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|By Dana Gardner
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|February 3, 2014 08:00 AM EST
Healthcare, like no other sector of the economy, exemplifies the challenges and the opportunity for improving how the various participants in a complex ecosystem interact.
The Open Group, at its next North American conference on Feb. 3, has made improved information flow across so-called boundaryless organizations the theme of its gathering of IT leaders, enterprise architects, and standards developers and implementers.
And so the next BriefingsDirect discussion explores what it takes to bring rigorous interactions, process efficiency, and governance to data and workflows that must extend across many healthcare participants with speed and dependability.
Learn now how improved cross-organization collaboration plays a huge part in helping to make healthcare more responsive, effective, safe, and cost-efficient. And also become acquainted with what The Open Group's new Healthcare Industry Forum is doing to improve the situation.
The panel of experts consists of Larry Schmidt, the Chief Technologist at HP for the America's Health and Life Sciences Industries, as well as the Chairman of The Open Group Healthcare Industry Forum, and Eric Stephens, an Oracle Enterprise Architect. The moderator is Dana Gardner, Principal Analyst at Interarbor Solutions. [Disclosure: HP is a sponsor of BriefingsDirect podcasts. The views of the panelists are theirs alone and not necessarily those of their employers.]
Here are some excerpts:
Gardner: Why is healthcare such a tough nut to crack when it comes to this information flow? Is there something unique about healthcare that we don't necessarily find in other vertical industries?
Schmidt: We've progressed in healthcare from a delivery model that was more based on acute care -- that is, I get sick, I go to the doctor -- to more of a managed care-type capability with the healthcare delivery, where a doctor at times is watching and trying to coach you. Now, we've gotten to where the individual is in charge of their own healthcare.
A lot of fragmentation
With that, the ecosystem around healthcare has not had the opportunity to focus the overall interactions based on the individual. So we see an awful lot of fragmentation occurring. There are many great standards across the powers that exist within the ecosystem, but if you take the individual and place that individual in the center of this universe, the whole information model changes.
Then, of course, there are other things, such as technology advances, personal biometric devices, and things like that that come into play and allow us to be much more effective with information that can be captured for healthcare. As a result, it's the change with the focus on the individual that is allowing us the opportunity to redefine how information should flow across the healthcare ecosystem.
The scenario of the individual being more in charge of their healthcare -- care of their health would be a better way to think of this -- is a way to see both improvements in the information flow as well as making improvements in the overall cost of healthcare going forward.
Because the ecosystem had pretty much been focused around the doctor's visit, or the doctor's work with an individual, as opposed to the individual's work with the doctor, we see tremendous opportunity in making advancements in the communications models that can occur across healthcare.
Gardner: Larry, is this specific to the United States or North America, is this global in nature, or is it very much a mixed bag, market to market as to how the challenges have mounted?
Schmidt: I think in any country, across the world, the individual being the focus of the ecosystem goes across the boundaries of countries. Of course, The Open Group is responsible and is a worldwide standards body. As a result of that, it's a great match for us to be able to focus the healthcare ecosystem to the individual and use the capabilities of The Open Group to be able to make advances in the communication models across all countries around healthcare.
Gardner: Eric, thinking about this from a technological point of view, as an enterprise architect, we're now dealing with this hub and spoke with the patient at the middle. A lot of this does have to do with information, data, and workflow, but we've dealt with these things before in many instances in the enterprise and in IT.
Is there anything particular about the technology that is difficult for healthcare, or is this really more a function of the healthcare verticals and the technology is really ready to step up to the plate?
Information transparency
Stephens: Well, Dana, the technology is there and it is ready to step up to the plate. I'll start with transparency of the information. Let's pick a favorite poster child, Amazon. In terms of the detail that's available on my account. I can look at past orders. I can look up and see the cost of services, I can track activity that's taking place, both from a purchase and a return standpoint. That level of visibility that you're alluding to exists. The technology is there, and it's a matter of applying it.
