On April 25, I will be speaking at the Constantine S. Macricostas Lecture Series at order levitrabuy levitra onlineWestern Connecticut State University.  The event will be in the state-of-the-art, 122,000-square-foot order viagraorder levitra onlinescience building on the Danbury campus at 181 West Street (see order viagra onlinebuy viagra onlinedirections to the campus). My topic will be about healthcare in the Internet age. The dawn of the Internet age has changed healthcare forever – diagnoses can happen faster, quality and patient safety can be improved, information is more readily searchable, our healthcare providers can more effectively collaborate on our behalf, and our health records are available with the click of a mouse or a tap on our personal digital device. Despite the progress, we haven’t seen anything yet! Internet technology will be having a much larger role in healthcare. Following are some examples of the things I will be talking about on April 25 (see invitation below) at WesConn and at the order cialisgeneric viagraDanbury Area Computer Society (DACS) on May 7. The DACS event will be at the Danbury Hospital auditorium. Both events are open to the public and no rsvp is required. If you are interested in the topic but cannot attend either event, you will find a video of a similar lecture in March order levitrabuy generic levitrahere.

I’m looking forward to discussing these topics and more on April 25. As always, I will learn a lot from the Q&A session. The event will start with a reception at 6 p.m. in the Science Building atrium and then continue at 7 p.m. in Room 125. No RSVP is required. 

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A fellow student in the healthcare doctoral class I am currently taking — Community Health and Epidemiology — posted some thoughts and research about flu vaccinations. His post reminded me of my 2 years, six months, and 22 days in the U.S. Army from 1969 to 1971 during which time I received many vaccinations. (I keep a record of all immunizations in my HealthVault database.) There are many studies on the effectiveness of influenza vaccine, whether various categories of people should have the vaccination, and issues about whether healthcare providers should be required to be vaccinated. The purpose of this post is not about those issues but rather about the development and production of the vaccine. Flu vaccine is a wonderful thing that has saved many lives, but the process of making it using billions of chicken eggs is quite slow and archaic. In a video interview with Dr. Eric Topol, Dr. Craig Venter talks about an innovative new approach to the development of vaccines (E. Topol & Venter, 2013). Venter said that the current process for developing the H1N1 vaccine took many months and the supply was barely adequate to cover healthcare workers. He said that if the H1N1 virus had been as deadly and widespread as some had forecasted that we would have had a very bad situation. Venter describes in the video how vaccines can be developed using synthetic DNA. An email containing data about the DNA of the virus to be protected against can be analyzed and a vaccine recipe for production can be available within 12 hours. Venter says the FDA approval is imminent. As new viruses such as H7N9 and H3N2 emerge, with others predicted to arise, the new approach could become extremely important (E. J. Topol, 2012).

References

Topol, E., & Venter, C. (2013). Venter and Topol on the true revolution in medicine. Medscape Today. Retrieved from http://www.medscape.com/viewarticle/780324

Topol, E. J. (2012). The creative destruction of medicine : How the digital revolution will create better health care. New York: Basic Books.

The Hammock Dunes Bicycle Club members call themselves “Folks on Spokes”. The Sunday morning weather in Palm Coast, Florida was perfect and eight of us enjoyed a 30-mile ride. We always stop for breakfast–75% or so of the way through the ride–and have a good time socializing. We talk about technology, healthcare, politics, bicycling, and other topics. This time breakfast was at the Oceanside Beach Bar & Grill. They have nice outdoor seating and the service and food are excellent. Shortly after sitting down, a young man stopped by the table to say that he had been trying to talk his father into taking up riding and he asked if he could take our picture to provide some marketing material for his mission. He probably described us as “Old folks on spokes”.

One of our spokespersons said that we were all 80 years old and that we normally ride 35 miles per day. Slight exaggeration on both counts! As we got talking about age, everybody volunteered their number and I was pleased to learn that I will no longer be chided for being the youngest of the group. It turns out that one member will turn 68 in November, three months after me. The more relevant part about ages is that the leader of the group is 75, the oldest, and I find it hard to keep up with him.  

