Monday, October 18, 2010

Geo-Medicine in Health IT

Geo-Medicine in the next generation of Health IT

Working with rural health clinics and under-served urban clinics we have begun the development of a new Health Information Technology software application that integrates GIS based Geo-medicine programming into a full suite of Open Source Health IT software bringing together Electronic Health Record, Personal Health Record and Health Information Exchange Network tools. Our work with clinics responsible for the health care of rural farm and ranch workers has perhaps most strongly demonstrated that “Geo-medicine” is an essential component of Health IT providing diagnostic and treatment related data to providers that takes into account issues of pesticide exposure, water and food quality and other environmental conditions that heavily impact on patients health.

Geo-medicine, (the application of spatial analysis methods to medicine), creates intelligent geographic solutions and technologies that help physicians improve their diagnostic capabilities by receiving geographically, culturally and environmentally relevant information at the time of a patient consultation. Our research, working with 145 health clinics over the past 11 years, has established the framework for the new software which permits an open source EMR software package to make use of a GIS tool set to establish the "place history" of a patient as a clinical marker and unlock basic information on a patient's health risks related to toxic air, water, ground, and food exposures, as well as culture and demographics, making this complex of information quickly and easily available to a consulting physician via the patient's EMR.

This next generation of Open Source EMR/HIE Geo-medicine enabled software tools are designed for use in rural areas, under-served urban communities and Developing Countries but have important implications for Health IT development in general.

Sunday, September 20, 2009

New Rural Broadband Projects

Rural Community Broadband - can we become local and sustainable through new funding?

Now is the time for action. We are making a very important effort to expand rural broadband access through the new funding made available by USDA and the Department of Commerce. There will be many important new programs initiated over the next year to expand rural Internet access and establish a diversity of Organizations providing access which will create new competition and new alternatives to the limited Corporate Telecommunications companies which currently provide access. There is a real need for competition to drive forward the quality and quantity of broadband access for rural Americans.

How will it work this year as we see these new programs unfold?

There are two possible directions in the new funding.

The first direction will see many small rural broadband projects funded, creating diversity, regional sustainability and a serious new market challenge to the limited services provided by large Corporate Internet. This direction will create locally managed rural projects which will establish new resources, create new jobs in the communities being served and empower rural communities to begin taking a more direct, active role in the management and design of their broadband systems. Important here is the challenge which this presents to the USDA and Department of Commerce. These new projects will not create the theoretical large number of jobs and broad range of services proposed by large, much more expensive proposals, but they will establish smaller programs that will in all likelihood have much more rapid start up and a much higher level of local involvement increasing the positive impact on local communities.

The second direction is that we will see large Organizations receive the bulk of funding, creating the possibility of State wide and multi-State rural broadband access to begin taking shape. This will create, at least on paper, a larger number of jobs and larger numbers of individuals served, but at a much, much greater cost and with far less local involvement. Also, the jobs created by these larger projects will not be in the rural communities, instead they will establish large companies that hire where their operations centers are. The larger projects will not create local involvement but once again leave rural communities to wait for large ISP Networks to find their way to the small rural areas.

Based on my experience over the past 18 years of working with rural technology projects the large budget proposals will take far longer to get underway and once again leave rural community residents, small businesses and farms hoping they will be noticed.

I believe it is critically important that we have serious discussion and review of these two possible directions. The history of technology build out in the United States has shown that the very large projects are too often given preference, if for no other reason than because they provide, on paper, much larger statistics. But our experience has also shown that this generally leads to rural communities having little say in the design and application of the services. And the cost is tremendously higher, running into millions of dollars per project, whereas more local, small efforts create new local businesses with sustainable budgets and real local involvement.

So the main question comes up as to whether we are striving for sustainable, achievable rural broadband projects that are built up from the local level or are we going to see projects selected for the statistics?

I began working with rural Internet technology projects in 1991 through National Science Foundation funding and later through 5 USDA RUS distance learning and telemedicine grants. One of the most difficult issues during this time was the shift towards large, Corporate telecommunications services. A tendency that is all to common. Small, locally supported Internet service providers have been gradually forced out of the market because of the larger corporate systems, leaving rural America greatly underserved, if served at all. The new ARRA funding gives us a chance to turn that around and put seriously needed resources into the hands of local organizations. This will encourage new rural business models, give rural communities a real say in what is developed and take us back to the traditional model of American small business as the mainstay of our rural telecommunications systems.

If we take the small, local approach much less tax money per project will be required and far greater local accountability will be established to ensure the success of the projects.

