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BODIES & BUILDINGS NYU ITP LECTURE COURSE FALL 2014 CLASS 3: SEPTEMBER 22, 2013 JEN VAN DER MEER @JENVANDERMEER WWW.JENVANDERMEER.COM
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BODIES &BUILDINGSNYU ITP LECTURE COURSE FALL 2014
CLASS 3: SEPTEMBER 22, 2013
JEN VAN DER MEER @JENVANDERMEER WWW.JENVANDERMEER.COM
April 13, 2023 2
BUILDINGS AND BUILDINGS IN THE NEWS
De Blasio Orders a Greener City, Setting Goals for Energy Efficiency of Buildings (NY Times)
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ASSIGMENTWhen developing ideas and concepts for our student projects, and future projects, business ideas, and save-the-world ideas, we often start by designing for ourselves.
For this assignment, research a part of the world at a local level (city, state, province, county) that has a problem with obesity. The only requirement: pick somewhere that you have never been.
In a one page essay, describe the social, cultural, technological, economic, and other conditions of this region that may be contributing to a growth in the prevalence of obesity. You may choose to write a non-fiction account or take this as a creative writing assignment – imagining a first person day-in-the-life account of what it feels like to live here.
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PLACES TO INTERVENE IN A SYSTEM: 12. Constants, parameters, numbers (subsidies, taxes, standards)
11. The sizes of buffers and other stabilizing stocks, relative to their flows
10. The structure of material stocks and flows (transport networks, population age structures)
9. Length of delays, relative to the rate of system change
8. The strength of negative feedback loops, relative to the impacts they are trying to correct against
7. The gain around driving positive feedback loops
6. The structure of information flows (who does and does not have access to what kinds of information)
5. The rules of the system (such as incentives, punishments, constraints)
4. The power to add, change, evolve, or self-organize system structure
3. The goals of the system
2. The mindset or paradigm out of which the system – its goals, power structure, rules, its culture-arises
1. The power to transcend paradigms
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6. THE STRUCTURE OF INFORMATION FLOWS
There was this subdivision of identical houses, the story goes, except that for some reason the electric meter in some of the houses was installed in the basement and in others it was installed in the front hall. What happened?
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6. THE STRUCTURE OF INFORMATION FLOWS
A new loop.
Missing feedback is one of the most common causes of system malfunction.
Adding or restoring information can be a powerful intervention, usually much easier than rebuilding physical infrastructure.
We humans have a systematic tendency to avoid accountability for our own decisions. That’s why so many feedback loops are missing – and why this kind of leverage point is so often popular with the masses, unpopular with the powers that be, and effective, if you can get the powers that be to permit it to happen (or go around them and make it happen anyway).
Donella Meadows. Leverage Points. April 13, 2023
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THE STATE OF GLOBAL HEALTH CARE
BODIES & BUILDINGS
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HEALTH CARE COSTS
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GLOBAL BURDEN OF DISEASE
Percent of Disability-Adjusted Life Years Lost to NCDs (Non Communicable Disease) in 2010. Source: IHME.
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GBD REPORT
One of the big headlines from the GBD is that there are now more people dying of obesity related diseases than starvation and malnutrition–that non communicable diseases like cancer are overtaking communicable diseases as the leading cause of premature death–how should that effect how the world makes decisions about global health resources?
- Impatient Optimists
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VACCINE PREVENTABLE OUTBREAKS
Source: CFR.Org. We are unlearning what we already know.
Figure 3. YLD rates (per 100,000) by country for depressive disorders in 2010.
Ferrari AJ, Charlson FJ, Norman RE, Patten SB, et al. (2013) Burden of Depressive Disorders by Country, Sex, Age, and Year: Findings from the Global Burden of Disease Study 2010. PLoS Med 10(11): e1001547. doi:10.1371/journal.pmed.1001547http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001547
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THE STATE OF US HEALTH CARE
BODIES & BUILDINGS
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RISE IN SPENDING
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HEALTH CARE COSTS
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HEALTH OUTCOMESOur health system—or better, anti-system—consumes nearly $2 trillion annually and does not deliver the value that it should. Those who think we have the best system in the world come up against the cold hard facts (if they matter in political debate anymore) of health outcomes, which indicate that we’re ranked 37th in the world and trending downward, not improving. Despite one of the most robust ecosystems for innovation in biotechnology and information technology that the world has ever seen, converting this into tangible health outcomes is an “innovation space” that we’ve yet to get a handle on.
How Connected Health, Public-Private Cooperation, And Big Data Can Revolutionize Health Care. Dr. Jody Ranck. Forbes.com. February 6, 2012. April 13, 2023
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WHY DOES THE MEDICAL PROFESSION HAVE TO BE PAID To be digital?
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MEANINGFUL USEThe goal of meaningful use is to promote the spread of electronic health records to improve health care in the United States.
