Finally the staff in the Waitemama Health Board speak out


As a footnote on my story yesterday, in this morning’s New Zealand Herald, senior doctors have finally spoken out, to the ‘disappointment’ of the Waitemata Health Board. I’ll bet they were disappointed. The Health Board say they have been working on it as fast as they can. But didn’t they close a whole floor of the hospital because they had insufficient staff? Now they are going to open a new ward.

At least it is now out in the open and we won’t hear any more stories of “It’s not usually this bad”, because we all know it is. The sad thing is that for the next few weeks at least, the newspapers, the woman’s magazines, TV and more are going to be full of sad stories about people who died because they couldn’t get their chemo or radiation treatments in time and now their cancers are invasive. We’ll hear about elderly people who didn’t make their 50th wedding anniversary because they didn’t get satisfactory care in time. I’ll put money on it that the Auckland and especially local nwespapers are going to be full of letters to the editor and many will be followed up as sad, sad stories.

The board will say “It’s not our fault, the government wouldn’t give us enough money.” The senior doctors, registrars and nurses will all be saying, “We told you over and over again, but all you cared about was budgets and efficiency.”

I have no problem with hospitals being run as a business, with controlled budgets and business plans, but let’s never forget what they are there for.

I do have one question though, and I wish my WordPress had a poll function, but then I doubt they would answer this question. Either way, here it is. To those people who work in our public hospitals. If you need surgery or have a serious medical condition, do you go to your public hospital, or do you go private? Why?

Sadly I am confident that for the majority, I already know the answer.

Again to those of you who work as staff in the hospitals, thank you so much for staying and not going oversees where you can earn at least twice as much money and in many cases function in a technological environment where most patients get their own drugs and not someone elses, where their files about their condition and allergies are available on demand and where far fewer people needlessly lose their lives. It must be very tempting sometimes to long for single shifts and an organisation that cares as much for their patients as they for saving money.

Now let the stories begin. I don’t want to sound cynical, at least any more than I already am, but it is election year this year isn’t it? There had better be some funds coming up for Auckland hospitals because health care is going to become an election issue.

The hospital is the best place to be when you are sick, or is it?


Lately there have been a spate of stories about medical misadventure in the news, focussed on hospitals in New Zealand. Tales of drugs being given to the wrong patient, the wrong limb being operated on, things left behind inside the body after the wound has been stitched and lots more. Stories like Mistakes Kill 40 and Death Tally have been around for years.

In my own personal experience I was once prescribed an antibiotic and an antihystamine where the medical documentation stated that they should not be used in combination. The consequence was a major long term allergic reaction. My father in law who has a lanryngectomy has suffered from pneumonia several times as a consequence, not a reason, of being admitted to hospital for other problems.

For years we have had stories of people waiting in corridors in hospital Accident & Emergency areas because there were insufficient beds in the wards for them, even though they had been admitted. Each time one of these stories come out, the hospital spokespeople make out that it is an isolated incident due to a suddent spate of health problems caused by weather or other factors outside their control. Funny then that each time I have visited A&E with various family members over the last couple of years, I’ve had the same experience, summer and winter. For example last year my daughter suffered what eventually was diagnosed as a relapse of glandular fever. She was instantly admitted to the hospital by agreement between an A & E clinic and the hospital. I got her to the hospital around 5 p.m. on a Saturday afternoon and she got to see a doctor at 1:30 the following morning. I assure you I can quote many more cases with the same results from personal, not anecdotal experience.

My younger daughter was a blue baby and had regular visits to hospital for that and as she got older for various injuries from her sport of gymnastics. As a child a common occurence was that they could not find her file, even for appointments scheduled a week or more in advance.

So what’s my problem with that, other than as a taxpayer and concerned citizen? It’s that they have had solutions available for many years that cost dramatically less than the consequences of not having them. I know because I presented many of those tools and solutions to them.

First there is a simple concept of bar coding or using RFID tags to identify and locate files and other plant. This is everything from patient files (even though a lot of information is digitised, it generally isn’t available to registrars and other staff on demand in the wards or at the bedside) to critical equipment. I’ve heard of operations being cancelled or postponed because equipment had been borrowed from operating theatres and not returned.

So what was my solution? Very simple. Every patient folder has a bar code on it, which identifies the patient, their national health code etc. Each staff member has a bar code on their ID card. A bar code reader can be placed at the entrance to all key areas and as critical documents or plant leaves an area, it is scanned and the person removing it scans their identity and when it arrives at the next location, it is again scanned. Now a central data register knows where each file is, where each heart monitor or other item of plant is. Imagine the amount of time and pain that could be saved and avoided!

