Winter Break Programming Class for BPS Students

The Boston Public Schools Office of Instructional and Information Technology is offering a free two-day training for students during vacation week.  OIIT's TechBoston Unit in conjunction with Machine Science are hosting the two-day Scratch programming workshop.  Students will learn how to design and write their own computer program or animation using Scratch, a graphical programming language developed at MIT.

During the training students will also:

• Learn how to make programs in Scratch
• Learn basic Scratch control structures
• Experiment with motion, sensing, looks, and sound
• Learn about using variables and operators
• Make drawing programs with the pen function
• Create original games and animations
• Share projects on the Scratch web site
• Download and “remix” projects from the web site

The free two-day workshop will be held on Tuesday, December 27 and Wednesday, December 28 from 8:30am-3:00pm at Madison Park High School.  This opportunity is open to any BPS students in Grades 6-12.  There are a limited number of seats, so sign up early! 

For more information please visit http://bpsengineering.wordpress.com/student-resources/december-2011-bootcamp/.  Online registration is required: http://tinyurl.com/december2011camp.

For further questions about the training, please contact:
Haruna Hosokawa
hhosokawa@techboston.org

To learn more about the Scratch programming language, please visit http://scratch.mit.edu/.

Thanksgiving in Health Care

Thanksgiving is almost here and between shopping for yams and turkeys and waiting for the cranberries to pop in the saucepan, there is ample time for reflection. Most folks evaluate the past year and make predictions for the next somewhere around Christmas, but since little serious business is conducted after Thanksgiving, and I’d rather leave predictions to professional gamblers, this is the week where I sift through this year’s events and try very hard to elicit personal feelings of gratitude. Since this is a health care blog, here are some health care related things I am very thankful for, and since like most social media aficionados, I too have a very short attention span, most are rather recent events.

• First and foremost I would like to thank the Supreme Court of the United States for agreeing to hear arguments from the States, the Federal Government and small businesses backed by large businesses, on the Patient Protection and Affordable Care Act (PPACA) (a.k.a. Obamacare). Although having PPACA end up in front of the Supreme Court was a foregone conclusion since before the ink was dry on the President’s signature, and perhaps long before that, I am particularly grateful for the Supreme Court’s chosen timing for making a decision on this matter. The Court will hear arguments early in the spring of 2012, and if all goes according to plan it will either uphold or obliterate President Obama’s most important policy achievement just in time to inform my decision on who to vote for in the Presidential elections. It means a lot to me, and I am sure to many other conflicted voters, to have the advice of the wisest nine men and women in the land, and it is much more elegant and efficient to mentor us now instead of having to fix the issue after the elections take place.
• Second, I would like to express my gratitude to Walmart who is finally volunteering to extend its unparalleled efficiencies in supply chain management to health care. Like most Americans, I have seen my health insurance premium go up by almost 20% recently and my deductible has too many zeros to fit in that little box on a standard check. It is reassuring to know that very soon Walmart will do for health care what it did for tee-shirts and accessories. Obviously, any organization that can put a plastic Luis Vuitton handbag in the hands of the humblest day laborer can surely be relied upon to bring PSA testing and chronic disease management to every hamlet and every housing project in the land. And even though I have no plans to start shopping at Walmart, particularly for health care, I am looking forward to the proven Walmart effect on prices of medical products and wages, which should make all health care, affordable for all of us.
• On a more technical, and more work related note, I need to thank the FDA for unequivocally excluding Electronic Health Records (EHR) from its proposed regulation of mobile medical applications. The mobile health (mHealth) field is in its infancy and chock full of bright eyed and bushy tailed young entrepreneurs who can obviously benefit from FDA guidance just like their brethren in the perpetually sizzling bio-tech and device industry already do, with more innovation than any investor can handle percolating up all day every day. On the other hand, the frail and elderly EHR field, led by billion dollar technology and insurance companies, is in no position to withstand the rigors of FDA regulatory activities, which may inadvertently interfere with the massive life supporting cash infusion from government initiatives.
• For a closely related effort, I am also grateful to the Institute of Medicine (IOM) for its recent report supporting the FDA position on EHR regulation. While acknowledging the inherent patient safety issues posed by use of EHR devices, the IOM is proposing a tangled web of voluntary and non-regulatory boards and organizations to be created for the purpose of observing and guiding EHR product use and development. The IOM does recognize that the system it proposes may very well fail to address the issue at hand, in which case it recommends that the FDA comes in to the rescue as a last resort. Hopefully by then EHR companies will have had every chance to absorb the Federal flow of cash to the industry in its entirety.
• A few days ago we observed Veterans Day and we all expressed our heartfelt thanks for the sacrifices made by our men and women in the armed services. I would also like to thank Congress and its Super Committees for going above and beyond gratitude, and actively trying to provide our Veterans, even those who are too old, too depressed or otherwise incapacitated, with one more chance to serve our country. As we sink deeper and deeper in debt, there is a great opportunity for millions of heroes to forgo a little bit of health care services, or pay a bit more for each, so the greatest nation on earth can save a whopping $11 billion each year. Compared to putting oneself in harm’s way, this is easy stuff and while it is true that one large corporation, like GE for example, could single handedly create those savings just by paying their taxes for the year, it is much more meaningful that the glory should go to our Veterans. It is the right thing to do and I am so proud of our honorable members of Congress.
• Finally, I would like to thank Congress one more time for perhaps the most extraordinary achievement in its history, and that is transforming pizza into a vegetable. Granted the Supreme Court of 1893 paved the way by declaring the tomato fruit to be a vegetable, but combining white flour and globs of animal fat into the texture of this new vegetable is nothing short of miraculous. Although Congress accomplished this in the context of ensuring that our children eat healthy food in school cafeterias, I am certain that many adults and most children will incorporate more of this wonderfully healthy vegetable in their diets outside of school lunch, and I for one, will try very hard to find a creative way to add this Congressional vegetable to our Thanksgiving table this year.

