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social, health, political imagery through the lens of George J Huba PhD © 2012-2017

Search results for healthcare

  • 22 MILLION people lose healthcare insurance (final House Trumpcare Bill)
  • 23 MILLION people lose healthcare insurance (first Senate Trumpcare Bill “repeal and replace”)
  • 20 MILLION people lose healthcare insurance (second Senate Trumpcare Bill “repeal”)
  • 16 MILLION people lose healthcare insurance and premiums go up 20% immediately for those who must buy individual insurance  (proposed Senate Trumpcare Bill “skinny proposal” to be voted on today)
  • 7,000 honorable, competent, and patriotic enlisted men and women “fired” from the US uniformed services because they are transgendered; they will lose their employer provided life insurance
  • 1 Attorney General currently being viciously shamed in the media hourly by the President
  • 1 Vice President mirroring the President’s viciousness
  • 1 Secretary of State currently under attack from the President
  • 1 FBI Director fired
  • 1 Special Counsel likely to be fired
  • 100s of BILLIONS of $dollars possibly illegally transferred from Russia to individuals associated with Trump and the Trump campaign
  • 1 Country under cyber-attack by the Soviet Union (whoops, Russia) and whose President is acting as if the Soviet Union is America’s BFF rather than a “gas station with nukes”

Those numbers are numbing and scary.

Numbing Numbers

The numbers listed below could counteract those listed above.

  • 435 members of the US House of Representatives that could impeach a sitting president
  • 100 members of the US Senate who could convict a US President and Vice President and Cabinet Officers of “high crimes and misdemeanors.
  • 1 President who could resign at any time
  • 1 Vice President who could resign at any time

We see so many of these ridiculous numbers every day that the country seems to have become numb. That’s a very bad thing indeed.

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ObamaCare revised/enhanced?

Trump/RyanCare another draft not submitted to Congress?

Within the extant and mythical healthcare plans, additional dementia care services need to be included. Most are cost-neutral or may actually save money while providing better patient outcomes.

Case Management makes existing healthcare services (doctor visits, medications, emergency care) work better. At a very small cost that should actually SAVE money, case management can provide better total patient care, cut unnecessary emergency room visits, and achieve better medication outcomes. What isn’t there to like?

Dementia Caregivers are most often UNPAID, female family members forced to juggle their own jobs/finances, families, and general lives to care for a loved one. Support is required for Dementia Caregivers in the forms of training, support, advice, and FINANCIAL COMPENSATION for their services. They do the work, they should get paid for their time. An upgraded system of paid family caregivers should make DementiaCare more effective and reduce other costs in the healthcare system to such a degree that it will be cost-neutral. An unnecessary hospital stay or emergency room visit can cost as much as $10,000 — $20,000. A family caregiver could be paid for 500 hours at $20 per hour for $10,000. Train family caregivers, pay them, and you have a cost neutral system. What isn’t there to like?

Mental Health issues often lead to huge patient distress, anxiety, and medical management problems. They can frustrate caregivers and lead to nonadherence to medication recommendations. Therapy and counseling can help patients and caregivers as well as cutting overall medical costs. What isn’t there to like?

Group Adult Daycare can provide needed respite for family caregivers as well as important social and recreational experiences for patients, thus enhancing their lives and to some degree ability to function independently. What isn’t there to like?

The following mind model provides some details. Click the image to expand it.

 

One way that healthcare communication can be made more effective is to supplement or replace traditional pages of small-type textual information with graphic displays such as mind models (AKA mind maps), sketches, graphs, and infographics.

This post focuses on mind models (mind maps). The same general arguments would apply to sketches, graphics, infographics, and other visual information methods designed to promote a more effective patient-oriented healthcare system with more complete, accurate, and easy-to-understand information for all.

If you are not familiar with mind models (mind maps), you should look at the mind map at the bottom of the page first (Footnote).

To expand the graphics, click on the images.
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Footnote

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Healthcare (medical, health, mental health, nursing, and other health professions) mind models (or mind maps) are not the same as those plain old “knowledge” mind maps you are used to seeing.

When you start to put a compelling and artistically sophisticated mind map together that gives symptoms for diseases or recommended treatments or medical information ranging from how to put on a bandage to how deal with your elderly mom’s dementia, you have entered the realm where misinformation can hurt people. Most of the health and medical information mind maps on archival websites like Biggerplate.com have errors of content ranging from being out-of-date to misleading to downright harmful. It is not necessarily enough to read something even from a definitive source and mind map it. Rather, you have to identify definitive sources and then know how to evaluate their claims against more recent research and regulations and criticisms by credible sources.

Being called (by yourself or another source) a professional or expert or inventor mind mapper does not mean that you are qualified to mind map health or medical information. It takes at least 22 years of total education to get through the formal training and supervised practice to meet the requirements of most types of professional health-related licensure in the USA. Physicians and nurse practitioners may need to complete as as many as 32 years of formal education and supervised practice. All licensed healthcare professionals are subject to requirements for continuing education requirements after completing training and licensure in most US jurisdictions for most fields.

