Category Archives: entrepreneurship

cool, entrepreneurship, meaning, musings, silly

PYMWYMI App

Had this idea yesterday while thinking about TP’s birthday present.

Wouldn’t it be good if we could convert our respects or displeasures for public figures into something virtuous like goats for people in disadvantaged communities? A “put your money where your mouth is” app that could let anyone pledge any amount of money whenever a public figure either impressed or distressed them? On a regular basis, but at least annually, the public figure with the most respects would be recognised in the media, and be given the privilege of deciding where the money was directed. The most disrespected public figure could be sent to Nauru for a couple of weeks.

 

complex adaptive systems, cool, data saving lives, entrepreneurship, healthcare, healthy habits, nutrition, policy, quantified self, rapid learning health systems, research methodology

Living on the edge with Farzad

  • It’s not as simple as you give people information and they change their behavior.  It’s information tools that build on that data and build on communities and a much more sophisticated understanding about how behavior changes. What TEDMED is also great at, is understanding the power of marketing. People think of marketing of being about advertising, but marketing is the best knowledge we have about how to change behavior and all those intangibles, those predictably irrational insights, of how and why we do what we do.
  • It’s harnessing those, instead of having them lead to worse health – like present value discounting that leads to people wanting to procrastinate and eat that doughnut now instead of going to the gym. Or the power of anchoring, where we fixate on the first thing we see and won’t think objectively about the true risks of things. Or the herd effect, our friend is overweight and so we are more likely to be overweight.
  • All those nudges that are possible can be delivered to us ubiquitously and continuously, and we can choose to have them. It’s not some big brother dystopic vision. It’s me saying, ‘I want to be healthier, so I will do something now that will help me overcome and use my irrationality to help me stay healthy.  To me, that’s the neat new edge between mobile cloud computing, personal healthcare, behavioral economics, healthcare IT, data science and visualization, design, and marketing. It’s that sphere that has so many possibilities to get us to better health.

http://blog.tedmed.com/?p=4153

 

The exit interview: Farzad Mostashari on imagination, building healthcare bridges and his biggest “aha” moments

Posted on  by Stacy Lu

Farzad Mostashari, MD, stepped down from his post as the National Coordinator for Health Information Technology at the U.S. Department of Health and Human Services (HHS), during the first week of October, which was also the first week of the Federal partial shutdown. During his tenure, Dr. Mostashari, who spoke at TEDMED 2011 with Aneesh Chopra, led the creation and definition of meaningful use incentives and tenaciously challenged health care leaders and patients to leverage data in ways to encourage partnerships with patients within the clinical health care team.

Whitney Zatzkin and Stacy Lu had the opportunity to speak with Dr. Mostashari during his last week in office.

WZ: Sometimes, a person will experience an “aha!” moment – a snapshot or event that reveals a new opportunity and challenges him/her to pursue something nontraditional. Was there a critical turning point when you figured out, ‘I’m the guy who should be doing this?’

Yeah, I’ve been fortunate to have a couple of those ‘aha’ moments in my life. One of them was when I was an epidemic intelligence service officer back in 1998, working for the CDC in New York City. I’ve always been interested in edge issues, border issues; things that are on the boundaries between different fields. I was there in public health, but I was interested in what was happening in the rest of the world around electronic transactions and using data in a more agile way.

In disease surveillance we often look back — the way we do claims data now – years later or months later you get the reports and you look for the outbreak, and often times the outbreak’s already come and gone by the time you pick it up. But I started thinking and imagining: What if the second something happens, you can start monitoring it? In New York City the fire department was monitoring ambulance calls. I said, ‘Wow, if we could just categorize those by the type of call, maybe we’ll see some sort of signal in the noise there.’

When I was first able to visualize the trends in the proportion of ambulance dispatches in NYC that were due to respiratory distress, what I saw was flu.  What jumped out at me was the sinusoidal curve. Wham! At different times of year, it could be a stutter process – it would go up and you would see this huge increase, followed two weeks later by an increase in deaths. It was like the sky opening up. The evidence was there all along, but I am the first human being on earth to see this. That was validation, for me, of the idea that electronic data opens up worlds. To bring that data to life, to be able to extract meaning from those zeros and ones — that’s life and death. That was my first ‘aha’ moment.

The second aha was after I joined New York City Department of Health, and I started a data shop to build our policy around smoking and tracking chronic diseases. What we realized was that healthcare was leaving lives on the table. There were a lot of lives we could save by doing basic stuff a third-year medical student should do, but we’re not doing it.  Related to that – Tom Frieden had a great TEDMED talk about everybody counts.

I said, ‘I want to take six months off and do a sabbatical, and see if there’s anything to using electronic health records to provide those insights, not to save lives by city level, but on the 10 to the 3 level – the 1,000 patient practice. That started the whole journey.  None of the vendors at the time had the vision we had, but we finally got someone to work with us and rolled this system out.  We called some doctors some 23 times, and did all the work to get to the starting line.  Finally, I took Tom on a field visit to see one of the first docs to get the program.

It was a very normal storefront in Harlem, and a nice physician, very caring, very typical.  I asked her what she thought of the program. She said, ‘It’s ok. I’m still getting used to it.’  I said, ‘Did you ever look at the registry tab on the right, where you can make a list of your patients? She said no.  I said, ok – how many of your elderly patients did you vaccinate for flu this year? She said, ‘I don’t know, about 80 to 85 percent.  I’m pretty good at that.’  I said, ‘o.k., let’s run a query.’  And it was actually something like 22 percent. And she said – this was the aha moment – ‘That’s not right.’

