TechCrunch has a good explanation of Footnote’s digitizing of the Vietnam Memorial, which is handy because the Footnote site is getting hammered with traffic right now, so the app is running slowly. The site lets you browse the Wall by multiple categories, and links together bunches of information. Sounds very cool.

The Vietnam Memorial wall is an argument for stone over information. But information is good, too.

[Tags: vietnam memorials ]

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Google Maps now (well, I just noticed) lets anyone add a place marker that is visible to all other users. Their example is a spot in a SF park where there’s open air dancing.

I’ll be interested in following two questions: 1. How will policy evolve to handle abuse and edge cases? 2. How will the system be hacked?

1. What controls is Google going to have to introduce to keep maps from being polluted with markers such as “Best pizza in town,” “Marcie the Slut lives here” and “[enter your choice of slur]town”?

As of now, Google lists two types of controls. First, some listings are protected, either because they’re hospitals or government buildings, or because the owners of a business have “claimed” the listing; Google does some form of verification before awarding ownership. Second, there’s a “report abuse” button which sends the listing to a moderation process.

I hope that that’s sufficient. But what about edge cases? If grieving parents mark the spot on the road where their child was killed, will Google count that as abuse and remove it? Historical markers? Celebrity homes? Notices of where events will be held? Treasure hunt clues?

2. Related to the first: How will people creatively hack the system, not to bring it down (the bad hacking) but to use it in ways Google didn’t anticipate (the good hacking)? For example, maybe citizens will mark potholes, possibly giving the text a distinctive, findable tag. Or educational walks. Or the rankings of public schools. Or all the places there was a death by gun. Or a link to a Flickr query that aggregates photos from that spot. Or the ten million better ideas that everyone else will have.

It’ll be fun to watch. [Tags: google google_maps everything_is_miscellaneous ]

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Ashish Jha at the Harvard School of Public Health is giving a Berkman lunch talk on “U.S. Healthcare: Can Information Drive Better Care?” [Note: I am typing quickly, getting things wrong, missing stuff...]

He says the first few minutes should leave us depressed about the state of health care in this country. A major problem underlying all this, he says, is a lack of transparency.

We spend $2.1 trillion dollars on health care in the U.S. in 2006. That’s about a sixth of the economy, about $7,000 per person (minimum wage is $11K/yr). It’ll be a fifth in the next decade. We spent a much bigger percentage of our GDP than other countries.

What do we get for this, Ashish asks. He cites a Rand study that came up with 439 “indicators of healthcare quality.” These are core, non-controversial treatments and practices. Rand found they get done about 54% of the time, suggesting “the care we get is pretty inadequate.” Even for privileged groups — e.g., white, wealthy, educated men — it doesn’t go much above 58%. “There’s a disconnect between what doctors think they do and what they actually do.” One of the listeners says that recent studies show that this is because there are typically 7 health care people involved with any one medicare patient, and they don’t get this done because they don’t know what others in the group are doing. “It’s completely about the system,” says Ashish.

He continues depressing us: About 10% of people admitted to hospitals suffer an injury there. One in four doctor visits lead to medication injury. (Ashish says he’s not confident in that study.) 44k-98k deaths come from medical errors.

His conclusion: The quality of care is unacceptable.

Why? 1. Because we pay for the quantity, not quality, of health care. 2. Care has gotten complex, but the health care systems haven’t kept up. 3. Little transparency. E.g., usually we don’t usually know how much our medical care actually costs (as opposed to what our co-pay is). We know how much health care for our pets costs, but not for our children. 4. No adequate feedback loop: Medical malpractice has been a failure and regulation sets the bar too low.

Ashish talks about one part of the response: The Ny State Cardiac Surgery reporting program. In the early 1990s, NY found huge disparities in cardiac surgery mortality across 31 hospitals: 1 in 200 dying vs. 1 in 14. So the state started publishing mortality info about every hospital and surgeon. As of about 2000, it’s all on the Internet. Over the course of 12 years, the rates dropped dramatically. Why? The market share of the hospitals didn’t change; the bad hospitals didn’t lose business. But the hospitals now had data that reinforced good practices. There’s anecdotal data that physicians began to learn from one another. Most dramatically, the rate of surgeons leaving their practices among the bottom fourth was way higher. Ashish’s project tracked them: Some quit, some moved. Even after adjusting for age, etc., people in the bottom quarter were 3x likely to quit.

People don’t check the ratings. Ashish thinks this is a place where the Internet could help.

90% of hospitals are still paper-based. Even those that are electronic can’t share info. The law says patients always have a right to get their records, but the doctor or the hospital owns the record. Patients can view it but it’s not in exportable, shareable form. (There’s a discussion about the state of electronic health records and why it’s a more complex problem than it seems.)

Ashish says that the HQA initiative has hospitals reporting on 23 quality indicators, and performance has improved steadily. HCAHPS makes patient experience data available.

