The Google self-drive car – a post from two years ago..

Remember when, two years ago or more, self driving cars were the hot topic firing our imaginations?

This was originally posted a couple of years ago and is shared with you unedited.. truth has already become stranger and more twisted than we could ever imagine..

A guardian article from Sept 2017 exposes one of the many risks discussed in the blog post copied below (the original blog is here)

Google’s Self-Driving Car (now a spinoff called “Waymo“) will be a reality very soon.  From a consumer perspective, there are many positive aspects to winning back this free time in your day, and arriving at your destination safely and in a relaxed state.

The surface questions have already been asked, but perhaps the impact (if you’ll pardon the pun) of having an information behemoth like Google influencing your decisions, while being in control of your geospacial location, bears some investigation and thought…

Caveat Emptor:   I am not a good – or reliable – blogger; any thoughts and notions expressed below do not reflect current or future reality, except in my own mind..

So, imagine, you’re heading home after a long day at the coalface. the car has welcomed you by opening its consumer portal (door) and you step in and make yourself extremely comfortable into a seat that has already adjusted itself to the most appropriate settings for your physical condition at the time.  You are tired, and feel like some “me time”, so choose to have an “Immersive Experience”…

Now read on – it gets a bit weird from here on in…

The car as an immersive experience

This is really interesting.  The car would lend itself very well to becoming The Virtual Reality Experience:  the windows would darken, full AV experience would kick in, and you’d suddenly find yourself in the jungles of Borneo, or paddling down the Amazon.. this wouldn’t just be the lame, and somehow disappointing VR ride down a roller coaster that we’re used to today.  Oh no, this experience would be AMAZING: All senses would be engaged.  Getting in a car would be an experience like the most immersive cinema you’ve ever enjoyed.  Think the first time you saw Star Wars (or Avatar, if you’re younger).

It could even be 3D!! (for premium content only of course)

Little suspension hiccups could be introduced (when stationary of course!) to simulate hitting a rock while cycling down the side of a mountain, or paddling through rapids.  These experiences would be available from a downloadable library (in a standard format of course), reflecting your current mood, health (nothing too extreme if your personal health monitor was concerned!), and personal preferences.  The experiences would be available as “Playlists” created by fellow SDC VR-ers.  Premium and “Freemium” experiences would be available, based on quality/immersiveness, and your willingness to have “ads” appear.

The Vehicle for public service…

Taxi rides could be free – but you’d have to put up with advertising of course.  the number of ads reflecting the length of journey, time of day, demands on the service etc.  for example at peak times you may have to submit to a detour or visit to one of the advertisers premises for a free sample of Aunt Molly’s Delicious Home Made Bathtub Ice Cream product (TM).  All advertising would, of course, be based on detailed Analytics of you, the consumer.

Now to the elephant in the Car – sorry – Room.  Porn. Yes, I’ve said it. we need to consider use/abuse of this immersive experience.  Teenage boys would now not be reluctant to go to the shops for milk for mom.  They would return, red-faced and spent – having deleted all records of their Immersive experience. It could be a fantastic environment for “Courting Couples”, culminating in the car recommending a drive to Vegas, or Gretna Green via a wedding shop, should things go well..

SDC vs STD

If you’re single, you could, of course, download “Tinder – SDC edition”:  You would be presented with 3D images of local potential love interest, swiping left and right as appropriate.  Wow he/she/it looks hot!  The SDC knows all about your love interest, their location, likes and dislikes, health (no STD’s) and strongly suggests you visit a tattoo parlour, buy a cool black jacket, pick up a specific bottle of wine and hey presto – you’re set.  Drinking and driving wouldn’t be a problem of course, provided you’d selected the “no human intervention” option.

HP, Linux, Apple, Yahoo, Walmart cars?

Imagine brands like these adding their unique spin on their version of an SDC.

HP’s would have “invent” inscribed on it, would probably require expensive proprietary consumables, and have a remote and inaccessible call centre should things go wrong.  it would also exhibit alarming tendancies to split in two at unexpected intervals.

Linux would be a collaborative environment.  it would appear somewhat “unfinished” in experience, but you’d benefit from the knowledge that your SDC was based on the best principles of collaborative design.

Apples would have a beautiful, handcrafted feel.  you’d have to upgrade every year of course.

Walmart would be a lively, chaotic experience.  All human life would be represented here, and there’d be a gun rack behind you.  Sweatpant malls would be a frequent shopping recommendation in the ad content.

Tesco would flip-flop in design from huge mega cars, to tiny locally sourced vehicles.

Starbucks would recognise visits to their outlets with special offers and rewards experiences.  Also for bringing a new customer to the store…

Yahoo, AOL, AskJeeves SDC’s would be tatty attempts with little functionality, typically driven by older members of the SDC community.

