Evaluating diverse electronic consultation programs with a common framework.

BackgroundElectronic consultation is an emerging mode of specialty care delivery that allows primary care providers and their patients to obtain specialist expertise without an in-person visit. While studies of individual programs have demonstrated benefits related to timely access to specialty care, electronic consultation programs have not achieved widespread use in the United States. The lack of common evaluation metrics across health systems and concerns related to the generalizability of existing evaluation efforts may be hampering further growth. We sought to identify gaps in knowledge related to the implementation of electronic consultation programs and develop a set of shared evaluation measures to promote further diffusion.MethodsUsing a case study approach, we apply the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) and the Quadruple Aim frameworks of evaluation to examine electronic consultation implementation across diverse delivery systems. Data are from 4 early adopter healthcare delivery systems (San Francisco Health Network, Mayo Clinic, Veterans Administration, Champlain Local Health Integration Network) that represent varied organizational structures, care for different patient populations, and have well-established multi-specialty electronic consultation programs. Data sources include published and unpublished quantitative data from each electronic consultation database and qualitative data from systems' end-users.ResultsOrganizational drivers of electronic consultation implementation were similar across the systems (challenges with timely and/or efficient access to specialty care), though unique system-level facilitators and barriers influenced reach, adoption and design. Effectiveness of implementation was consistent, with improved patient access to timely, perceived high-quality specialty expertise with few negative consequences, garnering high satisfaction among end-users. Data about patient-specific clinical outcomes are lacking, as are policies that provide guidance on the legal implications of electronic consultation and ideal remuneration strategies.ConclusionA core set of effectiveness and implementation metrics rooted in the Quadruple Aim may promote data-driven improvements and further diffusion of successful electronic consultation programs

Maintenance and Continued Development of the IISTPS Transportation Information System, TRANSWEB, MTI Report 99-01

The Norman Y. Mineta International Institute for Surface Transportation Policy Studies (IISTPS) at San José State University (SJSU) conducted this project to maintain and continue development of a transportation information system entitled TransWeb . The project elements included: 1) the maintenance and continued development of a World Wide Web site for IISTPS (TransWeb); 2) development and maintenance of a library resource database; and 3) a survey of transportation professionals, primarily in California, regarding their use of the Internet and TransWeb. Site statistics reported here show the extent to which the transportation community uses TransWeb. Standard maintenance procedures are employed, including a weekly review and update by student assistants. The report’s conclusions and recommendations focus on continued maintenance and updating of equipment, features and content to reflect the growing importance of World Wide Web for transportation professionals, researchers, and students

Green roof - understanding their benefits for Australia

Summary of Actions Towards Sustainable Outcomes Environmental Issues / Principal Impacts The increased growth of cities is intensifying its impact on people and the environment through: • increased use of energy for the heating and cooling of more buildings, leading to urban heat islands and more greenhouse gas emissions • increased amount of hard surfaces contributing to higher temperatures in cities and more stormwater runoff • degraded air quality and noise impact • reduced urban biodiversity • compromised health and general well-being of people Basic Strategies In many design situations boundaries and constraints limit the application of cutting EDGe actions. In these circumstances designers should at least consider the following: • Consider green roofs early in the design process in consultation with all stakeholders to enable maximised integration with building systems and to mitigate building cost (avoid constructing as a retrofit). • Design of the green roof as part of a building’s structural, mechanical and hydraulic systems could lead to structural efficiency, the ability to optimise cooling benefits and better integrated water recycling systems. • Inform the selection of the type of green roof by considering its function, for example designing for social activity, required maintenance/access regime, recycling of water or habitat regeneration or a combination of uses. • Evaluate existing surroundings to determine possible links to the natural environment and choice of vegetation for the green roof with availability of local plant supply and expertise. Cutting EDGe Strategies • Create green roofs to contribute positively to the environment through reduced urban heat island effect and building temperatures, to improved stormwater quality, increased natural habitats, provision of social spaces and opportunity for increased local food supply. • Maximise solar panel efficiency by incorporating with design of green roof. • Integrate multiple functions for a single green roof such as grey water recycling, food production, more bio-diverse plantings, air quality improvement and provision of delightful spaces for social interaction. Synergies & references • BEDP Environment Design Guide DES 53: Roof and Facade Gardens GEN 4: Positive Development – designing for Net Positive Impacts TEC 26: Living Walls - a way to green the built environment • Green Roofs Australia: www.greenroofs.wordpress.com • International Green Roof Association: www.igra-world.com • Green Roofs for Healthy Cities (USA): www.greenroofs.org • Centre for Urban Greenery and Ecology (Singapore): http://research.cuge.com.s

IHO S-100: The New Hydrographic Geospatial Standard for Marine Data and Information

