The Rolltop Laptop

If you have not yet seen the video of the Rolltop computer, click here, and I guarantee you wil be impressed, as I was. The amazing concept came from a team of Germans with backgrounds in areas of IT, design and business administration who share a vision regarding the future of portable computers. They started to work on the concept in 2009, and finalized it after just a few months of intensive work. It started out as a vision to be shared, but the response was so overwhelming that they decided to start a project aimed toward actual development of the concept. There is more than a dream behind the concept — see the details. The team is now looking for a partner to turn the design concept into reality.

Tags: design, gadget, german, innovation, laptop, portable computer, rolltop

Kindle Books Overtake Paperback Books

TechCrunch reported that Kindle Books Overtake Paperback Books To Become Amazon’s Most Popular Format. Last July Amazon’s Kindle eReader books had surpassed hardcover books in terms of sales, selling 143 Kindle books for every 100 hardcover books. Paperbacks have now also fallen behind with the Kindle selling 115 books for every 100 paperbacks. Hardcover books are now half of Kindle e-books, and there are now more than 800,000 e-books to choose from.

iPad stories on patrickWeb
Other gadget related stories on patrickWeb

Tags: amazon, books, ipad, Kindle

DACS.19

On April 5th, the Danbury Area Computer Society held it’s monthly meeting and it was my honor to give a talk about The Future of the Internet. (This was the nineteenth year in a row that I have done this). The meeting was open to the public and took place in the auditorium at Danbury Hospital. Rob Limbaugh wrote a review of the evening that appears below.

DACS General Meeting
April 5, 2011
Meeting Review:
John Patrick ‘Future of the Internet’

By Rob Limbaugh

JOHN PATRICK WAS BACK for his 19th year which coincides with the launch of ThinkPad.

In this time, the Internet has grown to adolescence. Expectations rise every day due to the new things that can be done. It’s still all about the power of the click, but we’re only 10% of the way there because so many sites are still ”lame”. For example, you search for a part for your old refrigerator. You finally locate the part, click to buy, but when you enter the zip code, you find it’s not available and you are redirected to a dealer that may or may not have a website or even be in business.

The internet is squeezing out the ‘old’ with new ways to connect people to things or information. It took Steve Jobs to figure out how to make money in the digital music industry. Digital book publishing has not learned from those lessons. Printed material has become a failing business model because people in that business don’t like to spend money. Hollywood chose a defensive approach to digital movie media and is now being picked away by digital media distribution companies that have embraced new delivery methods.

Retail sales last year were $4 trillion. Of that, 3.9% were e-commerce ($165 billion). 21% of that was solely Amazon. A merger of healthcare and the Internet is underway. The healthcare industry is about 30 years behind manufacturing in adopting digital methodology. The latest strides are led by the realization that healthcare is about patient data. Eventually healthcare IT will be bigger than all of IT as we know it today.

Here’s an example of how things are changing. The illegible prescriptions we are all used to are a thing of the past. A digital e-prescription is sent directly from your doctor to the pharmacy, where it will be ready for pickup when you arrive. Along the way it is compared with your other prescriptions and assessed for possible reactions or concerns. If any are found, the system alerts both your doctor and pharmacist.

The ”Patient Centered Medical Home” is an up-and-coming term based on the philosophy that medical practitioners work with you. Efforts in healthcare reform and  Health Information Exchanges are building blocks that are thrusting these changes forward. Monitoring sensor devices are becoming smaller and smaller and wireless which ushers in the ability to have a home monitoring system that can send an alert if your blood pressure or other critical statistics are out of range. Tools like the iPad are helping to bridge the communication gap between doctor and patient. There are now specialized apps that enable the doctor and patient to view anatomical illustrations  to help the doctor explain a diagnosis and treatment.

John reports that the US Government has generally been a progressive factor for the Internet. So far Congress and the FCC have resisted the temptation to regulate the Internet. A good example of government innovative is the e-file system to electronically file your income tax return. The Obama administration is the first time there has been a Chief Information Officer in the White House. For another innovation, take a look at data.gov to see how much data has been released to the public. There are even tools to search the Meta data to help find the data you need.

