How Health Care Can Deliver Better Quality at Lower Costs

I know, we are all sick and tired of the health care debate. But, while reading Don Clark's article in the WSJ today titled Chip Pioneer, Genetech Vet Bring High-Tech Sensibility to Medicine, the answer to how improved quality and lower costs will be achieved becomes clearer; and the solution won't be akin to rearranging the proverbial deck furniture on the health care Titanic. Therefore, I thought it worth a brief exploration.

The WSJ article sets forth a unique partnership of people interested in changing a system that does not make sense. You see technologist and former Intel Chairman Andy Grove and the charming and accomplished Susan Desmond-Hellmann , now Chancellor for UCSF, come from two very different industries, high tech and health care, but they see the same problem in how the health care system is broken and are doing something REAL to fix it. Kudos to Don Clark for identifying the two and their efforts.

We see this in industry everywhere. Existing leadership invested in past modalities having little affect on real outcomes because they are not REALLY changing how things are done. Health care is no different. As an example when asked why the system of health care is not driving costs down, Ms. Desmond-Hellman reflects:

There are a number of reasons, but the most important one is that there are no real incentives that drive cost as being a key parameter. If you are in product development, if you are developing new therapies, the most important barrier is Food and Drug Administration approval. The FDA has two metrics for success: safe and effective. Neither of those metrics has anything to do with cost. It's entirely different than every time you get a new iPod—it's got new features and it's cheaper.

She's right and more and more industries must adopt new models in order to have a real impact on the problems they are facing. Andy Grove shared a similar view when explaining why he is involved in doing something about health care:

The problem that actually bothered me is that there are dozens of ways of dealing with cancer in mice or neurological diseases in mice, and none made it across the chasm [to market].

Now UCSF is collaborating with the University of California, Berkeley to offer a two-year master's degree in "translational medicine," the discipline of transferring lab breakthroughs to the marketplace. The MBA-style program, which he helped establish with a $1.5 million donation, will target students from both medical and high-tech fields. Hopefully Mr. Grove's idea of using Silicon Valley-style techniques to speed and improve medical research will pay off.

Again, great article Don. Thanks for sharing it. Watch Susan's address on health care innovation below to learn more.

Fitness Industry Should Pay Attention to Changing Bookstore Biz Model

I am reading Jeff Trachtenberg's article in the WSJ this morning titled "E-Books Rewrite Bookselling". The article includes an important quote from Arthur Klebanoff, who is chief executive of New York-based RosettaBooks LLC, an e-book publisher. Arthur says "It's fair to say that the leadership folks at the major trade publishers didn't believe until very recently that e-books had any economic life in them." The important words here are "VERY recently".

I write and lecture about radical change happening in business today with a particular emphasis on the fitness and wellness industry. What I attempt to share with leaders and organizations is that the rate of change is exponential, not linear as many of us assume. Jeff's article on how the E-Book business is revolutionizing bookselling illustrates the circumstances all business models are facing TODAY. Unfortunately, as with the book business, most industry leadership doesn't understand the true pace of radical change and therefore does not see the disruption coming until its to late. As Jeff explains:

Nowhere is the e-book tidal wave hitting harder than at bricks-and-mortar book retailers. The competitive advantage Barnes & Noble spent decades amassing—offering an enormous selection of more than 150,000 books under one roof—was already under pressure from online booksellers. It evaporated with the recent advent of e-bookstores, where readers can access millions of titles for e-reader devices. Even more problematic for brick-and-mortar retailers is the math if sales of physical books rapidly decrease: Because e-books don't require paper, printing presses, storage space or delivery trucks, they typically sell for less than half the price of a hardcover book. If physical book sales decline precipitously, chain retailers won't have enough revenue to support all their stores.

Barnes and Noble has 1,362 stores, including 719 superstores with 18.8 million square feet of retail space: the equivalent of 13 Yankee Stadiums. That's a lot of fixed cost. As Jeff points out, Borders Group, the nation's second-largest book chain, saw same-store sales decline 14% at its superstores for the quarter ended Jan. 30. Of the 797 B. Dalton Booksellers stores that Barnes & Noble acquired in 1987, only four remain. And the number of independent booksellers continues to fall. As Indigo Books CEO Heather Reisman put it: "The days of filling the shelves and just opening the doors are gone."

