It is now obvious to everyone that the world has become fast. Very, very fast. I can't speak to how fast the world was pre-1985, but my guess is that it was a hell of a lot slower than it is today. Frankly, it's hard to keep up - and this is coming from someone who has basically grown up with the internet, and who has been an early adopter of AOL followed by Gmail followed by Facebook followed by Twitter. I can't imagine how fast the world must be for those who learn this stuff piecemeal; for those who don't think of an iPhone as an additional, indispensable appendage.
I've written about 50 topics in the past year. The process of learning -- and writing -- about a new topic each week has heightened my awareness of time in a way that I had not expected. I mean that on several levels. On a micro level, I now know exactly how much time it takes me to research, write, edit, and distribute a blog post (1.5 hrs, 1 hr, 15 min, 20 min, respectively). But I've also learned to appreciate the passing of a year. While on the one hand the structured nature of the blog (week 1, week 2, etc.) helped me at least recognize in a quantifiable way how time really does fly, on the other, I've realized that a lot happens in one year. More than most of us realize. Can you believe it has been a year since Haiti's disastrous earthquake? That we've had a Winter Olympics, an African World Cup, a US Congressional election, a stock market flash crash... It already seems so distant.
But lately it's been about more than just the discrete events that take place in a year; it's also about the rapidly increasing pace and magnitude of events. In five minutes on a random day in May 2010, stocks fell by almost 10% - FIVE MINUTES! 550 million people - almost 1 in 10 globally - now use Facebook (I was roughly user number 15,000, thank you very much). My point is, as the world speeds up, the new winners and losers are being determined ruthlessly, efficiently, quickly. I believe much of the angst about the future of the United States, the possibility of another recession, and certainly the great and ongoing deleveraging has to do with how quickly an assortment of events have transpired. Suddenly China is here. Suddenly there are no jobs. Suddenly we are forced to watch one stimulus measure after another enacted to keep us from the theoretical abyss. Those with scale and leverage to the global economy are again thriving, and those whose skills or education are provincial are losing out. How can this not create some serious social and political friction? How can the average person keep up with such strong, secular forces? The sheer magnitude of these shifts is hard enough to swallow - simultaneously comprehending the speed at which they are taking hold seems almost impossible.
So what can be done? It starts with an honest discourse. While fraud and greed have undoubtedly caused pain and suffering (as they do at the end of any bubble), what's really going on starts with the massive new supply of labor to the world. Billions globally want their shot at this capitalism game, and will work harder for lower wages to get there. In a world where money flows instantaneously and is agnostic to who has won in the past, this means wage pressures for most low to medium skilled jobs in the United States. We can argue all we want to about the rich getting richer, or about the highest marginal tax rate. That will address only tangentially this basic truth about the supply and demand for labor. When was the last time a politician talked openly about this? Change is happening, and it is happening fast. We need to recognize this, accept its significance, and adapt. Others already have, we are behind the curve.
The final 52 Week Project post will be a more positive piece that picks up where this post left off. As an example of how fast the world is, I've gone back to my old posts and highlighted a few topics for which meaningful changes have taken place since initial publishing:
- Since week 9's post on the iPhone, the iPhone 4 and iPad have come out. Apple's stock has gone up 58% since the post.
- Since my piece on the legality of marijuana, California's heralded Proposition 19 failed to make pot legal.
- Elias, the Bolivian potato farmer to whom I lent $25 on Kiva has paid back his loan in full.
- I've continued to drink more tea than ever and feel very healthy after having stuck to my new regimen of vitamins and supplements.
- The unpronounceable volcano Eyjafjallajökull has dropped from our collective memory.
- The great new beer that you've still never heard of, Old Swatty, continues to be produced on a small scale, although it now proudly sports labels!
- The answer to the question "Are we alone?" became more complicated with NASA's very recent discovery of an arsenic life form.
- Khan Academy has taken off, and is now carried and heavily promoted by iTunesU.
- My view that Borders and Barnes & Noble are dead appears to be a more mainstream view. Last week, the CEO of Simon & Schuster conceded: “My No. 1 concern is the survival of the physical bookstore.”
- The US Postal Service continues to lose money, while its private counterparties continue to increase revenues.
- Blockbuster announced plans to close another 180 stores.
- Finally, and perhaps most personally relevant, my new workout regimen has already been halted in its tracks. Too many pushups and dips have sadly caused some pulled muscles in my arms.
