While the initial round of Massachusetts healthcare insurance reform that took place in 2006, focused exclusively on solving the problem of accessibility and insurance coverage and has been largely successful in that respect, health care cost containment remains a huge issue. Independent analysis of Massachusetts health care reform shows that the associated increase in costs amounts to 1.4% of the total state budget. While this figure far from the “train wreck” of skyrocketing health insurance fees touted by some national media like the Wall Street Journal, the fact remains that in this decade our total personal health care expenditures will double; a frightening prospect to say the least.

In 2009, the Special Commission on Payment and Reform, composed of industry and non-profit group representatives, addressed the issue that the current fee-for-service model does not give the proper financial incentives to providers for health care outcomes. The Commission unanimously recommended a framework for global payments made to a group of providers for all care related to a patient. The global payment model is meant to ensure that providers are not only accountable to and coordinated with both each other and the patient, but also rewarded for delivering the right kind of care. Since global payments are tied to patient treatment outcomes, the test intensive, isolated, “defensive medicine” approach that a fee-for-service model can engender, is rendered obsolete.

The global payment model focuses on coordination between providers and patient outcomes.

The panel which followed Iselin’s presentation on payment reform, was comprised of a diverse mix of technologists, strategists and practitioners from organizations including CA Technologies, Mount Auburn Hospital, Veritas Health Solutions, and Kyruss. In the discussion that ensued, the unifying thread was that an innovative approach to total patient care was soon to become a necessity for both better health outcomes and cost containment.

Dr. Puneet Batra, Chief Data Scientist at Kyruus, a data and analytics startup focused on optimizing resource allocation in healthcare, discussed the benefits of big data analytics increasing both the personalization and accuracy of health care services. Frank Calderaro of CA Technologies, further expanded on the theme of health care personalization, contending that the combination of universal connectivity, mobility, and big data provided an opportunity for providers to accumulate data not just from a visit to the clinic or doctor’s office or hospital, but from the person’s daily life in a true 360 degree health assessment. Dr. Gary Goldsmith, Medical informatics Specialist for Mount Auburn Hospital addressed the topic of the sea of information that threatened to overwhelm providers, and emphasized the need for efficiencies in data collection and presentation. And Dr. Steven Locke of Veritas Health Solutions talked about using data and treatment efficiencies to facilitate cost reductions via better and earlier diagnosis of chronic illnesses, specifically depression.

Massachusetts continues to be a laboratory for health care reform; if we can combine forward thinking policy initiatives for cost containment with the realization of the potential efficiencies, personalization, and improved outcomes offered by the health care technology industry, we may provide a model worthy of imitation and adoption as Health Reform 2.0 takes shape.

CodeRyte’s sophisticated NLP technology streamlines the coding process and identifies clinically relevant information about medical records. The highly innovative, end-to-end health system solution offers a full picture of patient care over the lifecycle of treatment. CodeRyte is partnering with Involution Studios for the user experience design of its ground breaking Health System Coding software and recently extended its long-term collaboration, so that the software design consultancy can remain on board through the launch of the product and beyond.

3M Health Information Systems and CodeRyte have worked together since 2009 to bring 3M’s computer-assisted coding technology to more than 60 3M Health Information Systems clients. Building upon that experience in working and collaborating together, the 3M acquisition of CodeRyte brings many opportunities for innovation in the application of natural language processing to health care.

“CodeRyte’s mission, to improve individual and population health by making the language of healthcare meaningful, and our 250 fantastic clients will be best served by this combination,” said Andrew Kapit, Chief Executive Officer of CodeRyte. “Together, we can create change at the pace the nation needs.”

“Information technology is a critical component to transforming our healthcare system and providing patients, clinicians, and hospitals with better outcomes,” said Involution Studios Creative Director, Juhan Sonin. “CodeRyte’s software produces a comprehensive narrative of meaningful information in health records, which really defines the quality of care. We are thrilled to be designing this unique user experience with them, working with some of the best minds in the field of NLP.” Sonin is a recognized expert in design for health and wellness, providing consultation to the U.S. Department of Health and Human Services.

Among CodeRyte’s more than 160 clients are one-third of the nation’s academic medical centers, 20 IDNs and physician clinics, more than 60 single-specialty practices, and over 35 billing companies. This breadth and diversity across the nation’s top healthcare organizations speaks to the power and potential of the software.