So before you decide to read a book on dementia and make one of your wonderful artistic mind maps, think about whether you have the necessary professional training and experience to read the relevant research and clinical literature accurately and with the perspective and sophisticated judgment that can reject erroneous claims. And when you start to make claims that mind mapping or some herbal supplement or yoga or cognitive training or crossword puzzles or some exotic mumblings you heard in Haiti can cure or treat or prevent dementia, make sure you realize that if you provide false information you may be hurting people and possibly incurring a financial liability. I respect and use mind maps (and especially Huba mind models) from people who clearly have expertise in healthcare, medicine, psychology, and related fields. I do find the mind maps of “professional mind mappers” and mind map “inventors” and mind map developers to be very poor in their content when they try to stray into healthcare-related content they really do not understand and do not stay in the areas of management consulting, training, and brainstorming where they made their fortunes.

This is a consumer-beware situation as no one regulates mind maps and their content.

A mind model (AKA mind map) looking at the issues that can arise because healthcare mind maps are not typically within the expertise of individuals identified as expert mind mappers who have not been trained in a health-related field.

Click on the image to expand it.

A Healthcare Mind Model (Mind Map) Must Be More Than A Regular Mind Map

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This is another recording of my own development of mind maps to illustrate that this can be a way of communicating ideas while having cognitive impairment. I can develop models like this in less than an hour and have them published immediately on my web site.

Other posts in this sequence are

Part 1

Part 2

Part 3

Part 5

Part 6

Verbally I cannot get two sentences in a row out of my mouth so as to explain these ideas to others. Were I to try I would also be distracted by everything going on around me and probably experience great anxiety and coughing fits. You would also find it difficult to interact with me because you would want to end all of my sentences, be unable to look at me because my face goes into a fierce expression most interpret as anger when I am thinking, and be off-put because I often go into repetitive body movements (tapping fingers and feet and rubbing eyebrows) when I get moderately anxious (or worse).

This medium works. I attribute this both to the benefits of the mind mapping for everyone whether cognitively impaired or not and also to the fact that using these techniques I seem to be able to access parts of the brain that for me are less damaged than many of the other skill centers (such as speaking clearly or understanding others verbalizations or recalling the words I want to use to answer questions until 90 seconds later). Using it also makes me anxious, but much less so than trying to express myself in even small social situations.

Very importantly, the mind map lets me continually see my prior train of thought as I work. I don’t have to try to remember what I thought about 30 seconds, or 10 minutes, earlier because it is right in front of my nose on the computer screen. This is a HUGE assist.

The map is compressed so that 8 minutes appear as 1 minute. Just watch the video unfold. Then you can look at the final map more clearly using the static map.

The final mind map is shown in static form below. Click to expand.

Visual Thinking-Communication  Mind Maps Needed in the  Healthcare System

In Part 1, I discussed the benefits and costs of providing training to Persons with Dementia, Dementia Caregivers, and Healthcare Providers to empower them to use mind mapping methods.

I noted that unlike the traditional trainings given to primarily business users, healthcare workers and patients would need training which covered BOTH how to develop an effective mind map and specific ways to use the mind maps to enhance patient-centered care and patient-provider-caregiver communications and documentation.

I think that the minimal training in aggregate for the three stakeholder groups can be summarized in the following mind map. Note that not all modules (topics) are necessary or appropriate for all three groups.

Click mind map to expand.

Suggested Training  Topics for  Use of Mind Mapping by  Persons with Dementia,  Caregivers,  Healthcare Professionals

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I have argued for several years, especially in my book “Mind Mapping, Cognitive Impairment, and Dementia,” that communication among persons with dementia, their caregivers, and healthcare providers can be greatly improved by using visual thinking methods.

Mind maps are probably easier to understand for many persons with dementia than the traditional forms, small font information sheets, lists of to-do items, pharmaceutical labels, and guidelines. Mind maps can be used for visual journals and diaries that can still be understood at later stages of the disorder.

To use these methods effectively, it is imperative that healthcare providers and caregivers be trained in effective mind mapping methods. While many medical students are shown how to mind map, the techniques used are actually very ineffective ways of visual outlining that employ few, if any, of the real strengths of the method. These outline maps are clearly not appropriate for persons with dementia. Hence caregivers and healthcare providers need to be trained in “real” mind mapping methods AND how to communicate with these methods with persons with dementia.

Most of the trainings and mind mapping books and web sites are oriented to business users, especially at the management level. I have yet to find training sessions especially geared to both the mind mapping and patient care and management issues implicit in healthcare and caregiving. So how should we train healthcare professionals and caregivers to use mind maps effectively for the benefit of the person with dementia? The following mind map is a set of suggestions for how to train such individuals effectively. The trainings are designed to produce mind mapping experience specifically focused on patient care and management of those with dementia.

Click on the images to expand.

Training  Dementia  Caregivers  and Healthcare Providers to  Mind Map 3DTraining  Dementia  Caregivers  and Healthcare Providers to  Mind Map

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The majority of the posts on this blog are about using visual thinking methods — of which I think that by far the best is #Buzan-style organic mind mapping — to understand, explain, evaluate, and communicate about healthcare. A lot of my own thinking has focused on using visual thinking techniques to potentially improve the quality of life of those with cognitive impairment and dementia.