That’s generally the feeling the docs have when they get a quality measure report from the health plan. But that’s population health management — the ability to see for the first time ever that everybody counts. And being able to then think about decision support and care protocols to reduce your defect rate. That was the validation that we’re on to something. Without the tools to do this, all the payment changes in the world can’t make healthcare accountable for cost and quality if you can’t see it.

WZ: Everyone has that moment in life when they’re considering all of their career options. As you were considering medical school, what else was on the table?

I actually didn’t think I was going to go to medical school. I was at the Harvard School of Public Health. I was interested in making an impact in public health. I grew up in Iran, and thought I would do international public health work. And then my dad got sick; he had a cardiac issue. The contrast between the immediacy of the laying on of hands of healthcare, and the somewhat abstractness of international public health — the distance, the remove — tipped me into saying,  ‘You know, maybe I should go to medical school.’  I’ve been on that edge between healthcare and public health ever since, and always trying to drag the two closer to each other.

SL: Fast forward 20 years.  You’re giving another talk at TEDMED.  What’s the topic?

TEDMED and Jay Walker’s vision is more powerful in the futurescope, rather than in the retroscope. It’s more powerful to be where we are today and imagine a different future rather than look back and say, ‘Oh, yeah, we’ve done this.’  So what’s the future I would love to imagine?

The most exciting thing – as Jay Walker once mentioned in a talk comparing “medspeed” to “techspeed” – is to fully imagine what will happen if techspeed is brought to healthcare. Right now, there’s all this unrealized value that’s being given away for free that doesn’t show up on any GDP lists – what Tim O’Reilly called “the clothesline paradox.”  That kind of possibility brought to medicine, but where software costs $100,000 as opposed to free, and it evolves daily and is more powerful and quicker every day, and it’s beautiful and usable and intuitive, and that’s what people compete on.

And all of that is toward the goal of empowering people.  Someone said, maybe it was Jay at TEDMED, that a 14-year-old kid in Africa with a smart phone has more access to information than Bill Clinton did as President. Information is power, and it has changed everything but healthcare. For me the vision is breaking down that wall, so that patients can be empowered and can bind themselves to the mast to use what we’ve learned about how behavior changes.

It’s not as simple as you give people information and they change their behavior.  It’s information tools that build on that data and build on communities and a much more sophisticated understanding about how behavior changes. What TEDMED is also great at, is understanding the power of marketing. People think of marketing of being about advertising, but marketing is the best knowledge we have about how to change behavior and all those intangibles, those predictably irrational insights, of how and why we do what we do.

It’s harnessing those, instead of having them lead to worse health – like present value discounting that leads to people wanting to procrastinate and eat that doughnut now instead of going to the gym. Or the power of anchoring, where we fixate on the first thing we see and won’t think objectively about the true risks of things. Or the herd effect, our friend is overweight and so we are more likely to be overweight.

All those nudges that are possible can be delivered to us ubiquitously and continuously, and we can choose to have them. It’s not some big brother dystopic vision. It’s me saying, ‘I want to be healthier, so I will do something now that will help me overcome and use my irrationality to help me stay healthy.  To me, that’s the neat new edge between mobile cloud computing, personal healthcare, behavioral economics, healthcare IT, data science and visualization, design, and marketing. It’s that sphere that has so many possibilities to get us to better health.

The thing about the health is, we have a Persian saying: Health is a crown on the head of the healthy that only the sick can see. When you have it, you don’t appreciate it, but when you’re sick and someone you love is sick, there’s nothing better.  You would do anything to get that. We need to bring that vision of the crown to everyone and help each of us grab it when we can.

WZ: I noticed you closing your eyes while preparing to answer a question. How do you pursue being able to exercise your imagination, in particular while you’re sitting in a building that’s been marked for being the least imaginative?

Because the world, as it is, is too immediate and real and limiting, sometimes you have to close your eyes to see a different world.

What has been amazing has been to see that, contrary to what people expect, this building is filled with people with untapped, unbound, unfettered imaginations who are slogging through. They’re just trapped. You give them the opening, the smallest bit of daylight to exercise that, and they’re off and running.

I give a lot of credit to Todd Park as our “innovation fellow zero,” He saw the possibility that there are more than two kinds of people in the world, innovators and everybody else. For him, it was about going to create a space where outside innovators can be the catalyst or spark that elevates and permissions the innovation of the career civil servant at CMS in Baltimore. That’s been cool.

SL: What’s your bowtie going to do after you leave HHS?  Will we see it lounging on the beach in Boca?

I like the bowtie.  I think I’m going to keep it.  Perhaps the @FarzadsBowtie Twitter handle is going to go into hibernation, I don’t know.  I don’t control it. One of the things the bowtie does for me is help me remember not to get too comfortable.

I once said at the Consumer Health IT Summit – ‘You’re a bunch of misfits – glorious misfits. And I feel like I’m very well suited to be your leader. You know, I always felt American in Iran, and felt Iranian in America when I came here. I felt like a jock among my geeky friends, and like a geek among jocks. For crying out loud, I wear a bowtie!  I don’t have to tell you I’m a misfit.’

It’s that sense of not fitting into the world as it is. The world doesn’t fit me.  So instead of saying,  ‘I need to change,’ this group of people said, ‘The world needs to change.’ That’s the difference between a misfit and a glorious misfit.

The person who doesn’t fit into our healthcare system is the patient. The patient’s preferences don’t fit into the need to maximize revenue and do more procedures. The patient’s family doesn’t fit into the, ‘I want to do an eight-minute visit and get you out the door’ agenda. The patient asking questions doesn’t fit.  That’s the change we need to make. It’s not that we need to change. Healthcare needs to change to fit the patient.

