Virtually Life-like!

My friend Chris first introduced me to the idea of online economies 3 years ago. NYTimes ran a story about "virtual money" in a popular game called World of Warcraft this past summer:

"Every World of Warcraft player needs those coins, and mostly for one reason: to pay for the virtual gear to fight the monsters to earn the points to reach the next level. And there are only two ways players can get as much of this virtual money as the game requires: they can spend hours collecting it or they can pay someone real money to do it for them."

Now the idea has reached academia. Professor Bloomfield, from the business school at Cornell, is teaching a course on a game called Second Life. He calls the course "metanomics", the economics of the metaverse.

"In his course, Bloomfield says his goal is to get students to understand business and regulatory oversight in the metaverse using thought from the real world. Some students start with what Bloomfield calls the "immersionist" view of Second Life -- using their avatars in the metaverse, as if it were the only universe.

Another perspective he teaches is the "augmentationist" view -- considering the metaverse a new feature of real life and analyzing how the metaverse affects business and policy in the real world."

Sounds like an interconnected version of Sim City to me. Virtual simulation certainly offers strategic benefits for businessman and policy makers, but the model is as good as those who build it. Stay tuned!

Confound it!

Rudy Giuliani makes a mistake on his stats for surviving prostate cancer in the UK. Quotes 44%. In fact, the US is doing better, but not by that much; 82% vs. 74.4%.

Why don't politicians get it right the first time? Their staff has to be extremely specialized and well-informed. In this case, it might not be the people but rather the wide array of answers they get for one simple question.

In health care, its extremely difficult to control for confounding variables. Essentially, to get rid of underlying variables that may influence the answer to the question you're asking. The best example is the placebo effect. You want to figure out how to get rid of a cold. You take some medication and your cold goes away. Its very possible though that because you thought the medication would help you, you psyched yourself out of a cold. Its been proven time and again just by giving patients sugar pills and finding out a couple of days later that they feel great!

Anyway, comparing prostate cancer survival rates of two countries can be extremely confounding. Different people, different doctors, different education, different testing, different technology, the list goes on. I bet the survival rates in the south and north of US alone are different! Depending on what you confound, you're likely to get a different answer to the same question.

Bottomline: Countries are hard to compare. Maybe we should start smaller.

What is the health care industry really trying to accomplish?

Is the goal of health care actually to make people healthy? Its debatable. Look at insurer denials of coverage, defensive medicine and pharmaceutical advertising and you wonder what's really going on. Of course there's the other side of the coin too, the obviously patient-care oriented side; payer-sponsored PHRs, convenience clinics, and cheap generics just to name a few.

The point is that health care is so massively complex that rarely do all parties involved have one set goal in mind. Maybe it makes sense they don't. Different incentives lead to different pursuits, but there has to be something everyone's trying to accomplish?

Here's a thought, the goal of the industry is to make health care more affordable and accessible for consumers while keeping costs down for suppliers. Cost-efficiency. Delivery. Patient care. I believe this can serve as a good litmus test for what is really relevant to the advancement of health. Economists use ratios such as cost/life year gained to measure the cost-effectiveness of specific medical interventions. But it doesn't always have to be this rigorous. Next time you see a drug ad, presidential campaign ad, or policy ad on TV, question the incentives of the sponsors and see if they match with the overall goal above.

The emerging consumer-driven health care trend means we should get more involved. It all starts with perspective.

Convo: Short for Conversation. But is the Value of Conversation Shortening too?

E-mail worries me. Actually, its how we use it that bothers me the most. Think of email as little post-its left around for your friends, relatives and colleagues who must respond back to them with more post-its and you'll see the beginnings of a yellow brick road leading to an Oz where the wizard is none other than Adam Bosworth.

I have no problem with E-mail's original purpose of allowing people to passively communicate and remind each other of projects and grocery lists and stuff. But foregoing the meet-and-greet, face-to-face, in-person conversations for E-mail chat is another story.

For example, Netflix has basically allowed me to stop going to the movie theater unless its a must-see major blockbuster that really is worth the experience. That experience though, so often shared together with friends or family, has now become a lonely masturbatory affair in one's living room on a small flat screen and a worn-out couch with a permanent imprint of one's derrière.

Similarly, E-mail has made us loners (albeit very available loners), indifferent to the extreme of stepping out to knock on a friend's door when its so easy and convenient just to e-mail them. The impromptu get-together has become lost in the zany roads of the information superhighway. These days, we need video game consoles like the Wii to remind us to get a breath of fresh air and play outside for a change!