Tony Buzan and Chris Griffiths and their colleagues and staff at ThinkBuzan have done a very comprehensive job at getting many of Buzan’s ideas embedded into a general purpose computer program (iMindMap) which provides a general visual thinking environment, of which mind mapping is a special part. There are many computer assisted mind mapping programs, but I have concluded that iMindMap is by far the best for creative visual thinking and communication, in no small part because it fully incorporates Buzan’s theory and theoretical implementation.

Like scientists and management consultants and educators and healthcare providers and patients and patient caregivers and students and many others, illustrators struggle with how to best use visual representations to support better thinking and communications.

Which brings up this beautifully conceived and executed little book that I have found to be mind expanding and liberating in how to develop and use a series of illustration techniques and “tricks” to look at things differently when trying to make creative breakthroughs.

Whitney Sherman is the author of the book “Playing with Sketches” which provides 50 exercises which collectively will change the way you think about creating images to understand and communicate ideas.While Ms. Sherman wrote the book for designers and artists, the techniques will be just as useful for visual thinkers in science, education, medicine, industry, and other fields. The beauty of Ms Sherman’s exercises is that in showing you fairly simple ways to make hugely informative and well designed images, the tools will themselves suggest many applications to visual thinkers of all types.

And, I have found that Ms. Sherman’s techniques can be used by the severely artistically challenged (of which I am one); the techniques are ones for Visual THINKERS, not necessarily artists and designers.

I have mentioned this book before in much less detail, but in the months I have used the methods, I have found that they WORK very well to facilitate creative visual thinking. For me they have promoted a breakthrough in how I see the visual thinking canvas.

Get the book, try some of the techniques (pick a random one here and there to start), discover that great artistic talent or aptitude is not required, and see how the techniques fit the information you study in search for better healthcare or disease prevention or decision making or facilitating creative group processes.

In partnership with Tony Buzan’s techniques for organic #mindmapping and Mike Rohde’s framework for #sketchnoting, the techniques codified by Whitney Sherman provide very powerful visual thinking tools.

Ms. Sherman’s website is http://www.whitneysherman.com. She tweets at @Whitney_Sherman. The book is available from major online book sellers.

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I will be posting some examples of using the sketching techniques of Ms. Sherman to developing assistance and communication techniques for those with cognitive impairment or early-mid stages of dementia.

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Walmart today eliminated health insurance coverage for 30,000 workers who work less than 30 hours per week. Trader Joe’s, Target, and Home Depot had already done the same.

What do you think a low wage employee at Walmart or Target or Trader Joe’s or Home Depot would do if their employer offered them the opportunity to work 31 hours per week instead of 29?

I smell a rat that the Republicans are calling Obamacare and I would call the GOP (Non-)Insurance Plan. Either way, many US workers are screwed by the actions of these big employers.

And who works for Walmart and Target and Home Depot and Trader Joe’s? When you shop there do you conclude it is the elderly who still need to work in their 70s because they never worked at companies that ensured that they would have enough funds in their retirement or high school dropouts (often single moms) or the disabled or recovering drug abusers or those with mental health issues or an over-representation of minority workers, many of whom are recent immigrants? I do.

So these big box stores are basically selecting an unempowered, vulnerable group of workers who can be paid minimum wage (or close to it), denied healthcare plans, and work under what often appear to be draconian conditions. Who pays to fix this? You and I pay taxes to provide Medicaid (and Medicare Disability) benefits to those who have nowhere else to go, and of course you and I also provide additional services to dependent children in the families of these Walmart and Target and Home Depot and Trader Joe’s employees. All of the money you and I pay to fix the Walmart mess is  so that billions of dollars more can go to benefit a half dozen of the wealthiest Americans holed up in Arkansas.

We need to get this fixed. It is very clear that neither American political party has the acumen, motivation, humanity, and pure “guts” needed to right this situation once and for all.

Walmart and Home Depot and Trader Joe’s and Target will notice it if their sales come down 10 percent as a consequence of the poor treatment of their employees. Heck, they would notice if the sales came down 1 percent.

This is not a Democrat or Republican or Independent or “I don’t vote because it doesn’t matter” issue. This is not a minority issue nor is it an elderly issue nor is it an immigrant issue. The issue is quite simply that it is not right to tell a worker who goes into a fairly hostile work environment, works hard while there, and wants to continue to work instead of being dependent on public programs that they cannot work more than 29 hours a week because the company can make a lot more money by employing lots of “almost full-time” workers rather than full-time workers because it can deny workplace worker benefits.

These companies are causing their workers great pain and suffering by not paying living wages and providing enough hours to workers so that they can qualify for benefits and keep their families out of public programs. After all, the American dream is that working hard 40 hours a week will permit your family to enjoy at least a moderately comfortable life and provide your children with a good education and you with adequate healthcare and savings for retirement.

Your elected officials aren’t going to do anything. YOU can find other retailers that treat their workers fairly and buy your dog food, clothes, medications, motor oil, music and video disks, garden supplies, vacuum cleaners, condoms and lube, aspirin, watches, and cameras there. And I am sure there is a humane company who will sell you all of the power tools you want at the same price as Home Depot and also provide its workers with health insurance.