The program, “Linking Healthcare, Technology and Design”, explored aspects of the changing face of the industry, and how digital solutions could provide the answer to the current crisis in healthcare delivery and patient experience. The event, sponsored and organized by Boston product design consultancy Essential and moderated by Brian Dolan, Editor of MobiHealthNews, featured four speakers: Dr. John Moore from MIT Media Lab’s New Media Medicine group; Jeremy Gilbert, Head of Commercial Products for PatientsLikeMe; Bill Hartman, Director of Research at Essential Design; and Dr. Anand Iyer, President and Chief Operating Officer of WellDoc.

The evening began with Dr. John Moore of MIT Media Lab’s New Media Medicine group, who spoke about the concept of apprenticeship in medicine — a combination of mentorship, training, and ongoing education, that enables people with chronic diseases to manage them in a more proactive fashion — essentially making the patient the center of care. Apprentices could eventually be qualified to train other new apprentices, which would allow this model to scale over time. Dr. Moore also discussed a number of examples of innovative digital programs developed by or in conjunction with the New Media Medicine group. These included a system for diabetics that provided ongoing positive reinforcement for adhering to diet and lifestyle guidelines, and a program that enabled children to monitor and report on their own asthma.

Next, Jeremy Gilbert, Head of Commercial Products for PatientsLikeMe, spoke about the positive outcomes experienced by users of the health site. Don’t call PatientsLikeMe a social network though; This Web application is a comprehensive registry of patients and their diseases, focused on real-world outcomes. PatientsLikeMe enables members to log and share their data — including condition, treatment, and symptom information — so that they can monitor their health over time, and learn from each other.

PatientsLikeMe enables members to log and share their data — including condition, treatment, and symptom information — so that they can monitor their health over time, and learn from each other.

Bill Hartman, Director of Research at Essential Design, spoke about the meaningful use of Electronic Health Records (EHR). The Health Information Technology for Economic and Clinical Health Act, which was a part of the 2009 American Recovery and Reinvestment Act (ARRA) stimulus package, provides hospitals and physicians with incentives for the meaningful use of EHRs. In addition to the intended goals of using certified EHR technology to improve both information exchange and health care quality, there will be some significant indirect benefits from the push for meaningful use, suggested Hartman. Some of these benefits may include an increased emphasis on the overall health care team rather than an individual doctor, ending the myth of doctor “infallibility”, and providing the opportunity for health care providers to focus on a more empathetic approach, in contrast with the current system. According to Hartman, the quantified self movement clearly illustrates that people want to both track their data and have conversations with their health care providers about it; successfully achieving meaningful use of EHRs will further the possibility of that these aspects may become reality for many patients.

Dr. Anand Iyer, President of digital health company, WellDoc concluded the presentation portion of the event with a review of his firm’s software framework for assisting in the management of chronic disease. WellDoc’s technology framework includes a digital patient coach, for counseling and education; secure, cloud-based analytics; and a clinical decision support system for providers. Dr. Iyer envisions a future for digital health, in which doctors prescribe software solutions — like DiabetesManager, WellDoc’s flagship software product for diabetes care — much like they do medications today, to influence patient behavior, improve outcomes, and control costs. For this to happen, Dr. Iyer believes that health-related software solutions need to enable positive outcomes, be approved the FDA for patient safety, be available on all platforms, and integrate easily into a doctor’s workflow.

In the panel discussion that followed, Brian Dolan asked the speakers to make a prediction in the health care software space for the coming year. All of the panelists agreed that patient-centered health care was coming and that software would play a huge role, but were unwilling to pin a date on the trend taking hold. The panelists also agreed that enabling doctors to focus on patient care rather than working to conform to a complex payment system was a necessity, but is remained unclear how the US could find a way forward in the debate over healthcare for all.

“Working with Involution as our design partner, we are completely re-imagining the Health System Coding product, and taking a fresh look at how it can be extended to get the most out of its substantial vision. Involution’s experience in cutting edge technology and healthcare software design makes them the perfect choice for CodeRyte. Their team has been absolutely integral to our efforts to create a highly usable, useful, and robust experience,” said George Moon, CodeRyte Vice President.