The International Hydrographic Organization (IHO) is an intergovernmental consultative and technical organization established in 1921 to support the safety of navigation, and to contribute to the protection of the marine environment. One of its primary roles is to establish and maintain appropriate standards to assist in the proper and efficient use of hydrographic data and information. This paper describes the new IHO Geospatial Standard for Hydrographic Data to be known as S-100, together with the Geospatial Information Infrastructure (GII) that is in the course of development and implementation by the IHO. In both cases, details have yet to be finalised – for example, the first draft of S-100 – IHO Geospatial Standard for Hydrographic Data was only released for stakeholder comment in March 2008 and S-100 is not expected to be an active standard until at least 2009 or 2010. Nevertheless, the concepts and supporting organisational framework behind the GII are already beginning to take shape. The purpose of this paper is to draw attention to what is happening and thereby promote comment and the active involvement of both existing and potential stakeholders in the development and implementation of both the IHO GII and S-100

US Navy program in small cryocoolers

A Navy program to develop fractional-watt cryocoolers capable of operating below 10 K is discussed. Several varieties of Stirling coolers were built and are under evaluation. In addition, helium gas compressors designed for use with small, closed cycle Joule-Thomson coolers are under development. An overview of the technical aspects of the program are presented

Establishing a resource center: A guide for organizations supporting community foundations

Maintaining a resource center such as a library is a central tasks of an association to serve its members, though one of the first to be neglected. WINGS-CF commissioned this guide to assist organizations supporting community foundations to review and organize their resource items, and to propose several classification systems / taxonomies

Recording, Documentation, and Information Management for the Conservation of Heritage Places: Guiding Principles

Provides guidance on integrating recording, documentation, and information management of territories, sites, groups of buildings, or monuments into the conservation process; evaluating proposals; consulting specialists; and controlling implementation

Generic Continuity of Operations/Continuity of Government Plan for State-Level Transportation Agencies, Research Report 11-01

The Homeland Security Presidential Directive 20 (HSPD-20) requires all local, state, tribal and territorial government agencies, and private sector owners of critical infrastructure and key resources (CI/KR) to create a Continuity of Operations/Continuity of Government Plan (COOP/COG). There is planning and training guidance for generic transportation agency COOP/COG work, and the Transportation Research Board has offered guidance for transportation organizations. However, the special concerns of the state-level transportation agency’s (State DOT’s) plan development are not included, notably the responsibilities for the entire State Highway System and the responsibility to support specific essential functions related to the State DOT Director’s role in the Governor’s cabinet. There is also no guidance on where the COOP/COG planning and organizing fits into the National Incident Management System (NIMS) at the local or state-level department or agency. This report covers the research conducted to determine how to integrate COOP/COG into the overall NIMS approach to emergency management, including a connection between the emergency operations center (EOC) and the COOP/COG activity. The first section is a presentation of the research and its findings and analysis. The second section provides training for the EOC staff of a state-level transportation agency, using a hybrid model of FEMA’s ICS and ESF approaches, including a complete set of EOC position checklists, and other training support material. The third section provides training for the COOP/COG Branch staff of a state-level transportation agency, including a set of personnel position descriptions for the COOP/COG Branch members

Repository Interface for Overlaid Journal Archives: costs estimates and sustainability issues

The RIOJA project (http://www.ucl.ac.uk/ls/rioja) investigated the feasibility of an overlay journal model in collaboration with the arXiv and in the scientific domain of astrophysics and cosmology. Scientists in this community are active users of e-prints repositories such as the arXiv. Furthermore, they have the support of Professional Associations and Learned Societies that have been pioneers in adapting to new publishing models and in particular electronic journals. Long term access to information as well as maintaining provision to sustainable systems/services is important to various parties in the scholarly communication system: the creators of information, developers and managers of services, libraries, publishers, funders and also users. Although scientific journals have been in existence since the 18th century (Lawal, 2001), factors such as increased journal subscription prices in the last decades and the emergence of new technologies have triggered discussions on the potential of new business models for publishing research. Furthermore, the advent of the open access movement also contributed to exploration of the issues around free access to information and provision of sustainable services. Exploring aspects of sustainability is something that should be seen over a period of time and whether launching, converting or simply maintaining a new or existing system/service the needs of the community it serves should be taken into account. Scientific journal publishing is a complex process. Besides disseminating scientific knowledge, registration of a claim for new discovery and a quality “stamp” it also facilitates social factors. Besides making research findings available and contributing to the advancement of knowledge, publishing is also a means for measuring quality of the work of scientists, allocating funding, and acknowledging contributions to knowledge. In this report, we will try to provide an overview of a new publishing model, that of the overlay journal. We will discuss the use of the arXiv by scientists in astrophysics and cosmology as well as the role of professional associations and learned societies in the publishing process for this community. We will briefly explain the methods employed to compile this report. We will also briefly present the RIOJA toolkit before we try and identify costs in the publishing process associated with the functions of registration, certification, and awareness and archiving. This report does not aim to provide a comprehensive report of actual journal publishing costings. Despite the fact that there are studies in existence that tried to document costs associated with journal publishing, the information presented there rarely corresponds to the actual costs of individual journal functions. In addition, the interviews with publishers and editors did not reveal any substantial information about costings that have not already been reported in the literature or are available on some publishers' websites. Where appropriate, this report aims to acknowledge studies conducted previously as pointers to further reading and, where applicable, to compare reported findings to observations made during the development and implementation of the RIOJA toolkit (described below). We will conclude this report with some of the issues reported in the literature around sustainability of services and some brief suggestions for further work