September 25, 2009

Japanese Company Develops Mobile Phone Using Surplus Wood

NTT DOCOMO, a Tokyo, Japan-based mobile operator and provider of advanced mobile services, announced "it has developed the mobile phone prototype made with the surplus wood of trees culled during thinning operations to maintain healthy forests." The TOUCH WOOD, the prototype's body is made from cypress wood, making it resistent to water, insects, and mildew, which is a result of "three-demensional compression molding developed by Olympus Corporation. Conventional natural wood is not suitable for use as mobile phone bodies because they tend to wear out quickly." According to the press release dated September 24, 2009, "The prototype was created in collaboration with Sharp Corporation, Olympus Corporation and 'more trees,' a reforestation project founded by musician Ryuichi Sakamoto and others." (PHOTO ABOVE: TOUCH WOOD mockup featuring ergonomic design; PHOTO BELOW: TOUCH WOOD prototype based on existing SH-04A model)

Made from surplus wood of trees culled during forest-thinning operations, "each TOUCH WOOD handset features its own distinctive grain patterns and natural coloring. No artificial colors or paints are used, so the cypress retains its original natural appearance and aroma. The wood also has an attractive shine that is created during the compression process."

NTT DOCOMO further explains, "This new commercial use for thinned wood, which traditionally has only limited applications, helps to preserve other wood resources while strengthening the health of overgrown forests. So far, TOUCH WOOD production has used wood culled from the Shimanto forest in Japan's Kochi Prefecture. The forest is managed by the more trees project."

September 22, 2009

Workshop Focuses on Mobile Innovations in Developing World

Via webcast, I attended a workshop, "Mobile Innovations for Social and Economic Transformation," organized by the World Bank e-Development Thematic Group (e-TG), whose mission is to "promote the efficient use of ICT in development and World Bank operations by facilitating knowledge sharing on good practices in e-development, and an ongoing dialogue amongst a large and diverse community of practitioners." e-TG said the aim of this event was "to raise awareness of the transformational role mobile technologies can play in improving service delivery, efficiency and transparency by show-casing mobile-enabled innovations in a number of sectors and identifying emerging lessons learned and ways to scale up for achieving operational efficiencies and development impact." (Photo courtesy of Mobiles for Malawi)

This workshop addressed essential topics such as the mobile innovations in financial services, health, education, and governance, and mobile applications in agriculture and rural development. A detailed summary of the presentations may be found on's blog. (I understand that Florian Sturm of was providing the summary remotely from an Internet cafe in Ghana. Thank you, Florian.)

While the workshop covered a variety of topics, there were a few common conclusions. Although the capacity to utilize mobile broadband may be cost prohibitive in certain markets, mobile technology is a sustainable solution to educating people, providing medical diagnosis and increasing access to medical treatments, and developing an e-commerce solution to access financial capital and facilitate private sector development. Many of the presentations suggested increased investments to teach people the skills necessary to use and capitalize on the benefits of mobile technology and build the technological capacity required for a vastly expanding marketplace. As human and system capacity grows, the cost of mobile content delivery and devices required to utilize the content will continue to drop. In my opinion, developing nations must continue to deregulate the telecom sector and encourage private sector development including fair and equitable private-public partnerships.

The presenters agreed that the technology currently exists for mobile solutions, but there must be a focus on developing applications and refining business models. Although several successful projects were presented, there were general complaints that often such projects do not bypass the "pilot" stage and accordingly, do not achieve sustainability. Project scalability is another challenge people are encountering in implementing mobile solutions. According to the presentations and subsequent audience questions, impact evaluations and information sharing on project failures can help overcome these problems. Lastly, there is a need to further develop private-public partnerships and identifying viable and committed partners for implementing mobile solutions.

As the Internet has become a regular component to the daily lives of people living in developed countries, a digital divide has grown wide for those living in developing nations. However, over the past few years, I have seen innovative solutions to bridging the digital divide in the world’s most undeveloped nations. While there continues to be challenges in scalability, mobile technologies have and will continue to provide sustainable solutions. I commend the World Bank e-Development Thematic Group for organizing this relevant and informative workshop.

September 14, 2009

Electronic Medical Records in Clinical and Forensic Practice: A New Pandora’s Box?

By Jonathan A. Dudek, Ph.D.

Editor's Note: This post is part of a series that addresses the opportunities and challenges of using technological innovation in health care management and electronic health records.

