Imagine a hospital that could respond to medical emergencies armed with real-time information about exactly where all its doctors were located. Inside the hospital, which cardio specialist is closest to the 4th floor? Outside the hospital - if an on-call physician is racing to get to a patient's side, how far away are they and when can they be expected to arrive?

From emergency to non-emergency to everyday preventative health care, location tracking technologies could make a big impact on our health and well-being in the future. While two million consumers use Foursquare today to find the best nearby coffee shops and bars, what if in the future they used it to locate the best pediatricians, emergency clinics, or even restaurants that catered to their unique health needs? Some intersection between location and health care has already begun, but what we've seen so far is likely only the beginning.

Sponsor

I showed my dental hygienist who else was checked-in there on Foursquare last time I went to the dentist's office and she was quite taken aback. But we consumers willingly shared our presence at and feedback about that medical facility. That's only the beginning of what's likely to happen.

If health insurance agencies track your location and charge you more for insurance, you're probably not going to appreciate that. There are some possible upsides to the intersection of location and health care, however.

For the Patient

"I would love to see HospitalCompare.com and Health and Human Services (HHS) data mashed up with mobile location apps for health care consumers," says Brian Ahier, Health IT Evangelist at Mid Columbia Medical Center in the Dalles, Oregon. "Helping me find the best pediatrican or orthopedic surgeon would be a great application. And once I'm there, I want to lodge a positive or negative complaint on the same service."

"This is all about the patient," argues Mark Scrimshire, founder of the HealthCamp movement of healthcare unconferences around the world and an employee at a large healthcare payment corporation in the US.

"The one person who is not by their computer during a medical transaction is the patient. They are in the hospital or in the pharmacy. As smartphones take off, there will be tremendous potential for really suplementing the patient and bringing them data that's relevant. Location services could recognize that you are going into a pharmacy, for example, and remind you what your prescriptions are and of anything you needed to talk to your pharmacist about regarding those prescriptions.

"When you walk into the doctor's office, your smartphone should configure your data and prompt you to transmit your health measurements from home quickly and easily, because it knows where you are. I think there's a lot of potential for augmentation of the patient to let them monitor their own health. That will happen through a wide variety of sensors and location is one important factor that will provide context for that sensor data. 'Blood pressure up? Well, he was at work again.'"

Scrimshire also sees location data being served up to Augmented Reality style apps to help patients navigate their way through the maze-like halls of big hospitals - and providing the kind of in-home tracking that would help the elderly stay in place, instead of being institutionalized.

"Putting a few thousand dollars of monitoring equipment into a home, if it prevents someone from visiting an emergency room, it pays for itself with the avoidance of one visit," he argues.

These kinds of strategies may be less far-fetched than they seem. Medical providers are already offering Google Maps of the best facilities to seek appropriate care. A University Medical Center in Holland has even built an emergency Augmented Reality display that allows you to look through your mobile phone's camera view and locate the nearest automatic external defibrillators (AEDs) located in a public place.

For the Doctor

There are already systems in place in many hospitals to track medical equipment, but what about tracking the medical professionals themselves?

Brian Ahier works in the same small Oregon town where Google recently built a big data center, The Dalles. Earlier this year Google gave the town a grant to build a free city-wide wifi network. Wifi is just one of several ways that the locations of mobile devices can be tracked.

"If there's an emergency and we need to call up all hands on deck, it would be really handy to be able to pull up a map and see where everyone is," Ahier says. "It would need to be secure, and probably for people who are on call only. It would have to be an opt-in situation by the physician."

Inside the hospital, location data could prove very useful in tracking updates from devices located in various parts of the institution as well.

"At some of the HealthCamps there have been conversations about secure Twitter-like conversations in a hospital environment, even between devices," Mark Scrimshire says.

"Imagine if every bed and device could send and recieve Twitter-like messages. Imagine if you come onto duty and you get the feed of all the updates from all the patients and devices.

"Because of the life or death nature of the industry, it doesn't move that quickly and thus hasn't adopted technology like this. 'Meaningful use' in healthcare right now is about whole-record interoperability, this would be about real-time mashing together of data feeds from different devices and building filters and context. If a patient has a device on them, where are they and how does that relate to other things you're tracking? That makes for better management of the patient. Is a health care provider doing something out of sequence? Location becomes a factor that helps to add context to all these things we could monitor."

Obstacles to the Vision

Some location technologies will likely impact health care sooner than others. There are obstacles to the kind of future that Ahier and Scrimshire describe. Ahier, for example, says that GPS signals on phones vary too much in accuracy today. And the iPhone is too proprietary for many corporations to build on top of. "Almost all the doctors have iPhones, too," he says. "Even if we give them BlackBerries, they go out and buy their own iPhones."

"Ultimately, I think we're going to need to be platform independent, even device independent," Ahier argues. "We're going to need to be able to use an Ubuntu netbook, an iPad, etc. Our EHR (electronic health records) are going to have to run on all those."

Scrimshire believes that location technology providers in healthcare will go Google's route and build HTML5 mobile web apps, which nearly every smartphone on the market will soon support.

Scrimshire believes that the bigger issues are cultural. "The whole industry is very conservative because of privacy," he says.

"HIPAA [the Health Insurance Portability and Accountability Act of 1996] is used as an excuse not to share, but the P is for portability. The big trap door is that we as patients can demand our data, people may want to charge us for us, but our information is our currency. We can decide when and with whom we want to share it.

"Security is going to be the issue the industry is going to through up as an excuse to not do anything. It's been a minefield to get quality data published about doctors and hospitals, it's a minefield to go through. The healthcare industry is still one where there's a lot of advantage to a lack of transparency. You don't realize you could save $200 by going down the road for the same treatment because the information isn't available.

"But some trends are coming together, in part because of the recession. Employers are putting more of the responsibility for paying for health care on the shoulders of employees, through high-deductible insurance plans, for example. When they start feeling the cost more, then they start asking questions and asking if there are other steps they can take. When the onus is put on the consumer, you'll see them demand a change in the healthcare industry. The consumer can demand their information and be more on par with the physician and make decisions. Then you'll start to see the innovators really coming into the picture."

Will location data be a major disruption of the balance of power between the various stakeholders in the healthcare industry? Will it make shopping for health services, or staying healthy, an easier casual activity for more and more people with smartphones?

Will doctors and medical devices be instrumented, tracked, analyzed and more effectively managed to reduce cost and improve the quality of care?

These visions of location-based health care may be a ways off, but they could also be fast approaching. Just today the FCC and the FDA signed an agreement to jointly develop technical standards for wireless-enabled medical devices and services. Location technology and healthcare could come together sooner than we might expect.