Now that I thanked all I could think of, and before I return to my bubbling cranberry sauce, I would like to ask for one little thing. Bypassing the Congressional middlemen, and going straight to the top, I would like to ask Hershey and Nestlé and all other multi-national decision makers, if it would be possible to make chocolate a vegetable too. Since cocoa beans grow on trees, chocolate is practically a fruit as it is, so making it a vegetable should be trivial in view of the various precedents quoted above, and it would mean so much to me and to countless other women and children trying hard to take personal responsibility for their own health and health care.
Happy Thanksgiving everybody!

Ten Qualities of Top Trial Presentation Professionals

Dr. Conrad Murray, Michael Jackson Trial (see video below)

Back in the day, when I was the firm-wide in-house TrialConsultant for Brobeck, trial presentation software and technology wereactually quite similar to what we use today – at least with respect to the waythe exhibits are organized and presented in trial. Sure, computers and softwarehave come a long way, but the biggest difference is the fact that more lawyersare using it. So, what are a few of the key qualities that seem to be a commonthread among the nation’s leaders in trial presentation? I think you’ll findthat many of these are also the traits shared by successful litigators.

1.      TrialExperience
There is a reason this profession is often referred to as the “hot-seat.” There is nowhere to turn, or nobody else toblame when (not if) something goeswrong, and only experience can help develop the knowledge of how toimmediately correct most any issue, and in such a manner than nobody else evenrealizes there was a problem.

2.      Confidence
This comes naturally with actual trial experience, as noted in #1 above. Ifthere is a lack of experience, there will also be a lack of confidence.Typically, a lack of confidence is easy to spot, and often, the reasons forthis shortcoming become apparent in trial. A truly confident trial presentationprofessional will appear cool and calm, even when they’re under a great deal ofpressure.

