The Future Is More Than Facebook

The frenzy over Facebook is unprecedented.  There are many interesting dimensions to the story; the most interesting to me, is how the insiders are upping the number of shares they plan to unload on the public.  This does not give one confidence — that those with the most information have decided to reduce their long-term holdings the day before the company becomes public.  I am sure there will be a lot of coverage about that in the days ahead.  The more interesting story was presented by Rich Karlgard in the opinion pages of the Wall Street Journal this morning (See Rich Karlgaard: The Future Is More Than Facebook). Rich believes that the tech bubble is large, but more importantly he believes that social media is not the most important area of innovation.  He doesn’t ditz social media, but urges consideration of more important areas needing innovation including transportation, energy, electricity, food production, water delivery, health care, and education.  Great list! Rich poses the question for those who need to go places, which they most value: An iPad, a Facebook membership, or a car.  By 2050 there may be 9 billion people and 3 billion cars.  Will we have the right fuels and road access? Perhaps the Google driverless car is more important than Facebook groups.  In the world of manufacturing, a lot of smart money is going into 3-D printing, which can make physical objects from an artisanal model.  Rich believes that “Made in the USA” is about to stage a major comeback.  In the area of energy, who would have predicted that North Dakota would overtake Alaska in oil production.  Horizontal drilling technology is changing the world.  Rich poses a second choice: If America could have only one, would it choose Facebook, Twitter, or horizontal drilling? I agree with Rich that America remains the world’s innovator and is a country without limits.

Tags: 3D printing, bubble, energy, facebook, Google car, horizontal drilling, IPO, social media, technology, venture capital

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

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

iPad Evolution of Resolution

Today was the day so many of us knew would bring forth the next iPad from Apple. In some respects, it is just another iPad, but I am quite impressed with the technical specifications that have been announced. I can’t wait to get my hands on it! This may be the turning point for many new users of the iPad who previously were content with their desktop or laptop computer. I am a firm believer in the “post PC” era as described by Tim Cook in today’s brilliant keynote (watch the video here).

What to do with my current iPad? That answer is the same as what I had done with the iPad 1, iPhone, iPhone 3G, and iPhone 4. Gazelle.com has a very nice model for how to manage the transition of technology. They provide a guaranteed price and offer a very simple process to ship a product to them and receive a market-based payment for it. I especially like the feature that gives you get an extra 5% if you accept the payment in the form of a credit at Amazon.com. I will be receiving $304.50 for the iPad. It may be possible to do better on eBay but the convenience of Gazelle wins the day.

The price of the current iPad may drop fairly quickly as people get attracted to purchasing the newer technology. When will the rapid introduction of new products obsoleting predecessor products that still seem like new? The answer is not any time soon. The pace of technology is rapid and increasing. Consumers are the beneficiary and of course, it has made Apple the most valued company in the world.

The big picture is the transition to tablets. Today I read that a hospital in Canada has purchased 4,000 iPads for their physicians. There are so many applications where you have to “go to” your PC or laptop. With a mobile device such as the iPad or iPhone or any other of the rash of wannabes in the market, the Internet and the applications are where you are, not where your PC is. The updating of records of a patient in a hospital used to be by a chart on a clipboard filled out by the nurse. Much of that has moved to the PC or the laptop on a cart in the hall, or in some cases down the hall, not very close to the patient. The iPad can be with the nurse or physician and not only provide a way to enter the data, but also a way to show an x-ray with amazing clarity to the patient or a 3D model of their muscle and bone system enabling the physician to explain exactly what may be wrong and what will be done to correct it. The resolution of the new iPad is quite amazing and exceeds the ability of the human eye to discern pixels. The iPad displays 3.1 million of them — more than your HD TV. I can not imagine being a physician and not having one of the new iPads.

The laptop and desktop will not disappear because they are still quite useful for those who create information as opposed to those who consume information. Consuming information from a mobile device has changed the world and how we interact with information already — and we are still at the beginning. But someone has to create this content and most of that creation will be done on laptops and desktops as long as typing is involved. How long will that be the case? Talking to Siri on your iPhone is the beginning. Typing may become a thing of the past, but of course art work still requires paint and brushes — or does it? The WSJ reviewed a wide range of new styluses available for use with the iPad (Sketching Out a Future for the Stylus). The world is becoming digital at an increasing pace.

