Outside Innovation

A Pragmatic Solution for Eldercare in the US—Designed by Elders for Elders

2013-06-15T10:11:00-04:00

As many of you know, I now live year round on the coast of Maine. One of my local heroes is Chip Teel, who has been pioneering in eldercare for over two decades. He’s a local M.D., with a family practice of seven professionals. A large proportion of their clientele are elderly people. Chip, who has a specialty in geriatrics, served as director of the local nursing home. He has also been very involved as the Medical Director of a nearby retirement community.

Over the years, Chip’s elderly clients have been very clear with him about one thing: they don’t want to move out of their homes, no matter how frail they become. When their declining health and fragile mental states made it necessary for them to move out of their homes, they were often unhappy, and their conditions worsened. When Teel could figure out ways to keep them at home and provide the supplemental services they needed, they thrived. So he engaged with a group of his clients to try a couple of experiments.

The first experiment, the ElderCare Network, involved letting elders help design and run their own assisted-living group homes. Soon there were seven such group homes—all were homey, less institutional, and much more relaxed than conventional assisted living settings. They were staffed in part by elder volunteers. But moving into a group home still meant leaving “my” home. And, although inexpensive, they were still more expensive for the state of Maine and the clients than if people just stayed in their own homes.

So, undaunted, and building on what they had already learned from this ElderCare Network (in existence since 1995), Teel and his colleagues recruited a new group of 40 clients to help design the services they would need to age gracefully at home. Chip Teel’s book, Alone and Invisible No More: How Grassroots Community Action and 21st Century Technologies Can Empower Elders to Stay in Their Homes and Lead Healthier, Happier Lives, describes this amazing journey. You’ll meet many of these independent-minded seniors. They’ll probably remind you of people in your own family and circle of friends. Most of all, you’ll learn about an innovative new customer ecosystem that is slowly spreading from midcoast Maine across the country, as community after community adopts the practices pioneered by these feisty nonagenarians.

Customer Co-Design for Elder Independence
Revolutionary Approach for Elders to Age Gracefully in Their Homes
By Patricia B. Seybold, CEO & Sr. Consultant, Patricia Seybold Group

There are currently 5 million people in the U.S. over the age of 85. By 2050, there will be 21 million of us. Life expectancies are also increasing. There isn’t enough money, time, or people to build and staff enough nursing homes and retirement communities. But we can use high tech and high touch to empower people to live full lives at home until they die. Dr. Allan “Chip” Teel’s book, Alone and Invisible No More, tells us how.

(Download the full article in PDF.)

How Should the Disclosures about NSA Snooping Change Things?

2013-06-14T15:39:26-04:00

I can’t ignore Edward Snowden’s whistle-blowing revelation: The US government is snooping much more than our US Constitution allows on the private communications of its citizens, residents, and even lawmakers. Not to mention the rampant electronic eavesdropping being carried out by our spies hacking Internet and phone systems in most other countries. This is not a good time to be an American in the world. It’s embarrassing to be living in a “democratic” country that has turned fascist since 9/11.

It’s not my practice to speak out on politics to my clients. But I can’t ignore the fact that my most loyal customers have been discussing these events quite volubly online since the news broke. Their consternation isn’t so much political as it is technical: it appears that the NSA’s snooping has actually compromised ALL of the certificate-authority based security provisions that our entire global economy depends upon!

There are two main consequences from these revelations that I foresee. But I also fear that PR spin, human nature (bury our heads in the sand), and apathy (I have other things to worry about; I don’t have time to worry about whether I’m being spied upon) will, once again, prevail.

Consequence #1: Americans and global citizens will demand an end to government intrusion (anyone’s government) on our private communications. I believe that there will be political repercussions. Perhaps the emergence of a viable third-party movement in this country, combined with cyber-demonstrations and actual demonstrations around the world. Maybe some high-placed heads will roll.

Consequence #2: Smart people will take steps to protect their own important communications and transactions—both personal and business proprietary. Snowden himself recommended the use of PGP security for his correspondents. I expect that alternative anonymous end-to-end encrypted (protected even from our government) networking and cloud solutions will begin to flood the market. We will look back on this open Internet, open cloud computing, free-wheeling, social networking era with nostalgia. Just as the recent film, the Great Gatsby, celebrates the excesses of the idle rich in the roaring ‘20s, we’ll look back on the last decade with morbid fascination. How could we have been so carefree and careless? Why did we think Big Brother wasn’t slurping up every candid conversation we had?

Here are some of the most insightful articles/blog posts Patty’s Pioneers have been writing, sharing and discussing. Special thanks to “Master Curator” Scott Jordan, who finds many of these gems!