Then there is the very common problem of people being given drugs they are allergic to. I introduced 2D and 3D barcode readers into New Zealand many years ago, through an agency I managed with a well respected medical technology brand, Welch Allyn. The conept of these bar codes which are now (12 years later) starting to appear on patients bracelets, is that the bar codes can contain large volumes of digital data including crucial information such as allergies, their condition, their blood type and much more, without having to resort to a central database. Anyone that uses a computer, especially attached to a network, knows that its integrity and availability can’t be relied on.

So, at the bedside, I recommended a protocol each time drugs were administered, that the bar code be read with a small handheld scanner with a display, or built into a small handheld computer, and critical information could be confirmed before blood or drugs were administered. It would also ensure that it was clear that it was the right leg or appendage that was causing problems. By using a drug database, which can reside in a Palm sized computer, an alert would be delivered instantly if drugs that are dangerous when taken at the same time might be administered.

This is not a small problem and it is not a local problem, but it seems that only a few hospitals spend the money on using this technology which is readily available. It is usually hospitals that are attached to universities or med schools that invest in the technology. But it isn’t expensive and the cost of not using it is much greater. In Australia for example according to the Sydney Morning Herald, between 85,000 and 115,000 people over the age of 65 are admitted to hospital EACH YEAR due to adverse effects of their medication. And that’s the tip of the iceburg. What about those under 65, but of coursewith the older ones these problems are often fatal. Google in your country and you will find countless stories. This can so easily be avoided.

I’ve often wondered what has to happen before the government steps in. How many New Zealanders and people around the world have to die because of ‘accidents’ that could have been avoided. What is the cost of each one, or even the prolonged treatment of people who’s recovery from illness is hindered due to these problems. The solution is far cheaper than not doing something about it. I thought that perhaps if the family of an MP got caught i situations like this, that then maybe the Minister or others would do something about it, but I suspect that these people would not find themselves in public hospitals where cost restraints are more important than patient’s health and care.

I’m lucky that I can make a choice and I do have a couple of minor procedures I need to undergo soon. I can assure you, I will be using my medical insurance and going private.

But tell me please, what does it take. What are you going to do nect time you take one of your friends or family to hospital and they say take a number and we will see you as soon as possible. When you ask how soon, they tell you “Maybe 2 or 3 hours, because one of our registrars is off sick” and in ‘2 or 3 hours’ they tell you “another 2 or 3 hours because there has been a major car accident that was unexpected”. Are accidents ever expected? How come tow trucks and ambulance organisations know that there are certain spots at certain times of day or night where they should be waiting because an accident is going to happen, but hospitals don’t expect it. Goodness me, it’s 11 p.m. on Friday night and it’s raining. I guess there is no reason for the hospital to expect one out of a million people to cause an accident due to drunk driving is there?

I’m pissed off. This is the 21st century. I don’t live in the 3rd world, we have a modestly affluent society, but we can’t cater to a growing population? I shudder to consider what it’s going to be like in the next 30 years as the baby boomers get older and need more medical assistance because those that don’t succumb to medical misadventure or die in the waiting rooms. The hospitals might still be saying that they were caught by surprise with the extra people who succumbed to the flu this winter.

People are so forgiving. They say the staff did their best under the conditions they have to work in. I don’t disagree, I have utmost respect for the doctors, nurses, orderlies, domestics and everyone else who make the hospitals run, despite their masters. But why should they have to, shouldn’t health be one of our highest priorities?

Now throughout all this I have been talking about public hospitals funded by the state, by our taxes. I have a couple of minor surgeries coming up and guess what, I won’t be sitting in a waiting list for 2 years and then find myself being bumped after having starved myself overnight because they needed their resources for an unexpected accident. I’ll be going private. No I’m not wealthy, but I pay my medical insurance as I have since I was 18 or so and I’m going to take advantage of it.

Anyway, is hospital the best place to go when you are sick? I don’t think so.

 

Wash Your Hands After You Do Your Business!


This is really a story about men’s hygiene in the bathroom, but it probably applies to some women as well. I was listening to the Ante Up Podcast as I showered this morning and they were talking about men who leave the washroom without washing their hands after doing their business.

Ante Up is a great podcast about Poker and has lots of great information for amateurs like myself and even those who think they know it all. What’s more they very kindly played my new song I Tilted on their show.

