Fraud Reduction Could Fund A Chunk Of Healthcare

On February7 we will be discussing Computational Biology at Demo. No doubt we will hear about some potential breakthroughs in healthcare. One thing we know for sure is that new healthcare solutions are costly. How will people afford them? There are many issues associated with this and one of them is the fraud that occurs in today's system. IBM has been working on this area for years and recently introduced their solution in Rockland County, New York. The IBM Verify New York Medicaid claims management program has identified $13M in potentially improper Medicaid billing in just 10% of the cases in just one county in just one state.

For a modest software and consulting fee, IBM used it's powerful supercomputers to do a sophisticated statistical analysis of the billing from the top 10% of Medicaid reimbursed pharmacies and general practice doctors in the county during a 21-month period. Seems like a good target since New York's Medicaid program is the largest in the US, with an annual cost of $44.5 billion -- and rising fast.  Rockland County has more than 41,000 residents who use Medicaid and the county spends about $384 million a year on their care. Initial estimates are that as much as $13 million of the billing may be improper. If this turns out to be the case, the nationwide numbers are in the $billions for sure. The IBM system uses thousands of queries to look for anomalies such as suspiciously large numbers of bills for services on a single day, repetitive or duplicate billing or unusually expensive services. Forty-two percent of the ten percent in Rockland County appeared to have discrepancies.

The project doesn't mean that providers are automatically guilty nor that the money can be quickly recovered but at least it shows the investigators where to look. They have always had the data but with help from IBM they now have the tools. There are obstacles. In New York, the counties are responsible for Medicare but they are not allowed to take action against fraud. Only the state can do that -- but they haven't. The IBM program enables the counties to provide very specific information to the state and press for action to reduce fraud.

The Web Is Getting Ubiquitous

Two important developments in the first month of the year are enabling the web to move a few steps closer to ubiquity. Most mobile phones do not have a web browser -- or if they do have one it likely does not work very well. Generally, the mobile browsing speed has been slow and the displays hard to read because the pages were designed for a PC browser. Those shortcomings have changed dramatically with the introduction of Opera Mini.

The Oslo, Norway based Opera Software has announced the worldwide release of Opera Mini, a full Web browser that runs on almost every mobile phone, including low-end handsets -- in other words you don't need a $500 "Personal Digital Assistant" to get a great browser. This is quite a breakthrough. Trials of Opera Mini in the Nordics and in Germany during the fall of 2005 resulted in a user base of more than one million people. You can get more information and download instructions at the Opera Mini site. For most users, it is as simple as downloading a new ringtone.

Opera Mini was designed with mobile users in mind. "Mini" compresses Web pages by up to 80% and reformats them using an Opera developed technology called Small-Screen Rendering. SSR makes web pages fast loading and easy to read. It can also save money if you are paying your carrier for data "by the byte". On the Mini homepage you will see the familiar Google search box. Mini also has a customizable bookmark list to make it easy to save and surf your favorite sites. If your mobile phone supports EV-DO or WiFi you will find that surfing the web on a handheld device is a very nice experience. Opera Mini is available in English, German, Spanish, French, Russian, Polish, Norwegian, Swedish, Danish, and Finnish. Get the full story at opera.com.

Speaking of WiFi, wireless access points -- known as hotspots -- are continuing to flourish -- as predicted here for a number of years. The number of worldwide hotspots listed in JiWire's online directory has now surpassed 100,000. The growth since a year ago was 87 percent -- from 53,779 hotspots in 93 countries, to 100,335 locations in 115 countries. In spite of the early start, America has only about a third of the hotspots. The top cities are Seoul, Tokyo, London, and Paris. The good news is the growing availability. In spite of lobbying by telecommunications companies to prevent cities from offering free WiFi, and despite predictions that WiFi could not "scale", the growth continues. With the introduction of the new Opera Mini browser, continued price-performance of mobile phones, and the spread of WiFi, we are getting close to the vision of a fast, always-on, everywhere, natural, easy, intelligent, and trusted Internet.

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Internet Technology , Mobile , WiFi January 28, 2006 10:22 AM

Hotel Not On Demand

Some people don't agree with me that we are only 5% of the way into what we can ultimately expect from the Internet, but everyday I see examples that convince me that it is true. Tonight I visited Hilton Hotels online and tried to reserve a room. I got the following user-friendly message....

