OS/2 Celebrates 25 Years

Harry McCracken’s story (see 25 Years of IBM’s OS/2: The Strange Days and Surprising Afterlife of a Legendary Operating System) about OS/2 brought back a lot of memories. Seeing my picture in PC World magazine made me feel old — who is that young man? Bill Gates and I were both wearing purple shirts, but that was the only thing we had in common. OS/2 was a great product, but it failed in the end for many reasons that Harry described. From my perspective, the main thing that could have upped the odds for OS/2 would have been if we had tightly integrated the IBM hardware, software, and services that IBM had at the time. Unfortunately, there was a feeling of independence in the various divisions of the company; the PC Company, the Personal Sofware Products Division of which I was the vice president for marketing, the IBM Global Network, the amazing National Service Division of which I earlier was vice president for service business, the various industry vertical and marketing organizations of IBM, and the financial resources to put it all together.

But, we did not put it all together. The Apple iPad and Mac are successful because Apple put it all together so that “it just works”. IBM had a similar potential with OS/2. Three researchers developed a Web browser called the Web Explorer. It was the best Web browser at the time. The ThinkPad had just been introduced a year earlier. IBM was the only vendor that could offer a PC with an operating system, a suite of Internet tools for surfing, email, and news reading, plus the IBM Global Network — all bundled on a ThinkPad. That was 1994 and IBM had it all and no other vendor was even close. Unfortunately, IBM, at the time, wanted each division to stand on its own. The PC division believed they could sell more PCs if they put Windows on them instead of OS/2. The OS/2 team wanted to make their software work with all the industry software, but the Lotus division wanted just their products on the PC. The industry vertical groups wanted to sell whatever kind of PC the customer wanted, IBM or others. The service division wanted to service any brand and give-up the exclusivity of great IBM service. While Apple had one brand, IBM had multiple brands, each with its own advertising agency, that did not leverage the strength of one of the greatest brands of all times — IBM.  When Lou Gerstner took control, the company came back together again, but unfortunately, it was too late for OS/2. If you like technology history, read Harry’s story. He did a great job in pulling it together. In my basement, I have a collection of OS/2 hats on the wall. My grandchildren ask me, “Pop-pop, what is OS/2?”

Tags: IBM, IBM Global Network, IGN, internet, john patrick, os/2, ThinkPad, Web Explorer

Back from Florida

The weather was so nice, it was difficult to leave and come home. I feel very fortunate to have been able to spend a bit more time in Florida this winter. Thanks to FaceTime, Skype, Polycom, iMessage, email, and the web, it was easy to participate in board meetings remotely. I was even able to chair a hospital quality committee meeting remotely, thanks to the high quality PolyCom video-conferencing system they have. My current doctoral course is in health care economics. One of the team assignments required a teleconference. There were four of us in diverse locations; Ottawa, Baltimore, Florida, and Jordan. If two of the students were in Canada and the Middle East, it didn’t matter that I was in Florida instead of home in Connecticut. We were all just a few hundred milliseconds apart.

Before leaving Florida, I decided to try out the new iPhoto app on the iPad3. It goes beyond the photos app that comes with the iPad. In addition to taking advantage of the greatly enhanced retina screen, the iPhoto app has a new feature called Journals. In addition to viewing your albums, events, faces, and places, you can create journals. A journal is a web page that can include pictures from your albums plus special add-ins from the app including a calendar icon representing the date you took the pictures, a map showing where you took them, and a weather icon showing what the weather was like when you took the picture or alternatively what the weather there is now. You can also add quotations and text boxes. See March in Florida for a page I created as a first try. The pictures can be edited, touched up, brightened, manipulated with effects, air-brushed, and arranged in a collage — all with your fingers. You then save the journal to a glass shelf and it is uploaded to iCloud where you can share it with friends, family, or the public. A home page shows all your shelves with the journals lined up on them in date sequence. In effect, journals gives you the ability to create a web site at iCloud with no traditional design tools. Just your iPad and your fingers.  This is classic Apple making things easy — it just works. But, it is not perfect.