A friend and I took a follow-up 20-mile ride the next morning. I felt wiped out from the Sunday ride, but somehow found the energy to endure the ride, although completely expended. While riding on a boardwalk on the Lehigh trail in Palm Coast, we saw a large alligator who must have been expended also. Another rider said she had been watching for an hour and the alligator had not moved a muscle. See alligator picture.

It has been 31 months since my decision in August 2010 to begin a doctoral journey. I have now completed 80% of the academic coursework and have learned a lot from 20 courses — most of them 8 weeks in duration — and writing 75 papers. I am currently studying Population Health and Epidemiology.  After that concludes in May, there will be four more courses: Evaluation of Healthcare Programs, Contemporary Leadership Issues, and a Doctoral Seminar. The doctor of health administration program includes three “residencies”. These take place in one of several locations and involve an intensive week of study with faculty and students from your cohort. I chose Atlanta for my residencies and I have completed all three. The third residency, which ended in November, was 100% focused on the development of a research proposal that ultimately becomes the first three chapters of the doctoral dissertation. 

I have been an Internet advocate for 21 years. My basic tenet has been that the Internet provides “power to the people” and one of the many areas in which this is true is education. Whether it is computer assisted instruction, e-learning, distance learning, or the latest craze of massive open online courses (MOOCs), the concept is the same—to enable people anywhere in the world to learn what they want to learn, when they want to learn it, and use whatever device they want to learn it on. While evangelizing the power of the on-line environment, I also embrace the validity and need for meeting in person. There is no substitute for what occurred in the third doctoral seminar Atlanta. Webcams and various forms of virtual reality can enhance an on-line experience, but no virtual capability can replicate the emotion behind the learning shared by students in the class. We all shared a passion for the Scholar-Practitioner-Leader model, and we challenged each other’s proposals, which was a huge benefit to all of us.

The largest challenge standing between the doctoral students and graduation is the dissertation.  The goal that every learner shares is to develop a research proposal, get it approved, complete the research, and complete the doctoral dissertation. Some say that at least half of doctoral learners never complete their dissertation because of the incredible detail required to get a topic developed and approved for research. A typical dissertation is 200-300 pages in length. Some consider the process more than challenging – a friend of mine told me he completed all of his coursework and received an ABD degree – all but dissertation. A visit to Amazon can reveal many books on how to “survive” a dissertation. I still remember the meeting with the academic review committee when I had to defend my masters thesis forty years ago. It seemed challenging at the time, but I can now say that it was minor compared to what lies ahead for the doctoral dissertation.

On April 25, I will be speaking at the Constantine S. Macricostas Lecture Series at Western Connecticut State University.  The event will be in the state-of-the-art, 122,000-square-foot science building on the Danbury campus at 181 West Street (see directions to the campus). My topic will be about healthcare in the Internet age. The dawn of the Internet age has changed healthcare forever – diagnoses can happen faster, quality and patient safety can be improved, information is more readily searchable, our healthcare providers can more effectively collaborate on our behalf, and our health records are available with the click of a mouse or a tap on our personal digital device. Despite the progress, we haven’t seen anything yet! Internet technology will be having a much larger role in healthcare. Following are some examples of the things I will be talking about on April 25.

I’m looking forward to discussing these topics and more on April 25. As always, I will learn a lot from the Q&A session. The event will start with a reception at 6 p.m. in the Science Building atrium and then continue at 7 p.m. in Room 125. No RSVP is required. 

I had the privilege of participating in the Markley Data Center Summit in Boston last month. The topic of my keynote presentation was The Future of Healthcare and the Internet. I wrote a guest post about the topic which is posted on the Markley Cloud Services Blog. The post is an overview of what I see ahead in the field of healthcare. I am generally optimistic about healthcare, but there are many healthcare challenges in the United States. The cost of care is not the only challenge, but certainly a big one.  For example, see 21 graphs that show America’s health-care prices are ludicrous from the Washington Post.

The Markley event was well attended despite a cold and snowy day. There were 300-400 attendees.  After lunch I participated on a panel along with several information technology experts, including my son Aaron. You can see a video of the panel discussion below, or at Cloud Strategies to Manage Your Business Efficiently. 2013 Markley Data Center Summit on Vimeo.