CodeRyte’s new Health System Coding solution will offer a contextually relevant user interface and workflow. The software will not only deliver faster and better automation, but also offer healthcare providers a NLP-based technology platform to increase care quality and decrease costs.

“Information technology is a critical component to transforming our healthcare system and providing patients, clinicians, and hospitals with better outcomes,” said Involution Studios Creative Director, Juhan Sonin. “CodeRyte’s software produces a comprehensive narrative of meaningful information in health records, which really defines the quality of care. We are thrilled to be designing this unique user experience with them, working with some of the best minds in the field of NLP.” Sonin is a recognized expert in design for health and wellness, providing consultation to the U.S. Department of Health and Human Services.

Among CodeRyte’s more than 160 clients are one-third of the nation’s academic medical centers, 20 IDNs and physician clinics, more than 60 single-specialty practices, and over 35 billing companies. This breadth and diversity across the nation’s top healthcare organizations speaks to the power and potential of the software. For more information visit www.coderyte.com.

About Involution Studios
Involution designs and builds exceptional apps for innovative and visionary companies. We deploy small and experienced teams to create software that is highly usable and appropriately beautiful. Our client list includes Apple, AstraZeneca, McAfee, Microsoft, Oracle, PayPal, Shutterfly, and Yahoo. For more information please contact info@goinvo.com or +1 617 803 7043.

Visual note taking from principles of great companies brainstorming session.

1. Great companies focus.
It’s difficult if not impossible to be great at something if your attention is divided. The same is true of companies. Don’t try to do too much. Try sharpshooting rather than using a shotgun. Provide a unique service to clients and develop a niche business.

2. Great companies care about quality.
In our get-it-to-market-quickly world, where the greatest product is whatever is coming next, it’s ironic that quality may be the last, best differentiator. Cutting corners is far too easy, and the pressure to do so is intense. Don’t give in. It’s not worth it. Have a value set that includes quality of workmanship and make sure that every staff member and, just as importantly, every client shares and accepts that vision.

3. Great companies make things.
While it may not always be possible to have input into and control over the total system and process for designing and developing a product, it’s a worthy goal. Of course, understanding the business, technical, and user requirements and constraints for a product are critical to generating an excellent design. But being involved in the process from ideation to prototyping to production to testing to final release and onward ensures that the total product design is honored. Whether you’re designing and making something for clients or for your company, the same philosophy applies. Great companies are involved through the entire lifecycle of the product — from design to build.

4. Great companies take risks.
Experimentation is key to discovering new technologies, techniques, and potential product paths. If you’re interested in finding the next great product, it’s worth making lots of (small) bets and seeing what works out.

5. Great companies breed openness and transparency.
It’s essential that a company be able to confront the facts, not matter how brutal they may be, and face them head on. Being able to grapple with the truth about everything from internal company operations to external economic conditions is a critical component when striving for excellence. However, at the same time, while companies should be rigorous about these assessments, they should never be ruthless.

As a corollary to this tenet, employees should feel comfortable to argue, challenge, and discuss ideas across levels. Solutions can and do come from everyone, so we should embrace this kind of fluidity and ambiguity. To encourage this open discussion, and build trust, staff and leadership should have meals together.

6. Great companies decentralize decision making.
Empowering staff to make important decisions based on company principles and values, will not only improve efficiency, but also enable leadership to provide vision and guidance — steering the ship rather than manning the oars. Staff should be able to act as entrepreneurs within the larger organization, pushing projects forward and providing clients with great service.

7. Great companies measure performance.
You can’t see, analyze, or fix problems if you don’t have the data. Setting goals and reviewing results on a regular basis, not just for financial and project oriented items, but also in regards to team dynamics and client interactions and service will enable a company to continuously improve.

8. Great companies are profitable.
Profitability enables continued growth, evolution, and commitment to quality and excellence. The financial system that runs a great company should be designed for profitability so that all these elements can be honored.

9. Great companies evolve.
Especially in today’s ever changing digital world, it’s vital that a company be able to change as needed, to shift tactics when one potential solution misses the mark. We will not be doing the same jobs a year from now. As a corollary to this tenet, companies need to educate and train staff in order for them to grow, change, and remain competitive. Just as importantly, and for the same reasons, clients should receive ongoing training as well.

These are some of the principles that we strive for here at Involution. What are your key tenets for creating a great company?

