Al Hammond - Chestertown Spy

Minding a Big Gap: Digital Divide Leaving Students Behind by Al Hammond

June 29, 2020 by Al Hammond

The Covid-19 pandemic has made profound changes in how we live. Many adults have had to adjust to working from home. But for school-age children, the change in their lives since schools closed this spring has been even greater. How are they coping with learning from home? The experience of two Eastern Shore counties—Talbot and Kent—suggests that distance learning can work, but that it doesn’t work for some children or even some teachers. The problems include:

The digital divide. Talbot and Kent are fortunate, because in both counties every schoolchild had already been issued a digital device (tablet, chromebook, macbook, depending on age). In both counties the majority of families with school-age children also have internet access at home—even if kids sometimes have to share it with parents working from home.

Interview with Kelly Griffith, Superintendent Talbot County Public Schools

But some children—as many as 15 percent—have no access at home, either because they live in remote locations or because their families can’t afford it. (In both counties, about 50 percent of the students qualify for free or reduced-price lunch.) Others have some access, maybe over a mobile phone, but not enough to stream a live session with a teacher or even to download a big homework file. So for these children, access means traveling to a WiFi hotspot, assuming that the family has a car and a parent at home who can drive them there and wait while the student goes online. Both counties have scrambled to provide more hotspots, working with county IT departments and commercial service providers; and both counties now have WiFi on their school buses, so that they serve as a kind of mobile hotspot. Talbot has also been mailing weekly packets of schoolwork to students who can’t get them any other way.

It’s not just students who lack access—so do some teachers is both counties. It’s a measure of their dedication that those teachers have been driving to school to deliver lessons from an empty classroom or even, in some cases, teaching from their car while parked at a WiFi hotspot.

Teachers are essential. As Bill Poore, Kent County Public School’s IT director says, “Zoom doesn’t replace a teacher’s hands-on help” with reading, or a stubborn arithmetic problem. And while some parents feel comfortable providing that kind of help at home, others do not—especially if it’s been a long time since they confronted an algebra problem or are simply not familiar with the devices and software tools that enable distance learning.

The schools are attempting to help: Kent County has adopted an on-line learning management system that simplifies things for kids or parents, and they have bought all-new devices for every student for the coming year. Talbot focused this past spring on basic topics that could be most easily grasped by a student or a parent without a teacher’s real-time presence (so-called “asynchronous learning”) and is working to have students catchup and finish any incompletes with week-long “boot camps” over the summer. But as Talbot County Public School’s Superintendent Kelly Griffith explains, “synchronous learning is important, because it increases student involvement.”

No one knows yet whether schools will be able to reopen in September, and even if they do, whether parents will feel comfortable sending their children while the pandemic is still active. So Griffith’s goal is to get everyone connected—to close the digital divide, one way or another—and she is seeking state permission for virtual programming. That might mean scheduled sessions with both teacher and students online together: English composition at 9, arithmetic at 10, science at 11.

Making rural broadband—and more effective learning—a policy priority. Last week, governor Larry Hogan announced a $45 million program to address the education digital divide. It includes a plan to build out wireless educational networks in western and southern parts of the state and on the Eastern Shore, using wireless frequencies reserved for educational use or other available frequencies. Hogan’s plan also includes money for devices and software tools, and for innovation grants to help public schools test new online educational strategies. It’s not likely that these new networks will be in place in time to help the coming school year, but it’s nonetheless a worthwhile effort that will eventually help to close the digital divide in rural Maryland.

The broader challenge, however, is to rethink education strategies. No matter how good the technology is, teachers will still need to play a central role. But why not design the educational process so that it happens seamlessly at school and at home? Why not use virtual reality tools (including virtual field trips) and hands-on interactive tools (such as 3D printers) to enhance student engagement—techniques now being rapidly adopted for industrial training? Why not use artificial intelligence tools to monitor student learning in real time and adjust the process individually to how each student learns best? It’s pertinent that in international comparisons, U.S. school children rank behind those of 12 other countries in reading and no better than 30th place in mathematics—and those dismal rankings haven’t changed in recent decades. Moreover the labor market is changing much faster than school curriculums—we’re going to need more software engineers and data managers and fewer truck drivers or assembly line workers.

Maybe the disruption of the schools by the pandemic—and the renewed attention to enabling every student to learn—will turn out to be the catalyst we need to reinvent education too.

Al Hammond was trained as a scientist (Stanford, Harvard) but became a distinguished science journalist, reporting for Science (a leading scientific journal) and many other technical and popular magazines and on a daily radio program for CBS. He subsequently founded and served as editor-in-chief for 4 national science-related publications as well as editor-in-chief for the United Nation’s bi-annual environmental report. More recently, he has written, edited, or contributed to many national assessments of scientific research for federal science agencies. Dr. Hammond makes his home in Chestertown on Maryland’s Eastern Shore.

Dave Wheelan contributed to this article

The Spy Newspapers may periodically employ the assistance of artificial intelligence (AI) to enhance the clarity and accuracy of our content.

The Transportation Revolution by Al Hammond

June 8, 2020 by Al Hammond

If you are thinking of buying a new car or light truck anytime soon, you may want to reconsider. That’s because conventional gasoline-powered vehicles are about to become technologically obsolete and economically uncompetitive—which means it will become progressively harder to find gas stations to refuel them, mechanics to repair them, or buyers for used vehicles when you want to sell.

One cause of this transformation is the impending surge in the production of electric cars and trucks by every major manufacturer. These electric models—apart from the cost of the batteries that power them—are already cheaper to produce (many fewer parts) and maintain than those with internal combustion engines. The batteries themselves are about to see dramatic improvements that will increase their driving range on a single charge to 600 miles or more, reduce the time required to recharge them, increase their lifetime, and lower their cost—which in turn will make electric vehicles less expensive to buy and far less expensive to operate than comparable gasoline-powered models. Indeed, Tony Seba, a Stanford University economist, has published estimates that electric vehicles will soon be 90% cheaper to operate than gas-powered cars, taking into account the cost of fuel and repairs over the lifetime of the vehicle. All these changes add up to one thing: gas-powered vehicles may no longer make economic sense.

A second major technology-driven shift is the coming scale-up of autonomous or “self-driving” vehicles that use multiple sensors to detect roads, traffic signals, driving conditions, and other vehicles, combined with artificial intelligence tools to interpret this data instantaneously and guide the vehicle accordingly. That will save lives: human drivers make mistakes that cause nearly 40,000 fatalities and 4 million injuries per year in the U.S. alone. The proliferation of self-driving vehicles will also mean that people can potentially use their travel time to do other things.

More importantly, many people won’t need or want to buy a car at all—they will summon a self-driving vehicle to take them where they want to go. This revolution—often called Transportation-as-a-Service (TaaS)—will happen in urban areas first, reducing traffic congestion and air pollution. Already Waymo (owned by Google) has driven autonomous vehicles over 20 million miles without any accidents and has completed 100,000 self-driving rides in its test city, Phoenix, Arizona; it is buying another 60,000 self-driving vehicles to use there, which may enable it to provide half of all the local travel needs for that city. Waymo is not alone: a company called Aptiv has also completed 100,000 self-driving rides in Las Vegas and is starting service in several other U.S. cities.