iCloud can be slow in accepting your upload. The shelves on the iPad include a favorites shelf but that shelf does not appear on the homepage at iCloud. The six journals I created are not in date sequence as they are supposed to be. The iPhoto app does not sync with your iPhoto app on the Mac or your photos on a PC. The iPhoto pictures sync to the photos app on the iPad, not the new iPhoto app on the iPad. Syncing is one-way. If you delete or edit a picture or add a new one in one of your iPhoto albums on the iPad, it does not sync to iPhoto on the Mac or on your PC. There are a few things that need polish but you can see the vision coming through. Take a picture with your iPhone or iPad and the picture automatically goes to your photostream at iCloud. iCloud then pushes the picture down to all your other devices. You can then create journals and share them via iCloud. Facebook, Google, flickr, and others have nice ways to store and share photos, but journals are now offering an alternative that includes content creation for anyone with some imagination and an iPad. Take a look at patrickweb.com/iphotojournals and let me know what you think. As usual, I confess to not being a good photographer nor artistically creative.

Tags: albums, apple, events, ipad, iphotos, journals, mac, photos, pictures

The Future of the Internet

The following story was published in the April 2012 issue of  Sun and Surf Magazine

The Future of the Internet
By John R. Patrick

The future of the Internet in our lives is very positive but we are only about 10% of the way there. Of all the things that could be done online that would save us time and simplify our lives, only 10% of them are there. Travel and banking web sites are getting better, but we are still at the early stages of what is possible. Consider retail e-commerce. Although there has been continuous and steady growth of retail e-commerce, it still represents just 5% of total retail sales. Why isn’t it 25% or more? Much is written about that here at patrickWeb but the short version is that there are still a lot of lame web sites. “Click here for the location of our nearest dealer where you can visit” or “call to get a price on the product you just found” or “Click here to download this form, fill it out, and fax it to us”. It is no wonder that Amazon captured 28% of all online sales in the fourth quarter of 2011. One company out of 4 million retailers got more than a quarter of all the sales. Have you ever heard a friend complain about poor customer service at Amazon? They walk in the customer’s shoes and deliver a terrific experience. Most of the rest of the e-businesses in the world have a long way to go. And in the physical world, there are the ubiquitous clipboards at doctor offices where we take a pen and provide a lot of information that they already have.

The changes in Internet technology have been continuous for decades and there is no end in sight. For the past fifteen years, I have been writing about the evolution of the Internet by describing developments in seven key areas: Fast, Always On, Everywhere, Natural, Intelligent, Easy, and Trusted. In the following paragraphs, I will hit the highlights of some of the more important trends and developments.

Fast
Broadband in the U.S. is not a pretty story compared to other parts of the world. We are second after China in the number of broadband users, but 28th in the world in the number of broadband users as a percentage of our population. The problem is that there are too many lobbyists, and the FCC is a political organization. The new FCC head is a very smart guy with technology and business experience. He totally gets it. The only problem is that AT&T, Comcast, and Verizon have more lawyers than the FCC does. Meanwhile France is offering 100 megabit access for $90 per month and rolling out WiFi throughout the country. Thanks to the telco lobby, many states have banned the offering of WiFi by municipal entities. Every citizen in Greenland has Internet access. We have 31,000 post offices.

Always On
WiFi is part of the fabric of the world. The big shift is the streaming of data — not just tweets, but data from *things* — bridges, toll booths, traffic lights, buildings, cars, iPhones, Androids, handheld GPS devices, weather instruments, and health monitoring devices attached to people. The growth in creation of data is staggering. Of all the data in the world, 90% of it was created in the last two years. YouTube receives 60 hours of new video every hour – an hour every minute. Wikipedia has 4 million articles and 8,000 editors. Hospital physicians will soon be adjusting the drip rate on infusion pumps in the hospital from their office based on real-time data from the patient. WiFi-enabled infusion pumps will enable hospital administrators to know where the pumps are (they never have enough of them) and which ones need maintenance.

Everywhere
There are one billion computers (including tablets), one billion cars, 1.5 billion televisions, and 2 billion Internet users. Small numbers compared to cell phones — 5.2 billion paid subscribers. The Internet used to be where your PC is, but now the Internet is where you are.  Most of the cell phones are dumb but soon most of them will be smart and they will all have Internet access. The mobile web is unfolding and is taking part in creating data by streaming data to the Cloud and then consuming data by streaming it from the Cloud. When you take a picture on your iPhone, it goes into the photostream and from there to iCloud and from there to all of your other devices and, if you choose, to the devices of your friends and family.

