torsdag den 11. februar 2010

Om Danmarks første computer - Af Kai Mortensen, tidl. IBM


Jeg har fra Kai Mortensen, pensioneret servicetekniker fra IBM , modtaget denne herlige beskrivelse af SASCO I - og om de første 'rigtige' computere i Danmark:

SASCO I systemet bestod grundlæggende af 2 stk IBM 1410 computere.

Disse var tredje og fjerde IBM 1410 systemer i Danmark,

og blev ikke efterfulgt af flere.

Første og anden IBM 1410 system blev installeret i 1962 hos henholdsvis Dansk Folkeforsikring på Otto Mønsteds Plads og hos den daværende Handelsbanken på Frederiksholms Kanal, begge i København.

Dansk Folkeforsikrings var den første, og blev dengang udråbt som Danmarks første computer.

Den blev hentet på IBM's fabrik i Essonnes ved Paris under megen presseopmærksomhed i en specielt luftaffjedret lastbil, som ikke var almindelige dengang, og som var overmalet med hvad dens last var, og ”Danmarks første Computer”.

Dansk Folkeforsikrings direktør fulgte lastbilen på hele turen i sin egen bil.

Begrundelsen for at kalde den for den første computer var, at den som den første kunne multiplicere og dividere direkte, og ikke blot addere og subtrahere på samme måde som tidligere regnemaskiner, og som også mekaniske regnemaskiner gjorde det.

Om begrundelsen var rigtig, skal jeg lade være usagt, men for commercielle computere passer den formentlig.

Den blev dog næsten omgående overgået af en IBM 7070 hos Datacentralen.

SASCO I systemet blev også bygget på fabrikken i Essonnes, og måtte til formålet udbygget med funktioner til at kommunikere med reservationsterminaler (agentsæt), fjernskrivere og skrivemaskineterminaler.

Begge systemer blev opstillet på fabrikken i 1963, og et større udviklings- og testarbejde på såvel hardware som software blev påbegyndt.

Software blev udviklet af vor kollega fra system engineering, Søren Brandt.

1410-enheden bestod normalt af 4 sammenbyggede skabe, hvoraf det første indeholdt strømforsyningen, og det andet hukommelsen, som kunne være på enten 40K, 80K eller 100K 8-bit tegn. Vi startede med 80, og endte med 100K.

SASCO I systemet måtte imidlertid udvides med et ekstra skab, som blev propfyldt med førnævnte specielt udviklede netværksfunktioner.

For at kunne skifte netværket mellem de to computere blev der også udviklet en speciel omskifterenhed til formålet.

På billedet øverst kan man se, hvordan elektronikken i IBM's 14xx og 70xx systemer så ud dengang. Kortene havde trykte kredsløb på bagsiden, men forbindelsen mellem kortene skete med kobbertråde, som vikledes om de pinde, man ser forneden.

På grund af disse specialiteter var vi fire serviceteknikere fra Danmark, som blev koblet på projektet i december 1963 for at lære systemet at kende, og deltage i arbejdet til det var færdigudviklet omkring maj måned 1964. Foruden undertegnede var det Per Løve, Keld Nielsen og Ole Truelsen.

Det færdige resultat blev herefter transporteret til Danmark, og installeret i Københavns Lufthavn.

På det tidligere publicerede billede af SASCO CENTREt på denne Facebook-gruppe sidder personen til højre i billedet ved betjeningskonsollen til den ene 1410, og modsat ham står konsollen til den anden 1410 med bagsiden til.

Imellem de to konsoller sidder en kollega ved en skrivemaskineterminal med ovennævnte omskifterboks overfor sig.

Længere til venstre ses en række båndstationer, hvoraf de to længst til venstre er papirbåndststioner, som kan læse såvel 5-spors som 8-spors papirbånd.

Desuden havde centret 2 stk IBM 1403 kædeprintere og 2 stk 2540 kort-læser og -huller.

Endelig havde anlægget 2 stk IBM 1301 pladehukommelser. De kom fra USA og var derfor bygget til 60 hertz strøm, så for at klare dette blev 2 stk roterende omformere installeret på loftet over maskinstuen sammen med kølemaskiner m.v.

Teknikken på disse var en videreudvikling af IBM's 305 RAMAC, og i modsætning til denne var 1301 forsynet med et læse- skrivehovede for hver pladeside som vist på fotoet til venstre herunder.