For those of us that live in small towns or rural areas and can’t imagine not having a vehicle in the driveway or carport, the TaaS transformation may seem irrelevant, but we will nonetheless be affected by it. Among other changes, TaaS combined with electric vehicles will disrupt the car insurance business, lower the revenue that governments get from gasoline taxes, save families that can avoid buying a car lots of money, and lower the cost of shipping goods (because of self-driving trucks). TaaS will change the value of homes and other real estate (imagine what can be built on all those soon-to-be-empty parking lots, which in cities like Los Angeles take up nearly one-third of the space, or how much less attractive a house outside the range of a TaaS service might be to a potential buyer). It will also enable expanded home delivery services for packages or food by self-driving electric vehicles or battery-powered drones.

If all this seems too abstract, consider the following: Consumer Reports estimates it costs about $15,000 to fill up a Jeep Liberty over five years, if you drive 12,000 miles per year; the electricity to power an electric Jeep Liberty is estimated to cost less than $1,600 over the same period. And fuel savings are just the beginning. The drivetrain in a conventional car has as many as 2,000 moving parts, compared to as few as 20 in an electric car. Electric vehicles have motors, not engines, so they don’t need to shift gears… and they don’t need oil, spark plugs, air filters, coolant, or transmission fluid. A conventional car’s engine might last 150,000 miles before it needs rebuilding, but electric car motors can last 600,000 miles or more. That’s why some electric car makers warranty the drive unit for up to 8 years, with unlimited miles—something no gas-powered car can offer.

So if you could buy essentially the same car, except cheaper and 90 percent less costly to use and maintain, quieter to drive, capable of much more rapid acceleration and greater pulling power, as well as likely to last several times as long, which would you buy? That’s why many experts think that electric vehicles will account for more than half of all new cars and trucks sold in the U.S. within 5 years. And because of TaaS, the total number of cars sold is likely to be far lower—and most cities are likely to have fleets of electric, self-driving cars that can each deliver 100,000 miles of rides a year with little maintenance.

While all that’s good for us as transportation users, it means disruptive change for quite a few segments of the economy. Professional drivers—chauffeurs, cab drivers, truckers—may simply disappear. Demand for mechanics and replacement auto parts will drop. Insurance companies will have fewer accidents to pay for and will have to lower premiums, losing revenue. We won’t need as many gas stations and truck stops—electric cars will mostly recharge overnight at home and self-driving trucks don’t need to stop for food and rest. Oil companies will suffer. With less traffic on the roads, driving (or being driven by your car) may replace short-haul air traffic and the hassles of airports, to the detriment of the airline industry. On longer trips, you could simply sleep in your car’s fully reclining seats while it drives you, so roadside hotels and motels may face problems as well. And as TaaS scales up, the sales of auto manufacturers will drop; many may not survive.

That’s what disruptive technological change looks like. It happened before when cars replaced horses; now it’s happening again as electric vehicles with self-driving capabilities replace conventional cars and trucks.

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Saving the Choptank…and the Bay? By Al Hammond

May 18, 2020 by Al Hammond

It’s no secret that the health of the Chesapeake Bay ecosystem and its valuable blue crab and striped bass fisheries have been under threat from the region’s growing population and expanding economic activity. But a recent ShoreRivers report on improving water quality in some parts of the Eastern Shore of Maryland seems to suggest a positive trend. This is a story about actions leading to that trend, in which a U.S. National Oceanic and Atmospheric Administration (NOAA) laboratory located in Oxford, Maryland, has played a key role.

Agricultural land use dominates some parts of the Choptank watershed and is a major source of sediment and fertilizer runoff that contributes to poor water quality which may harm economically important fisheries. Source: NOAA

The seriousness of the environmental threat to the Bay’s fisheries was confirmed by a 2015 NOAA scientific study and a number of earlier studies that documented impaired water quality and poor biological health. A primary cause of the degradation, the studies found, was transformation of the natural landscape by agricultural activity and urbanization in ways that increased runoff into streams and rivers: runoff of sediment, nutrients such as fertilizers, and chemical and bacterial pollutants. The result is murky water, reduced underwater vegetation, and declining numbers of fish, crabs, and oysters coupled with increased levels of bacteria, fish disease, and fish parasites. The pattern of degradation seemed to track the types of predominant local land use, whether urban, agricultural, or forest.

NOAA scientists from Cooperative Oxford Laboratory pull a seine net in fish community composition sampling for the Tred Avon River ecological assessment. Source: NOAA

Since 1983, the Chesapeake Bay Program has been working to improve the Bay. The latest agreement, signed in 2014 by six states, the District of Columbia and the EPA on behalf of seven federal agencies, committed to achieving a long list of measurable outcomes and improvements. Included in these are water quality targets to reduce sediment and nutrient runoff and to restore native oyster habitat and populations in 10 tributaries, 5 in Maryland and 5 in Virginia, by 2025. (Oysters filter and thus help clean the water).

Also in 2014, NOAA designated the Choptank River—the longest and largest river that empties into the bay and a key blue crab producer—a habitat focus area. As part of the overall Choptank effort, NOAA initiated a detailed scientific assessment of one of the river’s tributaries—the Tred Avon River that flows from Easton to where it empties into the larger Choptank near Oxford.

The study—conducted by NOAA’s Cooperative Oxford Laboratory—was a massive effort. Dr. Shawn McLaughlin, who directed the research, says it involved repeated sampling and data collection: “For three years we conducted daily, weekly, or monthly field trips to river sites in eight Tred Avon sub-watersheds spanning forested areas, agricultural lands, and urban areas.” The scientists measured water clarity and dissolved oxygen levels, concentrations of nitrogen and other nutrients, the presence of underwater vegetation, and numbers and types of fish and their health—including seasonal patterns. The resulting 2018 report documents the impacts of different land use patterns on water quality and fisheries health and suggests management practices that could help mitigate damage and restore ecological condition. The findings include:

Urban areas such as Easton, with their abundance of paved surfaces, are a major source of runoff, leading to higher levels of chemical contaminants, nutrients, and fecal bacteria as well as low dissolved oxygen levels in nearby bottom waters and the absence of many fish species during high summer temperatures.
Agricultural areas also showed high levels of nutrients and poor water clarity (which affects underwater vegetation that provides shelter and food for fish).
Watersheds dominated by forests had relatively good water quality and abundant fish and shellfish species.

The report pointed out the need for continuing efforts to reduce nutrient and sediment runoff across the entire ecosystem and the importance of preserving critical habitats for fish and shellfish, especially in spawning areas such as the Choptank. It also calls for innovative management approaches such as planting or restoring oyster beds and setting thresholds for land development.

Concurrent with the research, as part of the overall Choptank effort, NOAA’s Chesapeake Bay Office initiated an effort to coordinate local organizations with similar goals to achieve more than would be feasible if they acted alone. While this “collective impact” strategy had proven itself at community-scale, attempting it on a much larger scale was a novel approach for NOAA. An experienced environmental consultant was hired to stimulate and coordinate local action by working with local governments, non-profit organizations, philanthropic donors, and other stakeholders such as ShoreRivers.

Sampling water quality as part of the Tred Avon Assessment. Source: NOAA

The consultant, Joanna Ogburn, brought many groups together and created Envision The Choptank (envisionthechoptank.org), a partnership focused on pairing the scientific findings with local knowledge and local actors to find collaborative solutions. It used preliminary data from the NOAA Tred Avon study along with other Chesapeake Bay Program studies and data to guide pilot projects, get people excited about what was happening, and promote best practices among county officials, farmers and individual homeowners. The organization also hired coordinators to work with landowners 1-to-1, raised funds to provide incentives, and linked landowners to technical assistance. The Envision partner organizations have helped to engage many different entities, share tools and information and ideas, and coordinate strategies and funding efforts.