In August, 2009, the U.S. Government announced that $1.2 million in grants would be provided to help hospitals and healthcare providers implement and use electronic medical records (EMRs), to include a system to facilitate the exchange of this information. The benefits of this technology have been well outlined in previous blog entries, such as permitting immediate access to records during a crisis, empowering the patient, and allowing family members to both monitor and assist with a loved one’s medical care. However, the use of EMRs raises a host of clinical, legal, human capital, and even criminal justice issues warranting thoughtful attention and caution.

In medical and psychological practice, there is a morass of applicable federal and state laws governing various aspects of personal health information, such as the Health Insurance Portability and Accountability Act (HIPAA; addressing the disclosure, protection, and electronic transaction of confidential patient information), the Americans with Disabilities Act (ADA; prohibiting discrimination against persons with disabilities with respect to employment practices), and state laws regarding confidentiality and doctor-patient privilege and exceptions thereof. In the latter regard, physicians, licensed psychologists, and other healthcare professionals are bound ethically and legally to keep a patient's healthcare information confidential, although there are exceptions, (e.g., when obtaining insurance reimbursement or when there is a duty to protect a third party threatened by a patient). In a legal context, the patient holds the so-called privilege (his or her right to prevent the clinician from disclosing this information in legal proceedings). Healthcare personnel will, in most cases, release confidential healthcare information only with the patient’s written consent. A critical question is who actually “owns” the information contained in EMRs. Is it the patient, their healthcare provider, their insurance company, the owner of the information management system, or some combination of these? How does this impact the laws governing confidentiality and privilege?

With respect to psychological records, licensed psychologists are required to maintain records in accordance with federal and state laws and professional ethics. They are also ethically and legally bound to protect proprietary psychological test information. Such testing data, when shared, is typically provided to another professional who is trained to understand and interpret the information. Providing such information directly to a patient, examinee, or defendant may be clinically (as well as ethically and legally) contraindicated because this data could be easily misinterpreted and even traumatic. Some specific personal healthcare information (e.g., HIV status and alcohol and drug abuse treatment information) may have special protection under state and/or federal statutes. How will such data be safeguarded electronically, to include accommodating variations among state laws with respect to releasing this information? Will patients have complete access to their medical records in this regard? Who is liable if proprietary information becomes part of an EMR? How will the use of EMRs impact psychologists' tangible record-keeping requirements?

Clearly, as has been observed, safeguards must be in place to protect information contained in EMRs, but the presence of confidential, personal data in an accessible, electronic format, in-and-of-itself, seems problematic. With such global transparency, who has access to this data (e.g., in a medical office, insurance company, data management center, etc.)? Are their different levels of access? Who makes these decisions? There is always the potential for unauthorized access to EMRs, to include identity theft, sabotage, and other forms of cybercrime, such as cyberextortion (e.g., threatening to release embarrassing patient information unless a ransom is paid). There is also an increased potential for external and internal healthcare fraud. An internal case of fraud would involve, for instance, an insurance company employee fabricating and/or altering claim information so that it is paid for personal gain, for a friend or relative filing the claim, etc. An external case of fraud would involve direct collaboration with a medical provider on the "outside," altering claims (e.g., making inappropriate claims appear legitimate, embellishing a claim to increase the amount paid by the insurance company, etc.) for illicit profit.

The use of electronic medical records further raises a host of legal and psycholegal questions. For instance, when processing a "first report of injury," an insurance company may scan a medical document after which it is codified into an electronic format. Employees then examine the scanned document, extract relevant data germane to the claim, and enter this information into an electronic record. There may be restrictions on the number of characters allowed in any given data entry field, so, inevitably, the data is summarized, shortened, etc. As such, the original information is modified while other important information may be omitted. From a legal standpoint, this altering of the original document as well as the potential for error in extrapolating information creates a real potential for heresay (in this case, written statements created by a party outside of a court of law or other legal jurisdiction who is therefore not present in the respective legal setting to make these assertions under oath while also being subjected to cross-examination). Heresay is generally excluded as evidence in U.S. courts, although there are exceptions (see the Federal Rules of Evidence).