Natural
Social networking has become fundamental to all aspects of our economy and society. Integration of social networking with a full range of web applications will evolve to become the primary means of finding jobs, finding employees, finding business partners, and collaborating on projects. The emerging issue is that many people, especially young ones, are a bit liberal with sharing their every movement — what they are eating, listening to, where they are headed, their current latitude and longitude, and where they slept last night. They are not thinking that some day they may run for office or interview for a job. A new protocol will emerge to enable people to “erase” things they placed on the Internet. The Europeans may legislate it. OpenSocial is an important new standard that will enable social media apps that work across all of the social media sites.

Intelligent
The Semantic Web is the next big turn of the crank for the evolution of the World Wide Web. Most web pages have links but do not have context. The words on the web page do not necessarily mean anything — but they could. For example, if a web page said “Join us for a concert by The Eagles at Kimmel Center in Philadelphia next Tuesday” that set of words could have a lot of context. Clicking on it could add the concert to your calendar, knowing what “next Tuesday” means. It would also know exactly where the Kimmel Center is and provide a map. The Eagles is a performing group that performs a particular genre and your music player would receive a list of suggestions of music they have recorded or links to live concerts under way at the moment and make recommendations about their music to your friends. This is the tip of the iceberg. The semantic web will lead us to a point where most of the interactions of web pages will be between computers, not between computers and people. The biggest growth of intelligence is occurring in the field of analytics. Exabytes of data are being stored. A byte is 8 bits (a bit is a zero or a 1) and represents one character. An exabyte is a 1 followed by 18 zeroes! Business Intelligence and analytics are poised to enable new insight into the mounds of data – “Big Data” — that are being accumulated. Analytics will enable businesses to make sense of the explosion of data, develop digital models of their business, and continuously adapt it to what is going on. IBM’s Watson successfully challenged humans on the Jeopardy Show, but what is more interesting is the ability for a primary care physician to call and get a recommendation based on patient symptoms and measurements they describe to Watson. Within a couple of seconds Watson technology will be able to review all available medical information in the world and make a useful suggestion.

Easy
Technology is not the easiest thing at times. There are many dimensions to “easy” but one good example is the Nintendo Wii. At a local senior center, members find the Wii to be their exercise coach. It is not just for kids! The iPhone and iPad have shown how easy it can be to get applications on a handheld computer. Amazon has done the same with the Kindle. Most companies still don’t get the idea that the Internet is about power to the people. If you can’t make it simple, people won’t buy it. Cloud computing has become the mainstay for me and for millions. The ease, convenience, and reliability of the Cloud is compelling. Add Dropbox to your laptop and your iPad and your iPhone and you have a completely replicated set of data – all of your data at your disposal wherever you are and with whatever device you may be using. How about the future of TV? Three of the most common remotes — BlueRay, Cable box, and TV — include 151 buttons. Even a savvy child could not possibly master this impossible user interface. Boxee TV has produced a good model of the future of TV – think of it like TV Guide on the web — but I suspect that an upcoming Apple TV will be what finally provides the needed regime change.

Trusted
This is the big one. Can we trust the Internet? Security technology is available to achieve much higher levels of security than is presently deployed both at enterprise and consumer levels. It is a constant battle and requires significant budgets and a lot of talented people to maintain the needed security. The equally important issue is privacy. The good news is that there are some good technology solutions available to help us control access to our Internet habits. The bad news is that politicians have gotten interested in the subject. Banks have our personal information and they are using it. Healthcare insurers have more information about our health than our doctors do. Nevertheless, there is much to be optimistic about when it comes to electronic medical records. Perhaps 25% of doctors and hospitals use them but they are not easily interchangeable and accessible. This will change over the next few years as the government adds dollar incentives to make it happen. The result will be better quality of care, better outcomes, and fewer errors. And, fewer clipboards.

In January, I gave a talk about the Future of the Internet and Healthcare at the SIIA Conference in New York. The slides and a video of the presentation can be found here.

