Why Everyone Hates The Electronic Medical Record

Curated on Posted on by Stefaan Verhulst

Article by Dharushana Muthulingam: “Patient R was in a hurry. I signed into my computer—or tried to. Recently, IT had us update to a new 14-digit password. Once in, I signed (different password) into the electronic medical record. I had already ordered routine lab tests, but R had new info. I pulled up a menu to add on an additional HIV viral load to capture early infection, which the standard antibody test might miss. R went to the lab to get his blood drawn

My last order did not print to the onsite laboratory. An observant nurse had seen the order and no tube. The patient had left without the viral load being drawn. I called the patient: could he come back? 

 Healthcare workers do not like the electronic health record (EHR), where they spend more time than with patients. Doctors hate it, as do nurse practitioners, nurses, pharmacists, and physical therapists. The National Academies of Science, Engineering and Medicine reports the EHR is a major contributor to clinician burnout. Patient experience is mixed, though the public is still concerned about privacy, errors, interoperability and access to their own records.

The EHR promised a lot: better accuracy, streamlined care, and patient-accessible records. In February 2009, the Obama administration passed the HITECH Act on this promise, investing $36 billion to scale up health information technology. No more deciphering bad handwriting for critical info. Efficiency and cost-savings could get more people into care. We imagined cancer and rare disease registries to research treatments. We wanted portable records accessible in an emergency. We wanted to rapidly identify the spread of highly contagious respiratory illnesses and other public health crises.

Why had the lofty ambition of health information, backed by enormous resources, failed so spectacularly?…(More)”.

Governing the use of big data and digital twin technology for sustainable tourism

Curated on Posted on by Stefaan Verhulst

Report by Eko Rahmadian: “The tourism industry is increasingly utilizing big data to gain valuable insights and enhance decision-making processes. The advantages of big data, such as real-time information, robust data processing capabilities, and improved stakeholder decision-making, make it a promising tool for analyzing various aspects of tourism, including sustainability. Moreover, integrating big data with prominent technologies like machine learning, artificial intelligence (AI), and the Internet of Things (IoT) has the potential to revolutionize smart and sustainable tourism.

Despite the potential benefits, the use of big data for sustainable tourism remains limited, and its implementation poses challenges related to governance, data privacy, ethics, stakeholder communication, and regulatory compliance. Addressing these challenges is crucial to ensure the responsible and sustainable use of these technologies. Therefore, strategies must be developed to navigate these issues through a proper governing system.

To bridge the existing gap, this dissertation focuses on the current research on big data for sustainable tourism and strategies for governing its use and implementation in conjunction with emerging technologies. Specifically, this PhD dissertation centers on mobile positioning data (MPD) as a case due to its unique benefits, challenges, and complexity. Also, this project introduces three frameworks, namely: 1) a conceptual framework for digital twins (DT) for smart and sustainable tourism, 2) a documentation framework for architectural decisions (DFAD) to ensure the successful implementation of the DT technology as a governance mechanism, and 3) a big data governance framework for official statistics (BDGF). This dissertation not only presents these frameworks and their benefits but also investigates the issues and challenges related to big data governance while empirically validating the applicability of the proposed frameworks…(More)”.

Public sector capacity matters, but what is it?

Curated on Posted on by Stefaan Verhulst

Blog by Rainer Kattel, Marriana Mazzucato, Rosie Collington, Fernando Fernandez-Monge, Iacopo Gronchi, Ruth Puttick: “As governments turn increasingly to public sector innovations, challenges, missions and transformative policy initiatives, the need to understand and develop public sector capacities is ever more important. In IIPP’s project with Bloomberg Philanthropies to develop a Public Sector Capabilities Index, we propose to define public sector capacities through three inter-connected layers: state capacities, organisational capabilities, and dynamic capabilities of the public organisations.

The idea that governments should be able to design and deliver effective policies has existed ever since we had governments. A quick search in Google’s Ngram viewer shows that the use of state capacity in published books has experienced exponential growth since the late 1980s. It is, however, not a coincidence that focus on state and public sector capacities more broadly emerges in the shadow of new public management and neoliberal governance and policy reforms. Rather than understanding governance as a collaborative effort between all sectors, these reforms gave normative preference to business practices. Increasing focus on public sector capacity as a concept should thus be understood as an attempt to rebalance our understanding of how change happens in societies — through cross-sectoral co-creation — and as an effort to build the muscles in public organisations to work together to tackle socio-economic challenges.