The Golden Rule

SCHIP is hard to argue against, especially when Bush is leading the veto effort and charities are so eager to remind you of the fund raising lure, "its for the children!" But Mike Leavitt makes the strongest case by arguing for preserving scarce present resources to anticipate for large-scale medical expenditures in the future, or in other words, saving.

The SCHIP argument primarily centers around which families will receive funding and how much they will receive. It seems that a resolution might just be around the corner, but its curious why Leavitt (and Bush) wouldn't want to help kids get easier access to medical care.

One reason is the Dems' expansion would actually cost more to maintain than the initial $35 billion they desire. The other is that it doesn't make sense for a family of 4 making a total of $83,000 to be eligible. But the uber-reason is that a GOP-approved $20 billion expansion would save $15 billion for other important programs, such as the development of national standards for health outcomes, information transparency so the public is aware of such standards, and a national IT/exchange structure to maintain and update these standards. And I'm not talking about the Zagat-like rating system Wellpoint is offering, either. What a joke.

Bottomline: Saving for the future is important. The Golden Rule of cutting back a little now to benefit future generations later is even more important. The environment, the debt-ridden budget, social security and certainly health care all depend on it.

Sell, Sell, Sell!

StartupNation is one of my most favorite sites for entrepreneurship ideas and advice. From step-by-step guides for creating a business plan to 100's of self-starter business ideas the site covers a lot of ground.

Recently I received a feed from the site about doing an elevator pitch, in my mind the most important element in selling your business idea (and yourself). A quick 60-second synopsis of what, how and how much, the ability to deliver a mesmerizing and attention-grabbing pitch is an art. One I'm trying to master!

When it comes to new ideas, we're all like HR managers filtering through sheafs of resumes a day. How many sound bites and info bites do we hear in a day? An effective pitch will separate itself from the daily jargon and deliver an impacting message that will jar you from your reverie. Sort of what the business should be doing, right?

Think of the pitch as an extension of your idea. The better you can explain what you're about, the sounder your idea will seem to the person listening to it.

The Satisfaction of Discovering (already discovered) Ideas

My academic advisor, Matt, told me couple weeks ago of a new idea he had for automated prescription reminders. Software that would alert you via text message or email to take your medication or monitor your blood pressure based on whatever condition you might have.

Its a great idea, but to Matt's chagrin, this service is readily available in reminder form right on your cellphone. Also, Google Calendar allows you to received automated email reminders for events you've pre-programmed. For free!

Despite this fact, there's a sense of satisfaction that comes out of the process of discovery even if that discovery has already been made. The sigh for what could have been is mixed in with gratitude for the person who worked so hard to bring that service or product to life.

I had such a feeling when Netflix came out and much more recently when I discovered that the niche of health care blogging wasn't as empty as I thought. It sobers you and makes you realize just how much effort is involved in making an idea a reality.

Convenience clinics going Global

Cardinal Health's Medicine Shoppe is opening up 500 mini-clinics in the slums of India. Medically trained professionals, minimal fees (20Rs!) and a well-stocked pharmacy are some of the attractions not to mention diagnostic labs and imaging.

In a way, the medical system is reverting back to its mom-and-pop roots, but on a much grander scale. Convenience clinics offer basic, personalized care usually for low-income, elderly or uninsured populations thereby diverting them from going to the ER for non-critical issues. This way, rationing of medical care does not end up occurring via triage and long waits in packed ERs but instead in convenient care locations around town.

With allocation of scarce resources always a concern for health care, this is one great way to keeps costs down and provide increased access.

BI Health: Reading between the Health Care lines

Business intelligence (BI) in health care has been growing slowly not because it doesn't add value but because the conservative world of health care has been slow in acknowledging its value. Jill Dyche from Baseline Consulting has written several white papers on efficiency, process improvement , and the drivers of BI within health care.

This is the kind of work that fascinates me! Connecting hospitals and systems together to share information, making that information transparent to the open market of consumers and third-parties, and using that information to develop metrics to measure performance on various levels. Its a great blend of logistical and academic know-how.

In an industry filled with bureaucratic claims processing and a set hierarchy of decision-makers, you need folks who think outside the box constantly. The various facets of health care and their interconnections can be hard to grasp, and BI experts really try to break it down and make sense of it all in a very methodical and logical way. I'm excited to learn more about this world of liaisons and be a part of its growth in an industry hungry for the change.