Even though more than a dozen states and Washingon, D.C., continue to square off with the federal government regarding the legality of medical marijuana, the folks at the Veterans Affairs Dept. has decided not to penalize veterans who use the drug in states where its permitted for medicinal use.

Until now, vets who admit to or who are found to be using marijuana -- even when prescribed by a physician -- could be denied pain medication because the federal government still considers it an illegal drug.

So while the VA's revised rules do not allow VA doctors to prescribe marijuana, it does clarify that VA clinics in the 14 states -- Alaska, California, Colorado, Hawaii, Maine, Maryland, Michigan, Montana, Nevada, New Mexico, Oregon, Rhode Island, Vermont and Washington (New Jersey will be added to this list in 2011) -- and Washington, D.C. will permit patients to use marijuana if it's prescribed by a physician.

A rep for Veterans for Medical Marijuana Access says that the previous policy had forced vets to choose between medical marijuana and seeking VA medical care:

For years, there have been veterans coming back from the Iraq war who needed medical marijuana and had to decide whether they were willing to cut down on their VA medications

In a statement regarding its decision, the VA makes clear that, while marijuana use no longer necessarily leads to a denial of pain medications, VA doctors can still not prescribe the meds if they foresee a negative interaction:

If a veteran obtains and uses medical marijuana in a manner consistent with state law, testing positive for marijuana would not preclude the veteran from receiving opioids for pain management... The discretion to prescribe, or not prescribe, opioids in conjunction with medical marijuana, should be determined on clinical grounds.

VA OKs Medical marijuana for Washington vets [SeattlePI.com]

Tsavo Man Eaters

"On reaching the spot where the body had been devoured, a dreadful spectacle presented itself. The ground all round was covered with blood and morsels of flesh and bones, but the unfortunate jemadar's head had been left intact, save for the holes made by the lion's tusks on seizing him, and lay a short distance away from the other remains, the eyes staring wide open with a startled, horrified look in them. The place was considerably cut up, and on closer examination we found that two lions had been there and had probably struggled for possession of the body. It was the most gruesome sight I had ever seen. We collected the remains as well as we could and heaped stones on them, the head with its fixed, terrified stare seeming to watch us all the time, for it we did not bury, but took back to camp for identification before the Medical Officer. Thus occurred my first experience of man-eating lions, and I vowed there and then that I would spare no pains to rid the neighbourhood of the brutes."
-J.H. Patterson, "The Man-eaters of Tsavo", 1907
For nine months in 1898 workers on the British Kenya-Uganda Railway were terrorized, attacked, and eaten by two enormous lions. At least 35 people, and possibly as many as 135 (depending on the source), were killed by the stealthy lions named by natives "Ghost" and "Darkness".
The railway project was intended to link Mombasa, Kenya to Lake Victoria in Uganda in order to create a trade route for raw materials and British goods into Uganda. The project relied on the skills of thousands of imported Sikh laborers from British India along with local laborers. The lions were only one of many problems encountered during the construction process. To start with, much of the construction crossed through Masai tribal lands. In 1895, 500 workers were killed by Masai in retaliation for the alleged rape of two Masai girls.
Back in Britain, many saw the project as a colossal waste of money. At the House of Lords the Prime Minister, Lord Salisbury, groused about the lack of progress on the railway: "The whole of the works were put a stop to for three weeks because a party of man-eating lions appeared in the locality and conceived a most unfortunate taste for our porters. At last the labourers entirely declined to go on unless they were guarded by an iron entrenchment. Of course it is difficult to work a railway under these conditions, and until we found an enthusiastic sportsman to get rid of these lions, our enterprise was seriously hindered"
From March to December the two lions picked off workers. Efforts to barricade work camps failed, and the work crew became increasingly terrified.
Tsavo lions are different from savanna lions. They are exceptionally large, and the males are maneless. Their behavior in the wild is also different, and they may have become accustomed to seeing humans as easy prey following years of slave trains passing through their territory, where bodies of the dead were left where they fell.
It fell to railway engineer J.H. Patterson to stalk and kill the man-eaters. Patterson was a skilled hunter, but not a professional marksman. He finally tracked and killed the first lion in December of 1898, and then shot the second lion three weeks later. It took 10 shots to kill the second lion. In his own words:
"...in a short while I heard the lion begin to creep stealthily towards me. I could barely make out his form as he crouched among the whitish undergrowth; but I saw enough for my purpose, and before he could come any nearer, I took careful aim and pulled the trigger. The sound of the shot was at once followed by a most terrific roar, and then I could hear him leaping about in all directions. I was no longer able to see him, however, as his first bound had taken him into the thick bush; but to make assurance doubly sure, I kept blazing away in the direction in which I heard him plunging about. At length came a series of mighty groans, gradually subsiding into deep sighs, and finally ceasing altogether; and I felt convinced that one of the "devils" who had so long harried us would trouble us no more."
In the wake of his heroism, Patterson went on to be a game warden in Kenya, and the book he wrote in 1907 about his time in Africa has become a classic of adventure writing.
In 1924 Patterson visited the Chicago Field Museum to give a talk on his experiences with the man eaters of Tsavo. After seeing the collections and receiving an enthusiastic welcome he offered the remains of the two lions, which had served as trophy rugs in his home for 25 years, to the museum for $5000.
Thanks to the skills of taxidermist Julius Friesser the lions are exceptionally lifelike for mounts of their age, particularly considering their years as floor coverings. The resulting pair of lions are somewhat smaller than the size reported by Patterson in his book, which may have to do both with exaggeration or mismeasuring on his part, as well as some trimming of the skins required both for creating tidy rugs, and later for fitting over three-dimensional taxidermy forms. They are displayed next to their skulls, also preserved by Patterson. In a separate display, the Field Museum also houses the largest man eating lion on record. Measuring 10 feet 6 inches in length, the "Man Eater of Mfuwe" was responsible for the deaths of 6 people, and was shot in 1991 by a hunter.
Since the 1990s the Field Museum has been actively involved in further field research in the Tsavo National Parks. Researchers have studied the Tsavo maneless lions, and have located the man-eater's lair as shown in Patterson's book.
The story's fame was re-kindled by the 1996 film "The Ghost and the Darkness", named for the two lions.
The railways are still in use today, under the control of the Kenya Railways Corporation. As their territory is encroached upon, the Tsabo lions continue to occasionally snack on humans.

Read more about Tsavo Man Eaters on Atlas Obscura...

