Bootstrap Institute logo Doug Engelbart's
   Colloquium at Stanford
An In-Depth Look at "The Unfinished Revolution"
Session 1
State of health service
Patricia Rush, MD
video clip. 1.*

Hi. I'm Pat Rush. I'm a physician in Chicago. And, I'm going to talk about some of the urgent and complex problems that are facing health care today. I'm a geriatrician and a primary care physician and I feel that there are many problems in health and health care that could benefit from the bootstrapping approach of Doug Engelbart and the Bootstrap Institute. 2

One of the most critical problems facing all of us, health care providers and patients, is the emergence of new and drug-resistant infectious diseases in the world. This has been identified as one of the top 15 problems facing us going into the 21st century. Great progress has been made in the fight against infections and infectious disease. And, in many ways, up until the past few years, we were lulled into a false sense of security. Infectious disease still kills more persons than any other disease and causes more pain and suffering worldwide. Previously unknown infectious diseases are emerging at an unprecedented rate. Over 20 new infectious diseases have emerged in the past 30 years including the ebola virus, the HIV viruses which cause AIDS, and hepatitis C. For most of these diseases, there is no treatment, no cure, and no vaccine. Meanwhile, in developed countries, we're also facing an emergence of micro-organisms that are resistant to antibiotics. These include common bacteria that all humans are exposed to, like staphylococcus and enterococcus. And, also, to more rare organisms, or organisms that were considered rare 20 years ago: tuberculosis, gonorrhea, and malaria, which is now emerging as a problem in the United States. Meanwhile, also, rare diseases, deadly diseases -- like bubonic plague and small pox -- are felt to be at risk of emerging on a global basis. These problems affect developed and undeveloped nations worldwide. 3

What is going on here? We have to ask ourselves, as scientists, how did this happen? Twenty years ago, we were claiming that we had conquered many infectious diseases and felt that we had removed the risk of infection worldwide. We understand now that we had incomplete knowledge and were somewhat naïve in understanding what causes infectious disease. We were equally naïve and incomplete in our understanding of what cures infectious disease. So, basically we have to go back to baseline and figure out how we're going to approach this going forward. This is an urgent and complex problem. 4

One thing we know for sure is, we cannot proceed as we have been. The micro-organisms are able to outsmart us faster than we're able to develop new antibiotics that can eradicate disease. So, we need a new approach; we need a global approach. I believe that this is a perfect problem to which to apply the bootstrapping technology developed by Doug Engelbart and the Bootstrap Alliance. Already, the World Health Organization and the U.S. Centers for Disease Control have established a worldwide network, although I don't believe it's considered, at this point, a network improvement community as you will hear Doug talk about. What the network improvement community could do is not only to outline the problem, but to explicitly look at what technology we do have, what knowledge we don't have, and how to improve our improvement process. This could lead to a readily accessible, dynamic knowledge repository, ever changing, ever growing, as our information and knowledge increases. Clearly,  because we are internationally interdependent, we will also need international co-operation. Within nations we will need co-operation of the public, not-for-profit and for-profit sectors -- including government agencies, public health officials, health care providers, pharmaceutical companies, and even all of us at home who chose to use, or not use, antibiotics or other kinds of cleaning materials that may, in fact, be adding to the problem of antibiotic resistance. This is an urgent and complex problem, and something, I feel, could be greatly helped through widespread adoption of the bootstrap technology. 5

[<] principal lecture]




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