Hver 1301 kunne rumme utrolige 50 millioner 8-bits tegn.

Da udviklingen løb fra 14xx og 70xx systemerne blev IBM's 1410'ere udskiftet med Univac computere til flyreservation.

Venlig hilsen

Kai Mortensen

NB: En gruppe SAS-veteraner har lavet en hjemmeside med deres side af SASCO-historien på http:/www.g-hit.dk/historie.htm


fredag den 5. februar 2010

BIOMETRICS - The Danish Perspective


To day I had the pleasure to participate in the network for Biometrics in Denmark. The network was originally established by Frederik Kortbæk, DeLoitte and others, and todays' meeting had 3 major elements, at status report from the Danish National Police on the biometric passports, a presentation on identity management by Omada, and a user report from the leading architect of the Capital Region, the organisation responsible for hospitals for 1.6 mio inhabitants in the Greater Copenhagen Area.

The representative from the Danish Police was Mrs. Lene Gisselø, a lawyer, presented the status of the bio passport. The passport is based on the EU Directive 2252/2004.

The directive is of course based on the increased focus on terrorism, and demanded the member countries to implement a 2-step strategy, first passports with photos of the card holders, which has always been the case in Denmark, and 2. step due in june 2008 to implement biometric fingerprints as part of the passport. (See the Technology Board report on Biometric Passports - where it is pointed out that also illegal immigration is supposed to be less after the bio passes are introduced. )Denmark is lagging behind the original target date, and in spite of a tender issued 2 years ago and supposed to be closed months ago, is still not signed. The tender called for multiple types of equipment to be used by the municipalities, by the foreign office's representations around the World and by the department for immigrants in Denmark. It was stated that one of the reasons for the delay is the lack of funding, as the preferred vendor was well above the allocated budget.

What wasn't mentioned was that in the meantime 20 municipalities out of the 99 already have established a local workplace to issue not only passports, but also driver's licenses, motor vehicle licenses etc. If the budget discussion drags out much longer, the wisest thing to do will probably be to drop the tender and open a new one based on the experiences with the municipalities.

Lene Gisselø presented all the security features around the Danish passport and pointed out, that even if the holders' picture and fingerprints were stored centrally during a 3-5 week period until the passport was duly delivered to the holder, there would be no centrally stored register on biometrics of the data – 'even if it would have benefitted the police'. The locally captured data is encrypted, the BAC method used to store the photo, and EAC to protect the fingerprint data. Also Lene G. discussed the enormous task of cross-certifying all passports within the European Community.

From the audience a question was raised why the Police didn't choose the 'Match on Card' method for authentication in stead of 'Match off card'. The issue here is that when the border police checks the passport, the passport officer takes a photo of the visitor, takes a digital print of the fingerprint and then let the SW on his workstation extract the data from the passport, convert to some sort of algorithm (which may vary between the countries), and then makes the comparison based on his local algorithm. This means that the data from the passport has to be extracted and at least for some time resides in another computer. The alternative method would be to have a chip residing in the passport with the capacity to perform the comparison without having to extract any data from the passport. Lene G's answer to this question was that is was what met the EU defined standard specifications. This of course raised the question if other countries in Europe were legally prevented from storing biometric data from Danish passports, and the answer to this is, that probably there is no legislation in place to prevent this. For instance UK and Netherlands have active plans to compare the extracted data with the criminal records. The representative from the Data Protection Agency, Janni Christoffersen, pointed out that although the Privacy Officers' forum, the WP29, was looking at these issues, no common agreement has been reached yet. See this excellent book on other outstanding issues regarding use of biometrics, commented buy the WP29.

The question after the presentation remains that one might wonder what will happen to the tender and the selected solution now 12 months after deadline while the World is changing and technology progressing.

The second presentation on Identity Management from OMADA corporation was an OK run down of the issues of ID management, but it clearly showed the lack of standard solutions in a Microsoft world based on Sharepoint, where Omada clearly filled a gap in providing multiple roles access management admin solutions, deploying even Kerberos in a federated security environment, but compared to the solutions offered by for instance the Tivoli portfolio and a Websphere environment, the presentation was not that ground breaking.