Make a loud enough noise and some alternate vendors are going to come out and show that they do pay their workers fairly and they would be glad to sell you the same goods you can buy at Walmart or Target or Home Depot or Trader Joe’s at the same or better prices. The free market is a powerful force for good as well as having a potentially dark side.

Capitalism is a great thing. Give your business to a humane company that will sell you the same stuff as the big box stores while also making the lives of their workers better and you will be practicing Humane Capitalism that rewards businesses for having great prices AND good conditions of employment.

My dog is not going to be eating Walmart food any longer. Hopefully your dog will not be eating it either. And I am no longer searching through those big bins of $3.99 DVDs in search of a movie with lots of plane, train, and automobile crashes.

After all, Walmart is already the worse kind of a train wreck imaginable.

The_Zombie_Angry

 

I drew this mind map in 2011 when I was disgusted with the lack of a organized process to develop a national consensus on what was needed for meaningful healthcare reform. I think this as true in 2013 as it was in 2011. Stylistically, I could redraw this map better now than in 2011. But everybody has to start somewhere, so I resisted that impulse.

I would note that some (all) of these scientist “types” are found in the US Congress (whether scientists or not).

Everybody in Congress wants the peanuts and bananas and too many act like King Kong.

Also note that I have been on consensus panels with all of these types.

Scientific Consensus Panel on Healthcare at the Zoo

I was sitting in the office of an individual designated as an “essential” federal employee at mid-morning on November 14, 1995. We were meeting at the US Department of Health and Human Services, Health Resources and Services Administration main offices in the Parklawn Building in Rockville, MD.

My federally funded Evaluation and Technical Support Center for a HRSA Initiative on Implementing the zidovudine protocol for preventing HIV transmission from HIV-positive mother to her child during birth was meeting with 10 federal grantees the next day in Baltimore. The meeting was mandated by the HRSA funding agreements.

Each project had at least three staff in transit to Baltimore (most by air) for the meeting the next day. At least one representative of each project was a woman living with HIV/AIDS; this was mandated.

The bell rang at noon in the Parklawn Building. The loudspeakers had started squawking earlier reminding all non-essential employees that they must exit the building by noon. Guards came through the building reminding people to leave. It was eerie to be in the second-largest US federal office building with almost no other people around.

I met with the essential employee, the head of a very large program on HIV/AIDS treatment. She could not tell me whether to have the meeting the next day. While she could guarantee that the representatives from the projects would have their travel reimbursed she could not tell me whether the scheduled meeting rooms, scheduled food service, and other costs would be covered although she would allow me to pay for costs already agreed to through contracts with the hotel. She did note that we could not use use the meeting room we had paid for nor eat any of the food we had pre-paid. The meeting would no longer be a federal meeting. Everybody there was just a private citizen meeting because they wanted to be there after being stranded by having flown to a mandatory federal meeting that was cancelled without notice. No federal employee, however, could be at the meeting because they were not working and they were not allowed to go to any activity that could be construed as federal “work” since they might then demand payment for their time.

I had to tell this to about 50 attendees at 9 am on Wednesday morning. The Maryland Dept of Health agreed to let the group use space at their offices 15 or so blocks away. Everyone walked over there in freezing rain. Maryland made available a conference room that could seat about 12 comfortably, about 25 uncomfortably, and the rest squeezed in and stood. The State Director (part of the group) lent us her personal 10 cup Mr Coffee to brew coffee. In trying to make enough coffee for 50, I broke it, and when I returned to California, I sent her another one by FedEx because I was a little annoyed that she got very upset that I had dropped the $20 machine and had announced to 50 people that I was the reason there was no coffee.

After about an hour or so of chaos and having everybody totally upset — as they should have been — about having about 15 women with HIV (many with advanced stage AIDS) in an overheated claustrophobic facility along with another 35 people in an overheated claustrophobic facility, I decided that the company I owned would personally guarantee the costs for the meeting facilities and food that had already been paid — if the government asked for the money back from anyone because I had decided that those who had come to Baltimore in good faith could meet in the rooms already paid for and eat prepaid food that was going to be thrown out. As I recall this was probably close to $5,000 or more. Fortunately no one ever asked me for the money back and since I over-ran our budget by far more than $20,000 (which we never billed) in part because the feds had totally screwed up the process, that we were even. And, no woman with HIV had fainted or otherwise hurt herself during the meeting because we did not have healthy conditions.

The grantees were — as would be expected — totally pissed off. The initiative ran for several more years, but in a fairly “inefficient” way. Chaos. The feds went back to work after Thanksgiving, but then went out again for more than a month starting in mid-December when Newt Gingrich and Bill Clinton still would not do their jobs. When the budget was settled in mid-January, the government announced it would pay all of the federal employees for all days they had been sitting at home in Maryland and Virginia and the District playing in the snow and worrying about their personal finances.

A demotivated, angry workforce went back to work to deal with a number of demotivated, angry contractors and grantees. It wasn’t the same for another two years.

Obamacare was passed by a majority of the US Congress, all of whom had been elected by the majority of their constituents. It was signed into law by a President elected by the majority of the US electoral voters as specified in the Constitution. When the Constitutionality of Obamacare was challenged by those who did not like it, the majority of the Supreme Court Justices, each confirmed when appointed by a majority of the US Senate, decided that Obamacare was constitutional.

