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 1,428 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.
There was no doubt that one day we would wake up to find that a multi-billion dollar e-commerce operation now accepts bitcoin. On July 18, Coinbase reported that Dell.com has become the largest e-commerce merchant to accept bitcoin. See (The Coinbase Blog — Dell.com Partners With Coinbase to Become the Largest Ecommerce Merchant to Accept Bitcoin.) Dell said that the reason they made the decision is that bitcoin offers more flexibility for customers, payments can be made easily from anywhere in the world, and bitcoin offers lower payment processing costs. All true. They expect to offer some product promotions offering a discount if the purchase is made with bitcoin. See Dell.com’s bitcoin payment welcome page. I believe the move by Dell puts pressure on other major online merchants to defend why they do not yet accept bitcoin.
Bitcoin continues to gain momentum. CoinDesk, a global news source for Bitcoin happenings, presented it’s State of Bitcoin Q2 2014 on July 10 at the CoinSummit in London. There are a number of highlights to their report. Bitcoin price has back come back 39% from the end of Q1. The number of stories mentioning Bitcoin in the mainstream media Rose 439%. The all-time bitcoin VC investment has reached $240 million. There are now approximately 63,000 businesses that except Bitcoin and 5.3 million digital wallets exist to pay for things. Larger and more established consumer brands are adopting bitcoin; e.g. Dish, Expedia, Newegg, 1800flowers.com, and others.
Bitcoin now represents 93.4% of total cryptocurrency market cap. Some pundits believe that cryptocurrency is going to take hold, but bitcoin may not be the major player. As written here before, the grass roots is hard to beat, and with 93.4% of the capitalization, it seems clear to me that bitcoin will be the winner, even if there maybe some technically superior alternatives available.
Bitcoin has the potential to disrupt numerous financial services including payment processing, title insurance, deposits, exchange trading, withdrawal and overdraft, escrow, foreign exchange, trust management, float, collections, transfers and wires, and notary. The total revenue of these services exceeds $3 trillion and the market cap of the companies that provide those services is more than a half-trillion. I see major disruptions ahead.
Venture capitalists see significant upside investing in bitcoin. One example is bit pay, which has received $30 million of financing. Here is why: bitpay has more than 30,000 total merchants. As of the beginning of 2014, they were adding more than 1,000 merchants to their network each week and processing $1 million in bitcoin payments every day. During 2013, they processed more than $100 million in Bitcoin payments.
The total venture capital investment in crypto currency startups to date is $240 million. This is approximately equal to the 1995 investment in Internet startups. Developers see bitcoin as a big opportunity also. There are now approximately 340 bitcoin apps for iOS and 250 for Android. The open question is who will dominate the enterprise-level infrastructure for the financial services industry. Will it be IBM, Microsoft, Amazon, or Oracle? Or, will it be Coinbase, Circle, coinplug, or some other startup that most of us have never heard of?
As written here before, I believe some level of regulation for bitcoin would be a good thing. I get flamed every time I say that, but I am quite sure that it is necessary. The second-quarter bitcoin report from CoinDesk says that the regulatory environment is stabilizing and trending toward the positive. Bolivia made Bitcoin illegal in May, while Chinese regulation has slowed, and California legalized Bitcoin in June. I am optimistic.
There are quite a few stories on patrickWeb about the Trike. It was a sad day when I sold it, but I am happy the person who bought it from me on eBay is a fine gentleman, and he and I and a friend of his got acquainted at Billy’s Downtown Diner in Bethlehem, Pennsylvania last summer (see last year’s post about our rendezvous). We planned a “Second Annual Billy’s Diner Breakfast” for today. It turns out that the diner where we had breakfast last year is closed for renovations, but we discovered that Billy has a second restaurant in Allentown, PA. We expanded the group to include my wife plus my brother and his wife. Three Harley-Davidson trikes and my can-am Spyder RT Limited pulled up to Billy’s at 9 a.m.