Thanks to David Gee for adding me to the alphaWorks group on Facebook. I am honored to be a member. I searched through the past 17 years of my blog and found a lot of references to aW. Perhaps the most meaningful is one from 2006 when I had attended the tenth anniversary of alphaWorks. I added to the post a section from my book, Net Attitude, where I wrote about the origin and vision shared by the team. The post is athttp://patrickweb.com/2006/09/25/alphaworks/ Andrew Morbitzer should be added to the group. He is the one that made the aW website happen with no budget. Elan Freydenson did the Domino coding and should also be invited. As soon as I post this, I will invite them both. At another time, I will post where the name alphaWorks came from and my conversation with Lou Gerstner about it. The following paragrpahs are the post from 2006.

There have been several stories here about alphaWorks. Today is a special day as IBM celebrates the tenth anniversary of the program. It was an honor for me to be part of the event in San Francisco. I made some remarks today about why and how alphaWorks was created but I decided to go further here and republish part of a chapter of my book, Net Attitude, where I gave some background on what alphaWorks is all about. It was part of a bigger subject called “Organizing to get things done”. Today we might call it collaborative innovation.

From Net Attitude (Perseus Publishing), November 2001

The most important ingredients to accomplishing great things as an e-business are to find, attract, recruit, hire, motivate, and retain really great people. Every year the crop of students gets better so you have to continually raise the bar — look at every movement of staff and ask yourself if you are improving your hand. Everyone has to not only bring something to the table but bring unique value to the overall equation. When things are working right the whole organization breeds and feeds on itself. If the caliber of your team is high, there’s a much greater likelihood of being able to attract additional high caliber people. Once you have them it is critical to nurture and support Net Attitude and to have creative programs to take advantage of their skills.

Every CEO I spoke to during the 1990’2 wanted to know how to make e-business web projects go faster. Every CIO I have met worries about e-business web projects going too fast. The CIO has spent decades getting information technology under control and making it reliable. Fast moving projects are sometimes in conflict with that goal. The solution to the dilemma is multifaceted but one key element is to have a “Skunk Works” where rapid prototyping is the modus operandi.

The Skunk Works

As far as I can tell, the origin of the term Skunk Works was at the Lockheed Corporation. For over a half century, the Skunk Works built a reputation that is unique in the world. Almost routinely, this elite group has created breakthrough technologies and landmark aircraft that redefined the possibilities of flight.

The Skunk Works was created to design and develop the P-80 Shooting Star, America’s first production jet aircraft. Since then they have created a string of firsts. In the 1950′s was the U-2, which to this day defines the possibilities of high-altitude jet aircraft. Then there was the SR-71 Blackbird which, with its titanium airframe is still the fastest jet aircraft in the world. The F-117A Stealth Fighter, which incorporated low-observable technology into an operational attack aircraft, created a revolution in military warfare. Its capabilities were demonstrated dramatically in combat during the Gulf War.

The company, now Lockheed Martin, says the key has been to “identify the best individual talents in aviation, blend and equip them with every tool needed, then provide complete creative freedom so they may arrive at an optimum solution in short order.” This simple formula is highly effective not only for creating state of the art aviation but also for any kind of corporate endeavor.

Lockheed Martin Skunk Works continues to serve as a wellspring of innovation for the entire organization and as they build advanced aerospace prototypes, and contribute to technology research and systems development. Lockheed Martin says this happens because they are “not big on titles or protocol – just getting the job done, regularly meeting schedules on time and under budget.”

The Skunk Works got its name from the “Skonk Works” of Al Capp’s L’il Abner comic strip, where they had a hidden still in a secluded hollow. The name still fits, because exciting things continue to “brew” there.

Small teams with maximum freedom of action

Product development is typically managed in a very structured organization with multiple levels of management and a lot of controls. This can be effective in many cases and is probably necessary for extraordinarily complex projects like putting a man on the moon but this approach will likely not bring any breakthroughs. The Skunk Works uses a different model.

Small teams with maximum freedom of action, very flat management structure, and minimal controls can lead to breakthrough ideas – if the people are allowed to work below the radar tracking level of the larger bureaucracy.