Each step of passing Obamacare into law was done according to the specifics of the US Constitution.

Those attempting to derail Obamacare by using certain procedural technicalities in ways never intended and just plain silly, are acting in opposition to the approved Affordable Care Act passed by the Congress and approved by the President and the Supreme Court according to the procedures specified in the US Constitution.

Are those in Congressional representatives holding the budget hostage Congressional “Leaders” or (in words attributed to Al Gore) “terrorists?”

Today, I hope that the US government will decide to “feed” those sitting around waiting for their US Congress and Executive Branch to meet their Constitutionally assigned responsibilities that the elected officials of the United States have sworn to uphold. Fortunately World War II vets in wheel chairs were allowed to look at the barricaded World War II memorial on the federal mall today (the barriers were lifted by Congress members in front of TV cameras); my further hope is that all of the veterans in VA hospitals get fed dinner tonight whether or not the TV crews are parked in front of the facilities.

Those elected officials who claim that their Tea Party is as much against “taxation without representation” as the founders were in 1776, obviously have not read the Constitution resulting from the actions in 1776.  Thankfully, a majority of the Supreme Court justices and the President were in school that day.

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ELIMINATING AIDS FROM THE PLANET  G J HUBA PHD  JULY 2012

One thing I have always feared about nursing home or home healthcare is that somebody who barely knows me would park me in a wheel chair or on a couch watching endless reruns of I Love Lucy or the Price is Right. Or ask me to endure hours of Kenny G or Hayden. Heck, if I have to watch TV for the rest of my life, at least put Battlestar Galactica or the college World Series on. Or Wynton Marsalis. Or Rocky and Bullwinkle.

Click on the figure below to expand. Seriously tell your caregivers and family members what you really like so they don’t have to guess. And so that they might remember you. As you really were.

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Click on mind map to expand.

academia and  healthcare  big data

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There are a number of things that can be done to cut the cost of healthcare while, at the same time, freeing doctors and others to do their jobs better. These improvements cost almost nothing to implement [if all of the constituencies and politicians do not compete to be King Kong].

Visiting legislator who stumbled across this web page? Here’s your chance to act like a grown-up and represent the people of the world, not drug companies nor major research universities nor individual “researcher” egos and retirement funds.

Click on images to expand.[almost free] strategies to improve healthcare

Cartoon Rabbit - Giving A Thumbs Up

The Old …

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The Current …

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And the Ideal

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  • Click on images to zoom.
  • Note that both the placement of the circles AND the front to back placement are significant and intentional.

BIG Data is coming (or has already come) to healthcare. [It is supposed to usher in new eras of research, economic responsibility, quality and access to healthcare, and better patient outcomes, but that is a subject for another post because it is putting the carriage before the horse to discuss it here.]

What is a data scientist? A new form of bug, a content expert who also knows data issues, an active researcher, someone trained in data analysis and statistics, someone who is acutely aware of relevant laws and ethical concerns in mining health data, a blind empiricist?

This is a tough one because it also touches on how many $$$$$ (€€€€€. ¥¥¥¥¥ , £££££, ﷼﷼﷼﷼﷼, ₩₩₩₩₩, ₱₱₱₱₱) individuals and corporations can make off the carcass of a dying healthcare system.

Never one to back away from a big issue and in search of those who value good healthcare for all over the almighty $ € ¥ £ ₨ ﷼ ₩ ₱, here are some of my thoughts on this issue.

Click image to zoom.

who is a health data scientist

Content knowledge by a well-trained, ethical individual who respects privacy concerns is Queen. Now and forever.

Keyword Board

topics and subtopics: who is a “health” data scientist? trained in healthcare? methodology research databases management information systems psychology? psychometrics other public health? epidemiology other medicine? nursing? social work? education? biostatistics? medical informatics? applied mathematics? engineering? theoretical mathematics? theoretical-academic statistics? information technology? computer science? other? conclusions must know content 70% methods 30% must honor ethics 100% laws practice privacy criminal civil federal state other greatest concerns correctness of results conclusions ethical standards meaningfulness validity reliability privacy utility expert in content field data analysis data systems ethics and privacy other member? association with ethics standards licensed? physician nurse psychologist social worker other regulated? federal hipaa state other insured? professional liability errors and omissions continuing education requirements? ethics renewal of licensure regulatory standards insurer commonsense laws go away if not well trained content field data analysis not statistics committed clean data meaningfulness subject privacy peer review openness ethics ethics ethics are arrogant narrow-minded purely commercial primarily motivated $$$$$ blind number cruncher atheoretical © 2013 g j huba

The USA has no highly visible, charismatic, scientifically-medically experienced, brilliant, and creative leader-spokesperson for federal healthcare programs. IMHO, the last one we had was C. Everett Koop in the 1980s.

Since being such a leader should be a Cabinet-level position, the best-qualified leader would get the same salary as an out-of-work former governor or political operative in the Senior Executive Service (about $200,000).

I favor a “healthcare czar” position to which the directors of various health-related US federal agencies report.

