via latimes.com
This article is so similar in nature to the one I just posted from the Harvard Business Review. In all walks of life, in all businesses, there is nothing more appreciated than simply showing love in the details.
The Values Proposition: Do Small Things with Great Love (from Harvard Business Review)
The world confronts vast uncertainty, from unrest in the social climate to accelerating shifts in the climate itself. The economy faces huge challenges, from public-debt crises in Europe to the overhang of mortgage debt in the U.S. The business community faces an ongoing series of stops and starts, from the loss of an icon like Steve Jobs to the rise of new-economy giants like Amazon and Facebook.
There is a temptation, amidst the turmoil, for pundits to conclude that the only sensible response is to make bold bets — new business models that challenge the logic of an industry, products that aim to be "category killers" and obsolete the competition. But I've come to believe that a better way to respond to uncertainty is with small gestures that send big signals about what you care about and stand for. In a world defined by crisis, acts of generosity and reassurance take on outsized importance.
I've written before about not-so-random acts of kindness that humanize companies and offer an uplifting alternative to a demoralizing status quo. Earlier this year, for example, a Southwest Airlines pilot delayed a flight from Los Angeles to Tucson to accommodate the needs of a distraught grandfather who was racing to the hospital bedside of his toddler grandson, the victim of criminal abuse. Despite the obvious security concerns and schedule pressures, the pilot, who had gotten wind of this late-arriving passenger's urgent situation, refused to budge until he made it to the plane.
"They can't go anywhere without me," the pilot told the grandfather, "and I wasn't going anywhere without you." The story immediately went viral, with travel writers and bloggers celebrating the stubborn pilot and his values. His genuine kindness was a welcome change of pace in an industry known for lousy service, surly passengers, and miserable conditions.
I experienced something similar myself not so long ago, and found it a striking enough to devote an entire HBR blog post to the experience. In an entry called "Why Is it So Hard to Be Kind?" I told the story of my father, his search for a new car, a health emergency that took place in the middle of that search — and a couple of extraordinary (and truly human) gestures by an auto dealer that put him at ease and won his loyalty.
"Nobody is opposed to a good bottom-line deal," I concluded at the time. "But what we remember and what we prize are small gestures of connection and compassion that introduce a touch of humanity into the dollars-and-cents world in which we spend most of our time."
We remember the lack of connection as well. A month or so ago, I visited my optometrist, who was troubled about something she saw in my routine eye exam and sent me to a renowned retinal specialist for a more in-depth look. This doctor did an utterly competent exam, explained my situation, and offered a sound course of action. So I'm fine.
Yet I keep thinking back to the experience, not because of the quality of the medical care I received, which was superb, but because of how uncaring the experience felt. As I sat in the waiting room, it seemed more like the offices of a payday lender or a bail bondsman than that of a highly credentialed surgeon. "If you arrive late, your appointment may be rescheduled," one sign warned. "Copay is due upon arrival," another signed explained. "We accept Visa, MasterCard, Discover, and American Express." However, a different sign warned, "If you do not have your copay, your appointment may be rescheduled." Finally, blared another sign, "If you have an overdue balance, your appointment may be rescheduled."
Since I had to wait an hour past my appointment time to see the doctor (there was no sign about what happens when the doctor is late), I spent a lot of time thinking about the surroundings, and the bizarre messages all these signs were sending. My fellow patients and I were nervous, anxious, worried about our eyesight. Yet it felt like the doctor thought of us as a collection of truants, tightwads, and general layabouts. Were we visiting a healer, or the ocular equivalent of the "Soup Nazi" from Seinfeld, for whom one wrong move means "No appointment for you!"?
Two weeks later, by the way, I got a call from the doctor's office. "Does the doctor want an update on how I'm doing?" I asked the staffer who placed the call. "No," she said. "Insurance did not cover the full cost of the exam, and we need to know if you want us to charge the credit card we have on file or use a different card."
Oh, right.
It's always risky to look to great humanitarians for lessons about business, but something Mother Teresa said long ago strikes me as a pretty good epitaph for our disruptive times — and for dispiriting experiences of the sort I had with this doctor. "We cannot do great things," she famously told her followers, "only small things with great love."
Yes, success today is about price, features, quality — pure economic value of the sort that requires you to rethink your strategy and business models. But it is also, and perhaps more importantly, about passion, emotion, identity — sharing your values. And all that requires is a way of doing business, a strategy for connecting with customers, that communicates who you are and what you care about.
As the value proposition gets rewritten in industry after industry, it's organizations with an authentic values proposition that rise above the chaos and connect with customers. Few of us will ever do "great things" that remake companies and reshape industries. But all of us can do small things with great feeling and an authentic sense of emotion.
What's your values proposition?
via blogs.hbr.org
I think of the recent nixed trade between the NFL Detroit Lions and the Philadelphia Eagles, involving Detroit running back Jerome Harrison. The trade was nixed because Jerome Harrison did not pass the physical. But this wasnt the memorable part of the deal gone awrye (that, in a minute, you will see was the best trade of Jerome's life). As part of any trade, players must pass a physical test. During the physical Jerome complained of headaches to the Philadelphia Eagles team doctors. They scheduled him for an MRI. In the MRI, they found a brain tumour. Needless to say, a procedure was scheduled immediately to remove the tumour, and as an aside the trade was nixed.
The memorable part of the trade / non-trade was that if it wasnt for the trade happening, Jerome would have never found out early that he had a brain tumour. Its this humanization of the NFL and the players, from the machines we tend to think of them as, that made this so memorable. People are looking to be treated like humans. Differentiate yourself through loving customer service and acts of kindness. Though not always thanked for, they are usually remembered.
Steve Jobs: Remembering His Leadership
I can still remember when Steve Jobs and Apple announced their iPod back in 2003, a Sony executive was quoted as saying "Who needs 1,000 songs on their MP3 player?" I think that, more than anything is the beauty of Steve Jobs leadership: he didnt just set the bar higher; he always wanted to progress by an order of magnitude. Jobs changed the game on so many levels while ignoring his critics
Everybody loves Apple's products - I myself own an iPhone, iPad and a Mac (this is after years of making fun of my soon-to-be-wife back in college for owning a Mac!). But to me Steve Jobs will be most remembered for his leadership. He relentlessly set the bar higher for his company and his competition. He understood what people wanted and needed, even if they couldnt express it themselves. He was stubborn in his design principals, his attention to detail and quality, and his foresight. And whether on purpose, or by accident (you make your luck though), he was able to put together an ecosystem of hardware, software and media that his competitors still only kind of get. Today, we lust after the products made by Apple - but this is because they innovated under Jobs' leadership and brought us technology that was cutting edge, yet incredibly usable.