Besides crowdfunding, the bill has two other significant provisions. It raises the ceiling on the number of shareholders a private firm can have — from 500 to 2,000 — before registering with the SEC. And it creates an “emerging growth” category for new public companies with less than $1 billion in revenue, exempting them from certain financial disclosure requirements —like hiring an independent outside auditor — for up to five years. The bill will make one more stop at the House of Representatives for reconciliation before crossing President Obama’s desk, where it almost certainly will be to be signed into law.

Depending on who you read, the JOBS Act is either the greatest thing going for the US innovation economy, or the end of the world as we know it. The New York Times editorial board falls into the latter camp, as does Senator Bernie Sanders, Independent of Vermont, who joined with 25 others to vote “No” on Thursday.

The New York Times had this to say in its editorial from March 10, entitled “They Have Very Short Memories”: “House Republicans, Senate Democrats and President Obama have found something they can all support: a terrible package of bills that would undo essential investor protections, reduce market transparency and distort the efficient allocation of capital.”

And here’s Senator Sanders’ “Statement on Con-Job Bill”:
“At best, this bill could make it easier for con artists to defraud seniors out of their entire life savings by convincing them to invest in worthless companies,” he said. ”At worst, this bill has the potential to create the next Enron or Arthur Andersen scandal or an even worse financial crisis. Have we learned nothing? Deregulating Wall Street led to the worst financial crisis since the 1930s. Now the same people who caused this horrible recession are telling us that more Wall Street deregulation will create jobs. Give me a break. I strongly support providing small businesses with the tools they need to create jobs. Sadly, that’s not at all what this bill will do.”

I find the hyperbole filled rhetoric cringe-worthy at a time when American technology innovators and other start-ups are actively contributing to an economic renewal. Let’s parse the second sentence in Senator Sanders’ statement a bit to see just how inaccurate it is. Enron, at the time of its implosion was, of course, a publicly-traded company, operating what amounts to a fraudulent shell game, by hiding its debt using hundreds of “special purpose entities”. It’s worth noting that when Enron collapsed it would neither have qualified as an “emerging growth” company nor a start-up as defined by the JOBS Act of 2012; Enron claimed revenues of $101 billion in 2000. But, let’s follow the argument through to its bitter end. Shareholders lost $65.5 billion when Enron’s stock tanked, which is 65,500x the maximum $1 million that can be raised per year by a start-up under the bill. So, for the Senator’s statement to be true, 65,500 of these crowdfunded start-ups would need to fail, or maybe 65 of the “emerging growth” companies (with a 1/1 price to sales ratio and $1 billion in revenue), or some combination thereof, in a roughly simultaneous fashion, to approximate the Enron collapse.

Anyone who’s contributed a small amount of funds to a Kickstarter project, seen the inside of TechStars or MassChallenge or a similar business incubator, or participated in a start-up company, knows that crowdfunding is actually more of a Main Street phenomenon than a Wall Street one. I don’t see Wall Street clamoring to fund start-ups where other investment is not available. I’m not even sure how crowdfunding would interest a major Wall Street financial institution. The amounts of money are far too small. Regarding “emerging growth” companies, you could argue that relaxing the financial disclosure rules for the first five years of a public company’s existence is bad policy that will lead to scenarios where fraud is more likely to happen and shareholders are more likely to lose out. But that’s not what the Senator is arguing. Or, at least, I can’t tell if he is.

When it comes to creating and funding start-up companies, it’s one thing to disagree on how best to do it, it’s another thing entirely to have limited knowledge of the ecosystem, and attempt to pin it to anti-Wall Street populism. Thankfully, that side of the argument lost on Thursday.

A recent study published by The Economist ranked Boston as the 10th most competitive city in the world, out of 120 major cities examined. For the study, the Economist defined competitiveness as “the demonstrated ability to attract capital, businesses, talent and visitors.” And last year, Boston ranked number one on the Innovation Cities Index.

In a recent study by The Economist benchmarking global city competitiveness, Boston ranked 10th in the world.

In the most recent issue of Architecture Boston, the Boston Society of Architects (BSA) asked business, research, and design leaders “Why Boston?”. Their answers were revealing, citing some of the very same creative assets Florida extols in his book — from the universities, to the culture of openness and support, to the multidisciplinary areas of the city like Kendall Square where the cross-pollination of design and technology can happen.