Now it gets a bit darker:

Imagine, in your jungle experience, that your health monitor detects you are hungry:  gradually, through the mists, appearing in a clearing is a tribe of indigenous people enjoying a campfire with a selection of delicious-smelling roast BBQ meats.  Remember, you can hear their happy conversational burble, smell the food and feel the warmth of that campfire on your face.  How convenient, that the SDC happens to know that “Joes Patagonian Burger bar” is just around the corner from you, and that they happen to have a special deal on, just for you??  You’ve even ordered ahead, thanks to the SDC’s interactive Input/output and “always on” capabilities!

Could the array of sensors – inward and outward facing – be used for third-party purposes? for example, facial recognition detects a known criminal and police services are notified.  Or more extreme, an Uber-programme (if you’ll pardon the pun) is invoked and the car immediately leaps to “active” mode, orchestrating a number of google SDC’s to “corral” the suspect.

“Hack-ney Carriage”

What about hackers? could they suborne control, and force you on a joyride, or over a cliff?  ISIS?  imagine if they controlled the door mechanism?

I need photos, graphics, artwork, based on some or all of the stupid ideas presented in this blog.  send me your art, and give me permission to incorporate it..

The next ten years are shaping up to be very exciting!

 

“Zap My Data” …A $5000 dollar browser app that could break the internet?

A $5000 dollar browser app that could break the internet?

What if, as part of the GDPR process currently generating so many dramatic headlines, someone developed a browser app that could automatically send a request for the return of all your personally identifiable information held by a site owner at the press of an orange button?

Mock up showing request, delete buttons.. other websites are available!

Behind the red button would be a request to be forgotten by the data owner and all associated information processors. I’ll bet not many of these data aggregators would be geared up to handle that… Google are though

Embellishments could include a dashboard showing non-respondents in order of delinquency, with the option to alert the appropriate Data Protection Authority.  Robotic Process Automation (RPA) could be used to harvest the database of email contacts for each site, as well as storing the text content for the equiry/delete orders.

Of course someone may have already developed this – if so, let me know!

Thoughts? Comments?

The NHS and Litigation (2) – what can be done to mitigate risk and streamline responsiveness

“Data is not information, information is not knowledge, knowledge is not understanding, understanding is not wisdom”
Clifford Stoll, Gary Schubert

My previous post on this subject ended up as a bit of a cliffhanger – the feedback was that I’d identified issues on which we could agree, but not given any clarity on ways to mitigate the problem (Thanks Mike Rutherford for your comments).  The problem statement might look like “how do I, as the person responsible in the NHS trust, identify, gather and package all responsive documents for a legal case in all of the diverse formats and modalities in a timely and compliant fashion?”

Major steps are underway in Government and the NHS to adopt a “Digital by Design” strategy, that would in theory at least mean that all information comprising a patient medical record resided in an easy-to-query format.  While it is gratifying to see that ruggedised tablets are in increasing use in secondary (non-GP) care settings for some patient interactions, the patient’s journey still relies on paper files at the sharp edge of treatment in many cases: paper continues to be, if not prevalent, then in many cases preferred by clinicians for it’s ease of use and perceived authenticity.

Patient Administration Systems are increasingly able to intercommunicate, smoothing the interaction between primary and secondary healthcare sources.  In GP’s surgeries, digitised summaries of a patient’s history are intended to make the old Lloyd George folders obsolete. NHS England have nominated Capita to manage elements of the GP2GP patient record management scheme, designed to simplify the process of patient record transfer between GP practices.  However, this hasn’t been an entirely smooth process, with assertions of incomplete transcriptions, irretrievability of attachments, and delays in paper file transfer causing friction and delays.

A curated PDF binder compiled using search terms agreed by interested parties has become the accepted format for legal review, but the varying formats of medical data continue to present expensive and time consuming obstacles:  MRI and other medical output modalities generate huge and proprietary file formats, and paper documents can have enormous volumes, even for one specific patient episode.  However, snapshot overviews in PDF format can be made for medical imagery, so one remaining problem is how to identify relevant paper records and render them into PDF?

There are two approaches to paper medical record digitisation –  proactive and reactive. many NHS trusts have attempted the proactive bulk digitzation of cohorts of their paper records.  The problem has been that to correctly identify each document within a record, extract relevant information and match that to enhanced metadata relating to the patient and episode has been prohibitively expensive, given that perhaps only 1% of the digitised record may ever be subsequently viewed.  The alternative approach – little or no document classification and a minimally separated record renders the digital experience unusable to clinicians and can actually make the problem worse, since a poorly-classified and separated medical casenote PDF may be several thousand digitised pages that cannot be usefully navigated in a realistic timeframe by a clinician.  However, it would be reasonable to surmise that a legal team involved in representing a patient would painstakingly scour that file, searching for documentary evidence of poor or inadequate care…

The answer may lie in new and more powerful interpretations of AI-based document classification, that can correctly separate, classify and index unstructured and semi-structured digitised case notes.  One such technology – called CloudHub360, has been able to demonstrate and deliver a cloud-based Document Transformation engine capable of high-speed, high-volume and highly accurate bulk document processing – with no human intervention, once configured.  

