On the Road Again

After a summer travel hiatus to work on research projects, I’m back on the road again this week.

Today, I’m chairing a break-out panel at Mayo Transform 2011 to talk about the power and opportunities in sharing health data across organizational and discipline boundaries.  Tomorrow I’m participating in a break-out discussion featuring Hugh Dubberly on self-tracking and visualization, also at Transform.  Check out the alternative announcmeent on the fantastic new Lybba.org website and blog.

On Thursday I’m participating on a panel about Innovation Scaning sponsored by the Office of the National Coordinator for Health Information Technology and the Health 2.0 team in DC.  

It feels great to exchange ideas in real-time with my collaborators the larger health innovation community again.  As always, Transform is off to a great start!

Discipline and Innovation

David Fore of Lybba forwarded me this article on innovation. It provides a set of beautiful examples of the role of discipline and standardization in fostering innovation.

At my first startup company, Silicon Spice, we were extremely disciplined in how we structured internal communications, identified and followed technology standards and incorporated automatic testing into all our technology development efforts.  The company-wide discipline we established allowed for an unprecedented pace of product innovation in the rapidly evolving communications market of the late 90’s.  Peaking at only 120 employees, we constructed a complex set of technology targeting telco equipment vendors including reference voice switching boxes, a 2.5 Watt 21-core DSP processor, companion ASIC devices, a vector compiler, a real-time OS, a fully-featured set of voice processing software and a complete suite of development tools for our platform.  A few people in key roles were able to spot opportunities that spanned numerous product sub-teams and we were able to quickly implement coordinated design changes across our home-grown technology stack.

A lead engineer from Texas Instruments, our primary competitor, once commented to me that they couldn’t believe that we had build our product in only 3-4 years with 100 people; I didn’t have the heart to tell him the product they were evaluating for acquisition was built by an average of 50 people over 16 months!  We seized 70% of the carrier-class market from them in the 18 months following our acquisition.

Continue reading “Discipline and Innovation”

OS X Lion?

Mac OS X updates often contain controversial features that lead people to wonder whether they should upgrade.  My short answer is there is no need to rush into Lion.  The only feature that I think is a real step forward is the new facilities for search in Mac Mail and increased support for cool gestures.  Even if those sound appealing, wait a couple of incremental releases for some of the various quirks to subside and more apps to integrate with the Lion look and feel changes.

  • Gestures.  Very nice, smooth, worthwhile.
  • Content scrolling.  Annoying, go to the Properties and disable for normal up/down two-finger scrolling
  • Look and Feel. Animations make the system feel slower.  Generally feels a little awkward to me.  I suspect you’ll be able to turn off animation in a future release.
  • Mission Control.  Expose + Spaces might have been harder for basic users, but mission control is a step backward for power users.  If you use those features heavily, you may want to hold off for awhile.  I’m disappointed by Mission control on multiple monitors.  It’s also feels slower than the old Spaces + Expose.  May be due to the animation issues.
  • New Mail widescreen layout and search functionality.  Search is great.  Almost worth the upgrade by itself.  New layout is nice when on small screens.
  • Safari 5 + Lion.  Faster!  Zippier!  Could just be the new js and rendering suppport, but feels good.  Sometimes the sandboxed renderer eats up CPU cycles and memory and there is no way to tell what tab is responsible.  Just force kill the Safari content process.
  • Fullscreen apps.  Meh.  Ok for mobile use and interacts cleanly with Mission Control.
  • Rosetta (Power PC binary support) is deprecated.  Beware of older programs; some programs may still be using Rosetta under the hood and negatively surprise you.

That’s it.  Of the hundreds of features they tout, those are the only ones that really pop out for me.  Generally the overall feel of the system remains inferior after several weeks of use.  

    Exercising Self-Control and Getting-Focused

    During the work day, interrupts from e-mail or social media can lead me to compose e-mails or get sidetracked, 20 web searches away, hot on the hunt for answers to interesting questions raised by the latest forwarded content.  Today I discovered a useful, free application called SelfControl (http://visitsteve.com/made/selfcontrol/) that blocks your computer from accessing certain domains such as Facebook.com, Twitter.com, or incoming mail servers.  It blocks these connections for a fixed period of time and it is nearly impossible to disable once you’ve started the clock.  It is just as if I were going into a meeting where I wouldn’t normally be checking my e-mail, but this meeting is with my own mental creativity team.

