New Technology Can Be Tempting, But Don't Go For More Than You Can Handle
Plus: Imperiled Public Health Agencies, the Importance of Statistics, And More
We've come to the conclusion that there's been a new disease afoot for some time that afflicts individuals as well as cities and states. In Latin, it's called diligo pro crus apparatus. The loose translation? A love for shiny machines.
We have a close friend, for example, who has a very fancy cell phone. Sadly, she can't quite figure out how to answer it when it rings. So the device is mostly just a ring tone in fancy packaging. At the same time, we can't begin to count the number of instances in which we've heard of vendors convincing sincere city and state leaders that they absolutely need to have every bell and whistle on a new kind of technology — despite the fact that there will never be sufficient time or money to ensure that employees know how to actually utilize the stuff.
With the speed at which technology advances, we'd argue that governments should only spend enough to buy the technology they actually have the capacity to use — and not allow themselves to be convinced that the mere presence of the technology, without a clear plan to ensure its utility, is worthwhile.
It's reasonably well-documented that public health agencies have been the victims of some pretty big cutbacks over the last few years. Of course, so have most other agencies. But we've often thought that public health departments have a distinct potential for saving great sums of money over the long term — and trimming them today may be a fiscally unfortunate decision. We just came across a piece by Dr. David Hemenway in the New England Journal of Medicine that spells out four reasons why public health is such a vulnerable area:
• Today's politicians won't get credit for many of the long-term benefits of successful public health efforts.
• The beneficiaries are generally unknown, since the services are spread across wide swaths of society. "People have stronger emotional and moral reactions to the plights of identifiable victims than to those of statistical victims," Hemenway writes.
• Public health practitioners — the "benefactors," in Hemenway's words — get little in the way of public attention or accolades.
• Some public health initiatives run directly into opposition from potentially powerful groups. Think tobacco.
Our favorite quote of the week: "If you don't understand statistics, you don't know what's going on — and you can't tell when you're being lied to. Statistics should now be a core part of general education. You shouldn't finish high school without understanding it reasonably well — as well, say, as you can compose an essay." — Clive Thompson in Wired (May 2010)
Better late than never. It's a pleasure, during these tough fiscal times, to see a government spending money today that will save it a great deal more in years to come. According to a piece in the Arizona Republic, Maricopa County is "moving forward with a $10 million plan to buy an electronic medical-records system, a key to improving inmate care." It's not that the county has suddenly grown more concerned about the residents of its jails. The fact is that for years, it hasn't effectively documented or managed medical data for them. As a result, reported the Republic, "Inmates died. Taxpayers paid out millions of dollars in settlements."
"From 1998 to 2009," said the Republic, "the county paid out $13 million in legal fees, settlements and jury verdicts to inmates and families for injury and death claims against the CHS. Dozens more lawsuits are pending."
There were other factors involved in the county's decision to use technology to help fix things, including pressure from the courts and some notoriety for failing to meet national health-care standards.
But whatever the pressures, this is clearly a smart financial move.
Maricopa's move makes us think about a post we recently wrote for our blog about stimulus act implementation for the IBM Center for the Business of Government. We explored the reason why the movement of federal funds to health IT was going so slowly. Turns out it's largely because the Recovery Act requires that this money goes to expenditures that provide so-called "meaningful use." Unfortunately, the feds haven't defined that term yet, and providers are reticent to start on projects that might turn out not to fit whatever definition the feds eventually settle on.
An extremely simplistic thought that we just want to vent about: Over the course of the past month or two, we've witnessed various groups of very smart, extremely well-meaning men and women who were advancing various solutions to local government woes. We like talking about solutions, so such opportunities are fun for us.
But we noticed a troubling recurring theme. While the solutions under discussion made lots of sense in principle, rarely were real-world politics brought up. For example, collaborative efforts in governments make a lot of sense. Still, when agency heads lose power in the process, there's going to be pushback.
Don't misunderstand. We think there's a lot of value to a room full of interesting, innovative ideas. But reality should be in the room, too.
Public Civility Corner. Based on scores of e-mails we received from B&G readers lately, it appears that rudeness aimed at public servants is an epidemic. We just came across a study that's based not on the public sector, but on university professors. We can't help but wonder whether the same phenomenon was as true for government managers and workers as it is for the college profs. Anyone with an opinion, please let us know.
Here's the story: Three researchers at the University of Redlands in California conducted an online survey of 339 faculty members at nine colleges and universities. Their discovery, according to an article in the Chronicle of Higher Education, was this: "When it comes to being rude, disrespectful, or abusive to their professors, students appear most likely to take aim at women, the young, and the inexperienced. ... When the researchers broke their data down by gender, they found that 24 percent of men, and just 9 percent of women, could not recall incidents of uncivil student behavior. Women were also much more likely to report that the uncivil behavior they experienced was severe, or to say that they had been upset by it."
With all the talk about openness and accountability, you'd think by now that cities, states and counties would be as transparent as a pane of glass. But talk is cheap. When researchers at Campbell University in Buies Creek, N.C., took a look at how hard it was to obtain public documents from counties in their state, the results were a bit discomforting.
The researchers found that the average county provided about half the public documents requested; officials in local schools were slightly more responsive than those in county governments; and it seems there are no strong relationships between counties' response rates and their demographics.
As their report stated, "This research found the response rate by county officials to be disappointing. Therefore this report suggests that the state post on the internet pertinent county information that it already possesses."
More bad news for analysis. When people ask us about models for clear, fair analysis of public-sector programs, we send them to the Office of Program Policy Analysis and Government Accountability in Florida. As far as we're concerned, it's set a shining example for other states to follow. So when we saw a headline from the News Service of Florida that read, "Sick of studying things, lawmakers cut analysts' budget," we were dismayed. According to the article, "The 2009-2010 budget for the legislative analysts is $8.2 million. Next year, upon approval by the full Legislature and the Governor, it will be $5.49 million."
Over the course of recent months, readers have been troubled when we suggested there was value in various nonessential items (like fireworks), even during tough budget times. And we get that message. But when careful review of the ways states, cities or counties are spending their money are deemed non-essential, we think that's penny-wise and pound-foolish.
If the last few items have left you feeling slightly depressed, here's a feel-good video, called "We Built Sioux City," that's sure to restore your civic pride. It was made by Sioux City's Office of Convention and Tourist Information. We came across it thanks to GovLoop ,a social network that connects people in government.