Happy Reading

Edward Snowden and His Revelations:

Edward Snowden: how the spy story of the age leaked out

Ex-CIA man ’s snooping claims raise alarm bells in Hong Kong

Why I Don’t Care About Edward Snowden

David Brooks: The last Stalinist

Are Normal US Citizens at Risk?

Two times the government used its anti-terrorism powers to target Americans not engaged in terrorism

7 Reasons to Worry About Federal Surveillance

3 Reasons the ‘Nothing to Hide’ Crowd Should Be Worried About Government Surveillance

What do They know about you?

Worried about the Mass Surveillance? How to Practice Safer Communication

How Long Has This Been Going On? And What IS the NSA Doing?

5 Basic Unknowns about the NSA "Black Hole"

The NSA's Ragtime Surveillance Program and the Need for Leaks

International Repercussions:

Inside the CIA’s Ultra-Secret China Hacking Group

India: New Monitoring System Threatens Rights

The Data Retention Disaster Heading to the US

Germans accuse U.S. of Stasi tactics before Obama visit

Bits of Freedom: Dutch Spooks Must Stop Use of Prism

Political Left & Right:

Bernie Sanders On NSA Leak Revelations: We're Heading For An ‘Orwellian Future’

Ryan: NSA program ‘creepy’

If Corporations Can Monitor Us; Why Not the Government?

Companies Scramble for Consumer Data

Should the government know less than Google? Comment from Peter Horne: The point this misses is that you can walk away from Google and they won't follow you down the road to MS, Apple, or what other service you use...

Technology/Security Implications:

The Prism Prison by Peter Horne, Patty's Pioneer

Silent Circle Announces New Pricing To Support Fast-Growing Business And Personal Use Customers

Boundless Informant NSA data-mining tool – four key slides – How do open source nerds feel about maintaining and evolving this infrastructure now?

NSA Prism: Why I'm boycotting US cloud tech - and you should too

Tackling a Wicked Problem: California’s Water Supply

2013-06-04T12:13:29-04:00

How do you address an intractable and contentious issue that’s becoming more and more urgent? That’s the problem faced by California’s newly formed Delta Conservancy. The delta region and estuary formed by the Sacramento and San Joquin Rivers provide some of the most fertile agricultural land in the country, support hundreds of species of wildlife and provide drinking water for 60% of Californians. Yet the ecosystem is fragile and beset by both man-made and natural calamities. For decades, farmers and environmentalists and water companies have been at each other’s throats. Government regulation and intervention seems to exacerbate things. So, facing the rollout of a highly controversial development plan, the Delta Conservancy took an unusual approach. They solicited key stakeholders, including farmers, fishermen, residents, water company owners, directors of environmental organizations, and members of local, state, and federal agencies to build a shared understanding of the issues. These people engaged in a six-month series of site visits and civil dialogues in order to build a common mental model. Now they’re about to engage in Phase 2: Deepen that shared understanding to help plan the future of the Sacramento-San Joquin Delta.

Tackling a Wicked Problem: Water Issues!
How the Delta Dialogues Project Is Using Dialogue Mapping to Build Shared Understanding
By Patricia B. Seybold, CEO & Sr. Consultant, Patricia Seybold Group, May 30, 2013

Jeff Conklin convinced the Delta Conservancy team that forging consensus around the future of the main California water supply was a “Wicked Problem,” and that it would be unethical for them to use strategic planning tools designed for tame problems on this much thornier, more complex, more socially fraught wicked problem. This triggered a unique 6-month initiative dubbed The Delta Dialogues, in which 19 passionate and interested people, representing most of the different constituencies impacted by water planning, agreed to engage in a prolonged dialogue to build a shared understanding of the issues surrounding the future of the Sacramento River and San Joquin River Delta area.

(Download the PDF of the entire article here.)

What Are Wicked Problems, Why Are They Wicked, and How Do You Deal with Them?

2013-05-27T11:06:00-04:00

I’ve been thinking a lot about wicked problems recently.

As faithful readers know, I’ve been embroiled for the past 10 months in a local community hospital issue and have aired our progress (or lack thereof) in a series of posts.

Our recent consulting work has also exposed us to a number of wicked problems: one is the design of a transformational new product line for a highly conservative industry in which our client is both a new incumbent and a distant also ran; the other involves trying to help a well-meaning group of very smart people get rid of layers of barnacles and bureaucracy so they can do their almost impossible jobs. Blowing up and starting over is not currently an option, at least not without dealing with the evolution of the current state at the same time.

I love these kinds of challenges! But they are frustrating and intractable. What makes them so is that they involve “wicked problems.” Wicked problems aren’t just hard problems to solve. They are design dilemmas that are heavily embedded in social context for which there is no solution. There are only approaches that are somewhat better for some, but not all, of the stakeholders. But what makes wicked problems particularly wicked is that it’s really hard to wrap your collective minds around them. And it’s difficult to do so without people taking sides or putting forward their own agendas. We are human, after all. We are social animals. We have agendas and careers and values and experience and history and things we are passionate about.