We propose to define public sector capacities through three inter-connected layers: state capacities, organizational routines, and dynamic capabilities of the public organisations…(More)”.

Civic Trust: What’s In A Concept?

Curated on Posted on by Stefaan Verhulst

Article by Stefaan Verhulst, Andrew J. Zahuranec, Oscar Romero and Kim Ochilo: “We will only be able to improve civic trust once we know how to measure it…

A visualization of the ways to measure civic trust

Recently, there’s been a noticeable decline in trust toward institutions across different sectors of society. This is a serious issue, as evidenced by surveys including the Edelman Trust Barometer, Gallup, and Pew Research.

Diminishing trust presents substantial obstacles. It threatens to weaken the foundation of a pluralistic democracy, adversely affects public health, and hinders the collaboration needed to tackle worldwide challenges such as climate change. Trust forms the cornerstone of democratic social contracts and is crucial for maintaining the civic agreements essential for the prosperity and cohesion of communities, cities, and countries alike.

Yet to increase civic trust, we need to know what we mean by it and how to measure it, which turns out to be a challenging exercise. Toward that end, The GovLab at New York University and the New York Civic Engagement Commission joined forces to catalog and identify methodologies to quantify and understand the nuances of civic trust.

“Building trust across New York is essential if we want to deepen civic engagement,” said Sarah Sayeed, Chair and Executive Director of the Civic Engagement Commission. “Trust is the cornerstone of a healthy community and robust democracy.”

This blog delves into various strategies for developing metrics to measure civic trust, informed by our own desk research, which categorizes civic trust metrics into descriptive, diagnostic, and evaluative measures…(More)”.

Citizen Engagement in Evidence-informed Policy-making: A Guide to Mini-publics

Curated on Posted on by Stefaan Verhulst

Report by WHO: “This guide focuses on a specific form of citizen engagement, namely mini-publics, and their potential to be adapted to a variety of contexts. Mini-publics are forums that include a cross-section of the population selected through civic lottery to participate in evidence-informed deliberation to inform policy and action. The term refers to a diverse set of democratic innovations to engage citizens in policy-making. This guide provides an overview of how to organize mini-publics in the health sector. It is a practical companion to the 2022 Overview report, Implementing citizen engagement within evidence-informed policy-making. Both documents examine and encourage contributions that citizens can make to advance WHO’s mission to achieve universal health coverage…(More)””

A complexity science approach to law and governance

Curated on Posted on by Stefaan Verhulst

Introduction to a Special Issue by Pierpaolo Vivo, Daniel M. Katz and J. B. Ruhl: “The premise of this Special Issue is that legal systems are complex adaptive systems, and thus complexity science can be usefully applied to improve understanding of how legal systems operate, perform and change over time. The articles that follow take this proposition as a given and act on it using a variety of methods applied to a broad array of legal system attributes and contexts. Yet not too long ago some prominent legal scholars expressed scepticism that this field of study would produce more than broad generalizations, if even that. To orient readers unfamiliar with this field and its history, here we offer a brief background on how using complexity science to study legal systems has advanced from claims of ‘pseudoscience’ status to a widely adopted mainstream method. We then situate and summarize the articles.

The focus of complexity science is complex adaptive systems (CAS), systems ‘in which large networks of components with no central control and simple rules of operation give rise to complex collective behavior, sophisticated information processing and adaptation via learning or evolution’. It is important to distinguish CAS from systems that are merely complicated, such as a combustion engine, or complex but non-adaptive, such as a hurricane. A forest or coastal ecosystem, for example, is a complicated network of diverse physical and biological components, which, under no central rules of control, is highly adaptive over time…(More)”.

How will AI shape our future cities?

Curated on Posted on by Stefaan Verhulst

Article by Ying Zhang: “For city planners, a bird’s-eye view of a map showing buildings and streets is no longer enough. They need to simulate changes to bus routes or traffic light timings before implementation to know how they might affect the population. Now, they can do so with digital twins – often referred to as a “mirror world” – which allows them to simulate scenarios more safely and cost-effectively through a three-dimensional virtual replica.

Cities such as New York, Shanghai and Helsinki are already using digital twins. In 2022, the city of Zurich launched its own version. Anyone can use it to measure the height of buildings, determine the shadows they cast and take a look into the future to see how Switzerland’s largest city might develop. Traffic congestion, a housing shortage and higher energy demands are becoming pressing issues in Switzerland, where 74% of the population already lives in urban areas.