Category: Fascinating Fauna, Hunting and Taxidermy, Memento Mori
Location: Chicago, Illinois, US
Edited by: Annetta

Rat lungs successfully grown in bioreactor: groundbreaking, yet also kind of gross originally appeared on Engadget on Wed, 21 Jul 2010 12:07:00 EDT. Please see our terms for use of feeds.

We have reached a fulcrum point in the history of health care in our country. The announcement on Tuesday of the final rule establishing Medicare and Medicaid incentive programs for the meaningful use of electronic health records (EHR) creates a framework for change that will have reverberations throughout the health care industry. An important companion rule (pdf) was also released that establishes standards, specifications and certification criteria for EHRs.

David Blumenthal, the national coordinator for health information technology at Health and Human Services (HHS), and Marilyn Tavenner, principal deputy administrator of the Centers for Medicare and Medicaid Services (CMS), published an overview of the meaningful use rule in the the New England Journal of Medicine. John D. Halamka, of both Harvard Medical School and Beth Israel Deaconess Medical Center, wrote an excellent analysis of the final standards rule on his blog. I expect in the coming months there will be a great deal of parsing of the language of these two rules, which total 1,092 pages.

The rule defining meaningful use will now allow health care providers to adopt health information technology that aligns with the goals of the incentive program included in the American Recovery and Reinvestment Act. The criteria for achieving meaningful use has been substantially scaled back from the proposed rule, which came out at the beginning of the year. After receiving more than 2,000 comments, the rule has some significant changes that could make reaching stage one of meaningful use easier.

A major shift is the move away from an all-or-nothing approach, where providers had to meet every single measure to be eligible for payments. Instead, there's now a set of must-have core requirements and an a la carte menu of discretionary options. There are 15 core requirements for physicians and 14 for hospitals. Health care providers can then choose five of 10 menu options to meet phase one of meaningful use. This strategy will enable a great many hospitals and small practices in rural and underserved areas to have a shot at cashing in on incentive payments.

Meaningful use in action

It's important to note there will still be second and third phases of meaningful use. Ultimately, the final stage must be met. After 2015, when the incentive payments end, penalties will kick in. By lowering expectations for the first phase the slope to reach succeeding phases only gets steeper.

Let's take Computerized Physician Order Entry (CPOE): more than 30 percent of unique patients being seen by an eligible provider or admitted to a hospital, must have at least one medication order entered using CPOE. But the final rule actually states that phase two will require a 60 percent threshold:

For stage 1, we are finalizing a threshold for CPOE of 30 percent for EPs, eligible hospitals, and CAHS. We believe this relatively low threshold, in combination with the limitation to only medication orders, will allow hospitals and EPs to gain experience with CPOE. However, as providers gain greater experience with CPOE, we believe it is reasonable to expect greater use of the function."

As difficult as small physician practices and critical access hospitals might find initial adoption and implementation, it will take a sustained effort to attain the results we need to see so that costs can actually be lowered and the quality of care will improve.

The Emergency Department (ED) is now included in the mix for hospital CPOE. "Nearly every commenter who commented on CPOE objected to our proposal to limit this measure to the inpatient department," the rule says. "Commenters stated that this limitation was inappropriate given the manner in which hospitals use EHR technology. To account for current practice, the commenters recommended the measures be expanded to include the emergency department." The rule then goes on to say: "We agree with the commenters, and therefore are expanding this objective and its associated measure to the emergency room."

This is significant because many hospitals are depending on CPOE orders coming from the ED to meet their 30 percent adoption requirement for meaningful use. Since orders coming from the ED, which is actually an outpatient department, are not included in ambulatory care, it wouldn't make sense to exclude them from hospital orders.

Another important relaxation is in the area of e-prescribing. This is the ability to electronically send an accurate and understandable prescription directly to a pharmacy. The e-prescribing requirement was lowered from the 75 percent under the proposed rule, to only 40 percent in the final rule for phase one. The requirements for phases two and three are not yet spelled out clearly. Eventually we need to reach 100 percent, and a lower initial bar only makes it a steeper climb to get to the goal line in the succeeding stages.

One huge barrier to physician adoption of e-prescribing has been the restriction on electronically sending prescriptions for narcotics. The Drug Enforcement Agency proposed a rule on June 27, 2010 that will allow e-prescribing controlled substances. This move has been cheered by providers and pharmacies alike. However, the rule will require two-factor authentication, which is going to require vendors to set up systems to enable this technology. So the final rule on meaningful use for phase one is not going to include requiring e-prescribing for the newly allowed controlled substances prescriptions.

The final rule also decreased the number of clinical quality measures that must be met to demonstrate meaningful use. The proposed rule listed 90 measures, of which eligible providers had to select and comply with three general measures and three specialty-specific measures. The final rule lists 44 measures for physicians with a requirement to comply with six, with no requirement to meet specialty-specific measures. Hospital clinical quality measures have been reduced from 35 to 15. For 2011, reporting will be through attestation; for 2012, electronic submissions will be required. HHS stated that they cut the clinical quality measures to reduce the burden on EHR vendors to meet the criteria. But since quality is such an important aspect of the overall goals of the program, these measures will certainly need to be ramped up in succeeding phases.

The final rule on meaningful use defers until phase two the requirement to submit claims and eligibility transactions electronically. With the forthcoming HIPAA 5010 and ICD-10 adoption, and creation of operating rules to make HIPAA standards more uniform, additional transaction processing criteria will be coming in 2013. The rule states, "In order to meet these and other administrative simplification provisions, most providers will have to upgrade their practice management systems or implement new ones."

Electronic copy of medical records required

The rule has added the recording of advanced directives and a provision for providing patients with educational materials, which were not included in the proposed rule. However, the proposed rule's requirement to provide an electronic copy of a patient's medical record is maintained in the final rule. This record must contain diagnostic test results, problem list, medication list, medication allergies, and for hospitals, discharge summary and procedures for at least 50 percent of patients within three business days. This requirement may prove to be one of the most difficult to achieve, but as Regina Holliday's poignant testimony during the press conference proves (video below), it is vital to include consumers in the process.

Regina Holliday is a 37-year old mother of two and an art teacher. Last summer, her husband, Fred, died from kidney cancer at the age of 39. She writes at the Medical Advocacy Blog and tweets at @ReginaHolliday.

Related:

• Health and Human Services finalizes meaningful use for electronic health records
• Aneesh Chopra on electronic medical records and meaningful use
• Giving patient data meaningful use
• From Apache to Health and Human Services

Shared by phillip
Acting Director of National Intelligence, David C. Gompert, reaction to the Washington Post series

This morning, the Washington Post began a series of articles on the growth of the Intelligence Community following the terrorist attacks on 9/11. The reporting does not reflect the Intelligence Community we know.