As to why it's not being applied in a rapid fashion in the healthcare industry, we could surmise a number of reasons. One of them is potentially around the cacophony of standards that exist and the lack of a "Rosetta Stone" that links those standards together to maximum interoperability.
The other challenge that exists is simply the focus in healthcare around the healthcare technology that's being used, the surgical instruments, the diagnostic tools, and such. There is focus and great innovation there, but when it comes to the plumbing of IT, oftentimes that will suffer.
Gardner: So we have some hurdles on a number of fronts, but not necessarily the technology itself. This is a perfect case study for this concept of the boundaryless information flow, which is really the main theme of The Open Group Conference coming up on February 3. [Register for the event here.]
Back to you, Larry, on this boundaryless issue. There are standards in place in other industries that help foster a supply-chain ecosystem or a community of partners that work together.
Is that what The Open Group is seeking? Are they going to take what they've done in other industries for standardization and apply it to healthcare, or do you perhaps need to start from scratch? Is this such a unique challenge that you can't simply retrofit other standardization activities? How do you approach something like healthcare from a standards perspective?
I think it's a great term to reflect the vast number of stakeholders that would exist across the healthcare ecosystem.
Schmidt: The first thing we have to do is gain an appreciation for the stakeholders that interact. We're using the term "ecosystem" here. I think it's a great term to reflect the vast number of stakeholders that would exist across the healthcare ecosystem. Anywhere from the patient, to the doctor, to payment organization for paying claims, the life sciences organizations, for pharmaceuticals, and things like that, there are so many places that stakeholders can interact seamlessly.
So it's being able to use The Open Group's assets to first understand what the ecosystem can be, and then secondly, use The Open Group's capabilities around things like security, TOGAF from an architecture methodology, enablement and so on. Those assets are things that we can leverage to allow us to be able to use the tools of The Open Group to make advances within the healthcare industry.
It's an amazing challenge, but you have to take it one step at a time, and the first step is going to be that definition of the ecosystem.
Gardner: I suppose there's no better place to go for teasing out what the issues are and what the right prioritization should be than to go to the actual participants. The Open Group did just that last summer in Philadelphia at their earlier North American conference. They had some 60 individuals representing primary stakeholders in healthcare in the same room and they conducted some surveys.
Larry, maybe you can provide us an overview of what they found and how that's been a guide to how to proceed?
Participant survey
Schmidt: What we wanted to do was present the concept of boundaryless information flow across the healthcare ecosystem. So we surveyed the participants that were part of the conference itself. One of the questions we asked was about the healthcare quality of data, as well as the efficiency and the effectiveness of data. Specifically, the polling questions, were designed to gauge the state of healthcare data quality and effective information flow.
We understood that 86 percent of those participants felt very uncomfortable with the quality of healthcare information flows, and 91 percent of the participants felt very uncomfortable with the efficiency of healthcare information flows.
In the discussion in Philadelphia, we talked about why information isn't flowing much more easily and freely within this ecosystem. We discovered that a lot of the standards that currently exist within the ecosystem are very much tower-oriented. That is, they only handle a portion of the ecosystem, and the interoperability across those standards is an area that needs to be focused on.
But we do think that, because the individual should be placed into the center of the ecosystem, there's new ground that will come into play. Our Philadelphia participants actually confirmed that, as we were working through our workshop. That was one of the big, big findings that we had in the Philadelphia conference.
We understood that 86 percent of those participants felt very uncomfortable with the quality of healthcare information flows.
Gardner: Just so our audience understands, the resulting work that's been going on for months now will culminate with the Healthcare Industry Forum being officially announced and open for business,, beginning with the San Francisco Conference. [Register for the event here.]
Tell us a little about how the mission statement for the Healthcare Industry Forum was influenced by your survey. Is there other information, perhaps a white paper or other collateral out there, that people can look to, to either learn more about this or maybe even take part in it?
