While debugging code of our application, can we customize our object property value in the debugger window? Hi there, this is Krishnag from Bitescout. In this video, we will explore the different ways of customizing our object property value in the debugger window. So sometime while debugging our code, it can be useful to have customized output available in the debugger window. In this code, I have defined an object of patient detail class, which contain a fewer getter setter property. Now, when I run this application and hover over this patient detail object, you can see that at the root level, we just get the name of the type, and when we expand this down, here we will get the individual property and their value. Now, let me stop debugging this code. Now, the first way that we can start to take some control of the debugger output is to overwrite the two string method in this patient detail class. So for that, let me define the overwrite method of two string. Instead of this, let me return this string. So here, you can see that first, we will set the patient name property over here and conkinate this decision release with this pipe sign using string.join method. Now, let's run this code and check our object property value. So now, this time when I hover over this object, you can see our customized two string value. Well, this one doesn't affect the individual members inside this object. And the other option we have is to use the debugger display attribute. So instead of this overriding two string method, we will use the debugger display attribute. So let me comment out this two string method. So in our case, we will be going to apply the debugger display attribute at class level. So in this square bracket, let us define this debugger display attribute. And here in the parameter, we need to supply a string. And within this string, you can reference the member of the class. Now, in this string to reference the class member, we need to enclose the name of the member in the curly braces like this. So here this patient name property is referring to this property name and this flattened this is history is referring to this property. Now let's run this application again. And now when I look at the debugger window, we can see that the root level now uses the debugger attribute at the class level. So here we get the patient name and this is history list. Well, we can also apply this debugger display attribute at individual property level. And we can also use this attribute at class level, struct level, delegates level and enum level. So whenever you use this debugger display attribute, you should make sure that it actually does increase the clarity at the debug time rather than distract from it.


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Good evening, everyone. Thank you so much for joining us this afternoon. I think we still have a few more people joining us. So thank you for joining the public policy and institutional discrimination discussion series where today's topic is race, media and political attitudes. So this is the second of four sessions of the discussion series. And before introducing the faculty discussant, I'd just like to take a few moments to talk about the goal and the format of today's event. So the goal of this series, as well as today's format, is to create opportunities for community engagement for members of the Ford School community and also to foster dialogue on important issues of U.S. public policy. This format is also an opportunity for students to engage with and get to know faculty as well as their research and perhaps what they do beyond the classroom. Concerning today's format, Dr. Mara Cecilia Ostfeld. She will be the faculty discussant and she will lead and we're very excited to have her with us today. And she will speak for about 30 minutes on the topic. And the last 20 minutes of the discussion will be reserved for questions and answers from the audience. And to allow for more interaction, participants are encouraged to make use of the chat box. You can also unmute your microphones and pose a question directly to Dr. Mara Ostfeld. And Dr. Ostfeld is also, she is fully comfortable with people jumping in and with asking questions and clarifications as they arise. And concerning the rest of the winter series or winter semester, Professor Earl Lewis will facilitate a session on February the 18th and that session will be on history, reparations and policy 2.0. And following that session, Roderick Johnson will facilitate the March 11th session on lobbying and mass incarceration. So today's faculty discussant is Dr. Mara Cecilia Ostfeld. She is an assistant professor of political science at the University of Michigan with a courtesy appointment at the Ford School of Public Policy. Her research broadly focuses on the relation between media and political attitudes, which is the topic for today's discussion. And she is currently working on projects exploring media coverage of protest activities, which is extremely timely. Her work has been published in journals that include political psychology and political communication. And her work has also been funded by places including the Institute for the Study of Citizens and Politics and the Russell Sage Foundation. She currently has a book project underway looking at the political, environmental and psychological factors that shape how we identify our skin color. So during national elections, she also works as an analyst at NBC and Telemundo. So please help me welcome faculty discussant, Dr. Cecilia Mara Cecilia Ostfeld. Thank you so much for joining us. Thank you so much for organizing this. I really appreciate it. I'm especially grateful for the discussion nature of this, that it is meant to be a discussion. So I'm really excited to share some of the work that's been done in the field of race, media and political attitudes, especially some of the more canonical work. And then just discuss a little bit about how it's evolved and how it's changed. And then how some people talk about where it is going or where it could be going. And as people who are highly engaged in policy and political science, I'd love to get everyone else's thoughts on this. So I just wanna start and begin this overview with one of the most infamous campaign ads that engaged with issues of race. And many of you may be already familiar with it. It's the Willie Horton ad that was created by one of the supporters of George H.W. Bush in his 1988 run against Dukakis. Bush and Dukakis on crime. Bush supports the death penalty for first degree murderers. Dukakis not only opposes the death penalty, he allowed first degree murderers to have weekend passes from prison. One was Willie Horton, who murdered a boy in a robbery, stabbing him 19 times. Despite a life sentence, Horton received 10 weekend passes from prison. Horton fled, kidnapped a young couple, stabbing the man and repeatedly raping his girlfriend. Weekend prison passes. Dukakis on crime. There's a couple of things that are key about this ad. And this was one of the foundational campaign ads that started a really robust body of research, exploring the relationship between race, media and political attitude. What's key about this is that it primes racial stereotypes and fears that especially many white people had about black people in the context of politics without explicitly endorsing these stereotypes or generalization. They weren't explicitly saying, like a lot of bad people or all black people are criminals, but they definitely primed the stereotype and primed it in the context of the campaign that was occurring at the time. The ad validated racist belief systems without making people feel like they were necessarily being racist by accepting them. As a result, the ad and tons of others like it have been found to activate racial resentment, whose support for the more racially conservative candidate sponsoring the ad and increased opposition to the redistributive policies and restorative policies that disproportionately are of benefit to people. Importantly, once this ad was called out as racist, the effects it had on public opinion at the time were largely undone. Many people were compelled and persuaded by the ad, but they didn't want to be labeled as racist. Bush and Dukakis on- Tali Mendelberg was one of the people who really wrote a lot about this ad and kind of founded a lot of this literature. Pretty succinctly summarizes this dynamic and says that in the age of equality, politicians cannot prime race with impunity due to a norm of racial equality that prohibits racist speech. Yet incentives to appeal to white voters remain strong. As a result, politicians often resort to more subtle uses of race to win elections. So at the time and for a while, we often saw ads that operated in a similar way where they made racist appeals without explicitly like articulating the whole racist belief system. So often they would use racialized imagery like this one where they both use racialized imagery associating Latinos with gangs or crime and using very evocative racialized, kind of coded racialized language. This one, it was illegal aliens, but it's often looks like inner city welfare undocumented criminal alien law and order. The thing that all of these have in common, again, is that they evoke racist stereotypes without necessarily saying some type of explicitly racist generalization. This of course has changed a lot in recent years. Trump in particular has made a number of very explicitly racist statements, not only faced no backlash or repercussions, but often received greater support after saying them. So he had referred to immigrants and refugees, especially Mexican-Americans and Muslims using language such as rapists, animals, ISIS fighters, people who all have AIDS and as criminals. He's referred to people of color in general as people who are ruining suburbs, as people with no education or jobs. And he referred to Baltimore as a disgusting rat and rodent and bested myths. So what's changed? Why was there this dynamic where you needed to be implicit and if it was explicit, then everyone would kind of pull back. But now you can say something very explicit in people, a lot of people, especially Republicans tend to be even more supportive after it's stated explicitly. And there's been a lot of research done on this by especially our colleague Valentino Nunez and Vandenbroek who argued that there's been two dynamics that have really resulted in the shift from having to rely on implicit racial cues to a context in which explicit racial cues are more acceptable. The first one is just that the two parties have become more cleanly sorted along lines of