We accept that we operate in an environment that limits the amount of information we can share. However, the fact is, the men and women of the Intelligence Community have improved our operations, thwarted attacks, and are achieving untold successes every day.

In recent years, we have reformed the IC in ways that have improved the quality, quantity, regularity, and speed of our support to policymakers, warfighters, and homeland defenders, and we will continue our reform efforts. We provide oversight, while also encouraging initiative. We work constantly to reduce inefficiencies and redundancies, while preserving a degree of intentional overlap among agencies to strengthen analysis, challenge conventional thinking, and eliminate single points of failure. We are mindful of the size of our contractor ranks, but greatly value the critical flexibility and specialized skills they contribute to our mission.
The challenges that lie ahead are difficult and complex. We will continue to scrutinize our own operations, seek ways to improve and adapt, and work with Congress on its crucial oversight and reform efforts. We can always do better, and we will. And the importance of our mission and our commitment to keeping America safe will remain steadfast, whether they are reflected in the day's news or not.

The top-secret world the government created in response to the terrorist attacks of Sept. 11, 2001, has become so large, so unwieldy and so secretive that no one knows how much money it costs, how many people it employs, how many programs exist within it or exactly how many agencies do the same work.

These are some of the findings of a two-year investigation by The Washington Post that discovered what amounts to an alternative geography of the United States, a Top Secret America hidden from public view and lacking in thorough oversight. After nine years of unprecedented spending and growth, the result is that the system put in place to keep the United States safe is so massive that its effectiveness is impossible to determine.

The investigation's other findings include:

* Some 1,271 government organizations and 1,931 private companies work on programs related to counterterrorism, homeland security and intelligence in about 10,000 locations across the United States.

* An estimated 854,000 people, nearly 1.5 times as many people as live in Washington, D.C., hold top-secret security clearances.

* In Washington and the surrounding area, 33 building complexes for top-secret intelligence work are under construction or have been built since September 2001. Together they occupy the equivalent of almost three Pentagons or 22 U.S. Capitol buildings - about 17 million square feet of space.

* Many security and intelligence agencies do the same work, creating redundancy and waste. For example, 51 federal organizations and military commands, operating in 15 U.S. cities, track the flow of money to and from terrorist networks.

* Analysts who make sense of documents and conversations obtained by foreign and domestic spying share their judgment by publishing 50,000 intelligence reports each year - a volume so large that many are routinely ignored.

These are not academic issues; lack of focus, not lack of resources, was at the heart of the Fort Hood shooting that left 13 dead, as well as the Christmas Day bomb attempt thwarted not by the thousands of analysts employed to find lone terrorists but by an alert airline passenger who saw smoke coming from his seatmate.

They are also issues that greatly concern some of the people in charge of the nation's security.

"There has been so much growth since 9/11 that getting your arms around that - not just for the DNI [Director of National Intelligence], but for any individual, for the director of the CIA, for the secretary of defense - is a challenge," Defense Secretary Robert M. Gates said in an interview with The Post last week.

In the Department of Defense, where more than two-thirds of the intelligence programs reside, only a handful of senior officials - called Super Users - have the ability to even know about all the department's activities. But as two of the Super Users indicated in interviews, there is simply no way they can keep up with the nation's most sensitive work.

"I'm not going to live long enough to be briefed on everything" was how one Super User put it. The other recounted that for his initial briefing, he was escorted into a tiny, dark room, seated at a small table and told he couldn't take notes. Program after program began flashing on a screen, he said, until he yelled ''Stop!" in frustration.

"I wasn't remembering any of it," he said.

Underscoring the seriousness of these issues are the conclusions of retired Army Lt. Gen. John R. Vines, who was asked last year to review the method for tracking the Defense Department's most sensitive programs. Vines, who once commanded 145,000 troops in Iraq and is familiar with complex problems, was stunned by what he discovered.

"I'm not aware of any agency with the authority, responsibility or a process in place to coordinate all these interagency and commercial activities," he said in an interview. "The complexity of this system defies description."

The result, he added, is that it's impossible to tell whether the country is safer because of all this spending and all these activities. "Because it lacks a synchronizing process, it inevitably results in message dissonance, reduced effectiveness and waste," Vines said. "We consequently can't effectively assess whether it is making us more safe."

The Post's investigation is based on government documents and contracts, job descriptions, property records, corporate and social networking Web sites, additional records, and hundreds of interviews with intelligence, military and corporate officials and former officials. Most requested anonymity either because they are prohibited from speaking publicly or because, they said, they feared retaliation at work for describing their concerns.

The Post's online database of government organizations and private companies was built entirely on public records. The investigation focused on top-secret work because the amount classified at the secret level is too large to accurately track.

Today's article describes the government's role in this expanding enterprise. Tuesday's article describes the government's dependence on private contractors. Wednesday's is a portrait of one Top Secret America community. On the Web, an extensive, searchable database built by The Post about Top Secret America is available at washingtonpost.com/topsecretamerica.

Defense Secretary Gates, in his interview with The Post, said that he does not believe the system has become too big to manage but that getting precise data is sometimes difficult. Singling out the growth of intelligence units in the Defense Department, he said he intends to review those programs for waste. "Nine years after 9/11, it makes a lot of sense to sort of take a look at this and say, 'Okay, we've built tremendous capability, but do we have more than we need?' " he said.

CIA Director Leon Panetta, who was also interviewed by The Post last week, said he's begun mapping out a five-year plan for his agency because the levels of spending since 9/11 are not sustainable. "Particularly with these deficits, we're going to hit the wall. I want to be prepared for that," he said. "Frankly, I think everyone in intelligence ought to be doing that."

In an interview before he resigned as the director of national intelligence in May, retired Adm. Dennis C. Blair said he did not believe there was overlap and redundancy in the intelligence world. "Much of what appears to be redundancy is, in fact, providing tailored intelligence for many different customers," he said.

Blair also expressed confidence that subordinates told him what he needed to know. "I have visibility on all the important intelligence programs across the community, and there are processes in place to ensure the different intelligence capabilities are working together where they need to," he said.

Weeks later, as he sat in the corner of a ballroom at the Willard Hotel waiting to give a speech, he mused about The Post's findings. "After 9/11, when we decided to attack violent extremism, we did as we so often do in this country," he said. "The attitude was, if it's worth doing, it's probably worth overdoing."

Outside a gated subdivision of mansions in McLean, a line of cars idles every weekday morning as a new day in Top Secret America gets underway. The drivers wait patiently to turn left, then crawl up a hill and around a bend to a destination that is not on any public map and not announced by any street sign.