3.      Obsessiveness
In addition to trial experience, there is nothing like preparation to bringpeace of mind to the trial team. During trial prep and the trial itself, thereare no adequate excuses for not getting something ready in time. If this meansworking 16+ hour days, and not going to sleep until everything is ready for thenext day, then so be it.

4.      Makes itLook Easy
Maybe you’ve seen at attorney working with a trial professional, and notedhow it appeared as if every step was rehearsed – almost as if they both knewexactly what to do, and when. On the other hand, perhaps you’ve witnessed (orbeen part of) of a trial presentation meltdown, where exhibits weren’t presentedin a timely manner, and frustration was apparent on the part of the attorneyand trial presenter – not to mention the Judge and jury. The best trialpresentation professionals are able to anticipate where the next callout orhighlight should be, and will just make it happen.

5.      Above-averageWork Ethic
One thing I have learned in my years working with some truly greatattorneys is that you must be willing to work harder than opposing counsel.While hard work won’t turn a bad case into a good one and win, laziness can makeyou lose. Great attorneys are relentless. So are their trial teams. GerrySchwartzbach once told me quite simply, “We will out-work them.” David Boiesonce asked his weary trial team, “Do you want to sleep, or do you want to win?”

6.      DataManagement Expert
One problem with those who find that trial presentation software isactually pretty easy to learn (at least the basics), is that it doesn’t makeyou a file management expert. Unless you are capable of organizing tens ofthousands of pages, you shouldn’t attempt to do so. One of the most commoncauses for problems in trial presentation is poor data management.

7.      Computerand Software Expert
While nobody can know everything, an experienced trial presentationprofessional will be familiar with most programs used by law firms, including litigationsupport applications. They will also be able to assist with computer problems,spreadsheets, and graphics. They will certainly be intimately familiar withtheir trial presentation software, and will know how to make the most of allfeatures. Paralegal skills and experience can also be a plus.

8.      Resources
One life-lesson I learned many years ago was that the smartest people arenot necessarily those who have all of the answers – but rather, those who knowwhere to find the answers. Whether that means knowing where and how to searchthe Internet, or having a list of fellow professionals handy, there shouldrarely be a situation that cannot be resolved. It can also mean finding a wayto get 3 copies of 20 exhibits scanned and printed at 2:00 AM.

9.      IT Expert
One quality that is often overlooked is the ability to simply “make thingswork.” This can mean installing and wiring an entire courtroom, setting up theremote war room, or getting everyone connected to the network. When working outof town in a remote war room, chances are you didn’t bring along your ITdepartment with you. There is far more to this business than putting exhibits upon a screen.

10.   Top Firms and Cases
Never hesitate to check the background of your provider. If you’ve neverheard of them, and/or if they don’t have an impressive list of clients and cases,chance are they don’t have the experience necessary to support your trial. Unless you’re willing to provide trainingwheels, don’t waste your time with someone who is just getting into thisbusiness.

Here’s an example of a total FAIL in the recent MichaelJackson trial of Dr. Conrad Murray, as described in #4 above, courtesy of ChrisBallard, of Video and the Law.

A Day in Trial

There is an increasing interest in using trial presentationsoftware to help persuade jurors in litigation of all types. Once considered the domain of themega-firms with their billion-dollar clients, trial presentation technology hasnow trickled down to the point that it can be used in most any matter. Thedecision is no longer whether or not to use it, but how to get the most out ofit, while staying within the budget. There are a few common options.

You may want to have an attorney handle it. At first glance,this appears to be a perfect match. Another attorney billing on the case, andthey are already familiar with the exhibits and the case. From a client’sperspective, however, the billing rate is likely quite a bit higher than thatof a trial technician, but even more importantly, it takes a great deal of timeto manage the database, prepare exhibits and deposition clips, and present theevidence. If the assigned attorney has little else to do, it could work. Ifthere are other “normal” trial responsibilities, adding a menu of tasks thatrequire constant attention and maintenance may not be a good fit.