Shortly following this interview, Dr. Mostashari left HHS and is now the a visiting fellow of the Engelberg Center for Health Care Reform at the Brookings Institution, where he aims to help clinicians improve care and patient health through health IT, focusing on small practices.

This interview was edited for length and readability.

entrepreneurship

HCA CEO Richard Bracken

  • A good article, possibly the best McKinsey CEO interview yet – practically coherent with not a single three letter acronym
  • On leadership skills:
  • The attitude of the organization toward change is established by the tone set at the top. For me, that means a continued statement, restatement, communication, and validation of the company’s mission and values, which includes reinforcing its culture. This is the CEO’s first and most important job and a clear requirement of leadership. As leaders, we must not only determine the appropriate strategic course but also define how we, as individuals and as an organization, will conduct ourselves.
  • Second, and most obvious, leaders must ensure the development and execution of a clear, well-communicated, and appropriately measured operating plan.
  • Third, effective leaders ensure that the right team, with the right values, is in place to execute the plan and can pivot appropriately when factors change.
  • Fourth, effective leaders show an intellectual flexibility that recognizes there are different ways to achieve goals and objectives within different environments. To me, it is important that environmental and market changes do not modify the company’s, or the executive’s, basic values.
  • Advice to aspiring leaders:
  • And finally, I think a good leader is a problem solver. How an organization deals with problems, failures, and missed opportunities clearly defines an important aspect of its culture.
  • First, make sure you’re working in an organization where there is a good fit between your core values and the organization’s values—it will be difficult to be engaged and productive if there is a misalignment.
  • Second, stay focused on delivering in your current position; many otherwise highly capable people are too quick to be thinking about the next promotion. No one likes a team member who is focused on the next opportunity.
  • Also, don’t be intimidated by the tough assignments, the ones others may not want. These are often the places where you can grow and prove yourself.
  • And finally, never forget that taking calculated risks is the mark of a good leader. And once you commit, it’s important never to go at it halfway.

Source: http://www.mckinsey.com/Insights/Health_systems_and_services/Leading_in_the_21st_century_An_interview_with_HCA_CEO_Richard_Bracken

PDF: Leading in the 21st century An interview with HCA CEO Richard Bracken

Interview

Leading in the 21st century: An interview with HCA CEO Richard Bracken

The chairman and chief executive officer of one of the world’s largest operators of health-care facilities discusses leadership in a time of significant industry change.

November 2013

With 165 hospitals, 113 freestanding surgery centers, and more than 200,000 employees in the United Kingdom and the United States, Nashville-based Hospital Corporation of America (HCA) is one of the world’s largest operators of health-care facilities. Chairman and CEO Richard M. Bracken is steering his publicly traded company through the significant changes now transforming the health-care industry—and doing so amid considerable uncertainty. For Bracken, the leadership challenge comes down to getting the balance right between performing in the short term and taking the necessary steps to position his company to cope successfully under multiple possible scenarios in the future.

“The nature of our business is such that we must produce a highly efficient and quality service with predictable clinical outcomes, 24 hours a day, seven days per week,” Bracken says. “By necessity, this creates a daily focus that is ever-present throughout the organization. However, we also must be cognizant of forces that are fundamentally changing the health-care delivery system in America—changes that will transform our organization in the years to come. How we strike the right balance between short- and long-term performance metrics and between traditional and evolving strategic approaches consumes much of our time.”

In weighing these trade-offs, Bracken draws from 32 years of experience at HCA, which, he feels, has helped to define his approach to leadership and helps him and his top team get these critical recalibrations right. He spoke with McKinsey’s Rik Kirkland, Ramesh Srinivasan, and Rick Schlesinger about leadership, the changing nature of health care in the United States, and how HCA is finding innovative ways to deliver better patient care at a lower cost.

 

McKinsey: The context seems quite different today than, say, 20 years ago. The pace of change has accelerated, the global economy is increasingly volatile, and there is more disruption across industries. Does today’s environment require greater leadership skills?

Richard Bracken: Although it is a volatile time and the pace of change does seem quicker now, I am hesitant to say that any one operating environment is a tougher test of leadership than another. Of course, business cycles vary, drivers of growth differ over time, and environmental and market-share disruptors are forever present. Importantly, it’s the degree to which these scenarios play out at any given time that defines the leadership skill set required. To me, the important key is to adjust your style and approach to what is required for the situation. Unfortunately, one set of attributes rarely proves to be adequate over a career.

That said, I do think today’s health-care industry presents some particularly unique challenges. At HCA, our starting point for considering any strategic change first must pass a fundamental test: how might such a change affect our ability to provide quality care and service? How well a strategy supports this very first standard significantly influences any action we might take.

McKinsey: Can you elaborate on the leadership skills it takes to meet that challenge?

Richard Bracken: I’m not fond of trying to sum up something as nuanced as leadership skills, but if I had to say what are some of the fundamental attributes of leadership that matter to me, the following would be high on my list.

First, the attitude of the organization toward change is established by the tone set at the top. For me, that means a continued statement, restatement, communication, and validation of the company’s mission and values, which includes reinforcing its culture. This is the CEO’s first and most important job and a clear requirement of leadership. As leaders, we must not only determine the appropriate strategic course but also define how we, as individuals and as an organization, will conduct ourselves. Second, and most obvious, leaders must ensure the development and execution of a clear, well-communicated, and appropriately measured operating plan. Third, effective leaders ensure that the right team, with the right values, is in place to execute the plan and can pivot appropriately when factors change. Fourth, effective leaders show an intellectual flexibility that recognizes there are different ways to achieve goals and objectives within different environments. To me, it is important that environmental and market changes do not modify the company’s, or the executive’s, basic values. And finally, I think a good leader is a problem solver. How an organization deals with problems, failures, and missed opportunities clearly defines an important aspect of its culture.

