MiNDS in the Media

Reality Check on the Future of Medicine, as of 28 Aug 2016

2016-08-29T08:00:00.001+10:00

Here's a couple of posts on the Future of Medicine.

http://singularityhub.com/2016/08/22/exponential-medicine-2016-the-future-of-health-care-is-coming-faster-than-you-think/

http://www.latimes.com/business/hiltzik/la-fi-mh-why-an-uber-for-healthcare-may-not-happen-20160201-column.html

https://www.globalcitizen.org/en/action/wash-explainer/

Key takeaways:

1. The "8 Areas to Watch": 1) The Connected, Interactive Home 2) Medical Tricorders to Connected Emergency Kits 3) Healthcare Chatbots 4) VR in the OR to AR on the Streets 5) From Quantified Self to Quantified Health 6) Uber for Health 7) Cancer Moonshots 8) Crowdsourced ‘Omic's...
... are all underpinned by the way data flows and disparate systems are able to connect with each other (interoperability) - which we haven't quite got right - or ubiquitous - yet. In healthcare, there is an important translation from "Physical to Digital back to Physical" delivery that has been (for the most part) overcome by logistic mechanisms like Uber's, but whether it's efficient or a wise investment of healthcare resources remains an argument to be proven.

2. The bigger question is who is addressing (and how) the dissonance between payment and ownership: the challenge (as identified in Michael Hiltzik's article) is that the person paying and the person receiving the service are often two different people. It's a rare thing in healthcare that they are the same person, without government compensation in one form or another (as it is in Australia) or insurance dropping the price to enable it to be palatable.

3. In a global context, we're still struggling to provide the basics of healthcare: clean water and sanitation. Combined with any lag in access to education, or the skill to assess if this is the best or most trustworthy information to use to inform one's subsequent actions, we still have a number of hurdles to overcome before "full stack" healthcare is available to everyone anytime and everywhere.

Linchpins and a post-Seth Godin binge on "What it means to be a Healthcare Startup"

2016-05-01T09:58:00.002+10:00

One of the most inspiring talks, critical for any entrepreneur who is "leaning in", changing the way their industry behaves.

The great thing about the 7 things that linchpins do, sounds exactly like the team of a great company, one that everyone who is trying to change the world wants to work with.

This is the list (or watch the video):

1. Providing a unique interface between members of the organization
2. Delivering unique creativity
3. Managing a product, project, situation or organization of great complexity
4. Leading customers - how to establish a tribe and take them somewhere
5. Inspiring staff - who will the rest of the staff follow to do almost anything
6. Providing deep domain knowledge - the Uber Geek :)
7. Possessing a unique talent

Summary of Seth Godin's insights:

1. Be the purple cow - be remarkable. People talk about the unusual and if you feel like you're standing out, realise it's a good thing.

2. ... unless you are three steps ahead.
It's a bit too far out for people to fathom, according to Godin. Though we see extraordinary mouthpieces of the creative and technology future, like Peter Diamandis and Ray Kurzweil, talk about things coming in the next 25 years... they always mention what is on the horizon, just on the edge of possible.

3. Ah, the edge... the ability to push til you find a boundary, or a No... and possibly fall off.

4. Cull your customers... or at least be selective.

5. But not so selective that the people in the club get "old". Refresh regularly!

Bonus: "if I can write down what you do, I can find someone who will do it cheaper". Godin mentions the role of radiologists as an example and it's important as we see the tech disruption curve move across medicine into areas of diagnostics and pathology... The science of medicine is being simultaneously expanded and replaced by computers: mobile phones, network computing, AI... leading to faster, better algorithmic processing. The art of medicine is being lost in the fear that we stand out - amongst our peers, that we are judged to have not performed in a way that others would have.

There are times to do that eg lumbar puncture (scientific, procedural), and times not to eg how your patient can watch you tell them about their procedure at any time they want, or how your front desk staff rings each of your post-op patients personally to thank them and follow up after a procedure (artistry, feeling, the experience).