I borrow a lot from Steve Jobs and Apple at Mobile Aspects. Our Company's managers constantly use analogies from Apple and strive to bring cutting edge technologies to nurses and technologists in a simple, easy to use package. We want our innovations to make an impact on their lives and drive patient safety. We dont want clinicians caring about the technical principles of RFID, much like Jobs doesnt want you caring about the details of the hard drives on their machines (he only wants you to know how many songs you can store on that hard drive). We want them caring about how it improves their lives at the Hospital. Mobile Aspects wants to put cutting edge technologies into a package that gives OR nurses and techs high value in their daily life, is easy to use, and to be honest, looks cool. (you should hear comments about our systems' lights when they turn down the lights in the operating rooms)
The world has lost a great Leader today with the passing of Steve Jobs. However, we can continue to learn how to lead by studying how he worked with his people. By doing so, we can make better products, better companies, and whomever we are selling our products to, make their lives better. I cant tell you on how many levels I appreciate Steve Jobs' accomplishments (think about the fact that he also brought Pixar to what they are today!) and I will continue to use him as an example everyday in my leadership style.
Your Silence is Hurting the Company (from Harvard Business Review)
This essay originally appeared in the collection End Malaria, proceeds from which go to Malaria No More. For more information or to buy the book, go to EndMalariaDay.com.
When I was an admin at Apple, I used to go to meetings and see the problem so clearly, when others could not. I didn't think I had the right or the capabilities to speak this truth. I worried about being seen as too young, or too brown, or too female, or too uneducated to offer the solution to the group.
But mostly, I worried about being... too wrong.
So, I kept quiet and learned to sit on my hands lest they rise up and betray me. I would rather keep my job by staying within the lines than say something and risk looking stupid.
That was nearly 20 years ago. Since then, I've worked at or with companies like HP, Apple, Autodesk, Adobe, Symantec, Nokia, and with startups funded by Greylock, Benchmark, and Accel. And I've learned one simple thing. As companies are figuring out their tough problems — like which new markets to go into, or how to create the next generation products, or defend against a big-ass competitor — the thing that stop any of these good teams from being successful is not stupidity.
No, when an organization' problems are tough (and interesting problems are all tough) the issue is rarely stupid people. Rather, what limits success, growth, and winning is something more like blindness. Blindness, as in we doesn't know the whole context, or see an issue in its full complexity. As in, we are blind in not knowing what we don't know. Smart people know how to solve most problems and so when they are failing, it's usually the fact that we can't see what we can't see because we are experts and we stopped looking at it fresh a long time ago.
And perhaps you can identify how this happens where you work? Perhaps you were attending a new strategy rollout and you "knew" big chunks of it wouldn't work. Or the latest re-org focuses on optimizing the delivery of X, when you know the market is really looking for Y. Or your leader never seems to address the one thing that is stopping a bunch of other things from being successful.
Maybe you've heard the hallway chatter such as "don't they get it?" and "will they ever deal with this?" The thinking goes like this — the plan seems crazy and the issue is Z, but since it's plain to me, well they must see it too.
But tragically, their blindness can make us silent. We conclude that a topic is mysteriously "taboo." We say to our selves how busy we are, telling ourselves that the issue is theirs and not ours. If we do ponder what best explains the unmentioned elephant, we notice that one option obligates us to be a bearer of bad news to the powers that be. And what if we're wrong? As Lincoln said, better to keep silent and be thought a fool, than speak up and remove all doubt. And so, in the end, 99 times out of 100, we choose silence. We don't express our viewpoint and offer what we think could help.
And here's the cost to our silence — when issues stay unaddressed, stagnant, broken — we all fail. We ship bad products, our brand suffers, and our company performance plummets. In general, things suck. Not just for "them" but for all of "us." The cost of silence is suck-ness.
When we are silent, we are hurting the outcome. You see, minority viewpoints have been proven to aid the quality of decision making in juries, by teams and for the purpose of innovation. Research proves then even when the different points of view are wrong, they cause people to think better, to create more solutions and to improve the creativity of problem solving.
And so here's the opportunity to avoid suck-ness, and the thing I've learned along the way to speak your truth without losing your job. Rather than saying, "This is the problem" which can risk looking the fool and quite possibly pissing someone off, ask this: "Could it be ...that this is the problem?"
"Could it be" is a conversation starter, rather than an assertion. It is the way you put it out there without having to defend it. Could it be allows the issue to be a question for everyone. Could it be allows for a dialogue exchange rather than a yes/no argument.
The blind need you to see. The silence needs to be broken. And perhaps risking being the fool is necessary to move forward. Underlying all that is courage — Courage to speak, courage to risk, courage to step forward rather than sit quietly. Courage to break the silence and when you do, the blind will see, the different viewpoints will be heard, and we can reduce suck-ness where we work.
Could it be....you're ready to speak up?
via blogs.hbr.org
At Mobile Aspects, we encourage everyone to speak their thoughts and opinions. We all come from different backgrounds, different experience levels and we have difference points of view. Along with the great brains in everyone in our company, our diversity is also a very strong asset. Whether you have been at the company for many years or your are just starting, we look to everyone to speak up when they have a thought on an issue. The company hope everyone will heed this in meetings, and also use different vehicles such as ideas@mobileaspects.com and talking with managers one on one about different issues, improving the company and our culture and / or improving our products and processes. We value every member; we value every member's voice the most.
American Healthcare Reform - as told by a napkin (or 4 of them)
Healthcare Napkins All
View more presentations from Dan Roam
Research shows Caregivers care more about patients than themselves #ptsafety
PRESS RELEASE
August 29, 2011
For Immediate ReleaseContact: Divya Menon
Association for Psychological Science
202.293.9300
dmenon@psychologicalscience.org
Can changing a single word on a sign motivate doctors and nurses to wash their hands?
Campaigns about hand-washing in hospitals usually try to scare doctors and nurses about personal illness, says Adam Grant, a psychological scientist at The Wharton School, University of Pennsylvania. “Most safety messages are about personal consequences,” Grant says. “They tell you to wash your hands so you don’t get sick.” But his new study, which will be published in an upcoming issue of Psychological Science, a journal of the Association for Psychological Science, finds that this is the wrong kind of warning.
Hand-washing is an eternal problem for hospitals. Healthcare professionals know it’s the best way to prevent the spread of germs and diseases. But, on average, they only wash their hands about a third to a half of the time they come into contact with patients and germs.
Grant had done research in hospitals before, on topics like getting nurses to speak up about safety and reducing burnout among doctors. But when his first daughter was born, Grant’s attention was drawn to the hospital’s signs about hand-washing. “I noticed a real disconnect between what the signs were emphasizing and what I knew as a psychologist,” he says.
As a psychologist, Grant knew about “the illusion of invulnerability”—that most people think they aren’t at risk of getting sick. His own research had also shown that people aren’t motivated only by avoiding dangers for themselves; they also go to work because they want to protect and promote the well-being of others. The problem was, the signs warned about personal risks. These messages should fall on deaf ears among healthcare professionals, who are frequently exposed to germs but rarely get sick. “If I don’t wash my hands, I’ll be okay. But patients are a vulnerable group,” he says.