Another way to staff your trial presentation is to pull aparalegal and have them do it. However, as in the example above, chances areyou’ve already assigned a full day’s workload on your paralegals, and unlessyou’re able to relieve them of all of their other chores during trial, burnoutmay be on the near horizon. It is notrealistic to expect anyone to work two full-time jobs, and that is about whatit amounts to.

Other considerations are familiarity with the software,protocols, and the case itself. Trial presentation software is not unlike manyother specialized programs that unless you use them regularly, you are notreally comfortable or familiar with the features. In trial, you don’t have time to search the Help Menu for solutions,or call for support when you have a problem. It’s all on you, and if youcannot make it work in a matter of seconds, you may find yourself using the hardcopy exhibits.

Whether in-house oroutsourced, a full-time trial presentation technician or consultant isgenerally going to be the best option available. Someone whose solefunction is to ensure that every exhibit is accessible, and presented to thejury as needed. The more experience they have in this role, the better thingswill flow, and the trial presentation database should be their primaryfunction. All other tasks should take secondary roles, as it often requires14-16 hours per day or more during trial to keep everything rolling smoothly. Oncecounsel is finished preparing for the next day’s witnesses and retires for theevening, the trial tech goes to work, getting all exhibits and testimony readyto go, backing up the database, and adding new documents. They will also befamiliar with the courtroom presentation equipment, and how to deal with theCourt staff.

Although it may seemcounter-intuitive to bring in someone who isn’t already familiar with yourcase, this can actually be one of the greatest assets of a consultant. Itis true that they don’t know the case, or how you view things. Neither willyour jurors, and if you have someone willing to share an objective “outsider’s”perspective, that’s the closest you can get to the mind of your jurors. Don’texpect (or ask) them to see it your way, and don’t attempt to convince them. Youdon’t need another pat on the back or a “yes-man.” Just ask for their feedback,and take advantage of any insight they have to offer.

Target & Heart of America Transform the Hennigan School Library

On November 2nd, the Hennigan School unveiled a new library, thanks to the phenomenal partnership of Target and Heart of America, a non-profit literacy-focused foundation. For the third year in a row, Target and Heart of America have selected a Boston school to make over as part of Target's School Library Makeover Program.  Complete with 2,000 new books, a state-of-the-art technology center, and eco-friendly design elements, the new library is bright and inspirational, just like the Hennigan Students. At the unveiling, students also took seven books for their home libraries.

Target incorporated its Meals for Minds program as part of this year's makeover, partnering with the Greater Boston Food Bank to establish a monthly food pantry site at the school's community center. The pantry will provide fresh fruits and vegetables, among other healthy food choices, to Hennigan families.

For more on the library makeover, as well as photos, visit The Boston Globe article at: http://www.boston.com/yourtown/boston/jamaicaplain/gallery/new_hennigan_school_library/

BPS Technology & Special Education Offices Launch iPad Collaboration to Support Students with Autism

OIIT is partnering with the Office of Special Education and Student Services on an iPad project for special education teachers and strand specialists within the Highly Specialized Strands for students with autism.  The use of iPads as an instructional support is proving to be instrumental in teaching students challenged with autism.

Approximately 60 teachers in 15 schools will began the project this past week with a two-hour training which will include basic operations and settings, overview of apps, use of a blog and wiki and BPS Connect devoted to this project, and small group discussion on how to use the iPad and applications in the classroom.

Each participating teacher will receive a 16 GB iPad 2 with wifi, which will be preloaded with over thirty applications, for student use in their classrooms. Applications will include basic Augmentative and Alternative Communication apps, speech-to-text apps, and literacy and numeracy activities.

For more information on iTouch technologies & OIIT’s app recommendations, visit our iTouch Technology Resources site. 