Now, combining with PG's comments about startups needing to make life better, then I truly think that every doctor, every healthcare practice, every medical app out there hanging out a shingle, from a surgeon to a multipractice physio-Pilates-massage clinic to a dermatology app, starting up their own business can benefit from how PG's and Godin's advice to startups applies to healthcare startups, which I see as:

Make someone's life better. Quickly. In small doses. (the good news is, this is what we've been training for, for most of our lives!!)
Don't be ordinary. Stand back and look at what people care about. For example, take a look at this list of UK Charities. To what health-related causes will people give their post-tax, cash-in-their-pocket? What will people go out of their way to experience: belonging, making a difference, ensuring others don't have to experience X or Y...
Be the artist, the creative, the indispensable. Especially as a doctor. Artistry might be through relationships, or how we make people feel... it's just not something that one can write a manual to do.
Find, be or partner with a linchpin organisation.
Operate at the highest level of the value chain: if all we do as health practitioners is mechanical, then we're at risk of missing out on expressing the artistry that is an intrinsic part of our practice. We're blessed to be in an industry where we blend both art and science (though you could argue, which industry isn't): but the way we make patients feel on both spectrums means that if we continue to practice and evolve the artistry of medicine, there will always be a demand for our service to the community.

Periop Partners will be at the Annual Scientific Congress 2016 on "Surgery Technology and Communication" in Brisbane, at Booth 24. Please come by, say hello and learn more about the technology affecting medicine.

Preparing for the future - Alec Ross - AI, robotics and importance of life-long learning

2016-04-03T10:53:00.002+10:00

Brilliant video, explaining the rise of AI and the importance of being a lifelong leading learner.

Key take-aways:

"Disruption": from the technologies in your reality now that weren't available 3 - 5 years ago. How is this going to change the way the users access the service you're providing (or the value chain you're part of?)
If you're a largely services economy (as Australia is) - what percentage of your workforce is in easily replicable / replaceable knowledge jobs eg AI, robotics and learning
This video reminds me of something that Sam Altman from Y Combinator said during his Blitzscaling talk: "I think if you could pick one thing to do that would help the poorest half of the world the most tomorrow you would pick friendly superhuman intelligence".

Thoughts on Artificial Intelligence in Health

2016-02-27T21:03:00.001+11:00

Thoughts on Artificial Intelligence in Health (last updated 27 Feb 2016)

Key points:

Current edge in AI is self-teaching systems
Data scientists offer a unique edge to information-dense, complex systems - make better decisions in the oncoming period of disruption.
The use of AI in Healthcare will aim to reduce the downside of the critical human element (eg fatigue, mistakes, gaps in knowledge) and augment the benefits (more patient-doctor time, comprehension / observation of complex emotional situations, comfort, human touch and compassion)

Latest News:

26 Feb 2016: Google AI group, DeepMind, launches DeepMind Health with two initial apps: Streams, to find patients at high risk of acute kidney injury; Hark, to manage clinical tasks and interventions. Here's Imperial College London's experience with Hark.
Artificial intelligence startup MedyMatch launches, former Philips exec tapped as CEO

Current Weaknesses in the System

Dependent on the accuracy of structured data
Ability to interpret unstructured data still rapidly developing
Disease is multifactorial - and treatment success is in part driven by patient compliance (human factor again)

Artificial Intelligence and its Impact on Health

2016-02-27T21:03:00.000+11:00

The aim of this post is to capture some static points on AI, catch up myself and readers on AI's history, definitions and touchpoints. Also cos the original post was getting super long.

For the latest updates and more interpretative components, you should read this post.

Where AI was
Here's a great article summarising the key milestones of AI and predicting where the technology is trending.

This was a particularly seminal moment: "In 2011, IBM's AI system, dubbed "Watson," won a game of Jeopardy against the top two all-time champions" but it wasn't til I played with Google Photos on a walk through Hobart that I realised this amazing potential spanned data in all its forms - not just words, but images, sound, light...

A Rose by any other name
Business Intelligence, Data Mining, Sensing, Pervasiveness, Ubiquity and Intelligent Agent

... essentially, data gathering + pattern recognition + prediction + learning / modifying rules = AI

AI in Health

From the 2015 EPIA conference in Coimbra, the organisers provided an overview of the expansive range of topics that fall under the AI banner, loosely:

Medical methodologies, architectures, environments and systems:

Agents for information retrieval;
AI in Medical Education and Clinical Management;
Wellbeing and lifestyle support;
Interoperability, Security, Pervasiveness, Ubiquity and Cloud Computing in Medicine;
Methodological, philosophical, ethical, and social issues of AI in Medicine;
Pervasive Healthcare Environments;
Software architectures.