Anyway, they covered an issue that really anoys me, which is guys who go to the toilet and then return to the poker table without having washed their hands. The thing is that of the guys that have been in and out of the bathroom at the same time as me in poker tournaments, as many as 50% do their business and return to the tables without using soap or water. Then they handle the cards, hand me their chips when I win them off them and share their germs with everyone on the table. How bad is that? Lots of people eat their fries or other food at the poker table while they are playing, they might lick a finger or thumb as they are dealing their cards and , well it doesn’t really bear thinking about. In this day and age you would think that grown men would have more self respect and concern for their health. I know that some women are the same, but I suspect the ratio would be far less.

I had a look at a website called 1st-in-handwashing.com and found:

The importance of handwashing can be assessed by looking at a list of germs found on human hands.  Here are a few:

  • Shigella flexneri…causes vomiting, headache, diarrhea
  • Streptococcus pyrogens…causes tonsilitis, sore throats, scarlet fever,impetigo
  • Salmonella … causes severe diarrhea, stomach pain, dizzyness, fever
  • Rhino virus…over 200 strains causing great misery in the form of colds
  • Proteus vulgaris…urinary tract infextions
  • Hepatitis A…vomiting, liver disorders, jaundice
  • Escherichia coli 0157 …kidney failure, uncontrollable fever, death
  • Rotavirus …55,000 children hopitalized with this each year
  • Echovirus…meningitis, encephalitis, neonatal sepsis, myocarditis, and chronic infection
  • Coxsackie virus…sore throat, abdominal discomfort, or nausea

Now that’s just for starters.

Some years ago a popular hotel in New Zealand conducted tests on the peppermint jar at the restaurant counter, where people paid their bills after their meals. They tested mints that were not individually sealed but were there for people to help themselves to. Amongst other things they found fecal coliforms, urine residue and even semen residue! This is new mints that people hadn’t yet enjoyed.

Now ettiquette says that you don’t confront people, you don’t tell grown adults to wash their hands, and if I did I might find myself getting smacked for my trouble. But we’re supposed to be civilised aren’t we? So what can you do?  What everyoe else does, when someone loses and leaves the table, you give them a firm handshake to make sure you don’t miss out on any of the germs that didn’t make it to the playing cards or the poker chips!

Does this make your stomach churn? Maybe if this is discussed in places like this blog, more people will be conscious of it and decide that even if they don’t care about giving their germs to other people, they might at least aim to wash the other people’s germs of their own hands.

You may think this is funny, but the amount of germs that get shared and cause serious illness, that could be avoided by a little attention to  hygiene.

Think about it. How many hands did you shake today. Have you touched any money lately> Have a sniff of that $5 note in your pocket and think about where that’s been and why does it smell? Now go and buy your lunch and watch the person handle your food with their gloves and then without taking them off, handle your money and change.

Scary isn’t it. Well, that’s my soapbox for today. Hope I made you think a little. See you at the poker table. My hands will be clean, at least when I first sit down.

Thanks for reading my soapbox, pardon the pun:)

What happens when there are no more whales?


I was just listening to a podcast about singer/songwriter Bob Fox and he was singing some whaling songs of old about the ships, the whalers and how it was in some ways more fair when men risked their lives on sailing ships and throwing harpoons by hand. Whales were one of the reasons people came to New Zealand back in the 17 and 1800’s.

Anyway, this isn’t going to be a long post. It just got me thinking about the ecosystem and how whales are part of the foodchain. I started wondering, not just about the whales as majestic mammals and how they should be left in peace, but what happens to the foodchain when the Japanese and others finally demolish them as a species and they can no longer propogate. Besides the tragic loss, could this be another element of man made Earth destruction that will add to our potential demise?

That gets me thinking of another thing which I won’t go into case I have things to do, but in 100,000 years, will aliens come to earth and find artifacts of an intelligent life form that somehow managed to make themselves extinct? Will the science fiction stories of human descendants come true with people coming back one day to find out what went wrong on earth and why there are no longer any humans living here?

Why were there so many accidents in New Zealand last week?


This month to date there have been around 32 road deaths in New Zealand compared to 15 at the same time last year. The crazy thing is that the weather has been awesome. Unlike right now as I write this blog, and it is blowing a gale with a little precipitation, it has been warm, dry and perfect driving weather.