racial attitudes and we saw this very clearly in the last election. So just looking at people who voted for Biden versus people who voted for Trump in 2020, 80% of the people who voted for Biden had favorable views of the Black Lives Matter movement, whereas about an equal number among Trump supporters had an unfavorable view of the Black Lives Matter movement. When we look at views on the criminal justice system, a similar number about a little over 80% of Biden supporters saw the criminal justice system as a system that treats Black people unfairly, whereas about 80% of Trump supporters thought it treated all people fairly. So because of this, people, especially Republicans can say something very explicitly racist and not have to worry about offending their base because most people in their base today are fairly comfortable with either explicitly racist views or are very outspoken about their levels of racial resentment. The other dynamic is that there's been a lot more attention in recent years to the fact that white Americans are a shrinking share of the US population and that's made the white identity much more salient and much more important to a lot of white Americans. So today up to 42% of white Americans say their white identity is very or extremely important to them. And there's a lot more concern, especially among white Americans, if you can see right here that the country has gone too far in terms of giving Black people equal rights with whites. So we have these two dynamics where the parties are now more cleanly sorted along racial lines in terms of attitudes towards racialized public policy and two, there's increasing concern about racial threat. And so today Trump and other candidates can run ads like this, which are very explicitly racist, very explicitly linking in this ad Muslims to stereotypes about criminality or terrorism with no consequences. And so for a while, we've known that implicit appeals to racism can evoke racial resentment in public policy preferences, that explicit appeals to racism can be effective tools that evoking racial resentment in public policy preferences. But it's also racist question about, is this it? Do even positive appeals to non-whites? Does even general outreach to non-white voters, does that also evoke racial resentment? And I explored this in some of my own work, just looking at first in 2012, I just looked at Obama's outreach to Latino voters and whether when ads were narrated entirely in English, if white voters were more supportive of Obama than when they saw ads that were partially in English and partially in Spanish with English slide titles. And when it's in Spanish, the obvious thing is that it's a tool of outreach to primarily Latino voters. And what I found was that especially that overall you can see that white Republicans and white Democrats were both less likely or viewed Obama less favorably when they saw the ad that had Spanish language content in it than when they saw the ad that was entirely in English, entirely in English. But the difference was much larger for Democrats than it was for Republicans. I looked at this again to see if even when it's not Spanish language outreach, what if it's just when candidates are just courting Latino voters, if that also has a similar effect, if just indicating that a candidate is doing outreach to non-white voters, if that has a similar effect. So I ran another experiment in which I asked a random sample of white Democrats since that seemed to be where the action was happening. I asked them to evaluate a news website that I made up. And I asked them to say, okay, like how clean does this website look? How much do you like the photos? How do you feel about the layout? And at the end they also asked them about their views on political candidates. This was right before the 2016 election. And so the only difference between the two treatments or the two types of websites that people saw was the headline and one treatment and one website featured a story saying that Hillary courts undecided voters, whereas in the second one, it was the exact same layout, but it said Hillary courts Latino voters. And I found a very similar effect, again, among white Democrats or whites who identified as Democrat, that when they saw the ad saying that Hillary was courting Latino voters, they viewed Hillary much less favorably and were much more likely to view Trump favorably. When I asked about who they were like most likely to vote for, and this was in the months, I think it was like September of 2016, who they were most likely to vote for in the 2016 elections. They were much less likely to say they were gonna vote for Hillary, about nine percentage points, less likely to say they were gonna vote for Hillary Clinton, and about 11 percentage points, more likely to say that they intended to support Trump when they saw the headline saying Hillary courts Latino voters as opposed to Hillary courts undecided voters. And so we've seen this evolution of research on race, media, and political attitudes where the types of messages that activate racial resentment went from being just implicit appeals to racism that didn't explicitly say anything racist, to then even implicit, explicit appeals to racism outright, racist stereotype statements have been shown to be to want to activate racial resentment and have it kind of shape people's political preference and candidate views at the time. And now we've seen robust evidence as well that even positive outreach to non-whites, stuff that doesn't evoke any of these stereotypes at all is enough to activate racial resentment among especially whites political views. So what types of messages advance a racially progressive agenda? So we know that a lot of things, almost any discussion of race can evoke racial resentment among people who hold high levels of racial resentment, but what types of messages could be used to advance greater support for, again, a racially progressive agenda or an agenda that takes more action to address racial and economic disparities? And there's been one argument that was put forth relatively recently by a scholar named Ian Haney Lopez who was a law professor at Harvard and is now at Berkeley. And he makes this argument in his book, Merge Left, that there's really three groups of people, right? So there's the base of Americans that actively supports institutional action to address racial and economic disparities. And it's about, again, 23% of the population. And there's this other group of Americans who are pretty opposed and unpersuadable. They believe very strongly in views of individualism and meritocracy that people are responsible for their own experiences and opportunities. And there's very little you can do to persuade them or get them to shift their preferences to support redistributive policies or proactive policies to address racial and economic disparities. But there's this third group, about 60% of the population that is persuadable. And he defines them as people who do think that racial and economic disparities are real, that they do need to be addressed, but they're not sure about institutional action. They often will accept concerns or will embrace concerns about reverse racism, but they also can be persuaded, again, to support more proactive policies about addressing racial disparities. And so he focuses on doing a lot of focus groups. He focuses on doing focus groups throughout the United States to try to understand what types of messages appeal to this group of voters. What types of messages increase the likelihood of persuadables to endorse these types of policies. And so he argues there's a lot of content here, but I wanna try to break it down a little bit. That it's important to not ignore differences that it's valuable to use language that no matter our differences, most of us want pretty similar things. So don't say that we all have the same experiences. Don't say we all come from the same place or same types of contact, but highlight that most of us want pretty similar things even with those differences in mind. But he argues beyond that, that we should focus on aspiration, common experiences and shared interests. So it's important he argues or he says it's been effective to make race explicit, but often talk about race as black people, brown people, white people all share these experiences or all share these goals and that's something we can work together towards. So instead of just saying, for example, working people, we might say working people, whether white, black or brown and he finds that it's really valuable to not just say working brown people or working people of color, but to say working white people and people of color. So the valuable thing in this is that he finds that it does increase support among persuadables for more progressive policies on racialized political issues. The critique that many people have put forth is it seems to focus on really assuaging kind of concerns among this middle group, kind of really focusing on making them feel included, almost to a degree where it minimizes the level of disparities has been the critique, but that's kind of the political trade off that many people have put forth. So I really wanted to end there and I wanna leave this up and just ask people what everyone else's thoughts are on this, what people's reactions are to this and what people's reactions are to all of this in the context of the last election. So I will leave it there. So thank you so much for your thoughts on this, media and political issues. And this includes the types of messages that can help us in making a rich, religious agenda that work in victimizing disparities and so forth and so on. And for the remainder of the session, I will just open it up to discussion for you all to ask a few questions. And as a reminder, you can make use of the chat box, you're invited to do so, or to unmute your microphones and pose the questions directly to the faculty discussant. My Zoom is freezing a little bit, so I can't see the chat box, but I really wanna know people's thoughts, especially as people again, really engaged in politics and policy. This is really the language that Bernie Sanders campaign was very focused on. He was focused on, again, using language that didn't just focus on black and brown people, didn't just focus on white people, but consistently referring to this unified collective of white, black and brown people who share similar aspirations. And I just wanna get people's thoughts on how effective that was or would be in a different campaign or appropriate it was. So we do have an comment in the chat box from Jamila James. She says, I feel like once again, it