Thanks for stopping by. My name is John Patrick and Attitude LLC is the name of my company. My activities include writing, speaking, and board service. I am fortunate to have a number of affiliations and I get to work with people from whom I am constantly learning. Prior to “e-tirement”, I was vice president for Internet Technology at IBM Corporation. Nearly everything I have ever said or written is here at patrickWeb or in one of my books, Health Attitude and Net Attitude. My newest book, Health Attitude, was published in March 2015. The book unravels the complexity of American healthcare and outlines technological and attitudinal changes to make our healthcare safer and more affordable. The patrickWeb blog contains more than 1,000 stories about technology, music, motorcycles, travel, business, and healthcare. I hope you enjoy reading them. Please click here to get an email update when there is something new in the blog. You can find me on Facebook, Google+, LinkedIn, and Twitter. You can also find me in Wikipedia. To buy Health Attitude, please click here. Find me on Facebook, Google+, and LinkedIn. Follow me on twitter. You can also find me in Wikipedia.
I had not visited the campus for quite some time. My eight years of service as a member of the College of Engineering advisory board ended a few years ago when I was engulfed in my doctoral journey. The visit this week was to lay the groundwork for a lecture on campus this Fall about Health Attitude. I met with the dean of the engineering college and then visited Kappa Sigma Fraternity where I lived from 1964 to 1967. I was greeted by the Grand Master, the fraternity’s name for the house president. It was a bit hard for me to imagine that I had been the Grand Master in 1965, a mere fifty years ago. Could I possibly be that old? I would rather think of it as being that young.
A few dozen brothers and I gathered in the chapter room of the fraternity house. I gave a brief summary to the brothers about my career since graduating in 1967 and then opened it up for Q&A. I was impressed with the maturity and depth of the questions the students asked. Although they are not active consumers of healthcare, they had insightful questions about the healthcare system. They also probed about the beginnings of the Internet and, in particular, the proper role of government and its ability to read our email. They asked tough questions that have no easy answers. I left the fraternity house with a positive feeling that this new generation of graduates would ask these same tough questions in their impending roles as new employees in government and industry.
One of the topics in Health Attitude that may be the most profound is genomics. The following post is an example.
Beginning in 1990, more than 200 scientists collaborated on a $3-billion project to sequence the roughly 3 billion bases of human DNA. Between 2002 and 2008 the cost to perform the sequencing gradually declined from $100 million to $10 million. The introduction of next generation sequencing technology in 2008 led to a plummeting of the cost over the six years until now, bringing the cost down to a few thousand dollars. See Falling Fast for a comparison of the price drop to Moore’s Law.
Does this mean all of us will be sequencing our genomes? Yes, that is likely, and some will push the envelope even further. Razib Khan decided to sequence the genome of his unborn son, who was later born in early June in California (see How a Geneticist Sequenced His Unborn Son’s Genome, Using Do-It-Yourself Biology Tools). Khan believes our genetic data, and that of our unborn children, belong to us. Physicians and policymakers will not necessarily agree, and many debates will be ignited in the months and years ahead.
Khan said his son turned out to be a “normal kid”. He used publicly available analytics tools to study the 43 gigabytes about his unborn son’s genome. Fortunately, he found nothing alarming or even unusual. But, what if he had found some disturbing news such as that his son would be born with some disability or with a likelihood of some future fatal disease? What actions would he and his wife then decide to take and what ethical issues would arise. I don’t think we know even a small fraction of the issues ahead. However, some things are for certain. The price of sequencing will continue to decline and the availability of big data about us and our children will be commonplace. Read more about this in Health Attitude.
With the power of a supercomputer, the iPhone is going to be the host for a wide range of healthcare-related consumer devices and related apps. The latest comes from a San Diego startup named Cue. The company has developed a compact consumer-oriented device that can detect five biological conditions at a molecular level. This is not a fitness tracker. To the contrary, the compact and simplistic looking device is a mini-laboratory that has been years in the making. With a simple nasal swab and insertion into the Cue device, the biological data is transferred to your iPhone and then compared with data from the Cue cloud to determine recommended dietary or other actions (see Cue health tracker brings molecular-level testing to iOS).
When Cue launches sometime this year, it says it will have five tests available :
The cue can detect the level of C-reactive protein (CRP), a commonly used marker of inflammation. Based on the level of the CRP, a consumer may get suggestions on how to optimize workouts, recovery, and a healthy heart.
Vitamin D, often called the “sunshine vitamin”, is a hormone produced by the body when the skin absorbs sunlight. Cue suggestions might include spending more or less time in the sun to achieve well-balanced health.
Cue says that tracking the detected level of Luteinizing Hormone (LH) is the best tool to determine the ideal time to conceive a child. The device helps you track the LH level as an indicator of fertility trends, and Cue can recommend food choices that are claimed to support fertility. Cue will provide alerts when LH is at an optimum time for conception.
Cue detection of flu can enable getting an early warning that can enable you to see a doctor early and get an appropriate treatment started.