The effects of having a great leader with oversight on most major US healthcare initiatives would be huge. A positive thinking, creative individual should be able to get $100s of millions (or billions) out of the healthcare system while increasing quality. Instead of squeezing physicians on Medicare reimbursements we need someone who can squeeze the bureaucracy to lift money-wasting and unnecessary health regulations, squeeze the health insurance and big pharma industries to get-real about their profits, and energize the general public to personally address such preventable diseases as those related to obesity, alcoholism, tobacco use, and unwanted pregnancies. Such an individual could get cooperation from the press to research and write stories about positive system change.

Such a change costs only the small expenses of a search committee compromised of prominent health stakeholder groups, and the commitment of the President to health- and socialcare.

There are 100s of great medical-science leaders in the USA who can do a fantastic job of getting healthcare coordinated and understood by the public. Koop was a conservative, traditionally religious, Republican who took on the religious right over his medical conclusions that the reality of good medical practice in the USA had to get over homophobia and hatred of the homeless drug abusers in order to dampen the effects of the HIV epidemic. He also took on the major of lobbies of the tobacco industry in stating clearly that tobacco was addictive and responsible for millions of deaths. Koop’s politics were almost opposite to mine but the actions he concluded were necessary were the same as I would have taken from my liberal vantage points.  Just as a conservative Republican can do an excellent job of guiding the healthcare system if she or he is a committed medical-scientist, so too can a liberal Democratic medical-scientist do a similarly excellent job.

Go ahead dismiss this idea. Then go back to reading my posts on your big Cinema Monitor from the company who had a charismatic leader and type your responses on a keyboard from the same company.

You want a great US national healthcare system that is efficient, treats patients and healthcare providers fairly, and stresses prevention and patient-centered care? Get a great leader. This individual will cost only about $200,000 per year and some ego stroking by POTUS and the Press. Let the unemployed former governors go find out what it is like to live on unemployment benefits and use Medicaid.

WTF hasn’t the search committee already started to form?

Seven Reasons Some  Healthcare-Socialcare Systems  Achieve Better Outcomes

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In the current healthcare system, the people who most need help are the least likely to get it.

Think they need an annual physical, some vaccinations, antibiotics when they get an infection, a scolding when they get too fat, and a lecture when they smoke?  Think again.

How do you deal with an individual who comes into an emergency room (or in the era of Obamacare, the office of a primary health provider) and is “sick.” Is it because they are homeless or abusing drugs or never had regular healthcare before or struggle with a psychiatric diagnosis perhaps developed as a survivor of rape, incest, or alcoholic parents?

Who do you think is in the current publicly-supported healthcare system of last resort? If that panhandler at the stop sign comes to see a doctor, the patient will typically be hungry, a chain smoker, unable to tell a coherent story or provide a medical history, and prepared to blame a doctor for not being able to fix all of the problems the person has encountered through life. Can you separate a life of living on the street while using drugs and eating fast food with lots of fat and cholesterol from what is found in a simple annual blood panel? Can you tell the medical patient to start eating in a healthy way (when the patient is homeless, has no job, has no money for Whole Foods Market)? Can you expect these patients to adhere to a doctor recommended treatment-intervention which might include lots of pills for an unhealthy lifestyle or because of HIV/AIDS?

High need patient-clients in the healthcare system have many needs and difficulties. Fix one and you see three more problems.

We need a system that can deal with patients-clients that have many of the problems shown in the mind map below. Concurrently. Simultaneously.

or alternately (same model, different way of viewing it) …

PS. I know that effective and cost-effective healthcare/socialcare agencies can be built because the US government has created dozens, if not hundreds, of these programs as “demonstrations” that the concept works. The program is then funded for about five years at a “fair” level and after five years receives no further federal funding (the program is then supposed to have a rich aunt or a “corporate” fund raising department). We KNOW that comprehensive service systems can be built, be effective, use resources appropriately and frugally.

It just takes a village.

Oprah, where are you?

For every case of dementia, mind maps can potentially be used to improve the quality of life of the patient, caregiver, and family.  Many people in the later stages of dementia are confused at times, frequently unresponsive, have minimal access to their memory, and can be aggressive and otherwise difficult to deal with. In spite of this, the care of almost every dementia patient, even one at a very late stage dementia, can be improved by mind maps and other visual thinking tools and better care will almost always produce a better quality of life.

Mind maps and other visual thinking methods are better ways to capture, store, manipulate, share, and understand an individual case. Image that. A method that costs pennies per use can improve the efficacy of $200 doctor visits, $20 pills, $3000 emergency room visits, $150 of home healthcare, and $1000 consultations because at the end of all the fancy stuff, mind mapping is an intuitive, easily understood method of communicating among and coordinating among the many parties that collectively are the care system for an individual person with dementia. No, simple mind maps will not substitute for medical treatments, but they can make the individual healthcare system developed for a person with dementia more efficient and help cut service redundancies and unneeded tests and treatments resulting from poor patient-doctor-family communications.