shows that if you want real change, you have to make sure you are comforting white people, making sure they don't feel bad. I mean, I think that was the big critique of this approach. I think, I agree. I mean, it's very much focused on like, again, assuaging white guilt or maybe making white people not feel like they're too different, so I think that's a valid concern. Professor Anlion has a question. First of all, Mara, this is just fascinating. Thank you so much. I think when I was thinking about the studies you were presenting about Latino using Spanish or using appeals to Latinos and how that affects support, one of the things that made me think of was the Republican convention this year because the Republican convention did a lot to sort of overtly appeal to voters of color, whether they had a lot of black speakers, they had a lot of Latino speakers. And I wonder if there's something different about having, so if Democrats make appeals to Latinos or African-Americans or Asians, then people take that for granted. I wonder if having the Republican party make those appeals would cause a different result, a different kind of, would it cause the same kind of decline in support among Republicans or might it even show an increase in support among white Republicans that you're hearing these kinds of appeals? I think that's a really good question. And I think where I hear your intuition going is exactly where my intuition would go as well, that because these parties views are so distinct on racialized political issues and the action that should be taken about racialized disparities, that it would not at all fall flat when it's used by Republicans that in that case, it might actually be super effective because it would again, it'd be like, saying that see like we're really, we don't have these racist concerns. It's like when Trump was like, I eat tacos or I had tacos on Cinco de Mayo, like he says these very superficial statements and it's taken as this very significant outreach. I think if they started doing it too much then I could see it going in the other direction but I don't see that happening. A lot of this is just built on evidence and there had been another group of scholars who had just showed a lot. And I know you already know this end but that just showed a lot of white voters that the percentage of the American population that's non-white that is growing and they're gaining greater access to power and resources and that that evoked a lot of racial threat among white people. And so as long as there's nothing that conveys that, I think anything short of that is really effective but I think just like Jamila said, is this really, I mean, do we always wanna have to be so sensitive, is that really making progress if we're just kind of like dancing around other people's discomfort? So Allison has a question in the chat box. We have a couple of questions in the chat box and also a couple of hands that are raised. So I'll go to a question in the chat box first before I acknowledge those with raised hands. So this question comes from Allison's. Allison, how do you shift your language to meet people where they are without a condoning racism? How do we hold people accountable and invite them into the change? I think that's a great question. I think there's so much really good work being done on this not just when it comes to racialized political issues but even like when it comes to talking across party lines or other lines of difference that and this is really what Ian Haney Lopez does or argues is effective. It's just highlighting any type of commonality even if that's commonality in where you wanna go. Even if you like say like, okay, we've had different experiences and we come from different places and our experience in the world is completely different but we both wanna get to this point. And so we need to recognize that so-and-so he argues that identifying shared like enemies or whatever you wanna call it is really useful. So in this example, he talks about wealthy special interests who rig the rules. So not just saying wealthy people, not kind of villainizing people because of the category they occupy but based on like the ideas that they're putting forth. His argument is that that's been really key. So we have two raised hand. One is Zoe. I don't see your hand raised now but Zoe, would you like to unmute your mic and ask a question? Yeah, I would love to, thank you. It's a question slash a comment. I just regarding the third point about making risks explicit. I feel like it depends on the audiences and if you have a really diverse group of audiences it feels challenging because you don't wanna leave out certain races and by looking at working people whether white, black or brown, I'm already wondering like, then what about like East Asian people? So I wonder like what is a better way to make race explicit but also be inclusive when you call out races? I think that's a good point. And the other point I think that your comment gets at is that I might use a label to refer to myself or I might use a certain label that I'm okay with like, some people are comfortable with lepinax but some people really prefer Hispanic and so then which label do you use? Even among, if you're talking about like Air Americans some people prefer Southwest, North African. There's just a variety of Middle Eastern, North African. There's so many different ways of representing ourselves and so you don't wanna use a term that some people find offensive. So I think that's another really important point. I don't think he addresses any way to get around that. I mean, he's also said in some of his focus group where just weaving in different groups even if you don't say them all at once but just weaving in different groups throughout like the conversation you're having so that no one group is constantly the focus but others are also kind of represented and included. But if you have thoughts or other people have thoughts or reactions even just like gut reactions I would love to hear that. So I do have, there is a question that I'd like to go to in the chat box and then I will acknowledge Jitam so she can make her comments. So the question in the chat box is sent to me, not a public message but this is a white from a white UM staff member here. So thank you for the very helpful advice on what to say and what not to say as a program leader slash manager I'm very conscious of the fact that I could say something that is offensive to other white people and those that are part of the BIPOC community meaning the black indigenous people of color community. So that's a comment and Jitam will go straight to Jitam. Good afternoon Dr. Osfield. Wonderful and very timely research as we've seen just different things shift over the last week. One of the conversations that I frequently have with my classmates last year during the primary season was around Bernie Sanders focused on class instead of race. I mean as a black woman from North Carolina I told them that's not gonna go well for black people because we understand we see every day how race is providing certain barriers in our lives. And so it's very interesting to see the poll data around majority of white people believing that that's not the case that we've gone too far, we've done just enough. So I just wanted to know like from your thoughts and just thinking about what we've seen in Arizona, Nevada, Detroit, Michigan, Philadelphia and Georgia and how these racial groups are actually shifting and winning elections in certain areas. What are your thoughts on how do we mobilize this group while also not isolating white Americans? You know what's so interesting about your comments too is that I mean I think so the data that I drew from kind of glasses over this other aspect that there's been a shift in how parties align along class. So we know that in the most recent election a lot of the wealthier, more educated people are voting Democrat. And then a lot of working class and lower income people and not just among white people there was a shift across racial groups towards Republicans that I think was really surprising to a lot of people. And I'm not really, that was very surprising to me I think it's still out, we've had so many problems with all our exit polls and our pre-election polls like how robust, how big that is. I really liked your point. There's another scholar who just focuses on the distinctiveness of like Southern identity and how that can intersect and really important ways with how people express their views on racialized political issues and in distinctive ways for whites who have strong Southern identity and non-whites especially blacks who have strong Southern identity. And so I think you're getting at a lot of divisions that weren't closely like fleshed out in a lot of Biden campaigning. Unmuted. So we have a question in the chat box and then I see where Susan Page has her hand raised. So we'll go to the audience after this question in the chat box. So this is from Jeffrey Grimm. Thanks for joining us today, Jeff. Dr. Osville, thanks so much for your talk. It made me miss our 2016 class in the Ford School because it seems like the media and public surprisingly learned this year that the Latinx vote is not a monolith. With your earlier study showing how Latinx voters respond to messaging, are there differences within the Latinx diaspora with political messaging? Yeah, I think, I just wanna be clear that the last, the experimental data I shared was all among white non-Latinos. So there were Latinos in that specific study but I do think that Jeff is getting at something really important that we know there's big differences in like Latino's political preferences and how they respond to campaign outreach. There was, and I think it's really unfortunate how both Latino and Black and Asian American and Arab American voters have often been treated as being completely driven by like singular issues that all Latinos are completely driven by immigration attitudes and that all people, all Cubans are completely concerned about foreign policy towards Cuba. And that's just not the case. When we saw that, there was a big shift, for example, in Southern Texas and the Rio Grande Valley towards Trump and a lot of that was because in economic concerns is what existing data has pointed to a lot of, there's not as many jobs in that area, one of the biggest employers in the area is border control. And so concerns about defunding the police while often has positive aspects because then a lot of communities of color are left police but especially in that area, that's the main employer of a lot of Latino families. So then it has this other