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 quite a few affiliations and I get to work with people from whom I am constantly learning. Prior to “e-tirement”, I was vice president of Internet Technology at IBM Corporation. Nearly everything I have ever said or written is here at patrickWeb or in my book, Net Attitude. As of today, the patrickWeb blog contains 1,375 posts. I hope you enjoy reading some of them. Get the email version of patrickWeb if you prefer. Find me on Facebook, Google+, and LinkedIn. Follow me on twitter. You can also find me in Wikipedia.
In August 2008, I had the pleasure to visit Greenland for the Konference Sarfarissoq in Nuuk, the capital of Greenland. The conference was hosted by Tele-Post Greenland, and the focus was the impact of the submarine cable which would soon bring broadband Internet to Greenland. A traditional kayak enabled the symbolic landing. A month after my August visit, the Alcatel cable-laying ship arrived. It brought the trans-Atlantic fiber optic cable to Qaqortoq on Sept. 8th and then to Nuuk on the 11th. It was a milestone event and the citizens of both towns were understandably excited and proud. I am sure they were even more so when the cable got hooked up and the fiber was no longer dark.
Brian Pedersen, then CEO of Tele-Post Greenland, Kaj Egede, the chairman, the mayor, and a cabinet minister received the cable at the shore. The new submarine cable will include four strands of glass, well protected in a multi-layer set of metal and petrol based materials to allow it to survive buried three feet below the bottom of the ocean — in some areas as deep as 10,000 feet below the surface. The four glass fibers will have a capacity of 2 terabits per second. Compared to what the country of Greenland has previously, this was a nearly infinite increase.
The cable is nearly 3,000 miles long and links Greenland to Canada and Iceland. Greenland previously connected to the internet via satellite with slow speeds and at times unreliable service. The fiber broadband link will open new opportunities for Greenland as a hub between North America and Europe. In addition to serving as an alternate route for digital traffic, Greenland’s central location may get the attention of companies building Cloud Computing datacenters. Perhaps the Arctic climate could help keep the servers cool.
Andrew Blum made an excellent speech at TED about how fiber optic cable is similarly being brought to Africa. Andrew’s speech was fascinating to me as he described the physical aspects to the Internet. Many people are not aware of the physical aspect of the Internet. When you click a link on a web page, what happens? Where does the data come from and how does it get from there to your tablet or laptop? Andrew Blum has given this a lot of thought and wrote a book about it called Tubes: A Journey to the Center of the Internet. I added it to my reading list.
Meanwhile, the WSJ reported this week that Foxconn, the contract manufacturer of iPhones for Apple, has upped their production of the new iPhone 5S to 500,000 per day. Imagine that: 20,833 every hour, 347 per minute, an amazing 5.8 supercomputers every second.
￼Thanks to my friend Tony for pointing out that I made a significant typo in the ACA story of last week. I used the word appeal instead of repeal! That has been fixed. My friend Irving has posted a story about the ACA that adds some depth to what I had written. Irving’s post is here and it is a good read.
One of the e-newsletters I look forward to every week is from MedicalAutomation.org. The site describes their mission as filling the need for unbiased information about processes and technologies that can make healthcare more effective, efficient and equitable. Their scope is worldwide. One of the topics that seems to be appearing more frequently in the weekly newsletter is 3D printing. From what I can see, 3D printing is becoming a game changer in many areas, much as the web was 20 years ago, and it surely will be equally disruptive in the world of making things.
This week’s medical automation newsletter features a story about about a man who lost half of his face to cancer, but now can eat and speak again thanks to a 3D implant. As the newsletter pointed out, the video is not for the faint-hearted. The video is here, but if you just want to just read the story, you can find that here.
Speaking of 3D printing, Mediabistro, Inc. had a major announcement today about how they are collaborating with 3DPrintingIndustry.com. It looks like a great match enabling each comp;any to leverage the strengths of the other in this rapidly growing sector. See the press release here.