Schmidt: We presented first a vision statement around boundaryless information flow. I'll go ahead and just offer that to the team here. Boundaryless information flow of healthcare data is enabled throughout a complete healthcare ecosystem to standardization of both vocabulary and messaging that is understood by all participants within the system. This results in higher quality outcomes, streamlined business processes, reduction of fraud, and innovation enablement.
When we presented that in the conference, there was big consensus among the participants around that statement and buy in to the idea that we want that as our vision for a Healthcare Forum to actually occur.
Since then, of course, we've published this white paper that is the findings of the Philadelphia Conference. We're working towards the production of a treatise, which is really the study of the problem domain that we believe we can be successful in. We also can make a major impact around this individual communication flow, enabling individuals to be in charge of more of their healthcare.
Our mission will be to provide the means to enable boundaryless information flow across the ecosystem. What we're trying to do is make sure that we work in concert with other standards bodies to recognize the great work that's happening around this tower concept that we believe is a boundary within the ecosystem.
Additional standards
Hopefully, we'll get to a point where we're able to collaborate, both with those standards bodies, as well as work within our own means to come up with additional standards that allows us to make this communication flow seamless or boundaryless.
Gardner: Eric Stephens, back to you with the enterprise architect questions. Of course, it's important to solve the Tower of Babel issues around taxonomy, definitions, and vocabulary, but I suppose there is also a methodology issue.
Frameworks have worked quite well in enterprise architecture and in other verticals and in the IT organizations and enterprises. Is there something from your vantage point as an enterprise architect that needs to be included in this vision, perhaps looking to the next steps after you've gotten some of the taxonomy and definitions worked out?
Stephens: Dana, in terms of working through the taxonomies and such, as an enterprise architect, I view it as part of a larger activity around going through a process, like the TOGAF methodology, it's architecture development methodology.
In the healthcare landscape, and in other industries, there are a lot of players coming to the table and need to interact.
By doing so, using a tailored version of that, we'll get to that taxonomy definition and the alignment of standards and such. But there's also the addressing alignment and business processes and other application components that comes into play. That's going to drive us towards improving the viscosity of the information, that's moving both within an enterprise and outside of the enterprise.
In the healthcare landscape, and in other industries, there are a lot of players coming to the table and need to interact, especially if you are talking about a complex episode of care. You may have two, three, or four different organizations in play. You have labs, the doctors, specialized centers, and such, and all that requires information flow.
Coming back to the methodology, I think it's bringing to bear an architecture methodology like provided in TOGAF. It's going to aid individuals in getting a broad picture, and also a detailed picture, of what needs to be done in order to achieve this goal of boundaryless information flow.
Drive standardization
One of the things that we can do in the Forum is start to drive standardization, so that we have the data and devices working together easily, and it provides the necessary medical professionals the information they need, so they can make more timely decisions. It's giving the right information, to the right decision maker, at the right time. That, in turn, drives better health outcomes, and it's going to, we hope, drive down the overall cost profile of healthcare, specifically here in the United States.
Gardner: Getting back to the conference, I understand that the Healthcare Industry Forum is going to be announced. There is going to be a charter, a steering committee program, definitions, and treatise in the works. So there will be quite a bit kicking off. I would like to hear from you two, Larry and Eric, what you will specifically be presenting at the conference in San Francisco in just a matter of a week or two. Larry, what's on the agenda for your presentations at the conference? [Register for the event here.]
Schmidt: Actually, Eric and I are doing a joint presentation and we're going to talk about some of the challenges that we think we can see is ahead of us as a result of trying to enable our vision around boundaryless information flow, specifically around healthcare.
As an enterprise architect, I look at things in terms of the business, the application, information, technology, and architecture.
The culture of being able to produce standards in an industry like this is going to be a major challenge to us. There is a lot of individualization that occurs across this industry. So having people come together and recognize that there are going to be different views, different points of views, and coming into more of a consensus on how information should flow, specifically in healthcare. Although I think any of the forums go through this cultural change.