Among other ways, mind mapping and other visual thinking methods can be used even with patients with advanced stages of dementia. While people in advanced stages might be limited in their ability to draw maps, they may be still quite skilled in reading them and picking up on associations. Whether or not patients with dementia can draw (or even read) mind maps at the end, caregivers, doctors, nurses, families, and others may use these visual methods of communication to easily share information among themselves. If the patient has created a “pre-dementia” set of diagrams for her or his life experiences, there will be a useful baseline for healthcare providers to better understand the individual case.

Good communication. Good coordination. Knowing the issues. Applying the best thoughts of all people in the care team (including the family, caregivers, and patient). Using the best treatment methods useful for the individual with dementia. And all because mind maps (compelling visual methods of producing insights into complex issues in a simple way) make communications clearer and more reliable, allow a patient to take part in her or his own treatment, and do so at a low-cost that makes the care team more effective and the patient and family happy about the quality care the patient is receiving.

Sounds almost too good to be true. It isn’t.

Click on the mind model (mind map) shown below to expand its size.

I know that a simple version of the outlined model has worked super well for my (dementia) care. It could also work super well for you or a person with dementia for whom you provide care.

 

If you have not read the Introduction to this series of posts, it is important that you read it before this post. Click here for the Part 00 Introduction. This post is part of a series of more than a dozen posts.

I worked on understanding health and social service programs, especially for the disabled, poor, disenfranchised, and traditionally underserved as a program evaluator for about 25 years. I was very good at it and worked with hundreds of programs spread over most US states.

In writing about my activities to achieve stability in my dementia and maximize my quality of life, I am going to employ the tools of program evaluation to describe what I was trying to achieve, what I did to achieve my goals, why I did various activities, and which parts of my interventions seemed to help me the most. No, not in this post but in a series of more than a dozen posts.

In this post I will start by describing the activities I designed for myself and did throughout my period of diagnosed dementia over six years of living with the disease. In subsequent posts, especially Posts 02 and 03, I will discuss the outcomes of my activities. After that, I will address some of my activities — and especially those that “worked” extremely well for me — and describe them in depth, show how other individuals might use these methods, and how dementia caregiver and healthcare systems might be built around them.


The image below is a mind map. Should you not be familiar with how a mind map is drawn and read, please search this website for posts on mind mapping using the search box. Or, go to the home page by clicking here and look at the list of pre-defined searches.

A very simple set of rules for reading a mind map is as follows.

  1. Start at the center of the diagram. Each of the topics (ideas or major branches) that come out of the center represents an issue. Important information about the main issues is given as a series of branches. The organization is in an outline or tree where large branches divide into smaller branches and smaller branches divide into even smaller branches.
  2. Think of the map as a clock face and start at the 1 o’clock position (upper right corner). Read outward from the center along the branches and sub-branches to see how ideas and information about the topics can be arranged in a hierarchical or tree structure. [If you could go up a huge fire truck ladder and look straight down, you would see a structure of tree branches that looks like a mind map. When we study or read a mind map, we are looking at a whole tree — set of information — and then seeing how small and more specific information spreads from the trunk.]
  3. Go around the map in a counter-clockwise manner (to 2 o’clock, 3 o’clock, etc.), following the branches down to their branches and their branches and finally to twigs. Remember that we are looking down at a whole idea [or tree] and its branches and their branches in order to understand how the information represented on these branches goes together and what the most important information is.
  4. The mind map is thus a picture of major ideas followed by its major subdivisions or branches and sub-branches. The “big ideas” are attached directly to the central issue.
  5. A mind map is a way of showing in an image how a set of data pieces or ideas go together.
  6. The pictures, color coding, and fonts are used to designate what is the most important information in the mind map. When you are trying to remember or organize or determine priorities, the pictures, color coding, and size of the fonts can help you store information in “visual” parts of the brain and then retrieve it by thinking about pictures, the color coding, or size-importance of the information.

Click on the mind map to expand its size and zoom to various portions of the map.

 

As you can see, I tested app after app after app on my Mac and iPhone to see which could help me. I read all about how to mindmap and draw sketchnotes and I practiced and practiced. I learned to read “dog” and taught my Newfie to understand “people.” I doodled, watched the news, built a highly-rated social media following of more than 140,000 individuals interested in healthcare, dementia, visual thinking, and 100s of other topics from around the world. I went to concerts, watched movies, and cheered for the two local universities with huge sports programs. I engaged some new parts of my brain. I thought in pictures.

  • I HAD FUN.
  • I LEARNED MANY NEW THINGS THAT STRETCHED MY BRAIN INTO NEW CHANNELS.
  • I BUILT COGNITIVE RESERVE.
  • I THINK I PROVIDED NEW INFORMATION TO PERSONS WITH DEMENTIA AND COGNITIVE DECLINE, CAREGIVERS, HEALTHCARE PROFESSIONALS, AND THE GENERAL PUBLIC. I FEEL GOOD ABOUT THIS.
  • I HAD FUN.

Stay tuned, the interesting stuff starts next.

In 2010 I was diagnosed with neurodegenerative brain disease with the initial diagnosis being supranuclear palsy which was later amended to the highly related frontotemporal dementia, behavioral type. Some believe that PSP and FTD are variants of the same disease.