Cold Medication for Children Under Review

Here's a NYTimes article on the possibility of children's cold medication causing more harm than good. The consensus of the FDA expert panel boils down to the fact "that if the drugs had not proven to be effective in young children, they should not be available." It seems that in the '70s regulators decided what works for adults should also work for children (using different doses of course). Since then though, many studies have shown the efficacy of these OTC cold drugs to be debatable and in the worst cases, causing serious harm.

Its shocking to me that medication like Robitussin, which I was given routinely for a cough when I was young, could have had an adverse effect. The numbers explain a lot: "Parents spend around $500 million every year buying nearly 95 million boxes containing 3.8 billion doses of medicine." Hence the manufacturer uproar against the possible ban on OTC drugs for children below the age of 6. Lobbying power makes all the difference in health care (and most other sectors as well).

The director of the FDA office of new drugs advises parents to be more careful reading labels, which while smart practice in general, is difficult to expect of parents who most likely aren't versed in medical terms and are worried sick about their children's condition. The gap in medical education is primarily the reason expert FDA panels have to be convened to pass such bans on drugs. Maybe pharmacists should start getting more involved.

Googlefficiency

Google has countless ways to make life more efficient. I'm a huge fan of Google's services: gmail, docs, calendar, reader, iGoogle, and of course Blogger to name a few. Its become so easy to organize my emails or load any document I've worked on anywhere there's internet or check out the weather in 5 different locations around the world with one click of a button. I only realize this when I see others not using the free apps Google offers. I figure they just don't know about it or they're skeptical. Well, if you fall in either of those categories, just give it a shot. Here's the link to get started: Google Apps.

Great Einstein quote

"There are some things that count that can't be counted. And some things that can be counted that don't count."

gPhone

Since the iPhone came out, there's been a lot of buzz about gPhone's debut. gPhone is Google's prototype of a mobile phone that would offer user-friendly search engine capability (www.google.com, what did you expect!?). In fact, this mobile OS functionality may be its primary attraction as there seem to be very few differences between the gPhone and the iPhone.

Google's also throwing the idea of free mobile service around. You would have to watch a 10-30 second ad before making a call. Surely that's worth $0.40!

Here's the Wiki.

On the Edge of Information

Web2.0, Health2.0, Life2.0.

There's so much information available at our disposable nowadays that keeping up with it can become a part-time job. We specialize because we have to. Yet being in the know can be a fantastic feeling. I've often called it being on the "edge of information"; following the news, blogosphere, local and global community events, social networking sites, and mainstream media just to name a few!

We're constantly absorbing and translating at exponential rates that we rarely get time to digest it all. Sound bites have become info bites, and while the quantity of information we hold in our minds has grown, the quality is debatable. Life2.0 must be self-defined. What does this information mean to us? What kind of impact does it have on our daily lives? We may be reading but are we retaining, processing, connecting...learning?

John Bogle on our Bottomline Society

Here's a link to Bill Moyers' interview of John Bogle, the founder of Vanguard and index funds. I ran across it since there is a brief mention of buyouts of nursing home by big private equity firms, but overall it turned out to be a pretty insightful interview. He makes a great Rome/America analogy. Below are some highlights:

"...ultimately, the job of capitalism is to serve the consumer. Serve the citizenry. You're allowed to make a profit for that. But, you've got to provide good products and services at fair prices."

"...the financial side of the economy is dominating the productive side of the economy."

"We have our own bread and circuses. And they're a little different than the bread and circuses they had in Rome. But, we surely have our circuses whether it's sports teams or casino gambling or the lottery in the states."

"China owns — I don't know the exact number — but, let me say about 25 percent of our federal debt."

"I've often said we're in a bottom line society. We're measuring the wrong bottom line."

HealthVault and Facebook

The announcement of Microsoft's personal health record, HealthVault, a couple weeks ago brought a mixed response from the health blogosphere. This cartoon puts a good comic spin on it (thanks Ben!):

HealthVault lets you share your "strong" password with other providers of your choice, but what happens when you move or don't want to see that provider anymore? Do you have to change your password everytime?

Think of how Facebook does it. You put in a whole lot of personal information and choose to privatize it so only your friends have access. This way, anyone outside your friend circle sees very basic information when looking you up. They can "add" you as their friend, but you have to give them permission first. It keeps things secure and private.

Similarly, you could create your "health profile" in HealthVault and "add" or "remove" doctors or they could request to be added or removed. Also, you could restrict how much content can be viewed based on who is looking at your profile; insurer, employer, provider, etc. The patient is empowered and the doctor is informed. Simple and secure. Maybe Google is up to something like this!?