We're going to talk about that at the beginning in the conference as a part of how we're planning to address those challenges as part of the Industry Forum itself. Then, other meetings will allow us to continue with some of the work that we have been doing around a treatise and other actions that will help us get started down the path of understating the ecosystem and so on.
Those are the things that we'll be addressing at this specific conference.
Stephens: As an enterprise architect, I look at things in terms of the business, the application, information, technology, and architecture. When we talk about boundaryless information flow, my remarks and contributions are focused around the information architecture and specifically around an ecosystem of an information architecture at a generic level, but also the need and importance of integration. I will perhaps touch a little bit on the standards to integrate that with Larry's thoughts.
Soliciting opinions
Schmidt: Dana, I just wanted to add the other work that we'll be doing there at the conference. We've invited some of the healthcare organizations in that area of the country, San Francisco and so on, to come in on Tuesday. We plan to present the findings of the paper and the work that we did in the Philadelphia Conference, and get opinions in refining both the observations, as well as some of the direction that we plan to take with the Healthcare Forum.
Obviously we've shared here some of the thoughts of where we believe we're moving with the Healthcare Forum, but as the Forum continues to form, some of the direction of it will morph based on the participants, and based on some of the things that we see happening with the industry.
So, it's a really exciting time and I'm actually very much looking forward to presenting the findings of the Philadelphia Conference, getting, as I said, the next set of feedback, and starting the discussion as to how we can make change going toward that vision of boundaryless information flow.
We're actually able to see a better profile of what the individual is doing throughout their life and throughout their days.
Gardner: I should also point out that it's not too late for our listeners and readers to participate themselves in this conference. If you're in the San Francisco area, you're able to get there and partake, but there are also going to be online activities. There will be some of the presentations delivered online and there will be Twitter feeds.
So if you can't make it to San Francisco on February 3, be aware that The Open Group Conference will be available in several different ways online. Then, there will be materials available after the fact to access on-demand. Of course, if you're interested in taking more activity under your wing with the Forum itself, there will be information on The Open Group website as to how to get involved.
Before we sign off, I want to get a sense of what the stakes are here. It seems to me that if you do this well and if you do this correctly, you get alignment across these different participants -- the patient being at the hub of the wheel of the ecosystem. There's a tremendous opportunity here for improvement, not only in patient care and outcomes, but costs, efficiency, and process innovation.
So first to you Larry. If we do this right, what can we expect?
Schmidt: There are several things to expect. Number one, I believe that the overall health of the population will improve, because individuals are more knowledgeable about their individualized healthcare and doctors have the necessary information, based on observations in place, as opposed to observations or, again, through discussion and/or interview of the patient.
We're actually able to see a better profile of what the individual is doing throughout their life and throughout their days. That can provide doctors the opportunity to make better diagnosis. Better diagnosis, with better information, as Eric said earlier, the right information, at the right time, to the right person, gives the whole ecosystem the opportunity to respond more efficiently and effectively, both at the individual level and in the population. That plays well with any healthcare system around the world. So it's very exciting times here.
Metrics of success
Gardner: Eric, what's your perspective on some of the paybacks or metrics of success, when some of the fruits of the standardization begin to impact the overall healthcare system?
Stephens: At the risk of oversimplifying and repeating some of things that Larry said, it comes down to cost and outcomes as the two main things. That's what's in my mind right now. I look at these very scary graphs about the cost of healthcare in the United States, and it's hovering in the 17-18 percent of GDP. If I recall correctly, that's at least five full percentage points larger than other economically developed countries in the world.
The trend on individual premiums and such continues to tick upward. Anything we can do to drive that cost down is going to be very beneficial, and this goes right back to patient-centricity. It goes right back to their pocketbook.
And the outcomes are important as well. There are a myriad of diseases and such that we're dealing with in this country. More information and more education is going to help drive a healthier population, which in turn drives down the cost. The expenditures that are being spent are around the innovation. You leave room for innovation and you leave room for new advances in medical technology and such to treat diseases going. So again, it's back to cost and outcomes.