Bill and George, my new Trike friends, and my brother are kindred spirits, for sure. We had a good time talking about motorcycles, rides, and of course healthcare. I won’t cite any specific ages other than me about to turn 69, but I can say that the sum of the ages at the breakfast table was more than 425 years!
This post would not be complete without a comment or two about Billy’s Downtown Diner. They have an amazing piece of technology that produces great orange juice. They drop oranges in the top and out comes fresh juice. I don’t know where the peels go. When it comes to the food, the menu has something for everyone — unless you have any dietary concerns. If I ate there regularly, I would have qualified as a congestive heart failure patient in my research study! However, I don’t think having Huevos Rancheros once a year will kill me. Ingredients?
Huevos Rancheros: Corn tortilla topped with refried beans, chorizo sausage, melted pepper jack and cheddar cheese with two fried eggs, guacamole and green chiles. Served with Idaho homefries.
The ride back to our lake house in the Pocono mountains was much longer than expected, and the temperature was in the low 90′s. We took the back roads, and things were going great until we ran into a detour at the same time that we went to reserve fuel. The detour was a wild goose chase, and the GPS was as confused as I was. When we found a gas station, my 5-gallon tank took 4.88 gallons. The ride for the day was just shy of 200 miles. I think we all look forward to the “Third Annual Billy’s Downtown Diner Rendezvous”.
Bitcoin continues to gain momentum. There are different estimates of how many merchants accept BTC, but there are thousands. Coindesk said that innovative merchants have been installing bitcoin payment-processing services in their stores and integrating it into their POS and ordering systems. Coindesk points out that bitcoin is a great way for merchants to appeal to tech-savvy customers. Some recent and notable additions to the merchant list include DISH, 1-800-flowers.com, Newegg, Expedia (for hotels), New York Holiday Inn, Digital River, and 1000bulbs.com. Although no commitments were made, eBay CEO John Donahoe said that PayPal “will have to integrate digital currencies”.
On the government front, the U.S. Marshals Service conducted an auction of 30,000 bitcoins that were seized in a raid of Silk Road, an illegal drug operation. The value of BTC was lower the week prior to the auction, perhaps in anticipation that “dumping” 30,000 BTC would depress the price. I did not think so, because there are nearly 13 million BTC in circulation. As suspected the auction went off without a hitch and the price of BTC then rose more than ten percent. Venture capitalist Tim Draper was reported to be the sole winner of the auction. In partnership with a startup named Vaurum, Draper plans to use the BGT as a source for new trading platforms in emerging markets. This should further cement the global role of BTC in countries with unstable currencies. Since the supply of BTC is limited by the bitcoin algorithm, expanded use of BTC should mean the value of BTC will increase.
On the exchange and software front, Coinbase announced that they will be offering bitcoin vaults. Bitcoin wallets are great for day-to-day spending, but storing more significant amount of bitcoin you may be holding as an investment is more suited to the Coinbase Vault, which will add an extra layer of security. I look forward to adding a vault to my Coinbase account.
A number of readers, and the university, have asked me if I would recommend University of Phoenix. It depends. I had searched for an accredited, online, healthcare-related doctoral program. U of P was the best one I could find. The structure of the program, with 25 online courses and three 7-10 day residencies in your choice of Phoenix, Washington, or Atlanta, was well organized and rigorous. I will describe my prior college education and the method of learning at the University of Phoenix, and discuss pros and cons.
I earned an LLB in law in 1971 from LaSalle Extension University (LSEU). LSEU was a nationally accredited private university based in Chicago, Illinois. Courses were delivered by “distance learning”. I read a library of printed law books, wrote assignments with a pen and paper, submitted them by the U.S. Postal Service, and received grades in letters delivered to my physical mail box. I started the courses in 1969 while I was in the U.S. Army, and finished the degree in 1973. (LSEU was founded in 1908, and ceased operations in 1982). An LLB is no longer relevant, but I did learn a lot, and gained respect for today’s lawyers who earn a Doctor of Jurisprudence (J.D.) degree. It is a bit hard to imagine how archaic the LSEU method of learning was compared to what is available today at a massive open online course (MOOC).