To test that, Grant and his coauthor, David Hofmann of the University of North Carolina at Chapel Hill, came up with two signs to post over dispensers for soap and hand sanitizer. One said “Hand hygiene prevents you from catching diseases.” The other said “Hand hygiene prevents patients from catching diseases.” They posted these signs above different dispensers in a hospital and recorded how often people washed, measuring how much soap and gel was used― and having trained observers spy on their colleagues.
The sign about patients was the winner. Healthcare professionals were much more likely to wash their hands if they were reminded that they were keeping patients safe. The patient sign increased soap and gel use by 33% per dispenser, and healthcare professionals were 10% more likely to wash their hands. The sign about personal risks did no good.
“Our findings challenge prevailing wisdom in the healthcare professions,” Grant says, “that the best way to get people to wash their hands is to scare them about their own health. Instead, his research demonstrates, you should remind them that hand-washing helps others.
A lot of interventions work well in the beginning, then drop off, and these studies only lasted two weeks. Grant suggests that future studies should test whether these signs would continue to work in the long term. It might be possible keep the message fresh by changing the signs frequently to mention different patients, or to use different slogans, like “Did you wash your hands? What if your mother was the next patient you saw?” Grant says. The punch line here is that it’s not all about me. To motivate people to engage in safety behaviors, we should highlight the consequences for others―not only themselves.
For more information about this study, please contact: Adam M. Grant at grantad@wharton.upenn.edu.
The APS journal Psychological Science is the highest ranked empirical journal in psychology. For a copy of the article "It’s Not All About Me: Motivating Hospital Hand Hygiene by Focusing on Patients" and access to other Psychological Science research findings, please contact Divya Menon at 202-293-9300 or dmenon@psychologicalscience.org.
I read this study this over my morning cup of coffee. Everyone else will get out of this article that the caregivers think they are invulnerable. Instead, I continue to see another article about how great our caregivers are. This article shows me that caregivers care more about their patients than their own personal safety. By changing a sign to say their patients may be at risk, rather than saying their own lives maybe at risk, caregivers increase their handwashing by 10%! This is not an insignificant amount.
This is also a very interesting case study on the nudge effect. Many times, everybody wants to make gigantic changes when there is a problem. But often times, it is a subtle change that can cause a huge effect. It is not easy, but it is about asking the right questions. In my mind, this sign is a big innovation (innovation does not always have to equal new technology).
Company Culture Counts... and its easier than you think
« Welcome Oren Jacob, Our Fantastic New EIR | Main
Company Culture Counts
What a great week I had last week. On Tuesday I attended the Splunk Worldwide User Conference. On Thursday I attended the SAY Media all hands meeting. (On Wednesday I had board meetings for StumbleUpon and Ebates -- they're building awesome companies as well, but that has nothing to do with this blog post). Both events reminded me of what excited me enough to invest in these companies over a half a decade ago. And both events reminded me that company culture really matters.
There is no single culture that assures a winning startup. Splunk and SAY have very different cultures. But I have found that successful companies have distinct cultures that reflect the values of their founders and the focus of the business they're building. What's more, successful startups have founders who really care about culture. And that desire to build a purposeful company sets the tone for the business as it grows.
When I invested in Splunk and SAY, each had fewer than half a dozen employees. Today both companies employ several hundred people and are growing rapidly. Yet despite growing by dozens of people a quarter, their company cultures are stronger than ever. This is in no small part due to the fact that both companies prioritize maintaining culture. New employees are not left to discover company culture on their own. Employee "indoctrination" (and I mean that only in the most positive of ways) begins at orientation and is an ongoing effort. As a result, culture is transmitted and propagates from one generation of employees to the next.
Since the early days of Splunk, it has been characterized by a sort of geek hipness (no, that is not an oxymoron) that has proven a fantastic cultural glue for the company. In many ways that hipness is reflected in the name Splunk itself. The company started out its life as Oplicity, then Transaction Engines, but neither name captured the attitude the company was trying to project. Along came the name Splunk -- a play on the idea of spelunking your log files -- and a culture and attitude were born. Splunk rules the trade shows with their often edgy t-shirts ("Taking the SH out of IT" remains the classic), which are worn with pride by customers, employees and board members alike. As Splunk has grown and delivers increasingly powerful solutions for giant corporate customers, the geek chic attitude continues to permeate the company and provide a unifying identity that will long outlast those of us who witnessed its birth.
SAY Media has always had an equally quirky company culture. From its inception, SAY has encouraged its employees to think creatively about its products, its brand, its attitude. The company's marketing materials have always featured employees. SAY videos have been produced starring its employees as actors and musicians. Company parties showcase employee bands. Company t-shirts are conceived of and designed by the people, of the people, for the people. The openness of SAY Media's culture assures that it is molded by the creativity of the employees from the bottom up, rather than by mandate from the top down. The culture that has emerged was clear at last week's All Hands Meeting, the highlight of which was the awarding of the "Raddies" -- a crowd-sourced award for those employees who exemplified the cultural values of SAY Media. The creation of the Raddies, the nomination process, the design of the trophy, and the awarding of the prize, all reflect the very same open and creative culture that they celebrate.
That all sounds like great fun and games, but why am I so high on company culture as an investor in startups? It is because culture matters. Companies with a strong culture inevitably find it easier to recruit like-minded employees. What's more, a strong culture dramatically decreases attrition. Companies with a shared purpose are more efficient -- they work well together in pursuit of a common goal. Employees can appreciate their company's priorities and focus on the stuff that matters. And, at the end of the day, fun and games matters. People would rather work at a company that they genuinely enjoy and believe in than one that lacks any real sense of purpose.
No two companies in which I have invested have the same corporate culture. Each has its own unique history, priorities, and traditions. But like Splunk and SAY, each of my portfolio companies has found its unique voice and is working hard to promote and protect that culture.
08/23/2011 in Entrepreneurial Success, Management Issues | Permalink
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Great post. Reminds me of a very interesting talk by David Russo, the head of HR at the Saas Institute last year at Business of Software (http://businessofsoftware.org)
He made the point that note only does culture matter, a lot more than people think, but that it is very hard to change. He shared some research that showed that if a company needs to change culture at some point after formation, it reduces the likelihood of an IPO by about 50%.
You can see my notes here http://thebln.com/2010/10/david-russo-business-of-software-company-culture/
Posted by: Mark Littlewood | 08/23/2011 at 11:42 AM
Don't count your chickens before they are hatched.
ytPosted by: Air Jordan Heels | 08/24/2011 at 12:22 AM
Enterprise culture is the enterprise through by the formation of the production and business operation activities for all the staff and recognized by and follow the ideal faith, concept of value, professional morality and code of conduct and the sum total of the standards.