Anything we can do to drive that cost down is going to be very beneficial, and this goes right back to patient centricity.
Gardner: Very good. I'm afraid we will have to leave it there. We've been talking with a panel of experts on how the healthcare industry can benefit from improved and methodological information flow. And we have seen how the healthcare industry itself is seeking large-scale transformation and how improved cross-organizational interactions and collaborations seem to be intrinsic to be able to move forward and capitalize and make that transformation possible.
And lastly, we have learned that The Open Group's new Healthcare Industry Forum is doing a lot now and is getting into its full speed to improve the situation.
This special BriefingsDirect discussion comes to you in conjunction with The Open Group Conference on February 3 in San Francisco. It's not too late to register at The Open Group website and you can also follow the proceedings during and after the conference online and via Twitter.
So a big thank you to our panel, Larry Schmidt, the Chief Technologist at HP for the America's Health and Life Sciences Industries, as well as the Chairman of The new Open Group Healthcare Industry Forum, and Eric Stephens, an Oracle Enterprise Architect. We appreciate your time Eric.
I'm Dana Gardner, Principal Analyst at Interarbor Solutions, your host and moderator for this look at the healthcare ecosystem process. Thanks for listening, and come back next time for more BriefingsDirect podcast discussions.
Transcript of a BriefingsDirect podcast on how The Open Group is addressing the information needs and challenges in the healthcare ecosystem. Copyright The Open Group and Interarbor Solutions, LLC, 2005-2014. All rights reserved.
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Implication of Changes
Jan 30, 2006
I was infected in April, 2005.
My September lab results were T-Cell 841, 27.6% and Viral Load was 214,000.
Four months later in January the T-Cell count was 522, 34% and Viral Load 49,717.
I'm a 56 year old white male.
Any insight on what is happening?
Thanks a lot!
Response from Dr. Young
Thanks for your post.
I can't be sure, but assuming that your health was good for both tests, you're seeing a somewhat larger variation in the tests than average, but your numbers in aggregate seem better in January than previous.
Good luck, BY
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Lupita Nyong'o Is People's Most Beautiful — Because, Duh, She's Gorgeous
We've said it before, and we'll say it again: This girl is on fire. We're not even halfway into 2014, and already Lupita Nyong'o has bagged an Oscar, landed atop every best-dressed list there is, and scored a major beauty contract. Oh, and today, she was named People's Most Beautiful. NBD.
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Let's Talk About Woody Allen
In September 1993, Connecticut State Attorney Frank Maco declared that he would not prosecute Woody Allen in court for the charges of sexual abuse of a child. He did, however, publicly declare that he had both probable cause and evidence that such abuse had taken place
Kelsey Miller
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Orange lose lead, unravel in second half
SYRACUSE, N.Y. (AP) -- Bobby Bowden probably has seen more than
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put the Orange in terrific scoring position twice -- with a fumble
return and an interception -- and they failed to score both times.
Against Florida State, that is a recipe for disaster, and the
tide began to turn late in the third quarter with Syracuse clinging
to a 10-3 lead.
"We left some points out on the field," said Syracuse coach
Paul Pasqualoni, whose job may be on the line after two lackluster
seasons. "In a game like this against an opponent like this, you
like to capitalize."
Instead, it was Washington who took advantage of some great
blocks. He scored on a 21-yard run late in the third to tie it at
10-all and capped the victory with a 45-yard dash down the left
side early in the fourth.
"The main thing was just picking my feet up," said Washington,
who also caught four passes for 24 yards. "We had to be patient
with our runs. The second half we just came out in the kicking
frame of mind and decided to run the ball."
And stop the Syracuse running attack. A week after rushing for
360 yards against Rutgers, the Orange were held to 58 yards on 31
carries. In the second half, the Seminoles held Syracuse to minus-2
yards rushing on 15 attempts and just 60 yards of total offense.
"We thrive on shutting down the run game," defensive tackle
Travis Johnson said.