Are we up to this change in approach to American Internet growth? Or will we return to the old model that so far has not worked, giving preference to large projects to give us better statistics on paper?

Through the small, local approach I have seen RAIN Network bring telemedicine and distance learning services to over 150 rural communities since 1997. I know from experience that this approach works and creates a level of local involvement that makes a real difference.

Those of us working at the local level should do all we can to encourage USDA and Department of Commerce to consider the value of small American businesses and not let the new rural broadband funding act as a tool to push small Internet Service Providers out of the market, leaving rural communities with little input and few choices as they endeavor to achieve equal access.

Monday, June 29, 2009

Permaculture, Rural Communities and RAIN Network

Work with Small Farmers, Ranchers and our friends who are helping shape new Permaculture projects has become central to our California Story video project. We have added over 6 hours of new video materials this spring and summer to the project's web site.

Permaculture represents a holistic technique for re-shaping modern communities which embraces all aspects of community life.

• Water management
• Food production and distribution
• Energy creation and distribution
• House design
• Time management
• Re-integration of the Family as a core part of a sustainable community and economy
• Creation of Rural and Urban food forests and neighborhood gardens.
• Socially Responsible Media

All of these represent components of Permaculture Design that will give us the tools to re-weave the fabric of a sustainable world.

There is a need, now, to put in place the tool-kits which will allow us to begin a new education process to help bring permaculture design into our communities.

RAIN Network represents one of the parts of that new tool kit. Using new technologies to expand the range of education and communication RAIN brings to the table essential resources to help us build new jobs, new alternative energy sources and new participatory communication tools.

RAIN’s California Story web site is part of the process bringing new video and learning resources forward for easy access through the Internet. Beginning in 1989 RAIN has worked with the U.S. Department of Agriculture, Department of Education, USGS and the National Endowment for the Arts to shape a new media, building an ever-growing Public Internet Broadcasting Network.

Stay close to our core web sites at :

http://www.rain.org/california-story - rural community, Permaculture, small farm and ranch video web - sponsored by the California Foundation for the Humanities

http://www.rainnetwork.ning.com – RAIN’s social networking web

http://www.rain.org/video-magazine - RAIN’s Telemedicine web

http://www.campinternet.net – RAIN’s Smithsonian Institution award winning online education web

https://twitter.com/rain_ca - join RAIN’s Twitter web site to stay in touch as we add new videos and new content

http://www.rain.org – RAIN’s Community web

Send email to rain@rain.org with questions and ideas

Tuesday, June 9, 2009

Internet You Can Believe In!

Highspeed Internet You Can Believe In!
- RAIN DSL -
Providing local, dependable Internet for more than 18 years.

Long before companies like Verizon were selling you Internet, RAIN Network was providing Internet access to California. For nearly two decades we have brought safe, reliable Internet and community services to the west
coast.

Join RAIN and bring reliability to your Internet access, and your wallet at the same time. Big corporations come and go, just like their 'Introductory Prices', but RAIN Network is here to stay, as are our reliable prices and services. We are always working to bring you more, never to cut corners.

You need Internet you can believe in, and RAIN is the Internet Provider to be believed in!

As one of the first ever ISPs in the Unite States, we know Internet and we know how to bring it to you!

• Highspeed DSL at a price you can budget!
Broadband starts at $24.95 a month.
• Joining is easy! Signup now or switch from
your old provider in days. Just signup and we
handle all the hassle of switching.
• Great Features. Join RAIN and get free email
and webmail, free tech support and even your
own website, free of charge.
• No hidden charges! no setup fees and no
price changes.
• No fees for switching. Move over from your
old DSL provider and join RAIN at no
additional cost.
• Join the Community. Get to know our
friendly staff and use our free forums and chat
rooms.

Why throw your hard earned money at faceless corporations when you can help support your local community.

Every dollar you spend at RAIN Network is another dollar in the community, not in a fat bank account across the country. Keep the money where it matters, at home.
Join now!

Call us at 805-686-1647 or Email us at rsvp@rain.org

With packages providing all levels of speed, we have the Internet for you.
Call or Email now to get all the information you need. No secrets and no tricks.
Signup and get connected in days.

RAIN DSL
Internet You Can Believe In!