Posted by: LED lights supplier | 08/24/2011 at 01:14 AM
Thanks for the great post! I couldn't agree more, and I think most entrepreneurs do themselves a disservice by not focusing enough on intentionally building a strong culture that supports their company's vision and strategy. It's been surprising to me how much more work has been done on defining best practices and methodologies for building a technology/product that meets customer needs than on the equally important work of building a culture that enables you to repeatedly and scalably continue to meet customer needs.
Posted by: Dave Kashen | 08/24/2011 at 10:15 PM
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via ventureblog.com
A fantastic little article from Ventureblog. As Mobile Aspects continues to grow, the main theme that our leadership is circling on is Company Culture. I'll admit, as we experienced the growth of the last few years, we did not focus on this area. I am not sure what happened - maybe it was a yearning by our company Founders to get back to our roots as the growth grew a bit out of hand, maybe it was infusion of new talent, maybe it was a combination of everything. But all I know is that there is an incredible focus by our team members on culture.
The great thing about it is its easier than you think to work on it. Yes, out of the gates, it seems daunting. How do you build (or get back to building, in our case) company culture? I can tell you where it starts... a simple coffee, a simple conversation. My CTO (a Founder) and me simply had coffee at Starbucks. We were meeting in our office for our weekly meeting and he suggested we meet outside of the office (his latest training told him this was a good idea, and I bought in). We started talking about the good old days. Then we started talking about how to get back to the good old days - focusing on people. The seed was planted for both of us. We started socializing this throughout the company. Lo and behold - company socials started reappearing, people are more involved in meetings, and "random" employees are posting to our employee blog (instead of the usual suspects). But be warned, it takes time and patience. But it does start with a simple conversation about your people. Its trite, but its true, the success of the company depends on the happiness of the people in the company. It then grows outward from there. Focus on it everyday.
Measure your heart rate with Cardiograph for iPhone with just the camera
via tipb.com
Now this is an amazingly cool app for the iPhone. Using just the camera on your iPhone (or iPad) this app can detect and record your heartbeat, for whatever purpose you may need it. It uses small changes in your finger color to detect the heartbeat. One of the users is saying it is quite accurate (hopefully that user was not planted by the company!).
3 Hidden Hospital Cost-saving Strategies (lean hospital)
It's all about Lean in hospitals these days, which is a great thing. In this article, Mr. Woods provides a great perspective in hospitals looking and acting more like manufacturing plants. Though the healthcare industry definitely has unique challenges, this does not mean they can't find cost and work efficiencies by looking at how they practice their art. Working with employees is the start. As the author points out, they see inefficiency everyday and are waiting for you to ask them to show it to them. This creates ownership within the employees and a mind sight of looking for cost savings. Mind you, the cost savings should not affect clinical outcomes. Lean is not about cutting corners; lean is about eliminating waste. The clinicians in hospitals know the difference between inefficiency and cutting corners very well. They experience both of these everyday. Often they will view a mandate from above as cutting corners, while they will view a self recognized lean practice as an efficiency gain. Mobile Aspects sees this positive spirit with our customers everyday. They are looking to become more efficient, eliminate duplicative paperwork and recording, drive hospitals to deliver better care. It takes the leaders of the hospitals and the departments to ask their 'boots on the ground' employees to provide feedback on possibilities of efficiency gains. Once you start the practice, you will see the benefit will be the gift that keeps on giving. http://www.healthleadersmedia.com/page-1/FIN-268656/3-Hidden-Hospital-Costsav...
How Khan Academy Is Changing the Rules of Education
Sometimes answers come from out of nowhere. In fact, this happens a lot of times when dealing with large, perplexing problems. Education in the US is one of these large perplexing problems. We still develop the most creative minds on the planet, but this is due to the culture of America, not necessarily our education system.
We don't have bad teachers either. They are bright people, who know how to handle children well. Not the only problem, but a major one is enabling different students with different aptitudes and abilities proceed at their own pace.
Khan Academy is one of those forces coming out of nowhere to potentially help the American education system. Simple, low cost videos taken while Khan teaches is providing students with abilities to learn at their own pace at home. What I found really interesting is the teachers turning what I think of for online education on it's head. The students watch the videos according to their past performance and aptitude. Then they all come in to the same classroom where the teachers then provides one on one training to those students.
Lets hope this and other initiatives begin to take in the US school systems. We were the first (I believe) to make sure all kids get to go to school in the world. Now that the world is catching up, we need to be the first to ensure we that kids continue to be treated as individuals (again, individualism being unique to American culture) and enable them to progress or slow down at their own pace.
How Khan Academy Is Changing the Rules of Education
http://www.wired.com/magazine/2011/07/ff_khan/all/1
The Internet of Things [Infographic]
The Internet of Things [Infographic]
http://gigaom.com/2011/07/17/the-internet-of-things-infographic/
http://gigaom.com/2011/07/17/the-internet-of-things-infographic/
Facebook Shares Server Design - WSJ
In an interesting move by Facebook, they are going to share their data center design as they are looking to kickstart an "open source hardware movement." Kudos to them for doing so. At Mobile Aspects we are constantly looking at sharing information to move the RFID movement forward. We love open source and movements like Arduino (read Make magazine if you don't know what that means). Collaboration is better than hoarding information.
Facebook Shares Server Design
http://online.wsj.com/article/SB20001424052748704013604576248953972500040.html
Medical devices: Inhaling information | The Economist
Big Doctor is watching you
IN 1985 and 1986 an epidemic of asthma hit Barcelona. The city’s researchers first turned to the usual suspects, such as air pollution, pollen and mould. But a series of telephone interviews with the sufferers pointed to a much more precise cause. All the attacks had occurred by the harbour, and at times when ships were unloading soya beans. The cause was clear: soya-bean dust. So was the solution: the installation of filters on the harbour’s silos.
Asthma is one of the world’s most common chronic diseases. It affects about 300m people (almost 5% of the population). Yet what triggers any given asthma attack is often unclear and, as a consequence, most asthmatics are not properly treated. Stories of success, like that of Barcelona, are rare.
Part of the reason for that lack of clarity is inadequate data on where and when attacks happen. But David Van Sickle, an epidemiologist and medical anthropologist who once worked for America’s Centres for Disease Control and Prevention (CDC), has come up with a solution. This is to use the asthma inhalers carried around routinely by patients to record the time and location of symptoms as they happen.
Related topicsTo develop his idea, Dr Van Sickle left CDC and founded a company, Asthmapolis, which is based in Madison, Wisconsin. The result is Spiroscout, an inhaler with a built-in Global Positioning System locator and (in advanced models) a wireless link to the internet. Whenever someone uses the inhaler, it broadcasts the location and time to a central computer. Asthmapolis plots and analyses the data, and sends weekly reports to participating patients and their doctors summarising the observations and making recommendations.