The 3rd item of the day was presented by Claus Thorsen, who is the lead enterprise architect from the IT department of the Capital Region. (Region Hovedstaden). This is a merger of 3 former counties, the Island of Bornholm and the city of Copenhagen. They are responsible for the health care and the 12 public hospitals int he region, producing more than 800.000 in take patients pr. year.

Claus' topic was based on the defined need for a single sign on solution for use in the hospitals; One hospital department (Gentofte) claimed, that due to the security regulations, logging on/off, changing workstations, registration of patient data at centrally placed terminals etc. required one additional medical doctor.

Against this, the National Health Domain committee has come to the conclusion, that only 1.2 minute pr. day is waisted because of long log-in procedures.

Claus took us through all the tedious steps required to register patient data, and where he hoped that 'some day' a biometric solution would help. One example is the use of the so-called Medical Card, introduced to increase patient security, so that the doctor checks that the right patient is getting the prescribed medicine. In order to access this application, the doctor is required to use his digital signature issued by the hospital. When he has signed and logged in, he has to make an additional log in using the digital signature to access the Medical Card application. But what happens if the doctor is ill and a substitute has to do the checking? You can't have fast track issuance of official digital signatures, and the result is that the doctor's from time to time borrow each other's digital signature. And this is only one example.

The most promising solution at this stage is to use virtual desktops, so that the desktop of each doctor remains 'active' in a sort of private cloud, so that it is much faster to check in at another terminal later. The Virtual Desktop Infrastructure is one possibility, but the enormous variation in clients and PC-equipment makes is complicated and difficult to implement this at a large scale.

So the biometric solution to assist in an almost-automatic sign on, could be helpful. But so far the conclusion is that you cannot just have one biometric solution: In the operations theatre you need to wear a mask, hence you can't use face recognition. If you wear glasses, Iris recognition is a problem, and if you want to avoid congestion, fingerprint readers (and even keyboards) are doubtful. As Claus put it: The problem is, that we are users, we are many , and we are poor!

The long range solution is probably a combination of RFID active tags and biometrics, but it remains to be seen if this can be implemented in a practical way. Yet the Region intends to start a number of pilot projects, because the problem is real – the workload around log in/log out is simply too heavy – either it takes too long time, or the doctors and nurses are cheating to ensure quality of patient treatment.

To this statement Janne Christoffersen from the Data Security Agency pointed out, that the privacy legislation 'definitely has no intention to be a problem for daily operations, as it only required, that the doctors and nurses only has access to the data, that are necessary!'

'This is exactly the issue,' Claus Thorsen declared, 'For who knows what data are necessary? Take use of Antabuse! If this is an information that is not revealed to the Doctor, the patient might be seriously mistreated!' This seems to be a very central point in designing an up-to-date privacy legislation, that ensures a more holistic treatment of patients.

The next question, equally central for the discussion, is whether Claus' Region are coordination or cooperating with the other regions, and why this is not a centrally managed development program.

The representative from the Health Domain Steering Group - (Digital Health is an organisation supposed to coordinate anything within the health domain) – claimed that they weren't funded to do this, which again lead us back to the fundamental question on whether the Regions should continue inventing hot water all of them or if the Government should step in and define real areas for centralized solutions.

But a very interesting and down-to-earth real-life presentation with lots of areas where a combination of new technology and use of biometrics might be helpful.

Following this presentation, Ulrich Østergaard from CardLab presented the biometric card that they were trying to introduce in a number of countries. As can be seen from their homesite, this seems to be very promising – the card contains an active RFIOD chip, it has a fingerprint reader, which can be used by the proper owner to turn the card on, and can be equipped with various passwords, digital signatures etc. Looking forward to see some pilot projects based on this idea – and of course combined with proper ID/access management systems on the network.




lørdag den 23. januar 2010

2 days with Chris Potts – Good Bye to IT as we know it!

(Breaking down the wall around IT !)



This week I spent 2 exciting days at one of Chris Potts' seminars on Corporate (IT) Strategy.

It certainly was an eye-opener for me, having lived through all stages of IT since the 360 mainframe.

A few years ago when Enterprise Architecture became the hot topic, we all agreed, that one of the fundamental problems of this world was to align business and business strategy with IT and IT strategy – but all this is nonsense, according to Chris Potts. 'You shouldn't have an IT Budget' was one of initial remarks. But after 2 days I am convinced he's right and that this new approach leads to complete different and much more meaningful business decisions, investments and methods of managing complex portfolio of projects – including projects heavily relying on IT and technology.