The historic challenge has been to maintain the accuracy of automated document classification, while maintaining an acceptably high classification rate.  The test results shown below suggest that this new implementation of AI can make the trade off between classification accuracy and classification rate less of an issue..

Results in red show results using the Cloudhub 360 engine against a leading competitor, based on 800 documents spanning 8 classification types..

Further, since the characteristics of medical record types demonstrate many consistencies in content, if not appearance, the memory of learned documents can be transported from one NHS trust to another, vastly reducing setup times and making the notion of a universal transformation processing engine, cloud-accessible, a reality.  This engine has now been integrated with a browser-based viewer, and made usable within the NHS IT environment.

We welcome the opportunity to work with you to investigate the applicability of this technology to your use case, and are very excited by it’s possibilities.  Please get in touch with us to find out more…

image 1 courtesy of Newtown Graffiti – https://www.flickr.com/photos/newtown_grafitti/5525985630

images 2,3,4 courtesy of CloudHub360

image 5 courtesy of Weiss Paarz – https://www.flickr.com/photos/141290938@N03/26682786574

Managed Print Services…. Supplier or Client Driven?

“Of course, we can provide you a Managed Print Service that caters for your every need”? (now let me sell you want I want to sell you)

Today’s MPS market is dominated by the major hardware manufacturers who are driving and defining the customer MPS requirement. In many engagements that I have been involved with, it’s the same supplier who conducts the initial assessment, design and delivery of the service.

MPS has become a supplier, rather than customer lead engagement.

Is the result an offering where customers are controlled and lead by suppliers? in which case, how do customers get to gain the full benefits available from an MPS and stay in control of their original vision? …. Now, there’s a question…

 

MPS Service Definition

The Managed Print Services Association (MPSA) define MPS as ‘the active management and optimisation of document output devices and related business processes’.

The key words within this definition are ‘active management’.  Many organisations still have a printing infrastructure that has grown organically over many years based on local tactical decisions and individual user’s demands.  This invariably leads to a sub-optimal print infrastructure with high overall cost of ownership.

At Charta Porta we have a truly independent approach to the knowledge share of best practice for MPS. Our advice is free of the shackles of the hardware manufacturers and thus creative in its approach to solving the problems that customers face when considering an MPS for their business.

Contact us today at info@chartaporta.com and be just one email away from a step closer to your vision..

 

 

 

 

The NHS and Litigation – how lessons learned from PPI can help…

Litigation is a fact of life in the NHS, but shouldn’t be a trauma in itself…

Logic will never change emotion or perception. Edward de Bono

For 2015, the NHS Litigation Authority (NHSLA – apologies in advance for the acronyms) earmarked £56 Billion to cover litigation costs against the National Health Service.  This staggering number is almost double the previous years allocation of £31 Billion, and represents almost exactly half of the total NHS budget for the year.  While the National Audit Office are rightly investigating why such an insanely large number has been earmarked against an actual litigation settlement figure of ‘only’ £1.5 Billion in 2014-5, the trends are hard to contradict: in 2006-7, the NHS received 5,419 claims, more than doubling to 10,965 in 2015-6.  Ten years ago, £667 Million was paid in settlement, compared to £1.5 Billion for 2015-6.

More than 75% of legal claims result in an eventual settlement against the NHS, with the claimant trade organisation – the The Society of Clinical Injury Lawyers – alleging that a culture of “defend, deny, and delay” exists in the NHS.  The Care Quality Commission (CQC) note that in many cases the NHS handling of a complaint was representative of the following statement:

…an absolute nightmare. They deny everything… and take months to reply to anything. You ask them specific questions and you end up with very general policy statements.

As one of the vast and mostly silent majority of individuals who have benefited from the huge array of healthcare services provided by the NHS, we naturally feel a tension between wanting to support the best of the NHS, while feeling sympathy to those involved where healthcare, very occasionally, falls short of the high standards expected.

This perfect storm of frustrated and aggrieved claimants, a well-organised commercial litigation machine, and a perceived culture of “defend, deny and delay” seems to have some similar characteristics to the Personal Protection Insurance (PPI) scandal, which has only recently come into the “beginning of the end” phase for the financial sector.  Some of the factors which went into the resolution of the Payment Protection Insurance (PPI) scandal are worth investigating to gauge their applicability to the NHS:

Remember PPI?