The effort has paid off. It enabled McLaughlin and her research team to meet with local, state and federal officials to share the evidence connecting land use to the condition of the aquatic ecosystem. It brought the laboratory together with Easton officials, Talbot county government and public works representatives, and ShoreRivers to discuss ways to “green” the proposed Port Street development in Easton by minimizing additional impervious surfaces that would intensify runoff. Envision partners also identified two stream restoration projects within the urban area and provided the Town of Easton with a small grant to design the projects, which led to a larger state grant to fully fund the work.

In another example, Envision partners engaged residential landowners to reduce storm water drainage. Using locations in the lower Choptank that the Oxford data showed regularly had low water quality, they got the Nature Conservancy to do digital map studies to determine the lands draining to those locations, then invited all the relevant landowners to workshops. There they taught residential homeowners how to build rain gardens and other techniques that improve water quality and the attractiveness of their properties. Envision partners have used the same strategy to identify agricultural landowners that are significant sources of runoff, so that they can reach out to them.

More than 35 organizations are now involved with Envision the Choptank, which is now expanding its efforts across the entire Choptank ecosystem. It organized a $1 million grant from the National Fish and Wildlife Foundation to engage, incentivize, and work with farmers in creating buffers and other strategies to manage runoff. Joanna Ogburn comments that “This grant is helping us launch a new wave of interventions. We’ve been able to build financial incentive programs to overcome the challenges landowners and farmers face in implementing restoration practices. We’re hoping to engage landowners in the Choptank watershed in creating buffers, wetland restoration, and drainage ditch management practices, ultimately restoring 230 acres.” And, as the latest ShoreRivers report suggests, these actions—at state and county and local levels—are beginning to show results.

It’s clear that the research and the scientific data it produced were critical in persuading both public officials and individual farmers and homeowners to get involved and take action. But it’s also clear that communication efforts and coalition building to find and implement local solutions were equally important—and that the Cooperative Oxford Laboratory played a central role in both. Suzanne Skelley, director of the lab, noted “Using research results to inform decision-making, especially to improve ecosystem condition while enhancing community resilience, is a core mission of the Lab and of NOAA.” The winning formula for saving the Choptank, and perhaps the broader Chesapeake Bay ecosystem, seems to be: science + communication/engagement + local action.

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Why COVID-19 is Far From Over for the Mid-Shore by Al Hammond

April 13, 2020 by Al Hammond

At the start of the second week of April, hospitalizations are peaking in New York, the largest epicenter of the pandemic in the U.S. Meanwhile, there are just 9 known cases of the virus in Kent County, 10 in Talbot, and 16 in each of Queen Anne and Caroline counties. President Trump is talking about “reopening” the U.S. economy and sending people back to work. But don’t be misled. Many more people will get seriously ill in the months to come, and even if the virus seems to retreat in the warm summer months, it is likely to resurge in the fall and winter.

We don’t really know how widespread the virus is, because many of those infected show no symptoms, even though they can infect others. The only careful survey took place in Iceland, which tested 5 percent of its population and found that about 50 percent of those infected showed no symptoms. Applied to the U.S., that would mean at least 800,000 people have been infected, half of whom don’t know it and are likely infecting those around them. Consider also that in the period from December through February, when the virus was actively spreading in China, more than 750,000 people entered the U.S. from that country. So it is likely that the virus is far more widespread than we know.

Just consider what it means if an infected person spreads it to 2 others—then the next day those 2 infect 4 others, and so on—the definition of exponential growth. The math works out such that a single case could grow to over 200 million infected Americans within a single month. It’s easy to see how big cities such as New York quickly became hot spots of infection.

But cases are rising rapidly now even in small towns and remote rural communities—where a quarter of all hospitals have fragile finances even before the pandemic and are largely unprepared clinically for a surge of cases requiring ventilators. Testing is not widespread in rural areas, meaning we don’t really know the extent of the threat. And the virus has hardly been eliminated even in urban areas past their peak. So “opening up” the economy and sending people back to work anytime soon will simply launch a second wave of infections.

To open up safely will require massive testing—so we know who had already had the virus and is therefore immune and can’t affect others, so can be allowed to work—or waiting until 50 or 60 percent of the population becomes immune, enabling what is called “herd immunity.” That means it’s hard for the virus to spread, because those who are immune can’t pass it on. But letting the virus run free could still take several seasons of the virus to build up a herd immunity, and in the meantime would kill many of those who are most vulnerable—those over 70 or who have underlying health problems.

The current wave of testing identifies who is ill with the virus. To find those who have already had it and recovered requires a different kind of test—a so-called antibody test that identifies a specific protein in a person’s blood created by their immune system to fight the virus. The test requires only a finger prick of blood, results are available within a few minutes, and mass manufacture of the tests has begun. Still, it will likely take months and a coordinated national strategy to test every person working or who wants to go back to work, so that even a partial reopening of the economy safely is possible. Development of an effective vaccine will very likely happen within a year—but that means after the likely fall-winter resurgence of the virus. Until then, social distancing, working from home, and continued closure of non-essential businesses are the only effective tools.

Meanwhile, there is some good news on the vaccine front. The University of Pittsburgh School of Medicine (UPMC) just announced a potential vaccine for COVID-19. The team of scientists there did extensive research on earlier pandemic viruses: MERS in 2014 and SARS back in 2003. Both of those were also coronaviruses similar in the molecular structure to COVID-19. Their new vaccine research was just published in The Lancet, a leading medical journal. What’s unique about this vaccine is the delivery mechanism, which uses a small patch the size of a fingertip—like a small bandage—that has 400 very tiny micro-needles that painlessly deliver the vaccine over time, teaching the body how to produce antibodies to fight COVID-19.

This ease of use will help speed up adoption tremendously if the vaccine makes it to market. But clinical trials to confirm that the vaccine does no harm, even to vulnerable patients, and then to show that it really does protect people against infection, will take many months. For now, staying at home is the only “vaccine” that we have.

Al Hammond was trained as a scientist (Stanford, Harvard) but became a distinguished science journalist, reporting for Science and many other magazines and on a daily radio program for CBS. He subsequently founded and served as editor-in-chief for four national science-related publications as well as editor-in-chief for the United Nation’s bi-annual environmental report. Dr. Hammond makes his home in Chestertown on Maryland’s Eastern Shore.

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Noted Author Will Highlight One School/One Book Program in Kent County Public Schools

July 26, 2018 by Al Hammond

Wil Haygood – author of Tigerland: 1968-1969

Wil Haygood’s new book Tigerland: 1968-1969: A City Divided, A Nation Torn Apart, and a Magical Season of Healing, which will be released September 15 but is already receiving glowing reviews, will be the centerpiece of a Kent County Public Schools program this fall. The program—One School/One Book—seeks to provide every student in grades 8 through 12 with a personal copy to read in advance of meeting with the author. Haygood, who finished the book as a writing fellow at Washington College, will participate in Meet the Author events at the Kent County middle and high school on November 14th, meeting with both students and staff. He will also participate in an event that evening open to the entire community.

The book is especially relevant and inspirational for secondary school students, because it tells the true story of a segregated black high school in Columbus, Ohio, during the heights of the 1960’s civil rights movement. Against all odds, in a single year the school produced state championship teams (the Tigers) in both basketball and baseball as well as a highly acclaimed debate team. The book describes that effort in exciting detail, including profiling the coaches, teachers, and school principal who helped make it possible and Eddie “Rat” Ratleff, the star of both winning teams, who would go on to play for the 1972 U.S. Olympic basketball team.