concern of like, how am I gonna support my family if we defund the police and different police institutions? And so all of these are very multi-layered. And then there's the concern that a lot of people of color are just being tired or very tired of being painted as kind of an assumed democratic vote. And I think we're seeing growing people really wanna push back against that because it results in parties and candidates not really putting as much effort into campaigning or doing outreach for BIPOC votes as they do among suburban white women and working class whites. Okay, we do have a hand raised from Susan Page. So Susan, please unmute your mic. Thank you very much, Dr. Ostfield. And I'm sorry that I missed a little bit. So I hope that this is not a sort of repeated question but it kind of follows a little bit on the last question that you just answered. But how do we, okay, as a person of color myself as a black woman, how do we help in particular, let's say, Democrats and Republicans understand exactly what you're just saying, which is that guess what? You can't take all of these votes for granted. Whether Republican or Democrat, you can't assume that everyone is, from the Latinx community is only concerned about socialism or communism if you're a Cuban American or immigration or if you're a person of color that it's only about race. When Michael Eric Dyson talked about this, I don't know, maybe two years ago, that black people are generally very conservative and socially conservative in particular. I'm not getting anything. I don't know, did Susan ask her question? I'm sorry, I didn't hear it if she did. Well, you can't hear me. Stephanie, can you hear me? I can hear you. Do you mind if I put it in the check box? Sure. So the question in the check box and this is from Theodore Ma. So he says, I've noticed that if you do have a shared common experience, that common experience can sometimes be used as a tool to discredit institutional racism that an individual may have experience. For example, when I comment on the challenges and subtle discriminations that I had experienced during high school as a first generation immigrant, I've had some respond by saying, oh, I'm sorry you had to go through that. But that's not what I experienced in high school. A similar attitude sometimes came from some self-proclaimed liberals as well. What would be the best approach to address this? And that's a really good question. And I have to say, I am not a campaign strategist. I am not like, I've really been, I've really been, I've studied the effects of different like messaging, but I can't say I figured it all out. I will say that I think it's hard when you're doing exact, I mean, I think you're getting at exactly what Ian Hennie Lopez had said, that it's good to talk about commonality, but sometimes it will be accepted, sometimes it will not be accepted. And sometimes it can even be kind of dismissed or commodified, or you can, as a result feel reduced to that. And that's not optimal either. I mean, I think the hardest thing is that everybody, everybody is different. And so I think especially when it comes to sharing your own experiences with discrimination, I would say you really have to focus on first prioritizing what makes you feel respected and taking care of yourself, especially in this context. But yeah, I mean, there's just such a range of reactions you can get from people. And it's a really vulnerable position to be in when you're sharing something that personal and intimate and not know how people are gonna take it or use it. So there's some, some really, some tension that's on the side of the phone. So building on, so this is when it comes from, I'm getting feedback. Building on both Jeff and JaTem's comments, there's a really interesting contrast between Hennie Lopez's focus on commonalities and what companies are doing, are now doing, which is micro-targeting.  They have these representations of groups about, you know, it started off with just soccer moms, but then it evolved into like, I don't know, like insecure millennials or like you hear all these labels. And I think what they're trying to do is say if they have all this data on you, but it just, it still comes across as kind of like high resolution stereotypes in some ways. Like the fact is that I think the focus of campaigns has shifted too much to trying to buy voters and too far away from just trying to like sell ideas. What are you about? What are you gonna do?  And I think that's like, that's a really tragic component of where our political system has gone. Susan, do you wanna cry again? Dr. Osfeld, can you hear me now? Dr. Sanders, maybe you can just read the, it's not very eloquent. Let's see, let's see. So Dr. Osfeld, can you hear me? Yep, I can hear you. Okay, all right. Susan, maybe something's, yeah, technical difficulties here. So this question is from Susan Page. How do we convince politicians to look at people for their values? It says, black Americans tend to be very conservative, socially and economically. Many black Americans are very religious and align more with conservatives or Republicans on these issues. But many Republicans don't seem to know that they could grow the Republican base without recourse to race by focusing on conservative values, quote unquote conservative values. In other words, back to the assumption, in other words, back to the assumption that blacks are only Democrats. Let's see. Yeah, that's it. Yeah, okay.  I think that's a great point. And I think that's the point a lot of people have been trying to make that there needs to be this assumption, especially that blacks are always gonna vote Democrat and to a lesser degree, but to a similar way that Latinos are always gonna vote Democrat has not always served these groups very well because then it's, sometimes there will be like a little bit of outreach by Democrats, but for the most part they're considered the solid base that's not really either not really gonna vote or not really gonna be a risk of not voting for them. And I know Angela Dillard really focuses on black conservatives and the importance of getting Republicans to invest more in the arts that they've made, they claim to have made efforts and most of them have come across as relatively superficial, but I think you're getting at something really, really important and problematic in our party system. Yeah, and I know you can't hear me, but Dr. Sanders can. I would just say, I'm not trying to suggest that a political strategy, but adding simply to what you're saying. So Susan said she's not trying to add to a political strategy if you can hear me. Can you hear me, Professor Osveld? Yeah, I can hear you great. Okay, all right. Thanks Susan so much for working through those technical difficulties. So there is a question in the chat box from Elizabeth LaPorte. So she says, in general, Dem seemed to develop much more complex messaging and GOP seemed to convey simpler messages. How can more liberal BIPOC supportive candidates take better advantage of simpler but meaningful messages about key issues? I'm gonna look, what do you mean? I'm gonna ask you to elaborate that. Like what are you meaning when you say to take advantage of that? Elizabeth, please feel free to unmute your microphone. Hi there. First off, thanks for everybody that's contributing to this. It's just been a really rich discussion. I think that's the piece is that what we saw with Hillary and other candidates was that their messaging was quite complex. They were addressing meaty issues. But I think people got lost in some of the detail. And so while I'm certainly not a Trump supporter, what I noticed about a lot of the Republican messaging was that- I am not getting any sound from anyone but you, Stephanie. I'm sorry. Elizabeth? Yeah. Can you hear me? She can hear me, but she's not getting sound from anyone else. So read your question again. Or if you could say it again and then I'll repeat it, I'll rephrase it and repeat it. So I noticed that Democrats are developing complex messaging and GOPs seem to convey simpler messages. So my question is, how can more liberal BIPOC supportive candidates develop simpler but meaningful messages? And how can they convey things just in a clearer way that I know it doesn't always have to be sound bites, but it seems to me that things are sometimes overly complex in terms of their communication strategy. So Professor Osveld, this will be the final question we are running out of time, but I'll rephrase here. How can liberals develop a simpler message, especially for BIPOC communities and convey a clearer message? It seems to be that some of the messages are really complex or for certain communities, such as a BIPOC community, how can liberals develop a more simpler message? I think that's a great question. And I think unfortunately the challenges that a lot of the outreach that campaigns typically do to communities of color tends to be really heavy on the symbolism. So they'll often rely on things like they'll translate something to Spanish or they'll have some type of cultural icons or music. But I would actually argue that there needs to be more of an investment into actually communicating policy in the outreach, especially to communities of color, because it's often very thin and superficial, like we're pro-immigration or pro-immigrant, but what does that mean? What exactly are you saying? Are you committing to supporting DACA? Are you committing to making that a priority? And I think that turns off a lot of people that then there's less capacity to hold them accountable. But I think, I mean, there's another aspect of what you're getting at that everyone is not as politically passionate as the people who spend their lunch hour coming to talks on this. And so how do we keep those people engaged while ensuring that the content of outreach is not reduced to symbolism? And I mean, some people would say that's where micro-targeting becomes valuable, but I think that that just comes with such a host of assumptions that can be very, like that can really minimize people. And so, I mean, I think there's some ways where you can provide information where people can like pursue more. So start with basics and then opportunities to get more information in various languages. Probably a good way to go and very spokespeople. Well, that's, it's, we are at time. So it's 1251, but we really appreciate everyone for joining us during the lunchtime hour today. Thank you so much for joining us for the second installment of the Public Policy and Institutional Discrimination Discussion Series. Thank you so much, Dr. Osfeld, for talking to us today about a very complex issue. And there was a lot of engagement around this topic. So I really appreciate you for joining us and engaging with the Ford School. So we will resume the discussion series on February the 18th with faculty discussant, Dr. Earl Lewis, who will discuss history, reparations and public policy 2.0. So this concludes today's event. Thank you so much for joining us. Thank you, everyone.