So, I found it refreshing to take some time out from this brain-breaking work to read a book written by an old acquaintance and colleague with whom I’d recently reconnected (through the auspices of Linked In!). The book is Dialogue Mapping: Building Shared Understanding of Wicked Problems.

Jeff Conklin has spent his entire career helping organizations and groups of people deal with wicked problems by 1) focusing on them as his sweet spot, and b) developing tools and methods to help groups of people develop shared understanding. Here’s Jeff’s take both on why wicked problems are so wicked and why shared understanding helps.

“It turns out there's a slippery linguistic trap in the name 'wicked problem,' because the name implies there's a 'solution.’ It's more accurate to talk about the degree of 'wickedness' in a situation (or perhaps how messy a given 'mess' is). (Framing the challenge in this way might help to break our addiction to racing around creating and exacerbating 'problems' with our 'solutions'.) The truth is that a wicked problem is a set of interlocking issues across many domains (i.e., political, environmental, economic, etc.), and any attempt to bound the scope of the challenge is arbitrary. Moreover, only a tame problem can be 'solved' -- wicked problems can only be managed more or less effectively, more or less efficiently. The best we can do is to find more elegant and expedient interventions, but ultimately the human condition is that there's no getting away from the 'Whac-a-mole' phenomenon that even the most elegant intervention on a wicked problem will make some issue(s) more wicked for some stakeholder(s).”

Even getting started on coming up with a solution to a wicked problem is intractable. Everybody involved has a different definition of “the problem,” and all of those definitions are probably flawed because we (collectively) don’t yet know enough. Jeff Conklin explains:

“With social complexity, ‘not understanding the problem’ does not show up as innocent wonder about the mystery of the problem, neither does it usually occur as a thoughtful collective inquiry into the deeper nature of the problem. Rather, ‘not understanding the problem’ shows up as different stakeholders who are certain that their version of the problem is correct or at least that other versions are fatally flawed. In severe cases, such as many political situations, each stakeholder’s position about what the problem is reflects the mission and objectives of the organization (or country) they represent.”

“The Holy Grail of effective collaboration – is in creating shared understanding about the problem, and shared commitment to the possible solutions. Shared understanding does not mean we necessarily agree on the problem, although that is a good thing when it happens. Shared understanding means that the stakeholders understand each other’s positions well enough to have intelligent dialogue about the different interpretations of the problem, and to exercise collective intelligence about how to solve it. Because of social complexity, solving a wicked problem is fundamentally a social process.”

~ Jeff Conklin

Here are some of my take-aways from reading Jeff ’s seminal book:

How to Address “Wicked Problems”
Use Dialogue Mapping to Build a Shared Understanding and Evolve a Group’s Thinking
By Patricia B. Seybold, CEO & Sr. Consultant, Patricia Seybold Group, May 23, 2013

Help Save St. Andrews Hospital

2013-05-25T22:05:25-04:00

Please take a moment to sign our petition--

Save St. Andrews Hospital before it closes in Boothbay Harbor on October 1st!

Aerial view of St. Andrews Hospital in Boothbay Harbor, Maine

Once we lose our LOCAL Emergency Department and hospital beds, we will never be able to get them back! The elderly people, young families and working fishermen in our 4 rural communities need the 24 hr. emergency room and hospital beds we have had locally for 107 years. But, without your help, St. Andrews Hospital will be shut down by October 1st! 65% of our population is over 65 years old. Historically a fishing and vacation community, the coastal Boothbay region has also become a coveted retirement destination. But without a local hospital with nursing care, rehab and end-of-life care, people are moving away!

St. Andrews was chartered as a rural nonprofit hosptal to serve the residents in the 4 communities on the Boothbay peninsula. 86% to 95% of the voters in these communities (the customers of this hospital) voted to keep it open. Yet, the corporate "parent" insists on closing our hospital. They claim it isn't "making money," but St. Andrews has generated a surplus of $450K per year for the past 11 years and is the first safety net for people in need. The hospital is one of two on the Maine coast that can be reached by sea, land and by air.

The people in our community are scared for their lives and angry that they have no say in their own health and wellness. Stop big corporations from making life and death decisions over our lives. Let the community control the local hospital by electing its board. We're ready and able. We've been working for 10 months to Save St. Andrews and we're going to keep up the fight until we gain control of our community's hospital! The people on our peninsula give $6 million in charity every year. We can afford to support and will improve and use our own local hospital and preventative health and wellness solutions.