Knowledge engineering and Decision Support Systems:

AI-based clinical decision making and Clinical Decision Support Systems;
Automated reasoning, Case-Based Reasoning or Reasoning with medical knowledge;
Business Intelligence in Health Care;
Clinical Data Mining;
Data Streaming;
Diagnostic assistance;
Expert, agent-based or knowledge-based systems;
Medical knowledge engineering;
Pervasive or Real-Time Intelligent Decision Support Systems in Critical Health Care.

Medical Applications and Devices:

Computational intelligence in bio- and clinical medicine;
Electronic Health Records (eHealth);
Image recognition and interpretation;
Intelligent devices and instruments;
Sensor-based applications;
Telemedicine and mHealth solutions;
Ubiquitous devices in the storage, update, and transmission of patient data;
Usability and acceptability.

AI in Healthcare Information Systems:

Autonomous systems to support independent living;
Healthcare System Based on Cloud Computing;
Intelligent Healthcare information systems;
Pervasive Information Systems;
Pervasiveness and Security in Clinical Systems;
Smart homes, hospitals and Intelligent Systems;
Simulation Computer systems.

Essentially: ... data drives decisions in large complex systems, and that's not a bad thing. Dan Sullivan from Strategic Coach, in a podcast on healthcare and education, observed: "to the degree that hospitals have data scientists, those are the ones that will have great breakthroughs".

What is the impact of that?
The human element is a strength and a weakness - so the use of AI will aim to reduce the downside of that (eg fatigue, mistakes, gaps in knowledge) and augment the benefits (more patient-doctor time, comprehension / observation of complex emotional situations, comfort, human touch and compassion).

See Fastcompany's assessment on how AI will fit into the hospital workflow:

"Robots won't steal doctors' jobs, says [Venkat] Rajan, but they will spare overworked docs some of the dangerous fatigue that can lead to mistakes. "They're stressed, they’ve got a million different things they're looking at, so [there's] stuff they might have missed."

*Venkat Rajan, Global Director, Visionary Healthcare program, at Frost & Sullivan.

Hope and Future Nanotechnologies

2016-02-20T15:39:00.001+11:00

"A Leader is a dealer in Hope" - Napoleon Bonaparte.

(... Notice it doesn't say *false* hope.)

This year at the Abundance 360 summit, I had the distinct delight of meeting Ray Kurzweil.

Described as the "rightful heir to Thomas Edison", and a prediction success rate of 86%, Mr Kurzweil's predictions about the future of human consciousness are:

in 2029 (or well, 2045), we will reach the singularity
in 2030, human brains will be able to connect to the cloud, allowing us to send emails and photos directly to the brain and to back up our thoughts and memories - via nanorobots

(The singularity is Mr Kurzweil's prediction of a point in time when improvements in artificial intelligence generates an intelligence explosion and surpasses human intelligence. Read more: Wikipedia and Kurzweil.AI)

Imagine what this means for the capacity of cognition, emotion, engagement, experiences... the presence and management of mental health conditions, intellectual pursuits and physical endeavours?

Read more: coverage on Huffington Post and Ray Kurzweil's talk on TED.

Neuro nanorobotics. The idea itself is appealing... to reach the corners of the human mind that have been hard to sweep clean, to scratch the itch that lies beyond the blood-brain barrier.

It is the ultimate in personalised medicine: robots derived from and integrating with your own DNA strands... Add to the trend of shrinking the size of technology and you have your own diagnostic, investigative and therapeutic agent swimming around your bloodstream.

Even better than that, according to Mr Kurzweil, is the augmentation of thought: the hybridisation of logical and emotional intelligence. Expansion of physical or quantitative (read: sheer volume) of the brain will lead to a qualitative leap in culture and technology. Want proof? We did it before - humans have a frontal cortex and our primate cousins do not.

Fortunately, we've got 14 years to get there.

And his answer to my question: "Where could I join the nanorobotics revolution?" (after all, it is the ultimate in personalised patient-centric medicine (hence my fascination): robots derived from and integrating with your own DNA strands...)

With a smile he said, "Why don't you apply to Singularity University?". :)

What are your suggestions? Where is the edge of neurorobotics research and who (or which institute) leads the field?