Disclosure: I am an investor and member of the board at Mediabistro, Inc. (MBIS)
A lot of knowledgeable experts are weighing in with their points of view about went wrong with the launch of healthcare.gov. A project as massive as healthcare.gov can have many possible points of failure. When I first heard that the upcoming October 1 launch, it reminded me of the website my team at IBM built for the Atlanta Olympics of 1996. In 1995, there were not many people who knew a lot about how to build really large websites. The Olympic site was the largest in the world back then and we learned a lot in building it. We were humble about our expectations. We didn’t know how many people would come to the site, when they could come, or what they might do when they got there. We learned many lessons, but I can summarize it in a simple mantra: Think big, start simple, iterate fast. Another way to say it is to take a lot of baby steps. It appears that the direction for healthcare.gov was “think big, start big, avoid failure”. My friend Irving Wladawsky-Berger (see his blog at blog.irvingwb.com) sent me a link to a very thoughtful analysis of what went wrong written by Clay Shirky. Clay is the author of an excellent book called Here Comes Everybody: The Power of Organizing Without Organizations, which I thoroughly enjoyed. In his posting about healthcare.gov, Clay analyzes the planning behind the site, the management system that influenced it, and the interactions of various constituents. If you want to get a better understanding of what happened, I recommend reading Healthcare.gov and the Gulf Between Planning and Reality by Clay Shirky.
November 1995 (edited September 11, 2003, November 23, 2011, and November 22, 2013)
Most of us remember vividly where we were on September 11, 2001. In my case, I was in Danbury, Connecticut in the board room at Bristol Technology meeting with their CEO, Keith Blackwell. Remember where you were when you first heard that President Kennedy was assassinated? (or when Jerry Garcia died if you are too young to remember JFK). Most of us remember major events and exactly where we were at the time — even if it was decades before. Things like that you just don’t forget. But do you remember exactly where you were? I mean the exact latitude and longitude. I didn’t remember exactly where I was when JFK died either; that is until I went back to Lehigh University for my 30th reunion with my handheld GPS receiver and captured the precise coordinates. A nearby building had been torn down and a new one constructed but dead reckoning got me to the exact spot. This might have seemed strange in 1995 when I wrote the first version of this story.
There are so many occasions when time and place get recorded. Auto accidents, package deliveries, construction sites, interviews, meetings and events of all kinds. We capture the time with great precision; e.g. Saturday July 4, 1998 at 2:15 PM. At times, we also record the location: e.g. IBM Corporate headquarters in Armonk, New York. We could be much more precise, however. How about N41° 06.774′, W73° 43.043′ (41 degrees, 6.774 minutes north and 73 degrees, 43.043 minutes west)?
Location (place) awareness has been an integral part of the history of mankind and the development of modern society. We don’t give it much thought, but location and navigation are inextricable parts of how us humans operate. Most of us have a built in ability to find our way around using “dead reckoning”. Since the beginning of time, man has noticed that stars provide a handy reference where landmarks are not available. Polynesians were able to travel great distances to tiny islands using only wind, waves, and the stars with nothing more significant than the width of an outstretched hand or finger. To study navigation and location is to study Columbus, Magellan, Lewis and Clark, Byrd, Armstrong, Aldrin and Collins — Apollo 13′s famous “Earth limb shot”. Not to mention the scientists that made it possible. Galileo, Copernicus, Kepler, Huygens, Fourier, Newton, Morley, Einstein, Marrconi, Mercator, Euler, and Gauss just to name a few!
Trade, commerce and free societies are not possible without location awareness. In a sense it is the very essence of our being. Primarily because of the different availabilities of technology, we were able to have time awareness long before we had location awareness, even though the two are so intimately tied together. New GPS technology closes the gap. (not new now, but new in 1995).
