Web-Tools and Public Health Preparedness and Response Tasks

Web-tools as potential assistance to Public Health Preparedness and response tasks.

Abstract Faced with the prospect of natural and man-made emergencies for public health, it is worthwhile to see whether any of the new software tools might help. The new "web-2" tools have changed in a surprising way - they are easier and more fun to use. These tools are often free of charge, require no installation, consume no disk-space, and require no IT-department support -- all of which meet constraints that public health workers have faced in the past. The focus of these new tools is on cost, agility, simplicity, ease-of-use, and collaborative work. This paper reviews what tools are available, and how they might fit into the set of public health tool-box. Finally, training issues and other barriers to adoption are assessed, with an eye to figuring out what University-based Disaster Preparedness centers might do to make this technology legitimate, more accessible, and better utilized.

Outline 1) Introduction 2) What scenarios are we preparing for? 3) Who exactly is "public health" 4) Task Inventory 5) Reality Check - tasks vs. Katrina and 9/11 6) Tool inventory 7) Task/Tool matrix 8) Survey of current tool use 9) Adoption issues / CSCW 10) Conclusions 11) Recommendations for further work 12) references 13) appendices 1) Introduction

A) The number and complexity of non-routine challenges for public health is growing. Large scale emergencies now fall under authority of the Department of Homeland Security and it's National Response Plan

The National Response Plan establishes a comprehensive all-hazards approach to enhance the ability of the United States to manage domestic incidents. The plan incorporates best practices and procedures from incident management disciplines-homeland security, emergency management, law enforcement, firefighting, public works, public health, responder and recovery worker health and safety, emergency medical services, and the private sector-and integrates them into a unified structure. It forms the basis of how the federal government coordinates with state, local, and tribal governments and the private sector during incidents. Source: . http://www.dhs.gov/dhspublic/theme_home2.jsp Copyright(c) 2006 -R. Wade Schuette page 2 of 27 -2

Within DHS, is Health and Human Services (HHS) and other groups, such as the Office of Disaster Preparedness.

Within HHS is the Centers for Disease Control (CDC), which coordinates public health response. The CDC has established a network of 40 "Centers of Preparedness" at universities in the USA, which develop curricula for on-going in-service training of staff who may be involved in emergency preparedness .

The most relevant centers to this author, in Ann Arbor, are

A) Columbia University Mailman School of Public Health (Drs. Irwin Redliner & Stephen Morse) http://www.ncdp.mailman.columbia.edu/program_cphp.htm

B) Johns Hopkins Bloomberg School of Public Health (Dr. Jonathan Links) http://www.jhsph.edu/preparedness/

C) University of Michigan School of Public Health. (Dr. Arnold Monto) http://www.sph.umich.edu/micphp/

These centers are tasked with in-service educational roles and would be the appropriate and expected place for development and deployment of training modules in new software related to public health emergency preparedness.

Follow-up of the concepts in this paper, if any, would probably occur in one of those three sites, two of which the author has some relationship with, and one (Columbia) which seems to be a direction-setter for inventories of competencies.

D) Web-2 - inventory

The last several years have seen explosive growth of a totally new type of web-based software often known as "web-2" which is bi-directional - that is, the users of the web- pages can not only read, but now are now free to write to the page as well and add content. In addition these tools are often free of charge, require no installation, consume no disk-space, and require no IT-department support -- all of which meet constraints that public health workers have faced in the past. The focus of these new tools is on cost, agility, simplicity, ease-of-use, and collaborative work.

E) recap / transition

This paper reviews what tools are available, and how they might fit into the set of public health tasks. Finally, barriers to adoption are assessed, and next steps considered for academic centers that could make appropriate technology more accessible and better utilized. Copyright(c) 2006 -R. Wade Schuette page 3 of 27 -3

2) What scenarios are we preparing for?