I attended “brick and mortar” universities for a bachelor’s degree in electrical engineering at Lehigh University (1967) and a master’s degree in management at the University of South Florida (1971). During my years at these schools, there were no Macs, PCs, iPhones, Android, nor the World Wide Web. The word “device” meant an object, machine, or piece of equipment made for some special purpose. There was no concept of a computer that fit in your pocket or purse. The two universities each had one computer. Lehigh had a GE 225 and USF had an IBM System 360 Model 67. Neither would fit in the house where I am writing this post.
University of Phoenix is predominantly an e-learning school. The online courses are taken at the e-campus. Twenty-five courses taken over 43 months had an average of 15 students in each. The courses were each eight weeks in duration. For most of the course, the first two weeks of the course were dedicated to reading three to five text books, mostly e-books. The professor of a course posted weekly discussion questions that each student answered in an online post. Each student was required to write at a half-dozen posts responding to what other students had written. A weekly paper of 1,500 to 5,000 words served as a basis for the course grade. The most significant benefit of the e-learning environment derives from learning from the other 14 students, some of which had vast personal and professional experience. In the traditional university, 15 students learn from one professor. At the e-campus, I felt that I was learning from one professor and 14 students that had each worked in healthcare for 10-30 years. Like a traditional university, University of Phoenix students and faculty had a bell curve of capability.
Online learning is not for everyone. The learning model is very good, but it requires a significant commitment of time on the part of the student, and support from friends and family. Although the online model offers flexibility, the eight-week courses have deadlines and participation requirements. The text book reading assignments required significant amounts of time. It is hard to take a vacation or a business trip while you are taking a course. Most of the courses have learning team assignments. These require active participation on a timely basis. Many of the students in my cohort held full-time jobs while meeting family and caregiving responsibilities. I marvel at the commitment of many of my fellow learners.
The area of greatest concern during the entire doctoral journey was the administrative and information technology (IT) processes of the university. For a university that has a College of Information Systems and Technology and offers both bachelor’s and master’s degrees in IT, they do not totally practice what I assume they teach. The e-campus is online but rather than utilize contemporary cloud computing approaches, the classes used attachments of Word and PowerPoint documents. When collaborating as part of a “learning team”, it was awkward at best. A typical posting would contain “who has the latest version of the team paper?”
A second admin/IT concern was with the process for submitting and gaining approval of the research dissertation. After the dissertation committee members all approved the draft by January 12, the next step was to submit the dissertation and a half-dozen related documents to a new workflow system at the university called the Editorial Manager. In theory the new system would eliminate email-tag and uncertainty plus provide 24×7 status information. This turned out to be untrue.
A central and essential element of a doctoral program is the dissertation committee. I was fortunate to have an outstanding, supportive, and constructive committee. The chair of the committee was a member of the faculty and was my advisor throughout the process. The other two members of the committee included another faculty member and a medical doctor from the hospital. After my submission of the dissertation on January 12, the committee members were asked to review the manuscript again following a detailed rating scale. They completed their review and approvals on January 14. At that point, the system showed a status of “Under Review”. It remained that way for 45 days. No feedback. No target review completion date. A fourth reviewer had been appointed by the university. The committee members nor myself would know who the reviewer was. An independent review is appropriate and adds integrity to the overall process. However, there was a lack of accountability and no expectation as to how long such a review should take.