Liberty Crossing tries hard to hide from view. But in the winter, leafless trees can't conceal a mountain of cement and windows the size of five Wal-Mart stores stacked on top of one another rising behind a grassy berm. One step too close without the right badge, and men in black jump out of nowhere, guns at the ready.

Past the armed guards and the hydraulic steel barriers, at least 1,700 federal employees and 1,200 private contractors work at Liberty Crossing, the nickname for the two headquarters of the Office of the Director of National Intelligence and its National Counterterrorism Center. The two share a police force, a canine unit and thousands of parking spaces.

Liberty Crossing is at the center of the collection of U.S. government agencies and corporate contractors that mushroomed after the 2001 attacks. But it is not nearly the biggest, the most costly or even the most secretive part of the 9/11 enterprise.

In an Arlington County office building, the lobby directory doesn't include the Air Force's mysteriously named XOIWS unit, but there's a big "Welcome!" sign in the hallway greeting visitors who know to step off the elevator on the third floor. In Elkridge, Md., a clandestine program hides in a tall concrete structure fitted with false windows to look like a normal office building. In Arnold, Mo., the location is across the street from a Target and a Home Depot. In St. Petersburg, Fla., it's in a modest brick bungalow in a run-down business park.

Each day at the National Counterterrorism Center in McLean, workers review at least 5,000 pieces of terrorist-related data from intelligence agencies and keep an eye on world events. (Photo by: Melina Mara / The Washington Post)

Every day across the United States, 854,000 civil servants, military personnel and private contractors with top-secret security clearances are scanned into offices protected by electromagnetic locks, retinal cameras and fortified walls that eavesdropping equipment cannot penetrate.

This is not exactly President Dwight D. Eisenhower's "military-industrial complex," which emerged with the Cold War and centered on building nuclear weapons to deter the Soviet Union. This is a national security enterprise with a more amorphous mission: defeating transnational violent extremists.

Much of the information about this mission is classified. That is the reason it is so difficult to gauge the success and identify the problems of Top Secret America, including whether money is being spent wisely. The U.S. intelligence budget is vast, publicly announced last year as $75 billion, 21/2 times the size it was on Sept. 10, 2001. But the figure doesn't include many military activities or domestic counterterrorism programs.

At least 20 percent of the government organizations that exist to fend off terrorist threats were established or refashioned in the wake of 9/11. Many that existed before the attacks grew to historic proportions as the Bush administration and Congress gave agencies more money than they were capable of responsibly spending.

The Pentagon's Defense Intelligence Agency, for example, has gone from 7,500 employees in 2002 to 16,500 today. The budget of the National Security Agency, which conducts electronic eavesdropping, doubled. Thirty-five FBI Joint Terrorism Task Forces became 106. It was phenomenal growth that began almost as soon as the Sept. 11 attacks ended.

Nine days after the attacks, Congress committed $40 billion beyond what was in the federal budget to fortify domestic defenses and to launch a global offensive against al-Qaeda. It followed that up with an additional $36.5 billion in 2002 and $44 billion in 2003. That was only a beginning.

With the quick infusion of money, military and intelligence agencies multiplied. Twenty-four organizations were created by the end of 2001, including the Office of Homeland Security and the Foreign Terrorist Asset Tracking Task Force. In 2002, 37 more were created to track weapons of mass destruction, collect threat tips and coordinate the new focus on counterterrorism. That was followed the next year by 36 new organizations; and 26 after that; and 31 more; and 32 more; and 20 or more each in 2007, 2008 and 2009.

In all, at least 263 organizations have been created or reorganized as a response to 9/11. Each has required more people, and those people have required more administrative and logistic support: phone operators, secretaries, librarians, architects, carpenters, construction workers, air-conditioning mechanics and, because of where they work, even janitors with top-secret clearances.

With so many more employees, units and organizations, the lines of responsibility began to blur. To remedy this, at the recommendation of the bipartisan 9/11 Commission, the George W. Bush administration and Congress decided to create an agency in 2004 with overarching responsibilities called the Office of the Director of National Intelligence (ODNI) to bring the colossal effort under control.

While that was the idea, Washington has its own ways.

The first problem was that the law passed by Congress did not give the director clear legal or budgetary authority over intelligence matters, which meant he wouldn't have power over the individual agencies he was supposed to control.

The second problem: Even before the first director, Ambassador John D. Negroponte, was on the job, the turf battles began. The Defense Department shifted billions of dollars out of one budget and into another so that the ODNI could not touch it, according to two senior officials who watched the process. The CIA reclassified some of its most sensitive information at a higher level so the National Counterterrorism Center staff, part of the ODNI, would not be allowed to see it, said former intelligence officers involved.

And then came a problem that continues to this day, which has to do with the ODNI's rapid expansion.

When it opened in the spring of 2005, Negroponte's office was all of 11 people stuffed into a secure vault with closet-size rooms a block from the White House. A year later, the budding agency moved to two floors of another building. In April 2008, it moved into its huge permanent home, Liberty Crossing.

Today, many officials who work in the intelligence agencies say they remain unclear about what the ODNI is in charge of. To be sure, the ODNI has made some progress, especially in intelligence-sharing, information technology and budget reform. The DNI and his managers hold interagency meetings every day to promote collaboration. The last director, Blair, doggedly pursued such nitty-gritty issues as procurement reform, compatible computer networks, tradecraft standards and collegiality.

But improvements have been overtaken by volume at the ODNI, as the increased flow of intelligence data overwhelms the system's ability to analyze and use it. Every day, collection systems at the National Security Agency intercept and store 1.7 billion e-mails, phone calls and other types of communications. The NSA sorts a fraction of those into 70 separate databases. The same problem bedevils every other intelligence agency, none of which have enough analysts and translators for all this work.

The practical effect of this unwieldiness is visible, on a much smaller scale, in the office of Michael Leiter, the director of the National Counterterrorism Center. Leiter spends much of his day flipping among four computer monitors lined up on his desk. Six hard drives sit at his feet. The data flow is enormous, with dozens of databases feeding separate computer networks that cannot interact with one another.

There is a long explanation for why these databases are still not connected, and it amounts to this: It's too hard, and some agency heads don't really want to give up the systems they have. But there's some progress: "All my e-mail on one computer now," Leiter says. "That's a big deal."

To get another view of how sprawling Top Secret America has become, just head west on the toll road toward Dulles International Airport.