Showing posts with label iPhone. Show all posts
Showing posts with label iPhone. Show all posts
Tuesday, December 28, 2010
Saturday, February 27, 2010
Week 9: Why the Stethoscope is on its way out...
Distribution Source: TED.com
Content Source: Eric Topol
Format: Video
Length: 16 minutes and 59 seconds
Link: The Wireless Future of Medicine
As many of my friends know, I am a huge fan of the iPhone. From my iPhone I can access my bank account, get directions, send a customized post card (from a photo I took on my phone), read the news, play games.. the list goes on. Hell, my iPhone can also turn into a flute, recognize unknown songs playing on the radio or at a bar, and even repel bugs. Yes, you read that correctly - the phone emits a high frequency noise that keeps bugs away. It is simply unbelievable.
I've always tried to convince people who don't yet "get it" that the iPhone and other smartphones are revolutionary not because they have the internet, or because they have great graphics. They are revolutionary because they represent a very new platform that spans all spheres of life and literally expands the realm of what is possible. I'm not joking when I say that the iPhone has saved me more time than any other single device, person - whatever - in my entire life. By far. And what's exciting to me is that the realization of this potential has barely begun in the two areas in which it may have the most lasting impact on humanity: education and medicine. Indeed, one of the points of this blog is to show how iTunesU - which I access through my phone - provides good, free information to anyone with the internet. But today I will focus on medicine, something my mom and girlfriend know a lot about, but about which I know basically nothing.
Dr. Eric Topol gave a fascinating talk last fall that starts with a bold prediction: the stethoscope, invented in 1816 and still widely used today, will be obsolete by 2016. Why? Because not only will a patient's heartbeat be available to a doctor in real time - anywhere in the world - but so too will all vital signals. Already the technology exists to see a patient's electrocardiogram on an iPhone. In some hospitals, doctors can see from their phones the heart rhythm, blood pressure, oxygen and temperature of their ICU patients - without having to be anywhere near the patients! Here is an example of how this would look on a phone.
Other technologies are equally fascinating - imagine, as an expectant parent, being able to monitor in real-time intrauterine contractions or the fetal heart rate. While we have continuous glucose sensors for diabetes patients, they have to be placed under the skin and then brought to doctors. The technology is almost there to have a non-implantable sensor, link it to a phone, and then send the results electronically to a doctor. Soon every smartphone user will be able to map literally every minute of his or her sleep, with breakdowns by different sleep stages (REM, light sleep, etc). There are already many calorie measurement programs - intake and outtake - on smartphones. Perhaps the most popular exercise-management program is the Apple-Nike partnership where a chip in Nike shoes automatically uploads workout statistics to the iPhone. Over 1.2 million Americans use this technology. The Holter Monitor, according to Dr. Topol, will also soon be obsolete. Now we have peripheral sensors or "smart band-aids" that can be uploaded through a "body area network" to your smartphone. Once it is on your smartphone it can be distributed wherever or however you like - to the hospital, the doctor, etc.
It is important to note that the wireless medical innovations are not limited to just physiologic metrics. They also extend to areas like imaging. For example, GE has introduced a hand-held ultrasound. This device has the capacity to do a Cardiac Echo or fetal monitoring, and is more sensitive than a stethoscope.
While some of this may seem like it is not practically applicable yet, Dr. Topol surprised the audience by revealing he was wearing a wireless device during his talk. He then showed in real time his ECG, heart rate, fluid status, respiration, posture, oxygen level and temperature. All of these are vital for monitoring someone with heart failure, the number one reason for hospital admissions and readmissions. The cost per year is estimated to be $37B, with 80% of costs related to hospitalization. The readmission numbers are staggering: over 50% will be readmitted after six months. This monitoring software is now being used in a trial that will attempt to prevent such high readmission rates among heart failure patients.
The armchair politician in me scratches his head and asks - instead of trying to guess at future health care costs based on models of the number of sick Americans, why not immediately seek bipartisan support for trials like this? In the same way that cheap energy ignited an industrial revolution, shouldn't we be focusing on extremely cheap and scalable preventative monitoring practices? If successful, this would both cut costs and improve the health of Americans in a way that seems to represent the ultimate in consumer-driven health care.