Gene Koo: Health care decisions aren’t made by purely rational agents. All sorts of quirks come into it. So, how does the transparency of info help us?
A: Maybe consumer involvement in health care won’t work out. I’m looking for empirical data.

Q: What’s the role of the consumer in this? Are there data now that consumers are taking on more of the responsibility for their health care?,br>
A: People on the right say that consumers aren’t behaving like consumers because they don’t have any skin in the game. You don’t know how much things cost. So, we need transparency (they say), linked to having skin in the game (i.e., you pay for visits out of your pocket). But, few have high deductible health plans. My personal feeling (says Ashish) is that this isn’t going to be big. People are generally in them not because they want to be involved but because the plans are cheap.

Rob Faris: There’s a huge role for intermediaries. Intermediation is not working well right now. We need intermediaries who looks at outcomes and figures out what works and what doesn’t. And I’d like to see how quality considerations can be inserted into this.
A: We’re at the beginning of a very interesting journey. If someone like you can’t navigate the health care system…

Q: What do you think of the candidates’ positions?
A: They all talk about the uninsured, which is just one part of a complicated set of issues. We have 47M uninsured because health care is expensive. Most of the health experts I talk with think Clinton’s health plan is a little more realistic. But all of this falls apart if we can’t get a grip on healthcare costs. They’re rising at twice the rate of inflation, and neither Obama nor Clinton have gotten serious about healthcare costs.

Q: (me) How do you contain costs?
A: Electronic records would help. Payers should pay more for outcomes not for particular tests, etc. And there;s a whole “comparative effectiveness” movement. E.g., what do you do for someone with low back pain? You get different treatments based on locality. Payers should start taking more of an active role. But payers have not wanted to take up that responsibility.

A (person in the audience): Part of the answer is that the amt of money spent in the last 6 months of life is shockingly high. We should spend more earlier on preventative measures.

Ashish: You don’t always know when the 6 months are. And there’s a huge issue around managing expectations at the end of life. Plus, when someone else is paying…From a policy point of view, it’s very hard to fix this stuff. Even though health reform comes up every five years, it doesn’t get done because the status quo is everyone’s second choice. [Tags: berkman healthcare health ashish_jha ]

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On the heels of her splendid explanation of the outcome of the 700MHz auction, Susan Crawford explains Google’s proposal to the FCC for the “white spaces.” Here’s my take on her take. (The NYT also has a useful article.) (Note: All errors in the following are mine. I am in over my head.)

Congress has mandated the end of over-the-air broadcast of analog TV signals. This frees up some spectrum. (Spectrum = frequencies = colors) Actually, it frees up a lot of spectrum: the 700MHz auction was for just 22MHz of frequency, whereas we’re now talking about 300MHz of spectrum. So, what should we do with this newly unbound stretch of public airwaves?

We could slice it up and sell it off to private companies. That’s generally what the FCC does with spectrum. And that made sense back in the 1930s when the FCC was created. Radios were so primitive that broadcasters had to be given untrammeled access to a frequency to avoid “interference” with other broadcasts. So, the FCC sold swaths of spectrum to broadcasters, but, recognizing that spectrum belongs to the public, the FCC also placed some requirements and restrictions on broadcasters.

Radio technology has advanced since the day the Titanic’s signal wasn’t decipherable. Not only are radios better able to tune in to particular frequencies and strip out noise, they are also able to respond dynamically. They can, for example, hop around the spectrum to hold on to a particular broadcast, if the broadcaster changes lanes, so to speak, in order to find a less unoccupied frequency. Not only does this sort of “open spectrum” approach promise far more efficient use of available spectrum — more bandwidth, to put it inaccurately — but it means that the government doesn’t have to decide for us who gets to use the spectrum. (For more on this, see David Reed’s explanation.)

Google has outlined to the FCC how it would use unlicensed white space spectrum. It’s proposing conservative approach that moves cautiously toward open spectrum, providing the FCC with a vision for how the white space spectrum might bring enormous benefits.

Google envisions how wireless devices running the Android operating system — Google’s mobile operating system — might use the white space frequencies. Google points out that such devices could help deliver Net access to rural areas, a sore spot at the FCC since the policy of handing the Internet over to a duopoly has kept the rural and the poor in the dark. (Surprise!) But, as Susan writes:

Google suggests that *all* devices for unlicensed use of the white spaces should be required to receive an “all clear” signal for the particular channel where they wish to operate, by using geolocation, checking a database of licensees in that location, and getting permission in advance.

This would achieve some of the objectives of an open spectrum system, allowing for the dynamic allocation of frequencies. Google suggests that they could use dynamic auctions to assign frequencies for limited times and strengths, adding another element of extrinsic control (as opposed to a fully open spectrum approach that depends on the devices negotiating for the airwaves). Further, Google suggests that some channels be kept unavailable for all but some high-priority, specialized uses.

