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Safety as CapacityI have a personal connection with the topic of safety. I grew up in the60s in a little town called Bhilai in India. It is a town built around amassive integrated steel mill. I remember seeing bill boards like Figure1 throughout the town and noticing signs, in the mills when we wouldgo on field trips (the Coke Ovens, the Blast Furnace, the Plate mill,the Rail mill etc.), with messages like “Safety Awareness Week”, “248days without an accident” or “Congratulations to Blast Furnace Team!Celebrating 100% on safety inspection” etc. That was my first initiationinto the importance of safety measures. Many decades later, on 9thOctober 2018, my childhood friend, Uday Pandey, fell victim to anindustrial accident1 at the same plant.InfeXBlocTMSafety as Capacity 1

Figure 1: Safety signs in my childhood townSafety is a feeling. Technically it is definedas a dynamic non-event. It cannot bemeasured directly. Safety is not the absenceof accidents, but the presence of capacity2.That notion of capacity in this context isinteresting. While often we use that term toindicate a physical property of an object (e.g.a 5 gallon bucket), here we use it to refer to asystem’s property that allows it to absorb theuncertainty of an accident while preventinguncontrolled harm.Several examples are quite illustrative: When building and safety departmentmandates earthquake code compliance,they are creating capacity in the structureto deal with the uncertainty of seismicshaking. Compliance with this coderequires extra design, engineering,materials and construction effort anda significant extra cost. But when anearthquake happens, the structure has thecapacity to deal with it. In the non-fire season, the department offire must diligently implement activitieslike dry brush clearance, dead woodremoval in forests, training of fire fighters,developing equipment and infrastructurelike air tankers, their fire-retardant supplies,staging airports, etc. If these capacitybuilding activities are adequately funded1. Industrial accident in Bhilai 04/compiled-BSP-report-pdfpagenumber.pdf2. Safety as a presence of capacity – Todd Conklin https://www.youtube.com/watch?v qo8hh Rb1kInfeXBlocTMSafety as Capacity 2

and executed in years before a fire ravagesa certain section of California, then thesystem has capacity to deal with a fire. In Silicon Valley are some of the giantsof the digital economy (e.g. Google,Amazon, eBay, Netflix etc.). In a shortperiod, they have significantly altered thecomposition of economic activity. Whenyou rely on cloud based computer systemsto carry out billions of dollars of business24X7, you must think hard about disasterpreparedness to deal with uncertaintyof emergent events. Netflix has investedyears and a very large budget with acontinuously improving effort to buildcapacity to deal with such uncertainty.They call it Chaos Engineering and someof the products out of this program (calledChaos Monkey simulations) have beenopen sourced. By doing this Netflix hasbuilt capacity in their system to preventunpredictable outage events from causinguncontrolled harm.In the Senior Care domain, accidents couldbe falls leading to injury to residents or a caseof infection entering the facility etc. Theseunpredictable events will always happen.Developing safety, then is not their absence,but developing a capacity to deal with themwithout leading to catastrophic outcomes.When analyzed from this perspective, itbecomes clear that Senior Care as an industrylacked capacity to deal with the virulentbug (Coronavirus). Once it entered severalfacilities, it burned through their populationslike dry brush as we experience every summerwith forest fires in California. It is not so muchthat people made bad choices, but peoplehad bad choices.precious life). Just like buying insurance is ahedge against financial risk, building capacityis a hedge against systemic risk.Capacity building, then is a deliberate, wellplanned and continuously executed activity.Regaining trust after this Covid-19 stormand fostering the feeling of safety will be acapacity building activity. Most importantly,as in the case of insurance, capacity must bebuilt before the risk materializes.InfeXBloc is anoperational architecturefor a Senior Care facilitythat will build a capacityto absorb uncertaintyof a pandemic.It will make the facility pandemic resistant.Moving Senior Care facilities to be InfeXBloc enabled will then be a capacity buildingactivity.Digitization of Senior CareEarlier, we agreed that safety cannot bemeasured. Unlike a physical object’s capacity(our 5 gallon bucket), we cannot measure theSenior Care system’s safety. We however, canmeasure other metrics and publish them inreal time in a transparent manner to foster thefeeling of safety.It is easy to understand that when you haveto build capacity, it is expensive, takes diligentwell directed effort and takes time, but whenyou don’t have capacity, coping with theeffects of it is really expensive and takes avery long time (not to mention the loss ofInfeXBlocTMSafety as Capacity 3

Using Real-Time DashboardsIf a Senior Care facility had a webpage that displayed a dashboard like Figure 2,that could help fostering the feeling of safety.Figure 2: A Possible Real-Time Safety DashboardInfeXBlocTMSafety as Capacity 4