A) Basic incidents i) Generally, the scenarios portrayed at DHS or CDC include these: * bullet list (Chemical, biological, radiation, etc.)

ii) The common element is that these emergencies involve envisioned cases in which:

 people's normal agenda and chain-of-command is suspended,  an emergency situation is formally declared,  the first responsibility for public health staff is locate the activated plan, find their immediate role and next task under that plan, and report for duty in the new chain-of-command.  In a large scale emergency, responsibility for tasking shifts to the DHS under the National Response Plan iii) Those common steps comprise the essence of the 9 competencies in Columbia School of Nursing, also described at PHS, consisting of.

B) Extraordinary incidents

The preparedness competencies are incomplete, and do not cover all possible situations. Are we training and preparing for the wrong type of emergency response tasks? Are we preparing to "fight the last war", not the next one?

A variety of other, more complex ecosystem and industrial system breakdowns are described in books such as Charles Perrow's Normal Accidents or Lloyd Duma's Lethal Arrogance

The scenarios that the CDC preparedness centers describe all seem to implicitly assume:

 the DHS chain-of-command (DCC) is itself functioning  communications with DCC are possible  The plan being followed makes sense and fits the reality on the ground  DHS itself has not been damaged and the operational decision process is rational, relevant, and could actually work if everyone did their part.  Martial law has not been declared and imposed  No components of the overall system are compromised and corrupted, in the sense of people who are part of the system but are driven Copyright(c) 2006 -R. Wade Schuette page 4 of 27 -4

by greed or criminal desires, not public health goals.  The DCC has not been taken over by hackers who are issuing false orders, effectively directing the troops to march off a cliff.  the overall goals of public health are compatible with the goals of the National Response Plan.

Issues of corruption, law & order, and coups

Since we are talking preparedness for extreme events, we might consider other types of extreme events which will change the parameters of any response. It is not clear what public health's response should be if the national response system itself is hijacked from the top and utilized to pursue personal aggrandizement or a political objective detrimental to public health. As Luttwak discusses in Coup d'Etat, the tighter a control system is to a blind-obedience machine, the easier it is to stage a coup.

More often, in many countries and some portions of the USA, components of government have already been captured and dominated by special interests or actual criminal elements, but taking cover within the workarounds normal for the status quo. As John Gall notes in his book "Systemantics", many large systems operate in failure mode, and, in fact, failure to operate may not even be noticed. However, when the chain of command shifts, these portions may be detected by not shifting willingly, and certainly will be relevant if they are groups that one suddenly has to work with or for.

It's not entirely clear how that will play out . The classic questions of subordinates arise as to how to respond when orders from above seem puzzling, when they seem ill- informed or completely out of touch with reality, and when they seem intended to actually worsen a problem that could be resolved., and fly directly against the charge of public health.

This is a touchy subject, and gets into the larger question of the breakdown of law and order of one type, and the replacement, perhaps slowly and clumsily, with a new type of military or martial law. Guidance may be needed, or training, or rules of thumb for how to operate in that middle transition period, when the old laws clearly don't apply, but the new ones aren't really in place yet either.

The simplest example may be illustrated by the 18 year old in New Orleans in Katrina, who saw that help was not coming, the area was flooding, no one had transportation, and an entire yard of school buses was sitting next door. He hotwired a bus, rescued his neighborhood, and drove them to Houston, all totally illegally. Is there a "right time" at which public health workers should break ranks and start "stealing the school bus"? How is that decision made? Is there any training we can do now to guide the issue that may arise during an extended crisis? These are complex, touchy, hot-wire issues that aren't in the current competencies, but could easily arise in practice. If university based preparedness centers aren't the right place for such a discussion, what is? Copyright(c) 2006 -R. Wade Schuette page 5 of 27 -5

Extended operation under unfamiliar, highly-stressful conditions

In addition, there is an implicit sense that may not be removed by scheduled exercises on a convenient sunny day, that an emergency situation is pretty much like normalcy, except that orders come from a different boss and you can forget about your normal chores.

Another reality is likely that a crisis will be filled with stress, last over 24 hours (it not weeks), and include direct physical threats to the workers safety, if not outright damage to person and property.