McKinsey: Given the shifting external environment in health care, how is HCA responding?

Richard Bracken: With regard to current environmental changes in the industry, we believe we are well-positioned to adapt and excel through reliance on certain core strategies—leveraging our size and scale to drive cost efficiencies, using our multimarket positions to test new and innovative ideas, using our collective “operating intellect” to drive best clinical and management practices across the enterprise, and balancing our capital deployment to respond to specific market opportunities. Also, because of the unique size and diversity of our market portfolio, a transitory softness in one geographic market or service area is offset by strength in another. This feature allows us to mitigate market risk and at the same time test new strategies.

Our scale also offers us the flexibility to deploy technology solutions to improve care. One recent example of this is our newly developed clinical-data warehouse, which will provide the basis for a resource that can inform and improve care, support the efficiency of operations, and, we believe, generate growth and new revenue streams.

We have been in development and are in the early stages of harnessing this “big data” resource, which will use our 20 million patient encounters a year to help improve outcomes and support predictive modeling and personalized medicine. While initially the product of all electronic health records, the clinical-data warehouse ultimately is expected to include patient-generated data, as well as data streams from diagnostic devices.

McKinsey: What other big changes may be out there?

Richard Bracken: Our research tells us the consumer is taking a growing and more meaningful interest in the details of his or her care, and that trend is expected to intensify. Generally, the more information we can put at an individual’s disposal—such as condition, treatment, history, cost, options and prognosis—the more effective the patient relationship could be.

For example, we are in the early stages of developing a patient portal, which has the potential to change how patients might participate in their care plans. The portal could centralize an individual’s health-care history, enable the provider to offer suggestions for the personalized care of each patient, and allow for improved communication among the entire care team. So, in the case of an individual who undergoes a knee replacement, for instance, the portal could allow participants to share data and to communicate in a more integrated fashion with regard to aspects of care—pain management, wound care, physical therapy, et cetera. The patient could be an active participant in discussions, which would allow the consumer to take a more dynamic role in his or her advancement. This development could be especially meaningful for patients with ongoing chronic conditions such as diabetes, cancer, or heart disease.

McKinsey: HCA is a complex organization with a large number of individual operating units and a small corporate center. How do you manage that relationship?

Richard Bracken: To begin with, we don’t take the position that corporate leadership in Nashville has all the answers. While certain regulatory standards or other industry requirements dictate a more centralized approach to ensure consistent compliance, we view the collective intellect of our enterprise as one of our most important assets. Our operations people are an integral part of our strategic planning and development. We field-test strategic initiatives so the people who are closest to execution can help shape solutions. By systematically gathering their input—and relying on their collective experience—we build a comprehensive viewpoint. For example, the idea of standardizing the emergency room–treatment process and reducing wait times came from corporate leadership, but the approach, process, and implementation were developed by our clinical and operations personnel. We have had great success in reducing wait times, as well as improving efficiency and the consumer experience.

McKinsey: Given HCA’s scale, how do you as leader stay connected?

Richard Bracken: This is a real issue, and it’s common for CEOs to feel surrounded by people who filter negative information. To get unfiltered information, I’ve found that you must spend significant and quality time in the operations environment. I have an advantage that others may lack. Having been with this company for over 30 years, I know a lot of people across the organization. I get important intelligence directly from them. I can assure you I get very candid input. It is these relationships that can drive a better understanding of a new initiative or identify flaws early in the process.

McKinsey: Any advice for aspiring leaders?

Richard Bracken: First, make sure you’re working in an organization where there is a good fit between your core values and the organization’s values—it will be difficult to be engaged and productive if there is a misalignment. Second, stay focused on delivering in your current position; many otherwise highly capable people are too quick to be thinking about the next promotion. No one likes a team member who is focused on the next opportunity. Also, don’t be intimidated by the tough assignments, the ones others may not want. These are often the places where you can grow and prove yourself. And finally, never forget that taking calculated risks is the mark of a good leader. And once you commit, it’s important never to go at it halfway.

cool, data saving lives, entrepreneurship, healthy habits, quantified self

Step Jockey – real world calorie indicators

  • terrific behavioural intervention
  • funded by UK Dept of Health

http://www.springwise.com/london-begins-labeling-physical-world-calorie-loss-indicators/

London begins labeling the physical world with calorie loss indicators

StepJockey is a project that raises awareness of the benefits of taking the stairs through smart labels that detail how many calories can be lost by climbing them.

alttext

United Kingdom 27th November 2013 in Government, Health & Wellbeing, Life Hacks.
Some people are fitness freaks and some are couch potatoes, but it actually doesn’t require rigorous exercise to stay in good shape. We previously wrote about Coca-Cola’s Work It Out Calculator — which details the small tasks that cancel out the calories in its products — and now the UK’s StepJockey is a project that raises awareness of the health benefits of actions such as taking the stairs, through smart labels that detail how many calories can be lost by climbing them.

Funded by the UK Department of Health, the startup believes that walking up and down stairs, rather than taking an elevator or escalator, can improve cardiovascular fitness and even help people lose weight. StepJockey’s research suggests that stair climbing burns more calories per minute than jogging and even walking down them is more healthy.