Haygood is a cultural historian and an award-winning author of seven nonfiction books, including a book that led to the 2013 film The Butler (which he co-produced) about Eugene Allen, the African American butler who served eight U.S. Presidents (from Truman to Reagan) in the White House. Haygood, who grew up in Columbus and remembers watching the events chronicled in Tigerland, has said he is excited to participate in the One School/One Book program here, because he believes there are parallels between Kent County and the story told in the book.

According to KCPS Superintendent Karen Couch, student and community involvement intensify when a whole school reads a book together. Tigerland’s publisher has agreed to make the book available for half price for this program. The school system is seeking donations to raise $10,000 to ensure every child in the relevant grades and each of their teachers receives a copy of the book. Donations can be made to the Kent County Public Schools Special Projects Fund, c/o Chesapeake Charities, 101 Log Canoe Circle, Suite O, Stevensville, MD 21666, or on-line at www.chesapeakecharities.org/fund/kent-county-public-schools-special-projects/.

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The Future of Healthcare: Medical Marijuana Dispensary Opens in Centreville

April 19, 2018 by Al Hammond

The leading edge of a quiet revolution in healthcare reached the Eastern Shore on Valentine’s Day. That’s when Ash + Ember, a licensed medical marijuana dispensary, opened its doors. The owners of the facility—sisters Ashley and Paige Colen—say they are seeing lots of early demand. The dispensary is located at 202 Coursevall Drive #108 in Centreville. Visit their website here.

Maryland is now one of 29 states (plus Washington DC) that provide legal access to hemp and marijuana derivatives to treat medical problems such as pain, nausea, depression, sleeping disorders, epilepsy, and other health issues. The medical marijuana movement, however, is increasingly global. Australia, Argentina, Canada, Germany, Israel and many other countries already provide similar access. The process in Maryland requires prospective patients to get a doctor’s recommendation, then register with state authorities and receive a specialized ID card, and then to work with a licensed dispensary to identify the particular formulation and mode of delivery that best meets their needs.

Ash + Ember offers to help would-be patients with the registration process and with finding a doctor who will recommend medical marijuana therapy, as well as with finding a formulation that best suits each patient. Since the dispensary is limited to suppliers in Maryland (federal regulations make it illegal to ship marijuana across state lines), it’s stock is fairly limited at present, but the local grower and processor industry is scaling up fast and the Colen sisters expect a much wider selection in coming weeks and months. For now, they accept cash only but expect to accept credit cards in the near future and to offer home delivery of their products.They can also be reached at 443-262-8045 and are open 10am-7pm weekdays and 10am-6pm weekends.

One of the barriers to full realization of the medical and health benefits of cannabinoids—the generic term for the active ingredients in hemp and marijuana plants—is widespread ignorance about them among both patients and doctors. Many people associate marijuana with the underground growing and smoking of “weed” to get high—a practice still illegal in most states. An informal survey suggests that many doctors in private practice on the eastern shore still won’t have anything to do with medical marijuana.

But medical cannabinoids don’t have much to do with getting high. Medical scientists have now identified as many as 80 different cannabinoids, most of which produce no buzz or high at all. Indeed of the 8 cannabinoids commonly found in the now bewildering array of commercial medical marijuana products, only one—THC—interacts with receptors in the brain to produce that kind of psychotropic effect. The other most common form—CBD, the mainstay of most medical/therapeutic uses—has no psychotropic effect at all and acts on receptors that are part of the body’s own cannabinoid system. That system, found in nearly all cells, produces cannabinoids to help stabilize the body’s internal processes.

Moreover, smoking marijuana is probably the least common form of administration. Instead, the active ingredients are extracted from the plant by solvents and used as oils (directly on the skin, or ingested in capsules or food, or vaporized and inhaled) or alcohol-based tinctures (delivered as drops under the tongue). Extraction allows manufacturers both to concentrate the active ingredients and also to more precisely control concentrations and purity. And the variety of ways of using medical marijuana gives patients more control as well. Inhaling a vapor has an almost immediate effect, but may be too strong for some circumstances or not a comfortable mode of use for some. Ingesting the drug means a much slower but longer-lasting effect (for controlling pain at work, for example). Putting a drop or two under your tongue also gives immediate effect, but the concentrations in tinctures are typically lower.

Clinical research on specific cannabinoids and their impact on health conditions is still in the early stages—in large part because the federal government had made it very difficult to get permission to do such research. But last year a randomized clinical trial found that high-CBD extracts helped markedly to control epileptic seizures in children. Another study in a mouse model of autism showed that CBD has promise as a treatment there as well. Canadian studies have provided evidence that cannabinoids can help with post-traumatic stress disorder, chemotherapy-induced nausea, sleeping disorders, and arthritic pain. More research is coming.

Arguably one of the most important potential impacts of medical marijuana is likely to be easing the opioid epidemic, the leading cause of preventable deaths in the United States. If pain can be treated with non-addictive cannabinoids, why use opiods—and enrich the pharma companies that make them—in the first place? Indeed, research studies have reported fewer opioid deaths and reduced opioid use in states where medical marijuana is available. That in itself would be a major benefit of widespread adoption of medical cannabinoids. And if cannabinoids can be used to help wean people already addicted from opioids, as some research suggests, even better.

Of course, medical marijuana is not the only revolution going on—more and more states are legalizing recreational marijuana as well, and the dominant brands for recreational use usually include quite a bit of THC. One genuine concern about recreational marijuana is its potential impact on adolescents: cannabinoids—especially THC—can have a significant impact on the development of adolescent brains. But the more tightly controlled distribution channels for medical marijuana seem far less likely to “leak” into adolescent culture, as well as focusing more heavily on CBD.

Another concern is work-related drug tests: will medical marijuana use show up on these tests and cause someone to lose a job? As it turns out, the tests that follow a federal standard are specific to THC, so using a low-THC/high CBD formulation to control pain should not trigger a positive test.

Another barrier to use is simply social: we’re not yet to the stage where people talk openly about their medical marijuana use. But if you have medical concerns that are not well met by conventional medicines, or want to avoid opioid use or anti-depressants with bad side effects, you might want to look into what’s available—and legal—in medical marijuana, now conveniently at hand on the eastern shore.

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21st Century Learning: The Future of Education in Kent County, Part II by Al Hammond

March 1, 2018 by Al Hammond

“Myki Ruby Bernard, a middle school student, is soldering her Code Club project—part of the hands-on approach to digital technology used in Kent County public schools”. Photo credit Laura Jacob.

21^st Century Learning: The Future of Education in Kent County, Part II

Talk to parents of students enrolled in Kent County public schools, and a common question is: What does my child do all day? In fact, students don’t spend the whole day looking at screens—a frequently expressed concern. But they do have chromebooks (simplified laptops), tablets, or laptops accessible to them throughout the school day, and can take them home from 6^th grade on. The schools’ digital platform is accessible wherever there is an internet connection, and high school teachers frequently assign course segments or practice sessions for students to do at home or over weekends.

Beyond the Discovery Education content, the Google education apps, and a set of administrative and teacher support tools (see Part I), Kent County schools don’t mandate specific digital tools or lesson plans. Teachers choose those they want to use and what they think works best with their students. Moreover, the innovation ferment in the Ed Tech sectors and in schools with digital platforms across the country means that there are new tools and creative new lesson plans that use those tools introduced every year. The result is continual experimentation, with teachers in Kent County sharing ideas and discoveries with each other. (See Box at end of article, A Short Guide to Digital Learning Tools)

Beyond specific tools, what counts is how a teacher uses them to enhance student involvement and learning. Here is what this reporter observed in three specific 50-minute classes last week.