About the author

John R. Patrick (john@patrickweb.com) is president of Attitude LLC and former vice president of Internet technology at IBM. Mr. Patrick was a founding member of the World Wide Web Consortium at MIT in 1994 and of the Global Internet Project. He is a fellow of the Institute of Electrical and Electronic Engineers and a member of the American College of Healthcare Executives.  He is a director of Knovel Corporation, WebMediaBrands, Inc., and Western Connecticut Health Network. He is the author of Net Attitude: What It Is, How to Get It, and Why Your Company Can’t Survive Without It (Perseus, 2001).

About SUN and SURF

SUN and SURF Magazine is published quarterly and mailed to all property owners in Hammock Dunes in Palm Coast, Florida. The magazine currently has a circulation of approximately 1,000.

Tags: analytics, big data, cardionet, corventis, IBM, internet, Internet Technology, ipad, patientslikeme, social media, telemonitoring

Expedited Deception

Last week I received a very official looking envelope in the mail. It came from PO Box 757, Chanhassen, MN 55317. Both sides of the envelope were emblazoned with labels including something for everyone -  “ExpeditedDelivery GRAM”, “Package Tracking Number 80495100562″, “Extremely Urent”, “Recipient please hand deliver to addressee”, “Expedited – Not available to all locations”, “Special Notes on Enclosure”, “Time sensitive material”, “Materials Inspected”, “Recipient Name Confirmed”, “Postage Paid”, “Address of Recipient Confirmed”, “Delivery Date Verified”, “Service – Expedited”, “Weight 1 oz”, “Zone – 4″, “Sender authorizes the delivery of this shipment without obtaining a release signature and shall indemnify and hold harmless the shipper from any claims resulting therefrom”, “Release Signature – KC”, “Revision date 1/96″, “Format 196″, “Printed in U.S.A.” The envelope contained everything except the identity of who had sent it. Can you believe it? I did not make this up. I actually received the envelope described. It was obvious that someone was desperate to deceive the recipient to open the envelope. Who was it from? SiriusXM Satellite Radio. What was the extremely urgent matter being brought to my attention? “There’s never been a better time to be a SiriusXM Satellite Radio subscriber. Reactivate your XMradio today with this Special Offer!” I respect aggressive marketing when it is of high-integrity. This sham from XMSirius had no integrity. Fraud might be slightly strong, but at a minimum their mailing is based on deceipt — trying to trick the recipient to open the envelope. If the mailing was intended to be humorous that would be ok — if they had added their name to it.

If you read financial commentary about SIRI (the stock symbol for XMSirius, coincidentally the name of the new voice recognition software in the iPhone 4S), you find the word “desperate” used quite often. Seeking Alpha said that the SiriusXM 2012 subscriber outlook fell short of Wall Street’s consensus estimates. It also noted that the low subscriber number was just one of several disappointing subscriber measurements (see the full story – SiriusXM And Slowing Subscriber Growth). The conversion rate – the percentage of OEM trial subscribers that become self pay subscribers – is expected to show no improvement in 2012 and the self-pay monthly churn (the cancellation rate for subscribers that had previously chosen to pay for the service) is projected at 2.1%. These are most likely two of the primary drivers behind the company’s relatively low forecast of 1.3 million net additional new subscribers in 2012.

Meanwhile, Pandora seems to be gaining subscribers rapidly. PaidContent.org reported that Pandora had 94 million registered users as of their IPO filing in May, of whom 34 million are considered “active” users. That’s up from 53 million users registered and 18 million “active” in the same quarter last year. The listening numbers are even more impressive — Pandora played 1.6 billion hours of music in the quarter ending April 30, compared with 700 million hours the prior year. See New Numbers From Pandora Show Big Growth But No Profits for more details. It is not just CDs, newspapers, and video that is being impacted by the Internet — add satellites to the list.

Tags: disintermediation, internet, music, satellite, sirius, xm

Speech at SIIA

It was a privilege to be a speaker at the Software & Information Industry Association (SIIA) conference in New York on January 25. The subject of the speech was The Future of the Internet but I included an emphasis on impact to healthcare and publishing. The conference was attended by executives from the publishing and software industries. I do not know why the video was captured in five segments, but until I get a consolidated version, the links are below. The slides were on my iPad and the video doesn’t show the screen the audience was looking at. If you want to see the slides, they are here.

