Category Archives: healthcare

complex adaptive systems, data saving lives, entrepreneurship, healthcare, healthy habits, nutrition, quantified self, rapid learning health systems, technology

Lunch date with Dickon

From: Paul Nicolarakis [mailto:paul.nicolarakis@outlook.com]
Sent: Thursday, 24 October 2013 8:09 PM
To: ‘Dickon Smart-Gill’
Subject: RE: Singpaore

Beautifully captured Dickon, and thank you for the eBook (it won’t go anywhere).

References for some of my contributions:

–          Online CBT pioneer: Prof. Helen Christensen/Black Dog Institute > blackdoginstitute.org.au // moodgym etc.

–          Research on protein and satiety in locusts, mice and men > Stephen Simpson

–          The Vitality Group (Sth Africa) – 15 min intro video on front page helpful, similarly 1hr webinar http://www.thevitalitygroup.com/

–          A short White Paper on Health Insurance billing analytics

 

Things we didn’t even get to, but expect to at some stage:

–          Antifragile by Nassim Nicholas Taleb (author of Black Swan) >> totally rocked my world, suspect you might enjoy

–          Very strong case for plant based diet by Michael Greger MD

–          4 Hour Body by Timothy Ferris >> where I started my body hacking journey (slow carbs, protein, cruciferous, blow out, but also stuff on sex etc.)

–          Proteus Digital Health – end to end health monitoring, including blood composition via skin patches (warning: interesting but potential ufero)

–          Scanadu – personal medical tricorder

–          Ginger.io – behavioural health analytics platform

–          Omada Health – evidence-driven, online preventive health programs

–          Eatery by Massive Health – recently acquired by Jawbone, but previously doing some interesting things with diet, analytics and amazon’s mechanical turk  (warning: interesting but potential ufero)

–          Kaggle – data modelling competition platform (I’m mates with its founding chairman)

 

Rough vision for what I want to get going over the next 5 years (from diary post):

Over the next five years, I want to develop a health-generating, outcome-remunerated, scalable, for-profit enterprise dedicated to the effective (i.e. live outcome data and analytics, a la rapid learning health system), efficient (i.e. probably not involving doctors) optimization of population health through the application of mobile-mediated behavioural economics, epigenetics, ubiquitous sensors, real time, predictive analytics and the social determinants of health.

 

 

From: Dickon Smart-Gill [mailto:dickon@outlook.com]
Sent: Thursday, 24 October 2013 7:11 PM
To: ‘Paul Nicolarakis’
Subject: RE: Singpaore

 

Notes from our lunch

 

CBT apps are as effective as face to face with professionals. Mood Gym

 

Body by science – Doug McGuff – high intensity, simple exercises.

 

Eatstop eat attached.  A quick and easy read. I bought it, so please don’t forward it on to others just in case my name is encoded into the pdf somehow.

 

Leangains.com – 16-8 protocol. Obviously this guy is genetically gifted, but the fasting technique works for me too.  The key is ‘never any guilt’ if you mess up one day, simply forget it and try the next day.

 

80/20 rule for weight loss 80% being diet, the 20% being exercise.

 

Vitality – south Africa – interesting model to approach insurance companies.

 

Your potential opportunity with the data analysis for medical insurance claims/fraud. Possibility for the same sales approach that they used in the stock trading world.

 

Cauli dabbed with macadamia oil in an 210 degrees fan oven. Crunchy yet still moistish in the centre. Excellent snack food. I suggested adding turmeric (curcumin) for it’s anti inflammatory characteristics. Though not to modify the taste as that is already in order.

 

Standing desks (we both use them and see the benefits).

 

Feel free to add what I missed.

 

Dickon

 

 

 

 

 

From: Paul Nicolarakis [mailto:paul.nicolarakis@outlook.com]
Sent: Wednesday, 23 October, 2013 7:18 PM
To: ‘Dickon Smart-Gill’
Subject: RE: Singpaore

 

Great. How about 1230 for something meaty at:

 

Royal Mail

2 Finlayson Green

Ascott Raffles Place

 

http://www.ladyironchef.com/2012/12/the-royal-mail-prime-ribs-singapore/

 

 

 

 

From: Dickon Smart-Gill [mailto:dickon@outlook.com]
Sent: Wednesday, 23 October 2013 7:02 PM
To: Paul Nicolarakis
Subject: Re: Singpaore

 

Looking good for lunch. Name the time and place. I’m easy.