Tags: art, digital, Healthcare, ipad, iPhone, media, nurse, paint, paint brush, physician, radiology, siri, stylus

My Doctoral Journey – Part 4

I really appreciate the support from my friends and family for my decision 17 months ago to begin the doctoral journey. I promised periodic updates and that is the purpose of this posting. I have now completed 27 credits of coursework out of the rquired 62 — approxmiately 43%. I completed a course in health care marketing in January and am now taking a course in health care economics. In December, I attended a second residency in Atlanta. The third residency will be in October. It will be an important step as it is the launching point from which I will be able to submit a proposal for my research study and dissertation.

The goal that every doctoral student shares is to successfully complete a dissertation as the final step in earning their degree. Some say that at least half of doctoral learners never complete their dissertation because of the incredible detail required to get a research topic developed and approved for research. A typical dissertation is 200-300 pages in length. Some consider the process more than challenging – a friend of mine told me he had an ABD degree – all but dissertation. A visit to Amazon and you can find a lot of books on how to “survive” a dissertation. I still remember the meeting with the academic review committee when I had to defend my masters thesis forty years ago. It seemed challenging at the time, but I can now see that it was nothing compared to what lies ahead for the doctoral dissertation.

I have completed a concept paper, which is the precursor to a proposal for a quantitative research study that I have in mind. The study relates to the cost of care and lives lost due to congestive heart failure (CHF). My mother passed away from CHF a few years ago and I learned a lot about the disease during her final months. As a member of the board at Western Connecticut Health Network, I can also see the impact from a hospital point of view. The concept paper is eleven pages long. Following are a few excerpts from the paper to share a few of the things I am considering.

Chronic heart failure (CHF) is the leading cause of hospitalizations and readmissions for the elderly, and accounts for a large share of developed countries’ healthcare expenditures. Although CHF is a condition for which hospitalization is often avoidable, nearly 20% of Medicare patients discharged from hospitals are readmitted within 30 days at a cost to Medicare of $15 billion annually.

The problem is that the frequent readmission of CHF patients to the hospital has a negative impact on the patient and the hospital. For the patient, it results in a reduced quality of life and a negative impact to their psychosocial and financial condition. For the hospital, it means using extra capacity for care while facing the risk of not receiving reimbursement for the associated cost. The purpose of my proposed quantitative research study will be is to answer the question of whether home-based telemonitoring with coordinated care could improve mortality and reduce hospital readmissions for patients with CHF.

Experimental research attempts to identify cause-and-effect relationships between variables by conducting a controlled experiment. The proposed research method I am considering would use a randomized controlled experiment in which patients are randomly allocated into two groups; one that receives pharmacological treatment with coordinated care (control group) and the other, which receives pharmacological treatment with telemonitoring and coordinated care (enhanced care group).

Telemonitoring makes it possible to gather daily data from patients in a consistent and automated manner. A wireless gateway device similar in size to a cellular telephone can automatically capture data from other wireless devises such as a weight scale, a blood pressure cuff, and a pulse oximeter to measure pulse and the level of oxygen in the blood (oxygenation). Since my last update, I have discovered several companies that have interesting technology for monitoring. These include cardionet.com and corventis.com. Around-the-clock access to a patient portal could display patient data and enable caregivers to respond proactively to the patient. For example, if the data from telemonitoring shows a sudden increase in the patient’s weight, a nurse might make a dietary suggestion or obtain authorization to make a change in medications.

There have been a number of similar studies but none have shown a significant benefit from telemonitoring. The research I have in mind would be focused on whether the right combination of healthcare delivery and technology can improve outcomes. The result could be improved quality of life for patients and, if the care plans are implemented in a cost-effective way, reduced financial risk for hospitals and the ability to invest more in their community healthcare mission.

I will have a further report on the proposal in a few months. In the meantime, I will be continuing with more course work. Since the program began one year ago, I have written 47 papers. Many more to come and then the big one! If everything goes right, I could be just a little less than two years from completion.

Index of stories about My Doctoral Journey

Tags: chf, dissertation, doctorate, e-learning, hospital, scholar, 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

Spectacular High-Res Image of Earth

The iPhone 4S takes great pictures, but nothing like this spectacular high-hes image of Earth. NASA Goddard oceanographer Norman Kuring gathered images from six different orbits of the satellite over an eight hour period last month. He stitched the six photos together to create the final masterpiece. I suspect it will be famous. The images were taken by a new instrument aboard the Suomi National Polar-orbiting Partnership (NPP) Earth observing research satellite called the Visible Infrared Imaging Radiometer Suite (VIIRS). It collects and distributes remotely-sensed land, ocean, and atmospheric data to the meteorological and global climate change communities. Among the data collected are atmospheric and sea surface temperatures, humidity sounding, land and ocean biological productivity, and cloud and aerosol properties.  As for those four vertical lines: that’s the reflection of sunlight off the ocean, or “glint”, that VIIRS captured as it orbited the globe. See Spectacular High-Res Image of Earth: The Other Side | Wired Science | Wired.com for the full story.