There are, of course, so many converging factors that are contributing to a Boston’s growth as a center of innovation. Here are a few more:

The Start Up Ecosystem
The Boston start-up sector is flourishing. Tech incubators and shared work spaces like MassChallenge, TechStars, and Dogpatch Labs are giving new companies a major boost. I can remember Web Innovators Group meetings, three or four years ago, where you could reasonably expect to meet almost everyone who attended. That is just not the case anymore, which is a good thing, as the event regularly packs the ballroom at the Royal Sonesta Hotel in Cambridge.

Investments and Growth
Boston firms that were start-ups only a few years ago are accelerating into their next phase. It’s amazing to see the growth of companies like RunKeeper and Gazelle and Hubspot, which have started to gain national attention. And along with these growing companies are venture capital funds looking to support them. One in particular, Boston based NextView Ventures, is entirely focused on early stage Internet companies.

Acquisitions
Over the past two weeks, acquisitions of and by Boston-based companies have been big news. One particularly significant Boston-related tech acquisition was EMC’s all cash deal for application development consultancy Pivotal Labs. If there was any doubt that infrastructure and hardware companies need great software to compete long-term in the big data / analytics marketplace, that should be erased with this purchase. The other recent deal of note was Amazon’s acquisition of robo fulfillment company Kiva Systems. Kiva, based in North Reading, Mass., makes robotic systems that reconfigure warehousing to fit with a human picker’s needs on a order by order basis, revolutionizing how e-commerce fulfillment is completed.

With a host of enviable creative class assets, strong activity in the start up, investment, and acquisition spaces, and high rankings for competitiveness on a global scale, Boston is fast becoming the place to be for innovators in a variety of industries. Whether you’re interested in big data, enterprise and marketing software, healthcare, biotech, or robotics, just to name a few, you can find it in Boston.

In New England, and the Boston area in particular, we’ve seen the big data / analytics and marketing optimization software wave coming for a long time. It’s a credit to the innovative regional culture that in many ways favors problem solving for infrastructure and the enterprise, rather than for consumer or public facing products and services. And slowly but surely people have begun to take notice nationally.

One bright star in the Boston software space is HubSpot, which creates business tools for inbound marketing. HubSpot recently poached the CFO from regional heavyweight Akamai, adding to management another big company veteran in preparation for an initial public offering. In the past year, the company also acquired several smaller Boston area software firms to enhance its product offerings, including e-commerce optimization company Performable.

In an interview with Forbes, Hubspot CEO Brian Halligan made this prediction: “Traditional marketing is going to get obliterated in the next ten years. The whole industry is just going to get ripped apart.” And in its place, Halligan and the HubSpot crew see the meteoric rise of inbound marketing.

Another Boston area success story is Affinnova, a marketing innovation firm based in Waltham, which was recently named one of the 50 most innovative companies in market research.

Involution led the design of Affinnova’s new product, Concept Studio.

Affinnova’s optimization platform, IDDEA, applies the practice of natural selection — as evidenced in biological evolution — to a process of rapidly innovating products and services. IDDEA enables marketing teams to get consumer feedback to a variety of concepts, winnowing out the lesser ones to find the most competitive, top ideas. To enhance its IDDEA platform, this year Affinnova launched Concept Studio, a Web-based application for collaboratively developing new product concepts and designs, which facilitates product innovation by allowing marketing teams to assemble numerous variations on a potential concept. By enabling the exploration of a wide spectrum of ideas, Concept Studio can help users discover genuine breakthroughs that might have otherwise been overlooked. Involution led the design of Concept Studio.

Aside from HubSpot and Affinnova, Boston has a host of big data, analytics, and marketing research and optimization firms, that comprise a new technology ecosystem for this up and coming sector. With this many promising companies, there’s little doubt that Boston is hub for the revolution in marketing software, and the industry will never be the same.

After the heartbreak of the Red Sox collapse last year, at Involution Studios we felt that, in order to maintain our sanity this season, we should hedge our bets by applying some data crunching and information design to the problem of winning baseball games. Our theory was that if, in baseball, money can be used as a proxy for talent, and talent a proxy for wins, then payroll and past win history could be a strong indicator of future success. So we constructed a lightweight Moneyball algorithm to determine if the Sox would be, once again, putting the Fenway faithful through the emotional wringer.