However, Chris' point of view is completely different from Nicholas Carr's 'IT Doesn't Matter' kind of approach trying to persuade business managers to spend less on IT, to follow in stead of leading at the 'bleeding edge'. Chris' point is straight forward: As you cannot do anything business wise without deploying 'some' IT and some technology in it's broadest sense, than there is simply no reason in treating IT 'projects' and IT spending as if it is an animal of it's own. What is even worse is, that this tradition has been thriving on the 'IT specialists' that have kept the WE and THEM paradigm in what Chris Pott calls the second generation II era. Fueled by crisis and downturn, the 2. G people are 'cutting down on IT spending' instead of asking the obvious question: What Value do we get for it? Which are the key business investment areas we should be concentrating on and first at this point maybe wonder of technology could be deployed in these areas in a smarter way than to day.


So it is not about cost, it's about value. (Even accountants are beginning to admit this!) IT in itself creates no value – as if we didn't know it, the sinister implication is that the public sector's (IT) projects being launched these days are all being selected according to the strict EU tendering rules focusing on minimizing cost and securing 'delivery' – meaning fulfillment of a development/deployment contract at a specific point in time at a spefic cost – but where is the value of the project?

Chris' observation not only leads to the clear conclusion that the perceived outcome in terms of value of a project not only should be the guiding principle, but that the whole accounting process around project selection and project management is completely wrong:

Any project – and public sector projects in particular – should be selected according to their contribution to value – maybe cost reduction is one of them, but in that case total operational costs. Also transparency could be a very interesting value of a public project as could citizen participation and take-up of eGovernment projects. So the estimated impact on all essential types of value is absolutely meaningful, but ONLY if the project management is measured on how the value of the project is created AFTER it's fulfillment. We are deploying 2. generation project managers maybe skilled in PRINCE 2 to deliver 4. generation solutions deploying web 2.0 technologies and aiming at involving citizens – but we are not measuring it.

One of the latest scandals in Denmark is the project dealing with electronic bonds and real estate registration. According to CSC's project manager 'The IT project is a success – we have a service level of 99.5% availability and we have had that for months!' - but reality is that now it takes anything from 4 to 8 months to register a sale of a real estate. Again – the tendering rules selected the winner of the development project, but didn't in any way measure, secure or include the total costs of the process, let alone found it necessary to manage that real value was actually achieved.

(See this blog: (In Danish) http://it-bizzen.blogspot.com/2007/11/csc-forsinker-hurtig-tinglysning-it.html )


So Chris Potts lesson is that you need to go to the thirds generation thinking: focus on the value people are getting from projects involving IT and employ BUSINESS experts to ensure this – not nerds, npår technical people – not even 'Enterprise Architects' still stuck in the THEM/US thinking.


But Nirvana only comes if you forget IT completely – drop the idea of a specific IT budget, think in terms of business organization and embed the investment and management issues of IT in the proper context.


In summary: From Chris we learned how to make an overall Corporate strategy in one page – with a clear strategic objective, with max 10 basic principles and/our beliefs and max 10 core tactics.

I can clearly recommend this seminar and the thinking behind it to any 2. generation frustrated IT manager or to any forward thinking CEO. If you happen to be employed by the Public Sector, I have to warn you, though: Your politicians are all 2. G, the rules are from last century and the narrow budget thinking is killing many bright ideas. But if you don't try, we might face 'civil unrest' – when the new generations used to web 2.0 technologies demand a decent way of thinking what value the Government is really bringing to the table!

(See also http://www.aeaassociation.org/ )

lørdag den 2. januar 2010

IT History - Fractions from a Journey



On December 30. I had my last working day with IBM. After 39½ years I received a very nice offer, and yet it was a strange feeling trying to summarize all the changes I have lived through since I joined the IBM Denmark company in 1970. It wasn't really my intention to make a career out of it – I graduated as a Master Economist, but I got interested in Data Processing, and decided that the best place to learn more probably was in the department for Operating Systems in IBM. At that time the Disk Operating System (DOS) was being outdated by OS that came in two brands: OS/MFT (Multiprogramming with a fixed number of tasks) and OS/MVT for the REALLY big machines allowing a variable number of transactions concurrently.