The team is currently crowdsourcing data about the country’s stairs, encouraging fans to type in the location of the office building or public staircase they want to measure and count how many steps there are. The site — or free iPhone app for smartphone users — then calculates how many calories are burned by using them. Users can then print off or order posters to hang next to the stairs, giving passersby that extra bit of encouragement to avoid the easy way up. Each poster features a QR code and NFC tag, enabling those with smartphones to log, track and share their calorie burning with friends.

According to StepJockey, the signs were developed using the principles of behavioral science, and tests proved that the nudge to take the stairs improved usage by up to 29 percent in some cases. Are there other aspects of the real world that can be improved with the addition of similar labels, offering useful data and digital interaction?

Website: www.stepjockey.com
Contact: www.stepjockey.com/contact-us

Spotted by Murray Orange, written by Springwise

entrepreneurship, file note, healthcare, healthy habits, policy, rapid learning health systems, research methodology, technology

Healthy life years is the key selling proposition for funding NCD interventions…

Non-communicable disease presents an as-yet, unresolved health research challenge. But they may also lie at the heart of a similarly unresolved intergenerational, macroeconomic challenge.

To date, governments and academics around the world have sat back and carefully observed the epidemic of overweight, obesity, metabolic syndrome and diabetes overtake their communities.

The food industry has aggressively defended its turf, understandably resisting any calls for regulation in the absence of definitive evidence that these interventions will work.

Only the most courageous of politicians would ever embark on the regulation of such a powerful sector in the absence of evidence supporting efforts such as restricting advertising to children, mandating processed food composition, food labeling and taxing macronutrients know to be harmful.

So we find ourselves at an impasse that no one seems particularly able to break.

An emerging theme related to this issue is the idea that while the health system has succeeded in delivering extended life, it has not yet extended healthy life years. As such, the population still shudders at the thought of raising the retirement age past 70, even though average life expectancy now surpasses 80.

Non-communicable disease is considered a major driver of this divergence. As such, preventing non-communicable disease may represent an important challenge, not only driven by a health/moral imperative, but also for important economic reasons.

There are significant macroeconomic consequences of people not living most of their lives in a productive state of health. Most significant of these is the capacity of societies to sustain pensions when boomer-driven demographic shifts result in an increasing ratio of pensioners to tax payers.

This places life insurers, governments and superannuation funds into the medium- to long-term frame as key beneficiaries of addressing non-communicable disease.

This in turn makes them key targets for attracting investment capital to a venture addressing this concern.

Imagine a world where people lived healthy, vital, productive lives well into the 70s.

Too much?

Google have spotted this opportunity by investing $100Ms in a new start up called the California Life Company (CaLiCo). Its initial focus is on “ageing” with an early emphasis on genomics, epigenetics and a pharmaceutical fix.

I starting to think the answer is much simpler: Eat food, not too much, mainly plants. Move.

It’s about less, not more.

Establishing the evidence for this inkling, and then commercialising the insights gained is the inspiration behind Riot Health.

Stand by.

entrepreneurship, storytelling

Forbes: Google Authorship

http://www.forbes.com/sites/netapp/2013/10/14/tiny-disruptive-change/

This One Tiny Change Will Deeply Disrupt Your Business

These days, businesses walk a knife-edge of disruption. Radical changes in your working practices will come from the least expected quarters. David Amerlandoutlines one tiny, yet important, change: You may have missed it, but it has a huge disruptive effect…

Your business totally “gets” the idea that search is marketing. So does Google. But Google also understands that search is a service: In order for it to work, it must be as spam-free as possible.

To achieve this, Google launched an identity-verification initiative calledAuthorship. The basic premise is simple enough: Use the Google+ social network platform to enable members to link their profile to content they’ve written, and so claim its authorship. A thumbnail of their image then appears next to the link description when that content appears in search.

Why Should You Care? 
It’s a small, seemingly cosmetic change in Google’s search, but it’s a catalyst for a huge disruption in the traditional employer/employee relationship.

Why has Google made the change? Because the way we relate to content in search is changing. People looking for information care more about the people who wrote it than a mere faceless link.

A thumbnail image personalizes the results, leads to more clicks, and creates a deeper emotional connection with the end user. It may also lead to the creation of a following for the authors: Online fans of their writing may actively look for what they have written.

Google also favors good writers: Its algorithm checks to see who writes what, and silently assigns a reputation score to them, based on the subjects they write about. This is then further adjusted by another algorithm that follows the complex web of interactions between the writers, their content sharing activity, commenting history, and the commenting and sharing histories of others they have online contact with.

It’s All About The People
In the new Web, people now truly matter.

A well-placed blogger with a strong following can help the company website rise in search and increase its visibility in social networks. Company employees interacting with and helping promote a company blog through social media channels can amplify its brand message and reach—not to mention boosting the company website in search.

Because authorship can only be ascribed to a person and not a company, content authored in company time, using company equipment and under company contract can be claimed by the person who wrote it. This is good for the company.

In multi-author websites, the more of the company’s employees write, the better it is for the company. A company that has strong writers benefits the most.

But this picture hides the seeds of disruption within.

Employees Now Hold The Power
Thanks to search’s digital sleight of hand, the balance of power within the enterprise has now changed.

A company that relies on its employees’ digital presence to amplify its own is no longer in the same position to call the shots the way it did last century. This doesn’t mean that employees can’t be told what to do, but it does mean that there’s a marked shift in alignment between company and employee values.

That shift is convincingly bringing both to the same side of the table:

  • It’s in a company’s best interests to have its staff fully informed and engaged in the development and online promotional of its brand.
  • Invested employees are stakeholders and studies show they feel more responsible, are happier, more productive and feel more in control of their working lives than ever before.