Last week I drove to Hamilton during the day on business. I passed 4 major accidents over a period of 3 hours and saw lines of congestion that averaged 2-3km of stationery traffic during a normally quiet time of day.

If you are reading this in the US, you might consider 32 road deaths as a pittance, but consider for a moment that there are less people in the whole of New Zealand than there are in many US cities. Most cars are relatvely new and feature power stearing and at the least anti-skid break technology, so there is no reason for multiple car collissions in these nice weather conditions. Our maximum legal speeds on our freeways is a mere 100 kmph and most people drive close to that.

I haven’t seen any statistics yet, but I am sure that the coroners will back up my theory. I suspect that a large number of people were in the process of text messaging and not paying attention to the road and other cars. Every time I drive I see literally dozens of people with one hand and eye on the road and the other on their phone. It’s a national disease. There is discusison about devices such as car navigation being a dangerous driver distraction, but as a seasoned user, I rarely look at my device when I am driving, I listen to the instructions. SMS is much more dangerous and distracting.

I don’t know what the usage statistics for SMS are in NZ, but with accounts allowing 2,000 free messages a month and services such as the ability for consumers to send a message to up to 15 recipients at a time, the numbers are mind boggling.

So my theory as to why so many people crashed and some of the 32 people who needlessly lost their lives on our road so far this month, is that they were sending or receiving text / SMS messages.

Seems funny now to think of the coroner in London in 1890 something who said that never again must any person die from a motor vehicle accident (that was when the guy walking in front of the car with the safety flag was killed by the very car he was protecting pedestrians from).

Surely no message is worth dieing for?

Contact lens display for your computer


I have said it before, all the stories I read about in Science Fiction are coming true, some of them even more advanced than the fiction. Think Robocop and other stories where police, soldiers and others can have access to their computer through a device attached to their eyes. I was half-watching the new series of The Bionic Woman last night and while some of the things she was doing, like using her bionic eye as a set of binoculars with the ability to lock onto faces and use facial identification, may be a little far fetched (so far) we are on the way there. The first concepts were something along the lines of a display attached to a helmet that you look at, in effect a sort of projector. That is old technology in that it has already been piloted by police in the UK and forces around the world. Now we are talking about a contact lens that incorporates a display, wiring and even a wireless receiver all built into a silicon lens that is placed on your eye just like your normal contact lens. Much of this research is being undertaken in the Unversity of Washington.

Animal lovers read no further, but apparently these lenses have already been tested on rabbits who reported that they felt no discomfort. I understand they have not yet determined how to display something that the eye can recognise because typically the eye needs to focus on something that is at least a very short distance from it. One research group is looking at having a seperate LED or similar device per pixel, which matches the eye receptors. This concept is also not unprecedented. My late grandfather went snowblind when climbing in the Swiss Alps in his early 80’s. He was the recipient of experimental eyes which looked like huge fly eyes. Not a fashion accessory, but he was able to faintly discern and identify shapes such as a human body.

Other researchers are using this technology to help determine health status and followers of iridology will tell you that you can tell a huge amount about a person’s health through an eye examination. I could imagine this sort of data being used in military and space research, allowing information to be gathered without having lots of additional hardware being attached to the body. Hey, we could require that everyone has one of these fitted, then anytime someone has a rush of blood to the head with the hormones associated with rage or excessive endorphins, it could send a message to the authorities. Imagine what would happen if they used that technology at the next Olympic Games, they would probably arrest the competitors and leave the terrorists to roam free, but I’m getting silly now, so perhaps I better head off to my Monday night poker tournament, where I could use my bionic contact lens to tell me the value of my starting hands and the play history of each of the tournament players from their Pokerstars records.

Now here’s a question I am struggling with. When you watch movies or TV programmes like 24 (which I must admit to enjoying, albeit on DVD with 4 episodes at a time) they have the technology to grab a security camera image and within seconds, not only enhance it to a high image quality, but instantly identify the person and download their life history. I’ve seen footage from companies like Arthur Anderson monitoring and analysing eye movement in a retail store, where they are studying the science of retail shelf product placement.

So why is it that when someone commits a crime which is captured on a security camera and they show us the picture or video on TV or in the newspaper, it is such a blur? On the one hand we are seeing unbelieveably exciting research, and on the other hand we can’t catch a thief in a petrol station using highly specialised camera technology.