Today the fitness industry is in a similar situation. Lots of high fixed costs and looming disruptive innovation. In an industry that loses almost half of its customer base each year, the days of filling a facility with equipment and just opening the doors are quickly coming to an end as well, but does anyone see what's coming? What is most telling, as identified in the WSJ article, was that Barnes and Noble was once a leader in the E-Book industry, investing in NuvoMedia in 1998. In a classic example of a market leader focusing on sustaining innovation as opposed to disruptive, the company abandoned the technology in 2003. B&N could have been the leader in E-books, but they gave up on the vision. Will leaders in the fitness industry make the same mistakes?

Watch and learn how new technologies are creating new innovations in publishing.

Bacteria Created From Scratch - The Singularity IS Near

I've written about the exponential advancement of science and technology and here is yet again another example. Scientists announced yesterday that for the first time they've created a complete set of synthetic genes and implanted them into living bacteria - this accomplishment could lead to the creation of new synthetic biofuels among other advances. That's right, people designed an organism on a computer and then made it real. Anyone left thinking Kurzweil is nuts when he refers to the law of accelerating returns ? See his video below.

J. Craig Venter, the human genome biologist who headed the project said, "The bacteria in the experiments reproduce naturally but behave exactly the way their newly constructed genes direct."

Although the advance is far from creating "life in a test tube," it was a singular achievement in making and assembling the chemical components of genes that functioned inside living cells exactly the way natural genes do. Watch Kurzweil talk about the law of accelerating returns and the singularity:



Intelligently Using Email - PS Connect & Gmail Contextual Gadgets

Last night my son brought to my attention a post by Dong Chen, of the Gmail Contextual Gadgets team.

At Campfire One it was recently announced that Gmail contextual gadgets will be released as a new extension point for developers. These gadgets can intelligently draw information from the web and let users perform relevant actions based on the content of an email message, all without leaving the Gmail inbox. For example, contextual gadgets currently available in Gmail can detect links in emails to show previews of documents, videos, photos, and more, right inside the messages.

For businesses, Gmail contextual gadgets can improve productivity by complementing email in a context-specific and actionable way. Appirio, a cloud solution provider, provided a demonstration of the potential of Gmail contextual gadgets and other experimental features
with their new product PS Connect:. Watch !

As Chen notes, "Soon we’ll be opening Gmail contextual gadgets as an extension for trusted testing by developers. If you have a good idea for this type of gadget today, please fill out this form. And for those of you who will be attending Google I/O in May, be sure to check out the session on building Gmail contextual gadgets."

The Era of Behavior

Tom Friedman's Op-Ed in the NYT's today was titled "A Question from Lydia". In it Tom addressed a question a 10 year old Greek girl wrote at the site of the Marfin Engatia Bank, which was firebombed a few weeks ago. The question was "In what kind of world will I grow up?". Tom answered, "that's a good question Lydia", and I agree. Good news is that world is changing to a place with great potential for not tolerating such bad behavior.

My writing proposes that 6 degrees of change are increasingly emerging as the result of the revolution created by technology, global ism and demographic shifts:

1. Transparency modality becomes essential;

2. Traditional institutions vanish;

3. Orchestration strategy dominates;

4. Participation explodes;

5. Wealth increasingly is redistributed;and

6. Human conciousness profoundly evolves.

The increasing adoption of transparency as a requirement for doing things cannot be ignored or discounted. This will be driven by hyper-connectivity and a world where people's behaviors will not be able to be hidden.

This view is shared by thought leader Dov Seidman, and articulated in his recent book: How, Why How We Do Anything Means Evertyhing . As Tom mentions in his NYT Op-Ed:

When Greeks binge and rack up billions of euros of debt, Germans have to dig into their mattresses and bail them out because they are all connected in the European Union. Lost in Athens, felt in Berlin. Lost on Wall Street, felt in Iceland. Yes, such linkages have been around for years. But today so many more of us are just so much more deeply intertwined with each other and with the natural world. That is why Dov Seidman, the C.E.O. of LRN, which helps companies build ethical cultures, and author of the book “How,” argues that we are now in the “Era of Behavior.”

Of course, behavior always mattered. But today, notes Seidman, how each of us behaves, consumes, does business, builds or doesn’t build trust with others matters more than ever. Because each of us, each of our banks, each of our companies, now has the power to impact, for good or ill, so many more people’s lives through so many more channels — from day-trading to mortgage-lending to Twitter to Internet-enabled terrorism.

Watch Dov's lecture below. Dov calls this , "The Era of Behavior". After reviewing the book, I recommend it highly thanks to Tom's editorial.