Part 1
Part 2
Part 3
Part 4
Part 5

Tags: future, health, Healthcare, hospital, internet, john patrick, medicine, music, publisher, siia, technology

Genesys XVIII

The 18th Annual Genesys Partners Venture Dinner — Gen XVIII– Monday night at the Union League Club in New York attracted more than 100 venture capitalists, investors, journalists, entrepreneurs, and industry executives. As always, Jim Kollegger — CEO of Genesys Partners and one of the pioneers of the information industry — was an elegant master of ceremonies. He introduced the various sponsors, next day panelists for the SIIA Conference, several startup CEO’s, and a few of us who have been around the block a few times, each to make some comments.

Like a broken record, I offered the normal upbeat view of the future of the Internet but prefaced my remarks by asserting that we are only 10% of the way there. In other words, of all the things that could be done on the Internet that would save us time and make our lives better, only 10% of them are there. It may sound low but consider retail e-commerce. Although there has been continuous and steady growth of retail e-commerce it still represents just 4% of total retail (as of the end of October). Why isn’t it 25% or more? Much is written about that here at patrickWeb but the short version is that there are still a lot of lame web sites. “Click here for the location of our nearest dealer where you can visit” or “call to buy the product you just found” or “Click here to download this form and fax it to us”. And of course there are the ubiquitous clipboards at doctor offices where we take a pen and provide a lot of information information that they already have.

I described one man’s view of the evolution of the Internet including the seven characteristics below. This parsed way of looking at the Internet has served me well for quite a few years. The things going on under each area continuously change and Jim asks me once a year to do a thumbnail sketch of my latest thinking.

Fast
Broadband in the U.S. is not a pretty story compared to other parts of the world. We are second after China in number of broadband users, but 28th in the world in number of broadband users as a percentage of our population. The problem is that there are too many lobbyists and the FCC is a political organization. The new FCC head is a very smart guy with venture and business experience. He totally gets it. The only problem is that AT&T, Comcast, and Verizon have more lawyers than he does. Meanwhile France is offering 100 megabit access for $90 per month and WiFi throughout the country. Thanks to the telco lobby, many states have banned the offering of WiFi by municipal entities. Every citizen in Greenland has Internet access. We have 31,000 post offices.

Always On

WiFi is part of the fabric of the world. The big shift is streaming of data — not just tweets, but data from *things*. Bridges, toll booths, traffic lights, buildings, cars, and health monitoring devices attached to people. Hospital physicians will soon be adjusting the drip rate on infusion pumps in the hospital from their office based on real-time data from the patient. The WiFi infusion pumps enable hospital administrators to know where the pumps are (they never have enough of them) and which ones need maintenance. The creation of data is staggering. Of all the data in the world, 90% of it was created in the last two years. YouTube receives 60 hours of new video every hour. Wikipedia has 4 million articles and 8,000 editors.

Everywhere
There are one billion computers (including tablets), one billion cars, 1.5 billion televisions, and 2 billion Internet users. Small numbers compared to cell phones — 5.2 billion paid subscribers. The Internet used to be where your PC is, now it is where you are.  Most of the cell phones are dumb but soon most of them will be smart and they will all have Internet access. The mobile web is unfolding and is taking part in creating data in addition to consuming it through streaming. When you take a picture on your iPhone, it goes into the photostream and from there to iCloud and from there to all of your other devices.  

Natural
Social networking has become fundamental to all aspects of our economy and society. Integration of social networking with a full range of web applications will evolve to become the primary means of collaboration. The emerging issue is that many people are a bit liberal with sharing their every movement — what they are eating, listening to, where they are headed, their current latitude and longitude, and where they slept last night. They are not thinking that some day they may run for office or interview for a job. OpenSocial is an important new standard that will enable social media apps that work across all of the social media sites. The Europeans may legislate it, but regardless, a capability is needed to be able to remove things from the social media.