Okay, I think with that, we'll go ahead and get started. Welcome to the opening plenary session for day three of the annual conference. Very glad to have you all with us. I'm Mike Frost. I'm the product manager for tracker here at the University of Oslo. And just am here to introduce the session and then turn the time over to my colleague Bob. Just to give you a sense of what we wanted to do with this session. We're often asked about where we think DHS to fits within a broader health information system ecosystem, and also kind of how we view interoperability. There's often requests coming to us about how do we categorize DHS to what are the health information areas that we do and don't work in how do we view interoperating with other systems. And quite honestly, we're often difficult to define. There are many global efforts to try to put together a taxonomy of different digital health interventions and DHS to crosses a lot of those categories. Largely do I think to the fact that our primary mission and the features and functionality that we work on. We have a lot of life from trying to support ministry of health needs. And we think that that's a very important aspect of why DHS to has been sustainable and successful. And more importantly, that that's how we can achieve data for action is to meet the needs of those that are on the ground and using systems, which has often driven DHS to into various different areas. DHS to from our perspective as a kind of underlying bedrock principle to be a free and open source software and to be as interoperable as possible with other systems. We've always intended for DHS to to fit in any country environment whether there's a very established kind of enterprise architecture or whether we're talking about ad hoc linking of various systems. We want DHS to to be flexible enough to be able to accommodate these these various scenarios. So we have recently made efforts to define this more clearly from our perspective. So we're going to go to web page DHS to dot org slash interoperability. I think, or integration. Sorry, integration. Take a look at that page. You'll get a lot of the information from this session there fleshed out in some detail. That's also where we will continue to update and provide more recent resources and links around integration and interoperability. My intention is to have DHS to kind of meet the needs of where you are in your countries and in your projects. So the Bob Joliff is going to lead us through some discussion here. Bob has been working as a senior implementation engineer with the University of Oslo for some 13 plus years. That title like many of ours at the university doesn't really do Bob justice he works as a lead in interoperability security contributing to infrastructure decision. He's often the one coordinating emergency responses, you may recognize him as someone who's come and train the system admins in your country, or who has helped link the DHS to team from your country to others to build a stronger community. I also think Bob serves a bit as the conscience of DHS to here he's often reminding us of the need to be aligned with global standards and principles, which means that he also stays up to date on a lot of those conversations and spends a lot of time on committee meetings and phone calls that he wishes he wasn't doing. I would like to nail down Bob today for this plenary session to give us from his experience, how we view a bit of DHS to and how it fits into the health information ecosystem. So with that, I think I'll turn the time over to you Bob. Thanks Mike for that illustrious introduction. And welcome everybody. Good morning, afternoon, evening, wherever you are. Yeah, as Mike was saying what I'm hoping to do with this session is to introduce a little bit of background and a little bit of where we've come to in terms of how we view our posture around interoperability and try and maybe use this session a little bit of a sounding board as well and hopefully get some reaction good or bad towards the end of it. So yeah, without further ado, let me just quickly jump in there. I didn't come up with the title for this presentation. Unfortunately, I'm going to stray a little bit from the title, but we have to deal with what's on it and it starts off talking about ecosystems. So what we'll do just very briefly talk a little bit about ecosystems and why I'm a little bit uncomfortable with that metaphor in fact. A little bit of touching on architecture. Furthermore, technical folk will do a little bit of one or two slides just on one of the features of DHS to which support interoperability, and perhaps getting into more interesting stuff around one of the shared understandings of metadata required for interoperability to work. So a couple of examples, and then when I really want to get to it just the last two slides where we bring out where we'll present our kind of principles around approaching interoperability. So ecosystems. I hope I don't get in trouble for using that image. Just grab it somewhere off the internet because we look nice. Make a system as is as you all know it's a biological concept right it's defined on Wikipedia at least as a community living organisms in conjunction with non living components in their environment interacting as a system. People are interested in ecosystems because of growing awareness of environmentalism and like. I started talking about digital ecosystems I think the idea has come really from the notion of business ecosystems. Which, as you see derived from from from the biological stuff largely that that kind of discourse has been around issues of competition and collaboration. The kind of properties which are interesting from from ecosystems are things like self organization and scalability and sustainability, probably resilience which is a popular word nowadays, nowadays resilience of systems as a result of those three kind of characteristics. It's frequently used in terms of in the context of API and platforms and you'll hear it used in the respect to DHS to sometimes when people will talk about the DHS to as a platform, which facilitates the growth or the nurturing of an ecosystem around it. Okay, some things to maybe step back and hold on to. I think this ecosystem metaphor can be very useful, but I think it's worth bearing in mind. First of all that health information systems, particularly architecture are not natural, right. They're produced by deliberate human action. And when you start looking at production you need to take into account things like who is doing the product, who is doing the producing, who are they producing for why. The end of the systems is to enhance health workers ability to improve health health outcomes. Right, it's not in order for business to flourish so I think in that sense, there's a little bit of departure from the business ecosystems kind of notion, which a lot of it is about how to create environments for business to flourish. So yeah, the ecosystem metaphor I think is very useful or can be useful in achieving the ends of enhancing health workers ability to improve health outcomes. But at least for us and we don't view the creation of ecosystems as an end in itself and I've seen this proposed in a number of places I can react a little bit to it. I mean our interoperability posture is not about creating ecosystems. So it can be where they are useful. We do a more, maybe a view which it may be more in touch with our kind of traditional mode of operation is around the notion of collaborative projects. Anybody's familiar with the work of Andy Blondard but all that collaborative projects are seen as kind of the kernel social scientist or the unit of analysis of anything which has to do with human action. Right, if we're talking about social human action, then at the kernel of that is the notion of a collaborative project. So, what can we say about collaborative projects and DHS to where does it lead us well. People familiar with the literature that the the his literature or mythology or history or whatever you want to call it will probably be familiar with with references to the early Scandinavian participatory action research. And what that involved was the formation of collaborative projects between system designers and unionized workers. So you move into the early his days. Yearn is probably the best, the best speaker on this kind of subject. Early his place were certainly characterized by collaborative projects formed between his and the National Ministry of Health in various countries, South Africa being probably the earliest one. An important concept I think that underlies both of those notions of collaborative project as a notion of solidarity. That was and I think remains a very strong basis for why and how we we bring those those collaborative projects forward in the world. So another concept, I guess, which is which is part of now that the his folklore history is the notion of networks of action, networks of action, the famous paper written by Yearn and some deep and Eric Monteiro. And what they recognized in that that it wasn't sufficient to see a collaborative project as as a as a unit on its own, but need to be, need to be seen in a, in a more holistic global context. And the need for much broader collaborative projects which spanned countries continents and sectors. Yeah, that's the early notion of collaborative projects within his has always been central to to our kind of mode of action. More recently, the range and scope and nature of collaborations and the kind of collaborative projects we engaged in has has become much more complex. And at any one moment in time, we involved in a significant number of different types of projects some very large and some very small. I like to think of collaborative projects sometimes as if you think of the simplest prototype for a collaborative project in human activity is probably taking a walk together, right two people get together and decide to take a walk. That's something that that humans have have done and continue to do people have walked from Syria to Norway, right people have taken a walk around a field, whatever it might be people are coming together with some reason to collaborate on an activity. Currently, yeah, we've been in large scale collaborations with