That is useful for the individuals involved, since it may illuminate patterns of which they were unaware (the proximity of a particular kind of crop, for example). It could also help doctors identify those patients whose asthma is not under proper control. Use of the inhaler more than a couple of times a month suggests there is something wrong, and that the patient’s medication may need to be changed. Patients do not, however, always report such problems, and so do not get the right drugs. The big public gain, though, will come from pooling all the data from the inhalers, once they have been suitably anonymised. That will open the way for a much more detailed analysis of what is going on, and may allow the triggers to be identified and ranked in order of importance.
Over the past three years Dr Van Sickle has run two pilot studies to test the new tool. Both of these showed useful improvements in patients’ management and understanding of their disease. They have also resulted in him questioning some longstanding theories about asthma, including the ideas that symptoms occur primarily at home and that the affliction is more prevalent in urban areas than rural ones. If those insights are confirmed, they will change the way asthma is managed.
The next step, commercialisation, is planned for the autumn. With nearly 500,000 asthma-related hospital admissions every year in America alone (often involving cases where the disease could have been properly controlled by drugs, but was not), the market could be large. Alternatively, Dr Van Sickle’s old friends at the CDC or some other medical-research agency might think the data sufficiently valuable to buy and distribute the things themselves. Either way, the upshot would be better lives for patients in the short term and, if all went well, a true understanding of the triggers of this debilitating and occasionally life-threatening condition.
via economist.com
I'm not a good multi-tasker... and I'm willing to admit it
I've been there, just as anyone has. Seduced by the idea that I can both listen to my coworker and keep working on my emails. We all do it. We all think that we're so busy we must do it. But I began to realize I wasn't good at it. As the leader of my business, I wasn't doing the most important I could be doing: listening to my people. Sure, I was in the room with them when they were talking, but that's not listening. Then one day, a coworker came into the room and told me I wasn't listening. So I hit ctrl-alt-dlt on my CPU to make sure I heard him. We had a good serious conversation and he walked out happier than I had seen him in a long time. I realized I needed to listen better. I hit ctrl-alt-dlt the next time another coworker came in and saw the same response. Now I do it every time. Then I added taking notes on my iPhone with Evernote. So I challenge all of you... In one on one's, in meetings, turn off (silent mode) your iPhones, close your laptop lids. Actually 'be in the meeting.' Everyone in my office now knows i have an open door policy, but to let me finish the email or whatever piece of work I am doing before they start talking to me. I finish, I hit ctrl-alt-dlt and then I focus on them. I've learned I am not a good multi-tasker. Are you?... really?
Is It Time To Rebuild & Retool Libraries?
Make magazine (one of my favorites) has a great article on the current state of libraries and suggestions for the future. The library, though in it's current carnation a dinosaur, is an incredibly important social resource at all economic levels. With two little ones now, I can't tell you how important our Carnegie library is to us in Pittsburgh.
But a new future is needed. Make puts forth a new future, of course biased towards 'Make' shops. But I could see this as my children grow up and we continue to find new resources for their minds to grow. Is It Time To Rebuild & Retool Public Libraries And Make “TechShops”?
blog.makezine.com/archive/2011/03/is-it-time-...
blog.makezine.com/archive/2011/03/is-it-time-...
Making Kids Work on Goals (And Not Just In Soccer) - Lean helps in our daily lives too
In a great article in the Wall Street Journal today, the author describes how a philosophy of small goal setting is helping out children perform better in and out of school. They work with coaches at the schools to set a small goal; once achieved, they set the next goal.
I am a huge advocate for Lean practices. It is our mission at Mobile Aspects to help make hospitals leaner and safer. As I look around, I see different version of Lean being performed everywhere I look. I believe not only our hospitals (and our Children's performance in schools) can be made better by lean, but also how we do in our daily lives.
Making Kids Work on Goals (And Not Just In Soccer)
http://online.wsj.com/article/SB20001424052748704758904576188453057819300.html
Doctors try new models to push health insurers aside
Seattle-based Qliance Medical Management's three clinics typically charge a patient about $65 a month for unlimited access to the practice's 12 physicians and nurse practitioners. (Fees vary depending on the level of service and the patient's age.) Office appointments last up to an hour, and clinics have evening and weekend hours, with e-mail and phone access to clinicians as well. Routine preventive care and many in-office procedures are free; patients pay for lab work and other outside services "at or near" cost, and they get discounts on many medications.
The average $700 to $800 per patient that Qliance receives annually in membership fees is up to three times more than a doctor in a standard insurance-based practice might make per patient, says Norm Wu, the company's president and chief executive. "So we can have a third the number of patients and get the same revenue per clinician, but with much less overhead," he says. The approach, he says, allows Qliance to funnel more money into the care itself - through longer office hours, for example, or better diagnostic equipment.
Bruce Henderson joined Qliance when its first clinic opened in 2007. Although at the time he had health insurance through his job, Henderson, now 63, was soon laid off. Now he pays Qliance $79 a month for primary care and carries a catastrophic medical plan with a $10,000 deductible, for which he pays $225 a month.
Henderson has high blood pressure, high cholesterol and Type 2 diabetes. Working with his Qliance doctor, he switched to lower-cost medications and reduced his monthly out-of-pocket costs from $500 to $100. He goes in regularly for blood work and exams to keep his diabetes in check. Periodically he also has early skin cancers removed and last month was in three times for a cyst removal. "The doctors will sit there with you as long as you need them to," he says. "They don't rush in and out."
A 2007 Washington state law encourages "innovative arrangements between patients and providers," such as direct-pay primary care.
There are 15 other direct-pay practices in Washington state, according to a 2010 report to the legislature from the state's insurance commissioner. Some are more conventional "concierge" practices, which are aimed at well-to-do patients, charging as much as $850 a month for personalized, high-touch services. But the biggest growth is in practices that charge fees in the $85 to $135 range, according to the report.
Although Washington state may be a hotbed of direct-pay activity, primary-care physicians in many other states are offering similar services. At Access Healthcare in Apex, N.C., for example, members pay $39 a month plus $20 per visit for unlimited primary-care services, says the practice's founder, Brian Forrest. Having run the subscription-based practice for 10 years, he is now expanding and expects the first franchises to open this summer.
Forrest, a physician, says that half of his clients have insurance, with their typical copayments for primary-care visits averaging $35 to $50. "For lots of insured patients, it's actually cheaper for them to see us," he says.
Washington state's representatives in Congress and its governor, Chris Gregoire (D), successfully pushed to involve direct-pay practices in the federal health-care overhaul. Under a provision in that law, insurers selling plans on the state-based insurance exchanges that will open in 2014 will be allowed to "provide coverage through a qualified direct primary care medical home plan . . . ."
As envisioned by Qliance, direct-pay practices like the one it operates will link to custom "wraparound" health insurance policies that would pick up where Qliance leaves off, providing specialist care, hospitalization and the like.
"What we're inventing here is a new relationship between primary care and insurance," says Garrison Bliss, chief medical officer for Qliance Medical Management. Patients would essentially have two monthly health-care fees: one that they'd pay to a doctor's office for their primary care and another they'd pay to an insurer for all their other care. Providing better primary care should reduce insurance claims for emergency care and hospitalization down the road, Qliance's Wu says.