The picture here is me in 1970 and the photo was illustrating 'Modern Data Processing' in the Danish encyclopedia. It was a 360/40 – huge machine, 256K memory.

Over the years a lot of rather dramatic changes occurred – both in the way the Company was organized, in technology and in the competitive landscape. I soon got captured by the Government Branch and spent most of my career working with Government in some way, interrupted by assignments in Stockholm organizing and running Sales School and internal Training in mid 70's and handling staff job in the early 1980's and again in the mid 90's.

My first job was with what became one the 4 DP Centers for the Kommunedata organisation, and the first center to work with typewriter terminals to run financial management systems. 5 years before the color screens and the Systems network Architecture was announced. I later become responsible for the entire local Government and Health Care market, which had a fantastic growth in the late 70'es

IBM changed dramatically in the early 80'es – we had been split up in 3 divisions, DP (the Large Customer segment), GB (mid size machine and small and medium customers) and the DCS - the Data center Operations. The split was made to prepare for a split up if a court ruling found IBM guilty in monopolistic behavior, but thanks to the growing competition from Amdahl for the high machines, Memorex and similar for peripheral and Digital for mini computers, IBM avoided to be cut up and instead pooled the resources. Then in 1981 the IBM PC suddenly emerged as a new star – based on standard components bought on the open market it seemed to be the brand name that sold the product. I was asked to organize a group of system engineers and salesmen to conquer the Danish Education and Scientific market for the PC's, and I had the pleasure of interviewing some 300 teachers before hiring 6 of them – with sweaters and hairy faces and everything. Plus a nice lady, a French teacher from a high school. In fact we succeeded in just 4 years, the mantra was that it was not the question of the Hardware but how the software could help the teachers. It worked – and I still recall the first IBM PC we sold with 2 diskette stations, 256K for 7.000 US Dollars (35.000 Danish Kroner). At the end of the 80'es and early 90'es I was responsible for Market Development for the Public Sector (including Post, Defense, Central Government, Tele). At that time it was dawning on IBM's management that the business model had to change and that we had to charge for our skilled Systems Engineers and Networking CE's. The Business Consulting area began to be the hot topic, but my position - together with some of the former Government Branch Managers - was that it was important to marry the consulting skills with deep industrial knowledge. We lost the argument, and the General Business Consultant emerged, later to be split into practices and boosted by the subsequent purchase of Price Waterhouse. (See: Seven Keys to Success )

In the 90'es a new thing emerged – the Internet. Although I already got acquainted with it during my job with the University Sector, it wasn't until around 1994 that it became clear that a new market was emerging; I started a fantastic group of quite young people, creative designer-types and long haired programming freaks plus a couple of deeply engaged old time Systems Engineers. Within just a few years we managed to create first-of-a-kind of websites for Copenhagen City, a number of Danish Companies, plus launched the first secure payment systems on the Internet. And then suddenly – it all became 'pervasive' – which in practice meant that the profit margin for doing websites and similar solutions were coming down, and that the new business model would call for a value chain of Business Partners and IBM withdrawing to delivering the SW platforms and intermediate layers.

So the turn-around of the Company mid to late 90's architected by Lou Gerstner, once again laid to a dramatic change in organization, and started the period of active acquisitions, that Sam Palmisano carried on. As of today, the organization is split in divisions reporting to global or regional managers, and the coordination that is necessary in every major customer engagement handled by a an all-encompassing CRP and accounting system and strict procedures for bidding.

Since the end of the 90'es I have worked internationally as an eGovernment Advisor in a job working with the public sector and the Software group – plus of course a number of dedicated business partners and our GBS people that on and off have supported Public Sector.

This has been an enormousinspiration, has brought me to the Middle East working with the forward thinking Governments in Dubai and Quatar, I have witnessed and supported the Baltic Countries in their quest to outgrow the older parts of Europe, with Iceland, with the Nordic Countries and during the last few years with Greenland and the new Greenland parliament, which I hope to continue as a ppensioner.The dramatic changes in the IT world since 2001 and the rise of the Open Source Community is a trend, that I expect we have only seen the tip off. When Cloud Computing really takes off, the business model for selling Software Licenses will change once again and the new competitive landscape will be different from anything we have seen so far. Google probably aiming to become the next top competitor and Microsoft standing to loose.