Over time we will start to think of the precision of place as being just as important as the precision of time. Starting with the advent of consumer GPS and into the future, there will be no uncertainty about when and where somebody meant when they refer to location information; especially with the incredible GPS devices such as those from Garmin and Magellan and built into our smartphones. These amazing devices are powerful handheld computers. They capture your precise location very quickly, tell you your speed and direction, store routes and hundreds of waypoints and enable you to back-track over a course to the starting point or points along the way. The advent of smaller and smaller silicon germanium chips has made embedded GPS capabilities a reality. After all, what exactly is the physical makeup of a GPS receiver? They have a microprocessor chip set of some kind, navigation keys, display, and an antenna. Which of these does a cell phone have? How about a camera? Could these non-GPS devices capture a conversation or a picture and supplement that data with a person’s precise lattitude and longitude? With the iPhone and iPhoto, they call it “Places”.
In 1995, I was imagining that every camera would have a GPS capability in it. Now that it has happened, there is no longer a question as to the legitimacy of certain pictures that depict something that was to have happened — whether it is an accident of some kind or a special event. You might even cryptographically sign the picture plus the coordinates with your digital certificate and thereby establish authentication and non-repudiation of the event. Or imagine that you find yourself lost in an unfamiliar city but since you have your smartphone with you with a digital readout, it can point you to the nearest library, ATM machine or hospital. One startup built a mobile phone for Muslims that has a built in pointer to Mecca.
In the 2003 version of this story, I said we were about to enter an age where an explosion of new data is going to be generated. All of it will find its way into databases, Web servers, new applications and be available for user access. This is part of the fast, always on, everywhere, natural, intelligent, easy, and trusted world that is upon us. It may have sounded bold then, but an understatement today.
Epilogue: there are a lot of links in this story. I had fun researching them and I hope they become valuable to at least some of my readers. The accomplishments of the famous referred to are quite amazing and inspiring.
Map of precise spot at Lehigh University at time of JFK assassination
Note: This is an edited version of a story I wrote in 1995. Most of the links should be valid.
￼Of all the nearly 1,400 stories I have posted here at patrickWeb, the one about the Patient Protection and Affordable Care Act (ACA) brought the most feedback. Since healthcare touches all of us in some way and the subject is so broad and deep, it is not surprising that there are many different opinions. Since the feedback came from both sides of the political aisle and different walks of life, I thought it would be of interest to share a sampling of the comments I received.
Well stated. Our nation’s inability to address healthcare as a right of the citizenry is appalling.
I think most doctors would support coverage for everyone but they don’t trust the government—-and unfortunately, the feds haven’t shown lately that they can manage it well!
Unfortunately the issues of morality and politics have become painfully confused.
It is an outrage that anyone would die for lack of access to medical care, but I think everyone should make some form of payment, just like I believe that everyone should pay some level of federal income tax.
The legislation is a mess, and although there are some valuable elements, it was rushed through, and the cost, policy, and practical implications are totally unpredictable.
I think you make a good argument and at a macro level it’s hard to argue with. I think a big part of the problem (at least in terms of fairness) is bolting it on to the current hodgepodge tax structure.
Healthcare is a right, we do it badly, and the ACA is a huge step, albeit flawed and mishandled, in the correct direction.
Jimmy Carter has addressed the moral issue; it seems his comments have largely been ignored.
Thank you for helping me to understand why my insurance is going up 136%!
￼Since I have been studying health care intensely for more than three years, I feel compelled to make some comments about what is going on currently with the Patient Protection and Affordable Care Act (ACA). There is no political agenda to what I have to say. My comments relate to healthcare, not the positions or arguments of political parties. There are many aspects of healthcare that I plan to write about, but for today, just two topics, both with regard to the ACA. Do we need it? Should it be repealed?
Do We Need the ACA?