We created this information visualization to better understand the relationship between wins and payroll in Major League Baseball.

We crunched the numbers on win and payroll data for the past six years of Major League Baseball, and came up with a few postseason predictions based on our calculations. If you’re an avid baseball fan there’s probably not a huge amount of controversy in our predictions for this year’s postseason teams. We’re picking the New York Yankees as the AL East division winners, and the Red Sox as one of the two AL wild card teams. Check out the rest of our predictions for MLB 2012 here.

In the infovis, you can view team data regarding wins and payroll for every year 2006 – 2011, as well as a prediction for 2012.

You can play around with our MLB Wins vs. Payroll interactive information visualization yourself and see if it sparks any additional insights. In the interactive visualization, you can drill down into each team to see their wins for each year, their cost per win, and how their payroll varies each year from the team average payroll.

Information Design
From an information design perspective, the challenge was to show both the big picture — payroll vs. wins for all 30 Major League Baseball teams over the past six years — while enabling the user to view data in the context of individual team performance. We accomplished this by creating two views, so that users could easily compare team performances in a single year or switch to the detailed view for a particular team. For the individual team view, we adapted a bubble graph to accommodate payroll and wins for multiple years. The bubble sizes were designed to proportionally represent the number of wins for a team, while color gradients provide a comparative reference for wins.

We adapted a bubble graph to accommodate payroll and wins for multiple years.

Coding
To render the visualization, we settled on the D3 library, which among other great features, allows you to bind data to DOM elements. Once the data has been bound, working with D3 is as easy as picking the attributes you wish to use as visual keys and setting them accordingly. Another huge plus for D3 is its ability to create scalable vector graphic (SVG) content that is easily manipulated by the user, for an engaging interactive experience. While HTML itself is capable of drawing rectangles, lines and maybe even circles — depending on your knowledge of CSS3 — SVG can create curves, triangles, and almost any shape you can imagine.

The Raphael Javascript library also does a good job of seamless SVG integration. However, we did not choose Raphael for two reasons: Because the library is not as data driven, it would have forced hard coding of data elements into the SVG itself; and while Raphael gives additional control over the objects being rendered, it is convoluted compared to the clear cut D3 library.

Calculations
In order to arrive at our calculations behind the predictions for Major League Baseball 2012, we created what we’ll call our Moneyball Ratio for each team — the change in payroll divided by change in wins, based on their six year averages. And, since we knew the 2012 payroll for each team, using this ratio, it was a simple matter to calculate projected wins based on the payroll change for this year. You can view our spreadsheet here, with data compiled from Major League Baseball, ESPN, and others.

We promise to follow up with some analysis at the end of the season to see if our predictions for the Red Sox and Major League Baseball were spot on, or way off. Let the baseball season begin!

One of the themes to come out of the MassTLC annual meeting was the idea that, in order to drive innovation in the Boston area, we should encourage risk taking in the funding of new companies. While not all new companies will survive infancy, the odds are in our favor that one of the wild business ideas of today will not only survive, but thrive in a spectacular fashion. After all, it’s no secret that Facebook began here, but was unable to put down roots. Today, Facebook is a dominating worldwide presence, but at the beginning, it needed nurturing and support. Making seed funding available to early stage companies is paramount to the Boston region accelerating as a hub of innovation.

Massachusetts fares well with its support of ground breaking ideas in the areas of biotech and life sciences. For evidence, we only need look at the thriving area of Kendall Square, a radius of just a few city blocks, which contributes significantly to the United States GDP when it comes to health and healthcare. However, it’s clear that we can do much better when it comes to encouraging digital innovation in the Boston area.

In recent years, we’ve made some strides forward, and it’s clear that there’s a transformation happening. The business incubators and shared spaces like MassChallenge, Tech Stars, and DogPatch Labs have given start-ups a much needed boost. The Innovation District at Fan Pier is another hugely positive development. And on the funding side, NextView Ventures, a seed stage venture capital fund that invests solely in internet businesses, recently closed its inaugural fund with $21 million in its coffers. More micro VC firms like NextView might be just the thing to help Boston’s early stage companies, and fit the needs of a city where start ups are in abundance, but angel funds can be hard to find. So, we’re on our way, but we still have miles to go.