Today our schools and libraries are in a renaissance. Libraries are expanding to add programs, and  computers rather than just books. Libraries have become a new resource center for people out of work. Lifelong learning and homeschooling are being used via the Internet. Adults and seniors can take courses online. Unfortunately, not everything is rosy. Digital speeds in the U.S., particularly in homes, is lagging behind much of the world because we do not have enough competition. John defines Net Neutrality as providing equal access to all Internet resources no matter who is providing the connection . Exclusivity contracts between content sources and the carriers threaten Net Neutrality by restricting access to content or services based upon the Internet service provider being used. An example would be if you could access content from Disney only through a Comcast connection. This is a bad idea, and John calls it the ‘Balkanization of the Internet’. TV is changing. Instead of watching shows when they are broadcast on some particular channel, you can watch them when you want to watch them.

The connected home and appliances promise a future where the repairman shows up to replace a worn part of your refrigerator because the refrigerator sent an alert to the manufacturer reporting the problem. John showed examples of how thermostats for our furnace and air conditioning have become smarter. The more sophisticated units can automatically adjust heating and cooling based on the season and your work schedule. Soon you will be able to control your heating and cooling while you are away from home so your house will be just right when you arrive home. The cloud is becoming the always-connected solution to portable storage and access to applications. The “new” tablet form factor does not replace other computers (yet) but does provide a means to do many things that do not require the full power of a computer. It’s an ‘intelligent window’ to web content. Phones and tablets with cameras are bridging distances between people with video chat.

Data security, privacy, and integrity constantly present new challenges as threats change. Overall security is good,  but the bar always has to be raised. Privacy is a larger issue because young people “over share” on social sites which are now used by employers to determine the character of a potential employee. Young people often do not understand the differences between ‘personal’, ‘private’, and ‘public’.

In closing, John’s advice for businesses is to ‘think outside in’ and be sure to ‘think big, act bold, start simple, iterate fast’.
Everyone can keep up with John via his website and blog at www.patrickweb.com. Also take a look at his newest endeavor, the Health Discussions Forum at www.healthdiscussions.net.

Tags: dacs, Healthcare, ipad, john patrick

Back to DACS – 2011

On April 5th, the Danbury Area Computer Society will hold it’s monthly meeting and it will be my honor to give a talk (at 7:45PM) about The Future of the Internet. (This will be the nineteenth year in a row that I have done this). The meeting will be open to the public and will take place in the auditorium at Danbury Hospital. The talk will be an update on how the next generation of the Internet is unfolding and how it will affect our personal and professional lives. I will discuss recent developments that are fueling the rapid evolution of the Internet and enabling nearly two billion people to experience a Net that is fast, always on, everywhere, natural, intelligent, easy, and trusted. The potential for information technology to improve healthcare will also be discussed. There is a Program Preview by Richard DiFranco on the DACS homepage. I will also be discussing the new iPad 2.

Tags: dacs, Healthcare, ipad, john patrick

The iPad Is Tops With Doctors

Bertha Coombs at CNBC reported that there are two things Dr. Larry Nathanson can’t work without when he’s on duty in the emergency ward: his stethoscope and his iPad. Early adopting physicians have been embracing the iPad since day one and now the trial stage has moved to a rush. Not only can a doctor scroll his or her list of patients to be visited, but they can also share information with patients. Dr. Henry Feldman, a surgeon at Boston’s Beth Israel Deaconess Medical Center, told Coombs that when it comes to treating surgical patients, being able to pull up diagrams and x-rays at their bedside has been a real game changer. Feldman said that he has been told more than once “That’s the first time I’ve understood my disease”.