In forensic psychological work, the "Devil's often in the details," and the use of EMRs has implications in this regard. During a recent pre-employment evaluation for a police department client, pursuant to a signed release of information from the examinee, I obtained a set of electronic medical records for review. The printed documents were extremely choppy to read to the point of being almost useless. Extraneous and "canned" data fields and descriptions were provided, making interpretation difficult along with the real possibility of drawing invalid conclusions. In essence, one may be creating heresay from heresay. In a courtroom setting, these mistakes would inevitably be drawn out during cross-examination. In such instances, forensic examiners might extract data they could understand and incorporate ethically while being at risk for omitting useful or even critical data. The latter problem is confounded given the time constraints inherent in such evaluations as well as the real difficulty of pursuing due diligence with an out-of-state medical facility (e.g., tracking down the actual provider who entered the data into the electronic record). Recently, a physician informed me about the negative impact of electronic medical records on her busy practice, having to now peruse volumes of irrelevant and poorly organized medical data (again, attributable to the software utilized) to find the same information that was better organized, more clearly written, and more easily retrieved in a written file. She now wastes considerable time reviewing charts. Clearly, such limitations could impact a provider's overall time spent with patients, increase stress, and, most significantly, increase the likelihood of error (e.g., missing critical information during a chart review). Given the sensitive nature of the stored data and the numerous, aforementioned concerns, EMR software producers should be expected, if not required, to maintain the highest quality standards.

The introduction of electronic medical records also impacts the "human side" of medical practice. My internist's medical group recently made the switch, and during appointments I have noted multiple effects of concern. First of all, errors and omissions were made in my EMR during the conversion from printed records to electronic format. Had I not noticed these while being interviewed by a nurse, it is questionable whether or not they ever would have been rectified. More significantly has been the negative impact on the doctor-patient relationship. Nurses and physicians alike now tote laptop computers and, understandably, are preoccupied with the accuracy of data entry and asking mandated prompts, resulting in an awkward conversation while looking at the machine. My physician - a wonderful, empathic person embodying the best qualities of the profession - now seems circumscribed by the dictates of computer software. In making the switch to EMR , the programmers have introduced an elephant into the examining room. Losing the critical bond between doctor and patient because of this new technology would be a travesty; the challenge lies in modifying the technology and/or its application so as to preserve this relationship. To maintain the status quo would seemingly continue a sea change toward McMedicine.

In summary, despite the best of intentions, the creation of electronic medical records has inadvertently opened a new Pandora's Box. The introduction of EMRs impacts the doctor-patient relationship; raises significant questions about the confidentiality, ownership of, and access to these records; creates the potential for a host of related criminal activities (e.g., healthcare fraud, identity theft, and cybercrime); raises questions about the accuracy and interpretation of recorded electronic information, to include its admissibility in court; and unnecessarily complicates the responsibilities of healthcare personnel who must read and interpret sometimes cumbersome and, possibly, inaccurate electronic records, increasing the likelihood for further human error and related liability. Software designers, legislators, and jurists would be well advised to consider these real human and legal implications.

Jonathan A. Dudek, Ph.D. is a forensic psychologist with a national security and law enforcement background. He maintains an international consulting practice assisting developing countries, corporations, and other public and private sector entities with business and program development; human capital and systems-based risk management, risk mitigation, and problem-solving; identifying strategic opportunities; and forensic and investigative consultation. Dr. Dudek may be contacted at The opinions expressed in this commentary are solely those of Dr. Dudek.

September 12, 2009

Mobile Phones and Applications Become More Prevalent in Law Enforcement and Investigative Services

This blog often addresses the opportunities mobile applications create in various sectors such as economic and trade development, telemedicine, and education. Mobile phones and applications are also used investigative services and law enforcement. Sprint Nextel recently announced that the Overland Park, Kansas-based company is collaborating with US Investigations Services, Inc. (USIS) in developing smartphones and applications that help Falls Church, Virginia-based USIS conduct background investigations for the federal government.

According to Sprint's press release dated September 2, 2009, "USIS is the largest commercial provider of security investigation services to the federal government, a leading provider of global commercial employment and drug screening solutions, and a top provider of information services to the insurance industry. Partnering with Sprint, USIS supplies its field staff with Treo™ PRO by Palm® smartphones as part of a program dubbed 'iCompass' to increase efficiencies in coordinating case work in a real-time environment."

In explaining the value of using smartphones for investigative services, Bill Mixon, Chief Executive Officer for USIS, said, "Not only does the Treo PRO streamline the investigative work conducted on our current contracts, it lays the groundwork for future opportunities. Functions like production control and master scheduling give USIS a tangible advantage when handling its varied contracts. This device provides a single interface for existing case management tools and is scalable for growth."

Another example of using mobile phones in law enforcement may be found within the Baltimore, Maryland Police Department. Ben Nuckols of the Associated Press wrote an article explaining that Baltimore's police department will become one of the first agencies in the nation to issue every patrol officer a BlackBerry that allows for instant warrant checks."