We're sorry but we are unable to process your login. You may book your reservations without login. Be sure to provide your HHonors account number on the Guest Information form.

I know I have an account and I know the password. I tried various options and finally gave up and called. After multiple "please pay attention because our menus have recently changed" routines I got to a person. She was very nice and informed me that the "servers are down for maintenance every Thursday evening from 9-11 PM". I could try again after 11PM or try again in the morning. What amazed me most was that this person thought that was ok. She has been convinced by the company that this is just how it is. Don't they realize that for two hours customers will just click on "anotherhotel.com"? And don't they realize in California the "maintenance" is closing out customers from 6-8 PM? And that in many parts of Asia, is prime morning time? What could they be thinking? Certainly not about customers and on demand.

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On Demand January 26, 2006 10:34 PM

FutureScan

Demo will be starting two weeks from today. I am looking forward to seeing all the new gadgets, software, hardware and business ideas and catching up with many friends from the press, consultant, and investing communities. The product introductions that take place will reveal key technology trends over the coming 12 to 18 months. A new twist will be added to Demo this year called FutureScan.

Chris Shipley, executive producer of Demo, asked me to moderate two panels to explore the more distant future. The idea behind FutureScan is to find some clues, not about what is hot today or next year, but about the next, next big thing. I'll share my own perspective on the future in the first few minutes of the panels but 90% of my effort will be to help bring out the depth and breadth of the incredibly knowledgeable experts on the panels and facilitate Q&A with the audience.

The first panel will be on the afternoon of February 7th and it will focus on "Computational Biology". Not an everyday topic for most of us, computational biology -- often called bioinformatics -- combines techniques from applied mathematics, informatics, statistics, and computer science to solve problems of life. Some of the topics we will be discussing include genome assembly, protein folding, and perhaps even the modeling of evolution. No doubt we will get some insight about major breakthroughs in health and science, such as personalized medicine. The panelists will be Ajay Royyuru, Senior Manager, Computational Biology Center at IBM Thomas J. Watson Research Center, Colin Hill, CEO, President, & Co-Founder of Gene Network Sciences and Steve Mayo, Associate Professor of Biology and Chemistry in the Divisions of Biology and Chemistry at the California Institute of Technology.

On the following afternoon, the FutureScan panel will explore "The Future of Security". Most of us are aware of current day security threats, but what about down the road? Will the good guys be able to stay ahead of the bad guys? Will we be able to trust the Internet for commerce and communication? Those are the key areas we will discuss. The panelists will be Charles Palmer, manager of the Security, Networking, and Privacy departments at IBM's Thomas J. Watson Research Center and Partha Dasgupta, Associate Professor, Arizona State University, Fulton School of Engineering.

Take a look at the panelists' links and you will see why I am humbled and excited about FutureScan.

Learn more about DEMO

Conferences January 24, 2006 04:10 PM

Music Blues

I have to admit confidence that it would happen -- more than $1 Billion in sales of digital music in 2005. This was triple the year before. People are willing to pay for music if it is offered to them in a contemporary way -- i.e. digital. What were the results of digital music alternatives for the year? According to the Sydney Morning Herald, the chairman and chief executive of the International Federation of the Phonographic Industry, John Kennedy, said that global music retail revenue fell about 2 per cent last year. It was also reported that music piracy was flat. That tells me that if music overall was flat, piracy was flat, and digital music tripled, then "traditional" music is in decline. That should not be a surprise to anyone. If piracy is not the culprit (clearly there is still much of it going on, but not growing), then why are music sales flat? My theory is that the reason there is not enough digital music available is that it is not yet well "packaged" and promoted. Apple is doing a great job of marketing music as evidenced in part by the many Christmas stockings containing iTunes Music Store Cards this year. (I just used mine to buy 25 tracks of Concerti Virtuosi and also the Bruckner 8th Symphony). I continue to believe the core problem is attitude. The industry group calls itself the "International Federation of the Phonographic Industry". Does that give us a clue that they are not keeping up with the times?

P. S. My only problem with iTunes is inter-operability. See iTrike.

Media , Motorcycles , Music January 23, 2006 11:18 AM

Power To The People: Still Not Getting It

Open source and open standards are taking hold, big-time. Web access to numerous public and private services are also growing rapidly. The ability to search, find and link to information of all kinds is truly awesome. In spite of this, there are many companies that still seem to be in the dark.