The IOM Report on Health IT Safety

A recent report from the Institute of Medicine (IOM),  “Health IT and Patient Safety: Building Safer Systems for Better Care”, introduces a new health care related term, "Health IT-assisted care", defined as "health care and services that incorporate and take advantage of health information technologies and health information exchange for the purpose of improving the processes and outcomes of health care services. Health IT–assisted care includes care supported by and involving EHRs, clinical decision support, computerized provider order entry, health information exchange, patient engagement technologies, and other health information technology used in clinical care”. And the IOM report, as its title implies, is recommending strategies to ensure that health IT-assisted care is safe for patients.

The IOM report presents a comprehensive literature review regarding the status of health IT as it pertains to patient safety from every conceivable angle, starting with the manufacturing process and drilling down into product selection, implementation processes, training, and actual use of EHRs and other health IT products. As most folks who follow the health IT industry know all too well, the report concludes that data concerning the effects of health IT on patient safety is currently scarce and inconclusive. Nevertheless, the scarcity of data and the “sparse evidence pertaining to the volume and types of patient safety risks related to health IT” did not prevent the committee from acquiring “the sense that potentially harmful situations and adverse events caused by IT were often not recognized and, even when they were recognized, usually not reported”. That maybe so and again it may be that what we see is all there is to see. Either way, “[t]he committee believes the current state of safety and health IT is not acceptable; specificactions[sic] are required to improve the safety of health IT”. To that end, the report presents 10 recommendations to the Secretary of Health and Human Services (HHS).

1. HHS should create and publish an action plan in the next 12 months to assess the risk of health IT for patient safety and begin mitigation through education, research, standardization and the testing and accreditation of health IT products. Suggested organizations for funding and carrying out these activities are ONC, AHRQ and NLM.
2. HHS should insure that health IT vendors freely exchange information regarding issues as they pertain to patient safety. This is where the infamous gag clauses in EHR contracts should be addressed.
3. ONC should work with public and private sectors to make user reports of patient safety issues publicly available. NCQA and JCAHO are amongst the suggested implementers.
4. HHS should fund the creation of a new Health IT Safety Council to evaluate criteria for measuring safety of health IT.
5. ONC should require all health IT vendors to publicly register with the agency.
6. HHS should define mandatory quality management processes for health IT vendors. ONC, FDA and certification bodies are suggested organizations for administering a compliance process.
7. HHS should establish a mechanism for reporting adverse events which is mandatory for vendors and voluntary for users. Reports should be collected analyzed and acted upon.
8. Congress should create an independent federal entity, similar to the National Transportation Safety Board (NTSB), to investigate the reports collected in item 7 above.
9. HHS should monitor progress and if found lacking, should direct the FDA to exercise its full authority to regulate health IT. The FDA should immediately begin preparing the infrastructure for this eventuality.
10. HHS should support cross disciplinary research of safety aspects of health IT, such as user centered design, safe implementation methods, sociotechnical systems, and effects of policy decisions on health IT.

This is a very impressive and very well-reasoned list of tactical and strategic initiatives, but it also presents some difficulties. First, reporting adverse events is a prerequisite to almost all activities recommended by the committee. It is not clear how such reporting is to be implemented when malpractice suits are a consideration. The report suggests that reports should be kept private, even anonymised, and that users should be protected from punitive actions. Does this protection extend to legal action? If the report-collection agency becomes aware that a patient died due to preventable error, should the patient’s family be notified? Should malpractice attorneys be allowed to review this public information and subpoena the identifiable data? Second, all ten recommendations made by IOM require significant funding and it is not clear where the monies should come from at the moment. The recommendation in item 9 above, that the FDA readies itself for full regulation of health IT as a contingency plan if all else fails, seems duplicative and particularly wasteful. Somehow the committee seems to believe that FDA regulation, unlike regulation by multiple disjointed organizations, would negatively affect anticipated innovation in health IT.