And this may be some of the reasons IBM has survived all the turmoil – at least during my 39½ years: We have always been careful to select the battlefield. The competitors we had in the late 70'es were all gone 10 years after; the competitors we had in the 80'es have almost all disappeared, with HP as an exception. And with IBM now launching the Smart Planet approach and going for Software as a service and supporting Open Source, the competitors in 10 years again will be a different crowd. An old IBM'er told me 25 years ago that IBM meant: I'll Be Moved – because the mantra of the company is change.

So I will. And I have promised to start to document IBM Denmark's History. It started January 1. 1950 as a local Danish Operation. It shouldn't be too difficult – after all I have lived through 2/3 of the history myself!


mandag den 30. november 2009

Eurocities Annual General Meeting


Stockholm Nov 25-28

The Eurocities organization that covers a number of the largest and most advanced cities in Europe, last week had their annual general meeting in Stockholm during the Swedish EU Presidency.

The main theme of this year's annual conference was of course focused on the upcoming COP 15 meeting in Copenhagen and the working theme name was 'Urban Challenges – Sustainable Solutions'. (The entire conference is available on line using this link - http://media.fronto.com/streaming/eurocities/091126/Default.aspx – you have to sign in first, but then you are in there, really a nice solution)

The mayor of Stockhom, Steen Nordin (M) welcomed the participants and explained that a large part of the program was dedicated to a number of green projects that participated to Stockholm's nomination as the Green Capital of Europe. Eurocities president, Jozias van Aartsen from Hague likewise expressed the hope that the conference could be a clear sign to the World that as the majority of the global population is now living in cities, the cities themselves are not longer 'just' the problem, but very much important players to solve the global challenges and the global warming in particular, but also the key areas where Eurocities has been active and where 3 awards were due under the headings of 'Innovation',' Participation' and ' Cooperation'.

One of the most interesting and engaging experts on international Health, professor Hans Rosling from Karolinska, then presented a breathtaking tour-de-force of numbers to describe how the World has changed and how all our prejudices dividing the World in 'They' and 'We' were no longer valid.

Look at this shortened version of his speech: http://paulchaffey.blogspot.com/2009/11/hans-rosling-om-utviklingsland-og.html

Under the headline: 'Sustainable Solutions for Business, Science, People and Culture' the conference split up in 9 groups and went on bus tours to study practical experiences and cooperations between Stockholm city and private and public organizations.

For my part I joined the tour to 'World Leading ICT cluster' at Kista, which in fact I have followed from its' early beginning with Ericsson and IBM as the first partners. Now more than 30.000 jobs have been created in more than 200 ICT companies in Kista. Really impressive and a positive experience and clear signs that the crisis is almost over in Sweden.

The other tours were labeledFuture Suburbia' – renewing Järva, a suburb from the 60's built to meet housing shortage and now in need for renovation - 'Teleco

m for green Cities' – a Visit to Ericsson Headquarter also describing the Intelligent Transportation System in Stockholm, where IBM performed the coordinating role – the 'Intelligent Electricity Project' – smart grids, smart electric cars - 'Creative cluster'- sustainable design in an industrial regenerated area - Mobility flows' – showing how the public bus system was converted to Biogas, also descr

ibing the Intelligent Traffic system - 'The Hammarby Model' – Integrated management of Waste, Water and Energy to 'Heating the city' – showing how 80% of the heating comes from

renewable sources and finally 'Low carbon Urban Transport'.

It was a tremendous well organized 2.5 hours extension for everybody and it was really impressive!

The plenum meeting was then led by mr. Ballasteros from the EU commission on the topic of 'the Covenant of the Mayors':

The evening program called for a galla dinner at Stadshuset, in the Blue Hall, where the famous Nobel Price ceremonies take place. The evening called for a reward to the cities that had earlier been presented as nominees for the categories Innovation, Participation and Cooperation.

Winner for the innovation group was the city of Malaga, that had developed an interactive map in 3D to optimize localization of solar energy batteries. Birmingham won the category 'participation' with an interesting project on building an 'eco-village', and finally city of Dortmund won the prize for Cooperation by an impressive, yet low budget project on ' Consultation Circle for Energy Effectiveness and Climate Protection'

Friday morning program was dedicated to 'the Stockholm Appeal':

The mayors of the largest cities in Europe and the United States have co-authored a mutual appeal, "The Stockholm Appeal on Climate Change". The appeal manifests the signatories’ desire for the COP15 meeting in Copenhagen to result in an international climate change agreement.