GarageTek has a great product and appears to be the leader in garage organization systems. I am really happy with their system, except that their tool holder is not very good and their selection of other hanging accessories is limited and what they do have is not available online. Their franchisees are small businesses that only have hours when I don't so it is hard to buy from them. That's one of the key reasons why e-commerce is booming -- people can buy at midnight or six in the morning. I was sure that by now there would be competitive OEM "garagetek" accessories available online and I found some at Sporty's Toolshop but I was not sure they would be compatible. Even though the Sporty's accessories appeared to be compatible, the product specialist could not say because she "never heard of GarageTek". I asked who the manufacturer of their accessories was but they said it was "against their policy to reveal that information".

Knowing I could return them if they did not fit, I ordered a few accessories from Sporty's. They are very nice -- much better than what GarageTek offers. The products came in packaging that said "Suncast" and so I checked out their website. It said

NOTE: To avoid competing with our retailers, we will only sell replacement parts on-line. For a listing of the retailers where you can purchase our product please click on the Find a Retailer link listed above

The link showed a list of "bricks and mortar" retailers with no websites or email addresses. They did not even show Sporty's as one of their retailers even though that is where I had bought the products.

The "bunker" mentality that ignores "power to the people" was understandable ten years ago but at this point the Sporty's and Suncast approaches seem Neanderthal at best. Whether it is manufacturers who are protecting their retailers, governments who regulate wine sales, or wholesalers who protect unjustified layers in the supply chain, demand from consumers on the Internet will ultimately determine the channels of distribution. The businesses that understand that and create an on demand model will be the winners.

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January 18, 2006 04:05 PM

Two New Books

Two new books arrived this week that may be of interest.

Naked Conversation - How Blogs are Changing the Way Businesses Talk with Customers by Robert Scoble and Shel Israel is very timely with all that is going on in the world of blogging. I know Robert from Microsoft. He has been active in evangelizing the potential of blogging and very much practices what he preaches, even when his postings may at times not be consistent with company practices. The book explores how blogging has changed the rules of communication and competition and gives business owners the tools to launch an effective blogging strategy. Robert and Shel interviewed many business leaders including Mark Cuban of the Dallas Mavericks, Bob Lutz from General Motors and Johanthan Schwartz of Sun Microsystems.

Let Go to Grow - Escaping the Commodity Trap by Linda S. Sanford with Dave Taylor is about strategy and management practices. Normally pretty boring stuff, but Linda and Dave have organized the book in a way that makes it flow very nicely. It is all about driving innovation and gaining productivity -- both urgent topics for anyone in a leadership position today. The book explains the concepts of componentization, outsourcing, and off-shoring in a clear but strategic way and then lays out an approach for leveraging the concepts across an enterprise. Practical case studies about Dell, eBay, GE, Procter & Gamble, and Toyota bring it all home. I have known Linda for quite a few years. She has had a number of top-level executive positions in systems, storage, and global sales and is now Senior Vice President of IBM's internal On Demand Transformation and Information Technology initiatives. In addition to being one of IBM's highest-ranking women, she also serves as a member of the Women in Technology International Hall of Fame and the National Association of Engineers. She was named one of the 50 Most Influential Women in Business by Fortune magazine, one of the Top Ten Innovators in the Technology Industry by Information Week, and one of the Ten Most Influential Women in Technology by Working Woman. She is also a nice lady!

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Blogging , Favorites , On Demand , People January 15, 2006 02:22 PM

Open Hopes for 2006

The debate about the OpenDocument format is still underway. See this link for a list of the stories in patrickWeb about it. Bob Sutor over at IBM just posted a very good story called "Open standards, open source, open minds, open opportunities". Rather than repeat or plagiarize it, here is a link to it. It is a worthwhile read about the difference between "open standards" and "open source". He also talks about an "openness movement" that he hopes will take hold in 2006. Me too. Bob will no doubt be discussing this on the SIIA Technology panel which I will be moderating in New York in a few weeks

Upcoming conferences in which I will be participating

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Conferences , Internet Technology , People , Personal Computing January 13, 2006 02:59 PM

Internet Phones

Today's Wall Street Journal story, "Web Phones Go Unplugged", summed it up pretty well. There is a convergence taking place between cell phones and Internet phones. Utopia has not quite arrived but at the Consumer Electronics Show in Las Vegas earlier this month there was a slew of new announcements surrounding Vonage, Skype, and various new handsets. The "ideal" phone is very close.