But staff turnover is a constant, so this also raises interesting questions about the impact that staff changes will have on a company’s brand:

  • Will staff members with strong, respected online profiles still be expected to maintain online links from their Google accounts to content they authored for the company after they leave?
  • If so, under what conditions?
  • What happens if the relationship between a company and an employee turns sour?

Work Will Never Be The Same Again
Companies are looking to change their business models to better align their interests with a fast moving market driven by its social customers. So they have to tackle change from the inside first.

Altering the traditional, top-down power dynamic of employer/employee to a more equitable one is a great start: Make sure those within the company share its goals and values. Enable employees to work collectively to achieve those goals.

entrepreneurship, musings

Mentally Strong People: The 13 Things They Avoid

A solid list with no surprises.

Source: http://www.forbes.com/sites/cherylsnappconner/2013/11/18/mentally-strong-people-the-13-things-they-avoid/

Mentally Strong People: The 13 Things They Avoid

For all the time executives spend concerned about physical strength and health, when it comes down to it, mental strength can mean even more. Particularly for entrepreneurs, numerous articles talk about critical characteristics of mental strength—tenacity, “grit,” optimism, and an unfailing ability asForbes contributor David Williams says, to “fail up.”

However, we can also define mental strength by identifying the things mentally strong individuals don’t do. Over the weekend, I was impressed by this list compiled by Amy Morin, a psychotherapist and licensed clinical social worker,  that she shared in LifeHack. It impressed me enough I’d also like to share her list here along with my thoughts on how each of these items is particularly applicable to entrepreneurs.

2. Give Away Their Power. Mentally strong people avoid giving others the power to make them feel inferior or bad. They understand they are in control of their actions and emotions. They know their strength is in their ability to manage the way they respond.

3.    Shy Away from Change. Mentally strong people embrace change and they welcome challenge. Their biggest “fear,” if they have one, is not of the unknown, but of becoming complacent and stagnant. An environment of change and even uncertainty can energize a mentally strong person and bring out their best.

4. Waste Energy on Things They Can’t Control. Mentally strong people don’t complain (much) about bad traffic, lost luggage, or especially about other people, as they recognize that all of these factors are generally beyond their control. In a bad situation, they recognize that the one thing they can always control is their own response and attitude, and they use these attributes well.

5. Worry About Pleasing Others. Know any people pleasers? Or, conversely, people who go out of their way to dis-please others as a way of reinforcing an image of strength? Neither position is a good one. A mentally strong person strives to be kind and fair and to please others where appropriate, but is unafraid to speak up. They are able to withstand the possibility that someone will get upset and will navigate the situation, wherever possible, with grace.

6. Fear Taking Calculated Risks. A mentally strong person is willing to take calculated risks. This is a different thing entirely than jumping headlong into foolish risks. But with mental strength, an individual can weigh the risks and benefits thoroughly, and will fully assess the potential downsides and even the worst-case scenarios before they take action.

7. Dwell on the Past. There is strength in acknowledging the past and especially in acknowledging the things learned from past experiences—but a mentally strong person is able to avoid miring their mental energy in past disappointments or in fantasies of the “glory days” gone by. They invest the majority of their energy in creating an optimal present and future.

8. Make the Same Mistakes Over and Over. We all know the definition of insanity, right? It’s when we take the same actions again and again while hoping for a different and better outcome than we’ve gotten before. A mentally strong person accepts full responsibility for past behavior and is willing to learn from mistakes. Research shows that the ability to be self-reflective in an accurate and productive way is one of the greatest strengths of spectacularly successful executives and entrepreneurs.

9. Resent Other People’s Success. It takes strength of character to feel genuine joy and excitement for other people’s success. Mentally strong people have this ability. They don’t become jealous or resentful when others succeed (although they may take close notes on what the individual did well). They are willing to work hard for their own chances at success, without relying on shortcuts.

10. Give Up After Failure. Every failure is a chance to improve. Even the greatest entrepreneurs are willing to admit that their early efforts invariably brought many failures. Mentally strong people are willing to fail again and again, if necessary, as long as the learning experience from every “failure” can bring them closer to their ultimate goals.

11. Fear Alone Time. Mentally strong people enjoy and even treasure the time they spend alone. They use their downtime to reflect, to plan, and to be productive. Most importantly, they don’t depend on others to shore up their happiness and moods. They can be happy with others, and they can also be happy alone.

12. Feel the World Owes Them Anything. Particularly in the current economy, executives and employees at every level are gaining the realization that the world does not owe them a salary, a benefits package and a comfortable life, regardless of their preparation and schooling. Mentally strong people enter the world prepared to work and succeed on their merits, at every stage of the game.

13. Expect Immediate Results. Whether it’s a workout plan, a nutritional regimen, or starting a business, mentally strong people are “in it for the long haul”. They know better than to expect immediate results. They apply their energy and time in measured doses and they celebrate each milestone and increment of success on the way. They have “staying power.” And they understand that genuine changes take time. Do you have mental strength? Are there elements on this list you need more of? With thanks to Amy Morin, I would like to reinforce my own abilities further in each of these areas today. How about you?