Does this mean that Apple will dominate healthcare tablet computing like they do music? What about the Blackberry and Android and the many other tablet entries? The market is certainly large enough for a lot of players but Apple has some distinct and relevant advantages including ease of use and a vetting by Apple before apps are made available. CNBC reported that in February, four out of five doctors surveyed by health marketing company Aptilon said they planned to buy an iPad this year. The major push by healthcare information technology currently is on the electronic medical record. This is in part because the federal government has declared this to be “meaningful use” of IT and has put billions of dollars of incentives in place to accelerate adoption.

I see a major shift ahead similar to what happened 30 years ago when enterprises were focused on solidifying their mainframe computer applications but department chiefs wanted their own solutions and they opted for local area networks of PCs. It took chief information officers a couple of decades to regain control of IT.

Dr. John Halamka, chief information officer at B.I. Deaconess, summed it up for CNBC. “I would call this a perfect storm for medicine,” he said . “You have alignment of funding; a cultural change where doctors want to use devices to improve quality; you also have new devices and new software that is much easier to use.” One of the big unknowns is how federal regulators will respond to the grass-roots demand. There are many questions to be answered. If a doctor takes a picture of a patient with the iPad, does that make the iPad a medical diagnostic device? A similar set of questions were raised in the field of aviation but the demand from pilots was so strong that the FAA found a way to certify the iPad for paperless flight charts. The FDA has already cleared a handful of apps for the iPhone and iPad including a remote patient cardiology monitoring system and a radiology app for reading of medical images.

It is common knowledge that errors are made in healthcare and patients can be harmed. A major contributing factor is imperfect information communication. Can a handheld device such as the iPad improve communications. There is no doubt about it when it comes to patient interaction. The missing link is connecting the iPad to the “backend”. For music the backend is iTunes. For healthcare the backend will be the health information exchanges that are springing up around the country. When that linkage is made, the iPad will become the window into our health and be a tool for improved outcomes. The sooner the better.

Other healthcare stories at patrickWeb
Other healthcare stories at Health Discussions Forum

Tags: apple, cardiology, emergency medicine, Healthcare, hospital, ipad, radiology, surgery, tablet

iPad 2 Launched

The iPad 2 announcement was mostly as expected. Ordering it at 7 AM this morning was also as expected — easy, fast, pleasant, enticing for extra goodies, followed by immediate and precise confirming communications from Apple. The order status shows: Ships: 5 – 7 business days and Delivers: Mar 22 – Mar 29. I ran into a friend at lunch who ordered around noon and his confirmation showed April 8, so that implies a large backlog already created. Not surprising. I have heard many people say that the iPad 2 will cause them to order because of the cameras for FaceTime. I agree with them — that is going to be a really great feature of the iPad 2. I can’t wait to see my grandchildren on it. Not a substitute for seeing them in person but a great experience in between visits. I read today that a manufacturer of private aircraft is including an iPad with each airplane that will include the POH (pilot operating handbook) and all documentation associated with the plane. This is just one of many thousands of ways that the tablet computer will integrate with our business and personal lives. Even if the price was the same, who would want to buy an airplane and get a PC included with all the documentation? Nobody. It would never be considered. There are many implications of tablets. One of them is that physical media is history — disks, tapes, diskettes, CDs, DVDs, USB memory sticks, external hard drives, etc. When you combine an iPad with Dropbox you have it all — a powerful computer connected to the Internet and a cloud computing repository that will sync all of your data between the iPad, the iPhone, your Mac, your PC, Windows, Linux, whatever. Although Bill Gates’ PC is moving toward history, he was right when he envisioned information at your fingertips!

Tags: apple, cloud computing, dropbox, facetime, gates, ipad, ipad 2, pc, tablet

Batteries that Breath and Holographic Phone Calls

For many years IBM developed a ten year outlook every year and proudly presented it to executives inside and outside of the company. The TYO was a high-level glimpse into the future of technology. About ten years ago the TYO was stopped because the pace of technology evolution had reached the stage where the future that far out became very difficult to predict. As Yogi Berra said, “The future isn’t what it used to be.” Not that IBM is any less focused on creating the future. The company earned 4,186 U.S. patents in 2008, becoming the first company ever to earn more than 4,000 U.S. patents in a single year. IBM’s 2008 patent issuances exceed those of Microsoft, Hewlett-Packard, Oracle, Apple, EMC, Accenture and Google — combined. IBM now issues a five-year forecast annually of five specific technology shifts that 3,000 of its researchers see coming. The International Business Times reported briefly on IBM’s “Next Five in Five” list of five innovations expected over the next five years.