Primal survival issues such as food, water, and security from those without food and water may berelevant. Setting up shifts and sleeping arrangements may come into play. Everything will be disrupted, including sleep schedules. Fatigue will set in. Stress and fear can turn small events into bitter fights. Mistakes may have much larger consequences than normal. There may be very significant distractions as well, including explosions or sirens or alarms or people running and yelling. There could be smells or actual toxins in the air. The could be the general "fog of war" at play.

As pilots know, it is one thing to practice a landing in a simulator, that has a reset-button, and quite another to try an approach and landing in stormy weather at the end of an exhausting 4 hour flight. It is very difficult for fatigued people to realize how tired or fatigued they are, or that they are already taking micro-sleep blackouts. Mistakes are amazingly easy to make and very difficult to notice. Easy things become hard, and hard things become impossible. Walking across the parking lot to another building may be a life-threatening activity, between sharp debris, angry people, and environmental toxins.

So, not only will the normal external resources not be available, but people's own bodies and psychologies will often not be cooperating, causing additional stress and anger. But, long before total mental or psychological breakdown, there is continued operation in a somewhat damaged mode, that may be completely unfamiliar to public health workers or others. Normally, in that condition, one would stop and go home, or be replaced, or sleep. In a crisis, those luxuries may be unavailable.

Military style operation - sidebar

Undoubtedly there is a lot of literature in the military literature dealing with continued operations under live-fire with damaged troops. To some extent, "ontogeny recapitulates phylogeny", or, put another way, civilians should consider these "military" lessons something they will need to learn, and not object to a "military way of doing things" or be forced to rediscover the wheel the hard way.

In point of fact, actually, there is increasing discussion that the first several days of a significant crisis should be managed by the military, since they are, in fact, set up and trained for such conditions. "Militarization" of public health has Copyright(c) 2006 -R. Wade Schuette page 6 of 27 -6

many pros and cons in such situations. There are unresolved issues of Posse Comitatus, role of the National Guard versus Federal troops, who has authority to commandeer vehicles, private and corporate property and assets, etc.

Still, it's clear from Katrina that a necessary first step for many emergency responders is to have law and order as a context. It remains unclear how that will work out in practice.

Literature on this can be found at:______

Rules of thumb for high-stress extended operations

Off the top of this author's head, the following type of actions could be helpful for any type of continued operation in a hostile, unfamiliar situation under fatigue and stress:

 Get a buddy, stay with your buddy, and keep an eye on each other.  Don't expect yourself or others to be up to par. Be tolerant.  Have your buddy double check everything that you do and vice-versa  Despite pressure, don't rush. If anything, move more slowly. It's faster to do it once, right, than to have to do it over.  If you possibly can, use a checklist for everything you do so that you don't forget steps. Have one person read the list, and check off items, as the other person does them. Expect to find mistakes. Be tolerant.

Software that directly supports front-line workers

An ancient Chinese poem by ___ may be relevant:

Tremble, be fearful. Night and day be careful. Men do not trip over mountains -- they fall over dirt-clods.

Similar thoughts are common in literature regarding mastery learning -- that the key to successful complex activity is getting the basics extremely right. If we follow that line of thinking, and experience, both agree that where errors will tend to occur in unfamiliar hostile territory is in the basic operations. The errors will propagate and damage higher level activities, but the cause of the errors, and place to fix them or prepare them to be "combat ready", is on a surprisingly, extremely basic level.

A sample of "simple" operations that will tend to break-down under extreme conditions, because much of it is context senstive:

* Following a check-list, alone * Following a multi-person check list of tasks, with coordination steps. * Asynchronous communication - leaving a message that someone will get * Overcoming ambiguity in language in messages * Assuming a normal resource is still there (copier, phone, phone-book, ...) * Assuming everyone won't change locations abruptly before we're done. * Expecting to complete an action without being interrupted * Remembering correctly what you've done and what you just intended to do before you were interrupted. * Thinking that others have done things they haven't done * Thinking that bases are covered that aren't because someone else started to do something. Operating in "fire and forget" mode, without demanding confirmation of completion. * Expecting a person, or resource, that is there at the start of some activity, to still be there throughout and at the end of the activity. Letting a substantial amount of information or status-tracking be kept in someone's head, instead of where someone else can step in and take over if the first someone becomes abruptly unavailable, disabled, or communications are cut off.