After the 45 days, I received an email outlining 16 requested changes to the dissertation. Some were trivial and some were substantive. I spent a week researching the questions raised and editing the document with the requested changes. The committee members then approved the revised dissertation and I submitted it to the Editorial Manger with all the related documents (unchanged) again. Included with the updated dissertation was a change matrix that I used to list each of the 16 requested revisions and an explanation of what changes I had made. The “process” now indicated “Under Review” for a second time. No feedback. No expectations as to how long it would take for the reviewer to look at my changes. It took the three committee members one day. It took the external reviewer 13 days — not hours — days. I am surely not alone in observing that the doctoral dissertation process is not an efficient business process. My tuition was paid in full. I had completed 62 credit hours of academic studies. At this stage, I was powerless and the university was unresponsive. The administrative delay caused me to receive an email from the university that said “According to our records, it appears you may no longer be with University of Phoenix.”
On March 25, I received an email saying that the reviewer had approved the dissertation “with changes”. The six additional changes were reasonable and mostly constructive. Since no resubmission was required, I made the changes and scheduled the oral defense for the following Friday. The purpose of the oral defense was to provide a final checkpoint in the journey — to validate if the doctoral candidate can explain his or her research, conclusions, implications, and recommendations. I made a 26-slide presentation to the committee (by teleconference), which was then followed by a Q&A session. I then dropped out of the conference call to allow the committee to decide: pass, pass with changes, or fail. Ten minutes later, I received a call from the committee chair informing me that the dissertation was accepted without changes. Following that I received an email saying “Congratulations Dr. Patrick! Enjoy your weekend.”
On March 28, the doctoral journey was over – almost. The last step is to get the dissertation published. I uploaded the final approved dissertation on March 28, immediately after the oral defense. It is now July. More on this last step coming in a final doctoral journey posting.
The new library is beautiful and has a leading edge program room for lectures. Approximately 100 people attended. Many people are interested in the future of healthcare. I am planning a new book that I intend to name Health Attitude. I will be launching a website for it this month and will seek input on the matters of most interest to readers.
Ridgefielders are quite proud of their new library, and I am honored to be able to give a talk there. I stopped by the new program room today to check out the audio/video. The room seats 100+, there are multiple high-quality speakers in the ceiling, and the screen is huge. The program manager expects 75+ to attend. I have no idea, but I look forward to it. The library recommends making a reservation, which you can do on their events page.
I was one of the 4,000 people who attended the Inside 3D Printing Conference and Expo at the Javits Convention Center in New York during the first week of April 2014. Although 40% of the population sampled said they had never heard of 3D printing, it is clear from this conference that it is revolutionizing manufacturing, enabling new products, and impacting business processes. One speaker called it an industrial renaissance. Another said that the design-to-manufacturing value chain market opportunity is $35 billion. I think of it as an industrial revolution that will be equal to the impact of the Internet.
I could not resist buying an XYZprintingdaVinci 3D printer to experience the printing renaissance myself. Free shipping from Amazon Prime brought the 50-pound printer to the doorstep in less than 48 hours. The unpacking and setup took less than a half-hour. Unfortunately, there was a problem with printer and I had to return it. Amazon had a replacement printer on the way as soon as I hit the returns link. My first object to print was an XYZ keychain to validate that the printer was working properly. I then printed a die (as in roll the dice) and then a pen and pencil holder. As I write this post, I am printing a toy elephant. You can see all of these items in my Facebook 3-D printing album.
Many find 3-D printing hard to imagine, but when you watch it happening, the concept takes hold. I first saw 3-D printing at IBM Research back in 1992. The machine cost many thousands of dollars. I next saw one in Greenland at a technology conference in 2008, but they have a come a long way since then. XYZprinting is a new company that started in China in 2013 and showed their new da Vinci at the 3D Printing Conference and Expo in April. It is priced at $499. I am pleased with it so far. Printing the toy elephant really shows off the potential. It starts out by printing four single-layer circles and you then watch them become feet. Then legs. After a couple of hours, some under-belly begins to show. The entire printing is scheduled to take 11+ hours. I will take a picture every hour or so and put them in the FB album. After printing a toy elephant for one of my grandchildren, I will focus on more important projects. With the 123D Catch app, you can take pictures of an object from multiple angles and then create a 3-D model, which you then can print. Have a drawer knob that is missing and for which replacements are not available? Just make a new one with pictures from another one. Custom made kitchen or office gadgets, holders, jewelery, vases, artwork, gifts of all kinds. The potential is only limited by your imagination. Visit sites like Thingiverse and you can find a large number of designs to download and print.