The US chairman for the US Mayors Goncress, Mrs. Elisabeth Krautz already the day before stressed the dedication from the US cities to back the Stockholm initiative.

The Stockholm Appeal was signed earlier this year by U.S. Conference of Mayors President Seattle (WA) Mayor Greg Nickels, U.S. Conference of Mayors CEO and Executive Director Tom Cochran, Stockholm Mayor Steennnn Nordin, and Mayor of The Hague EUROCITIES President Jozias von Aartsen.

The Appeal was presented to the representatives of the Swedish Presidency of the European Union, as well as the Obama Administration by Mayor Kautz and Mayor Nordin. From this ceremony we have the following citation from the Canadian mayor:

"U.S. mayors proudly stand with our European counterparts in asking international recognition of the role of local leaders in climate protection. At the forefront of creative strategies, U.S. mayors have forced our national government to act to combat climate change. To date, over 1,000 mayors have signed the USCM climate protection agreement pledging to meet or beat Kyoto goals. Mayoral leadership is a major impetus in climate protection," said Mayor Nickels.

The Swedish Deputy Prime Minister, Maud Olofsson and the US Chargé D'Affair in Stockholm, Robert Silverman, underlined the strong intention behind the Stockholm Appeal, and Robert Silvermann declared that his president and the congress this time would do it's utmost to reach a politically binding treaty in Copenhagen on climate warming.

And finally, before the forum reports, Senator John Kerry appeared on video conference to persuade the European audience about the good will of the Congress in Washington, where he was at least partly successful. We are all now very much focused on what will happen in Copenhagen but take it as a good sign that President Obama has declared that he will participate.

Stockholm's Mayor Steen Nordin will hand over the Stockholm Appeal to the UN Conference COP15 in December in Copenhagen.

For the full Wording of the Stockholm Appeal, see this link: http://www.eurocities2009.eu/pages.aspx?page=42


fredag den 23. oktober 2009

Hospitals of the Futurè

An important part of the Danish Prime Ministers future plans deal with the construction of a number of bright, new so-called Super Hospitals. When he addressed the Danish Parliament on his opening speech first Tuesday in October, the amount of 40-50 Billion Dkr (9 – 10 B US $) was mentioned.

In Denmark the Regions are responsible for hospitals, but they have no tax income of their own, so they are completely depending on the Government allocation of funds. So the 5 regions are looking to negotiations with the Government, and as it looks they are treated rather differently; the regions that have been most eager to close down small and inefficient hospitals stand to gain the most.

In any case the question any Dane should put to his regional politicians, now up for re-election in November, is how they see the future of the hospitals. If this is not discussed, I fear the entire discussion will be around the brick-and-mortar investment, and not about the rethinking of the entire health structure as I feel is highly needed – not least in light of the demographic changes we can foresee, including the lack of doctors, nurses, more elderly, more chronic diseases etc.

So where can we find the inspiration needed before these new super tankers are cast in iron?
Normally you would look to US: http://health.usnews.com/articles/health/best-hospitals/2009/07/15/the-high-tech-hospital-of-the-future.html
But US has its own problems and has a highly different tradition than Northern European health systems, where this is an integral part of our welfare system, hence mainly paid for by the tax budgets. (Try to see the notices from the US Commission on the Future of Health Care from 2008:
http://www.fiercehealthcare.com/story/adaptibility-important-future-hospitals/2008-11-21?utm_medium=rss&utm_source=rss&cmp-id=OTC-RSS-FH0 )

There are sources and best-of-breed examples out there that can easily by reached; the web page for DesignIT has a very interesting article of hospitals of the future.
One of the cases that DesignIT describes is the Il Camino Hospital (Silicon Valley, Ca):