This idea raises a host of questions, policy experts say, including how direct-pay primary-care practices could charge monthly fees for preventive care services that under the new law are supposed to be provided free.
Some experts have more fundamental reservations about this approach. While agreeing that the current payment model for primary care doesn't work very well, Robert Berenson, a fellow at the Urban Institute, says "it doesn't make any sense" to provide primary care outside the health insurance system. "This is not going to work for a lot of patients who can't afford the out-of-pocket subscriptions."
This column is produced through a collaboration between The Washington Post and Kaiser Health News. KHN, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health-care-policy organization that is not affiliated with Kaiser Permanente. E-mail questions@kaiserhealthnews.org
Norm Wu, the company's president and chief executive: "So we can have a third the number of patients and get the same revenue per clinician, but with much less overhead."
The Young And the Perceptive
Chicago
IT has been more than three years since the beginning of the Wall Street financial crisis, yet we continue to hear about new evidence of glaring errors and widespread misdoings. Even the smartest minds in finance are left scratching their heads: how did we not catch any of this sooner?
When I hear this refrain, I am reminded of Boris Goldovsky.
Goldovsky, who died in 2001, was a legend in opera circles, best remembered for his commentary during the Saturday matinee radio broadcasts of the Metropolitan Opera. But he was also a piano teacher. And it is as a teacher that he made a lasting — albeit unintentional — contribution to our understanding of why seemingly obvious errors go undetected for so long.
One day, a student of his was practicing a piece by Brahms when Goldovsky heard something wrong. He stopped her and told her to fix her mistake. The student looked confused; she said she had played the notes as they were written. Goldovsky looked at the music and, to his surprise, the girl had indeed played the printed notes correctly — but there was an apparent misprint in the music.
At first, the student and the teacher thought this misprint was confined to their edition of the sheet music alone. But further checking revealed that all other editions contained the same incorrect note. Why, wondered Goldovsky, had no one — the composer, the publisher, the proofreader, scores of accomplished pianists — noticed the error? How could so many experts have missed something that was so obvious to a novice?
This paradox intrigued Goldovsky. So over the years he gave the piece to a number of musicians who were skilled sight readers of music — which is to say they had the ability to play from a printed score for the first time without practicing. He told them there was a misprint somewhere in the score, and asked them to find it. He allowed them to play the piece as many times as they liked and in any way that they liked. But not one musician ever found the error. Only when Goldovsky told his subjects which bar, or measure, the mistake was in did most of them spot it. (For music fans, the piece is Brahms’s Opus 76, No. 2, and the mistake occurs 42 measures from the end.)
Goldovsky’s experiment yielded a key insight into human error: not only had the experts misread the music — they had misread it in the same way. In a subsequent study, Goldovsky’s nephew, Thomas Wolf, discovered that good sight readers report that they do not read music note by note; instead, they rely on their recognition of familiar patterns and on their ability to organize the music into those patterns and dependable cues.
In short, they don’t read; they infer. Moreover, this trait is not unique to musicians: pattern recognition is a hallmark of expertise in any number of fields; it is what allows experts to do quickly what amateurs do slowly.
Goldovsky’s insight offers a useful metaphor for understanding the crisis on Wall Street: Not only did hedge-fund managers, bankers and others misread the danger involved in many of their investments, but they misread them in the same way.
As Paul E. Kanjorski, a former congressman who served on the House Financial Services Committee, put it, “Why does it appear to the general public that all the finest minds in finance missed the most obvious?”
It appears that way because they did miss it. These types of errors are most likely to be discovered by those who, like Goldovsky’s young student, look at the world with new, unblinking eyes.
In 2009, for instance, a first grader in Virginia noticed that a popular library book depicted a meat-eating dinosaur as an herbivore. A year before that, a fifth grader from Michigan discovered an error at a Smithsonian exhibit that had gone undetected for 27 years.
And in 2007, another error was caught, this time by a 13-year-old boy in Finland. The mistake involved an image of a submarine that a Russian TV company had used to illustrate a report about a Russian submarine voyage to the Arctic. The image, distributed by Reuters, was used by news outlets around the world. No one noticed anything awry. But the boy, Waltteri Seretin, did. The sub, he thought, looked suspiciously familiar. His suspicions were right: it was a film clip taken from the movie “Titanic.”
Unlike the Titanic, the stock market appears to have righted itself — even as many investors remain underwater. It may be too much to suggest that we let adolescents run Wall Street (assuming, of course, that this isn’t already the case). But it wouldn’t hurt to let them check the math.
Joseph T. Hallinan, a former reporter for The Wall Street Journal, is the author of “Why We Make Mistakes.”
via nytimes.com
Its amazing to me how in today's world, the amazing human mind is now being "thrown under the bus." I find it incredible how the human mind, in connection with our input mechanisms (see: the 5 senses), is able to make sense of a world so rich and do so much. Part of it comes from our ability to infer. Human beings are great at this. Whether in sight, or in conversations (not just a sense, but a combination of hearing, speaking and computing) our ability to infer is incredible. Recently, Watson, the IBM invention, has taken the world by storm, by beating some champions of Jeopardy. Good for Watson and IBM. The problem is, the world is bigger than a game show. It is taking in input 100% of your time, computing through them, making decisions. A computer will never do that to the extent a human can. Human beings are amazing and I am thrilled to read more into the cognitive study and neuroscience behind how we work and tick.
The insanity of health care pricing: Alice in Medical Land #leanhealthcare
The insanity of health care pricing, aka Alice in Medical Land
February 28th, 2011 by
David E. Williams of the Health business blog
One of the interesting things I learned in business school is that not only is it typical for a business to earn 80 percent of its profits from 20 percent of its customers, but that 75 percent of its customers may represent 120 percent of its profit. In other words, not only are some customers more profitable than others, but a fair fraction of the customer base is unprofitable. This kind of pattern is evident in a normal (i.e., non-health care) business. The main drivers are usually cost of customer acquisition and cost to serve. For example, some customers demand a lot more service than others and some customers that cost a lot to bring on only buy once. Price is usually a secondary factor, with more powerful or shrewder customers negotiating discounts.
Once businesses understand their true costs and profitability by customer segment they can take steps to improve profitability. For example, if customers recruited through advertising on Facebook are unprofitable, the company can advertise elsewhere. If some customers use a lot of service, the company can start charging for service explicitly.
Health care is a lot weirder than that, as Ambulance-Bill Chasing in the Sunday Boston Globe Magazine illustrates. A non-health care person wrote about how he tried to understand the bills for his mother’s ambulance rides to and from the hospital. The more he dug, the more bewildered he became:
As a reporter, I’m used to dealing with complex material, but this drive down one of the countless, curvy roads that merge into the Health Cost Superhighway left me both more informed and more confused. Maybe it really is easier to remain clueless and indifferent about our medical bills. The alternative, as a friend who has spent decades in the health care trenches told me, is “to be clueless and terrified.”