Intelligent
The Semantic Web is the next big turn of the crank but the crank is moving slowly. Most web pages have links but do not have context. In other words the words on the page do not necessarily mean anything — but they could. If a web page said “Join us for a concert by The Eagles at Kimmel Center in Philadelphia next Tuesday” that set of words could have a lot of context. Clicking on it could add the concert to your calendar, knowing what “next Tuesday” means. It would also know exactly where the Kimmel Center is and that The Eagles is a performing group that performs a particular genre and your music player would receive a list of suggestions of music they have recorded or links to live concerts under way at the moment. This is the tip of the iceberg. The semantic web will lead us to a point where most of the interactions of web pages will be between computers not between computers and people. The biggest growth of intelligence is occurring in the field of analytics. Exabytes of data are being stored. Analytics will enable businesses to make sense of it, model their business and continuously adapt to what is going on. IBM’s Watson took on humans on the Jeopardy Show, but what is more interesting is the ability for a primary care physician to call and get a recomendation based on patient data they describe to Watson. Within a couple of seconds Watson will be able to review all medical information in the world and make a useful suggestion. Business Intelligence and analytics are poised to enable new insight into the mounds of data that are being accumulated.

Easy
Technology isn’t the easiest thing at times. There are many dimensions to “easy” but one good example is the Nintendo Wii. At a local senior center, members find the Wii to be their exercise coach. It is not just for kids! The iPhone and iPad have shown how easy it can be to get applications on a handheld computer. Amazon has done the same with the Kindle. Most companies still don’t get the idea that the Internet is about power to the people. If you can’t make it simple, people won’t buy it. Cloud computing has become the mainstay for me and for millions. The convenience and reliability of the clouds is compelling. Add Dropbox and you have a completely replicated set of data, wherever you are and with whatever device you may be using. How about TV? Three remotes — BlueRay, Cable box, and TV — include 151 buttons. Even a savvy child could not possibly master this impossible user interface. Boxee TV has produced a good model of the future of TV, but I suspect that an upcoming Apple TV will be what finally provides the needed regime change.

Trusted
This is the big one. Will we trust the Internet? Security technology is available to achieve much higher levels of security than presently deployed both at enterprise and consumer levels. It is a constant battle and requires significant budgets and a lot of talented people to maintain the needed security. The bigger issue will be privacy. (Stay tuned for the Firefox “do not track” feature). Banks have our personal information and they are using it. Healthcare insurers have more information about our health than our doctors do. Nevertheless, there is much to be optimistic about when it comes to electronic medical records. Perhaps 25% of doctors and hospitals use them but they are not easily interchangeable and accessible. This will change over the next few years as the government adds dollar incentives to make it happen. The result will be better quality of care, better outcomes, and fewer errors. And, fewer clipboards.

On Wednesday I gave a talk about the Future of the Internet and Healthcare at the SIIA Conference. The presentation can be found here.

Other patrickWeb conference related stories

Tags: broadband, fcc, future, health, health care, Healthcare, IBM, internet, ipad, iPhone, jeopardy, john patrick, Mobile, opera, siia, social media, supercomputer, union league, WiFi

Why You Should Embrace Your Company’s Heretics

CNNMoney’s Fortune published a story last week called Why You Should Embrace Your Company’s Heretics. The story was written by Polly LaBarre. I have not talked to Polly for ten years but we did attended a number of the same conferences back then. This new story described my evangelism of the Internet and she said some complimentary things. The story is accurate, but I never thought of myself as a heretic. One fellow board member who read the story sent me a note saying he thought heretics were burned at the stake. Back in 2006, Polly and Bill Taylor, founding editor of Fast Company Magazine, wrote a book called Mavericks at Work where they described 50 “mavericks”. I was one of them, but had not yet been promoted or demoted (not sure which it would be) to “heretic”. I was labeled with the term “rebel” by Gary Hamel in his Waking Up IBM: How a Gang of Unlikely Rebels Transformed Big Blue that appeared in the Harvard Business Review in April 2001. A few months before that, Fast Company magazine published an interview I did with Polly where we talked about technology futures (see Think Ahead: John Patrick). The only heretic I can think of is ”Homer the Heretic” — an episode of The Simpsons‘, which originally aired in 1992.