The problem, of course, is huge: 140MM Americans have one or more chronic diseases, and 80% of the $1.5 Trillion in medical expenditures are related to chronic disease. How can wireless medicine help? Dr. Topol outlined the ten targets for wireless medicine, listing the innovations that will improve each:
Alzheimer's (5MM Affected) - Vital signs, location, activity, balance
Asthma (23MM Affected) - Respiratory rate, FEV1, air quality, oximetry, pollen count
Breast Cancer (3MM Affected) - Ultrasound and self-exam
COPD (10MM) - Respiratory rate, REV1, air quality, oximetry
Depression (21MM) - Med compliance, activity, communicatio
Diabetes (24MM) - Glucose, hemoglobin A1C
Heart failure (5MM) - Cardiac pressures, weight, BP, fluid status
Hypertension (74MM) - Continuous BP, med compliance
Obesity (80MM) - Smart scales, glucose, calorie in/out, activity
Sleep disorders (40MM) - Sleep phases, quality, apnea, vital signs
The potential impact of these technologies on Hospital/Clinical Resources are huge, with major implications for hospital beds, outpatient visits, assisted living facilities, sleep labs, Holter Monitoring, mammography, and ultrasound/echocardiography (to name a few). Also fascinating is the potential for overlap in advancements in genetics with wireless advances. We have learned more about the genetics of diseases in the last three years than in human history. Using technology for both monitoring and cross-referencing, we can begin to predict who is likely to get Type 2 Diabetes, who is at risk for breast cancer, who may get atrial fibrillation, sudden cardiac death, etc. To some degree this capability exists, but not on a widespread, scalable, cheap platform like that which smartphones will allow.
In short, the potential changes and implications of wireless medicine span the globe, span age, sex and race, and span the many types of diseases. Put simply: we need to accelerate the era of wireless medicine. An article on this topic said the following: "The personal metrics movement goes way beyond diet and exercise. It's about tracking every facet of life, from sleep to mood to pain, 24/7/365." This may sound very scary, and in some ways it is. But it's not inconsistent with the underlying theme that to some degree has and will continue to define my generation: uber-transparency and significantly less individual privacy. This is yet another piece of the puzzle that is the exponentially increasing volume of information. To me the two key underlying questions are: how do we use this information, and how do we protect both the integrity and security of sensitive information? These questions, while extremely important, are somewhat irrelevant to the bigger picture. The train has left the station: the unbelievable power and scale of these new platforms has been unleashed. Now we must learn to maximize their benefits and minimize their potential costs. Supporting wireless medicine is a good place to start.
Content Source: Eric Topol
Format: Video
Length: 16 minutes and 59 seconds
Link: The Wireless Future of Medicine
As many of my friends know, I am a huge fan of the iPhone. From my iPhone I can access my bank account, get directions, send a customized post card (from a photo I took on my phone), read the news, play games.. the list goes on. Hell, my iPhone can also turn into a flute, recognize unknown songs playing on the radio or at a bar, and even repel bugs. Yes, you read that correctly - the phone emits a high frequency noise that keeps bugs away. It is simply unbelievable.
I've always tried to convince people who don't yet "get it" that the iPhone and other smartphones are revolutionary not because they have the internet, or because they have great graphics. They are revolutionary because they represent a very new platform that spans all spheres of life and literally expands the realm of what is possible. I'm not joking when I say that the iPhone has saved me more time than any other single device, person - whatever - in my entire life. By far. And what's exciting to me is that the realization of this potential has barely begun in the two areas in which it may have the most lasting impact on humanity: education and medicine. Indeed, one of the points of this blog is to show how iTunesU - which I access through my phone - provides good, free information to anyone with the internet. But today I will focus on medicine, something my mom and girlfriend know a lot about, but about which I know basically nothing.
Dr. Eric Topol gave a fascinating talk last fall that starts with a bold prediction: the stethoscope, invented in 1816 and still widely used today, will be obsolete by 2016. Why? Because not only will a patient's heartbeat be available to a doctor in real time - anywhere in the world - but so too will all vital signals. Already the technology exists to see a patient's electrocardiogram on an iPhone. In some hospitals, doctors can see from their phones the heart rhythm, blood pressure, oxygen and temperature of their ICU patients - without having to be anywhere near the patients! Here is an example of how this would look on a phone.