Epilogue: After four hours of printing, the elephant trunk turned out to be a mess of spaghetti. I am not sure if the digital model is defective or if the printer is not able to handle the complexity of it. I sent the picture to xyzprinting support and hopefully they will have an answer.
Charles H. Duell, commissioner of the United States patent office in 1899, was quoted as saying “everything that can be invented has been invented.” All os us, and especially patent attorneys, know the quote is far from the truth. One example is the periodic table of chemical elements. When I was born in 1945, the table had 96 entries, with curium being the latest. When I was in chemistry class in 1961, lawrencium was discovered and became #103. No doubt, many believed in 1945 and in 1961 that all the elements had been discovered. Then, earlier this year, atoms of a new super-heavy element #117 were created by scientists in Germany, the temporarily named ununseptium element is on the way to being officially recognized as a member of the periodic table.
Discovery of new things goes far beyond new elements. Scientists from IBM Research have discovered a new class of polymer materials that could potentially transform manufacturing and fabrication in the fields of microelectronics, aerospace, and transportation. By combining high performance computing with synthetic polymer chemistry, the scientists have found materials that are resistant to cracking, are stronger than bone, and have the ability to self-heal to their original shape. The new materials are completely recyclable to their original form.
Perhaps the most amazing materials discovery is graphene. Imagine a material that is one atom thick, can conduct electricity, is 100 times stronger than steel material, and can stop bullets. Some would say that is not possible. Scientists have known about graphene for decades but had not been able to extract the one atom thick, two-dimensional crystal material from graphite. However, the future changed in 2004 when two Russian-born researchers at The University of Manchester in the United Kingdom, Andre Geim and Kostya Novoselov, unraveled the mystery. The two scientists were awarded the Nobel Prize in physics in 2010.
It seems that the possibilities for the use of graphene are infinite. graphene could revolutionize medicine as nanotechnology is beginning to transform the practice of medicine. Scientists at Manchester are predicting breakthroughs for the treatment of cancer and other rare conditions such as Parkinson’s. Because graphene can be used as a membrane to separate liquids, it may have huge benefits for water purification so badly needed in many developing countries. Graphene could make the world a safer place by improving aircraft and automotive technologies. Bulletproof clothing for the defense industry could save many lives. Since graphene conducts electricity, it may revolutionize the development and manufacturing of electronic devices. New forms of paint may be developed that reduce corrosion. Graphene sensors may be able to detect even minute traces of dangerous chemicals. Graphene can absorb light and retain it as energy. Combined with its strength and flexibility, graphene may result in bendable mobile phones and cameras with enormous battery life. Wearable electronics in clothing made from graphene may change how we communicate. These are just a few of the ideas emerging from researchers about the potential of graphene, but the ultimate potential will be limited only by our imagination. See Possibly the biggest technological revolution since the silicon chip for a short video describing some possibilities.
During the open enrollment period for 2014 healthcare insurance a few months ago, my wife and I chose the AARP Medicare Rx Preferred plan offered by United Healthcare, the largest health insurance provider in America. How could we go wrong? UnitedHealthcare is an operating division of UnitedHealth Group, the largest single health carrier in the United States. A United Healthcare unit had been chosen to fix the healthcare.gov website. They are reputed to be a company with the technical expertise to make the health care system run more efficiently. Efficiency is desperately needed in healthcare. How efficient is United Healthcare?