The United States is the only developed country in the world that does not have universal healthcare, meaning that all citizens have healthcare insurance. I am not referring here to “single payer” — that is a different subject. Germany has universal healthcare coverage and 200+ payers. Canada has universal health operated by 13 provinces. More on that subject later. What I am posing here is a moral question: Do all citizens have the right to healthcare? Some say it is a privilege, not a right, but the developed countries of the world, other than the United States, believe healthcare is a right. All American citizens have a right to vote, a right to free public education, a right to be defended by the military, and a right to be protected by local police. All these rights apply whether you make $20 million per year or $20,000. In countries other than the United States, you would add healthcare to the list of rights. This is a moral question and I have not heard any politicians from either party talk about the subject. One reason for the unending debates about healthcare is that, as a country, we have not come to grips with the basic question of whether citizens have a right to healthcare.
Many citizens and politicians believe that people who lack healthcare insurance get the care they need through emergency departments (ER) of community hospitals. The Committee on the Consequences of Uninsurance at the Institute of Medicine studied the consequences for adults who lack health insurance and released a report called Care Without Coverage: Too Little, Too Late. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. The study focused on roughly 30 million – one in seven – working-age Americans without health insurance. (The number today is at least 50% greater). This study excluded those over 65 who are covered by Medicare and 10 million uninsured children. The main findings, extrapolated to today, show that 25-50,000 people die each year because they do not have healthcare insurance. A person with a serious cancer that was not diagnosed until the pain was significant can go to the ER and then go home with pain killers ultimately to die. Our great nation has a history of unleashing unlimited resources when a number of our citizens are killed by attackers, but we have not been able to establish universal healthcare coverage to prevent tens of thousands from dying every year because of lack of healthcare insurance.
I. Reform of private health insurance, the individual mandate (upheld by the June 2012 U.S. Supreme Court decision that upheld the ACA)., subsidies, guaranteed issue, and employer responsibility
II. Expansion of Medicaid to all low-income Americans made a state option (also upheld by Supreme Court).
III. Reform of the U.S. medical care delivery system and changes to Medicare
IV. Prevention, wellness, and public health initiatives
V. Health workforce initiatives
VI. Fraud and abuse prevention, transparency, and comparative effectiveness research
VII. Creation of a regulatory pathway for marketing and sale of biosimilar drugs
VIII. Community Living Assistance Services and Support (CLASS) - repealed by Congress on January 1, 2013
IX. Revenue measures to pay for about one half the cost of the ACA
X. Amendments to Medicaid and the Indian Health Care Improvement Act
McDonough said that each title description could have ended with the words “and a lot more”. No matter how you look at it, the ACA is the most significant law ever passed that seeks to provide comprehensive health system reform, dwarfing the 1965 law that created Medicare and Medicaid. I am not suggesting that all of these titles are free of error or mischief. No doubt, all of them can and should be improved, but when a politician says we should repeal “it”, I am not sure they know what the “it” is.
While there is plenty of room for improvement, there are some excellent programs in the ACA that are well underway and that are improving patient safety and quality and reducing the cost of healthcare. Do we want to repeal them? In addition to not having made the moral decision to make healthcare a right, there are major issues about how to pay for universal healthcare. One way is through cost savings. If there are 50 million people without healthcare insurance and if the cost of healthcare is $10,000 per person, that would represent $500 billion. That is less than 25% of what the United States spends for healthcare. We spend far more per person for healthcare than the other developed countries who get better health outcomes than we do. I won’t go into it now, but most healthcare economists believe that the waste, redundancy, fraud, and inefficiency of American healthcare is much more than $500 billion. Repealing “it” may be throwing out the baby with the bath water.
I have added a new page to the Hobbies section of patrickWeb. It is about one of my very first hobbies — Ham Radio. The contents of the page are repeated here in the blog. I have had many friends over the years who were hams and with whom I compared notes over the years. These included David Singer, formerly at IBM’s Almaden Research Laboratory, and Bill Machrone, formerly at PC Magazine.
