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Health is one area where rural broadband can change lives, even save lives.

Broadband gives health professionals and patients fast access to resources and expertise. In rural areas this would often be difficult, expensive or time-consuming to get any other way.

Broadband helps move patient records and test results. It’s fast and can be secure. Thanks to broadband a single medical specialist can serve a larger geographic area.

A Ministry of Health press release says hospitals and health centers in country areas benefit from the government’s Rural Broadband Initiative.

To date 18 rural hospitals or health centres that have either already connected to the RBI network or are connecting.

Half-way there

The Ministry of Health identified a total of 37 rural centres that could use broadband. Which means the job is still only half-done. Over time all, or almost all, will have fibre.

Health is the focus. Yet, running broadband to rural hospitals, health centres and clinics has another benefit. The buildings often act as centres in civil emergencies.

After the Kaikoura earthquake, the town’s local clinic became a communications hub. Crowds gathered outside the building to use connections to let their families know they were safe.

Hokianga Hospital, Rawene
Hokianga Hospital, Rawene

Hokianga Hospital in Rawene recently got its fibre connection.

John Wigglesworth, CEO of Hokianga Health Enterprise Trust says fast broadband makes a difference. He says: “The technology improves data linkages between the hospital and its central GP clinic in Rawene with its nine primary health clinics situated in remote locations throughout the Hokianga.

Rural health video consultations

“This data network means patients don’t have to remember details or repeat their medical history if they go to any of the clinical locations. Medical staff don’t spend so much time re-gathering information that’s already available in the central database.”

Wigglesworth says the hospital uses tele-medicine. Patients in remote areas can have video consultations. The obvious benefit of this is that health professionals spend less time on travel, there’s also a cost saving from this.

He says the hospital also uses these links for planning and administration.

In a similar way, staff can take part in online training sessions. Again, without the need for travel.

Hokianga Hospital uses fibre to send x-rays to radiologists and specialists for diagnosis. In the past couriers handled this. Broadband means responses can be instant — and that can be vital in some cases.

Patient portal

Wigglesworth says: “Having improved internet services available to parts of the community means people who are connected will be able to access their own health information via a patient portal.

“This means they will be able to check their lab results without having to phone their clinic, look up what vaccinations they’ve had and medications they’re taking, and review their medical history. The patient portal provides an opportunity to save everyone – patients, clinicians and administration staff – time. It also enables people to play a greater part in managing their own health care.”

There are still gaps in broadband coverage. The second phase of RBI and UFB will take broadband further into rural areas. Most likely it will mean fibre in places with wireless networks filling the gaps. For some people in remote areas, boosted cellular coverage will give them mobile internet.

Wigglesworth helped ISPs with proposals that could give fibre connections to remote clinics in the area.

He says:“The goal is for our rural health services to have equitable access to the same digital technologies available to urban centres, technology which ultimately contributes to improving health care outcomes for all.”

It looks odd, but the Truly Ergonomic Mechanical Keyboard delivers on its promise of pain-free typing

The keyboard has its frustrations, but it works.

It’s now several weeks since I took on the Tek, and, yes, I can report it keeps RSI at bay — just as it promises.

I have minor RSI problems and, although I still find the Tek’s unusual layout strange, my arms and fingers feel much less stressed.

The Truly Ergonomic Keyboard, to give it its full name, has a couple of ergonomic things going for it — it’s strange, but effective layout and the fact it is a mechanical keyboard.

Mechanical keys

But let’s start with first impressions. While it wasn’t love at first sight — it’s not a very pretty keyboard — I immediately took to the Tek’s mechanical keys. You get a satisfying tactile feedback when you strike them.

It is like using a typewriter. I also like the Tek’s small footprint. It compares well with that of the Microsoft ergonomic keyboard I had been using. A big beast, it dominated my desk. The Tek is 60 percent the size of Microsoft’s keyboard. I really noticed the difference — much more desk working space.

The other first impression concerned the weirdness of the keyboard’s layout, which does, however, start to make sense after a while. For instance, the Enter/Return key is in the middle of the keyboard, rather than on the outer right (which requires you have to use your weak pinkie to strike it). I have always found this forced use-of-the-pinkie nonsensical.

Using one’s much stronger thumb, to strike the Enter key when it is placed in the middle of the keyboard makes a lot more sense. The only problem is getting used to a different keyboard layout, especially if you still use other keyboards.

I haven’t been able to touch-type properly on the Tek during my several weeks of use and still find myself having to look at the keys. But the increased comfort of use and the lessening of my mild but sometimes painful RSI symptoms make it worth it. Having to switch between keyboards is the main issue for me.