The gist of the story is:
- A public (Town of North Andover) ambulance charged $650 for a 4-mile trip to the hospital. Medicare and supplemental insurance will pay $316 and $79 respectively, or $395 in total
- A private (Patriot) ambulance charged $1153 for the return trip. Medicare won’t pay, because it doesn’t consider such trips medically necessary, and Patriot is apparently allowed to charge his mother the full amount. However, they are only planning to charge her $257
Here’s the interesting nugget:
So if Patriot is unlikely to collect its initial steep fees, why bill for them in the first place? Because in this Alice in Wonderland health care world, some people actually do pay them. Car insurance companies, for example, may cut such checks when their clients are in accidents, a windfall [the ambulance company owner] says he needs to offset lower payments from Medicare.
The example here isn’t particularly extreme, because the $1153 for Patriot is only about 3x what Medicare pays. It’s not unusual to see health care charges at 5x negotiated rates. What’s interesting is that there are still quite a few health care businesses that operate in this mode, earning a modest margin on their core business that’s reimbursed by Medicare and commercial insurers with which they have contracts, losing money on the fairly high percentage of patients who don’t pay anything –either because they’re uninsured or just don’t pay–, and making almost 100 percent of their profit on the occasional out-of-network sucker whose insurance pays full boat or who actually pays the bill himself or herself. Some ambulance companies operate in that mode as do other businesses, such as kidney dialysis centers and providers of mail order medical supplies.
It’s not healthy to operate in such a skewed mode, where the normal 80/20 rule cited above doesn’t apply. Price transparency and consumer-directed plans can make some impact here.
However, global capitation would be even more effective. Not only would it give provider systems (such as Accountable Care Organizations) the incentive to negotiate with ambulance companies and their ilk, it could also encourage a more rational view on utilization. If that ambulance trip home really wasn’t medically necessary, why not call a cab instead for $10? Even throw in a nurse or attendant for another $50 or $100 to help mom get settled back into the home…
Posted in Economics, Hospitals, Physicians |
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Daring to Practice Low-Cost Medicine in a High-Tech Era | Health Policy and Reform
A child with chest pain or tics, a toddler who is limping, a 12-year-old girl with abdominal pain or headaches, an infant whose fever does not respond to antibiotics — these are age-old challenges that pediatricians face. I have been teaching pediatrics to residents and medical students for more than three decades, but over the past few years, as I’ve watched trainees at work, sitting at their computers, and ordering and monitoring tests, I’ve grown worried that the practice of medicine has tipped out of balance.
Recent advances in scientific knowledge and technology have resulted in the development of a vast array of new tests, new pharmacologic agents, and new diagnostic and therapeutic procedures. These are so accessible to us in the United States that few of us can resist using them at every opportunity. By being impatient, by mistrusting our hard-earned clinical skills and knowledge, and by giving in to the pressures and opportunities to test too much and treat too aggressively, we are bankrupting our health care system. Ironically, by practicing this way, we are perpetuating serious economic and racial disparities and have built a health care system that rates in the bottom tier among all developed countries in many categories of children’s health outcomes.
Most doctors are intensely risk-averse. We don’t tolerate uncertainty. Not wanting anything bad to happen, we reflexively overtest and overtreat in order to protect our patients — and ourselves. We feel judged by everyone — ourselves, our colleagues, our patients, the health care system, and the lawyers. The meaning of “first do no harm” has changed for us. We feel that “doing everything” is the best practice and the way to prevent harm, and we believe that it will shelter us from blame. We order tests and treatments because they are available to us, well before their importance has been established, their safety has been determined, and their cost–benefit ratio has been calculated.
The evaluation of a child with fever and cough is a good example. There are many possible causes, and we have a huge battery of available tests that might give us potentially relevant information. But why should we no longer trust our physical exam, our knowledge of the possible causes and their usual courses, and our clinical judgment? How much will we gain by seeing an x-ray, now, and how likely is it that the result will necessitate a change in our management? How dangerous would it be if we chose to perform certain tests later or not at all? Might our residents not learn more by thinking, waiting, and watching? Who is actually benefiting when we order a test — the patient, the laboratory, the drug company, the health plan administrators, or their investors? And who is losing health care as we spend these dollars? We need to ask these questions of ourselves and our residents at every step of the clinical process.
I believe that we must rediscover the value of clinical judgment and relearn the importance of the personal, intellectual, scientific, and administrative thought that is central to the best practice of medicine. We need comparative-effectiveness research, as well as cost-benefit and long-term–benefit analyses, to inform us how to integrate traditional clinical skills with the use of new tests and therapies. Our time and attention have been diverted to the task of sorting out data instead of sorting out what is important to our patients, their families, and the community at large. This new style of test-avid, cover-all-possibilities practice is bankrupting our health care system and depriving many families of access to health care and a medical home. Not having a medical home can be as devastating as not having a physical home. If children have no primary care, we have no way to prevent their asthma attacks, poisonings, obesity, or suicides, and if they are unimmunized, they may spread vaccine-preventable illnesses to their young siblings and aged grandparents. Society as a whole is the loser.
We as clinicians must change our practice patterns, but first the medical community, through standard-of-practice guidelines, must give us permission (or better yet, encourage us) to practice in a less costly way, so we don’t feel we are expected and incentivized to order expensive tests or treatments. Similarly, clinician-teachers must develop the confidence (or be given the imperative) to teach students, residents, and fellows how to practice in the most knowledge-based, least invasive, most frugal fashion possible and to seek input from physicians with more clinical experience when they feel the urge to order a test or initiate a treatment.
Education of the public is also critically important. We need to admit to our fellow citizens that the United States, despite its wealth, technology, and research expertise, is 21st in the world in terms of many indicators of health, and we must convince them that population-wide changes designed to improve health outcomes would be in everyone’s best interest. We need to teach our patients that more medicine is not better medicine, that it is poor health care for doctors to order too many tests or too many interventions, and that costly efforts do not equal better health care. As we address their personal needs, we need to explain to our patients that we have to use new medical technology with care and wisdom. Indiscriminate health care spending is not fiscally sustainable at a national level and actually hampers the achievement of many universal health benefits.
Every participant in our health care system must focus on ways to optimize health while decreasing cost, at every step of the process. We need to change the financial incentives currently embedded in health care reimbursement systems that reward the use of tests, procedures, consultations, and high-cost therapies. And finally, the legal system needs to be more restrained about pursuing lawsuits when a difficult diagnosis is missed or a treatment fails, to diminish the pressure on health care providers to practice expensive, defensive medicine at every turn.
These are major changes, but today we are far from providing good care for all our citizens and far from achieving health care equal to that in many other countries. We need to incorporate more realistic clinical, scientific, and financial information into practice in order to bring our health care practices, and our health care system, back into balance.