3-D images will not be limited to action movies on TV. A cell-phone call from a friend may be accompanied by a 3-D image of your friend. Videoconferencing is already gaining a lot of traction but when they can be conducted through holographic cameras that fit into cell phones, the virtual reality will become much closer to real reality.
Advances in transistors and battery technology will accelerate — potentially allowing electronic devices to function without charging 10 times longer than currently. Today’s lithium-ion batteries could be replaced by batteries “that use the air we breath to react with energy-dense metal, eliminating a key inhibitor to longer lasting batteries,” IBM said. The amount of energy needed by electronic circuits may be reduced to such a degree that a modest amount of physical motion may create sufficient energy to power them. Wrist watches exist that have no batteries and get their energy from movement of our wrists. Within five years, the same concept may be used to charge mobile phones.
Personalized commutes are another advancement seen by IBM scientists. New mathematical models and predictive analytics technologies will produce the best routes for daily travel. The models will take into consideration the patterns of travelers and various conditions to predict where traffic congestion is going to occur and then give you the fastest and safest route to your destination.
Human beings will also increasingly become “walking sensors,” IBM said. Within five years, sensors in your phone, your car, your wallet plus your texts and tweets will create data that will give scientists a real-time picture of the environment around you. A whole class of ‘citizen scientists’ will emerge using their sensors to create massive data sets for research. The result will be more effective efforts to fight global warming, save endangered species and track invasive plants or animals that threaten ecosystems around the world.
Finally, IBM said, scientists will find better ways to recycle heat and energy from the huge data centers that power the millions of web sites around the world. Up to 50 percent of the energy consumed by data centers goes toward cooling air. Most of the heat extracted is then wasted because it is just dumped into the atmosphere. New technologies, such as novel on-chip water-cooling systems developed by IBM will provide heat for buildings in the winter and air condition them in the summer.

They were not mentioned in IBM’s “Next Five in Five” list, but the company is making large investments in multiple dimensions of healthcare. Breakthroughs are a certainty and technology will play a major role in containing healthcare cost while improving outcomes for patients. Stay tuned at healthdiscussions.net for updates on this topic.

Tags: batteries, data center, energy, green, hologram, holographic, hvac, IBM, research, traffic

Home Monitoring

My mother lived to just weeks short of 90. During the first 89 1/2 years she had a good quality of life, but during the last six months it was very difficult for her and her family. Having spent a lot of time with her between the assisted living home and the hospital, I learned a lot about healthcare for patients with chronic heart failure.  For those over 65, somewhere between 6 and 10% have CHF and the estimated annual expenditure for their care and treatment is $35 billion.

A typical scenario would be for an 89 year old person to enter the emergency department with shortness of breath. After a few hours or more in the ED the patient is admitted to the cardiac care unit. The patient is taking a dozen or so medications which are changed by the hospitalist to conform to the hospital formulary. After a week of tests, fluid infusion, and monitoring, the patient is ready to be discharged back to a nursing or assisted living home. The goal is to have the primary care physician see the patient within a week to make sure he or she is on track to stable health. The patient is confused about the new medications they have been discharged with and the appointment with the PCP may or may not happen in a week. Things go fine for a few weeks and then it is back to the ED and a readmission to the hospital. Repeat.