Cheryl Snapp Conner is a frequent speaker and author on reputation and thought leadership topics. You can subscribe to her team’s bi-weekly newsletter, The Snappington Post, here.

cool, data saving lives, entrepreneurship, healthcare, healthy habits, meaning, nutrition, policy, politics, quantified self, rapid learning health systems, research methodology, storytelling

Chronic Disease Fear Factor Ageing Messaging

Governments won’t be able to afford you if you are over 70 and can’t work
You will need to be productive
The current health market can only extend your life, but not your productive life
The new health system will have to do both if we are to preserve our standard of living
Sure, people will need to die sometime, but it’s the when, how and why they die that needs to evolve
This health system aims to deliver on this
Australia is well positioned to lead the world on this
Excitement

data saving lives, entrepreneurship, healthcare, healthy habits, nutrition, policy, politics, rapid learning health systems, research methodology, technology

Katz slam dunks….

  • Used the Harvard Nurses Health Study to develop an algorithm for food healthiness as determined by health outcomes from the study – a GPS for nutrition – CLEVER!
  • Offered to do this with Government in the early 2000s but was knocked back
  • Developed a proprietary algorithm called ONQI, owned by NuVal
  • Choosing higher scoring foods correlates with a lower risk of dying prematurely.
  • “The very government agencies that regulate the food supply are extensively entangled with the entities producing our food, from farm to factory. In comparison, we mere eaters of food have very little clout. The government may be just a little too conflicted on the topic of food to be in the business of putting the truth, the whole truth and nothing but the truth on at-a-glance display.
    Certainly the big food manufacturers, the makers of glow-in-the-dark snackattackables, should NOT be in the business of nutrition guidance whatever their inclination. That approach makes the fox look like a highly qualified security officer for the henhouse.
    Which leaves independent nutrition, and public health experts and private sector innovation. And here we are.
    Private-sector innovation often involves intellectual property, trade secrets and patent applications. It involves some entity making an investment and wanting a return. That is all true of NuVal, for better or worse. It wasn’t my plan – it was just the only way to get this empowering system into the hands of shoppers. Of note, the ONQI remains under the independent control of scientists, and not the business.”
  • This is a terrific strategy – worthy of emulation.

Source: http://health.usnews.com/health-news/blogs/eat-run/2013/06/11/nutrition-guidance-who-needs-to-know-what

Nutrition Guidance: Who Needs to Know What?

  June 11, 2013 

I am writing today about nutrition guidance and who needs to know what to make it useful.

Permit me to disclose right away that I am the principal inventor of the Overall Nutritional Quality Index (ONQI) algorithm, used in NuVal – a nutritional guidance system that stratifies foods from 1 to 100 on the basis of overall nutritional quality: the higher the number, the more nutritious the food. As the Chief Science Officer for NuVal, LLC, I am compensated for my continuous and considerable allocations of time and effort. But it was never supposed to be that way – and the reasons why it is are an important part of this story.

As to why this column now, there are two recent provocations. One is our ongoing work to complete the updated algorithm, ONQI 2.0, and the window that provides into a world of weirder foods than I ever even considered possible. The other is a paper published in the Journal of the Academy of Nutrition and Dietetics a few months back and a more recent exchange of letters related to that article. The article described the advantageous novelties of a nutritional profiling system, such as weighting nutrients for their health effects rather than counting them all the same. But this was less about novelty, and more about NuVal, since the innovations described have long been included in the ONQI.

[See: Debunking Common Nutrition Myths.]

Claims about alleged novelties that were already included in NuVal prompted a letter from my colleagues and me to the journal, which was published along with a response from the original authors. In that response, they acknowledged that the NuVal system included the so-called “novelties” and acknowledged that the ONQI is, to date, the only nutritional profiling system shown to correlate directly with health outcomes. So the real concern, the letter went on, is that the ONQI algorithm is proprietary and the details are not fully in the public domain.

Which brings us back to why NuVal is a private and proprietary system in the first place and whether or not it matters that certain details of the algorithm – which populate 25 pages or so of computer code written in a language called SAS – are not on a billboard. Why isn’t the ONQI public rather than private, and who really needs to know every detail of the algorithm for it to be useful? (All of the nutrients included in it, and the basic approaches used to generate scores, have been published.)

The ONQI, and NuVal, are a private sector innovation because the public sector said: no thanks. In 2003, I was privileged to be a member of a group of 15 academics invited to Washington, D.C. by then-Secretary of Health Tommy Thompson. A Food and Drug Administration task force had been formed to guide efforts related to the control of rampant obesity and diabetes, and we were a part of that effort. We gathered in a conference room with Secretary Thompson, the FDA Commissioner (Mark McClellan) and others, including the surgeon general and the heads of the National Institutes of Health and the Centers for Disease Control and Prevention.

[See: Why Aren’t Americans Healthier?]

We were each given one three-minute turn to offer up one good idea the FDA and other federal agencies might use to help combat the ominoustrends in diabetes and obesity. I used my turn to describe, in essence, the project that later became the ONQI. I suggested that the secretary might convene a totally independent group of top-notch experts in nutrition and public health, perhaps under the auspices of the Institute of Medicine.

The group should have no political or industry entanglements and should be allowed to work for as long as it took to convert the best available nutrition science and knowledge into a guidance system anyone could understand at a glance. I was thinking, in essence, of the equivalent of GPS for nutrition, so that no one trying to identify a better food in any given category would get lost, confused or misled by Madison Avenue.

[See: 10 Things the Food Industry Doesn’t Want You to Know.]

I waited two years for the feds to do something along these lines. When they didn’t, I decided to undertake the project myself, with the backing of Griffin Hospital in Derby, Conn. – a Yale-affiliated, not-for-profit community hospital, which owns the ONQI algorithm to this day. Other than this being a private rather than federal endeavor, all other aspects of the project were just as proposed to the U.S. Secretary of Health. When we completed the algorithm, I offered it again to the FDA. A scientist at the agency recommended a private-sector approach if I hoped to live long enough to see the system do its intended good.