Anyway, I’m putting an order in for my bionic lens. Maybe I can have it installed together with my eyePod implant. I’m told I have a few terrabytes free in my brain, so perhaps I could just download the entire  EMI/Warner music list straight into my brain. My car has an invisible antenna for my car stereo, perhaps I could have one mounted on my scalp so I can download the latest podcasts from any WiFi Hotspot after using the RFID tag in my contact lens for identification.

I said I was going so now I am stopping for real. Hey, if you are reading this, how about leaving me a comment, or if you know someone who might be interested in my rantings, send them a link.

While this blog is starting to get a good following, I would love to get more readers and encouraging me to keep writing. If you feel that my blog is interesting I would be very grateful if you would vote for me in the category of best blog at the NetGuide Web Awards. Note that the form starts each site with www whereas my blog doesn’t and is of course http://luigicappel.wordpress.com.

Thanks so much for your support:)

What can they find out about you on Facebook and who is looking


I was having a discussion with my new Sales & Marketing Assistant today about permission and proximity based marketing and the impact that social networking is going to have on this market. The topic of Facebook came up and how it is different to other consumer facing networks. The key difference is that unlike ‘most’ social networking sites people use their real identities, names and other information rather than nom de plumes. This means that a huge amount of information could be available, much more than they might want known.

Who might want to use this information? Potential employers, lending institutions, the police, security services, marketing companies, loyalty companies, asociations, manufacturers, brands………………… Why? Lots of reasons, some good, some bad.

I may have mentioned in a previous blog that a major university in the UK is doing some research to find out what they can learn about their current students from Facebooks, and I’m assuming the exercise is to find out what they can learn without people’s informed consent.

It’s no secret that brands like Coca Cola are very interested in the ability to market to users of Facebook and I’m sure they will come up with some very cool games or other applications to get people to participate and then the fun begins.

Now the areas I am particularly interested in are proximity based marketing, in the long term using GPS based mobiles. Currently less than 4% of all phones have built in GPS and therefore tracking people’s whereabouts now is not a marketing proposition, but it will come. Subject to controls, and that is already looking difficult to impose, I would have no problem with a music shop sending me a text message saying “Luigi, we know you are close by, come and show us this message and we will let you have a play on our new Roland Guitar Synthesisor just in from the lab and if you by a set of strings while you are here, you can have a second set to the same value free.”

We know that in future fashion stores will have a database of their clients measurements, colours, likes and dislikes. I see in the future a scenario where a woman will get a PXT or Video message, saying “seeing as you are in the area, we’ve sent you this photo to show you what you will look like in the new autumn-wear that has just come in from Milan. Drop in in the next 30 minutes and we will give you a 25% discount on your purchase.”

But I digress as I often do. In marketing and collection of information, the theory is that you have consented to companies or organisations collecting and holding information about you and often you have unknowingly consented to their sharing your information with others. I am concerned that the definition of consent is blurring. If you put personal information onto your Facebook profile and for one reason or another people you have no direct relationship can access it, did you consent to their having it and did you understand what that meant.

For example, if you send a message or email to someone you don’t know via certain applications in Facebook, you will get a message saying that the recipient will be able to see your profile and information for 1 month, even if you don’t accept them as friends. Is that scary or what? People tell me that they don’t allow their information to be seen by strangers, but that’s what they think!

The thing about this phenomenon is that Facebook is not an application, it is a development environment that anyone can use to make applications that link in to the Facebook network through a range of API’s and Widgets with commonality in functions. In an environment like Bebo or even MySpace, you are really dealing with one company who have control of the environment, even if they allow people to add little Flash applications or plugins. Facebook is quite different. If I had the smarts, or the inclination, I could build a Facebook  application. Let’s say for example I decided to build an application for Flashmobbing. It may be a little old concept now, but I’m sure if I focussed on a High School or University as a start up location I could get hundreds of people to join up and I would then have access to their profiles.

There are lots of more criminal or sinister things I could do, but I don’t want to even mention them and give other people ideas, but I’m sure you get the gist.

I’m going to stop now, I have things to do, but this is what I’m thinking about. On the one side I would like to see a world of permission and location based marketing that knows what I am interested in and where I am, but on the other hand I want to be able to ensure that I am not pestered with spam and that my personal details remain personal.

While this blog is starting to get a good following, I would love to get more readers and encouraging me to keep writing. If you feel that my blog is interesting I would be very grateful if you would vote for me in the category of best blog at the NetGuide Web Awards. Note that the form starts each site with www whereas my blog doesn’t and is of course http://luigicappel.wordpress.com.

Thanks so much for your support:)