Interface moment and VR / AR

2015-02-03T17:21:00.002+11:00

Take a look at Peter Diamandis' blog entry about "11 steps for going BOLD".

For my VR, AR, 3D printer, Wearables and AI fans out there, pay particular attention to this sentence: "One key is looking for the creation of an ‘interface-moment’ (e.g. Andreessen’s creation of the Mosaic browser for the Internet) which allows entrepreneurs to build new businesses."

Interface moments, like VR and AR headsets, like 3D printers, like wearable (sensor) technology and like AI / big data analytic platforms out there, take heart. You're paddling at the beginning of the wave (as my mentor would say) - get ready to ride it. Don't be disheartened. Take a look at his last post about the prescient Ray Kurzweil.

I wanted to share this insight with you, as so many of us are not within the hallowed confines of Silicon Valley... there is a community that shares your viewpoint. These are the technologies of the future, they are coming in the next 20 - 30 years (as many years as we've had Personal Computers at home, really).

If you can imagine how far we've come since that moment, think about being part of the future action.

Human Longevity and Virtual Worlds Day 2 Abundance 360 highlights

2015-01-28T15:54:00.000+11:00

Phew... I'm exhausted. It has been a huge conference and every day - nay, every hour - has brought more exciting opportunities and topics that make my mind buzz with possibility: human longevity; integrated, personalised medicine; virtual worlds, virtual reality...

Here are some questions that came out of Day 2 that really changed up the level of thinking:

Human Longevity
1. How does life and your behaviours change if humans live to 150, if 100 is the new 60?
2. DNA contains all the necessary information for cellular life. We are just beginning to understand the interaction of the human system with the microbiome. How would you feel if your doctor prescribed you bacteria?

Virtual Worlds
1. Could virtual reality environments, like SecondLife, revolutionise the way we interact with each other? The conference attendees were excited about the possibility of improving the usual boring conference calls with avatars and (gulp) replacing the corporate offsite with "virtual holidays" to Maui...
2. You can buy property, virtual furnishings and even virtual clothes in virtual worlds. Real money is exchanged for these virtual items. With 39 million VR head mounted displays (to be covered in next article) expected to be sold by 2018, what does a new world (and a platform) mean to your business? Your life?

This is essentially a mindset shake up, another advent of totally different platform and technology, requiring different ways of thinking about some age old problems (quality of health, aesthetics, communication, connection, cost savings, entertainment...).

#virtualreality #longevity

Ever Forward - Abundance360 Day 1

2015-01-27T06:46:00.000+11:00

Hi peeps, writing from the Abundance 360 conference +abundance360. This is a conference for Entrepreneurs "passionate about generating extraordinary wealth while creating a world of abundance". Essentially, future focused decision makers and dreamers with exponential growth and change in mind.

My mind has exploded about two or three times just in the first module. (Thank you Roger James Hamilton for telling me I should come to this event) I totally thought I would be intimidated by these giants of industry and a bit reluctant to "network" but instead, found everyone here to be lovely, warm and totally like us: inspired by the future and excited about improving their businesses and taking life to the next level!!!

This was this morning's activity with Peter Diamandis that blew my mind: "Identify your 10x problem and its solution - and write it down like it's a science fiction story. What's the evidence that it's possible in the next decade?".

My big a-ha is that my businesses (ultimately) have all be about making healthcare sustainable in the face of massive and rapid technological change.

What would the healthcare system look like if we lived to 150?
What would we as individuals have to do differently?

Thinking about it like a science fiction story let me dream wildly. Thinking about the evidence let me consider the possibility of it coming into reality in my lifetime... and being part of that movement.

The example would be the vision of taking the 1970s reality of a solo 2 tonne computer and having the science fiction story of computers being small enough to fit into a watch and talk to other devices (and yet, here we are...).

In a discussion with another health entrepreneur, though, we had the realisation that it wasn't the science fiction writers that (arguably) created the most value per-say, but the engineers and business decision-makers that made the hard calls and thought creatively to step humanity in smaller bounds towards that vision. It took guts, determination, self-belief, lateral thinking, funding, community engagement and feedback. The gentleman next to me reflected on health as an orchestra, with a conductor and a composer and the various musicians doing their part.