But updating and managing digital twins will become more complex as population densities and the levels of detail increase, according to architect and urban designer Aurel von Richthofen of the consultancy Arup.

The world’s current urban planning models are like “individual silos” where “data cannot be shared, which makes urban planning not as efficient as we expect it to be”, said von Richthofen at a recent event hosted by the Swiss innovation network Swissnex. …

The underlying data is key to whether a digital twin city is effective. But getting access to quality data from different organisations is extremely difficult. Sensors, drones and mobile devices may collect data in real-time. But they tend to be organised around different knowledge domains – such as land use, building control, transport or ecology – each with its own data collection culture and physical models…(More)”

The Radical How

Curated on Posted on by Stefaan Verhulst

Report by Public Digital: “…We believe in the old adage about making the most of a crisis. We think the constraints facing the next government provide an unmissable opportunity to change how government works for the better.

Any mission-focused government should be well equipped to define, from day one, what outcomes it wants to bring about.

But radically changing what the government does is only part of the challenge. We also need to change how government does things. The usual methods, we argue in this paper, are too prone to failure and delay.

There’s a different approach to public service organisation, one based on multidisciplinary teams, starting with citizen needs, and scaling iteratively by testing assumptions. We’ve been arguing in favour of it for years now, and the more it gets used, the more we see success and timely delivery.

We think taking a new approach makes it possible to shift government from an organisation of programmes and projects, to one of missions and services. It offers even constrained administrations an opportunity to improve their chances of delivering outcomes, reducing risk, saving money, and rebuilding public trust…(More)”.

AI as a Public Good: Ensuring Democratic Control of AI in the Information Space

Curated on Posted on by Stefaan Verhulst

Report by the Forum on Information and Democracy: “…The report outlines key recommendations to governments, the industry and relevant stakeholders, notably:

  • Foster the creation of a tailored certification system for AI companies inspired by the success of the Fair Trade certification system.
  • Establish standards governing content authenticity and provenance, including for author authentication.
  • Implement a comprehensive legal framework that clearly defines the rights of individuals including the right to be informed, to receive an explanation, to challenge a machine-generated outcome, and to non-discrimination
  • Provide users with an easy and user-friendly opportunity to choose alternative recommender systems that do not optimize for engagement but build on ranking in support of positive individual and societal outcomes, such as reliable information, bridging content or diversity of information.
  • Set up a participatory process to determine the rules and criteria guiding dataset provenance and curation, human labeling for AI training, alignment, and red-teaming to build inclusive, non-discriminatory and transparent AI systems…(More)”.

Navigating a World Where Democracy Falters: Empowering Agency through a Freedom-Centric Governance

Curated on Posted on by Stefaan Verhulst

Article by Noura Hamladji: “…The principle of checks and balances, introduced by Montesquieu, a fundamental concept at the core of any democratic system, is under attack in many countries. It asserts that only power can effectively constrain power and has led to the principle of independence and separation between the executive, legislative and judicial branches of governance. Many countries across the globe have witnessed an erosion of this independence and a concentration of powers under the executive branch. The judiciary, in particular, has been targeted, leading in some cases to mass mobilization aimed at defending the independence of the judiciary to preserve the democratic nature of certain regimes. 

Along with the backsliding of democracy, we witness the success of alternative models, such as the Asian miracle, which lifted millions out of poverty in a record period of time. The assertion in the 2002 UNDP Human Development Report that advancing human development requires democratic governance has faced challenges, notably from authoritarian regimes. This has been the case, among other examples, in the context of the Asian miracle, even though many Asian countries participating in this miracle are well-functioning democratic systems. Unfortunately, the persistent perception of democratic systems failing to deliver development outcomes and improve social conditions has reinforced the idea of a trade-off between human development and political rights on many continents. 

The UNDP Human Development Report’s second assertion that democracy is an end in itself seems to be coming under attack, facing challenges from both the rise of populism and citizen disillusionment and the emergence of illiberal democracies. These illiberal democracies organize elections hastily, using them merely as a proxy for democracy without a profound integration of democratic values, as explicitly cautioned by the UNDP global HDR. Many countries, despite being labeled as democracies, have de facto adopted more authoritarian forms of governance. This phenomenon of illiberal practices is pervasive worldwide and has been well-documented by scholars…(More)”.