Sidebar on Culture, Privacy, and Public Work

Much of this changed operating style involves being extremely open and working in public, not in private, revealing mis-steps, mistakes, errors, gaps in knowledge, and other vulnerabilities that are typically easier to cover up. Two significant issues are justifiable confidentiality and unjustifiable ego-protection. Getting people in IT-crisis response teams this author has experienced to work openly and publicly, in a glass-box, with every step logged and recorded for debriefing purposes, was a cultural shift that some people found impossible.

The higher up the management chain one goes, it appears to this author, in general, the harder it is for people to work with the protective walls down. At high management levels, situations are far more likely to be perceived in terms of enemies and opponents and threats and opportunities to take advantage, not in terms of getting an actual task in the real world completed.

At the front lines, however, it seems often far more common for people to ignore political considerations and turf-boundaries and just focus on getting the immediate work done. Sometimes it as surprising to management that front-line staff in "competing agencies" actual collaborate as it is to staff that upper management in "competing agencies" battle over turf.

There is a fascinating cultural change, somewhat age-based occuring in society that is reflected in the web-2 software, namely, a trend towards less privacy, less "me" and more "us". Millions of teenagers don't find it unusual to have their preferences for music, or political positions, or entire journals, diaries, and biographies visible to the rest Copyright(c) 2006 -R. Wade Schuette page 8 of 27 -8 of the world, or stored where everyone can see them. Millions of people now store their photographs in systems such as Flickr, where everyone else in the world can see them as well. Expectations of privacy in one's home, one's work place, one's email or phone conversations are changing - interestingly enough, towards the Chinese model where privacy is a concept that almost doesn't exist, or towards a "feminine" gender model where much of the shortcomings of one's internal thinking and decision-making process is open for inspection to close-friends, who think through things together.

For whatever else is going on, that sense of open, cooperative, collaborative work style has permeated many of these new software tools.

Not surprisingly, this presents a conflict with use of such tools in locked down, us- versus-them, never-reveal-weakness, cultures. Many managers and management styles are antithetical, and the last thing in the world they want to do is encourage opening up the decision-making process to inspection or "improvement". They are characterized by top-down command structures in which bottom-up feedback is typically not only not welcome, but is actively discouraged or punished. The underlying mental model and justification, if it were ever articulated, would probably be that "the boss knows best".

Over the past 30 years, management structures in many places have flattened out, ramped up with professionals at the "bottom", and the situations being dealt with environmentally are much more rapidly changing. The support for the contention that upper management knows "best", or even has a clue what is going on out there today, is less. The extreme case for this is precisely the emergency scenarios this paper is considering, where all hell is breaking loose, and the situation on the ground may be not only unexpected, it may be almost indescribably unusual.

This implies that, in abstract modeling of an emergent situation, a much higher flow of information from the bottom up than normal is going to be required to develop a coherent new picture at the top of what is actually going on -- and top management or government officials are going to have to do something extraordinary and accept new input from below that challenges their preconceived notions of what's happening.

Unfortunately, at the same time, a crisis situation produces maximum stress at the top levels, which will tend to close ranks, lock down ability to be flexible, and be even more paranoid about loss of control. Therefore, any information from below that challenges preconceived notions is not only unwelcome, it's a sign of "enemy action." and a threat to be dealt with.