    RescueTime has a similar feature called “Get Focused” which uses their database of distraction ratings to turn off all sites you have labeled as Very Distracting.  Unfortunately, there isn’t yet a way to add your e-mail to this service so SelfControl provides a useful extra bit of filtering.

    (It’s really too bad this doesn’t apply to my spare computer, my iphone, ipad or my wife’s computer…but technology only takes us so far in supporting behavior change)

    Innovating with Lybba

    Over the past year, I have had the pleasure of advising the non-profit organization Lybba.  Lybba’s vision is closely aligned with the work we’ve been doing at New Media Medicine.  This month I accepted a one year Research Fellowship with Lybba; the objective is to complete and apply my PhD research in the context of Lybba’s ongoing projects.  Chief among these projects is the Collaborative Clinical Care Network (C3N) which I wrote about a few weeks ago.  

    I’ve been extremely impressed with the scope of their ambition, the quality and breadth of their team and partners, and the concrete projects they’ve chosen to invest time in.   Continue reading “Innovating with Lybba”

    Personalized Health Experiments for Wellbeing and Scientific Discovery

    Nearly one quarter of US adults read patient-generated health information found on blogs, forums and social media; many say they use this information to influence everyday health decisions. Topics of discussion in online forums are often poorly-addressed by existing, high-quality clinical research, so patient’s anecdotal experiences provide the only evidence. No method exists to help patients use this evidence to make decisions about their own care. My research aims to bridge the massive gap between clinical research and anecdotal evidence by putting the tools of science into the hands of patients.


    Specifically, I am enabling patient communities to convert anecdotes into structured self-experiments that apply to their daily lives.  The self-experiment, a type of single-subject (N-of-1) trial, can quantify the effectiveness of a lifestyle intervention for one patient. The patient’s challenge is deciding which of many possible experiments to try given the information available. A recommender system will aggregate experimental outcomes and background information from many patients to recommend experiments for each individual. Unusual interventions that succeed over many trials become evidence to motivate future clinical research.


    I’m sharing the current status of my proposal to invite feedback and discussion.

    Holy Radioactive Bananas!

    I was reminded today by my social media brethren (thanks Jesse) that bananas are radioactive. They contain roughly 450mg of potassium and the isotope K-40 has a natural abundance of 0.01% which translates to 0.01 millrems per day. The radiation is split between 80% beta decay, 10% electron capture and 10% gamma rays.

    Perhaps this explains my wife’s strong aversion to bananas? Continue reading “Holy Radioactive Bananas!”

    The Collaborative Chronic Care Network (C3N)

    I just returned from spending a day with the team working on the Collaborative Chronic Care Network (C3N) who are part of the amazing ImproveCareNow (ICN) network of clinics as well as some very creative visionaries building the Anderson Center of the Cincinnati Children’s hospital. 

    ICN/C3N is focused on helping the families of children with Crohn’s disease or other IBS/IBD diseases like Ulcerative Colitis.  In recent years the team has focused on improving care delivery by showing how a network of centers can systematically improve care delivery by being disciplined in measuring and sharing outcome data.  They actively seek to translate learnings from over and under performing centers or sub-populations to change care delivery across the network and effect a shift in the mean outcome curve for chronic disease.

    More to the point, they are actually implementing the data collection, cross-institutional transparency and systems processes we all talk about. Continue reading “The Collaborative Chronic Care Network (C3N)”

    Using 100% of your brain

    The new movie Limitless is based on the premise that a drug can enable us to use “100% of our brains” because according to common wisdom, we currently only use 10%. This claim has been used in innumerable science fiction settings to provide a hypothetical source of magical cognitive abilities from super-intelligence to extra-sensory perception and is one of the most ill-informed and silly pretexts I’ve seen.  Of course, this realization is not new but I felt like writing a short rant.

    Continue reading “Using 100% of your brain”

    Writing Java plugins for Flume in Clojure

    I recently wrote a plugin in Clojure to add to the Cloudera Flume framework.  As it was my first time writing a full java class interface I had to learn about the proper use of both proxy and gen-class.  Given the poor error reporting at the java-clojure boundary, figuring out what you did wrong if you don’t get every detail exactly right (particularly when loading a class in the plugin’s final environment) can be difficult.

    Continue reading “Writing Java plugins for Flume in Clojure”