As a Michaels craft store and a Books-A-Million give way to the military intelligence giants Northrop Grumman and Lockheed Martin, find the off-ramp and turn left. Those two shimmering-blue five-story ice cubes belong to the National Geospatial-Intelligence Agency, which analyzes images and mapping data of the Earth's geography. A small sign obscured by a boxwood hedge says so.

Across the street, in the chocolate-brown blocks, is Carahsoft, an intelligence agency contractor specializing in mapping, speech analysis and data harvesting. Nearby is the government's Underground Facility Analysis Center. It identifies overseas underground command centers associated with weapons of mass destruction and terrorist groups, and advises the military on how to destroy them.

Clusters of top-secret work exist throughout the country, but the Washington region is the capital of Top Secret America.

About half of the post-9/11 enterprise is anchored in an arc stretching from Leesburg south to Quantico, back north through Washington and curving northeast to Linthicum, just north of the Baltimore-Washington International Marshall Airport. Many buildings sit within off-limits government compounds or military bases.

Others occupy business parks or are intermingled with neighborhoods, schools and shopping centers and go unnoticed by most people who live or play nearby.

Many of the newest buildings are not just utilitarian offices but also edifices "on the order of the pyramids," in the words of one senior military intelligence officer.

Not far from the Dulles Toll Road, the CIA has expanded into two buildings that will increase the agency's office space by one-third. To the south, Springfield is becoming home to the new $1.8 billion National Geospatial-Intelligence Agency headquarters, which will be the fourth-largest federal building in the area and home to 8,500 employees. Economic stimulus money is paying hundreds of millions of dollars for this kind of federal construction across the region.

Construction for the National Geospatial-Intelligence Agency in Springfield (Photo by: Michael S. Williamson / The Washington Post)

It's not only the number of buildings that suggests the size and cost of this expansion, it's also what is inside: banks of television monitors. "Escort-required" badges. X-ray machines and lockers to store cellphones and pagers. Keypad door locks that open special rooms encased in metal or permanent dry wall, impenetrable to eavesdropping tools and protected by alarms and a security force capable of responding within 15 minutes. Every one of these buildings has at least one of these rooms, known as a SCIF, for sensitive compartmented information facility. Some are as small as a closet; others are four times the size of a football field.

SCIF size has become a measure of status in Top Secret America, or at least in the Washington region of it. "In D.C., everyone talks SCIF, SCIF, SCIF," said Bruce Paquin, who moved to Florida from the Washington region several years ago to start a SCIF construction business. "They've got the penis envy thing going. You can't be a big boy unless you're a three-letter agency and you have a big SCIF."

SCIFs are not the only must-have items people pay attention to. Command centers, internal television networks, video walls, armored SUVs and personal security guards have also become the bling of national security.

"You can't find a four-star general without a security detail," said one three-star general now posted in Washington after years abroad. "Fear has caused everyone to have stuff. Then comes, 'If he has one, then I have to have one.' It's become a status symbol."

Among the most important people inside the SCIFs are the low-paid employees carrying their lunches to work to save money. They are the analysts, the 20- and 30-year-olds making $41,000 to $65,000 a year, whose job is at the core of everything Top Secret America tries to do.

At its best, analysis melds cultural understanding with snippets of conversations, coded dialogue, anonymous tips, even scraps of trash, turning them into clues that lead to individuals and groups trying to harm the United States.

Their work is greatly enhanced by computers that sort through and categorize data. But in the end, analysis requires human judgment, and half the analysts are relatively inexperienced, having been hired in the past several years, said a senior ODNI official. Contract analysts are often straight out of college and trained at corporate headquarters.

When hired, a typical analyst knows very little about the priority countries - Iraq, Iran, Afghanistan and Pakistan - and is not fluent in their languages. Still, the number of intelligence reports they produce on these key countries is overwhelming, say current and former intelligence officials who try to cull them every day. The ODNI doesn't know exactly how many reports are issued each year, but in the process of trying to find out, the chief of analysis discovered 60 classified analytic Web sites still in operation that were supposed to have been closed down for lack of usefulness. "Like a zombie, it keeps on living" is how one official describes the sites.

The problem with many intelligence reports, say officers who read them, is that they simply re-slice the same facts already in circulation. "It's the soccer ball syndrome. Something happens, and they want to rush to cover it," said Richard H. Immerman, who was the ODNI's assistant deputy director of national intelligence for analytic integrity and standards until early 2009. "I saw tremendous overlap."

Even the analysts at the National Counterterrorism Center (NCTC), which is supposed to be where the most sensitive, most difficult-to-obtain nuggets of information are fused together, get low marks from intelligence officials for not producing reports that are original, or at least better than the reports already written by the CIA, FBI, National Security Agency or Defense Intelligence Agency.

When Maj. Gen. John M. Custer was the director of intelligence at U.S. Central Command, he grew angry at how little helpful information came out of the NCTC. In 2007, he visited its director at the time, retired Vice Adm. John Scott Redd, to tell him so. "I told him that after 41/2 years, this organization had never produced one shred of information that helped me prosecute three wars!" he said loudly, leaning over the table during an interview.

Two years later, Custer, now head of the Army's intelligence school at Fort Huachuca, Ariz., still gets red-faced recalling that day, which reminds him of his frustration with Washington's bureaucracy. "Who has the mission of reducing redundancy and ensuring everybody doesn't gravitate to the lowest-hanging fruit?" he said. "Who orchestrates what is produced so that everybody doesn't produce the same thing?"

He's hardly the only one irritated. In a secure office in Washington, a senior intelligence officer was dealing with his own frustration. Seated at his computer, he began scrolling through some of the classified information he is expected to read every day: CIA World Intelligence Review, WIRe-CIA, Spot Intelligence Report, Daily Intelligence Summary, Weekly Intelligence Forecast, Weekly Warning Forecast, IC Terrorist Threat Assessments, NCTC Terrorism Dispatch, NCTC Spotlight . . .

It's too much, he complained. The inbox on his desk was full, too. He threw up his arms, picked up a thick, glossy intelligence report and waved it around, yelling.

"Jesus! Why does it take so long to produce?"

"Why does it have to be so bulky?"

"Why isn't it online?"

The overload of hourly, daily, weekly, monthly and annual reports is actually counterproductive, say people who receive them. Some policymakers and senior officials don't dare delve into the backup clogging their computers. They rely instead on personal briefers, and those briefers usually rely on their own agency's analysis, re-creating the very problem identified as a main cause of the failure to thwart the attacks: a lack of information-sharing.

A new Defense Department office complex goes up in Alexandria. (Photo by: Michael S. Williamson / The Washington Post)

The ODNI's analysis office knows this is a problem. Yet its solution was another publication, this one a daily online newspaper, Intelligence Today. Every day, a staff of 22 culls more than two dozen agencies' reports and 63 Web sites, selects the best information and packages it by originality, topic and region.