”Il Camino Hospital is a completely wireless hospital that is well on its way to becoming paper and film free. The hospital estimates that the new system has saved them 120,000 dollars a year in medical costs and 300,000 dollars a year in avoidable errors.
The hospital’s wireless technology includes:
· Voice-activated communicators: Nurses and doctors use a small voice-controlled, hands-free device that they wear around the neck to communicate with each other. The device is made by Silicon Valley start-up Vocera Communications Inc.
· Biometric supply cabinets: A device that enables authorised personnel to open doors or cupboards for medicine and other medical items by reading a thumbprint.
· Automated laboratory system: Laboratory tests go through various ‘stations’ that together make up an automated production line. Staff calls it ‘race track’. Automisation is made by
· Beckman Coulter Inc.
· Tablet PCs and handhelds: Doctors test small, tablet computers and handhelds devices. In time, these will replace the clipboard. These devices are manufactured by Hewlett-Packard Corp.
But this system would appear to be particularly exposed to terror attack or technical failure – unfortunately key considerations in the future. How will medical staff cope if the system goes down? Will they be able to treat patients? While innovative, this hospital must also be fool proof. Otherwise technology will control people rather than vice versa.”


But we don't need to go to US to find fine examples of forward oriented hospitals: In Glasgow, for instance the Homeopathic Hospital has an interesting, holistic approach that could very well be part of the design principles for Hospitals for next several decades.

In Taiwan, the Chiang Gung memorial hospital with 8.800 beds has a very advanced deployment of RFID for controlling logistics, likewise an important part of the future High Tech Hospital, where the focus is on accountability, quality, saving human resources for the health and care oriented tasks.
Asia seems to be really pushing the uptake of new technology when they plan for future hospitals;
See for instance these award winners Asian hospitals: http://www.hospitalmanagementasia.com/awards/winners.htm . Not so surprisingly, there is a number of Singapore, Taiwan, Philippine references, but China and India is beginning to appear on this list as well.
Construction of hospitals is indeed a hot topic in these mega-countries.

In Sweden, Karolinska Sjukhuset, already a leading Nordic hospital in many specialties, is constructing a new site where the use of microelectronics and Gene technology is being deployed at a World record level. See for instance this description on their use of ICT.
Hospital trends in Europe can be found here: http://www.reportlinker.com/p07613/Hospital-Trends-Europe-2004-2009.html .
Since 2006 IBM has been running a Health Competency/Innovation center for the Latin speaking countries out of Barcelona. The center benefits from cooperation with the Hospital of Barcelona, one of Spain's most modern hospitals.

Each of the hospitals awarded in US, in Asia, being recognized as World leaders, contribute to the picture of the Hospitals of the Future, yet no hospital alone seems to have it all.
Given the pressure from the Climate debate and the mentioned adverse demographics plus not least the current financial crisis, new aspects has to come into the design principles.
And of course IT is going to play a major role. (See this New Scientist Article)

But in line with IBM's recent announcement of the Smart Planet initiative, I recommend that we look at the entire value chain of 'Health' – and not only look at the Hospital and the IT infrastructure: It has to be regarded as it is: A system of systems.
A Hospital is but one (important) station en route from disease to cure, but it doesn’t solve the long range development in human habits: from eating and drinking to travelling and social interaction.

The brick-and-mortar thinking should be replaced by thinking intelligent buildings:
imbedded control of material, light, control of electricity, water, sewage..

Around the hospitals we have a huge logistic task: transporting patients in and out, particularly in light of many more ambulant treatments, but also emergency systems, evacuation plans, logistics for delivery of goods, linen, visitors etc.

And we have the internal communication and collaboration between all the different stakeholders, doctors and nurses,, including admin, records management, knowledge management – and, not to forget: Electronic Patient Records that can be exchanged, distributed and disseminated with full compliance for data protection.

Another subsystem is the flow in and out of highly advanced diagnostic systems, surgery, remote collaboration, robotics. The advanced RFID plus asset management can take care of hospital beds, instruments, (patients), all sorts of critical material.

The final major sub-system is of course the entire process of a patient's engagement, not least how the out-patient services are provided, how collaboration can be obtained between hospitak satff and primary care, between patient and local government social services, including telemedicine and a holistic treatment of cronic patients in their own home, something we have been engaged in in far too many 'pilot projects' – now it is the time to deliver.

Or as Obama has put it: It's time to Change. This is understandable if you look at the status reports from 2008. So we Northern European spoiled citizens must cross our fingers that his medical plan for US comes true, because that would create yet a stronger, global drive to real forward thinking hospitals in the future.