However, the need for ergonomic keyboards is not going to go away. We now have a generation of children growing up who are using keyboards from their earliest days and will likely use them for decades. And touch pads and voice recognition software are unlikely to replace keyboards completely.

Split_Symmetrical_Ergonomic_Keyboard_227 Staggered_ergonomic_keyboards

What we liked

The Tek keyboard’s pluses are that it is a mechanical keyboard and that it has an unusual and symmetrical layout (see images). Commonly used keys, like the Enter, Delete, Backspace and Dash keys, are placed in the middle of the keyboard, so you use your stronger thumbs – or, in my case, index fingers – to strike them. No stretching delicate pinkies to the far reaches of the keyboard. However, there is a second Backspace key in the top right-hand corner, which I found useful.

The standard QWERTY keyboard has been in use since the 1860s. It requires you to splay your elbows and twist your wrists out slightly too, causing strain. The Tek seeks to overcome this and keep your arms and wrists straight by placing the commonly used keys in the middle of the keyboard. This makes for more width in the keyboard overall (despite the smaller footprint) so you do, indeed, hold your arms straighter, as it makes the keys symmetrical – see image. The only problem is your fingers don’t know quite where to go if you’re used to touch-typing on a conventional keyboard, and especially if you use both.

This symmetrical key alignment is the Tek’s big point of difference – it’s not the only mechanical keyboard out there. And it’s a valuable difference as it cuts back on hand and arm strain when typing.

Less tiring

But the Tek’s mechanical action is also important. Keyboards that use mechanical switches require less effort to press down the keys, so are less tiring on the hands. I found this to be true.

The clicking sound and tactile feel of the dish-shaped keys also help you not press too hard. Ideally, says the Tek brochure, you should “float” your hands above the keyboard for maximum comfort. But getting to this nirvana is hard if you are accustomed to the kind of membrane keyboards used on laptops and tablets, and still need to use them. These keyboards give much less physical feedback, so you tend to hit the keys harder. It seems necessary too. I want to “float” with the Tek because it really does cut back on finger and hand strain. But I’m not there yet.

As a check, I did a conscious comparison of the Tek with my excellent Logitech iPad keyboard and I definitely found I had to hit the Logitech’s flat membrane keys harder. My Mac PowerBook laptop proved better but still not as good as the Tek, especially for prolonged typing.

Using the Tek got me thinking about that other ergonomic problem – the mouse. Stretching for the mouse also causes strain. There is still some stretch with the Tek keyboard, so I went googling and found the Roller mouse. This could sit well with the Tek if mouse fatigue is also an issue.

What’s not so good

It’s noisy – all that clicking. Lots of people like the sound, including me, but it could annoy others if you share office space.

The Caps-lock position. The key for this is above the number keys, which is a bit odd, although I can live with it.

There is also a Gmail problem – the two space bar keys (another unusual Tek feature) seem to get stuck sometimes and either won’t work at all or you need to click the mouse to activate them. Alternatively, they act as the ‘Enter’ key and take you to the next line in the email. Again, clicking on the mouse sorts this out, although it’s not ideal. This is a Gmail issue, not a Tek one though.

Re-programmable keys are another special aspect of the Tek. This sounds good, but we are getting into seriously geeky territory here. I’m not sure many people want to play with their keys this way. However, it makes sense if you have an IT department, or just like tinkering. It means the keys can be optimised for other languages, for example. Also, one keyboard reviewer complained about thumb strain, so re-mapping some keys could make sense for some users.

Cost – there have been some complaints about the cost – US$249. However, mechanical keyboards tend to have a long life and other mechanical keyboards are also pricey. Much cheaper is my Microsoft ‘natural’ ergonomic keyboard, at about NZ$60 nowadays, but it comes with cheap membrane keys.

Conclusion

Yes, the Tek is worth it. It’s not very pretty, but it is comfortable and non-pain inducing to use. I won’t be able to touch-type properly on it so long as I continue to use other keyboards, but I can live with this because of the other benefits.

Keyboard strain issues tend not to be taken as seriously as other industrial injuries, but they are quite as real. So it’s good to see an effective keyboard that doesn’t look like an ugly medical device – announcing your problem to the world – or doesn’t take over your desk it’s so big.

USEFUL EXTRA: Researching this article took me to some useful places. This website on RSI and keyboard issues might be helpful for some as it features some anti-RSI exercises – stretches are known to help.

Bill Bennett writes: I asked Johanna to review the Truly Ergonomic Keyboard as she has experienced RSI pains with everyday keyboards. 

A few days after I first tried the Apple Watch I found myself scratching my irritated wrist. I took a break from wearing it and my wrist got better.

For a while I fell into a pattern of only wearing the watch when I worked away from home. At home, I’d leave it off. This runs counter to the idea of wearable devices, but it worked for me.