UnitedHealthcare delivers products and services to approximately 70 million Americans. Their network includes 751,609 physicians and health care professionals, 80,000 dentists and 5,629 hospitals, and access to drugs for 13 million people. The company claims that has made significant investments in research and development, technology and business process improvements – nearly $3 billion in the past five years. They say that the investments led to changes that are improving the way care is delivered and administered. I am not impressed with their business processes. After receiving a letter from AARP Member-Advantages (run by UnitedHealthcare), I noticed an error in my address. It was close, but not accurate. I contacted them with the correction. A few weeks later, I received a letter confirming the change. Here are a few observations about the letter:
“Your records have been updated to reflect the address listed below.” Ok, that is good, but they sent the letter to the old address with the mistake in it.
Insured and addressee on the letter showed: Mr John Patrick. No period after Mr
Membership# with no space after the p
The membership # showed ten digits as in 0987654321. My membership card ends with -11, like 098765432-11. The website will not accept the membership # shown in the letter
The first error tells me there is a lack of common sense in their business process when they send an address correction confirmation to the old address. The period and space are nits, but show me their business process lacks attention to detail. In big systems like healthcare.gov, it is little things that can cause big problems. Printing an account # on the letter that is invalid on the web site is not a nit, it is a failure of data integrity.
Three months after enrolling in the United Healthcare AARP MedicareRx Preferred plan, I received their Coupon Payment Book. Yes, a physical paper payment book with printed coupons in it along with 12 envelopes in which to return checks for my monthly premium payment. The last coupon book I can recall was from a bank after I bought my first car in 1967. I cannot remember the last time I wrote a check. My wife also received the same set of coupons and envelopes. This is the digital 21st century, but our nation’s largest healthcare insurance company is using coupon books. They do offer the option of automated deductions of the monthly payments from either the social security payment or by a deduction directly from a checking account.
Many services provide for automatic deductions from your checking account and can be set up online and be activated in minutes if not instantly. Not so with our nation’s largest healthcare insurance company. They require that you fill out a paper form and send it with a check. Then they say, “If you choose a payment method such as deduction from your Social Security benefit check or EFT, it may take up to three months to begin. Continue to mail checks and coupons until you receive a letter from us”.
I do not like to make negative statements on patrickWeb about individual companies, but I must say that I find United Healthcare more than disappointing. As an American citizen and taxpayer, I am embarrassed to receive a coupon book and 12 envelopes in the mail. United Healthcare gave its top executive a compensation package valued at about $13.9 million last year. I am confident he doesn’t write checks and probably doesn’t even know his company is following antiquated practices. Bill Gates once called the major banks “dinosaurs”. I wonder what he would say about this healthcare behemoth. Many people say the government is incompetent and we should turn healthcare administration over to the private sector. If the healthcare insurance leader is using thirty-year old coupon and check technology, do we want to turn administration over to them?
This post is partly a rant, but mostly about a serious issue — the cost of American healthcare. We spend more than two-and-a-half times as much as most developed countries in the world, including relatively rich European countries like France, Sweden and the United Kingdom. There are numerous reasons why our healthcare is so expensive, but, in part, higher costs arise because the U.S. has been slow to adopt progressive information and communications technology to improve the administration of healthcare and to reduce waste. In Sweden, all drug prescriptions are “written” electronically — a message is sent directly from the doctor’s office to the pharmacy. Not only does this cut down on medical errors, it also reduces pharmacist workload. E-prescribing is rolling out in the U.S. also, but adoption has a long way to go.
So much for the rant. What do I recommend? I will be writing much more about this, but, in a nutshell, I believe the best solution is for the government — yes, the government has a role — should mandate payment standards. Hospitals and doctors must adhere to uniform accounting standards to report their financial performance, but they can use whatever electronic medical record system they want, or chose to use none. There are 250+ EMR vendors and they are less than compatible. Germany has 300+ healthcare insurance companies, but they all must comply with certain standards. That is the first part of what we need. Second, healthcare administration should be done at the state level. New York, Ohio, Florida, and Texas are truly different, and they are all large enough (all are much larger than Sweden) to fund and develop efficient information technology systems.
There is obviously much more to this topic and I have other recommendations. Stay tuned.