Analysis is not the only area where serious overlap appears to be gumming up the national security machinery and blurring the lines of responsibility.

Within the Defense Department alone, 18 commands and agencies conduct information operations, which aspire to manage foreign audiences' perceptions of U.S. policy and military activities overseas.

And all the major intelligence agencies and at least two major military commands claim a major role in cyber-warfare, the newest and least-defined frontier.

"Frankly, it hasn't been brought together in a unified approach," CIA Director Panetta said of the many agencies now involved in cyber-warfare.

"Cyber is tremendously difficult" to coordinate, said Benjamin A. Powell, who served as general counsel for three directors of national intelligence until he left the government last year. "Sometimes there was an unfortunate attitude of bring your knives, your guns, your fists and be fully prepared to defend your turf." Why? "Because it's funded, it's hot and it's sexy."

Last fall, U.S. Army Maj. Nidal Malik Hasan allegedly opened fire at Fort Hood, Tex., killing 13 people and wounding 30. In the days after the shootings, information emerged about Hasan's increasingly strange behavior at Walter Reed Army Medical Center, where he had trained as a psychiatrist and warned commanders that they should allow Muslims to leave the Army or risk "adverse events." He had also exchanged e-mails with a well-known radical cleric in Yemen being monitored by U.S. intelligence.

But none of this reached the one organization charged with handling counterintelligence investigations within the Army. Just 25 miles up the road from Walter Reed, the Army's 902nd Military Intelligence Group had been doing little to search the ranks for potential threats. Instead, the 902's commander had decided to turn the unit's attention to assessing general terrorist affiliations in the United States, even though the Department of Homeland Security and the FBI's 106 Joint Terrorism Task Forces were already doing this work in great depth.

The 902nd, working on a program the commander named RITA, for Radical Islamic Threat to the Army, had quietly been gathering information on Hezbollah, Iranian Republican Guard and al-Qaeda student organizations in the United States. The assessment "didn't tell us anything we didn't know already," said the Army's senior counterintelligence officer at the Pentagon.

Secrecy and lack of coordination have allowed organizations, such as the 902nd in this case, to work on issues others were already tackling rather than take on the much more challenging job of trying to identify potential jihadist sympathizers within the Army itself.

Beyond redundancy, secrecy within the intelligence world hampers effectiveness in other ways, say defense and intelligence officers. For the Defense Department, the root of this problem goes back to an ultra-secret group of programs for which access is extremely limited and monitored by specially trained security officers.

These are called Special Access Programs - or SAPs - and the Pentagon's list of code names for them runs 300 pages. The intelligence community has hundreds more of its own, and those hundreds have thousands of sub-programs with their own limits on the number of people authorized to know anything about them. All this means that very few people have a complete sense of what's going on.

"There's only one entity in the entire universe that has visibility on all SAPs - that's God," said James R. Clapper, undersecretary of defense for intelligence and the Obama administration's nominee to be the next director of national intelligence.

Such secrecy can undermine the normal chain of command when senior officials use it to cut out rivals or when subordinates are ordered to keep secrets from their commanders.

One military officer involved in one such program said he was ordered to sign a document prohibiting him from disclosing it to his four-star commander, with whom he worked closely every day, because the commander was not authorized to know about it. Another senior defense official recalls the day he tried to find out about a program in his budget, only to be rebuffed by a peer. "What do you mean you can't tell me? I pay for the program," he recalled saying in a heated exchange.

Another senior intelligence official with wide access to many programs said that secrecy is sometimes used to protect ineffective projects. "I think the secretary of defense ought to direct a look at every single thing to see if it still has value," he said. "The DNI ought to do something similar."

The ODNI hasn't done that yet. The best it can do at the moment is maintain a database of the names of the most sensitive programs in the intelligence community. But the database does not include many important and relevant Pentagon projects.

Because so much is classified, illustrations of what goes on every day in Top Secret America can be hard to ferret out. But every so often, examples emerge. A recent one shows the post-9/11 system at its best and its worst.

Last fall, after eight years of growth and hirings, the enterprise was at full throttle when word emerged that something was seriously amiss inside Yemen. In response, President Obama signed an order sending dozens of secret commandos to that country to target and kill the leaders of an al-Qaeda affiliate.

In Yemen, the commandos set up a joint operations center packed with hard drives, forensic kits and communications gear. They exchanged thousands of intercepts, agent reports, photographic evidence and real-time video surveillance with dozens of top-secret organizations in the United States.

That was the system as it was intended. But when the information reached the National Counterterrorism Center in Washington for analysis, it arrived buried within the 5,000 pieces of general terrorist-related data that are reviewed each day. Analysts had to switch from database to database, from hard drive to hard drive, from screen to screen, just to locate what might be interesting to study further.

As military operations in Yemen intensified and the chatter about a possible terrorist strike increased, the intelligence agencies ramped up their effort. The flood of information into the NCTC became a torrent.

Somewhere in that deluge was even more vital data. Partial names of someone in Yemen. A reference to a Nigerian radical who had gone to Yemen. A report of a father in Nigeria worried about a son who had become interested in radical teachings and had disappeared inside Yemen.

These were all clues to what would happen when a Nigerian named Umar Farouk Abdulmutallab left Yemen and eventually boarded a plane in Amsterdam bound for Detroit. But nobody put them together because, as officials would testify later, the system had gotten so big that the lines of responsibility had become hopelessly blurred.

"There are so many people involved here," NCTC Director Leiter told Congress.

"Everyone had the dots to connect," DNI Blair explained to the lawmakers. "But I hadn't made it clear exactly who had primary responsibility."

And so Abdulmutallab was able to step aboard Northwest Airlines Flight 253. As it descended toward Detroit, he allegedly tried to ignite explosives hidden in his underwear. It wasn't the very expensive, very large 9/11 enterprise that prevented disaster. It was a passenger who saw what he was doing and tackled him. "We didn't follow up and prioritize the stream of intelligence," White House counterterrorism adviser John O. Brennan explained afterward. "Because no one intelligence entity, or team or task force was assigned responsibility for doing that follow-up investigation."

Blair acknowledged the problem. His solution: Create yet another team to run down every important lead. But he also told Congress he needed more money and more analysts to prevent another mistake.

More is often the solution proposed by the leaders of the 9/11 enterprise. After the Christmas Day bombing attempt, Leiter also pleaded for more - more analysts to join the 300 or so he already had.