With Chris Rix on the sideline nursing an ankle sprain, Sexton
started his second straight game, and this one was not like the
first. Sexton was 20-for-31 for 193 yards and three TDs in a win
over North Carolina last week. Against the Orange, he was 15-for-26
for 169 yards but maintained his poise in the face of a raucous
Carrier Dome crowd of just over 40,000.
Sexton kept his passes short for most of the game. And when he
opened up with time winding down in the third, he put Syracuse on
its heels with a 24-yard completion to Craphonso Thorpe and a
12-yarder to Chauncey Stovall to set up Washington's first score.
Syracuse closed to 17-13 on a 39-yard field goal by Collin
Barber with 10 minutes left and drove to the Florida State 30 in
the final minute. But linebacker Sam McGrew intercepted Perry
Patterson's pass in the end zone with 5 seconds left.
"It was more of a corner route, and the last thing we thought
would happen was an interception," Pasqualoni said. "I think when
the ball is released, you always have hope."
Patterson, who was brilliant in the first half, completing 10 of
12 for 145 yards and a 44-yard touchdown pass to Jared Jones,
sputtered in the second. He finished 19-for-28 for a career-high
207 yards, but with his passes not connecting, the Orange couldn't
come back against the Seminoles defense.
Syracuse led 10-3 at halftime, and the advantage could have been
larger. Ferri ripped the ball out of Lorenzo Booker's hands at the
Syracuse 25 and returned it 30 yards, but Barber missed wide right
on a 42-yard field goal try with 4:53 left in the second.
After Florida State went three and out, Patterson hit Andre
Fontenette for 33 yards and Reyes gained another 24 on a screen
pass. But three plays later Reyes fumbled on a first-and-goal play
from the 5 and Bryant McFadden recovered for Florida State.
Syracuse missed another great opportunity at the start of the
second half. The Seminoles drove to midfield, but Ferri intercepted
a pass over the middle and returned it 45 yards to the Florida
State 23. When the Orange offense faltered, Barber missed wide left
on a 37-yard field goal.
"I'm thinking of scoring every time I get my hands on the
ball," said Ferri, who began his Syracuse career as a tailback.
"I had the opportunity, I just didn't cash in on it. It's a sore
loss, but it's kind of a boot for us."
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We plan to be in Italy in May of 2013. We have tentatively decided on Siena and Perugia as our bases for the trip. We will be driving and I know that driving into and out of some towns is rather challenging. I hope that some of you will be able to give me some hotel recommendations that will make getting into and out of town not too frustrating. We don't mind a reasonable walk to get into the city center at night for dinner. Just need a good location, clean, with parking. Would like to stay around $100-150. per night.
Thanks for your advice.
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Please help with Siena/Perugia hotels
We plan to be in Italy in May of 2013. We have tentatively decided on Siena and Perugia as our bases for the trip. We will be driving and I know that driving into and out of some towns is rather challenging. I hope that some of you will be able to give me some hotel recommendations that will make getting into and out of town not too frustrating. We don't mind a reasonable walk to get into the city center at night for dinner. Just need a good location, clean, with parking. Would like to stay around $100-150. per night.
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With a car, I would not stay right in either town---too much driving hassle. And, that budget may be challenge for you. If you can go higher, the Santa Caterina in Siena is perfect for you.
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If we choose not to stay directly in either town, what would you suggest as alternatives. We generally like to stay in a town that has a good selection of restaurants for dinner each night. One where we can stroll after dinner and enjoy the town without feeling like it is deserted. We have stayed in Pienza before and liked it very much. It was easy to get into and out of each day for our daytrips. Would not want to stay anywhere smaller than that.
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For Perugia, try Hotel Rosalba. It is at the bottom of the escalators and has "squeeze" parking. You'll fast learn how to get in and out of Perugia. Go to the Slow Travel website and look up tips.
I'll also recommend agriturismo Marciano near Siena, although for May, it is likely to stretch your budget and you will have a hike into Siena, and if you don't eat at the agriturismo restaurant, you will want a taxi back to your lodgings from the center of Siena.