There are many long term solutions involving diet, exercise, and medications, but in the meantime there are millions of people with CHF who will likely follow the scenario above. Is it possible that using home monitoring can have a positive impact on quality of life and reduced healthcare expenditures? The jury is out. Research studies are underway at distinguished medical centers around the country. The idea is that by monitoring weight, blood oxygen, blood pressure and some basic questions like “How do you feel today?”, “Did you take your medications?”, etc., a stream of data is created every day that may be predictive of what is ahead. A recent study by Yale and reviewed in the New England Journal of Medicine concluded there was no difference in outcomes between those under monitoring and those not. I read the study and found that my idea of “monitoring” is different than what their study used. Although many experts were involved in the study, the data collection was done by the patients calling an automated telephone service and entering data. That is not monitoring from my perspective. Apparently it wasn’t for some of the patients in the study either because many did not enter their data.

Major companies including GE, Intel, IBM, and others are putting millions of dollars into research and development in the telemedicine market. I visited a lady in Connecticut that was being monitored by equipment provided by the Visiting Nurses Association. It was basically a PC with plug-in measuring devices. Each day the patient interacts with the PC and answers a couple of dozen questions in addition to providing weight O2, and blood pressure measurements. What struck me about the visit was not the technology but the social aspects of the process. The lady was “attached” to the PC — not technically but emotionally. She was taking responsibility for her health. She had previously been called a “frequent flier” by people at the ED. Now she doesn’t visit so often. Maybe she fears being away from her PC? The PC had become her buddy. It was Facebook to her. Some studies have shown that a person being monitored will fess up to having had a fall which they would not have told a nurse about for fear of being told they would have to go to the ED to be checked.

The data collected by the PC is sent through a dial-up telephone connection to a monitoring center, much like an alarm center. I can envision vast improviements to the system being used today. Instead of a big clunky PC how about something the size of an iPhone? O2, blood pressure cuff, and scale all connected by wireless. Data transmitted via broadband in realtime. Data going to a patient-centered medical home facility where a resident scans the data rather it going to an alarm center. Supercomputer analytics being applied to the data to look for patterns between weight, O2, blood pressure, and answers to various questions with the result being a prediction of fluid buildup that will lead to problems in 6 days unless the intake of diuretics is increased by 50% for ten days. Compared to the monitoring and predictions that are made by NASA for a spacecraft, the monitoring and predictions made for CHF patients is archaic. Skeptics say that there are too many factors involved and that only a doctor can make sense of them. I have the utmost respect for physicians but I also know, as sure as I can spell my name, that a few years from now we will be asking why it took so many years to realize that complications of various chronic diseases are in fact related to data that is collectible and very nicely subject to sophisticated analytics which can improve the quality of life and dramatically lower cost.

Milt Freudenheim at the New York Times summarizes many of the issues with home monitoring in his story Wired Up at Home to Monitor Illnesses. It is an excellent story that I can highly recommend reading.

Tags: chf, chronic heart failure, ge, health care, Healthcare, home monitoring, hospital, IBM, intel, telemedecine

The Future of the Web

The Demo conference two weeks ago was in Santa Clara, not San Diego. Sorry for the error — Demo has often been in San Diego, but not this time. My last posting summarized what the event is all about and mentioned a few companies that launched there. In addition to the excitement of seeing so many enthusiastic start-ups I gained some new insight at the conference as well. Executive Producer Matt Marshall made some brief but profound comments in his opening talk. The content was not really new but he pulled together and nicely summarized the big picture of where things are headed (See more about his talk at DemoBeat. In a nutshell Matt said the future of the web is evolving around social networking, mobile, and cloud computing.

All three of these topics are written about throughout this blog but I truly gained some new perspective on them at Demo. I have often said that social networking is not about eleven-year old kids on MySpace. It is more about grown-ups looking for jobs, hunting for people to hire, or collaborating on a new venture. The new ingredient is e-commerce integrated with social networking. People can buy what their friends are buying and can offer help to a colleague who wants to know how a particular product works or might fit into their environment. More broadly speaking, social networking is finding its way into every web application, not just a separate application of its own.