Tags: CNNMoney, Fast Company, Fortune, Fortune Magazine, Harvard Business Review, heretic, IBM, john patrick

Connecticut’s Power Woes – Epilogue

We got power restored at 5:17 PM on Monday night after an eight-day outage. As of 10 AM today (Thursday) there were still 1,124 customers in Connecticut not yet restored with electricity. Although that is less than 1% of the customers in the state, it represents several thousand people who are without power for a twelth day. No doubt there are some extreme and extenuating circumstances that are making it difficult for the repair crews to get back to 100%. The power company has offered to pay for an independent consulting study to examine disaster preparedness. That seems like a good idea. I hope they look carefully at the role that technology could play in the logistics of identifying the outages with precision and planning the optimum priorities for restoration. If every transformer had a sensor that could continuously report its status could that help? There are more than 100 million Apple iOS devices out there that, if their owners chose to activate the “Fine Me” feature, can have their location be identified by Apple’s iCloud. Does the electric company have a real-time display of their entire network that shows what is up and what is not? Can they deploy repair crews in a way that maximizes the restoration of power in the shortest time? I do not know the answer to these questions, but I hope they do. It seems to me that sensors could help a lot. The sensors would be powered by the electricity at the pole. The data could be sent using BPL technology that has been around for many years. If a pole or transformer stopped reporting, that would mean it has lost power and that would be reflected in the overall map of the electricity network. Analytical models could be used to create the repair strategy that makes best use of available resources. This might work better than having the need for 196 Connecticut politicians all calling for priority to their towns.

Tags: connecticut, electricity, generator, power, storm

EMRs — The Time is Now

Electronic medical records (EMRs) are on the way, and not any too soon. The government is offering large incentives to healthcare providers to start using EMRs and for those who skip the incentive, there will be penalties to follow. Whatever you may think of the EMR, it is at our doorstep. I am not making a political statement about this – to me it is common sense and a technological imperative that will reduce costs, enhance healthcare quality, and improve patient safety. A reader sent me an account of what he and his family experienced two weeks ago and, with his permission, I am sharing this true story because I think it is one of millions of examples that justify the move to EMRs.

The reader is from California and I will call him Frank for purposes of this post. Frank’s 15-year-old son Alex was scheduled for non-emergency pulmonary valve replacement surgery on Friday afternoon. He was born with a number of congenital heart defects and had open-heart surgery at 30 days old 15 years ago. A recent MRI showed his pulmonary valve to be leaking extensively so it was recommended it be replaced with a new adult-sized pig valve. Before leaving for the hospital Friday morning, Frank received a phone call saying that Alex had been bumped from the schedule due to a critical newborn with heart problems.

Although Frank understood the bump, Alex took it extremely hard. As the day wore on, he got more and more upset and stressed out. Around 9 PM he mentioned that he was having shortness of breath and was having pains around his heart. Since he had a full pre-op earlier that week, Frank’s immediate thoughts were that this was a combination of extreme stress and possibly indigestion, but he decided to take Alex to the local hospital emergency room (ER). Once there, clinicians checked Alex’s vital signs and ran an EKG. The ER doctor did a quick echocardiogram. After reviewing the test results, the ER Doctor asked if Frank had any historical EKG’s so that a comparison could be made to Alex’s abnormal EKG.

Around 11 PM Frank signed the paperwork to authorize a search for the EKG — the nursing staff started calling hospitals where Alex had been a patient to see if they could obtain EKG data. They hit a brick wall. The large hospital where Alex had the pre-op wanted to help but had no access to data. A call to the cardiology specialist’s office got a recording — they were closed.

As Frank reflected on the data void, he realized that he can download an obscure piece of music from multiple sources on the web, but in spite of valiant efforts, he could not get a copy of Alex’s EKG. Isn’t it a collection of ones and zeroes, just like music? Although it was a stressful weekend for Frank, Alex began to feel better and was able to go back to school the next day.

On Saturday morning Frank did an extensive web search, and found that Medic Alert provides emergency information to caregivers if a physician sends them data. This is a great service, but shouldn’t it be an automatic by-product of healthcare by any caregiver? From Frank’s perspective, having access to someone’s past EKG could either save a life, prevent misdiagnosis or save time and money. To Frank, it seems like a basic for anyone with an affected child or if they themselves have a potentially serious ailment. Frank’s perception is that EKGs for the most part are still “paper driven” and nobody is thinking about getting them on the web as a standard practice.