In the late 1950′s and early 1960′s, when I was a teenager, building electronic kits from Heathkit was my favorite hobby (see Anyone Remember Heathkits?). During the Heathkit era which lasted from the late 1940′s through the mid 1980′s, it was possible to build a wide range of things from hi-fi/stereo and ham radio to computers, radio control, and home electronics. Heathkits were first marketed by mail-order, with advertisements appearing in electronics and amateur radio publications such as Popular Electronics, Radio Electronics, CQ and QST (the monthly membership journal of the American Radio Relay League (ARRL). I eagerly awaited the next issue of these magazines to see if Heath had introduced any new kits. Even more exciting was the arrival of a new Heathkit catalog. The largest kit I ever built was the TX-1 “Apache” Ham Transmitter. It had 1,600+ parts in it and I was quite proud to have built it. I kept the Apache for more than 40 years, mostly on a shelf in my basement, but the time finally came in 2013 to put it to rest at the local recycling center.
Terminology (Q Codes)
Although I still have a latent interest Ham Radio, I was most actively involved in this technology as a teenager – chatting with people far away (DXing), experimenting with antenna designs and QRP (operation at reduced power levels), and collecting QSL cards (written verifications in the form of postcards which confirmed contact between other amateur radio operators and myself) from people I talked to on the radio. This was great fun and allowed me to meet people from all walks of life and parts of the world that I had not ever been to.
From the mid ’50s to early ’60s, while living in Salem, New Jersey I was able to collect (and send) hundreds of QSL cards from other operators while making two-way radio contact with distant stations. I initially started collecting these cards in order to participate in the many certificate programs available to amateurs at the time – collecting these cards and saving them was proof that I needed in order to support my claim to the many awards that were available to DXers.
Two examples of QSL cards are shown below. The card on the left is my card which I sent to other operators to confirm contact and which shows my station known as WA2ECU. The card on the right is one that I received from an operator whose station was WV2MUV.
Other than the station codes there are other points worth mentioning about QSL cards.
They request the other party send a QSL (card) in return.
They have a spot for minimal contact info such as date/time known as QSO.
They usually have standard fields for the Receiver used (eg. a DX302), the Antenna used (eg. half wave dipole), the Transmitter used (eg. a GE EF-120), and Remarks.
My QSL Card (Click to enlarge)
QSL Card from U.K. (Click to enlarge)
☛ An extensive collection of QSL cards I received from other ham enthusiasts may also be viewed in the photo gallery.
So, Where is Amateur Radio Today?
Ham radio as a hobby for youth may not be as relevant now as technology has changed dramatically in the last 50 years. The good news though is that Ham radio still lives on for many reasons – including HF contest participation (despite degraded propagation conditions), and emergency communication to name just two. There are also more manufacturers bringing out more rigs than ever before; frequency allocations devoted to ham radio cover more spectrum that at any time in history. Some governments have been allocating more frequency bands to hams. In short, the hobby is flourishing.
The Future of Amateur Radio
The birth of amateur radio as a hobby was a function of the growth of radio frequency (RF) technology. The same could be said for Twitter and other social networking relative to the growth of Internet technologies. Young people (we were once young people) are attracted to what is new; this has never changed. Amateur radio will transition as every other hobby eventually does. This isn’t bad — it simply is just the way it is.
One of the many current myths about healthcare is that “nobody wants to be a doctor” because of the various regulatory and economic restraints in the United States. As a result, some believe, there will be a large deficit of physicians to care for the impending addition of tens of millions of uninsured people. The one thing for certain is that there is a lot of uncertainty surrounding the question. Medscape Today had a very interesting three-minute video by Dr. Eric Topol, author of The Creative Destruction of Medicine, about whether our nation is on the verge of a healthcare provider shortage, or whether clinicians are being phased out by algorithms (Topol, 2013). (Also see Doctor Shortage or Surplus). Another uncertainty is how many uninsured will join the rolls of the insured. The goal of universal healthcare is admirable and important for a wealthy nation, but unfortunately, it appears that it is going to take more time than projected to make it a reality.