So, not unlike all movements, or great opera of work: we've got to keep that momentum, that energy of a compelling future and take those shuffling steps and move them into single bounds.

Fail forward, keep moving forward, ever forward.

In this story: +abundance360, +RogerJamesHamilton, +PeterDiamandis

Augmented Reality and Virtual Reality - What can Startups do?

2015-01-24T08:20:00.000+11:00

If anyone had seen me this morning, I was *that* gym bunny in the Beverly Hills Hilton who stopped running just so she could read the paper.

What had caught my eye was the Financial Time's front page reference to Microsoft and Artificial Reality (full article on p14). It's a highly recommended read. Richard Waters' article is a quick, crisp guide to the Virtual reality (VR) vs Augmented reality (AR) landscape, drawing comparison to the advent of the #Realitywars much in the way the battle forces amassed in the www.Browserwars.com of the 90s and 00s.

There are the usual suspects, the big hardware players (Sony and Samsung), but where it gets interesting is that unlike the battle of twenty year's past, the software makers (eg Microsoft, Facebook and Google) are also wading into the war and arguably have more clout with cross platform applicability in the days of iOS vs Android vs Windows.

This puts the old hardware vendors (and all the startups in the VR / AR hardware space) into an interesting predicament.

To play well, to play beyond the niche, you'll need a bit of cross-platform cooperation from the same platform software vendors entering the VR / AR space.

This then becomes a game of strategy, particularly timing and niche appeal. It helps a little that the whispers around CES '15 for OculusRift's release date was as late as "early 2016". So what can you do?

I spent the last 10 days in SF and Silicon Valley immersing myself in the AR / VR scene, attending as many AR and VR events, including talks by HealthTech Women, an excellent showcase by UPLOAD and a Meetup by SFHTML5.

Here's what I saw: the VR solutions, for its very ability to create a truly immersive experience, appeal to isolated environment experiences, mostly not requiring typing (feature not yet fully functioning) or interacting with text. VR vendors (small and large) have consequently focused on gaming or situational plays that lend itself to replaying and re-enacting scenarios (which have promising implications for therapy).

AR solutions attempt to walk a middle-ground: a balance of (currently, hardly) unobtrusive access to information when you require it and the ability to interact with your real-life environment. I've seen a variety of solutions and I'm sure there's more to come. The field of visual graphical language is evolving, with no small part being played by the illustrious Tony Parisi and co. The biggest challenges, I think, will be high-quality visual integration (how do you get a screen to be visible and unobtrusive at the same time?), content supply (volume of skilled talent and that old platform chestnut again), integration with existing eyewear and avoiding a completely scary-looking/socially-unacceptable device hanging off the front of someone's face.

For either AR or VR new entrants, the Holy Grail here is a mobile, untethered solution, with text and visual display interaction capabilities, ideally hooked into an augmented audio experience with voice command and bone conduction hearing. It's secure, not heavy on the nose, allows users to wear glasses (I mean, c'mon) and syncs effortlessly with your other devices. The basic features you want of your phone (call coming in, calendar, contacts and battery power) with the entertainment of your TV and the information access of your, well, everything.

And, just like that sacred object, may it endow its bearer with super powers.

Dr Grace Lai (+Grace Lai) is the Founder and Managing Director of a medical software business in Australia. She is an ex-IDC analyst, specialising in Infrastructure Software, Asia/Pacific and Japan business trends, as well as Strategy, Marketing and Operations. She also knows how to do a craniotomy, which nowadays comes in handy during awkward social situations.

+Financial Times +Tony Parisi @sfshtml5 @Healthtechwomen
Augmented Reality and Virtual Reality - What can Startups do?

Finding the edge, SF 11 Jan, 2015

2015-01-12T17:01:00.001+11:00

Headed down to Redwood City, to catch up with a friend.

"Over here is Box's new headquarters," she said, pointing to a open walled, multistorey monolith, rising above a suburban supermarket parking lot. "They IPO next month, so.... Once I got lost and found Sandisk around the corner. It's like driving through the Internet."

Ahh, Silicon Valley and its beguiling suburban charm. It is a long way from the rest of the world: its own ecosystem, which makes looking for the edge a little hard if you aren't immersed in the action.