WHO, PEPFAR and UNICEF, as well as collaborations with with software other software vendors. Open MRS long history with we'll see more of that in a bit more recently we've been talking to the likes of DIVOC on COVID certificates, rapid pro long, long history of collaboration with the depth of engagement, particularly without the software vendors. There is quite a bit. But I think at its at the simplest and least committal this is like the walk in the park rather than the long march. We simply said well here's the API and here are the docs and you know what you want to do and see if you can do it. And there are fortunately I think many examples and probably some of them quite unknown to us where this has been very successful. And this is something we naturally want to encourage it's kind of a validation that our API works and that our documentation is suitable. When we see these kinds of uses. We get involved in more one on one interaction with different vendors to hammer out a common approach or common patterns. This is an example of which I suppose over the last year we've done. A lot of discussion with rapid pro for example, along these kind of lines it's not a short term thing we really want to go into a lot of depth in terms of what are the actual opportunities to be had the collaboration. Similarly, I guess with IVOC. There is a risk to do in terms of setting up regular meetings and doing the homework and and there is a risk sometimes when having in depth, intra vendor discussions like this that you're not always going to be well grounded in terms of what's happening on in the context but the subject right at the end. Often it's sufficiently important or the relationship that you have with the other parties sufficiently important to you that it justifies the effort involved. Thirdly, I guess type of engagement. It implies a kind of longer term architectural perspective and I think this characterizes for example the way in which we have interacted with open HIE since its inception. I suppose nearly a decade ago now I've got a slide on open HIE later so return to that. The point here I guess is to say that from the early days where the collaborative project initially was a relatively simple thing and characterized by very clear understanding of solidarity of purpose. Those collaborations have become more richer and complex. The challenges. This could have been 20 slides I suppose some of the challenges that we've encountered generally in in working with integration. First of all, I think keeping center our solidarity driven collaborative project with with country partners in particular as central in all the engagements that we take, we participate in. It is possible to lose track of that, particularly in the excitement of looking at new technological developments and possibilities and what have you. Staying in touch with the base is really important. I think we find over and over again particularly people working quite closely at the core in Oslo that in the local his groups who often have a much stronger understanding of architectural concerns on the ground. As you have back in Oslo and keeping that very strong that strong connection is is is yeah ongoing challenge. Obviously rationalizing time and efforts I mean what I think we've realized and we've talked about recruitment and more recruitment and the need for more interoperability engineers and delight is that it can be very, very time consuming. Obviously if you're involved with lots of one on one interactions or involved in lots of standards committees and discussions and like, there is certainly need to rationalize. We have had interesting challenges grappling with standards. Generally, from our perspective we view standards as very important as key enablers in simplifying a lot of interoperability and integration scenarios with participate quite directly with things like ADX for example for aggregate data. As part of the technical committees maintaining and developing those standards. GI on the GIS side I think we're quite strong in terms of very, very clear support for the likes of GeoJs and WMS, TMS I think we still support GML also to a certain extent. We grappled a bit with fire partly because it's arrived with such a bang in a way. I'll talk a little bit about fire shortly hasn't been easy. The other challenge I think we've had historically is dealing with the notion of scope creep everybody knows that DHS to can do a lot of things. And very often people are pressuring DHS to do even more things. And historically I think we've had a tendency to drift into areas where, where we probably would be better holding back a bit. I think that the work that's currently going on with this newly formed logistics group is very interesting that regarding the sense that they are, they are very clearly trying to demarcate in the LMIS world, where it is the DHS to has a role to play, and at what point, it's much more useful and beneficial to have, have clear interfaces with, with other LMIS systems. In terms of interoperability features I guess from more technical perspective what's provided in DHS to which makes interoperability possible. The most important thing is to, is to talk of the rest API. It seems almost, almost trivial to be even mentioning that at this point, but it's not been around forever I think the rest API really took shape only around 2011 2012 I suppose. The API is something which exposes pretty much all of the functionality of DHS to the fact that it's used by the DHS to sort of stock web apps means that the, the functionality exposed is fairly complete. It's an ongoing moving target I think, I think that at the moment, we can say it's, it's, it's pretty strong it's, it's almost comprehensive I don't think we can, we're 100% complete. It's something that we constantly striving towards. Clearly, it's good enough that it enables quite a lot of interoperability at present, but yep, that will, that will continue to, to be more become more rigorous. People who work with DHS it will know that it has a very flexible metadata model, which you know is a, is a blessing and a curse, but having this flexible metadata model some of the more important aspects from an interoperability perspective is that it allows for, for custom attributes so it's possible to do things like create multiple identifiers with different types of entities to be able to make a matching between different systems possible. We have very, very primitive support for notifications. I mean up until quite recently what we could do is send out an SMS or send out an email. Part of a result of our discussions with RapidPro in fact and also with Tyvoq has led to the conclusion that we really need to have much better, much better support for, for webhooks. And that's a little bit of functionality is has been implemented already but that's going to be a strong, a strong focus for development of the future.  So an API is inherently a passive thing with webhooks we enable a little bit of more active responses to events in the system. And the syntax of things like REST APIs and data models and the like. Obviously for interoperability to work, you need to get into the into the semantics of what the data actually means. And one of the things that's clear is that if you were to share data between between any kind of systems, it sort of presupposes that there's some kind of common understanding of, of what I call anyway the structural metadata. That consists of things like facility identifiers. There's always a starting point to, to, to try to exchange data between any two systems or five systems is they need to have some common understanding of how to identify facilities. And as you grow go a bit deeper into these metadata ontology, things like data sets data elements tracked entities, all of these things. You need to have some way of, of getting common understanding between systems on them. Similarly control vocabularies for option sets and categories code lists as people often call them. All of our communities not just DHS to have been grappling with the challenges of how do you actually optimally reach and maintain shared understanding of this structural metadata across different systems. The facility registry was proposed 10 years ago as a low hanging fruit to resolve some of the issues of facility identifiers. I don't want to go into all the detail about here but I think many of us know that is not quite as low hanging fruit as perhaps people, people thought some years back. There's a role I think for terminology services and standard standardized code systems, ICD-11, SNOMED CT, MEDRA has come across quite recently. More and more I think that if we start using standardized code systems it can potentially ease the burden of translation. But again, there's it's no silver bullet we often find that the types of metadata we have there isn't really a corresponding standardized code that's useful. We have IP issues to resolve some of these code systems are not freely available. It causes a bit of conflict with our licensing model of particularly around the metadata packages which I'm going to come to on the next slide. I think people have been around DHS2 community the last couple of years one of the things many of you would be aware of these these packages, which evolved initially from collaboration between between University of Oslo and and WHO. The original rationale is my understanding has been that that they allow a very rapid and simple configuration of the DHS2 of what was current WHO guidelines on on areas like TB, malaria and HIV. The benefit of that being that then all users who who use those packages could benefit from having these pre-designed indicators and dashboards and graphs and charts and the like. I don't think it was considered at the time. I think to do with interoperability, but what has happened I guess as a kind of unforeseen side effect is that now as you start to see a number of systems which effectively have the same packaging of metadata. It's actually quite easy to design data exchange flows right whether you do it with with native DHS2 or ADX or even with fire. If you have some kind of standardizing of the metadata that are in different DHS2 instances, it becomes it becomes an attractive interoperability target and I think we've seen a lot of interest between the last year, particularly around that. One of the things that we've been able to do, at least with the HIV and the COVID aggregate package is to take them to the IHE, to the Quality Research and Public Health Technical Committee and produce committee-balloted standard profiles out of them using ADX. There's ongoing work I think within the metadata packages team to investigate different ways and find different resources for improving standardization of terminologies. I say where appropriate because sometimes it's been hard to find a good fit there. I'll just briefly talk a little bit about fire because it is very important and it's something that I know a lot of our fellow travelers have invested a lot of time and effort into. It's probably become of increasing interest over the past five years. It's a really exciting thing for anybody who's worked with fire and particularly developers get very excited about the richness of the model, the kind of level of energy around it. It's quite challenging, particularly for kind of legacy systems I'd say or systems which like DHS2 are primarily involved with help but not entirely. I think we also have been used in education as a lot of you would know, but also in some other areas, food security.  