The city's police department will use $3.5 million provided by the federal stimulus to purchase 2,000 BlackBerries, known as "Pocket Cops." According to Mr. Nuckols' article, "The devices allow officers to run warrants, check vehicle registrations, and pull up criminal histories and suspect photos." The objective of using the Pocket Cop is to get officers to be more efficient and spend more time outside of their cars. Baltimore Police Commissioner Frederick H. Bealefeld III said, "In the last 15 years in domestic law enforcement, we've trained cops around their vehicle. We've made their vehicle their mobile office. Except that now, they don't leave the office. This Pocket Cop will help move them away from that car and break that tether." Getting police officers to be more mobile outside of their cars will help "repair relationships with residents of the city's poorest and most dangerous neighborhoods, who are often reluctant to cooperate with police."

Already using 100 Pocket Cops, the Baltimore Police Department said, according to the AP article, "the 2,000 additional devices should be enough to equip every regular patrol officer with one, police said. There are more than 3,000 officers in the department. Early reviews for the devices have been positive. Officers using Pocket Cops made twice as many arrests over a 3-month period than those equipped with radios or laptops, according to statistics provided by the department. They also hauled in more offenders on outstanding warrants."

Furthermore, the BlackBerry devices will allow officers the ability to pull up photos of wanted individuals, which make it easier to obtain suspect descriptions and confirm identities should a suspect provide a false identification. Sgt. Shawn Edwards of the department's Violent Crime Impact Division said, "In several instances, it's been great with just identifying people."

Pocket Cops will also allow the City of Baltimore to save money. With an annual service plan, the purchase price of a BlackBerry is $1,700, Mr. Nuckols writes, "compared with $7,800 to install a laptop computer and software in a police car, city officials said. BlackBerries, which are made by Research in Motion Ltd., are likely to take the place of computers for officers who don't have them in their cars, and laptops may not be replaced after they become obsolete, Bealefeld said. The devices are also equipped with global positioning software that will allow commanders to pinpoint exactly where officers are."

September 8, 2009

Nokia Money Increases Accessibility of Mobile Financial Services

On August 26, 2009, Nokia introduced "a new mobile financial service offering consumers with mobile device access to basic financial services." Through Nokia Money, many consumers in developing and emerging markets will have access to such financial services for the first time. Services such as Nokia Money are essential since gaining access to financial services is a significant problem for individuals and small and medium-sized enterprises (SMEs) in developing nations. Mobile devices will improve the access of mobile financial services for individuals through money transfer services, which will give consumers a sense of empowerment. SMEs will benefit by improving inventory control, paying vendors electronically rather than mailing or hand-delivering payments, which is not a productive use of time, and gaining improved access to financial services necessary to meet the needs of business growth.

The Finland-based company explains that "Nokia Money has been designed to be as simple and convenient as making a voice call or sending an SMS. It will enable consumers to send money to another person just by using the person's mobile phone number, as well as to pay merchants for goods and services, pay their utility bills, or recharge their prepaid SIM cards (SIM top-up). The services can be accessed 24 hours a day from anywhere, meaning savings in travel costs and time. Nokia is building a wide network of Nokia Money agents, where consumers can deposit money in or withdraw cash from their accounts."

Mary McDowell, Executive Vice President and Chief Development Officer, Nokia says that "with more than 4 billion mobile phone users and only 1.6 billion bank accounts, global demand for access to financial services presents a strong opportunity to combine mobile devices with simple but powerful financial services such as Nokia Money." Nokia is capitalizing on a great opportunity to increase its market share in mobile devices by providing an essential service desired by consumers worldwide. "Mobile payments will be the next step for delivering financial services to hundreds of millions of people, both urban and rural, who are underserved by existing payment means, especially in emerging economies."

The mobile telecommunications company's press release further explains, "The Nokia Money service will be operated in cooperation with Obopay, a leader in developing global mobile payment solutions, which Nokia invested in earlier this year. The service is based on Obopay's mobile payment platform, with unique and newly developed mobile elements. Nokia intends the service to be open and interoperable with other payment services as well."

Nokia Money was created through a collaboration of different partners in different markets around the world. "It is designed to work in partnership with mobile network operators and financial institutions, involving distributors and merchants in a dynamic ecosystem to seamlessly provide the new services." The Nokia Money service was shown for the first time at Nokia World on September 2-3, 2009 in Stuttgart, Germany, and the service will be gradually implemented in select markets in early 2010.