Sent from my iPhone
On 23 Oct, 2013, at 15:21, “Paul Nicolarakis” <paul.nicolarakis@outlook.com> wrote:

How are you looking for tomorrow? Any chance of lunch or afternoon instead of evening?

 

 

 

From: Paul Nicolarakis [mailto:paul.nicolarakis@outlook.com]
Sent: Friday, 18 October 2013 10:56 AM
To: ‘Dickon Smart-Gill’
Subject: RE: Singpaore

 

done

 

From: Dickon Smart-Gill [mailto:dickon@outlook.com]
Sent: Thursday, 17 October 2013 12:59 PM
To: Paul Nicolarakis
Subject: Re: Singpaore

 

Pencil in the evening of the 24 th.

Sent from my iPhone
On 17 Oct, 2013, at 8:15, “Paul Nicolarakis” <paul.nicolarakis@outlook.com> wrote:

I’m currently leaving on the 25th Dickon, but may stay longer… shall we try for something on the 24th?

 

Cheers, Paul

 

 

 

From: Dickon Smart-Gill [mailto:dickon@outlook.com]
Sent: Thursday, 17 October 2013 12:01 PM
To: ‘Paul Nicolarakis’
Subject: RE: Singpaore

 

Hi Paul,

 

I’m in Bangkok now.

 

However, on the 24th, 25th 26th, I’m in Singapore.

 

Does that overlap with your travel?

 

Dickon

 

From: Paul Nicolarakis [mailto:paul.nicolarakis@outlook.com]
Sent: Thursday, 17 October, 2013 5:31 AM
To: ‘Dickon Smart-Gill’
Subject: Singpaore

 

Checking in again… will be in Singapore next week, let me know if you’re around for a bevvy. Cheers, Paul

 

 

 

From: Dickon Smart-Gill [mailto:dickon@outlook.com]
Sent: Saturday, 14 September 2013 12:47 PM
To: ‘Paul Nicolarakis’
Subject: RE: g’day

 

I’m in Bangkok right now and will still be in Bangkok on Wednesday.

 

Thanks for the invite, if I were in singapore I would definitely have met up with you.

 

Dickon

 

From: Paul Nicolarakis [mailto:blackfriar@gmail.com]
Sent: Saturday, 14 September, 2013 5:05 AM
To: Dickon Smart-Gill
Subject: g’day

 

Hey Dickon,
Am in town through to Wednesday – would be good to catch up if you’re around?
Cheers, Paul

data saving lives, healthcare, healthy habits, nutrition, policy, rapid learning health systems

futuresupermarkets…

I received this email on Thursday from my local supermarket. Not my local supermarket chain. My local supermarket. It featured personalised in-store specials for what I like to buy.

And so it begins.

Prompted by this development, I just searched for Coles and Health Insurance and came up with this media release from June 2013 announcing a partnership between Medibank Private and Coles whereby you get double flybuy points for buying fruit and vegetables.

And so it has already begun. Sure it is Vitality-lite, but you have to start somewhere. Awesome.

FlybuysCapture

 

content of personalised flybuys email (PDF)

Coles and Medibank Reward Customers for Better Health (PDF)

TripleFlybuys_MedibankGenerationBetter

 

Generation Better Triple Flybuys TVC: http://www.youtube.com/watch?v=Ftq2i9f6PBo

entrepreneurship, healthcare, rapid learning health systems

Paying for clinical performance

This is a decent blog post about the frailties of paying for performance, providing interesting observations on the disabling impact of financial incentives associated with intrinsic motivation in nuanced professional jobs (a la Dan Pink).

It also gives some interesting insights into how the structure of incentives to address cognitive biases like loss aversion to deliver greater impact e.g. paying up front for quality with the possibility of a refund on those payments if the measures are not met.

From the last paragraph: “While health care providers want to help the patient in front of them, they may not feel obligated (or have the incentive) to solve system-level problems stemming from factors they feel are outside their control. One potential solution lies in broader health reform, such as global payment for populations rather than piece-rate bonuses for individual patients. Coupled with public quality reporting, global payment reform has the potential to expand the scope of provider accountability, take advantage of providers’ intrinsic motivation, and improve population health. Such efforts may hold more promise for value improvement in US health care than attempts to exploit providers’ extrinsic motivation through tweaks to fee-for-service payment.”

I think we need to fire up both the clinician’s and patient’s intrinsic motivations to drive real improvements in health. Some sort of clinician involved version of the Vitality Group program.

Doubts About Pay-for-Performance in Health Care – HBR (PDF)