The Department of Homeland Security asked for more air marshals, more body scanners and more analysts, too, even though it can't find nearly enough qualified people to fill its intelligence unit now. Obama has said he will not freeze spending on national security, making it likely that those requests will be funded.

More building, more expansion of offices continues across the country. A $1.7 billion NSA data-processing center will be under construction soon near Salt Lake City. In Tampa, the U.S. Central Command's new 270,000-square-foot intelligence office will be matched next year by an equally large headquarters building, and then, the year after that, by a 51,000-square-foot office just for its special operations section.

Just north of Charlottesville, the new Joint-Use Intelligence Analysis Facility will consolidate 1,000 defense intelligence analysts on a secure campus.

Meanwhile, five miles southeast of the White House, the DHS has broken ground for its new headquarters, to be shared with the Coast Guard. DHS, in existence for only seven years, already has its own Special Access Programs, its own research arm, its own command center, its own fleet of armored cars and its own 230,000-person workforce, the third-largest after the departments of Defense and Veterans Affairs.

Soon, on the grounds of the former St. Elizabeths mental hospital in Anacostia, a $3.4 billion showcase of security will rise from the crumbling brick wards. The new headquarters will be the largest government complex built since the Pentagon, a major landmark in the alternative geography of Top Secret America and four times as big as Liberty Crossing.

Wolfram Alpha's not the first place you'd think to look for medical information, but try it out next time you're digging in online. The computational search site offers detailed statistics on disease symptoms, treatments, drugs and their generics, and other data-geek details.

It's not a health dictionary or a physician-monitored forumWolfram's all about data, so you'll mostly get reports about how many people are treated with X for Y, the most common other illnesses people with Y also have, and hard lists of generic drug equivalents for prescriptions you may have. But in being so cold, calculating, and intensive, Wolfram can be just the thing you need if you need help talking to your doctor or exploring the treatments available to yourself or others.

CyberCity 3D has teamed up with The Sanborn Map Company to create an "engaging map can be customized for a variety of uses for entities including Emergency Medical Services, Police Departments, Fire Departments, Utilities, and Public Safety. Available data includes specific building types and locations; emergency exits; fire hydrant/fire house sites; utilities; and parking." An example of the map is seen below, and you can try it for yourself here .

This product will officially launch at the 2010 ESRI International User Conference in a couple of weeks.

More merged products from the two companies are expected in the future, which makes perfect sense given their very complimentary offerings. I think we'll see some great stuff from them in the future.

The full text of their press release is below:

El Segundo, CA - CyberCity 3D, Inc., a state-of-the-art 3D geospatial modeling company based in El Segundo, CA and international geospatial solutions provider The Sanborn Map Company, headquartered in Colorado Springs, CO, today announced they will launch the first of a series of products resulting from their recent partnership at the annual ESRI International User Conference in San Diego, CA July 12th through the 16th.

The Sanborn Emergency Response Maps website combines Sanborn's detailed CitySets and CyberCity 3D's data integration to provide critical building and surrounding area information through the power of the Google Earth API plug-in. The site (www.cybercity3d.com/sanbornermaps) offers maps in 3D on Google Earth through its API plug-in, in 2D on Google maps, in Google Street View, and via satellite imagery.

This engaging map can be customized for a variety of uses for entities including Emergency Medical Services, Police Departments, Fire Departments, Utilities, and Public Safety. Available data includes specific building types and locations; emergency exits; fire hydrant/fire house sites; utilities; and parking.

"We look forward to working with Sanborn to deliver new and engaging public services web mapping sites. The synergies between the two companies are quite complimentary. Web mapping is undergoing great change and the combination of Sanborn's vast experience and strong relationships combined with CyberCity's cutting-edge technologies is a perfect fit," CyberCity 3D CEO Kevin DeVito stated.

"Sanborn and CyberCity 3D combined now have the largest online catalog of 3D structures. Coupled with the advanced web application services, we are even more capable to meet and exceed our customers' requirements today and in the future," said Robert Lega, Sanborn Products Manager.

The CyberCity 3D / Sanborn alliance enables the companies to provide groundbreaking GeoWeb solutions like the Sanborn Emergency Response Maps to a variety of government agencies and geographic information system (GIS) services as well as data products.

The CyberCity 3D/Sanborn collaboration integrates the two companies' 3D libraries to bring clients more 3D choices and high quality, cutting-edge web solutions-- including those built around the Google Earth API platform.

In their continuing partnership, the companies plan to create more merged products involving web publishing and planning.

About CyberCity 3D, Inc.:
CyberCity 3D (www.cybercity3d.com) specializes in emerging GeoWeb solutions for government agencies, the environment, geographic information systems (GIS), and travel destinations, as well as commercial and residential real estate. The Company also develops 3D, web-based, energy efficiency applications in addition to green house gas (GHG) information-gathering and computing tools designed to assist municipalities, utilities, and environmental agencies in their implementation of environmentally sustainable programs. CyberCity 3D is one of the first to offer realistic, three-dimensional, building and city models through the Google Earth API plug-in.

About Sanborn Map Company, Inc.:
Sanborn (www.sanborn.com) has been delivering quality geospatial solutions to clients worldwide since 1866. Sanborn provides high value solutions for mapping and geographic data, imagery and spatial analysis, custom applications, system integration, data management, and outsourcing as well as advanced web-based information systems, 3D modeling and visualization systems for customers worldwide.

• Glass-Steagall: Paul Volcker supported provisions that were hopelessly watered down, so much so that they can accomplish nothing. This was a complete failure.
• Derivatives Reform: Banks successfully lobbied for derivative exceptions big enough to drive the planet Jupiter through. They succeeded. Derivatives reform is meaningless.
• Too Big To Fail: The reform bill did absolutely nothing to rein in the widely recognized "too big to fail" policies of the Fed. This was a complete failure.
• Preventing the Last Crisis: There is not a single thing in the bill that can possibly be construed to have prevented the last crisis. This was a complete failure.
• Preventing the Next Crisis: There is not a single thing in the bill that can possibly do anything to prevent the next crisis. This too was a complete failure.

• None. The bill accomplished virtually nothing.

Mike "Mish" Shedlock is a registered investment advisor representative for SitkaPacific Capital Management. Sitka Pacific is an asset management firm whose goal is strong performance and low volatility, regardless of market direction. Visit http://www.sitkapacific.com/account_management.html to learn more about wealth management and capital preservation strategies of Sitka Pacific.

Out on the battlefield, blood is constantly in short supply at military trauma care centers. But rather than just do endless blood drives, the Pentagon's research arm, DARPA, decided to just make their own.