Other technologies are equally fascinating - imagine, as an expectant parent, being able to monitor in real-time intrauterine contractions or the fetal heart rate. While we have continuous glucose sensors for diabetes patients, they have to be placed under the skin and then brought to doctors. The technology is almost there to have a non-implantable sensor, link it to a phone, and then send the results electronically to a doctor. Soon every smartphone user will be able to map literally every minute of his or her sleep, with breakdowns by different sleep stages (REM, light sleep, etc). There are already many calorie measurement programs - intake and outtake - on smartphones. Perhaps the most popular exercise-management program is the Apple-Nike partnership where a chip in Nike shoes automatically uploads workout statistics to the iPhone. Over 1.2 million Americans use this technology. The Holter Monitor, according to Dr. Topol, will also soon be obsolete. Now we have peripheral sensors or "smart band-aids" that can be uploaded through a "body area network" to your smartphone. Once it is on your smartphone it can be distributed wherever or however you like - to the hospital, the doctor, etc.
It is important to note that the wireless medical innovations are not limited to just physiologic metrics. They also extend to areas like imaging. For example, GE has introduced a hand-held ultrasound. This device has the capacity to do a Cardiac Echo or fetal monitoring, and is more sensitive than a stethoscope.
While some of this may seem like it is not practically applicable yet, Dr. Topol surprised the audience by revealing he was wearing a wireless device during his talk. He then showed in real time his ECG, heart rate, fluid status, respiration, posture, oxygen level and temperature. All of these are vital for monitoring someone with heart failure, the number one reason for hospital admissions and readmissions. The cost per year is estimated to be $37B, with 80% of costs related to hospitalization. The readmission numbers are staggering: over 50% will be readmitted after six months. This monitoring software is now being used in a trial that will attempt to prevent such high readmission rates among heart failure patients.
The armchair politician in me scratches his head and asks - instead of trying to guess at future health care costs based on models of the number of sick Americans, why not immediately seek bipartisan support for trials like this? In the same way that cheap energy ignited an industrial revolution, shouldn't we be focusing on extremely cheap and scalable preventative monitoring practices? If successful, this would both cut costs and improve the health of Americans in a way that seems to represent the ultimate in consumer-driven health care.
The problem, of course, is huge: 140MM Americans have one or more chronic diseases, and 80% of the $1.5 Trillion in medical expenditures are related to chronic disease. How can wireless medicine help? Dr. Topol outlined the ten targets for wireless medicine, listing the innovations that will improve each:
Alzheimer's (5MM Affected) - Vital signs, location, activity, balance
Asthma (23MM Affected) - Respiratory rate, FEV1, air quality, oximetry, pollen count
Breast Cancer (3MM Affected) - Ultrasound and self-exam
COPD (10MM) - Respiratory rate, REV1, air quality, oximetry
Depression (21MM) - Med compliance, activity, communicatio
Diabetes (24MM) - Glucose, hemoglobin A1C
Heart failure (5MM) - Cardiac pressures, weight, BP, fluid status
Hypertension (74MM) - Continuous BP, med compliance
Obesity (80MM) - Smart scales, glucose, calorie in/out, activity
Sleep disorders (40MM) - Sleep phases, quality, apnea, vital signs
The potential impact of these technologies on Hospital/Clinical Resources are huge, with major implications for hospital beds, outpatient visits, assisted living facilities, sleep labs, Holter Monitoring, mammography, and ultrasound/echocardiography (to name a few). Also fascinating is the potential for overlap in advancements in genetics with wireless advances. We have learned more about the genetics of diseases in the last three years than in human history. Using technology for both monitoring and cross-referencing, we can begin to predict who is likely to get Type 2 Diabetes, who is at risk for breast cancer, who may get atrial fibrillation, sudden cardiac death, etc. To some degree this capability exists, but not on a widespread, scalable, cheap platform like that which smartphones will allow.
In short, the potential changes and implications of wireless medicine span the globe, span age, sex and race, and span the many types of diseases. Put simply: we need to accelerate the era of wireless medicine. An article on this topic said the following: "The personal metrics movement goes way beyond diet and exercise. It's about tracking every facet of life, from sleep to mood to pain, 24/7/365." This may sound very scary, and in some ways it is. But it's not inconsistent with the underlying theme that to some degree has and will continue to define my generation: uber-transparency and significantly less individual privacy. This is yet another piece of the puzzle that is the exponentially increasing volume of information. To me the two key underlying questions are: how do we use this information, and how do we protect both the integrity and security of sensitive information? These questions, while extremely important, are somewhat irrelevant to the bigger picture. The train has left the station: the unbelievable power and scale of these new platforms has been unleashed. Now we must learn to maximize their benefits and minimize their potential costs. Supporting wireless medicine is a good place to start.
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