If you dig deep on the internet with google looking for a b&b in Siena, you can stay within the walls and within in your budget, but you will need to park your car a long walk away. Might be worth it.
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I too like to stay in smaller towns with good food options but a true Tuscan flavor. Other than Pienza, I have stayed in San Quirico, Montalcino, and Montepulciano and liked them all. The latter is larger at about 12,000 people. The Politian apartments are the best value in Tuscany, and Giacomo is a delight.
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Siena with parking (check to make sure it's free):
Cannon D'Oro hotel also has a residence at the edge of town with bus service to the center.
Hotel Chiusarelli is across the street from the historic center and has a small parking area.
Le Vigne has bus service to the center every 15 minutes (travel time 5 minutes or 15 minute walk).
Il Cadduccio says they are a 10 minute walk and has free parking.
Villa Fiorita is near the train station, but you can bus or take the new escalators up to the center. On street parking.
Perugia is more of a hassle driving in and out than Siena. I would pick another base and just visit Perugia for a day.
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We found driving to Palazzo Ravizza in Siena very easy. You do have to go in/out a specific town gate (the hotel will email clear instructions), but once inside the city walls it's just a couple of turns to the hotel's parking lot. (You are allowed to drive to the hotel's front entrance to unload/load luggage.) The hotel is an easy walk to the Campo. Ask for a room on the back side of the hotel for a garden and countryside view. (This is what you see on the hotel's website.) Lots of exploring within an easy day's drive.
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Thanks a bunch. I'll check on all the above.
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We enjoyed our stay at the Palazzo Ravizza and did drive out from there for several day trips. I can't remember if we paid extra for parking but, if we did, it was worth it!
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We did not pay for parking at P. Ravizza in October.
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I can help you just for Perugia and suggest you Hotel Perusia www.hotelperusia.it, which is related to the center by shuttle or by feet in less than 10 minutes. You can see Assisi (just 30 minutes away by car) from its rooftop terrace. Bye
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I'm going to rely on other Fodorites to confirm my information because DH and I didn't drive. We stayed at Locanda della Poste ( http://www.locandadellaposta.com/ ) right at the edge of the old center. It was a 2-minute walk to a main bus and taxi area and a 10-minute walk to the bus station via escalators.
My impression was that there weren't a lot of hotels with private parking in the historic area, however, there was a large public facility right near the bus station. We didn't ask about parking at our hotel so I can't say for certain.
We absolutely loved the old center to come "home" to--wonderful food, the duomo and student vibe. Easy enough to get to public parking but not immediate.
We only visited Siena as day trips so can't help there. Some steep hills there, fyi.
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Princess's Tribute
Neil's Other Pets
All about Princess
Pet Tip
Tip 53 – Dog sticks its head out the car window – Car travel with your dog.
Many people travel with their dogs in the car and we often see dogs with their heads sticking out the window. Although the dog does enjoy this, it is not recommended at all. Passing cars or busses can approach too …
- Owner:
- Neil Van Dusen
- City:
- Lower Sackville
- Province, Country:
- NS, Canada
- Type/Breed:
- poodle/terrier
- Date of Birth:
- May13, 1995
- Date of Death
- March 31st, 2006
- Sex:
- Female
- Height:
- 35
- Weight:
- 30
- Coat Colour:
- grey/white
- Eye Colour:
- brown
Princess was a loyal and fun loving dog, she would play like a puppy, but protect like a soldier. She hated cats, mailmen, delivery pesonel, and oil truck drivers. She only barked when prompted, or to warn of strangers. She was kind, loving, and loved to be scratched, chase balls, go for rides in any vehicle, and any kind of food. She holds the record for most craps in one walk, a record that may never be broken. She will be sorely missed.


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You know, when you can play with the greatest players of that particular era, you look forward to going to the ballpark. I mean, you thought it was great to be there in the clubhouse. You thought it was great to be on the field.
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