So, I'm here to learn where the edge is in neurological health solutions, both software, device and services. It's partly because my unique career has provided experiences in neurological surgery, business operations and IT market analysis. It is also because it is one of the hottest areas to come in the healthcare IT market. It also helps that I will then join the Abundance 360 mentoring circle and be part of Singularity University's kick off in LA in late January.

The "systematic disruption" of technology through the field of health has a beautiful double meaning: not only has it thoroughly revolutionized the way we practice medicine (remember when the only way to see a film was to fumble through the archive boxes, one by one?), speeding up and informing (?well) our decision processes. Technology is also moving through each system of the body. We see heart monitors on chests, then wrists, then ears, then woven into shirts.... We have musculoskeletal splints then crutches, then prostheses and exoskeletons. Now we can even wire it into the spinal cord.

The challenge with the brain? That we don't know what we don't know. The majority of the anatomy and physiology of the heart has been well documented for over 200 years. Neurosurgery as a specialty has been around for about half as long as that and as recently as three years ago we accepted that it really did have a lymphatic (or glymphatic) system to explain what it did with all its metabolic wastes.

So, neurological-oriented innovations stands as the Great Challenge because of the nature of the organ, what man has been able to comprehend of it and the complexity of its utility beyond the structure and function we can discern (the role of the mind, for example). Think of the possibilities!!

Looking forward to meeting as many companies passionate about neurological technology, artificial intelligence, cognitive computing, EEG devices, virtual and augmented reality companies... Come one, come all. Maybe we can crack this code together.

Future notes to self as an exhibitor in a conference

2014-09-11T04:42:00.002+10:00

Congratulations to all the startups chosen for The Hive at TEDMED 2014.

... these could be general business rules, but here's three observations (and future reminders for me) from Day 1 at The Hive at TEDMED 2014

1. If you're here, be present

The usual tradeshow rules apply: the whole point of this event is engagement. Other words & phrases: networking, mixing it up, acknowledgement, cross-pollination.

So that means, for business owners: get out and shake hands, or at least send your most sociable employees and get off the laptop.

2. If people can't figure out what your product does by your name, or a five second glance at your booth, you may have lost the battle

Think of it like speed-dating: people like the subject, are intrigued by how it looks, how you look using the product, or why the hell people are flocking around it... and want to know more. In exchange, they'll give you their most precious commodity: attention.

Pique their curiousity, make your booth interesting, have data on hand (we are an information hungry lot at TEDMED) and models we can play with and be able to back it up to at least the "Why" x 5 times question.

3. Free feedback is good and bad

We're also an opinionated lot. So don't be offended if we ask a lot of questions and throw out "yeah, but..." or "that's so cool! How did you do it?" A great idea and a great entrepreneur has persistence and resilience. Great opportunity to practice those pitches til they are smooooooooth.

That said, it is feedback, which is good, cos from a marketing research point of view, you have immediate contact with partners, patients and providers all under the one roof. It's also "free" in the sense that we're not paying to use the product, just to hear you pitch it. That also lends itself to biases - we haven't used it in the field and to the nth degree that will find all the bugs for you. Change your entire product on our suggestion? Wellllllll..... maybe not.

What do you think? What other advice would you give exhibiting startups at conferences?

Enjoy TEDMED 2014!

Does your Government support Healthcare innovation?

2014-06-13T14:43:00.001+10:00

Travelling provides many benefits, including the opportunity to see how other countries tackle similar problems...

Encouraging healthcare innovation is one such challenge.

Having attended the HealthXL Global Gathering, I had the opportunity to see the Irish government's passion for attracting and growing healthcare companies. They recognise it is their nation's interest to find new and existing business, and grow a community. They have experience in courting and fostering the pharmaceutical market.

Thus, the latest move by the Australian Government is somewhat baffling... On one hand, they recognise the mining boom is drawing to a close, they see that the nation's future is no longer in manufacturing, for our wages and standard of living are significantly higher than other manufacturing economies.

On the other hand, they have some how fostered a handful of super - healthcare companies: multimillion dollar niche subsector superstars such as Cochlear and Resmed. The university / education and medical research sectors should take a bow.