(Small teams of really top people are also more productive, and have more fun, than a significantly larger team.) Skunk Works are also good at figuring out what key problems there are in existing systems — because the Skunk Works members have no vested interest in the success or failure of those systems. They can often solve problems that the larger organization can’t solve because the larger organization is too close to the origins of the problem. It is usually best to let the Skunk Works figure out what things they should work on as opposed to “assigning” problems or projects to them. Problems the organization thinks are most important may not be optimal ones for the Skunk Works to invest in.

The formal requirements processes typically used to determine what should be developed don’t always anticipate some of the most profound issues and problems. The Skunk Works often just stumbles into profound things if you trust them and give them freedom of action. The instant messaging system being used by over 200,000 people at IBM did not come about because anybody asked for it or because a strategic planning or requirements process called it out. A few Internet software engineers stumbled into it, tried it out, built a prototype, and then nurtured it. In a couple of years it became an indispensable application for the company.

A subtle but critically important element in a successful Skunk Works is executive support, or “air cover”. There needs to be a well respected and highly placed executive who trusts the “lunatics” who are out on the edge.

At times the executive will be scared to death that a project the Skunk Works is pursuing will fail, but has to have the nerve to place a bet on it and trust the team to come through. Visiting the team late at night or on a weekend, bringing pizza and soda, showing that he or she cares and has a clue about what the team is working on, even if they don’t really understand the details, are critical ingredients. The little touches motivate the team beyond belief.

Impedance matching

One of the biggest challenges with a Skunk Works is figuring out how to take the prototypes developed by a small team with a “just enough is good enough” mentality and integrate it with a more disciplined development process of the larger organization. In effect you have a tiny gear spinning at high speed trying to synchronize with a much larger and slower turning gear. One approach to solving this dilemma is to use an “impedance” matcher. Think of it as placing a third in-between-sized gear between the small one and the large one. Rather than a gear, of course, it is a small group of people whose mission is to adapt the prototype to the standards of the larger organization. Their focus is not developing it but rather adapting it, smoothing over the rough edges, and getting it into good enough condition that the larger organization will look at it and say it is good enough to be adopted and taken to market or put into production. The result is a speed to market that is a little slower than pure prototype but much faster than the full-blown process. Without the impedance matcher the larger organization is more likely to view the prototype as a virus and seek to eradicate it.

Fail and fail often

A successful organization has to be willing to have projects that are going to fail. A process designed to keep failures from happening is antithetical to a Net Attitude for innovation. But you need to be able to declare a failure, move on, and not punish the participants for being assigned to (or even creating) the failure. A good process encourages people to submit ideas into the mill as quickly and as often as possible and allow others downstream to figure out which ideas are worth pursuing further. There should be no penalty for putting in an idea that gets rated “close – no action required”.

Skunk Works are a vehicle for developing new things, or for bringing alternative ideas forward – they are not a universal answer to all problems of innovation. For Skunk Works to succeed, the company at some point may have to be cannibalistic. Children that come to life through the Skunk Works have to be able to eat their parents. In many companies there are countless examples of brilliant ideas and technologies that came to life in Skunk Works fashion but were then squashed by the mainstream part of the company. These same innovations are often successful when they are brought to market outside of the company.

alphaWorks

There are a number of Skunk Works scattered around IBM Research laboratories and other parts of the company. One thing they have in common is the challenge of finding a path to market for some of their ideas which have no clear destiny. During an early 1996 visit to one IBM’s Research laboratories, Irving Wladawsky-Berger, then general manager of IBM’s Internet Division, noticed a particularly interesting streaming audio technology that had potential use for Internet applications. In fact he saw numerous technologies that seemed to have potential. While the technologies were quite impressive, there was no clear “business case” to take them to the market. Irving asked me to figure out how to reinvent the process of getting these research-phase (often referred to as “alpha”) technologies out of the lab and into the market. I thought about it all that weekend and then it hit me like a ton of bricks — all the bells and whistles went off in my head. Put these technologies on a website and offer them as free downloads and let the market tell us what they think the technologies are good for. We could put basic legal protections in place, create an easy mechanism for feedback, and perhaps even build a community around these early stage technologies. Without much planning, reviews, or analysis, we decided to implement alphaWorks quickly.