In extreme situations, such as the issue of Weapons of Mass Destruction in Iraq, or global warming significant actions were taken from above to try to stop the flow of unwelcome discordant information from intelligence agencies or scientists, to the point of firing people or entire departments who insisted on asserting "contrary" points of view. Copyright(c) 2006 -R. Wade Schuette page 9 of 27 -9

There are two messages that are particularly unpopular in such top-down cultures, in response to an order given from above with authority. One is "What you just ordered us to do can't possibly work" and the other is "What you claim is working isn't working." From control-based management, both of these are direct challenges to authority and need to be "nipped in the bud". From a model of cybernetic control, these are the most significant feedback messages possible, and cutting off the message flow or killing the messenger results in upper management being cut-off from their only source of information about non-political reality. (which some deny exists.)

Which puts public health workers in an emergent situation between a proverbial rock and a hard place. Regardless how this particular public health function is implemented at the person by person task level, overall there is a need on a basic intelligence front to gather snippets of information and assemble them into an overall picture of what's actually going on. Somehow, information has to flow contrary to it's normal path, UP river, from the "lowest staff members" up to top management - and, at the same time, not be seen as or constitute a threat to the authority or perceived god-like wisdom of upper officials. In particular, surprising information, the most important kind, the kind that contradicts assumptions, has to flow uphill, in a period of high-stress and threat.

How the heck that is supposed to work is a challenge question and what preparation or competencies in public health could facilitate this unexpectedly difficult process is a remaining open question. It is not clear that this is something that can be turned on and off with the imposition of or standing down from a declared crisis situation. This problem is embedded at a deep cultural level. If it's not viewed as a "problem to be fixed" it is certainly still a tilt of the playing field that must be taken into account in designing plays. Although, of course, the existence of this tilt itself may be a prohibited assertion, in which case it has to be analyzed indirectly, using code-words.

There is good software that supports this type of multi-person checklist. It's more an attitude than a process, but the process helps a lot. Professional pilots learn to use checklists. It's actually a hard skill to master and takes practice and training to get over innate tendencies to take shortcuts and skip over items. The concept of action, pause, check-off, pause is foreign to many people, who want to, say, do all of page one and then go to the checklist and check all the items off. A "one-step-one-check" routine is not needed in unstressed life.

Without the normal secondary channels and luxury of time to clarify ambiguity, many people discover they've never learned how to be precise and pay attention to "small details", such as whether the person wanted to be called on the phone, or paged, when a certain task was completed. Or, if called, what was that phone number? (there may be no directory assistance, no phone book, no front-desk, no internet to look it up on.)

So, again, on a normal blue-sky day, it may work to "remember" a list of 8 items to do. On a crisis day, you should assume that memory will betray you, and everything must be written down neatly and legibly - and then the list has to be not lost, and regularly referred to. "To Do" lists are mandatory in hard-copy, not in wetware.

Conversations cannot be assumed. Pilots have a short-hand and understanding on the radio that no one starts talking until the other person is "ready to copy". Talking at a person, who appears to be listening, may be talking to a brick wall. Communications that matter should be "read back" and confirmed. It's amazing how many will be incompletely or incorrectly received.

The idea of "fire and forget' messages has to be abandoned. If you don't have confirmation that a message or page or note you left was received, then you have to assume there's a good chance it got lost, or will arrive later. Is it dated? What would happen if the message arrived out of order?

Then, there are the interruptions. Normal business is bad enough, with average time between an interruption now down to about 10 minutes; on a crisis day, the interruptions may include a rushed evacuation and relocation to a new site. What are Copyright(c) 2006 -R. Wade Schuette page 11 of 27 -11 the odds that some people will lose track, in the process, of their notes, their lists, or where they were in doing something? Have you called Phipsburg yet, or did you just think of it, or did you try and that's the one that was busy?

Finally, there's the really big one - work-breakdown and dependent task assignments and completions. Processes that you used to do alone may now take 3 different people to do parts of. Way beyond "communication" is "coordination." With multiple people, and even multiple teams located in different place carrying out parts of one task, how is all that goign to be coordinated? Does it require the EOC, or can it be managed at a lower level to keep the phone lines free at the highest levels?