Alex has a new surgery date in early November. Hopefully, Alex will be feeling better, and with the surgery delay he should get to finish his soccer season.

It is time for healthcare to catch up to banking, e-shopping, e-music, YouTube, and social networking. What could be more important that the health of our families? Privacy is a valid and important concern, but it can and is being addressed as part of the rollout of EMR systems.

Alex’s privacy was intact – his EKG results were in a manila folder somewhere – private, secure, and unavailable when needed.

Tags: cardiac, ekg, emr, health care, Healthcare, heart, heart surgery, phr, surgery

e-Government

e-Government is a really good idea and there are many initiatives underway to make it happen (see Government 2.0). In some respects the U.S. Government has been a model for using the Internet. The IRS e-file program, for example, has been very successful with nearly 99 million individuals filing their federal income tax returns electronically during 2010. Of the 141.5 million returns filed so far this year, almost 70 percent were filed electronically. There are other parts of the government that just don’t seem to get the idea of “electronic”. When I joined the Medicare program a year ago, I signed up for the Easy Pay program where the monthly Medicare premium is deducted automatically from my checking account. I have now changed my bank and so it was necessary to update various parties that either put money in or take money out of my account electronically. Except for Medicare, I was able to update them all online and have the changes take effect within a few days. Medicare said it was easy to change Easy Pay. Just complete an Authorization Agreement for Preauthorized Payments (Standard Form 5510). No problem. Where do I get that form online? Not available online. The authorization agreement may be obtained by calling 1-800-MEDICARE (1-800-633-4227). Upon request, 1-800-MEDICARE will mail a Medicare Easy Pay Packet directly to the beneficiary. The Medicare Easy Pay Packet includes a Medicare Easy Pay brochure, an Authorization Agreement for Preauthorized Payments, instructions for completing the authorization form, and a pre-addressed return envelope. All Authorization Agreements must be signed by the account holder and returned in the pre-addressed envelope to the address specified. Processing of the authorization form may take between 30 and 60 days. I called two weeks ago and still have not received the “packet”. Of bigger concern is that somebody thinks this is ok. Electric utilitiy companies have not always been known as model e-businesses, yet the three that I deal with all have an online application that takes just a minute or two to enter a new routing code and account number. Three to six minutes versus 30 to 60 days is not a small difference. Think of the cost of creating, printing, stuffing, mailing, and processing the contents of the Medicare “packet” compared to the electric company’s few mouse clicks. Think of how many employees have to touch the contents of the package. I am not making a political statement, but it is quite obvious that reducing the cost of government by hundreds of billions or perhaps trillions should not be difficult.

Meanwhile, the post office continues to operate 5,000 or so offices that are unprofitable and deliver mail six days per week. They have seen a huge drop in mail because of Internet applications such as e-file, e-billing, Quicken BillPay, electric and telecommunications companies taking credit cards and sending e-statements, etc. Unforutnately for the post office, they haven’t seen the worst of the dropoff. Netflix now offers unlimited streaming for $7.99 per month. They spend $700 million per year with the post office distributing DVDs. The holloywood producers are fighting a losing battle to protect their old models. The $700 million revenue stream to the post office will go to zero. And then along comes Zumbox.  There is still a lot of mail that gets sent, not invoices, but notices of privacy policies, service updates, account information, etc. Billions of pieces of mail. This mail will soon be going to the cloud — to Zumbox. To get a Zumbox account you sign up and provide your email address and your snailmail address. Zumbox goes to AT&T, Charles Schwab, Comcast, JC Penney, and the rest and gives them the addresses of people who have signed up for Zumbox. The companies then send all their mail to those members to the members mailbox at Zumbox. As a Zumbox user, you just login to the Zumbox website and check your mail. The mailers save a bunch of money, we save time from retrieving, opening, and throwing away the paper mail. Unfortunately, the post office revenue decline accelerates. It will not be too long before the post office will not have any mail to deliver.

Tags: e-billing, e-file, irs, medicare, post office, zumbox