People actually still make websites from scratch? Why not just use a CMS. I think rather than focus on actual content, techies just want to tinker with the code. It's like building/restoring a vintage car rather than just buying a Prius when all you want to do is go from point A to B.
As a veteran traveller I've always wondered why when there's a hiccup, it takes the gate staff so long to find an alternative and what is it that they are busy typing on their keyboard. A typical query like "Is there an earlier flight I can take" is usually answered only after 5 minutes of frantic tapping. What are they typing and why is it so complex when I can pull up Google Flights and find the information in a fraction of that time. This video does a great job of explaining what's going on behind the scenes and how even slick looking booking systems on the front-end are all interacting with ancient command-line based systems on the backend.
The term cobra effect was coined by economist Horst Siebert based on an anecdote of an occurrence in India during British rule. The British government, concerned about the number of venomous cobras in Delhi, offered a bounty for every dead cobra. Initially, this was a successful strategy; large numbers of snakes were killed for the reward. Eventually, however, enterprising people began to breed cobras for the income. When the government became aware of this, the reward program was scrapped. When cobra breeders set their now-worthless snakes free, the wild cobra population further increased.
The malaria RDT costs about $0.25. To be clear this is a screening test - not a diagnostic test. An actual diagnostic would involve taking a small blood sample, smearing on a slide and looking for malaria plasmodium under a microscope. Not expensive but time consuming and requires a microscope and a trained technician.
The SOAP note (an acronym for subjective, objective, assessment, and plan)is a methodology for documenting a patient's condition on first examination by a medical professional. It serves as an excellent cognitive framework for medical professional to assess their patients.
The SOAP Note originated from the early work done by Dr. Lawrence Weed (an American physician, researcher, educator, entrepreneur and author, who is best known for creating the problem-oriented medical record as well as one of the first electronic health records).
SOAP notes are commonly found in Electronic Medical Records as a means to succinctly communicate patient information in a standard format and are particularly useful between hand-offs between medical professionals.
Modern Electronic Health Record (EHR) Systems offer a great deal more in terms of adding additional diagnostic information as well as a longitudinal patient record but the basics SOAP note could prove immensely valuable as we think about how to design a system that can empower Community Health Workers (CHWs).
SOAP Note in Practice (highly simplified for an illustrative example)
Situation: A medical professional encounters an individual who seeks or is identified for medical care
Subjective data collection
Shaking chills
Muscle ache
Fatigue
Objective data collection
Fever of 102 F (suing a Bluetooth connected thermometer or a cell phone camera based temperature detector)
Malaria Rapid Diagnostic Test (RDT) administered - shows positive
Assessment
The Subjective and Objective information is collated in the medical professionals mind and and she assesses that the patient shows indications of Malaria
Plan
Based on the Subjective and Objective and informed by the Assessment, the medical professional develops a Plan that is specific to the situational context - in this case it may involve sending the patient for a confirmatory Malaria confirmatory test or in some cases starting them directly on anti-malarial treatment.
The SOAP note allows a complicated problem to be broken down into components to then become a simple problem. However, in Global Health today, this complicated problem is treated as a complex problem because it is felt that only a doctor with decades of experience and a medical degree would be able to accurately diagnose and treat Malaria.
In The Checklist Manifesto, Atul Gawande wrote that he
...came across two professors who studied the science of complexity, which highlighted three types of problems in the world: the simple, the complicated and the complex. They are defined as:
Simple Problems – “are ones like baking a cake from a mix. There is a recipe. Sometimes there are a few basic techniques to learn. But once these are mastered, following the recipe brings a high likelihood of success.”
Complicated Problems – “are the ones like sending a rocket to the moon. They can sometimes be broken down into a series of simple problems. But there is no straightforward recipe. Success frequently requires multiple people, often multiple teams and specialized expertise. Unanticipated difficulties are frequent. Timing and coordination become serious concerns.”
Complex Problems – “are ones like raising a child. Once you learn how to send a rocket to the moon, you can repeat the process with other rockets and perfect it. One rocket is like another rocket. But not so with raising a child. Every child is unique. Although raising one child may provide experience, it does not guarantee success with the next child. Expertise is valuable but most certainly not sufficient. Indeed, the next child may require an entirely different approach from the previous one. And this brings up another feature of complex problems: their outcomes remain highly uncertain. Yet we all know that it is possible to raise a child well.”
For the longest time medicine has been part of the complex problem set. Doctors (very rightly) are highly trained with a minimum of 4 years of training followed by years of residency. The profession is seen as highly complex where they need to combine their book learning, with hands-on training and decades of experience to diagnose and treat a wide variety of health conditions. However in Low and Middle Income Countries, where doctors are in short supply, can some level of healthcare be provide by applying Artificial Intelligence to the SOAP (Subjective, Objective, Assessment, Plan) Note along with a touch of the Bayesian Priors?