This is a calm and rational approach that could see an enormous blossoming of innovation. Think about how many devices exist because tiny ranges of spectrum have been left unregulated. Opening a big swath of spectrum is like opening up a big tract of land. Who knows what we’ll build once we have the space? [Tags: fcc spectrum susan_crawford google open_spectrum wifi ]

* * *

Harold Feld thinks Google conceded too much too soon.

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Solana Larsen has a fabulous idea. For those of us vegetarians who love faux meat, why doesn’t a restaurant serve up something besides the usual mock chicken, beef, pork, etc.? Why not faux endangered species? Solana suggests a menu… [Tags: vegetarian solana_larsen food ]

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[Info: Think Progress] [Tags: democracy cheney iraq ]

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It came to me as if in a dream. They constructed Stonehenge by digging holes in the ground, dropping slabs into them, laying the crosspieces on the ground, and then excavating around the whole shebang.

Or, possibly, Superman built it for them. [Tags: stonehenge ridiculous_theories ]

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My wife and I saw Gus Van Sant’s Paranoid Park last night so you won’t have to.

I’m about to tell you what the movie is about, but I won’t go further than what you’ll read in the typical capsule review. So, if you don’t want to know that, please count this as a [SPOILER ALERT].

The movie is about a teen-ager who may or may not be involved in what may or may not be a fairly random-sounding murder. It’s told in a jumbled-up chronological order. It’s not a murder mystery, though. It’s focused tightly — and literally, since much of the rest of the frame is often blurred — on the boy’s day-to-day coping with the maybe-murder. And here’s the key to the movie’s ultimate failure: If you assembled the pieces chronologically, it’d be clear that it utterly does not address the moral, psychological, and spiritual consequences of the boy’s involvement in the movie’s central event. The disentangling is not of the boy’s feelings or culpability but of a timeline arbitrarily snaggled by the film-maker. He cuts up the narrative simply to keep something from the viewers. That’s a cheap way to manufacture revelation.

The result is a movie that is told from no one’s point of view. The boy remains a cipher. We don’t think he’s heartless or psychotic. He seems to be simply emotionally guarded the way many teens are. He is effectively portrayed as a subordinate member of his social group, under the wing of a dominant friend, and appealingly nervous about hanging with the hardcore guys at the local illegal skateboarding park. But we don’t get past his bangs and fetching face. We don’t know why he is heartless to his girlfriend. An important event with his girlfriend (no spoilers here!) is shot carefully so we don’t get any sense of how the boy felt about it. We don’t see any emotional change before and after the movie’s central event. We don’t see him wrestling with the consequences in any except the most pedestrian ways. You could edit out the central event and not affect the movie.

Maybe Van Sant is trying to show us a teen who is so alienated that not even an event as horrific as the one he shows us — an intense and graphic scene out of a horror movie — can get a response from him. If so, it’s got to be an indictment of an entire generation, or perhaps of the teen years themselves, for Van Sant seems to tag the protagonist as typical to a fault. Are we supposed to think that teenagers are that impervious to events outside their own narcissistic sphere? If so, then this movie is Van Sant saying “I just don’t get kids today.” But I don’t think that’s his point. I think he thinks he’s showing us the turmoil under the skin.

Except he forgets about the part where he shows us the turmoil under the skin.

* * *

By the way, Ted Fry of the Seattle Times is among those who disagree with me. Here’s his opening paragraph:

Gus Van Sant’s capper to a trilogy of experiments in elliptical narrative and lyrical structure is a masterful triumph of art, craft and empathy for the complicatedness of being a real teenager. With “Paranoid Park,” Van Sant has solidified his niche as a singular American film auteur whose vision melds formal skill and abstract invention with an intuitive sense of the poetry movies can exploit to convey their unique interpretation of life.

Yeah, that’s what I meant. [Tags: movies van_sant paranoid_park reviews ]

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CNN actually had a reporter listen to the entire tape of Rev. Jeremiah Wright’s sermon, instead of just the sound bytes. Wow! What a revolutionary idea! And it turns out that in context, Wright’s words are — get this! — more understandable and less inflammatory. Isn’t it crazy how context will do that? Furthermore, it turns out that the when Wright suggested that our chickens were coming home to roost, he was quotingciting Edward Peck, former U.S. Ambassador to Iraq and deputy director of President Reagan’s terrorism task force.

How many days did it take for the professional news media to get around to this?

[Tags: media journalism obama jeremiah_wright cnn ]

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Susan Crawford has a brilliant, clear explanation of the significance of Verizon’s winning the auction for Block C in the FCC’s 700MHz auction.

If that sentence made no sense to you once you got past the phrase “Verizon’s winning the auction for,” all the more reason to hie yourself to Susan’s post. Ten minutes ago it didn’t make sense to me, either. Don’t worry. Susan will explain it.

[Tags: susan_crawford auction 700MHz internet fcc verizon net_neutrality ]

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