At least I thought it did. I was getting a mild rash and would find myself scratching my wrist and the area around it. But things seemed under control.

It turns out they weren’t.

Discomfort

There was still some discomfort. I took to loosening the band in case the problem was to do with it being too tight. My skin didn’t improve. In fact the problem got worse. I found the area where my thumb meets my hand was red and itchy.

At home, Johanna says she noticed swelling around my wrist, across the lower part of my hand and thumb. We compared my right and left hands. I wear the watch on the left hand, but am right-handed for most things. The left hand is clearly swollen in comparison with the right.

My instinct was to wear the Watch even less and keep an eye open for more symptoms.

Warning Will Robinson

Ten days ago I visited a medical specialist needing treatment for another medical problem. Like a lot of people he noticed my Apple Watch. I thought he was interested in the technology. He wasn’t. Instead he took a closer look at my rash and told me to take the watch off.

He told me I had an allergic reaction to the material. It could be the strap — my Watch has a black Sports Band. Or it could be the watch itself.

The medical specialist asked if my reaction had worsened over the weeks I’ve been wearing the watch. I couldn’t be certain, there’s a boiling frog aspect, you don’t notice a slowly worsening skin reaction creeping up on you.

After some thought, I realised it was getting worse.

Potentially serious

He said this could be serious. It turns out some allergic skin reactions have a cumulative effect. They can go on getting worse and reach a point where it is hard to recover. In extreme cases it can lead to anaphylactic shock.

Now, this was the doctor’s reaction after seeing the rash. I wasn’t there for this condition and we didn’t take things further. It wasn’t a formal diagnosis, just some friendly, informed advice.

Screen Shot 2015-12-07 at 12.01.20 PM.png

Apple acknowledges some people may have a reaction to the Watch materials. It says it went to great lengths to test and check materials first. The Apple Watch support website offers some advice on possible allergic reactions.

Material care

It says: “A great deal of care and research go into choosing materials for all our devices. A small number of people will experience reactions to certain materials.

“This can be due to allergies, environmental factors, extended exposure to irritants like soap or sweat, and other causes.

“If you know you have allergies or other sensitivities, be aware that Apple Watch and some of its bands contain nickel and methacrylate.’

Apple suggests people who have problems should talk to a doctor before wearing or returning to wearing the Watch. I’ve done that and for me, the long-term review is over.

In the next few days I’ll report my thoughts about my time with the Watch. Top of that list is that the best thing about the Apple Watch is that has made me more aware of my health. Some irony there.

IDC Research reports Australia’s healthcare industry spent A$2 billion on IT in 2012. Spending is growing at an annual rate of one percent. That number is slow because the infrastructure investments have already been made.

New Zealand spending is estimated at NZ$286 million in 2012. That’s a long way behind Australia on a per citizen basis, however, in New Zealand the spending is growing at a compound rate of 4.1 percent.

In both countries telecommunications accounts for almost one-third of budgets. New Zealand’s spend would have been just NZ$184 million without telecommunications.

The key driver in both countries is ‘connected healthcare’. Louise Francis, IDC’s research manager for NZ IT spending says the update of the National Health IT Plan, which was first published in 2010,  will also have a significant impact on investment over the next five years. The new strategy has a strong
emphasis on engagement and involvement of healthcare service users in all aspects and stages of their care.

She says: “New Zealand health organisations must continue invest in IT solutions that contribute to the overall objective of a connected healthcare system.”

“Ultrafast broadband and mobile platforms are expected to enable key areas of the connected health system including mHealth initiatives, telemedicine, shared care records, actionable business intelligence and building systems around the needs of patients.”

wellington cloud

Do you ever wake up early and instead of rolling over for a longer sleep glance at your phone and start reading work-releated emails?

You’re not alone. As consultant Ian Apperley explained at the New Zealand Cloud Computing Summit, we’re now entering a new way of working where there no longer seem to be hard and fast boundaries between your job and your social life. It’s something he describes as fractilised working and we’re living that way thanks to cloud computing.

Apperley says fractilised working is a move away from a nine-to-five world governed by command and control management style with censored internet and fixed location. All of that belonged to the desktop computer  era.

Instead, he says today’s workers are free to move. We are now always connected, using smartphones,  tablets or other devices to stay in touch with customers and work colleagues from anywhere, at anytime.

He says social media plays an important role in fractilised working, although voice and email are still in there. And workers are now using smartphones to augment their brains to get real-time information.

There are all kinds of productivity advantages and lower costs for companies, meanwhile people are happier and more able to work in ways that suit them.

It’s not all positive. Apperley warns while younger people have grown up as this way of working emerged, older people struggle with some aspects of it. And, he says, there’s potential for disaster when fractilised working is blended with old-style command and control management.