Tags: earth, nasa, NPP, photograph, satellite, space, suomi, virs

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.

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

Big Data

The storage capacities of laptop and desktop computers has been growing rapidly, but the growth may not be fast enough. According to IBM, we create 2.5 quintillion bytes of data every day. Perhaps quintillions of bytes are not meaningful to most of us, but it is the growth rate that is staggering — 90% of all the data in the world has been created in the last two years. Where does all the data come from? Data comes from everywhere: from sensors used to gather climate information, physiological readings taken 1,000 times per second from a patient, posts to social media sites, digital pictures and videos posted online, transaction records of online purchases, and cell phone GPS coordinates to name just a few. Collectively, the phenomenon is called “big data”. (See  IBM Big data and information integration for smarter computing).

Note: Data is plural. The singular term is datum. Should we say data is or data are? There are many views on which is right.

 IBM describes big data as spanning three dimensions: Variety, Velocity and Volume.  Variety refers to the fact that big data extends beyond structured data like we might find in a spread sheet. It includes unstructured data such as text documents, email, audio and video recordings, click streams from the web, log files that record financial and business transactions, and much more. Velocity of data refers to the fact that data can be time-sensitive such as bid and ask data in a financial market or physiological data that affect the lives of patients. In these cases, historical data is interesting but real-time data is critical. The third parameter is volume. IBM says that big data comes in one size: large. Organizations are flooded with data — terabytes, petabytes, or even yottabytes.

Big data is a challenge in various technical ways, but more importantly, it is an opportunity to find insight in new and emerging types of data and to answer questions that, in the past, were not possible to analyze effectively. Data that has been hidden can be surfaced and acted upon. The result can be a more agile organization or in the case of health care, better outcomes for patients.  Picture a hospital neonatal environment where a plethora of medical monitors connected to babies are used to alert hospital staff to potential health problems before patients develop clinical signs of infection or other issues. There are breakthroughs on the horizon for how this will be done. Today the instrumentation generates huge amounts of information — up to 1,000 readings per second — which is summarized into one reading every 30 to 60 minutes. The information is stored for up to 72 hours and is then discarded. If the stream of data could be captured, stored and analyzed in real-time there could be a huge opportunity to improve the quality of care for special-care babies.

The Hospital for Sick Children in Ontario, Canada developed such a vision and is acted on it. Dr. Carolyn McGregor, Canada research chair in health informatics at the University of Ontario Institute of Technology visited researchers at the IBM T. J. Watson Research Center who are working on a new stream-computing platform to support healthcare analytics. A three-way collaboration was established, with each group bringing a unique perspective — the hospital focus on patient care, the university’s ideas for using the data stream, and IBM providing the advanced analysis software and information technology expertise needed to turn the vision into reality. The result of the collaboration was Project Artemis which pairs IBM scientists with clinicians and`researchers to explore how emerging technologies can solve real-world business problems, in this case developing a highly flexible platform that aims to help physicians make better, faster decisions regarding patient care for a wide range of conditions. At the Children’s hospital the focus is real-time detection of the onset of nosocomial infection (often called hospital-acquired infection). Regulatory, ethical, privacy, and safety issues were addressed and then two infant beds were instrumented and connected to the system for data collection. The team then created an algorithm that deciphered the streaming data. By establishing the impact of moving a baby or changing its diaper, those things can be filtered out to help spot the telltale signs of nosocomial infection.

Dr. Andrew James, staff neonatologist, at the Hospital for Sick Children is optimistic that as they learn more they will be able to account for variations in individual patients and eventually be able to integrate data inputs such as lab results and observational notes. In the future, any condition that can be detected through subtle changes in the underlying data streams can be the target of the system’s early-warning capabilities. It is likely that sensors attached to or even implanted in the body will allow monitoring of important conditions from home or anywhere. Big data has the potential to improve the health of patients whever they may be.

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Tags: analytics, big data, health, Healthcare, hospital, IBM, monitoring, neonatal