Imagine that your "cell phone" is on your belt or in your pocket. You are at home. When you make a call, the connection goes through your DSL or Cable Modem over the Internet and through one of the VoIP providers such as Vonage. When the phone "rings", you will hear a voice saying who is calling and if you look at the phone you will see a picture of the person and the person will have a unique "ring" associated with them so you can tell just from the ring. When you get in the car with your Bluetooth headset on, you will be using the same phone that you were using in the house except that phone calls will use the cellular network. When you arrive at the airport, the phone will pick up the free WiFi service being offered and you will once again be able to use Vonage or Skype for unlimited long distance calling.

Some would argue that the environment I have described is already here. There are in fact quite a few products and services available. However, there are a few wrinkles. A seamless 911 system is not quite there. There are still some places you might be that have no reliable signal of any kind. A power failure at home can cut you off from communications if you don't have a good cellular signal or if your phone is dependent on a base station. Some telecommunications providers and airport operators are attempting to block free WiFi services. Finally, some of the devices have so many features that they are hard to adapt to for many people. In spite of the wrinkles, we are getting very close to the point where the Internet is pervasive in our lives for all forms of communications and interactions. I am sure we will see and hear much more about all this at the upcoming DEMO conference.

Other patrickWeb stories about Long Distance

Conferences , Gadgets , Home Automation , Internet Technology , Mobile January 12, 2006 08:29 AM

DEMO Coming

Demo has always been my favorite conference and I am looking forward to the next one -- to be held in Phoenix, February 6-8. The Demo conference allows entrepreneurs to show off new gadgets, software, hardware and business ideas and enables the press, analysts, investors, and technology enthusiasts to assess what they see. The product introductions that take place reveal key technology trends over the coming 12 to 18 months. A new twist will be added to Demo this year that will add a look at the more distant future.

Moderating panels is a way to share one's perspective but more importantly to help bring out the depth and breadth of knowledgeable experts through an interactive conversation plus questions from the moderator and the audience. The new modules to look at "the more distant future" will be called "FutureScan". The idea is to find some clues, not about what’s hot today or next year, but about the next, next, next  big thing. There will be two panels -- one on the afternoon of February 7th and the other one the next afternoon. The topics which the panelists and I will explore are "Computational Biology" and "The Future of Security". In the next few postings I will provide some thoughts about the two topics and also about the distinguished panelists who will be sharing their insights.

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Conferences January 11, 2006 06:29 PM

Miscellany - 01-06-06

Just back from sunny Florida. When we left Palm Beach Gardens on Thursday it was 84 degrees and blue skies. It was a bit cooler when we got to Palm Coast and St. Augustine Beach. There was construction everywhere -- condos, homes, malls, highways, and infrastructure. Seems like a "bubble" is a legitimate concern.

The sky was blue in Connecticut today too but the temperature was only in the high twenties. The Widder electric gloves and vest kept me warm for a short twelve-mile motorcycle ride. The wind chill made it well below freezing.

There is a lot of conference activity coming up in the next few months. I am looking forward to all of it but have a lot of preparation to get ready for the three panels I will be moderating -- one at SIIA and two at Demo. Stay tuned for more about them.

Word (no pun intended) is that Massachusetts is hanging tough with their decision to require the OpenDocument Format. It is shaping up to be a battle of Microsoft versus the people. It is not about Office and it is not about open source. It is about the ownership of documents -- do they belong to the person who created the document or do they belong to the application which created the document? That is the issue.

Opera Software continues to innovate in Web browser technologies. This past week they announced a partnership with Industria, a leading broadband communication solutions provider and IPTV systems integrator in Iceland. This is the tip of the "iceberg" that will accelerate the move toward the use of open Web technology in Television -- the word is already starting to sound old-fashioned.

Many more things in the blog queue to write about. Stay tuned.

Blogging , Conferences , Internet Technology , Media , Motorcycles , Travels January 7, 2006 04:28 PM