Monday, May 25, 2009

RAIN Social Networking Web

Visit RAIN's new Social Networking Web at http://www.rainnetwork.ning.com

Thursday, May 7, 2009

Jesuita Fire Updates

JESUSITA FIRE Information
UPDATE: 6:25 a.m. Thursday, May 7

 Acres Burned: 500
 Date Started: May 5, 2009 at 1:50 p.m.
 Cause: Unknown
 Percent Contained: 0%
 Structures Threatened:2,000
 Homes Evacuated:5,400 homes, 16,000 people
 Structures Destroyed: Several structures have burned, however no official number has been released.
 Injuries: Three firefighters

Governor Arnold Schwarzenegger proclaimed a state of emergency in Santa Barbara County as a result of the Jesusita Wildfire which has burned over 500 acres, destroyed homes and caused the evacuation of over 8,000 people.

The Governor will hold a briefing/media availability regarding the Jesusita Fire at 9 a.m. in Santa Barbara.
The Jesusita Fire has over run it's perimeter and in now burning into the Mission Canyon and San Roque Canyon areas of Santa Barbara. At this time there is no containment, and multiple structures have been lost.
KEYT has received confirmed reports that homes in the Palomino Road and near the Skofield Park area
have burned.

At this time there is 0% containment and over 500 acres scorched.
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The public can call the Jesusita Call Center at 681-5197.
Residents with any information about how the fire may have started can call a fire tipline at 686-5074.

Red Cross has set up a Red Cross Shelter at Dos Pueblos High School, located at 7266 Alameda Avenue in Goleta.

The Santa Barbara Sheriff’s Department has issued the following MANDATORY evacuation order for the following areas due to the changing conditions of the Jesusita Fire.

MANDATORY EVACUATIONS

•Mandatory evacuation order are reduced to an evacuation warning in the following two areas: Constance and State Street, South on State to Micheltorena, Micheltorena to Garden Street, Garden Street to Constance, Constance to State Street, and the Alamar Road area. On the east from State Street to Calle Noguera, Calle Noguera West to San Roque, San Roque South to State Street, State Street East to Alamar.

Residents may return to their homes and businesses. Please remember that an evacuation warning still exists in the area. Returning residents and business owners are cautioned to remain aware of the potential for an evacuation order on short notice.

EVACUATION WARNINGS
•The evacuation warning area has expanded and now includes: La Cumbre Road (Western boundary) to State Street, State Street to De La Vina, De La Vina to Anapamu, Anapamu to Anacapa, Anacapa South to De La Guerra, De La Guerra to Milpas, Milpas to Montecito Street, Montecito Street to Alameda Padre Serra

Road closures are in effect at:
•Mission Canyon and Tunnel Roads
•Montrose and Tunnel Roads
•Las Encinitas and Mission Canyon Roads
•Alameda Padre Serra and Los Olivos
•Mountain Drive and Mission Canyon Road
•Laguna St. at Los Olivos
•Los Olivos and Garden Street
•Foothill Road (Highway 192) and Mission Canyon Road

What do “Evacuation Warning/Advisory” and “Mandatory Evacuation Order” Mean?
Evacuation Warning/Advisory: Residents are strongly encouraged to make arrangements to leave their homes and seek shelter out of the advisory area. Evacuation

Warnings/Advisories can turn into a Mandatory Evacuation at a moment’s notice. There is no set rule as to how long a Warning/Advisory cold take. There is
always the possibility that a situation may require an immediate mandatory evacuation without an evacuation warning/advisory. Please make sure that you prepare to evacuate at a moment’s notice having your belongings ready, including pets and/or other animals. Know the routes you wish to take, by pre-planning. Information as to how to plan for an evacuation can be obtained by calling the Red Cross at (805)
450-5921. If you leave your home during an Evacuation Warning/Advisory, you may not be allowed back to your home if it turns into a Mandatory Evacuation.
Mandatory Evacutation: Evacuate your home immediately. Once a mandatory evacuation has been ordered please evacuate your home immediately.

•Once you have left your home you will not be allowed back until the danger has passed.
•Emergency vehicles will be entering the area. Obey all directions given by law enforcement and fire personnel.

Fire Status:
•At approximately 1:45 p.m. a fire began in the Cathedral Peak area. The cause of the fire is currently under investigation.
•The fire response is being administered by a Unified Command consisting of the Santa Barbara Fire Department, Santa Barbara County Fire Department, Montecito Fire, and the US Forest Service.
•A large animal evacuation center has been established at the Earl Warren Showgrounds in Santa Barbara.
•A small animal evacuation shelter has been established by the Humane Society on Overpass Road. For more information call 681-4332.