Publishing a Stream of Events Pictures taken events etc.We often emphasize the importance ofdocumentation in a Senior Care facility as asustainable defense strategy against a liabilitylawsuit. Underneath that, is the desire to havean immutable chain of events that can painta chronology to illustrate a diligent effort bythe facility. There is a variety of events thatoccur in a senior care facility: Video streams published with time lag ADL assistance events Medication delivery events Meal delivery events Activity events Hospital events Professional visit events Family visitation events Tour events Fall events To bed and wake up eventsIf a Senior Care facility could curate andpublish, with time delay or in real time, sucha stream of events (Figure 3), it would goa long way to help relatives feel safe abouttheir loved ones in our care. Needless, tosay, we would need to take care of dataanonymization to meet HIPAA compliancerequirements.Just like a commercial airliner has 2 “blackboxes” (a Cockpit Voice Recorder and FlightData Recorder) to record the events in realtime which are used for forensic analysis incase of an accident, an InfeXBloc facility willhave 3 black boxes to record the events inthat facility in real time. These will be the: Audio Data Recorder (ADR) – audiorecordings of all streams from the CCTVcameras in the facility Adverse health condition eventsFigure 3: Events streams from InfeXBlocTM enabled Senior Care facilitiesInfeXBlocTMSafety as Capacity 5

Video Data Recorder (VDR) – videorecordings of all streams from the CCTVcameras in the facility Events Data Recorder (EDR) – datastreams of various types of events inthe facility for example security events,visitor’s arrival and departure events, tourevents, any alarms and reset events, fallevents, EMR, EHR events etc.These will be used for forensic analysis. Toensure privacy needs are met, data fromthese black boxes could be combined andsynchronized by authorized personnel only”.Implications for LitigationEvery facility owner or investor has a secretnightmare of the likely lawsuits that will ariseout of this pandemic handling. If we read thetea leaves, Corona virus litigation may makeits Tobacco or Asbestos brethren look likechild’s play. While it is unclear how much helpour Insurance companies provide or Congressprovides with any umbrella protection,what is clear that regardless of the eventsof the last 5 months, we owe it to ourselvesto build a capacity for the future againstthis predictable risk. Publishing a stream ofimmutable events would go a long way. Itwould make our insurance companies veryhappy and they may even consider fundingsuch efforts. They have already done so inthe world of automotive insurance.Implications for Licensing, Oversightand Human Capital ManagementOur LPAs and Ombudsman often haveexpectations that parallel those fromattorneys. The oversight function is animportant one to assure that our seniorresidents’ rights are well protected. Animmutable stream of events will go a longway to help this oversight function.Figure 4: A 5 Level Maturity ModelInfeXBlocTMSafety as Capacity 6

More than anything, our care givers couldfreely revisit their own event streams andassess their own performance. It would berelatively easy to report their own metrics.continuum in our industry. InfeXBloc architecture was designed to capture themomentum created by this pandemic to helpmove our industry up this continuum.Quantitative Management –An OpportunityOnce again, our customers – the residentswe serve as well as their families and thecommunities we serve – will ultimately be thebeneficiaries.Most industries go through a maturationprocess which can last multiple decades.For example, e-commerce began in 90’s andhas matured in nearly 24 years. What startswith low automation, negligible regulation,no standardization, high instance of fraudand overall low trust, eventually arrives ata place where processes are standardized,predictable service is achieved, andquantitative management and zero defectprinciples are practiced. Along the way,customers benefit from these improvements.It’s debatable where on this continuum(Figure 4), Senior Care as an industry lies.Nevertheless, the Coronavirus pandemicpresents us with an unprecedentedopportunity to accelerate along the maturityFor Owners, Operators and InvestorsWhen we build project business plans, werequire a risk mitigation strategy. Beforethis pandemic, most of that was bundledinto the 3 insurance coverages desired(Facility liability insurance, Workman’s compinsurance, Professional Liability insurance).This pandemic has exposed a systemicweakness and the engine check light for ourbusiness model is on. It is incumbent uponus to build capacity to deal with this andstrengthen our business model to prepare forthe Silver Tsunami.To learn more about InfeXBloc and howyour facility can leverage the architecture tomove forward, enhance safety, and rebuildtrust in a post-pandemic world, check outwww.infexbloc.com.InfeXBlocTMSafety as Capacity 7

INFEXBLOC TM PILOT SITEGolden Springs RanchInfeXBlocTMSafety as Capacity 8

About Ashish WarudkarAshish has worked in the software industry for 30 years including19 years in the healthcare sector. He also has been an entrepreneurfor over two decades and provides consultation to “Golden SpringsRanch” which is an upcoming InfeXBloc home in Palmdale, Californiawhich will introduce the innovations discussed in this paper to provideits precious residents with a safe happy home and their families withpeace of mind.Ashish Warudkar is trained at:IIT BombayMechanical EngineeringUCIPredictive Analytics (7/8)HarvardDisruptive Innovation Strategy with ClaytonChristensenMITAdvanced Certificate for Executives in Management,Innovation & TechnologyArchitecture & Systems Engineering of ComplexSystemsPlatform Strategy – Building & Thriving A VibrantEcosystemBusiness Dynamics – Diagnosing and SolvingComplex Business ProblemsExecutive Certificate in Strategy and InnovationInfeXBlocTMProduct SchoolProduct ManagementBWWNetwork MarketingOren KlaffPitch .com; ebook:InfeXBlocInstagram:InfeXBlocMeetup:Monthly meeting (first Sunday 6pm CA time) of Senior Care Accountability bility-Network-SCAN/Safety as Capacity 9

the facility for example security events, visitor's arrival and departure events, tour events, any alarms and reset events, fall events, EMR, EHR events etc. These will be used for forensic analysis. To ensure privacy needs are met, data from these black boxes could be combined and synchronized by authorized personnel only".