Here's where the models of Napster come into playh- EOC is in the picture onlyl long enough to link up team A and B and give an overall assignment, then they have to drop out and it has to be managed at as low a level as possible, with a corresonding check-to-be-sure it got done by peers at that level, plus alamrs and checks if it didn't get done on the next two higher management levels. Is that trivial and auto matic to get working, or is it a major challeng?

Incidentally, that just walks down the list of software available at 37-signals, for free, including the following web-based tools: Ta-da list - on-line to-do list manager Writeboard - shared multiperson text editor BAckpack - CAmpfire - real-time text "chat" for a small group, with logging. No prior setup required. No account required. Basecamp - Shared project manager software with * Milestones * Abilty to leave messages for each other * [ with preparation} abilty to leave documents for others RSS-feeds -- ability for people to "subscribe" to be automatically notified if someone changes or posts something related to part of the work you want to keep tabs on.

While the average public health worker should not be spending time assessing those conditions, as overall planners we need to consider them as possibilities.

In very simple example, the immediate Katrina response led by FEMA, some or all of those assumptions were violated. Workers were either cut off entirely, or, if they could connect, there was no functioning decision capacity at the other end of the line to plug into. A tragic and visible consequence was that available resources and needs were not connected. Acres of parked school-busses and supermarkets sat, slowly flooding , while people nearby were stranded without transportation and food. The "law and order" being imposed made no sense, as orchestrated commandeering of such squandered resources would have saved many lives and much misery.

Every pilot in the national airspace is trained in what they are expected to do if they are operating under a flight-plan and communications are lost. Their actions have been thought through, approved, and are predictable. It's not clear this is true for public health or emergency responders in situations involving a loss of central command. Even for the level of governors or mayors, the process of invoking emergency powers is not a familiar one. In addition, as with the "War on Terrorism", it is not clear how to terminate emergency powers if "the marching band refuses to yield." On a personal situation, it is not clear when it is appropriate to simply declare an emergency, steal a school-bus, and start rescuing people and food. This is an expensive area to leave so ill-defined, producing paralysis just at the time rapid-action initiative might be the better response.

It is easy to imagine new situations in which one or more of those assumptions listed just above will be violated. Anything from an extremely visible event and panic to an air- burst nuclear device's electromagnetic pulse (EMP) to a massive solar flare (thank you Discovery Channel...) could effectively tie up or permanently disable all communications for an entire metropolitan region or larger. A single hacker, flooding the SMS text- messaging channel, could paralyze the entire cell-phone system as that system is the one used for call-routing. Communications security is not guaranteed.

Even if there are communications, a multi-pronged attack, or an attack that brought multiple conflicting political issues to an instant conflict, could totally tie up centralized Copyright(c) 2006 -R. Wade Schuette page 13 of 27 -13 decision-making on the few top-priority or top-regional issues, leaving every other region and issue waiting, in vain, for decisions or even a return phone-call. A "star" architecture is notoriously subject to a "single-point-of-failure" or bottleneck problem. It's not obvious to this observer that the simple bandwidth and time-constant issues have been thought through adequately.

In other cybernetic situations, such as robotics or the human body, substantial decision- making responsibility is delegated "downwards", and must be, for effective action and response time. Given the speed of signals along neurons, it is actually not possible for the brain to be involved in the fine hand motions of catching a ball, say, or of executing keystrokes on a keyboard at high speed. Keystokes, for example, may occur at intervals of 50 milliseconds, while it takes 100 milliseconds, round trip, to have the hand just "check in" with the brain, let alone establish a phase-lock loop and guide actions based on "central control" with multiple iterations. Extensive use has to be made of "feed- forward" processes, where general ideas are sent out to the extremities, which have to carry them out locally and just report back success or failure, after the fact. Any national control system is subject to similar physical speed and bandwidth constraints that make completely centralized control infeasible in practice, regardless how nice it looks on paper or in the power-point presentation.