Testosterone is a hormone that is essential for health and well-being as well as the prevention of osteoporosis. Cue claims its recommendations can help you plan exercise, training, and diet that can boost your natural testosterone levels.
The Cue device is expected to retail for $300. It is considered a “consumer health product” at this stage, but the company is hoping for an FDA approval to enable the device to join the growing list of consumer medical devices.
In Health Attitude: Unraveling and Solving the Complexities of Healthcare, I wrote about how people’s attitudes about healthcare are shifting and they are accepting more responsibility for their health. People also are collecting data related to their health. A study about migraine headaches published in Neurology more than a dozen years ago established the principle that keeping notes on one’s health is a good tool for improving it. Tracking one’s health today is becoming a part of our daily lives.
The Pew Research Center’s Internet & American Life Project performs surveys to study the evolution of the Internet, how Americans use the Internet, and how their online activities affect their lives. In a January 2013 report, “Tracking for Health”, Pew Research said 69% of adults keep track of at least one health indicator. The survey of 3,014 adults indicated 60% tracked weight, diet, or exercise. Thirty-three percent tracked blood pressure, sleep patterns, headaches, or other healthcare indicators. Twelve percent tracked a health indicator for a loved one.
Steve Lohr at the New York Times reported how one patient took tracking to the next level. A 26-year-old doctoral student at the Massachusetts Institute of Technology’s Media Lab. Lohr said the student, “Pushed and prodded to get his medical information, collecting an estimated 70 gigabytes of his own patient data.” Lohr said that the student pushed doctors to conduct an MRI and the result was Boston surgeons removed a “cancerous tumor the size of a tennis ball from his brain”. Lohr concluded from his research there is evidence “letting patients see their medical files helps them take better care of themselves, but the medical establishment still resists sharing the data”. See the full story, The Healing Power of Your Own Medical Records. Also, see Steve Lohr’s newest book, Data-Ism.
Health Attitude is here. Get a revealing look at the cultural, attitudinal, and technological barriers holding back the United States from achieving a more affordable, accessible, and effective healthcare system. Read how the inability to share personal healthcare information between hospitals, specialists, and primary care doctors is a major problem. Health Attitude describes how the challenge of increasing collaboration for more effective healthcare is not a technical problem, it is attitudinal. The reliance of the uninsured on expensive emergency care instead of preventive care is not limited by healthcare capabilities, but by the attitude of healthcare policymakers and politicians.
Health Attitude argues we need new attitudes about healthcare to achieve true reform. The vision includes a system focused on patients and using an accountability oriented, fee for value model. Learn how consumer smartphone devices and apps are revolutionizing healthcare and how we relate to our physicians. Health Attitude promotes an attitude that provides incentives for wellness, not sickness.
The Sunday night interview with Mark Walsh and Jonathan Aberman on Sirius XM Progress Channel 127 was a pleasure. They both asked good questions and gave me the opportunity to explain what Health Attitude is about. You can play the 15 minute interview below. Read about Mark and Jonathan and their Left Jab Radio program here.
Mark Walsh, a fellow speaker at the 21st Annual Genesys Partners Venture Dinner this week, will interview me about Health Attitude this evening on SiriusXM Channel 127. The interview will take place at approximately 7:15 PM. The name of Mark’s weekly program is Left Jab. Sirius XM describes the program as “An informative talk show that mixes politics, business and pleasure.” I have no idea what questions he will ask but likely something about the Patient Protection and Affordable Care Act (ACA). I discussed the ACA in my new book, Health Attitude. Click here to watch the short video of Mark Walsh and I.
Mark Walsh, a fellow speaker at the 21st Annual Genesys Partners Venture Dinner this week, will interview me about Health Attitude this evening on SiriusXM Channel 127. The interview will take place at approximately 7:15 PM. The name of Mark’s weekly program is Left Jab. Sirius XM describes the program as “An informative talk show that mixes politics, business and pleasure.” I have no idea what questions he will ask but likely something about the Patient Protection and Affordable Care Act (ACA). I discussed the ACA in my new book, Health Attitude. I will post the interview audio here as soon as it is available.
The 21st Annual Genesys Partners Venture Dinner — Genesys XXI– Tuesday night at the Union League Club in New York included more than 100 invited venture capitalists, investors, journalists, entrepreneurs, and industry executives. As always, Jim Kollegger — CEO of Genesys Partners and one of the pioneers of the information industry — was an elegant master of ceremonies. Jim announced a new conference called Agility First! Forum which was held the following day. He introduced the various collaborators and sponsors, next day panelists at Agility First!, several startup CEO’s, and a few of us who speak at the dinner each year. Following is a synopsis of what I had to say.
Like a broken record, I offered my normal upbeat view of the future of the Internet but prefaced my remarks by asserting that we are still only 10-15% of the way there. In other words, of all the things that could be done on the Internet that would save us time and make our lives better, only 10-15% of them are there. It may sound low, but consider retail e-commerce. Although there has been continuous double-digit growth of retail e-commerce for twenty years, it still represents just 6.5% of total retail.
