Health Infomation Tech Regional Extension

Extension means reaching out, and— along with teaching and research— extending resources. In agriculture this dissemination of knowledge and skills is the Cooperative Extension System (CES). CES in rural America helped make possible the American agricultural revolution, which dramatically increased farm productivity and resulted in "the breadbasket of the world."

The eXtension Web site is a business model for Health Information Technology Regional Extension Centers (HITRECs). One of the goals of eXtension is to develop a coordinated, Internet-based information system where customers will have round-the-clock access to trustworthy, balanced views of specialized information and education on a wide range of topics mentioned in the bulleted paragraph that follows.

The value proposition of a HITREC is be personalized, validated information addressing specific questions, issues, and future needs and IT developments.

Information on the HITREC web site could be organized into Communities of Practice (COP). Each COP would include articles, news, events, and frequently asked questions (FAQs). The information from online and print sources is analyzed, organized, and disseminated as paper checklists, podcasts to celphones, and online. COPs are organized around a many topics, including but not limited to

• ICD-10 planning and implementation
• electronic records (PHR, EHR, EMR)
• HIPAA 5010 transactions
• smartphones as portals to electronic records
• principles defined in Visual Display of Quantitative Information by Edward Tufte and
  
• health 2.0 topics.

The foundation principle for any HITREC presentation is "Make Knowledge Visible and Useful." Visible knowledge must based on unbiased research and undergoes peer review prior to dissemination. When a provider wants to read the source(s), s/he will use the provided citations (author, source name, date, pages) and links.

CES and eXtension invented the "wheel" for effective expertise and technology transfer in the U.S. There is no need for the Obama administration, HHS, or his Office of the National Coordinator for Health Information Technology (ONC) to re-invent the "wheel."

Mutually inclusive

When each of us has an electronic personal health record (PHR) and expect a care provider to have interoperable health information technology (HIT), adoption of electonic health record (EHR) or electronic medical record (EMR) systems by chronic, acute, and geriatric care providers will be accelerated.

Electronic management of health/medical data will help to

• improve outcomes
• reduce errors (incompatible meds, incorrect location, and the like) and
• reduce costs due to preventing repetititious tests and mis-filed charts.

A smartphone application that streamlines interoperability of these electronic records in the context of ICD-10 will leverage expert system and cloud computing capabilities.

Make knowledge visible for ease of understanding and subsequent decision-making about

• ICD-10 and HIPAA 5010 transactions
• smartphone-mediated EHR/EMR and PHR systems and
• cloud computing for managing and mining electronic records (e.g. cost-reduction, utilization, and efficacy trends).

Health Information Technology Regional Extension Centers could carry the lion's share of the electronic record technology burden so providers at all levels don't have to add "IT" to their plates.

Moving away

Wind farming is wind development as practiced by an individual, a small business, a group, a community, or a school. Other types of farm energy production range from converting waste cooking oils to biodiesel to anaerobic digestion. With development of an I-29 manufacturing and technology corridor, we are on the brink of being America's "Energy Basket."

Wind farming is for the courageous; I am not courageous.

South Dakota cities near I-29 can spur economies

When the region learns from many decades of experience that taught Silicon Valley- from which the corridor cities can learn- how to create and maintain a “habitat” for innovation – a unique setting where entrepreneurs find easy access to

• scientific research
• rapid prototyping services
• intellectual property attorneysworkforce training programs
• venture funding and
• local governments that understand the relationship between time and money.

Business starts and failures during those decades have highlighted three factors that explain a lot about why companies tend to succeed in Silicon Valley- and by extension- in the I-29 corridor development

• industry clusters
• personal networks and
• an exceptional workforce.

How to Kick Silicon Valley’s Butt by Guy Kawasaki June 06, 2006), commented on what makes for a successful economic area by saying "Be logical. Make the challenge to create a Silicon Valley as easy as possible. Thus, a region should use it’s natural, God-given advantages. For example, aquaculture in Hawaii, security technology in Israel, alternative fuels in the Midwest, and solar power in the Sun Belt. There’s a reason why the best succeed with what they have because they know everything about the resource or asset."

Why Startups Condense in America, by Paul Graham, says "the recipe [for a Silicon Valley-like economic engine] is a great university near a town smart people like. A silicon valley has to be a mecca for the smart and the ambitious."

Mr. Graham offers tip for governments that want to encourage startups: read the stories of existing startups, and then try to simulate what would have happened in your county. When you hit something that would have killed Apple or Hewlett-Packard, prune it off. Startups are the kind of thing people don't plan, so you're more likely to get them where it's ok to make career decisions on the fly.

According to Rebecca Buckman in Venture Capital's New Green Machine (January 2, 2008), "In the first nine months of last year, U.S. venture investors poured $2.6 billion into clean tech, more than the $1.8 billion invested in all of 2006." This enthusiasm for "green" products and energy is a "glove in hand fit" with agri-energy technology, manufacturing, and production in the I-29 corrodor.

South Dakotans know agriculture; its farming and ranching families are problem solvers having great work ethics and electrical and mechanical aptitudes. Agri-energy production and manufacturing are as complementary to farming and ranching operations as computer software is to hardware.