Remember the media frenzy that followed the Judicial Review into PPI mis-selling by various financial institutions and their agents?  Very quickly, a specialist ecosystem of legal firms and associated agencies were spawned, using very efficient systems to support the huge numbers of outraged product purchasers claiming against their PPI vendors.  Shortly thereafter, the Financial Ombudsman Service significantly ramped up their resources and technical infrastructure to handle final adjudication in up to 200,000 cases per year – the majority being related to PPI claims.

This left banks, building society, credit card companies, loan companies and their agents in the situation of having to somewhat passively manage a huge caseload of very unhappy customers, often from a position of blindness to the scale of their own exposure.  Put simply, in the worst cases, financial institutions did not know how much money to set aside for PPI claims:  In the wake of the financial crash of 2008-9, this was not a good place for a retail bank executive (for example) to find themselves.

Very often, the first task of confirming whether a customer was justified in their claim was very expensive and time consuming, involving drawn-out trawls of legacy systems, or even archived physical documents such as microfiche.  In the most extreme cases, this process was so onerous that some financial organisations simply calculated it was more cost-effective to settle, without going through a process of discovery

In another life, I was involved in a project on behalf of a UK bank to provide them with a database of customers who’d paid for PPI on a particular banking product, using data we’d extracted from over 1,000,000 microfiche representing 500,000,000 + pages of customer statements.  Remember, these microfiche were their only source of the truth, but not easily accessible to the bank.  It was a fascinating project, completed in less than six months with minimum user intervention involving the resolution of many technical obstacles such as deteriorated fiche, complex rules and extremely challenging SLA’s.  The delivered dataset allowed this particular organisation to be proactive and make contact with all involved parties and their agents in advance of a claim.  The bank was able to understand and report on it’s exact exposure, and to mitigate reputational damage by proving pro-activity to the Financial Conduct Authority, The Financial Ombudsman Service, the media, and most importantly, their customers.

Summary

Lets look at the process by which a claimant currently pursues a claim against the NHS:

A claimant engages a legal specialist (either a law firm or associated claim management organisation), who validate the claim as far as it is known.

On the basis of a perceived valid claim, a Letter of Notification is issued to the relevant Healthcare Agency and the NHS Litigation Authority.  The claimant from this point will have expended legal fees, which will have to be paid by someone.  Remember, that in 75% or more of cases, the NHS settle, and that one third of the total cost of settlement is in legal fees.

At this point, the Healthcare Agency acknowledge the claim, assess it’s validity and assign a contact point.  At this stage costs are incurred by the Healthcare agency.  It is their duty to validate the claim and notify the claimants agents, and to research the case and to decide whether to settle or contest the litigation.

The case continues through increasingly involved and costly phases requiring detailed phases of discovery and legal interactions (Letter of Claim, Letter of Response, discovery, disclosure, court)…

Through each of these phases of complex interaction lasting years (in some cases), costs are incurred to the NHS, which are usually eventually covered from the overall NHS budget.  While it is proposed to cap the cost of legal fees in any particular claim to £25,000, this has not yet been legislated.  Well-documented cases exist where the claimants legal agency submitted bills many times the value of the claim to the patient:

Claim for costs struck out by court

“The claim arose out of the failure to diagnose
a tumour to the claimant’s kidney following an
attendance for chronic back and groin pain.
The trust admitted breach of duty but denied
causation and made an offer of £5,000.00
which was accepted. The claimant’s bill of
costs totalled £121,701.00. An hourly rate of
£400 per hour was claimed despite the bulk of
the work being conducted by unqualified staff.
In addition a 100% success fee was claimed,
which meant the true hourly rate claimed was
£800 per hour. A further concern was that the
claimant appeared to have the benefit of BTE
(“before the event”) insurance and had
entered into two CFAs (conditional fee
agreements – otherwise known as “no win, no
fee” arrangements).”

This quote was taken from the NHSLA annual report 2014-5, and could be argued to be biased against the claimants, but this only emphasizes the confrontational attitude between parties.

Litigation is a fact of life, and will not be going away for as long as our (relatively) free society exists. Reluctance to respond to the challenges of litigation and unwillingness to learn from experience are natural and human reactions, but are to be avoided.  Systems, resources, and experience do exist to help remove the friction of response, and to make it possible to avoid expensive mistakes and learn from those regrettable mistakes that happened.  By looking at how the commercial world has learned from mistakes and delivered better litigation response, the NHS have the potential to maximise their ability to deliver the best possible healthcare to our communities in a time of unprecedented pressures on the service…

 

Please leave a comment – we will be posting more on this, exploring specific aspects in detail, including more on technology use cases to support litigation management, General Data Protection Regulation, Corporate Memory and best practice in Record-keeping and more…