This article (10.1056/NEJMp1101392) was published on March 2, 2011, at NEJM.org.
Disclosure forms provided by the author are available with the full text of this article at NEJM.org.
Source Information
From Boston University School of Medicine, Boston.
TED2011: Dan Ariely Talks About the Biases We Don’t Recognize - Health Blog - WSJ
By Shirley S. Wang
The Health Blog has written a lot about conflicts of interest. At the TED2011 conference, Dan Ariely, a behavioral economics professor at Duke, talked about how hard it is to detect our own subtle biases.
Ariely, a burn victim, recounted how one of his doctors called him into the office and announced he was going to improve Ariely’s life. The doc was going to make Ariely’s face more symmetrical by tattooing little black marks on the side of this face that no longer had hair growth so it would look like the stubble on the other side.
The head of the Center for Advanced Hindsight (motto: “Research into what might have been”), Ariely was skeptical and asked many questions, including what would happen when he aged and his stubble became white. Ultimately, he decided not to go through with the procedure. Ariely said the doctor responded with a big guilt trip.
Puzzled about why his doctor cared so much, Ariely asked the doctor’s colleague and learned that his doctor needed him to be the third burn victim to undergo this procedure so the doctor could publish a paper on it, a conflict of interest that the doctor hadn’t disclosed.
But everyone is subject to this kind of bias. Later, Ariely was looking at some data from a study he was conducting and noticed a participant in one of the two groups yielded data that was unexpectedly poor. Ariely also noticed that participant was significantly older than others and also may have been drunk when the experiment was conducted.
Ariely was about to simply drop the individual as an outlying data point when he realized that if the man had been in the other group, the resulting data would have supported Ariely’s hypothesis. In that scenario, Ariely realized, he probably wouldn’t have been so quick to drop the subject as an outlier.
Realizing he had a bias — wanting his findings to appear a certain way — and a conflict of interest not unlike that of his doctor, Ariely decided to re-run the study.
Only by recognizing that we’re susceptible to conflicts of interest can we try to prevent them from happening, says Ariely.
Image: iStockphoto
Correction: An earlier version of this post incorrectly stated the institution where Ariely is a professor.
via blogs.wsj.com
How the Sword Swallower led to development of endoscope & better patient safety #ptsafety
Directly from the article: "Dan Meyer, president of the Sword Swallowers Association International, cited sword swallowers’ contributions to the development of the endoscope, a device used by physicians in some instances to peer down a patient’s throat to examine esophageal disorders."
Not sure if I would call it a lost art, but a fascinating read none the less. You never know where important medical contributions will come from.
Connected Medical Devices At The GSMA Embedded Mobile House
via crunchgear.com
Lean healthcare advocates realize that improving healthcare is not just about the hospital. In fact, 50% of the problem or opportunity (glass half empty or full) is at the home. Some interesting technologies for the home to help us improve our lives. Though, most of these are just for geeks, they will work they way down to a very usable level for regular folk too.
Robot Botches Geography on ‘Jeopardy!’; Why the Machine will never crush the Human
The thing I find most interesting about the whole Watson vs Humans contest on jeopardy is not the competition. I have no doubt that a computer can process things faster, and if taught right, interpret human questions well. There a basic laws of our language and also processors are becoming faster and faster as well as memory cheaper and cheaper. What's really interesting is when the computer is wrong, it is way wrong, by like a human-like mile. In the case below, the question was asking about a US city, and Watson named Toronto. Watson didn't get Wichita, Topeka, Dallas or Pittsburgh; but instead Toronto. The human brain, even when wrong, knows not to be wrong by too much. Think if your GPS... It is right most of the time. But sometimes when it is wrong, it takes you to the wrong place, or on a route that is way off target and you double the time. I see the same thing with Watson here. If machines do indeed rise against the human (ok, being a little cheeky here), this will always be it's downfall. We just need to wait for the opportunity when it strikes against itself, or does something blatantly stupid. From The New York Times: ARTSBEAT BLOG: Robot Botches Geography on ‘Jeopardy!’ In its second outing on "Jeopardy!", IBM's Watson computer answered the first 24 questions correctly but got the last one wrong when it confused Toronto for a city in the United States. http://nyti.ms/hb42R3
Gawande on Checklists: Why Dont Hospitals Use Them #ptsafety #leanhealthcare
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Brigham and Women's Hospital surgeon Atul Gawande, MD, is on the road talking up one of his favorite topics: Checklists. You could say he wrote the book on them, "The Checklist Manifesto."On Wednesday Gawande talked at a Scripps Quality Summit in San Diego about how the 19-point system he and others developed is proving every day that its use can reduce surgical deaths, complications, surgical site infections, and unplanned reoperations.
Death rate dropped from 1.5% to .8%; complication rate from 11% to 7%; surgical site infections, from 6.2% to 3.4% and unplanned reoperations, 2.4% to 1.8% as measured within the first 30 days in eight hospital sites globally, after his surgical checklists were adopted, he said.
He also talked about how hard it is to get providers to adopt those checklists, that they are controversial, and listed some of the reasons many providers are resistant, even with so much evidence that they improve care. Gawande told his audience that providers largely think they alone are responsible for the treatments they administer to one patient, but in fact, it takes 19.5 full-time equivalent positions to make that process happen.
Gawande recounted one bone-chilling example of how the failure to perform one thing – the administration of a simple vaccine that should have been part of routine medical procedure – caused the system to disastrously fail for one young man.
It was the story of Duane Smith, a 34-year old grocery store worker from Texas, who got in a terrible vehicle collision while driving in Boston.
"He'd had a broken leg, broken pelvis, broken arm, bilateral lung collapse and internal bleeding from an unknown source. The team that took care of him worked like clockwork. The EMTs got on the scene immediately. They extracted him, gave volume resuscitation, and kept him alive. They transported him rapidly to the nearest level one trauma center.
"There in the emergency room, they enumerated and found every injury, identified bilateral lung collapse and needed chest tubes, confirmed the bleeding was not coming from his chest and moved him to an operating room so that his ruptured spleen (could be) removed."
Its important to understand the underlying reasons hospitals are not using a simple technique of checklists in order to improve patient safety. This is not a problem alone in hospitals. As checklists are implemented in any industry, in any company, there is always initial resistance. People tend to think that checklists wont work in their environment. Everyone always thinks their environment is different. Sometimes, people think it will make the work rote. Sometimes, its as simple as, change is hard. People never used checklists before, and now you are asking them to make a behavioral change. The important thing to do (and I learned the hard way at Mobile Aspects) is just to keep reiterating the point over and over, and lead by example. You need to talk to your leaders and get them to get aboard and lead by example. But changing culture is hard work, and not for the weary. It is done through diligent, consistent work each and every day. I continue to applaud all those in the healthcare field trying to make a difference in the culture of healthcare delivery for the better.
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