The benefits of the meaningful use of EHRs include:
Complete and accurate information. With electronic health records, providers have the information they need to provide the best possible care. Providers will know more about their patients and their health history before they walk into the examination room.
Better access to information. Electronic health records facilitate greater access to the information providers need to diagnose health problems earlier and improve the health outcomes of their patients. Electronic health records also allow information to be shared more easily among doctors' offices, hospitals, and across health systems, leading to better coordination of care.
Patient empowerment. Electronic health records will help empower patients to take a more active role in their health and in the health of their families. Patients can receive electronic copies of their medical records and share their health information securely over the Internet with their families.
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HOW ELSE DO WE DEFINE PATIENT EMPOWERMENT? To be digital?
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GENOTYPES + PHENOTYPES
BODIES & BUILDINGS
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GENOTYPE PHENOTYPE
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GENOTYPE PHENOTYPE
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GENOTYPE PHENOTYPE
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GATHERING THE PHENOTYPESIf we hope to continue the rate of improvement in healthcare we must find a way to coordinate the contributions of countless clinicians, researchers, and patients. To make any sense out of the genotype, we must have a understanding of phenotype —the manifest characteristics of individuals, such as their age, weight, medical symptoms, mental status, and many other measurable traits —than is several orders of magnitude deeper than it is today. We must be able to gather and parse a hundred times more data about each patient than we do today, and we must be able to compare that rich data among millions of patients. Today, the sciences and the software that support clinical trials, genomics, and standard clinical operations are separate and distinct, with infrequent overlap. Tomorrow, these disciplines will merge into a single enormous effort to improve healthcare. Science on this scale is impossible without mass high-quality computerization. There is no reason why all of this cannot be accomplished while respecting patient privacy and other basic notions of human dignity.
-Hacking Healthcare. Fred Trotter & David Uhlman
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OPEN DATA FOR HEALTH
BODIES & BUILDINGS
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VALUE OF ALL OF THIS DATA
In an era of “big data,” when personal health information can be derived from sources as diverse as credit card records and GPS, and when individuals can acquire a genome sequence without consulting a doctor, Wilbanks urged the medical research and entrepreneurial community to take the lead in integrating and applying these various data in useful ways
-John Wilbanks Interviewed. OPEN-DATA ADVOCATE SAYS HEALTH INFORMATION MUST BE SHARED. NYGenome.org. Dec 10, 2012.
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OPEN DATA IN HEALTH
U.S. government’s work to “liberate” data to spur entrepreneurship and innovation that improves health care and simultaneously contributes to economic growth.
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THE VA AND BLUE BUTTON The Blue Button enables users of personal health records to download their personal health information as an ASCII text file.
The Blue Button Initiative emerged out of the US Department of Veterans Affairs (VA) with a simple goal – create a big blue button on their website that would enable a logged in user to download their health records.
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CURRENT SYSTEMS: FRAGMENTED, NOT YET OPEN
According to Kalorama Information, six vendors dominate half of the $18 billion EHR market in terms of revenue.
1. Cerner (just bought Siemens)
2. McKesson
3. Siemens
4. GE
5. Epic
6. Allscripts
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OPENING APIsAllscripts: The Open App Challenge encourages a broad community of developers and vendors to “Start a Revolution” by designing and integrating applications that become an extension of Allscripts Open Electronic Health Records software.
Walgreens: Walgreens will be offering access to its data through a variety of Application Programming Interfaces (APIs) and Software Development Kits (SDKs).
Aetna: The CarePass Developer portal offers unique and powerful APIs from Aetna, HHS, and other innovators in the health and wellness community, plus all of the support you’ll need to work with these APIs. Check out our APIs and then register.
Nike: Nike+ data helps athletes know more - and do more. The Nike+ platform gives select partners access to the real activity data captured by the Nike+ FuelBand and Nike+ Running devices, used by millions of Nike+ users.
Healthkit: Aetna and Nike shut down their apps ecosystems and wearables ahead of Apple’s healthkit announcement
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ASSIGNMENT: SEPTEMBER 29
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READING/VIEWING The quantified self, Counting every moment. The Economist.
US CTO seeks to scale agile thinking and open data across federal government via Strata Rx
The Business Case for Open Data Omidyar Network
Video: Changing Behavior and Changing Policies: Todd Park
Further Learning:
Todd Park: Opening Data for Social Change
Social fMRI: Investigating and shaping social mechanisms in the real world. Nadav Aharonya, Wei Pana, Cory Ipa, Inas Khayala,b, Alex Pentland. Persuasive and Mobile Computing. Vol 7, 2011, 643-659.
Openhealthdata.org
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ASSIGNMENT
Assignment for September 29, 2014: Write a one-page essay to be presented in class. Assume someone you love has been prescribed a wearable device to track their glucose levels, heart rate, and emotional state, and the doctor is at a research organization asking for the data to be donated to a larger research effort. What do you advise and why? Would this change if the research study was also measuring the quality and quantity of interactions between caregivers (yourself) and your loved one?
