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20 With a generic space encompassing the basic features of our metaphors, we merge the characteristics of our inputs spaces, thereby creating a blended space which uniquely fits our conceptual needs. The strengths of conceptual blending theory are that it provides an account of how metaphorical meanings are actively constructed and that the „products‟ of metaphorical mappings are more influential when they adhere to a set of specific principles known as the „optimality principles‟: a set of constraints under which metaphors are most effective. We shall make use of the integration principle, which states that representations in the metaphorical blend can be manipulated as a single unit (Cornelissen, 2006).
Conceptual blending is used in this study to understand the arising of innovation and new ideas by looking in-depth the concepts within each unit of representation. We shall make use of the theory of conceptual blending as a start to understand how the process can be utilized for further innovations and new meanings.
2.2.4 Applying conceptual metaphor of ‘cloud’ on ‘computing’
Cloud clusters exist among the three delivery models and a massive cloud across all the vendors, providing services for the enterprise (Jaeger et al, 2008). This can also be observed in Figure 1, which illustrates the relationship between the cloud clusters. These cloud clusters gave a metaphorical idea of a cloud of services on the internet, which is flexible enough to accommodate different levels of sophistication, and is evolving all the time, rapid and furious.
Other than its „opaque‟, „soft‟ and „amorphous‟ nature in the services provided through the internet as mentioned earlier, there also exist different layers of the „clouds‟, within each, serving varied functions and having different forms of interaction between the cloud clusters.
In fact, the clouds referred to in cloud computing are so alive and unpredictable that they can be as small as a piece cirrus cloud, servicing a simple application, or be combined to become a massive cumulus humilis, huge enough to undertake some mammoth computing and storage facilities. Because of its flexibility, these services on the internet, like the moving
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21 clouds in the sky, can also form links and connections within one another, increasing their capabilities and functionality and ability to travel across the globe. Enter the cloud, which spreads computing resources across a swath wide enough to achieve major increases in efficiency and utilization. With access to IT resources increasing and costs decreasing, a perfect storm for transformation on a massive scale is forming (Murray, 2010). This, is the very idea of the evolvement of cloud computing.
A source and target mapping of the concept of „Cloud‟ as the source domain and this latest
„Internet Computing Technology‟ as the target domain can be seen as follows:
Source: CLOUD Target: INTERNET COMPUTING
TECHNOLOGY
Opaque Inability of users to know the data-processing
process sent to the network of computer systems.
Amorphous Ability to hold small or large amount of data.
Soft Mobility of information and use of
applications at different locations.
Transformed from water Capable of transforming inputted information and data.
A conceptual blending done between cloud and computing technology allows for more detailed and specific features of both inputs to be sifted out and placed into a generic space.
In this case as shown in Figure 3, both inputs allows operating procedures of system to be unknown to users, ie. an opaque system, has massive space for storage and also expansion in terms of technology advancements, and finally the nature of mobility of clouds can also be mapped onto this particular advantage of mobility that the computing technology can now allow with possible usages in any venues that has computers and internet accessibility.
Specific to supporting successful aging, these features of the generic space opens up possibilities in giving more ownership to the users and family members in maintaining a
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healthy lifestyle with increased mobility and easier timely access to information on healthcare issues.
Figure 3: Conceptual blending between cloud and computing technology Input 1:
- Allow users to access through single platform.
- Allow large amount of data to be stored and processed.
- Information accessible at different locations.
- Transform data and information into useful output.
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23 Cloud Computing Technology henceforth evolved in the blended space, where these specific features are included to provide the winning edge of this technology.
While users and services forms the major part of the system, one of the crucial ingredient to ensure the operationability of the system is the data inputs from each players. From the concept of cloud, it can be understood that the element „water‟ is the main component which make up the cloud. Indeed, as elderly care involves largely on the availability of clear information such that proper primary or home care can be given. Similarly, the main constituent for the computing technology to function is the presence of data. Another mapping which is as follows evolved:
Source: Cloud Target: Computing Technology
Water Data from participants in the system
With understanding in the main features of EHR and key characteristics of cloud computing technology based in its metaphorical understanding, the Dossia Health System can now be explored to identify vital stakeholders and their roles such that its functionality can be fulfilled.
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24 2.3 The Dossia Health Service System
Initiated by 50 Fortune companies in USA, the vision of Dossia is to transform the American healthcare system by reducing waste and facilitating better care by developing and making widely available a lifelong personally-controlled health record. Dossia hopes to achieve their aim through empowering the people and their doctors to be active partners via a comprehensive and secure access in individual health information.
By understanding the Dossia Health system including its functions, services and operating platform online, we can have a better picture of the benefits it provides to its users and how this system coincides with the vision of meaningful use of EHR specific to countering issues of aging population as mentioned in the previous chapters. By looking at the current phenomenon of electronic health care system, we can look at how it is applicable to future usage. Table 1 presents the association between the various stakeholders within a healthcare system and the roles which they play to ensure the functioning of the system.
Table 1: Players and their responsibilities in Dossia Health Service System
Players Responsibilities
Dossia System Committee (organized by the group of 50 Fortune companies)
Regulates and maintains the effective running of the system. Ensures that the operations within the system platform adhere to the objectives and guidelines.
Users (Patients and family) Actively using the system and the relevant equipment, thereby providing substantial amount of data and information to other players in the system for analysis.
Non-medical caregivers (including social workers, fitness coach,etc)
Comprehend medical data of patients and provide necessary non-medical assistance.
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Analyse relevant data (from users, vendors or within medical providers) and transform them into useful health information, which can then be utilized by users, thereby providing superior medical care. Consolidate medical information for research enhancements.
Health equipment vendors (medical instruments such as blood pressure monitors, heart-rate monitors, calorie measuring machine, pedometers, etc)
Provide equipment and devices which can be synced with the Dossia online platform. Data collated from equipment should be transformed into useful information which can then be utilized by users or other players in the system (e.g. for analysis by medical providers)
Technology Providers (cloud computing technology)
Create a cloud computing system which supports the technology of the various players in the system. Ensures the smooth transmission of data and into the system for analysis and finally useful information back to the rest of the players with sound web applications for all players within the system.
By understanding the mechanism behind cloud computing comprising of Paas, Saas and Iaas components and the elements present in the Dossia system, Figure 4 presents the interdependent relationships amongst the players.
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Figure 4: Pictorial representation of system in Dossia Health Service PlatformThe concept of Paas, Saas and Iaas adopted from cloud computing allow the meaningful use of cloud computing stated by USA policy to be realized. While the responsibilities of the stakeholders in Dossia system as shown in Table 1 assemble the healthcare system in place, the functionality of these stakeholders are made workable due to the operating structure of cloud computing system.
In the Paas segment where a service platform has to be established, the Dossia System Committee played a crucial role in creating a model in which the objectives of an effective healthcare system are realized by setting rules and regulations and determining the vision and mission of the Dossia Personal Health System.