Body Computing Conference 2013

So one week ago, I attended the 7th Body Computing Conference at USC, hosted by Dr Leslie Saxon.  I first attended in 2012, and found it extremely refreshing. Why? 

1. Science driven agenda

2. Speakers who have actually built stuff

3. A warm and family like atmosphere 

Maria Binaghi from WIkiLife

This is definitely now one of my top 5 events. I was invited to the pre conference dinner, where one of the speakers was Maria Binaghi from Wikilife. They have come up with  Data Donors, a new platform that connects a number of devices and apps and by sharing your information, you can help them to create an extensive database that can be used by researchers to improve health and eradicate illness. I love the idea, but for me personally, I believe we should be compensated financially in some way for sharing our health data, especially if this platform scales at a global level.  

A civilised affair 

BCC is probably the most civilised event I attend. Why? Lunch gets served to you at your table. Ever been to a super large conference only to grab a boxed lunch, find all the seats are taken, and end up sitting on the floor? One of the other brilliant things is the wireless at USC. Not only is it free, but it covers the entire campus, even if you are not in a building, but just walking down the street!  

Panoramic view of Town & Gown venue

Human shared experiences matter more than devices

BioGram app screen with heart rate added to the picture

One of the first sessions of the day was by Dr Saxon and Charlie Haskins. In an article a few weeks back where  Dr Saxon talked about the future of body computing not being about devices, but about experiences, a new app was mentioned. An app that combines heart rate data with Instagram! This app, BioGram, that is being developed at USC was shown for the 'first time' at BCC.

THE future is about 'context'. For example, knowing WHY my heart rate was elevated at 10.20am. Was it because I was at a conference surprised by a new app or was it because I was stuck in a traffic jam on the freeway at rush hour? Just having a picture associated with the heart rate measurement is a step forward. What other 'contextualised' data could YOU capture to help understand the meaning of the biometric data at that moment in time? 

Pioneers and Visionaries

When I'm at BCC, I'm humbled by the brilliant minds that gather there. One of the highlights of the day was hearing from Andy Thompson, Co-Founder and CEO of Proteus Digital Health who said;

In the 20th century, we've built a sick care system, built to solve problems of that era, which were largely acute. It was also built using signature technologies of that era.

Wain Fishburn, Partner at Cooley made the following point regarding the next 10 years. 

To really do the sensing that's going to allow this ambient influence in healthcare, you've got to get well beyond surface, get into the body, got to be touching the blood. The data will matter, more than ever, but it will require a lot of integration.

I was pleased to see that a good friend of mine, Dr Michelle Longmire delivered a demo of her new system, Medable in a session titled 'Digital doctoring: Diagnosis and treatment through Digital Information'. The video of her demo, and the video of Andy Thompson's talk are below [Note: You may have to turn the volume up very high in order to hear the audio]

Demo by Dr Michelle Longmire

Andy Thompson, CEO of Proteus Digital Health

Dr Dave Albert - A true visionary!

Talking to Dr Dave Albert is always fascinating. At the event, he launched AliveCor's ability to work with Android phones, in addition to iPhones. I'm still amazed by the ability to perform an ECG using my phone! He and Dr Saxon also launched a new 1 year study using the AliveCor heart monitor.

How can sensors really make a difference?

At the end of the event, Esther Dyson remarked on the need for more post-marketing surveillance, in addition to clinical trials. Sensors may provide additional data to regulators and pharmaceutical firms wishing to understand the safety of drugs in the real world. This arena was one in which I worked in at GSK for 9 years.

I had access to the largest patient databases on the planet, yet I often viewed the data from health insurance claims and EHRs as incomplete. The data told me, Who, What, When and Where? It didn't tell us Why? For example, from the data, I might see a 65 year old male patient was diagnosed in the ER with Angina on Wed 30th Jan 2008 and prescribed a drug to control the angina. According to the care pathway, let's say they were supposed to see the cardiologist after a month, but there was no record of such visit in the database. After 6 weeks they had an Adverse Drug Reaction, which was recorded in the database. Why didn't they visit the doctor after 30 days? Could real-time data from sensors help us answer WHY? I certainly hope so.

What else could BCC cover?

The legendary Dr Leslie Saxon!

As much as I enjoyed the event, one aspect of Body Computing was missed out, Privacy, Security & Ownership of the health data. For many innovators, their current business models work on the basis that the person wearing the technology trusts the vendor with security of their data, does not own their own data, and does not necessarily have control over who can access their data. Nothing wrong with that, except that these points should really be discussed at events such as BCC. High tech toilets have already been hacked. With the Internet of Things expected to connect billions of devices, and Google wanting to put implants in us, what are the risks that our bodies and wearable technology could be hacked to gain access to our health data? You may believe that your body's data is useless on the black market. However, what if you are HIV+, have a form of cancer or are diabetes type 1 - are you aware of the risks of those data points one day being publicly available? 

In addition, having given a talk at Health 2.0 Silicon Valley on what's happening outside of America, I believe BCC could be enhanced by having innovators in this arena, from around the world. I'd certainly love to see demos of sensors from Emerging Markets such as India and China. Aren't you curious what sensors exist from a combined population of 2.5 billion?