These dig into competencey #__, "gap" analyiss. When the plan and reality are not in the exepcted agreement, what is it public health should be doing, and what tools and skills and experiences can be put in place to prepare for this highly likely event? What set of tools facilitate a type of constrained initiative that can be locally responsive and yet centrally coordinated? This situation sounds much more like Chaos Theory's "strange attactors" than a deterministic, machine-model of "command and control" where each part has only one possible relationship with its neighbors.

A question to look at then, is whether the preparedness competencies are only valid in deterministic command and control, or whether there are also competencies in Chaotic attractor control plan for the next more extreme level of emergency situations where deterministic assumptions breakdown.

This is an extremely relevant question, because this is the same sort of transition which took place between the old Web-1 tools (unidirectional central control, slowly varying, input from the front neither requested nor accepted) and the new Web-2 tools ( distributed control, empowered end-users, very agile and dynamic, content input for end-users is expected, provided-for, and crucial. )

This brief discussion, and the prospect of more Katrina-type situations in the coming year, suggest that we should consider preparing for both types of tasks. Fortunately, as discussed below in section ___, some of these tools are "dual-use" and those should be a focus for moving the front of the line for consideration in adding to the public health toolbox. Copyright(c) 2006 -R. Wade Schuette page 14 of 27 -14

4) what Task inventory for response - 3 way

Existing competencies - Columbia / CDC

Provide entire list

Provide PH core list

6) Tool inventory

Since 2003, a new generation of internet-enabled personal computer tools have come on the market, including weblogs, wikis, RSS-feeds, feed-aggregators, frapper, etc. In the industry, these tools are often referred to as "web-2" or Web-2.0" tools. The distinction being made, compared to the older web-tools (such as the classic "web-page") is that these tools are bi-directional; users can not only read the page, they can write directly to the page and add their own content. It is a very significant difference, of interest to public health and other emergency responders.

There are some other significant distinctions. These tools, typically, do not require any software to be installed on the local computer, other than some browser, such as Internet Explorer or FireFox - and these days most computers come with those installed. In addition, no local disk-space is required, as all persistent information content, photos, or text is stored centrally somewhere, not locally. And, since neither software nor disk space needs to be provided, no software support group ("I.T. Help Desk") needs to be involved in installing or managing these tools. Furthermore, since the content is not actually local, the user can move to any other computer that's on the internet, and pull up the work they started somewhere else, without having to carry it with them personally.

Another extremely dramatic difference between web-1 and web-2 is cost. Most of the web-2 software is free. There is an entirely different business model at work, and no purchase or monthly charges are required to use the lower-end tools of these types. There are advanced versions which cost money, but the basic versions are free.

In addition to single-user use from multiple locations, many of these web-2 tools also provide for multiple-user simultaneous or multiple-user different-time use. Often these can be stored or retrieved from cell-phones or Personal Digital Assistants (PDA's).

Since the names are so strange and unfamiliar, it might help to simply list the kinds of things that are supported in web-2 software as of this writing (3/2006):

* web-based phone call and conferencing (Skype). * text-document editing and storage. * photo storage, indexing, and display (flickr) * voice or music ("podcast") storage, indexing, and delivery-on-demand * video ("videocast") * e-mail (including indexing and keyword search capability) (gmail) * "to-do list" managers (37-signals) * project management software (37-signals) * group "chat" including multiperson intergrated text, voice, and video (many entries, including MSN "spaces") * chronological journals with "comment" feature (many "weblog" or "blog" services) Copyright(c) 2006 -R. Wade Schuette page 19 of 27 -19

* reference handbook / encyclopedia type documents * Newspaper/magazine/newsletter type documents (with feedback) * Maps, including interactive maps in which users can place icons ("push-pins") to mark their location, or locations of things of interest for some reason, and attach text as well.

9) CSCW lessons - adoption issues

There are some concerns with these new tools, and some downsides, but the benefits and power of them are so significant it seems they should be part of any responder's tool-box, available if needed and appropriate for the task at hand.