Why didn’t the feds take on the project? We can all conjecture. I suspect it has something to do with the story Marion Nestle told us all in Food Politics, and the stories we routinely hear about the Farm Bill from the likes of Michael Pollan, Mark Bittman and others. The very government agencies that regulate the food supply are extensively entangled with the entities producing our food, from farm to factory. In comparison, we mere eaters of food have very little clout. The government may be just a little too conflicted on the topic of food to be in the business of putting the truth, the whole truth and nothing but the truth on at-a-glance display.

[See: Seeking a More Perfect Food Supply.]

Certainly the big food manufacturers, the makers of glow-in-the-dark snackattackables, should NOT be in the business of nutrition guidance whatever their inclination. That approach makes the fox look like a highly qualified security officer for the henhouse.

Which leaves independent nutrition, and public health experts and private sector innovation. And here we are.

Private-sector innovation often involves intellectual property, trade secrets and patent applications. It involves some entity making an investment and wanting a return. That is all true of NuVal, for better or worse. It wasn’t my plan – it was just the only way to get this empowering system into the hands of shoppers. Of note, the ONQI remains under the independent control of scientists, and not the business.

[See: Mastering the Art of Food Shopping.]

Which leads us back to the second question: Is it a problem for a system like this to be a private-sector innovation? Who, really, needs to know every detail of such an algorithm?

Consider that if you are shopping for a car, you do need to know if it comes with anti-lock brakes or all-wheel drive. But to decide if these are working for you, you don’t need engineering blueprints; you just need to drive in the snow. When shopping for a smartphone, you may want to know if it has GPS. But you don’t need the trigonometry equations on which the GPS is based to determine if it works; you just have to see if it helps you get where you want to go.

Nutrition guidance in general, and NuVal in particular, are just the same. What are the exact formula details? Who cares. We routinely rely on tools based on math and engineering most of us don’t understand – but we don’t need all that input to know if the tools are working for us. We just need the output. We need to be able to use them. People using NuVal have lost more than 100 pounds, and even over 200 pounds. Choosing higher scoring foods correlates with a lower risk of dying prematurely. More than 100,000 scores are on public display in 1,700 supermarkets nationwide. The ONQI is at least as transparent as any car or smartphone or computer.

[See: The No. 1 Skill for Weight Management.]

Let’s acknowledge: If you are reading this on a computer screen, neither of us truly understands the engineering involved in me writing it, using word processing software, attaching it to an email and sending it to my editor at U.S. News & World Report so she could post it in cyberspace, where you found it. But we do know it worked.

We rely on private-sector innovation for a lot of important jobs, and even many that put our safety on the line. The private sector makes our cars and planes. We seem to be comfortable using these without scrutinizing patent applications. The private sector makes our computers, and smartphones and GPS systems, and we can tell whether or not these work, even if we don’t know how.

Why, then, is nutrition guidance different? The answer, I believe, is politics, profits and the inertia of the status quo. We are accustomed to vague nutrition guidance from conflicted sources, and those same sources are apt to imply there is something wrong with private-sector innovation and the intellectual property issues that come along with it. But if those issues don’t undermine the cars, and planes and navigation systems that get us from city to city and coast to coast, it’s not at all clear why they should be a problem when navigating among choices in a supermarket aisle.

[See: The Government’s MyPlate Celebrates Second Birthday.]

As a scientist, and not a businessperson, my preference would be to put the ONQI on a billboard for all the good it would do. But on this, I must defer to the businesspeople who have made the relevant investments and are entitled to safeguard potential returns. As for the scrutiny that all advanced systems should get, the ONQI has been shared with scientists at leading universities and health agencies around the world – but for private assessment and use rather than public display. Others like them who want to review the program need only ask.

We should all care that the military-industrial establishment seems opposed to putting the blunt truth about nutritional quality, as best we know it, on at-a-glance display. We should care that federal authorities responsible for nutrition guidance are also responsible, if only indirectly, for food politics and supply-side profits. That story may lack novelty. It may be old news. But it is nonetheless something everyone who eats does need to know – engineering blueprints not required.

data saving lives, entrepreneurship, facts & data points, healthcare, quantified self, rapid learning health systems, technology

Medical Body Area Network

  • The FCC has proposed the allocation of spectrum for Medical Body Area Network (MBAN) devices.
  • Deloitte expects the wireless health device market to triple in the next few years

From: http://www.fool.com/investing/general/2013/11/17/3-technologies-that-will-change-the-face-of-medici.aspx#!

3. Wireless body monitoring
We need only to listen to the words of FCC chairman Julius Genachowski to get a feel for the potential for wireless body monitoring. Genachowski noted last year that “a monitored hospital patient has a 48% chance of surviving a cardiac arrest,” compared with only 6% for an unmonitored patient.

With the tremendous opportunity for improving health care in mind, the FCC proposed allocating spectrum for Medical Body Area Network, or MBAN, devices. Such devices will record vital signs and other important physical information through sensors attached to a person’s body, with the data transmitted to a local wireless hub. The information can then be monitored remotely by clinical professionals, with alerts sent to let these experts know when medical intervention could be needed.

GE Healthcare (NYSE: GE  ) is one company already developing MBAN devices. The giant company plans to introduce technology using sensors that monitor heart and breathing rates, temperature, and pulse oximetry within the next few years. Deloitte predicts that the wireless body monitoring market could more than triple in just the next couple of years. Within the next decade, this technology could be key in helping control overall medical costs.