Back to the question of physician shortage, are students applying to medical school? Yes, in record numbers. Last year, 48,014 students applied to U.S. medical schools, a 6.1% increase from the previous year. Is it possible that the 20,055 who enrolled care more about taking the Hippocratic Oath, saving lives in the emergency room, and caring for the sick than they do about the politics of the Patient Protection and Affordable Care Act (ACA)? Read the ACA here if you want to know what is in it.
More students enrolled in medical school in 2012-2013 than the previous year despite not being guaranteed a residency position after graduation and the prospect of having enormous debt — $170,000 on average — upon graduation. The medical students take on the debt with no assurance they will be able to earn a sufficient living to pay it off while providing for their families. The real issue is not how many uninsured will get coverage nor whether or not there will be a shortage of physicians. The real issue is whether there will funding for the teaching hospitals of America to provide the residency training that is required before a physician can practice on their own.
There is a long list of things that our Congress legislated but then failed to provide the funding to implement. Medical residency training is one of them. The Balanced Budget Act of 1997 froze funding of graduate medical education at 1996 levels for most teaching hospitals. Teaching hospitals are facing restrictions on their ability to develop or expand new programs, according to the Association of American Medical Colleges (AAMC). The CEO, Darrell Kirch, MD, said that if Congress does not address the funding issue that there could be a serious shortage of physicians across the board.
Home automation is a broad term. I would define it simply as automating things in your home. The age-old and most trivial example is the “automated” coffee pot that is programmed to turn on at a certain time, and when you arrive in the kitchen the coffee is ready. At the other end might be an automated home theater. When you push the “Watch a movie” button in the kitchen, the lighting begins to dim behind you and light up in front of you on your way into the theater. As the screen comes down from the ceiling, the projector rises from a cabinet in front of it. As the projector bulb warms up the lighting in the theater synchronously dims until it is movie time. There is a wide range of things in between these two examples, and any one of them can add a lot of fun and functionality.
Home automation has been one of my hobbies for more than twenty-five years. In the early days it was mostly lighting control using X10 technology from Radio Shack. There was a PC program written by a researcher at IBM’s Almaden Research Center that calculated the precise time of the daily sunset based on the latitude and longitude of your home. At that time, a radio signal rode across the electrical wiring of the house and turned on some exterior lighting. At midnight the lights would turn off. This is all trivial now, but not so in 1987. Since that time I have learned a lot about home automation. After Year 2000 (Y2K), when I began to think about e-tirement from IBM, I also started planning a new “smart home”. Two years later, with the help of a sales engineer from Phoenix Audio Video, electronics contractors, networking and electronics experts, and a programmer, the new home became a smart home at the end of March 2002. Many homes today have lighting and music control with keypads. What I tried to achieve was a higher level of integration — not just music and lighting, but also control of the home theatre (as described earlier), the security system, spa temperature, maintenance of pond water level, single button to close all garage doors or toggle all lights, Christmas wreath lighting control, auto-off of wine cooler compressor during dinner, setting musical scenes for each of 15 audio zones, and the list goes on and on.
The only limitation to what you can automate is the willingness of vendors to provide programming interfaces to their devices. A subtle trend I see emerging is that some vendors like their devices to be proprietary. For example, last summer, I replaced a garage door opener at our Lake house. I asked if they had one that I could control remotely. Yes, they have one, but to use it you have to subscribe to their cloud and get their proprietary app for your smartphone. (I chose a different model that used the good old-fashioned push buttons and then I interfaced that into my Indigo home automation system). The trend I am referring to is the replacement of a dozen remote controls laying around to a dozen separate apps on your smartphone — one for your front door lock, one for your coffee pot, music system, security, etc.
David Strom, a long-time technology colleague and author of the Web Informant, posted a story about how Marshall Rose has tackled the challenge of the Internet of Things. It is a short and very interesting read. David refers back to the day he visited my smarthome nearly ten years ago. The clipart at the beginning of this story is a screenshot of the display that can be found throughout my home and on the iPhone and iPad. See more stories in the home automation section of patrickWeb.