Estimated Used Cooking Oil in South Dakota

Used cooking oil (UCO) can be transesterified to road-grade biodiesel in eight hours or so. Rather than having a waste disposal problem, generators of UCO in South Dakota have an untapped fuel resource for local

• fire departments
• ambulance services
• city street / county highway maintenance depts.
• city buses
• U.S. Postal Service
• furniture / large appliance delivery vehicles
• tool vans ("Snap-On") and
• other local delivery service vehicles

as well as for farm equipment.

According to chemical engineers at the University of Saskatchew, an estimate of annual U.S. per capita generation of yellow grease [used cooking oils and greases] is of 9 lbs.

Using that estimate, 754,844 SD residents generate 6,793,596 pounds of yellow grease. Tyson Foods determined that about 8 pounds of yellow grease and animal fats transesterified to 1 gallon of biodiesel (BD).

If mathematics are consistent, each year we could have 849,199 gallons of BD to use. At between $4.11 to $4.39 per gallon of petro-diesel (U.S. Energy Admin., 28 April 08), the BD is worth $3,490,210 - $3,727,983.

Each year South Dakotans throw away about $3.5 million; other states are throwing even more millions into landfills or down drains. Rudolf Diesel designed his engines in the 1890s to run on peanut and other vegetable oils before crude oil refining was economical.

By 1912 the first Chevron gasoline station had been built, changing internal combustion practices for the forseeable future. Perhaps Diesel's initial vision will enjoy a greater resurgence here in the U.S. as we travel "back to the future."

Disposal problem is a profit center

Perhaps the National Restaraunt Association's “Conserve” environmental initiative would be wise to have a "roadmap" on how to convert used cooking oil to biodiesel? The fuel can be marketed to

• municipal and county departments (fire, ambulance, transit, street/highway) and
• organizations that use diesel fuel in boiler operation as a means to reduce their petro-diesel costs.

Biodiesel

• is also less toxic than salt
• biodegrades as fast as sugar and
• releases far fewer pollutants when burned compared to petro-diesel.

Liquid used cooking oil is filtered, tested for FFA and water content, then put in a processor for conversion. A processor can produce as few as 30 gallons (in a large closet) or as much as 275 gallons (in a backroom) of the fuel.

In a mall a central facility could occupy several thousand square feet off in a remote corner of a parking lot.

Ted Turner and others at a National Restaurant Association conference on going green mentioned "environmental stewardship and local sustainability" and '“the plus one' attitude emphasizes using local/regional sources." Producing biodiesel for city and county vehicles through "restaurants going green would have an even bigger impact."

PR would be fantastic and used cooking oil disposal costs would be replaced by profits from long-term contracts for biodiesel purchases.

Why throw away a fuel source at a time when "product-innovation and profitability have become even more important staples of successful restaurants."?

No more cheap oil, No. 2

This continues from yesterday's post-

The Wall Street Journal, p. C10; 'The Mother of All Bubbles'? by Gregory Meyer.

• the speed of the ascent of the price of a barrel of crude oil to nearly $117 has forced banks and brokers to repeatedly revise their oil price forecasts up-ward.
  
• some analysts continue to warn that oil prices may fall to $80 per barrel as the world's oil supply and demand balance rights itself- could be seen by June [2008].
  
• $50 per barrel could be reached if pent-up supply in Iraq, Nigeria, Venezuela, and other producers makes it to market.

[Historic political / religious conflicts are major stumbling blocks to that happening.]

• pricing sentiment seems to ignore the signs of a supply surplus through the end of 2008.

Tim Evans, energy analyst, Citigroup: "There is no supply-demand deficit."

[but] global demand is expected to be 1.3 million barrels per day higher in 2008 than 2007.

Michael Lynch, Strategic Energy & Economic Research, thinks the supply / demand situation justifies a price of $30 - 40 per barrel

• local and geopolitical events double that price.

"We are stuck in this rut of an upward market until something major changes in the macro picture," advises Adam Robinson, energy research analyst, Lehman Brothers.

theoildrum.com comments on a The Wall Street Journal article - "Oil Officials See Limit Looming on Production," posted by Gail the Actuary on November 19, 2007

"A growing number of oil-industry chieftains are endorsing an idea long deemed fringe: The world is approaching a practical limit to the number of barrels of crude oil that can be pumped every day. Some predict that, despite the world's fast-growing thirst for oil, producers could hit that ceiling as soon as 2012."

[We started refining oil about 100 years ago] "with a finite amount of oil, and this is gradually being depleted. As it gets depleted, it becomes more and more difficult to extract economically, so production tends to decline [and prices quickly climb]."

"The WSJ article quotes Randy Udall:

Randy Udall, co-founder of the U.S. chapter of the Association for the Study of Peak Oil and Gas, has written that these unconventional oil supplies are like having $100 million in the bank, but 'being forbidden to withdraw more than $100,000 per year. You are rich, sort of.'"

"This is a good way of understanding our current problem. There is a lot of oil in the ground [North Dakota, Alaska, offshore Florida, Brazil], but it is complex oil to get out. It is expensive, and requires a lot of trained workers. We are rapidly reaching the point where we cannot pull as much oil out of the ground, because the 'easy oil' is gone, and the remaining oil is in difficult locations and is hard to extract."

Fuel for action, if not thought.