Monday, December 1, 2008

Building an Internet Bridge - Part 4

Creating Community Technology Centers which ensure Internet Access for the Community, including low-income families, seniors and rural area folks.

We have been discussing the Framework which RAIN Network was establishing in the early 1990's to help define the National development of Community oriented Internet Networks.

That first Framework for Community Internet was made of these parts:

•Services to Small Farms, (early Ag-Tourism efforts, Small Farm online marketing, Permaculture and Sustainable Agriculture teaching and support as well as use of our GIS system for land, water, and crop management.)

•Services to community non-profits and community government

•Distance learning services for public schools, charter schools and home schools

•Telemedicine services for rural and chronically underserved urban seniors, families, and youth.

•Services to community Small Business to build new e-commerce skills

•Community Technology Literacy Skills development

•Services to non-English language speaking community residents

To help make these services available and understood in the Community RAIN Internet hosted technology skills classes and provided online access at Farmers Markets, Schools and Senior Centers using the Network’s web site and for on-site classes we used RAIN's Internet Bus. The Internet Bus was developed through USDA funding, designed to provide a mobile Computer learning lab with solar panels on the roof of the bus providing power and a satellite dish on the roof providing Internet connectivity.

The idea was to have a local Community Technology Lab and a mobile Tech Lab that could get out to those in our Community who did not have transportation to get to the Lab.

For 12 years, from 1994 to 2006, RAIN’s Community Technology Center in Santa Barbara, California, U.S., provided a model for other communities to follow in setting up an effective, well used Community Technology Learning Lab, library and meeting place. The Santa Barbara Tech Lab was used by over 500 non-profit organizations, over 2000 local small businesses as well as by families, teaches, seniors and youth, as a place to come to get online, to learn about the Internet and build Technology Literacy Skills. The Santa Barbara RAIN Community Internet Lab was the Training Lab for Teachers, Physicians, Small Business owners, seniors and students.

Community Technology Centers are as important to every town and city as Public Libraries are. They provide a place where low income families, seniors, youth, (basically, anyone in the community who needs it) can come for free Internet Access and regular Technology Literacy Skills classes.

The Community Tech Centers are as important for the growth of American Technology as access to adequate bandwidth for rural areas. They ensure that the Internet becomes something regular folks understand. It is important to remember that each Community Technology Center in the United States, Mexico, South America and Europe represents a point of Free Access for members of the community who might not otherwise have that access.

Here is a bit of history:

In the mid-1980’s RAIN Community Network was formed as a BBS system designed to link Santa Barbara's public library, city hall, community non-profits and small business and small farmers together.

Up until 1990 our main conversations with other Network developers were primarily about the issue of “user interface”. Early work with BBS systems and early Internet tools like Gopher did not provide what was needed. The “Network” or as it was to become the “Internet” was not the main point of discussion.

There was a need to resolve the human to network server interface and get a Framework established for putting education, health, local government and non-profit agency as well as business information online in the most accessible way.

When we decided to move from the University, (UCSB), out into the Community there was suddenly a great deal of conversation and cause for meetings regarding the new issue “should the Internet bandwidth be given over to the public?, (that is a curious thought today, isn't it). Many in the Academic community felt the Network should be kept for research and academic use only.

We had argued that the Community at large had as much use for the bandwidth for health, education, business and local government as the University did. We were lucky. Then State Senator Jack O’Connell was very supportive of the early efforts to build this new technology into the Community. Ultimately, when we began the first of what would be 5 USDA Rural Distance Learning and Telemedicine grant projects that would take our Network model out to 150 rural communities in California and the Southwest. State Senator O'Connell and Congresswoman Capps continued to be a strong supporters of the Community Internet Network as a necessary part of our Nation's larger Technology growth.

Things have changed a lot since then. The Internet is now very much Private Enterprise. Back then there was a feeling that it was a “Public Utility”, something created through Government funding that should remain a resource for the Public.

But back in 1989/90, we sat in the most remarkable meetings with professors, administrators and government representatives while the issue of "public use of the Network" was discussed. In the end, we took RAIN Community Internet out into the community starting up a Hub at the Santa Barbara Unitarian Church where we made our first two hundred 2400kbps baud modems active in 1991.

As the Internet becomes more and more an Internet with management and control shared between many Countries, it is important to recall what some of the original goals and expectations were. Should management of the Network remain with the United States or should the United Nations be made responsible for management of this Global Resource or should the responsibility go to each Country on a revolving schedule?

In our next blog we'll discuss our most recent work with rural community connectivity, telemedicine and Public Internet Video broadcasting.