There were a lot of questions. Aren’t we giving up control of the technology? How about if someone takes our idea and turns it into a big business? By putting great technologies on the Internet for anyone to download, are we giving up intellectual property and will we later regret it? Yes, it is surely giving up some control but we believed there was more upside than downside. The technology candidates for alphaWorks were in some sense “orphans”. If the business case was clear for them they would be adopted by a product line of business and would be developed into products.

These orphans seemed to be brilliant ideas but the application for them was not clear. If a lot of people download them and find them useful we will get feedback on what they found them useful for. This could help us go the next step toward product development. If nobody downloads them or the feedback is negative we could kill the project and redeploy the resources to other more fruitful areas.

There was no formal organization; it would just evolve. That is how most important ideas flourish. If there is conviction in the idea, just do it, don’t’ study it. Don’t focus on who reports to whom. Just focus on getting something into the market and then let the market tell you what is good and what isn’t. If the idea takes hold you can build a more formal organization later — organization can kill an entrepreneurial idea if it is formalized too early.

A full-blown web site for alphaWorks was built in weeks. A couple of college interns who didn’t know things like this were supposed to be hard created a very impressive site. The legal team created a very simple agreement that said that if someone downloaded our technology they could do whatever they wanted to with it – except sell it. A process was put in place to enable IBM researchers to introduce one of their technologies onto alphaWorks.

Executive “air cover” was in place and alphaWorks came to life – downloads started happening and feedback started to pour in. Outside-in.

alphaWorks morphed from a site for “cool orphan technologies” to an effective way to surface emerging technologies and create paths to market for them. A community of hundreds of thousands of early adopters, entrepreneurs and innovators emerged that provided “headlights” to enable the company to see how people are thinking about the technologies, what challenges they face, and what features and support they would like to have.

As a byproduct of reaching out and forming a community the company received positive press coverage and was able to build mind share about its technology.

Ten years later alphaWorks is thriving and innovating and reinventing itself.

Paper currency was invented in Massachusetts in 1690 and the wallet was invented to have a place to store and carry the cash. Barney Garcia said that wallets today are more often used for carrying credit cards. In the near future, we may not need traditional leather wallets at all.  The e-wallet or digital wallet is not a new idea, and there are multiple players working to make the transition from leather to digital happen.  

The good news is that the competition between the banks, credit card companies, telecommunications providers, and technology companies may result in multiple choices for consumers.  The potentially bad news is that some of them may join forces to form exclusive deals that reduce consumer choice and add new fees to the mix. With four trillion dollars of retail sales in the U.S. alone, even a small percentage of each transaction can be quite lucrative. One model of the e-wallet that I particularly like is the Apple Passbook.

Rather than describe the technology, I will share how I setup my and have been using the Passbook app as a digital wallet.  The Passbook is an app that comes with the latest version of the iPhone software (iOS 6). You don’t have to install it — it is part of the suite of apps that comes with the iPhone such as the calendar, phone, contacts, etc.  The Passbook can contain airline boarding passes, movie tickets, Target or Walgreen sale coupons, and numerous other items to come.  The one I use the most is the Starbucks card.  I was never a fan of Starbucks until the Passbook came along.  I have to admit that there is some kind of technology gratification associated with the process of buying a cup of cafe misto.

For complete details with screenshots and photos, see Jason Cipriani’s excellent “how to” article.  The following is my summary of the process.  The first step is to buy a Starbucks card at one of their stores. It can be for whatever amount you want.  If you have $6.86 in your pocket, you can buy a $6.86 Starbucks card.  Install the  Starbucks app on your iPhone and when you launch it, the app will ask you if you want to add your Starbucks card to Passbook. After you tap OK, you can set your favorite Starbucks location, which will then appear on your lock screen whenever you enter the store and the iPhone will put your new electronic Starbucks card at your fingertips.  After you have entered your Starbucks card number, the app will give you the option to add your card to your Passbook.  The best part is that you can link your credit card to the Starbucks pass and set a threshold for replenishment.  For example, when your balance goes below $10, you can have an additional $20 automatically added to your Starbucks pass.  Using your new Starbucks pass is a breeze. 