The issues include such things as: * managing confidentiality, privacy, and access control * relying on a vendor that might abruptly disappear, along with one's data * ability to get help-desk type support when needed. * migrating to such tools, or away from them, without losing work. * possible abuse scenarios (loss of control of what staff are doing.) Copyright(c) 2006 -R. Wade Schuette page 23 of 27 -23

10) Conclusions

As many others have said, dual-use technology and tools may be valuable, in that the way to be better prepared to operate in a crisis is to be better prepared to operate on a day to day normal events. So, what are the rate-limiting factors here? Why is this so surprisingly hard to do? We all have opinions and stereotypes, many of which involve incompetence, stupidity, and cupidity on the parts of others, but the problem may be instead a structural abstract-system issue that we've run into, as perplexing as birds running into glass or pilots running into the sound-barrier; in which case it may be amenable to an entirely different method of emergent solution. To do that, we need to build a framework and model why and how this turns out to be such a difficult thing to accomplish in practice, and what core assumptions are violated that this is so baffling and surprising to us? There's something wrong with our mental model, if this keeps being a surprise. How do we fix that so we're not blind-sided again? Copyright(c) 2006 -R. Wade Schuette page 24 of 27 -24

references

Charles Perrow, Normal Accidents Lloyd Dumans, Lethal Arrogance Osterholm, Living Terrors Howitt and Pangi - Countering Terrorism John M. Barry - The Great influenza

Appendices / screen shots.

A1 - Rule Based Expert Systems

Rule-Based Emergent Plans

Now that Red Hat has released JBoss Rules, there are open-source rules in Java and the following scenario is possible to explore without the $250,000 threshold cost of using a rules-engine such as Fair Isaac's Blaze Advisor.

One of the intrinsic problems with static "plans" is that the odds the plan fits are very small. If there are, say, 20 variables that might be relevant, and each has, say, 10 possible values, then there are 1020 possible situations, of which you actually have plans in the play-book for perhaps 100.

It doesn't have to be that way. For example, a financial spreadsheet really consists of a set of local rules that let you look at a very small set of cells, and based on them conclude something else, say a sum or a difference. Collectively, these rules produce the planning or accounting result you need. If you change the input values, the output values automatically adjust to the corresponding ones. What is specified, really, is the rules.

The same thing is conceptually possible for emergency scenarios. A set of universally true rules-of-engagement can be specified in advance, without insisting on what the actual input situation is going to be. The rules can be evolved, and tested, by putting in all the "plans" one has already written, to see where the rules need to be adjusted or tweaked or added to to generate the desired plan. However, at that point, if the assumed values change, the system can generate a new "plan" custom fit to the actual situation.

Rule-based expert systems, as they are called, are very powerful and are used regularly in business situations. For example, if you attempt to use an American Express card, the rule-based system at the home office assesses whether this charge should be allowed or not, in the one second it takes to "process" your charge. I wrote a rule-based system to assign students to sections of classes at the Johnson Graduate School of Management, at Cornell, and it worked very successfully for 8 years. Rule-based systems are used to determine the order on which to load containers on container ships, to minimize total costs, given continually changing constraints of location, refrigeration, shelf-life, costs of unloading and reloading at each port along the path the ship will travel, etc. I was on a panel in Anaheim at a computing conference with several people from the team writing the Hubble Space Telescope guide-star selection program, who had just replaced 50,000 lines of FORTRAN with 210 rules, with far better results. This really works. Copyright(c) 2006 -R. Wade Schuette page 27 of 27 -27

On a good rules-based system, you could even significantly under-specify the inputs, not knowing what the values are for half of them, and see if there are any conclusions or actions recommended or ruled-out based simply on the facts you do know.

The first rule, of course, would be something like: If the chain of command is intact, and communications are operational, fall into place and follow orders. The nice thing about rules, by the way, instead of classical programming logic, is that they can be "one-sided". The rule just stated doesn't say what to do if either of the assumptions are false, it just says what to do if they are true. That's adequate for an "inference-engine" program to work with, and makes it far easier for humans to make many simple rules, instead of trying to write extremely convoluted and complex branching logic that covers every possible combination of "if...then...else".