofallthings.com/</a> <ul class="bullet"><li>David will be visiting there over next few weeks</li></ul> Watching a refrigerator over a long period of time <ul class="bullet"><li>Could do with MQTT, now an emerging open source standard</li></ul> A Debategraph on pattern languages (mostly for social change) <ul class="bullet"><li><a href="http://debategraph.org/Stream.aspx?nid=329727&vt=bubble&dc=focus">http://debategraph.org/Stream.aspx?nid=329727&vt=bubble&dc=focus</a></li></ul> Healthcare as a problem in communications Benenostic <ul class="bullet"><li>Fixing what's wrong with the patient might make him worse</li></ul> David and Tom and Jack continued on a conversation which led to a social tie with Judith Rosen << ended call >> ----- Here's the transcript from the Hangout Group Chat Group chat To list all available commands, enter "/?". me 13:08 I've created an Etherpad at <a href="http://pad.s2t.org/p/2014-10-01">http://pad.s2t.org/p/2014-10-01</a> Allen Byerly left group chat. Allen Byerly joined group chat. Jack Park 13:12 Heart rate as anticipatory Chinese meds has indicators that western meds ignore Allen Byerly left group chat. Jack Park 13:20 Bill Moyers did a book Healing and the Mind, which is all about Eastern practices It's also a DVD series Allen Byerly joined group chat. Tom Munnecke 13:23 <a href="http://philosophyandpsychology.wordpress.com/2008/02/13/reductionism-or-holism-mu-2/">http://philosophyandpsychology.wordpress.com/2008/02/13/reductionism-or-holism-mu-2/</a> Jack Park 13:24 David Ing: Churchman ways of knowing <a href="http://en.wikiquote.org/wiki/C._West_Churchman">http://en.wikiquote.org/wiki/C._West_Churchman</a> me 13:24 <a href="http://coevolving.com/blogs/index.php/archive/the-meta-design-of-dialogues-as-inquiring-systems/">http://coevolving.com/blogs/index.php/archive/the-meta-design-of-dialogues-as-inquiring-systems/</a> Jack Park 13:27 Tom: federation and graceful reciprocity Tom Munnecke 13:30 munnecke.com/papers/healthepeoplechap1.rtf I wanted to start with the universal... HHS started with the Castles and drawbridges Ward Cunningham 13:32 <a href="http://munnecke.com/papers/healthepeoplechap1.rtf">http://munnecke.com/papers/healthepeoplechap1.rtf</a> Tom Munnecke 13:37 munnecke.com/papers/D16.doc Ward Cunningham 13:40 <a href="http://munnecke.com/papers/D16.doc">http://munnecke.com/papers/D16.doc</a> Jack Park 13:46 <a href="https://code.google.com/p/bloomer/">https://code.google.com/p/bloomer/</a>  is a project I did which adds an IBIS structured conversation plug in to MediaWiki me 13:48 Did you know about the IBM Research on Babble? <a href="http://www.pliant.org/personal/Tom_Erickson/AdoptionOfBabble.html">http://www.pliant.org/personal/Tom_Erickson/AdoptionOfBabble.html</a> Jack Park 13:49 Thanks David! me 13:54 Maybe Welcome Visitors was the wrong title. It should have been Hello ... which most people understand Jack Park 13:54 Ward: era and region for language Tom; era, region, community, and discipline as dimensions of semantic space Tom: era, region, community, neighborhood, discipline, scale Tom: question of intrinsics, things which happen across scale Tom: identity as intrinsic -- boundaryness what's inside and what's outside Tom: need a language to talk about that. Ward: can assign indexes to things; outside them, then match on those -- transcends scale Tom Munnecke 14:01 <a href="http://www.icd10data.com/ICD10CM/Codes/V00-Y99/W50-W64/W61-/W61.02">http://www.icd10data.com/ICD10CM/Codes/V00-Y99/W50-W64/W61-/W61.02</a> Jack Park 14:03 Tom: language for abstract transformation in longitudinal ensembles Ward Cunningham 14:03 functional reactive programing Jack Park 14:05 I cannot see why members of categories cannot be stateful; functors them map among states... Tom Munnecke 14:07 mit guardian angel Allen Byerly left group chat. Ward Cunningham left group chat. Tom Munnecke 14:09 Pete Szolovitz me 14:11 <a href="http://hubofallthings.com/">http://hubofallthings.com/</a> MQTT Message Queuing Telemetry Transport Jack Park 14:14 imp microcontroller googles well <a href="http://en.wikipedia.org/wiki/Electric_Imp">http://en.wikipedia.org/wiki/Electric_Imp</a> Jack Park 14:19 <a href="http://debategraph.org/Stream.aspx?nid=329727&vt=bubble&dc=focus">http://debategraph.org/Stream.aspx?nid=329727&vt=bubble&dc=focus</a> David: distinction between problem solving and problem seeking Tom: replace record systems with improved communications; records are part of communication Tom Munnecke 14:29 nothing is missing munnecke Chafik Hamadouche joined group chat. Paul Rodwell 14:31 got to go