3^rd Grade math, Kelley Melvin. The focus in 3^rd grade, Kelley tells me, is really mastering multiplication, both memorizing the multiplication tables and being able to apply them in many different contexts. Today’s class will use three different digital tools—a whole class exercise at their desks; then one where students are on their feet and moving around the room, working in teams; then individual exercises at their desks again.

“Gallery Walk” tool helps teams of students learn basic math. Photo credit Kelley Melvin

The class starts with a Kahoot session reviewing the concept of area. Every child enters their secret game pin on their tablet, which keeps their answers private from other students. The video screen shows a rectangle, with the area and the length given, and asks, what is the missing width. Kelley reminds the class of the formula for area, length times width, and says “think before you click”. Then she starts the clock, giving students 30 seconds to select the right answer on their tablet, which shows four color-coded choices. Music plays while students ponder. And the video screen tabulates responses (while keeping individual answers anonymous). Everyone gets this one right. Cheers break out.

Then a new exercise, with more complicated geometry. Then another. Kelley reviews the formula for area again. Then more exercises, nearly a dozen over a span of about 15 minutes. The Kahoot software keeps track of each student’s answer to each exercise, so that Kelley can see where any individual student is having trouble. To see Kahoot in action, watch this short video.

The class then switches to an activity called Gallery Walk, where pre-assigned teams of 3 students gather at stations around the room to complete exercises that are posted under a plastic sheet. One child has a marker and writes out the answers on the plastic sheet. A second child then uses his or her tablet to take a photo of the answer and submits it digitally. The third then erases the answer, clearing the slate for the next team. (See photos) The teams are working under a time limit, and when the bell rings, they move onto the next station and a new exercise. The teams also rotate roles, so everyone gets chances to take and submit the photo of the result—which they think is cool, and makes the whole exercise fun. Meanwhile, the tool has stored each team’s work, so that Kelley can review it later (often at home), make comments on it, and send it back to students—all digitally.

“Gallery Walk” Students work as team on a question and write their answer on the erasable plastic sheet Photo credit Kelley Melvin

Finally, students use a tool called Splash Math—one of their favorites—to do individual arithmetic exercises by hand at their desks, before entering their answer on the tablet. Each student’s exercises are skill-adjusted to that student, and the tool both tracks each student’s answers (so Kelley or teaching aids that circulate can see where a student is having problems and help) and won’t let the student move on until they have mastered that skill. The tool also awards digital “coins” for each right answer, which the kids can use to “buy” digital fish for their private aquarium—an incentive system that keeps kids motivated.

6^th grade science, Amelia Markosian. Amelia is teaching a segment on rocks—rock types, their distinctive properties, how they are formed, where they are found. As the students come into the room, a tool called Science Sizzler is on the video screen with questions on a previously assigned article about igneous rocks. Students sit at their desk, turn on their tablets, and start work on answering the questions, submitting their answers on Google Classroom. When the class formally starts, Amelia asks if they have any questions about igneous rocks, and they do; a short discussion ensues. Science Sizzler is in effect a daily warm-up exercise with new questions every day to get the students engaged in the subject matter and prompt an opening discussion, where the teacher can answer questions and show pictures or hold up examples (in this case of rocks).

Then Amelia introduces a Radical Rocky Recognition Mission—her name for a Google Classroom interactive lab on rock types, introduced with a music video featuring a song about the rock cycle. The lab is designed both to impart information, but also to teach critical thinking skills, and it gives feedback, so that students end up with a score for the lab. The students get involved in the lab, on their tablets—they’re doing the work, leaving Amelia free to circulate and help individually with students. Every student works at their own speed—some complete the lab early and share their scores with the teacher, then go on to other things.

When everyone has finished the lab, Amelia opens another group discussion by asking each student to name their favorite type of rock, and say why they chose it. Some of the answers are amusing, provoking laughter. Others prompt students to make follow-on comments. Amelia uses the discussion to reinforce some of the lessons from the lab. The discussion is still going strong—and no one seems bored—when the bell rings.

12^th grade Advanced Placement Psychology, Caron Saunders. Today’s class is small because a number of students are out with the flu. The students carry laptops and are very savvy about digital tools. The class is preparing for the Advanced Placement exam toward the end of school that will give those who pass it credits that enable them to skip introductory college classes. Today’s class is mostly review of psychology concepts and the specialized vocabulary used to name and describe them. Caron tells them to start a tool called quizlet.live, a kind of digital flashcards. It gives the students, working in teams, a definition and asks them to select the matching vocabulary term. The team approach forces collaboration. If the team picks the wrong answer, the tool gives them immediate feedback. Meanwhile, Caron can circulate and observe or reinforce understanding.

The class then moves on to individualized flashcards, and the tool adjusts the definitions for each student to focus on areas where he or she is weak (based on their prior use of the tool). It starts with multiple choice, but then moves to asking students to write out definitions from scratch. Caron can circulate, or prepare another lesson on her tablet, or set up a homework assignment.

Caron says that she also often uses Ed Puzzle, a video that stops and asks the students to answer a question before it continues, and which can be used by a group or by individual students or even when the student is at home (for weekend review or for students that are out ill). She also uses a tool called Noodle to give multiple choice tests, both because it gives student instant feedback (right or wrong)—promoting learning—and also, for wrong answers, gives the student a second chance at the question (for which Caron awards a correct answer half credit).

As the bell rings, Caron assigns homework for which the students will use a tool called Amanda that provides on-line lectures by leading high school psychology teachers.

What’s common to all of these classes is that none of the teachers are lecturing. The digital tools provide content (sometimes organized by the teacher in advance and often automatically customized to the student’s attainment level), and the students are actively involved in learning—absorbing or researching content, practicing skills, collaborating with other students. Meanwhile the digital platform remembers and stores everything—no paper shuffling here. Teachers, freed from both lecturing and many administrative tasks, focus on helping individual students, re-inforcing key learning, guiding classroom discussions—as well as on creating or finding lesson plans that will engage their students.

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A Short Guide to Digital Learning Tools

Some tools are widely used in Kent County public schools, because teachers find that they work. They are a far cry from textbooks, homework sheets, calculators, and flashcards (although there are digital flashcards) The short descriptions below—hardly a complete list—give some sense of what life in school is like these days:

Clever. Home base for all the tools that students use. It works like a tablet on the web—a student logs on and clicks on the app or tool, including Google apps such as email and Microsoft apps such as Office 365 for writing documents or creating presentations.
Boards. These are similar to a website, can display text, photos, videos, and are easy for even elementary school students to create. Teachers use them to send assignments to students, and students use them to prepare their work and send it back to the teacher. For example, if a teacher assigned a lesson about the different categories of living things, each student would pick an example that interests them and research the topic further. A student intrigued by crocodiles might investigate them as an example of reptiles, for example, and build their own board with facts, pictures, and other things he or she has learned about where crocodiles live, what they eat, etc. The students then share the board with other students in their study group, who comment and help the student improve it. When it’s ready, the student uploads it to the teacher, who can share it the whole class for discussion.
Kahoot. An informal assessment tool that gauges class learning and also helps to review lessons, but which feels like a game show, with competition, lively music, and rewards. It’s very interactive and engaging, but gives the class as a whole (and each student privately) a clear sense of whether they are mastering the content. Some teachers let students create their own review questions and manage a Kahoot for the class.
Virtual Field Trips. Let’s a teacher take the class on a multi-media “trip” to anywhere in the world to see and learn about local conditions or unique artwork.
Gizmo. An interactive tool used in grades 3-9 to simulate mathematics concepts or run virtual science experiments. It allows students to vary the numbers or the conditions to see how things change and to make graphs.
Frontrow. A tool that gives a student feedback on areas where they are weak in mathematics or English and then provides practice exercises targeted to overcome those weaknesses.
Mondo guided reading. This tools helps early grade students to learn new words, to speak them correctly, and to master spoken and written language.