The latest announcements from the Australian Government and the from @AusIndustry roadshow that followed shows a desperately underprepared Government and a Department caught by surpriae. The renunciation of funding and the Innovation Investment fund, and its replacement with suggested a non-guaranteed matching fund is ludicrous in its structure. The generation of a large pool of commercial - ready ideas have been dissuaded by length of time to market and the hefty corporate tax.

Some questions:
What qualifies an idea worth commercialising?
What is the Government's plans for creating a healthcare innovation community?
What were the results of the Innovation Investment fund, that it was pulled (and what will replace it)?

Other countries are solving this problem, quicker, faster and more attractively priced than Australia. This is critical for the next twenty years of business that can we learn from them and learn to compete against them.

The Future is Patient-centric EHR

2014-05-31T01:03:00.001+10:00

(From the Global Gathering 2014 #hxlgg)

Everyone has already accepted the reality of Electronic Health Records. But the current responsibility for management of EHRs lies with hospitals and health institutions, rather than the patient. Why?

It is the reason why #bigdata has such weight. But to the patient... It's not big data. It is their data. It's personal.

So off the back of this, the critical patient-management issues for EHR and Big Data going forward are:

Personal data security - catch and release, temporary or occasion based insight
Data synthesis - what does all their personal data sources mean? For some, it will be too much... What does this mean for the role of the doctor?
Data motility - where the patient goes, the data flows...

What does this mean for your business?

Doctor Bashing

2014-03-08T17:26:00.005+11:00

Dear Readers,

Let us talk of the popular sport called "Doctor Bashing".

It is rife in the media, amongst patients, health practitioners (alternative and allied) and, let's not forget, lawyers. Doctors have been vilified as ignorant and blind to economic realities. We have been labelled as expendable and replaceable with algorithms.

Even better, are blithe remarks like this one by Alex Green, wealth author and weight loss columnist:

The best medicine, of course, is preventative. Unfortunately, too many doctors are inclined to prescribe a pill rather than a healthier diet.

Market forces would dictate that demand usually determines supply. Doctors (amongst others) will tell you the basic principle of weight loss is: "Less energy in!! More energy out!!". Basic maths, folks. But as soon as there is a hope of an "easy" cure, a miracle in a pill form... the rest of the advice is conveniently forgotten. The same doctor-bashing patients flock: "I could lose weight by taking this pill? And I don't have to stop eating??". Give me the pill! With fries!

It's easy to vilify doctors. Like teachers, we are seen to be keepers (sometimes, accused as withholders) of knowledge, softies for a good cause, confusingly committing years of study and accepting decidedly less pay than what we could have earned privately or in other sectors, all "for the benefit of mankind". We make choices voluntarily to help others. Like teachers, we have responsibilities to current and future generations. And like teachers, we have somehow become the cellar-dwellers of society and yet, we are one of its most important building blocks.

New colony on the Moon? Really? They're not going to put a stockbroker, or magazine editor up there? They want whom?

When it comes to health outcomes, particularly obesity, the need for patients to acknowledge their role on the demand side is palpable and critical.

The completely befuddling thing is that most people realise the consequence of years and years of flagrant spending without saving. Even with the presence of a credit card, which helps to bring the consequence home sooner, spending without saving becomes a bit of a drag. It's also basic maths. Reasonable people don't turn up to the doorstep of their banks and accountants after years and years of such behaviour and demand that they "SHOW ME THE MONEY!!!".

It is a curious thing that when the health equivalent shows up: the obese, smoking, hypertensive, hyperlipidaemic, diabetic, non-exercising, non-medication compliant patient turns up in Emergency with crushing left-sided chest pain, their family members turn to the emergency physicians and say: "Do everything you can! Please don't let him die!".

Preventative health is critical. Doctors have been focused on treatment and "unhealthy" management because that is where the demand for their supply is most critical. The shift towards incorporating preventative health is here. For success, it requires joint cooperation (and mutual respect) between doctor and patient. Just basic maths, folks.

Joint effort for Patient-centric Medicine

2014-03-08T10:16:00.003+11:00

Much is spoken of patient-centric healthcare, providing more information to the patient, the coming revolution in doctor-patient / doctor-paramedical relationships.

Robin Farmanfarmaian, of Exponential Medicine, writes about the emerging shift in healthcare - the shift to patient-driven healthcare and "joint effort". The foundation of this patient-driven healthcare evolution is access: the increased access to up-to-date information via tools, gadgets, platforms and programs. This spans access to their own biometric data, access to information resources on their diseases as well as increased access to practitioners.