Speaking of the FDA, the immediate question, of course, is why do we need a 137 page report from the IOM to figure out how and who should oversee patient safety? The Food and Drug Administration (FDA) is currently overseeing patient safety issues arising from surgery-assisted care, radiology-assisted care, pharmaceutical-assisted care, implantable device-assisted care and all sorts of other types of assisted care. Most recently the FDA published its proposal to oversee mobile device-assisted care (phones, tablets and laptops). How and why is health IT-assisted care different? How is a medication dosing calculator on an iPhone different than the same calculator in an EHR? How is an iPhone connected to a blood pressure cuff different than an EHR connected to a blood pressure cuff?

To my immeasurable delight, the IOM report contains the answer in the Dissent Statement of Dr. Richard Cook. While the IOM report is recommending that health IT be regulated and monitored by a smorgasbord of existing or yet to be created organizations, none of which have the required expertise to tackle the task, and all of which will need to be heavily funded for this endeavor, with the FDA as a last resort measure, Dr. Cook proposes to allow the FDA to do its job in the first place.  Dr. Cook’s simple and straightforward recommendation is to have HHS “direct the FDA to exercise its authority to regulate health IT, including all EHRs and associated components, and health information exchanges, as Class III medical devices”. While possessing all salient characteristics of a Class III device, “health IT is on track to be a medical device used for every person in the United States” [italics in the original], which makes it both urgent and imperative to have health IT regulated and monitored properly and Dr. Cook's conclusion succinctly sums it all up: "health IT is a medical device. It should be regulated as a medical device now and should have been regulated as a medical device in the past".

Ten Questions to Ask Your “Hot Seat” Provider

First, I’ll define the term “Hot Seat.” In litigation, thisis used to describe the role of the trial presentation technician or consultant– the one responsible for managing and presenting the evidence to Judge andJury. Any delay in presenting the requested exhibit can seem like an eternity. One miscue on their part, such as bringingup the wrong exhibit, can immediately result in a mistrial – hence the term, “hotseat.”

1.      How much will it cost?

Make sure to get the “real numbers” in any estimates you receive, and see ifthere are hidden extras, such as overtime, travel, equipment, weekend orholiday charges, project management fees, etc.

2.      How much do you personally make?

Cost does not always equal value, and hourly rates do not necessarily indicatethe level of competency of the individual actually providing the services. Thismay be a very personal question, but if the hourly rate is $250, and yourhot-seat tech is making $25 of that, there’s a problem.

3.      How many actual court trials have you personallyhandled the “hot seat” in?

This should be a realistic number, and is not the same question as, “How manycases have you worked on in any capacity?”

4.      Have you ever been involved in a trial similarto this?

Your “hot seat” person will be comfortable, and thus more effective, infamiliar surroundings. Although it would be unrealistic to expect experiencewith the exact case type, things like the size and value of the matter, venuetype, data formats, and general type of litigation are all helpful qualities.

5.      What extra value do you have to offer the trialteam?

In some cases, the answer may be zero, and that is fine. In others, similarcase experience, case feedback, jury monitoring, or other extras may help makethe decision whether or not to hire.

6.      May I see your bio?

Don’t expect to see a résumé, as you’re not hiring an employee. However, youhave every right to request a bio of the person(s) who will be assigned to yourcase. Make sure you’re getting what you pay for.

7.      How long have you been doing this type of work?

A few years can be a reasonable amount of time to master most of this. Unless you’re knowingly hiring a trainee(can you spell m-a-l-p-r-a-c-t-i-c-e?), make sure they’re not learning on yourdime, and at the expense of your case.

8.      Can you assist with Opening Statement andClosing Arguments?

Depending on the case, it can often be helpful to have another set of eyes lookingat things, and offering ideas on how to tell the story visually. This may ormay not be something you need or are willing to pay for in your case.

9.      Are you capable of producing on-site graphics?

Any hot-seat technician should be able to make at least minor changes on thefly as needed. There’s simply not always time to engage the “graphics team,” regardlessof wherever they may be located.

10.  What sets you apart from your competitors?

This can apply both to the company, and the individual(s) assigned. However, hiringa well-known company does not necessarily mean that the person they will assignis the best for you. Make sure it’s a good fit from top to bottom.