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The Spy Newspapers may periodically employ the assistance of artificial intelligence (AI) to enhance the clarity and accuracy of our content.

21st Century Learning: The Future of Education in Kent County, Part I –by Al Hammond

February 23, 2018 by Al Hammond

You still hear people in Kent County say “Our public schools are so awful!” Some people probably view the busing fiasco last fall or the recent, painful consolidation of elementary schools (shrinking from five to three) as further evidence of decline, even though consolidation is likely to improve educational quality. But what seems clear is that few if any of the critics have recently visited a school and observed a classroom in action, or they might have noticed that a remarkable transformation is underway.

Guided by Superintendent Dr. Karen Couch, the schools are now in the fourth year of transitioning to an entirely new educational model—one that treats each child as unique and prepares them for life and work in the 21^st century far more effectively than traditional methods. The effort is positioning Kent County schools to become a leader in what is now a nationwide movement toward the use of digital learning platforms.

The old model of education is sometimes described as a teacher on one end of a log and a student on the other—or, for most of us, a teacher at the blackboard and students taking notes. In that model, it was easy for students to get bored and stop paying attention, or for slow students to get left behind. So a visit to Kent County public schools might be a bit dis-orienting at first, as if you had stumbled into a different century. Students start having “hands-on” experiences in pre-kindergarten (see video here) They are issued simplified laptops in kindergarten, start learning to “code” (write software for computers), and to understand how the internet works in 2^nd grade, graduate to tablets and eventually full laptops in higher grades, and work with interactive digital tools throughout their education. Textbooks have largely disappeared—content comes in digital form, adjusted to the capabilities and needs of each individual student, and includes videos and soon virtual reality experiences that can illustrate the workings of a beating heart or how galaxies form.

Perhaps the most important aspect of the digital tools is their ability to monitor and test each student’s progress in learning in real time—making it virtually impossible for any student to just drift along. The digital platform also notices when a student has difficulty in a particular math activity or a weakness in vocabulary and can immediately reinforce the student’s learning in that area. It also keeps the teacher aware of each student’s progress, and keeps records. The digital platform supports a wide range of interactive resources—math visualizations, digital maps, competitions—that enhance learning and animate class discussions. A typical class might include a group learning activity (watching and responding to a video), an exercise conducted in a team of three or four students competing with other teams, and an individual activity where each student works alone on material appropriate to their learning level. Lesson reviews might take the form of a quiz show game, where students compete to choose the right answer. Homework assignments are on-line, and students use vetted on-line resources to research assigned topics and create and upload portfolios of their work, usually after collaborating on it with other students. A teacher can also take a class on a virtual field trip to the Grand Canyon, the Great Barrier Reef, or major art museums anywhere in the world—quite something for students who have never been off the Eastern Shore. The impact of all this on students is significant: boredom seems largely banished. Teachers report that the digital learning experience engages students like nothing they have ever seen.

What’s the Evidence that Kent County Schools are Getting Better?

Critics of the school system point out that Kent County student scores on statewide achievement tests haven’t yet markedly improved. With a few exceptions (algebra, for example), they’re correct. But it’s also true that the school system is still in the early years of a transition to a dramatically different educational model—it will take another 8 years before graduating seniors will have used the digital platform throughout their school experience.

Another factor is the small size of the County’s student population—so even a few bad scores drag down the averages—combined with the unusual level of economic diversity in the county’s population. A recent statewide survey found that 40 percent of Kent County households have incomes below the ALICE (Asset Limited, Income Constrained, Employed) level—a more accurate gauge of economic constraints than federal poverty levels—which is the second highest percentage of constrained households on the Eastern Shore. In addition, Kent County receives a relatively small amount of state education aid per student—a result of the county’s relatively high amount of income and real property wealth (all those waterfront estates) and the way that is reflected in the state funding formula.

Kent County school officials believe that tests scores will improve. They also point to the fact that teachers from outside the county, attracted by the digital platform, are increasingly applying for any vacancies—the Kent County public schools are becoming a magnet for educational talent, which will help under any educational model. Still another assessment comes from the founder of LearnLaunch in Boston—the country’s leading “Ed-Tech” accelerator—who told this reporter that “the Kent County schools are clearly among the top 10% of districts in the US in their adoption and use of these new educational tools.” In fact, Kent County is the lead county in Maryland in the use of a digital educational platform; Baltimore County has recently decided to begin a similar transition. Furthermore, the County’s recent acquisition of its own fiber network and its plans to ensure near-universal internet access to households with students means that students can take advantage of the digital platform and its growing universe of content evenings and weekends too.

But both administrators and teachers in the school system say that the best—and for now, the only way—to really gauge the difference is to see the new educational model in action: to sit in a classroom and watch how students are engaged in learning. Many parents, wondering if and how this new educational model really works and what their child does all day, would probably like to do just that—but don’t have the opportunity. So this reporter has visited and observed three classrooms in action—3^rd grade math, 6^th grade science, and 12^th grade Advanced Placement psychology—and will in a second article offer his observations, together with videos of classrooms in action.

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But beyond the technology, what is really going on is an educational process that is far more student-centered than anything most adults have experienced. In an advanced math lesson, each student proceeds at their own pace, checking that they have understood a concept before moving on to the next material. The teacher, freed from lecturing, can monitor each student’s progress and intervene when a student seems stuck. Imagine a 3^rd grade class doing a social studies lesson, all reading the same material, but with the vocabulary adjusted to fit the reading level of each individual student—which in Kent County can mean, as one teacher explained, “some kids who can barely read and others reading at 8^th-grade level, but all able to engage and discuss the lesson together.” The technology, in effect, helps bridge learning gaps, so slower students are neither left behind nor slow down the entire class. The technology also allows the teacher to respond to different areas of interest within a class—“six different videos going at once, or the ability to project a student’s just-submitted portfolio onto the screen so the whole class can discuss it.” One teacher said “I was dubious and a bit intimidated at first. Now I wouldn’t want to teach without my tablet and the digital platform—it makes things so much easier, and the kids learn better.”

How did this come about? It began with the recruitment of a visionary educator—Dr. Couch—who had begun to use digital tools in her previous assignment and had seen their impact. When she arrived in Kent County, the Governor’s office was offering an educational innovation grant—large enough to finance the equipment, software tools, and services needed to start a digital makeoverhere. So Dr. Couch and her team applied and won. The transformation has also involved strong support from the School Board and the County Commissioners, who have supported Dr. Couch’s plans with additional budget.

A second factor depended on engaging and empowering teachers. Dr. Couch recruited 22 teachers who were interested in the new educational model and willing to become part of a “digital leader corps” to be trained as the initial users of the digital platform. It involved a three-year commitment by those teachers, with 15 days of off-site training as well as near constant mentoring by phone and email from an expert coach. Some of that initial corps were understandably a bit uncertain whether the extra effort would be worth it. Within a year, however, the doubts disappeared: the teacher corps has become both advocates of the digital tools and a resource for other teachers, helping to spread expertise through the system. Teachers especially appreciate the intensive coaching, and say that even on a Sunday evening, struggling to prepare digital materials for class the next day, they could email their coach and get immediate help. A new corps—eight more teachers—entered the training process this school year. In two more years, when the current corps finishes their training, the majority of the district’s teachers will be highly skilled in the use of the digital platform and its interactive tools.