Critical to this is each patient's knowledge on how to access it and their ability to use the information once obtained. For example, did you know that the Cleveland Clinic offers an online service called "My Second Opinion"? Using this service, people from around the world can tap the knowledge of Cleveland Clinic's specialists in the USA to seek another assessment of their diagnosis, investigation or treatment.

Why is this important?

The other important piece of a joint-effort pie is provider of health information. The Doctor, and the role of the Doctor, has taken some battering in recent years. Watch this video from Stanford Medicine X of Vinod Khosla, who highlights the shortcomings of doctors and the art of solo-effort (and even team-effort) diagnosis.

The exact quote that Mr Khosla references in part during his talk is:

“There are in fact two things, science and opinion; the former begets knowledge, the latter ignorance.” ― Hippocrates

My interpretation (opinion!) of this is the level of humility both patient and doctor must retain when casting an opinion on the profoundness of the disease. An opinion implies certainty, but as Nassim Taleb asserts in his book "The Black Swan", it is the temptation, the arrogance of certainty that blinds you to the possibility of other explanations.

Patients are looking for certainty and consistency, both of which arise from the assumption that medicine, as a science, can provide both. This also implies their desire of exactness, singular explanations and the absence of grey. Much like a simple math problem, eg 2+2, it is assumed that when abiding to the rules of arithmetic, the result must always be 4.

But Mathematics is a language, and is thus also an art. It has levels of sophistication and complexity. There can even be widespread debate and consternation on the seemingly simplest of problems. In part, thus, it governed by rules but is opened to interpretation, based on the skill and prior experience of both speaker and listener.

The same has been argued about Medicine being a science and an art.

Why might people receive multiple different diagnoses, investigations and treatment plans? It is because the application of different skill levels and prior experiences of different doctors to the solution of a range of simple to complex problems will naturally lend different perspectives on the identity and solution of the same problem.

Which means doctors need to collaborate with other doctors (read: all health practitioners) as well as patients to deliver on this patient-centric medicine.

The Most Powerful Arm - Jacob Lancaster

2014-02-04T06:48:00.001+11:00

Jacob Lancaster is drawing attention to the plight of sufferers of Duchenne Muscular Dystrophy.

In a campaign entitled "The Most Powerful Arm Ever Invented", Jacob urges the government to support funding for clinical trials for treatment of Duchenne Muscular Dystrophy.

DMD affects one in 3,500 children and is a congenital, recessive X-linked disorder caused by a mutation of the dystrophin gene. It is a terminal condition which is commonly diagnosed around the time of kindergarten. Progressive muscle weakness, first proximal, then central causes paralysis and most DMD patients succumb to their disease at age 25.

Watch the creation of a mechanical arm that sign the petition on sponsors behalf:
http://vimeo.com/62678149

Minority Report made reel

2013-04-08T10:16:00.000+10:00

The latest in crime fighting, LAPD-style, is a unit called the "Predictive Police".

PredPol, initially the brainchild of a group of PhD mathematicians, anthropologist and criminologist, is able to target "crime hot spots". These are determined on the 'highest probability', aimed at increasing the odds of stopping crime, based on current and historical data of crime type, time and location that are pushed through a series of algorithms. Armed with the resulting GoogleMap, the shift's officers are guided on possible car theft, burglary and burglary from cars.

"“This is the next era of policing… very soon we will be using a predictive policing model where, by studying real-time crime patterns, we can anticipate where a crime is likely to occur.”
- William Bratton, Former Commissioner of NYPD and Chief of LAPD"

In the Age article, Captain Sean Malinowski stated that use of PredPol alone for six months led to a 12% decrease in crime overall in the LAPD division of Foothill and a 25% drop in car theft. Compared to the use of other intelligence in a different six month period, crime rates rose.

See: http://www.theage.com.au/world/to-predict-and-to-serve-the-future-of-law-enforcement-20130330-2h0rb.html

Compare:

1. The Future Attribute Screening Technology (FAST) program by the Department of Homeland Security http://www.youtube.com/watch?v=48FuWeF4m7U.

2. Movie: "Minority Report" http://www.imdb.com/title/tt0181689/