So we've grappled a little bit on how best to integrate with HL7 fire-based activities. There was a fire adapter developed back in 2019 through our interoperability or integration team. And we're going to hear a little bit about that in the interoperability session coming up after this. My colleague Morton has developed some quite clever Python integration scripts, which act as a little bit of a facade for for example presenting our native DHS2 option sets as fire value sets, all units as MCSD fire resources. After we've seen relatively low adoption of any of that work in the field. And so, I think as it was exchanged between DHS2 and fire, I think it's always going to be a bit lossy in the sense that the data models are never going to be 100% the same. And for the moment, I get most of the actual interoperability work that's gone on. I think fire has been a little bit on the periphery of that. And that may change over time, but at the moment that's the case. We're following the work on fire, I guess, particularly that's been going on with the WHO smart made lines and within HIE. Many, many challenges and rivers to cross there still. I want to call out a little bit on HIE. It's kind of difficult to talk about interoperability and health in developing countries without without recognizing I guess the place that open HIE has had in all of that. One of the things that is really important to point out is that there's no DHS2 and they open HIE people often I mean I've been engaged with many conversations around this. Why are you using DHS2 you should be using open HIE or some variation on that. The DHS2 is part of open HIE and we have been part of it's not quite very, very start but very near the very, very early years. I should say maybe this is different perspective to some of the other or other open HIE collaborates. We see open HIE as a convening forum for important architectural discussions. I tend to view architecture as the work of architects. Architecture is the practice of what architects do and open HIE has been a very rich forum for bringing architects together to hammer out approaches, resolve conflicts and generally I think in live and deepen the discussion around architecture. We don't really see it as a source of software. It's not like something that you download and run. I think some people may have different perspective on that. Historically within the open HIE community we've been part of the facility registry sub community before it was part of open HIE. We have the HMIS sub community which is in fact run primarily by myself and Morton at the moment. More recently and I've been trying to drive this for some years and I think we're getting better. We've seen some involvement of other parts of our teams with different communities within open HIE, particularly around supply chain terminology. There's been some participation with the COVID-19 task force. Elaine is going to kill me because I haven't mentioned the data use community. There's quite a deep and long term collaboration within the whole open HIE space which we hope to continue to develop. I see it as one of the most fertile forums for architectural discussion currently that we have. I want to point out a few interoperability examples. It's really a shameless plug for the session that's coming up next. I want to then move quite quickly to interoperability principles. We've got open MRS long, long history of attempts to get good integration going with open MRS. A very interesting presentation coming up on that. Bikina Faso has got a really interesting use case. Again, it's about individual data from the periphery towards aggregate data at the center. It's a big theme that's interesting use cases around AMR. Anybody who's worked with AMR over the years will know that who net is the thing. We have John Stelling who's the sort of bees knees of AMR and who net. Working together with Julius describing integration that they've done there. Fire adapter people may be quite interested in what's the fate of the fire adapter where it is now. Ranga will be giving us some progress update on that. So this is just what we were able to talk about in the interoperability session which is coming up next, but obviously there's many, many more. Probably one of the more interesting things we're looking at currently is talking to open function who are they produce a kind of middleware integration software. And it's quite possible that we will end up using open function as the kind of middleware software. But also as support in terms of collaborating open function group around things like code with digital certificate generation using diver. Okay, so I want to finish off really presenting some principles which I think we've had a galva starting to galvanize around as DHS to community and bounce them off the rest of the world to get some feedback off your as at the past 10 years since the birth of rest API we've seen lots of developments we've been involved directly in large numbers of projects. Some of which should be pointed out maybe most of which I don't know but some of which haven't actually born a lot of fruit but consumed a lot of cycles. And DHS to is very, very far from perfect. We've got lots of walks, lots of rough spots. But I think continues to evolve in a good direction. We've galvanized as a team around the set of of six guiding symbols are just run by you here now. But firstly, I can't actually rid of all of these cameras so that I can see what I'm doing. Okay, good. They're all of DHS to and his in keeping with our 25 years historical mission is to act always in solidarity with our country partners brought up solidarity again. Bob just to mention because I think we're stuck on your open HIE slide and if you've advanced already to the side with the principles. My screen sharing is false. Sorry about that. Resume share. You have me. Okay, we can see you now on the full presentation. I'm going to go down to where I was there.  Okay, you see that principles. First principle and I think this is this is the most important principle and one that we want to keep very much at the forefront is that the role of DHS to is to act always in solidarity with our country partners. And this includes particularly when we engage with, with many other collaborations with many other vendors and partners and funders and whatever it might be central to our collaborative project is the solidarity with our country partners. Resulting from that I guess is that all interoperability efforts that particularly ones that we play a direct role in should have a clearly identified use value to the end users and system owners which kind of implies that they need to be involved from the start informed, as they by their direct input, what is useful. We've seen unfortunately too many interoperability projects where where data has sometimes flowed. Maybe not maybe for a very short time, but not sufficient thought has been put into well what's the use of that and the use for whom. The interoperability use value has got to be balanced against the cost right. Often people will say we want to have this system talking to that system without without a sense first of well what's the value in doing what the use value in doing that, how expensive is it to do it. It's important that that we, we keep this balance at the forefront where we're evaluating what kind of engagement that we need we would like to have or we would encourage our his partners to have for flame. And this is this is lesson from bitter experience I suppose is when you're talking about integration don't start with talking with the vendors of different systems would you it's much more fruitful to start with having data conversations between the data controllers or data users program managers about what's useful. If we have a clear emphasis on what is the data use that's being reinforced by interoperability, then we can have much more informed discussions with vendors about what kind of data flows are important. Fifthly, I have mentioned I think that the important thing to me about architecture is well who are the architects, right architecture, who is who is doing the architectural practice. Very often, the country level architects who are bypassed or ignored in the in the discussion and working with country level architects. Influencing them where possible if they don't exist, facilitate their emergence where we have local his his country teams regional teams, ensure those history involved in in the architectural discussion and not simply focused on the DHS to And sixthly, we view it as incredibly important and beneficial to to participate in girl in global collaborative processes I think I think that they inform a lot of activity on the ground. And it's sharing expertise and like so global collaborative process around interoperability and architecture and standards participation in standards bodies I think it's really very important. But all of this, you know, with with a very very strong foot on the ground. So that's it really that all I was going to present you all what I'm really quite interested at this point is to try to get some reaction, particularly on our six principles, whether they are offensive, useful in need of further elaboration. Otherwise, it's for me. Thank you. Thank you Mike. So we have, I can see john Lewis has his hand raised there john do you want to unmute and tell Bob that he's he's wrong. It's nothing about wrong. It's, you know, these six principles are very good. We all agree, not only in DHS to committee but like in a in many like whether it is open the maras, like everyone like who will be with open standards or things. This is how we just to go, whether it is on open HIV, all the other things. But now like my problem is like, when we are trying