A third factor is the rise of what is now called the Ed Tech revolution—hundreds of companies developing digital tools and content that facilitate improved, individualized learning. One of the leaders in this new industry—and the source of the primary digital content for Kent County schools—is Discovery Education. Created in 2009 as a division of the Discovery Channel, the company began by selling classroom videotapes drawn from their successful nature and science cable channel. But they soon realized that kids interact with digital content in a different way than they do with books or simple video tapes. So they began to create a digital platform for schools and a unique kind of digital content: for social studies classes, material with vocabulary that could be adjusted to a child’s current reading level; for science and math classes, interactive content that kids found more engaging and helped them to visualize or understand concepts better. The result is what are now digital “textbooks” spanning a wide range of content for k-12 classes and designed to enable students to learn in the way that suits them best. The Discovery educational materials can even read themselves out loud for students who can’t yet read, or provide content in another language such as Spanish for students still learning English. The Kent County digital educational platform also includes Google’s educational apps that include unlimited digital storage, Google Expeditions (the virtual fieldtrips), Google Cardboard (virtual reality tools), and Google Classroom, which tracks kids’ progress and handles administrative records for teachers, enabling almost paperless schools.

Discovery Education also provides the intensive off-site training for teachers as well as the coaches that help teachers with day-to-day use of the materials and tools. Teachers seem to love the tutorial sessions and they say that the company introduces them to a wide range of available tools (many new ones crop up every year), not just those made by Discovery Education. As a result, Discovery Education has become a clear leader in fostering the digital transformation of education—their content is now used in half of the k-12 classrooms in the U.S. and by some 50 million students overseas in more than 50 other countries. Tens of thousands of teachers across the U.S. are using these tools to prepare digital lesson plans, sharing them with each other online, and rating their effectiveness. Teachers in Kent County usually create their own digital lesson plans, but they can also—and do—choose from the best of those already on-line.

The aim of Kent County public school’s new education model is not only to teach traditional subjects—English, math, science, social studies—more effectively, but also to teach critical skills that will be needed in the 21^st century workforce. These include skills in teamwork and collaboration, as well as the technical ability to use and program smart digital devices and interactive digital content (See Box below: Hands-On Training in IT Skills) and the intellectual ability to evaluate ideas and content critically. Such skills –both the teamwork and critical thinking skills, as well as the technical skills—are likely to become more and more essential for getting and keeping a job, especially as robots and artificial intelligence invades the workplace. For that reason, there is now a renewed focus on teaching such skills across the U.S. as well as internationally. In Maryland alone there are currently more than 100,000 unfilled positions in such areas as cybersecurity, computer system maintenance, or IT application development. So Kent County’s 21^st century approach to education is clearly going to be advantageous for the students, as well as for local businesses.

But the stakes go beyond equipping today’s students. Already the most valuable U.S. companies are so-called “platform businesses” that build and maintain vast IT-based networks connecting billions of users—think Google, Facebook, Amazon, Apple, Uber. These companies are very profitable, highly efficient, and increasingly global in their reach. Many business analysts now believe that such companies will dominate nearly every sector of the economy. Although the U.S. now leads in digital education and Ed-Tech tool development, China is accelerating its investment in these areas as well, and it too has platform businesses with global ambitions. So training an IT-savvy workforce is likely to be important for the future of U.S. economic competitiveness.

For Kent County, with its coming new high-speed internet infrastructure and a new industrial park in progress that hopes to attract sophisticated businesses and new residents, a high-quality public school system attuned to the skills that today’s job market increasingly needs is an essential requirement. Fortunately, that seems well on the way to becoming a reality.

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Hands On Training in IT Skills

Kent County public schools are unique in expecting students to complete both a college-prep curriculum and a Career Technical Training (CTE) curriculum focused on practical skills, which more than 80 percent of students complete. Now the latter is being expanded to include information technologies. The schools already teach coding (programming digital devices) because, as Dr. Laura Jacob—the new head of technology for the school system—says, “programming is the next literacy.” Dr. Jacob has only been here since the summer, but already she serves on a committee that is establishing Maryland K-12 computer science standards. She also applied for and won a Google grant for Kent County (the only Maryland school district to win one) that is enabling 6^th – 8^th graders to learn more advanced programming and app development in bi-weekly after-school sessions. The students then work with local businesses to put those skills to practical use—micro-coding the controls for a fan at Dixon Valve was one of the first projects. A comparable program for high school students will focus on “ethical hacking”, helping organizations test their on-line security systems. These will be part of a new K-12 digital skills CTE curriculum that Jacob is organizing and that will culminate with an Advanced Placement computer science course for high school seniors.

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Photography by Laura Jacob

The Spy Newspapers may periodically employ the assistance of artificial intelligence (AI) to enhance the clarity and accuracy of our content.

GigaBit County: An Update on the Kent County Fiber Network

November 2, 2017 by Al Hammond

The optical fiber network spanning Kent County—which will enable gigabit (1000 megabit) internet access to every County facility and to any home or business that wants it—is nearly complete. Despite rumors to the contrary, the fiber buildout is on schedule and on budget, according to FTS President Adam Noll. In fact, virtually the only part of the backbone network that remains to be built are the fibers serving the towns of Chestertown and Rock Hall. Noll says that construction of Rock Hall will begin in the next 2 weeks, now that plans of the existing underground utilities have been found.

Meanwhile, the company hooking up individual homes and businesses to the fiber and providing high speed internet access, Think Big Networks, reports that it is already providing service to more than 100 customers, including Dixon Valve and La Motte—the County’s largest businesses—and has many more ready to install. Mark Wagner, CEO of Think Big, says that progress has been slower than he hoped, but that it is steady. He sees no reason that they can’t connect any Kent County residence.

The fiber installation in Chestertown has been delayed because Delmarva Power, which owns the above-ground power poles, has demanded a price that FTS considers way above market rate and refuses to pay. Delmarva Power can demand such fees because FTS is not a regulated carrier in the state of Maryland (it is in other states), but Noll says one solution is for FTS to apply for regulated status, which would guarantee access to the poles. Another possible solution is to use micro-trenching techniques to put the fiber underground. In any event, Noll says that Chestertown will soon get fiber too, one way or another.

One cause of the rumors—and a recent pause in the fiber buildout—was a management reorganization at FTS, which resulted in Noll becoming president and taking charge of day-to-day operations. But the buildout is not at risk; in fact, FTS’s prospects are much larger than Kent County and are best understood in terms of that larger context.

The Kent County fiber network is just the first of what FTS hopes will become a major business connecting rural counties—in Maryland and Virgina to start with. Central to that plan is the company’s planned fiber ring connecting a new undersea cable that comes ashore in Virginia Beach to the major internet hub in Ashburn, Virginia. The ring—one arm through Virginia and the other through Maryland’s Eastern Shore—would contain hundreds of fibers, enabling County governments, large internet data centers and other companies, and residential internet providers to access or provide high speed internet.

The new undersea cable connects Bilbao, Spain to Virginia Beach and provides an alternative to cables that go through New York City (and whose vulnerability was demonstrated by superstorm Sandy). The cable is being built by Microsoft, Facebook, and the Spanish company Telefonica and will have the highest capacity of any undersea cable yet, capable of transmitting 16o terabits per second (roughly the same as 71 million high definition movies every second). It is expected to begin operation in 2018, and its presence will transform the entire region, as well as underlie the business case for the FTS ring. The ring, in turn, will be the main revenue source for FTS, but it is what enables the County networks, where the financial return is slower.