I started to examine Mac and iPhone/iPad apps that might be useful early in 201o. After I retired in 2011 I started to use a number of the apps for such things as calendars, task lists, alarms, reminders, and other business-like functions. The business-like apps failed to motivate me to use them continuously nor could they address executive functioning problems that were at the core of my disease. As early as late 2011 I had concluded that mind maps and other visual thinking methods could be very helpful.

As I read about every mind map book around by dozens of authors and bloggers, including the majority of those written by Tony Buzan who makes the claim he is the “inventor” of mind mapping (it is a silly claim no matter who makes it), I rapidly discovered that virtually all visual thinking work focuses on lucrative management consulting that few who use it have strong background in substantive areas like medicine, healthcare, psychology, and related disciplines. What little work exists in mind mapping and other visual techniques within the health and medicine areas indicates a total lack of understanding of visual thinking and is generally painful to read.

I wasn’t scared off by the fact that there was no clear guide to what a person with cognitive impairment and later dementia could do with visual thinking procedures and computer apps to try to improve the ability to cope with dementia. I had, after all, spent 35 years of a successful career as a (nonclinical) psychologist and much of my career had focused on developing new applications of psychological knowledge to addressing medical, psychological and social disorders. And much of the 35 years were spent studying the service care system for those who were least connected with society and traditional healthcare.

I am writing a series of posts (currently more than a dozen) evaluating my experiences during the last six years with a progressive brain disease. Each will focus on a specific test of methods and outcomes I think were achieved.

My studies are one-subject research (often called N=1). I will present results that I believe can be inferred from specific indicators. However, what I discuss is DERIVED FROM MY EXPERIENCE AND MY INTERPRETATIONS OF THE OUTCOMES OF WHAT I DID. I do not claim that any of what I write about is applicable to all people or that what I did should be considered to prove anything as opposed to simply observing it in myself validly or not. And, I see no evidence that the outcomes from what I did have done suggest I found anything to treat or cure or slow the progression of dementia: I never expected them to do so. What I do believe that I have demonstrated for myself is that these methods have helped me maintain a much higher quality of life. Not more days in my life, but many more good days while having dementia. I feel blessed to have received those extra good days.

Most of my “writing” is in pictures. That’s the point of visual thinking.

The following mind map is a general introduction to my work over the past six years. I call it Part 00. Starting with Part 01, I am going to start to present both observations and objective indicators of what happened for me.


Should you not be familiar with how a mind map is drawn and read, please search this website for posts on mind mapping using the search box. Or, go to the home page by clicking here and look at the list of pre-defined searches.

A very simple set of rules for reading a mind map is as follows.

  1. Start at the center of the diagram. Each of the topics (ideas or major branches) that come out of the center represents an issue. Important information about the main issues is given as a series of branches. The organization is in an outline or tree where large branches divide into smaller branches and smaller branches divide into even smaller branches.
  2. Think of the map as a clock face and start at the 1 o’clock position (upper right corner). Read outward from the center along the branches and sub-branches to see how ideas and information about the topics can be arranged in a hierarchical or tree structure. [If you could go up a huge fire truck ladder and look straight down, you would see a structure of tree branches that looks like a mind map. When we study or read a mind map, we are looking at a whole tree — set of information — and then seeing how small and more specific information spreads from the trunk.]
  3. Go around the map in a counter-clockwise manner (to 2 o’clock, 3 o’clock, etc.), following the branches down to their branches and their branches and finally to twigs. Remember that we are looking down at a whole idea [or tree] and its branches and their branches in order to understand how the information represented on these branches goes together and what the most important information is.
  4. The mind map is thus a picture of major ideas followed by its major subdivisions or branches and sub-branches. The “big ideas” are attached directly to the central issue.
  5. A mind map is a way of showing in an image how a set of data pieces or ideas go together.
  6. The pictures, color coding, and fonts are used to designate what is the most important information in the mind map. When you are trying to remember or organize or determine priorities, the pictures, color coding, and size of the fonts can help you store information in “visual” parts of the brain and then retrieve it by thinking about pictures, the color coding, or size-importance of the information.

Click on the mind map below to expand it and let’s start the process of understanding of what visual thinking methods help me to do.

The best mind maps are stories.

  • How dementia is diagnosed.
  • Where you can receive experimental treatments for cancer.
  • History of immigration to the USA.
  • History of the United States Virgin Islands.
  • Strategies for re-building Puerto Rico after it was leveled by a hurricane.
  • What components should be in a comprehensive healthcare plan?
  • How Russia and American citizens conspire to launder money through US banks and businesses.
  • The size of food, water, and medicine problems in various geographical areas.
  • The story of how Edison stole credit for AC (alternating current electricity) from Tesla.
  • The location of abortion clinics in the United States and what each provides as general healthcare services to women whether seeking an abortion or not.
  • What you did on your summer vacation.
  • Recollections of people and places.
  • Your grocery list.
  • Recipes.
  • Family history.
  • Favorite music.
  • Your appointments for the week.

Click the following mind model to increase its size.

Well organized and visually compelling information can “turn on” many parts of the brain. Having information stored in multiple places in the brain is an excellent strategy for retaining functions should there be brain damage or disease.

Great “mind map” stories include many different elements to make them memorable, distinct, attention-grabbing, and engaging.