to promote this one in the Minister of Health level in in our countries in the lower research settings and just saying these are things. And they think this is DHS to standards. You are from DHS to you only want to use these standards. So I guess like it's somewhere it gets into. Yes, like we adopt these standards but they at the, the Minister of Health level they think, especially these different vendors, the Minister of Health don't really know much about the IP system at all. So they just say, oh, these are DHS to standards, but this is not DHS. These are just like a normal global standards which has to be which DHS to adopted it. And like the you're using it and changing it to meet the global standards. My thing is like if we can try to as a community come around together, like we have the blature work package, if you can have this. This is a standard as a separate one doesn't have to be so much onto the HR. So they say these are global standards, like if a Ministry of Health wants to get into building a COVID self registration the module or COVID vaccine module or other things. These are some something which they have to think through, rather than just like going back to 20 years back when they're just like doing things in the in a very silent matter. And all of the developers country, they know about this one. They include it but in low settings, the countries where we don't really know the message has not reached that. And every time like the his members or things we want to try to educate on things. It's always it is interpreted as these are DHS to standards, not as a global standards. Maybe we can try to include something on that one. John, are you suggesting, first of all, when you talk about standards you're talking about these principles. Are you suggesting that we should be elevating these principles to a more broader audience than just than just DHS to. No, I think. I think we can try to lead by example. Just listen these are the things I'd say but when we are talking about it, the people think because we are promoting VHS to. That's what all the people, they think wrong, but it's nothing to do with VHS like PSI, which they used in Vietnam or out place. They have their own app and other things they talk to you to VHS to send the data perfectly fine all this major actors they know about the standards, but not the Ministry of Health. And Ministry of Health, they get into developing small from their own local company and other things. They just sending the data they will download in Excel and then like upload it up all the patient data and everything. So there are these kind of problems what we are facing. I guess like when we talk about this one, like maybe open HIE or anything like we are trying to promote but instead of like this like diverting to towards DHS to. Because these all the things. It's, it's nothing to do with the VHS to itself. Yes, we are doing it in our principle, but it can also be a bit more, let's say, the guidelines. Maybe like other people can from the field can clarify. I'm not sure I see another clarification on that point but there is one that come up that may be fun to respond to so a question from the chat was for principle for where you said don't start with the vendors of systems does DHS to classify as a vendor and if not why not. Yeah. That's good question. I had a grapple to bit without words. I know if there's a better word for it, but as as we produce a product right we produce DHS to its open source people can download it and use it. But there is a sense in which we are a vendor. I'm not sure if there's a better word for that so the producers of systems or whatever it might be but yeah I in the way I'm using the word vendor I would say yes DHS or the University of Oslo classifies as a vendor. But I'm not using it in the sense of you put money in your vending machine and get the kind of coke out. Maybe maybe vendor implies a more commercial exchange I don't know. I think it's also worth saying from our side I mean we do straddle that line of it that we also from the University of Oslo we always consider ourselves a university first with a research program attached to it. That doesn't mean that you or your country need to trust that but this is the angle that at least we come from and that kind of guides the things that we choose to work on and the principles that we promote. So we're offering a free open source platform. People can take or lose but we also think very much in terms of you know from an outside perspective you'll see that research coming out of the University of Oslo also is critical of DHS to at times and what we're doing and we try to learn from that and grow from that so. Anyway it's it's again very much up to up to the country how they view that and I think we would all feel comfortable saying don't don't trust DHS to either. I mean take a look and see what makes the most sense in terms of data flow and what is the data need that you have. Does the system work. We don't think of DHS to is being perfect and we don't think of it as covering every possible use case. So, I don't know if you want to add any more to that Bob. I'm very open to suggestion to a better way than vendors. Like when we deal with open MRS rapid pro. I mean these are all produced by different groups with different kinds of organization. There's a sense in which they're all vendors of systems, but I'm happy to use a different word. If somebody's got one for me. Okay, so I've got I've got a hand raised here from Adam, Adam, do you want to jump in. Yes. Thank you both for this presentation I think this is highly welcome, given the context in which we are now and particularly in countries in Western Central Africa where people believe interoperability is now a sort of. magic words to skip to escape criticism about duplicating system or implementing fragmented ecosystem in. I think I and I hope that we have many partners in this session. So, on the principles, I think. What I would suggest is that. First, we, we need to have a sort of. Readiness checklist of tools or whatever for countries and stakeholders to move if a country, what it takes to have interoperable systems and if the country is ready for it. Often when these initiatives come. Sometimes they don't even know who to talk to is it the technical people is it the decision makers. Why are we going to talk to and from what you said in this presentation it is clear that you need to talk to many people, the program managers, the users, the it people. The sometimes the politicians and so forth so I think we need to have this kind of to be in place to help people in knowing what to do and. And who to talk to. The other points I have regarding the the six principle is. I mean he says it's a good attempt, but as we all know the, the entry barrier for this kind of arenas is very high. And it's not given to countries or people in countries to participate in this kind of arenas and gets their voice heads so I know there is no. Magic solution for it, but we need to think of how can we make it's possible as much as possible. Thank you. Good thanks thanks Adam and you touched a little bit on operationalizing, which I haven't really got around to in this presentation. Some of the things like like checklists for for architectural discussions and like, but we are working in that direction at the moment. Yeah, thanks. Like how are we doing on time. Yeah, I think we just have time for one more question I see Scott has his hand raised as one of our researchers here at the university probably to disagree with how we described a vendor. Oh, great. So that kind of myself now. No, I don't disagree at all. Well, I have some other thoughts but that's, I'll put those in the chat. I actually just wanted to say I really appreciated the historical and kind of theoretical framing Bob that you did of the presentation I thought that was a really illuminating and not something that really we hear a lot of and it strung together a lot of different elements that kind of shaped a larger approach. I was going to ask, you know, kind of a practical question. You have been in a lot of interoperability projects. At what point, you know, many of those are unsuccessful, unfortunately, and at what point. Do you think there are diminishing returns or maybe to use like the classic analogy by nor stoop stoop's kicking it you know trying to get a dead horse or trying to ride a dead horse. Right when when is it that the interoperability project is is failed. Does it ever fail and at what points of countries like reconsider the interoperability approach. Do I hear a cynical answer. Yeah, of course, yeah. That's when the money runs out Scott. The interoperability projects will run as long as they are funded to run, regardless of what use value is being delivered on the ground. And the point where you pull the plug is when the funding gets pulled. Okay, that's that's that's the cynical answer. I think that sometimes sometimes projects seem to have failed and they somehow. They reemerge in a better form. I mean, I think the open MRS report was I actually wrote the first open MRS DHS to module for reporting to DHS 10 years ago. It was kind of horrible. I think it's still works to some some state in India in Himachal Pradesh, but generally it was really very horrible, and not not something I was very proud of but I really pleased to see that there's new workers come along where people have a new DHS to module and fixed all the horrible things in the early one. So sometimes you know there is a phoenix that emerges from ashes of bad interoperability projects. So, in terms of, you know, when to pull out or when to pull the plug. I think it depends a lot on the nature of the calibration that you have with the partners that are involved as well. But very often it's about when the money stops. Because that raises the question, whoever has control of money when should they stop the money. I would love to keep talking forever but I think that we better give some time for the next sessions that people are going to be dispersing, but wanted to say thank you very much Bob for for your transparent and interesting presentation with us we we are always open to feedback on these things and are constantly learning from the what we learn or hear from the community so please take a look I did put a link to the website where we've started to elaborate on these points. And if you're interested in the topic of interoperability as Bob says there's a session coming up just now this afternoon so take a look for that. So thank you everyone thank you again Bob thanks for all those that participated, and we'll see you in the next sessions.