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