When you get close to the store, your lock screen will show an alert.  You swipe the alert and your Starbucks pass will appear.  You place your order with the barista, and then let them scan your pass just like they would with a plastic card.  That’s it!  I think Apple and Starbucks are doing this in exactly the right way.  It is simple to setup and simpler still to use.  There are no extra fees.  The only shortcoming I have seen is that some locations do not yet have the Square software for their payment system.  The company owned stores do, but some of the franchised locations do not.  One of the franchised stores at Orlando airport does not have the software yet, but takes your iPhone and keys in the card number.  Whether it is keyed in or scanned, the balance displayed on the Starbucks pass gets updated after a transaction.

As near field communication (NFC) becomes more prevalent, the Passbook process will get even simpler.  Assuming the next iPhone has NFC, you will be able to pay for your purchases by just placing your iPhone within a few inches of the cash register.  In the meantime, the scanning approach works fine, just as it does for scanning your boarding passes.  

One of the many things that attracts people to Florida is Bike Week in Daytona Beach.  The weather was not ideal today, with no sun shining, but nevertheless, it was a nice 30-mile motorcycle  ride on the FatBoy.  We stopped for a salad at The Black Sheep in Ormond Beach — one of the many “welcome bikers” establishments which were geared up for the deluge of hundreds of thousands of bikes and riders. 

Daytona’s Bike Week is an annual motorcycle event and rally that attracts approximately 500,000 people from all over the country.  I suspect it would be hard to find a non-conflicted estimator of the size of the crowd, but it is very large.  The 10-day event includes motorcycle racing, concerts, parties, street festivals, and of course a huge presence of vendors selling everything imaginable — and some things unimaginable.  Bike Week is a model when it comes to diversity. You will see people old and young, tall and short, slim and obese, well-clothed and barely clothed, long hair, pony tails, short hair, flat tops, and no hair. There are many couples — last year there were reported to be more than 100 weddings that took place on bikes during the event.  Some bikes are painted with pagan and satanic images, but among the vendor booths are some that pass out “biker Bibles” and others that offer Christian counseling. Speaking of counseling, the biker attornies have a strong presence for both plaintifs and defendants.

Harley-Davidson is to the Bike Week crowd as the iPad is to the tablet computer market — dominant. Every model and color the company makes were present, but of course the hallmark of a Harley is the customization performed by or for the owners. With my normal disclosure that I am a poor photographer, there are a couple of dozen pictures from today here on Facebook. What makes a person a biker? There are as many reasons as there are bikes. For me, it is an enjoyable hobby wherein you see places you don’t notice when driving a car,  and you   meet some very interesting people.

I always get the question from someone who learns I am a rider, “Do you wear a helmet?”. The answer is yes. The three states that I hang out in — Connecticut, Florida, and Pennsylvania — all have no helmet law. Pennsylvania had a helmet law and repealed it. The motorcycling lobby is a strong one. The argument is that helmets obstruct your vision and hearing. I think there is an element of truth to that but it is incontrovertible that falling off of a bike without a helmet is dangerous to your head. There have been a number of scholarly peer-reviewed journal articles that reflect considerable research on the subject. There is no doubt that lack of a helmet is tied to increased mortality. The key from my perspective is to take it as a fact that motorcycling is dangerous and to ride defensively. Assume that a car at a cross intersection does not see you and will pull out in front of you. I believe in the slogan “Ride to live and live to ride”.

On the way home we took the scenic ride along the Old Dixie Highway. The original Dixie Highway was part of the National Auto Trail system, first planned in 1914 to connect the U.S. Midwest with the Southern United States. In total, it is nearly 6,000 miles of segments. The stretch from Ormond Beach to Daytona Beach is quite scenic with a cathedral of overhanging moss and live oak trees.

In a couple of weeks, I will be a guest speaker at the Markley Data Center Summit 2013, sharing some thoughts about the future of healthcare and the Internet. The Internet has changed healthcare forever – diagnoses can happen faster, quality and patient safety can be improved, information is more readily searchable, our healthcare providers can more effectively collaborate on our behalf, and our health records are available with the click of a mouse or a tap on our personal digital device. I highlighted some of the things I will be discussing at the Markley event in a guest posting on the Markley Cloud Service Blog.