For Kent County, says Noll, access via the FTS ring both to the internet hub at Ashburn and to Europe creates a huge opportunity to attract internet-based businesses and young, internet-savvy families. And at least for now, Kent County is unique on the Eastern Shore in having that opportunity. FTS was negotiating a similar contract with Queen Anne’s County, but would face higher costs per foot of fiber installed (it’s a much larger county). Queen Anne was not willing to pay a higher price, and they additionally demanded that FTS provide a bond to guarantee completion. Noll says that it simply did not make business sense, and so FTS walked away; it will instead focus on building its larger ring and exploring opportunities in some Virginia counties.

In summary, FTS is a major internet infrastructure company that is currently building a high-speed fiber ring through Virginia and Maryland, that conveniently passes through Kent County. Think Big is the local company that connects local businesses and residences to this high-speed fiber network. This provides a wonderful opportunity for Kent County. The completed network may open the doors to economic development unlike any the county has experienced in living memory.

The Spy Newspapers may periodically employ the assistance of artificial intelligence (AI) to enhance the clarity and accuracy of our content.

Telemedicine, Virtual Health Coaches, and Other Wonders: The Future of Health in Kent County, Part 1

July 18, 2017 by Al Hammond

UM Shore Regional Health Center – Chestertown

Small rural hospitals are an endangered species everywhere in the U.S. In Kent County, an intense, citizen-led campaign to save the Chestertown hospital has made progress, but—contrary to recent press reports—the hospital’s fate is still uncertain. Shore Regional Health, part of the University of Maryland Medical System that provides healthcare to 5 mid-shore counties and which owns and operates the Chestertown facility, has said it would like to maintain in-patient services in Chestertown after 2022, as part of a broader plan to upgrade healthcare on the Eastern Shore. But doing so will be contingent on legislative or regulatory changes to establish a new reimbursement model for vulnerable rural populations. Whether such legislation is passed is likely to depend on recommendations in the upcoming report of the Maryland Rural Health Study, due this September. Watch this space for an in-depth report when the recommendations are released.

But the future of the hospital—as a full in-patient facility or as a standalone medical facility with more limited services—is only one of the factors that are likely to shape healthcare in the county in coming years. Moreover, a just-released nationwide assessment of the quality of health—county by county within each state—finds that Kent County has lots of room for improvement. It ranks only 18^th (out of 24 Maryland counties) in health outcomes, far behind Talbot (5^th) and Queen Annes (7^th), and only barely ahead of Caroline and Dorchester.

Healthcare is changing rapidly, driven by both economic pressures (healthcare expenditures make up nearly 20% of the U.S. economy, far above all other industrial countries) and by new technology. Shore Health’s strategic plan for the Eastern Shore deals with both aspects, but focuses on improving access to care, while also implementing services that can help keep people out of hospitals. Here we profile some technologies and other innovations likely to impact our healthcare in one form or another in coming years, drawing on both local and national examples.

Transport. A big unmet need in Kent County, as in most rural areas, is transport to get people to care. That could take the form of local transport—to see a doctor, then pick up medicines at a drugstore—or could mean emergency transport by van or helicopter to a distant hospital. One model for local transport could be a kind of “Uber for healthcare” service that would allow people without cars or who can’t safely drive to arrange pickup and transport when they need it with just a phone call or an app. Potentially, a similar service—private but subsidized, or run by a healthcare system or insurer—could also provide transport services to regional hospitals. Will any of these happen? Such services are being started or are under discussion in a few places already, but whether they happen here may depend on local initiatives and some state financing.

Telemedicine and Telehealth. Under the best of circumstances, however, it’s a hassle to drive across the bridge to consult a surgeon or a specialist not found on the Eastern Shore. Suppose instead you could talk to them over a video link from a local facility or, eventually, even from home? As it happens, Shore Regional Health is already gearing up for telemedicine services on the Eastern Shore, in part under a grant from the Maryland Health Care Commission. In April the first patient, a 22-month old boy brought to the emergency room at the Easton Hospital, was linked in minutes to a specialist at the University of Maryland Medical Center in downtown Baltimore—resulting in a diagnosis, immediate treatment, and referrals for followup. “Bridging the gap between the eastern and western shores is a wonderful opportunity that this technology has given us,” says Marc T. Zubrow, MD, vice president of telemedicine for the University of Maryland Medical System. “We will continue to enhance and expand the telemedicine capabilities [to] allow patients to receive the expert care they need without having to leave their local communities and support systems.”

Telehealth refers to broader, non-emergency services at a distance, linking patients at home to doctors or nurses via voice or video or data links. A patient with high blood pressure at risk for stroke, for example, might periodically measure his or her blood pressure at home with a device that transmits the data to be screened automatically by an algorithm and checked periodically by a nurse. Many wearable or in-home sensors capable of monitoring chronic health conditions are now available. Telehealth calls or data streams can also record physical exercise, help patients to improve their nutrition, help a mother decide whether her baby’s fever is high enough to need a doctor’s care, or address other health concerns. The savings in costs and peace of mind could be substantial, and sometimes life-saving.

In-home Care. Some health conditions call for personal contact by a nurse, physical therapist, or health coach. Increasingly, taking care to the patient at home is not only less expensive than institution-based care, but sometimes far more effective—as well as overcoming the necessity to travel and the tendency to put off seeking care. Surgical aftercare through home visits is now common, in-home infusions or dialysis or massage therapy constitute a growing trend. Regular visits by a nurse or a health coach, especially for seniors with chronic conditions or for those struggling with opioid and other addictions, are being tested or considered in many places, and there is some evidence that such visits are more effective in helping people adopt healthy behaviors than care in an institutional setting—as well as less expensive. Assistance with non-medical tasks of daily living that are important to maintaining health are now often provided by volunteers, but increasingly such wellness services are being viewed as a part of basic healthcare. In one instance in California, simply inspecting homes of seniors and installing grab bars or stair railings or replacing loose rugs cut the number of falls (and the resulting hospital stays) in half.

The Amazon Dot, a smaller version of the Amazon Echo, can help with daily tasks, make phone calls, answer questions, even remind a person to take medication at a certain time.

A Virtual Health Coach. Millions of people now have an Amazon Echo and its voice-driven intelligent assistant, Alexa, that they use to order new supplies, turn on lights, or play music—just by talking to it. Now Alexa (and similar voice-based systems from Google and Apple) are starting to be used in healthcare. Alexa can answer questions about your conditions or symptoms or an upcoming doctor’s appointment, remind you to take medicines or order refills, or provide updates on vital signs or pain levels to a remote nurse—all without touching a computer. If you fall, Alexa can call the ambulance. For patients with limited eye sight or who are bed-ridden, Alexa can become a constant companion and a vital link to assistance.

Expert Assistance. Increasingly, large organizations are using artificial intelligence tools to mine large datasets and “learn” how to do things more effectively. So as voice-driven systems interact with millions of patients, asking them about their symptoms—and that data is coupled to the clinical signals provided by in-home sensors for blood pressure, blood sugar, fever, etc.—it’s not very far fetched to imagine that IBM’s Watson or other AI systems may be able to diagnose many health conditions as well as even the most expert doctors—and enable earlier diagnosis and treatment—all without leaving home.

If such things seem hard to imagine, remember that Kent County will soon have the essential infrastructure—near universal access to fast internet connectivity. Keeping in-patient services at the hospital would be important (and might take some lobbying with lawmakers in Annapolis). But in the long run, improved access to care through the new tools and services described above, especially for vulnerable populations, may be even more important for the future of health than what kind of local health facility we have.

The Amazon Echo with “Alexa,” your new personal – and maybe even healthcare – assistant.

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The Spy Newspapers may periodically employ the assistance of artificial intelligence (AI) to enhance the clarity and accuracy of our content.

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