The mobile Internet is booming as we can all witness from the massive press coverage about every new phone, phone rumor and network pricing change. The new trend I observed at Demo is that startup companies showed off their new application and pointed out that in addition to the mobile app, the data from it can also be viewed from a PC or Mac. That is a 180 degree flip since a year ago. The iphone and Android phones have the power and speed and graphics to make e-commerce, business apps, video conferencing, and other sophisticated apps practical on the handheld devices. The iPad and coming tablets take things to the next level. The PC and Mac become secondary.

Every start-up at Demo either offered some form of cloud computing service or had it built in to whatever they were offering. While there are still skeptics about cloud computing it is clear to me that it has evolved to where the Internet was ten years ago. Cloud is a natural evolution of the Internet. What makes cloud computing so powerful is actually what is on our computers and devices — the browser. Browsers are getting very sophisticated and able to execute javascript incredibly fast. The result is that apps in the browser have the look and feel of what we expect from a desktop computer or better.

When you combine all three of these market factors — social networking, mobile, and cloud computing — you get a new generation of capability. It takes things up a notch in terms of power, flexibility, convenience and ease of use. I no longer say we are just 5% of the way there. I revise that to 10-15% overall but still 5% in healthcare.

Tags: ethanol, find a doctor, health care, Healthcare, mac, vmware, windows

Kindle Sales Defy iPad

PC World Magazine says “Amazon Kindle Sales Defy IPad by Rising Each Month in Q2“.  This does not come as a surprise for a number of reasons. One is that the Kindle is a great product that is highly intuitive and easy to use. People get addicted to it and they tell their friends and family about it. I have been wanting to read Michael Lewis’s The Big Short but it was not available until recently on the Kindle. I waited. Great book, by the way. I know people who told me a few years ago that they had no interest in the Kindle but now are addicted. It was a popular gift item last holiday season and with the price reduced (again) it has become attractive to a much larger audience. Another factor is that the iPad is not the Kindle killer that some had thought. As described here a number of times, the iPad is great but not for for long periods and not for reading outdoors. Summer reading is the sweet spot for the Kindle.

Now we have the new Kindle DX.  The “old” Kindle DX was already quite nice.  We have been using it as an “electronic flight bag” for roughly 15,000 approach and airport charts. The Kindle reduces clutter in the cockpit but the iPad does a better job as an EFB since it has numerous aviation applications that enable pilots to calculate weight and balance, get the latest weather, and file flight plans directly with the FAA. Now that we have the iPad the DX can revert to the original reason we got it — reading newspapers and magazines. The DX is great for books too but the smaller Kindle is more comfortable to hold. The sweetspot for the DX is magazines, newspapers, and documents. Putting the DX on a stand and flipping through the Sunday paper is a treat. And now with the new DX it will be even better.

The new 9.7″ diagonal, high contrast e-ink screen has 50% better contrast than it’s predecessor. The Kindle DX display looks and reads like real paper, with no glare. With the free 3G wireless (no monthly payments and no contract) and the lower price, the DX is going to be a good choice for many people. Battery life is great too — read for up to 1 week on a single charge; turn wireless off and read for up to two weeks. The built-in PDF Reader has enhanced zoom capability to easily view small print and detailed tables or graphics. For professionals who have thousands of documents it will be a natural.

There will be a lot of competition for tablets and e-readers but from what I have seen so far the iPad and the Kindle, and the Kindle DX are the best. I love my iPad but for reading books the Kindle is better. I especially like being able to go back and forth between the iPhone 4, the Kindle, the Kindle DX, and the Kindle e-reader on the iPad and always have the bookmark synced to where I last was reading. As for newspapers and magazines the next move needs to be from the publishers who seem frozen with indecision. They want to charge a lot of money for their content but most of us don’t want to pay. Why pay for a New York Times app on the iPad when you can read the New York Times blogs on Pulse for free? As for magazines there is great potential for electronic versions but I don’t think people will pay the $4.99 for each new issue that Time and Wired are charging. I expect a lot of news about the news in the months ahead.

Tags: approach plates, Aviation, documents, dx, e-book, e-ink, e-reader, efb, flight charts, ipad, Kindle, kindle dx, magazines, New York Times, newspapers, pdf, time magazine, wired