I observed the total United States retail e-commerce for 2014 came in at $305 billion. This represented 6.5% of total retail sales. One company — Amazon — amassed nearly $90 billion in revenue during the year. Why is retail e-commerce 6.5%, not 25% or more? Much is written about that at patrickWeb and in my book, Net Attitude, but the short answer is that there are still a lot of lame web sites. “Click here for the location of our nearest dealer where you can visit.” or “Call to buy the product you just found.” or “Click here to download this form and fax it to us.” How about healthcare? How is it fairing in terms of exploiting the Internet? If only it could be 5% of the way there! Don’t you love the ubiquitous clipboards at doctor offices where we take a pen and provide a lot of information they already have? In the years ahead, I am hopeful healthcare delivery will operate more like Amazon. I attempted to unravel and solve the complexity of our healthcare system in my new book, just published last week. It is called Health Attitude.
I then offered my view of the status of the Internet and health care. This is one man’s view of the evolution of the Internet including the seven characteristics I discuss every year. The things going on under each characteristic continuously change and Jim asks me once a year to do a thumbnail sketch of my latest thinking. The seven characteristics I discussed are: Fast, Always On, Everywhere, Natural, Intelligent, Easy, and Trusted. I will share my comments on each in the next post.
The 21st Annual Genesys Partners Venture Dinner at the Union League Club in New York included more than 100 invited venture capitalists, investors, journalists, entrepreneurs, and industry executives. Jim Kollegger, CEO of Genesys Partners and host of the dinner asks me each year to offer my view of the status of the Internet and health care. This is one man’s view of the evolution of the Internet including the seven characteristics I discuss every year. The things going on under each characteristic continuously change and in a short dinner speech I hit a few highlights.
Broadband in the U.S. is getting faster, but not cheaper. The FCC has developed rules to preserve Net Neutrality. The concept is not to disallow different pricing for different user demands, but to prevent balkanization of the Internet where an operator and a content company might form an exclusive arrangement that blocks access for others or creates a fast lane that might disadvantage new startups. Verizon sued the FCC and was upheld. However, the Federal judge ruling also validated the FCC’s ability to regulate broadband which it has now announced plans to do. Government regulation is often not a good thing but in this case I trust the FCC more than the telcos and cable operaters.
WiFi is part of the fabric of the world. Gigabit WiFi is here and will provide dramatic performance improvement for office buildings, campuses, and homes. Ultra HD 4K TV will be streaming to multiple large flat panels throughout the home — with no network cables. In healthcare, always on means better care for patients with chronic illness and home healthcare telemonitoring may grow ten-fold over the next few years. The Medical Body Area Network (MBAN) was approved by the FCC and will facilitate wireless healthcare.
In last year’s “Everywhere” I talked about the billion computers (including tablets), one billion cars, one and a half billion televisions, two billion Internet users, and nearly six billion paid cellular subscribers. Last night I talked about 3D printing. It is happening everywhere and having the effect of the industrial revolution. 3D printing touches every segment, but I am most impressed with what is happening in regenerative medicine. Researchers in the U.K. have developed a technique to simultaneously print a scaffold and living stem cells to create human bone tissue. Eventually, any body part will be replaceable.
Social networking continues to be fundamental to healthcare and spawns vertical sites such as patientslikeme.com. Further empowering consumers are sites like zocdoc.com that allow you to make doctor appointments in a simple and useful way. The newly emerging trend is for consumers to perform self-diagnosis. Doctors worry consumers may self-diagnose, then self-prescribe, and possibly self-destruct. However, new techniques such as Isabel can put patients in the loop, gain highly accurate information through differential diagnostic technology, and improve the productivity of doctors. Consumers are now using mHealth devices to measure cholesterol, heart activity, and eventually genomic measures.
The biggest growth of intelligence is occurring in the field of analytics. Exabytes of data are being stored. Analytics will enable businesses to make sense of it, model their business, and continuously adapt to what is going on. IBM’s Watson took on humans on the Jeopardy Show, but what is more interesting is the ability for a primary care physician to call and get a recommendation based on patient data they describe to Watson. Within a couple of seconds Watson will be able to review all relevant medical information in the world and make a useful suggestion. Within 5-10 years, Watson may be available on a smartphone.
This may be the year for TV to get easier. Last year I talked about the three remotes — BlueRay, Cable box, and TV — including 153 buttons. Even a savvy child could not possibly master this impossible user interface. An Apple TV remote has three buttons. Apple is rumored to be announcing new TV Stations available through the Apple TV. Once consumers can get news and sports on their Apple TV or Roku or Amazon Fire TV, millions will cut the cord that has been locking them in to high prices and hundreds of channels most of which are never watched.
There are many dimensions to trust. Can we trust the Internet with our healthcare information. I said we can trust the Internet but not necessarily companies like Anthem that do not properly protect the data. I also talked about Bitcoin. The various nefarious things we hear about related to Bitcoin are about people we can’t trust, not about Bitcoin. With Bitcoin, we are trusting the Internet and cryptography. The evolution of Bitcoin has all the trappings of the web of 1995. The last question posed was whether we can trust our hospitals and doctors and big pharma. That is what Health Attitude is about.