The future is 'Contextualised' data

We need a lot more 'contextualised' data to truly unlock the value of this body computing technology, otherwise in 10 years time, we run the risk of having lots of historical 'big data' available in healthcare, but offering little or no real value to decision makers. 

[Disclosure: I have no commercial ties to the companies & products mentioned above] 

Day 3 - Health 2.0 Silicon Valley

Yesterday was Day 3, the final day of Health 2.0 Silicon Valley. Another day packed with demos, networking and cutting edge insights.  

The highlights of Day 3 for me were seeing the winner of the XPRIZE Nokia Sensing Challenge announced, the session on Clinical Trials and Research, Health 2.0 International session and the session on the Frontier of Health 2.0.  

Mark Winter, Senior Director, Nokia Sensing XCHALLENGE came on stage and told us more about the competition, including how it was judged. 

The winner, Nanobiosym Health RADAR was also announced at the conference by Mark Winter. It must have been a difficult choice. The video below includes the announcement as well as hearing Anita Goel from the winning team speak about their journey.  

Peter Diamandis, CEO of XPRIZE came on stage, and he believes that in the future, patients will be saying, "Don't let that human touch me, he makes mistakes". The rise of machines, I guess.  

Mark Winter announces the winner of the Nokia Sensing XCHALLENGE live at Health 2.0 Silicon Valley

Front page of Wall Street Journal - Oct 2nd 2013

The session on Tools and Platforms for Clinical Trials and Research was very good. Bill Silberg moderated the session, which included Harris Lygidakis, Roni Zeiger, Anna McColister-Slipp and Joseph Dustin. Demos from the panel members highlighting how their tools could impact clinical trials. Very timely, as yesterday's Wall Street Journal had a headline on how Merck is cutting 20% of it's workforce in the next 2 years. Having worked within GSK R&D until 2012, I've always believed that there are immense opportunities for startups to help pharma deliver the medicines that patients are waiting for. However, many people in pharmaceutical companies are terrified of even using the word 'Disruptive' in the same sentence as 'Innovation'.  

The commercial opportunities in the #pharma industry for #health2con entrepreneurs are huge! Go find a pharma firm today and DISRUPT!

— Maneesh Juneja (@ManeeshJuneja) October 2, 2013

In the afternoon, in the international session, we heard from Poonacha Machaiah at Qyuki talking about The Weightloss Project. What a brilliant idea! People who are overweight and lose weight can help those in the world who are malnourished and don't have enough to eat. 

Poonacha Machaiah from Qyuki talking about The Weightloss Project

James Mathews, Chairman of Health 2.0 India posed the question - how do we bring Health 2.0 to Southern Sudan or to Syrian refugees? I'm glad he was challenging us to think of those around the world who are underserved. I remember a phrase he repeated multiple times, "Use simple tools to do great things". 

Southern Sudan

A Syrian refugee

In Frontier of Health 2.0, moderated by David Ewing Duncan, I loved hearing from Pasquale Fedele who showed us BrainControl, a device that gives people the ability to control assistive technologies with their thoughts using a headset and a tablet.  

Pasquale Fedele, Founder & CEO of Liquidweb talking about BrainControl

Also heard from Louise-Philippe Morency, who shared his work with 'Ellie', a virtual interviewer specialising in facial recognition. Virtual humans in healthcare coming soon!   

Demo of 'Ellie' with Louise-Philippe Morency

Life isn't perfect, and neither are Health 2.0 conferences. Nearly all conferences I go to are packed with sessions, workshops, demos and exhibit halls. It's a challenge to try and fit everything in each day, as well as the all important networking with potential clients and collaborators. It's a personal choice, but if one wants to spend time meeting people at the conference, it can sometimes mean having to skip a session or two. Alternatively, some folks do their networking late into the night over a few beers or glasses of wine. Difficult choices, especially if one is jet lagged. Small things like having the Twitter handles of each speaker listed in the printed program would have made my life a lot easier. The wifi was hit and miss for me, I had problems connecting every day. It wasn't the fault of Health 2.0, I believe there were some attendees grabbing all the bandwidth. Whilst the venue had great facilities, the actual location was sort of like a big business park. Nothing to do or see if you wanted to stretch your legs and have a wander around. By and large, the conference was one of the better managed events I attend. A big thanks to all of the volunteers who were stationed around the convention centre all day and helping us get to the right room at the right time. 

This must have been one of the healthiest conferences I attended. According to my Misfits Shine activity tracker, I walked 2.8 miles during Day 3 of the conference. The layout of the hotel and convention centre meant a lot of walking! Coming from a walking city like London, it didn't bother me, but I could see that amount of walking bothered some American attendees.  

Why have I attended Health 2.0 conferences in the USA, Dubai, Berlin and Delhi? Why did I start the Health 2.0 Chapter in London? There is something unique in the vibe, that Matthew Holt and Indu Subaiya bring to each conference. Especially as they are far more down to earth and friendly than a lot of conference organisers I've met. That translates into an enjoyable experience for attendees! At other Health tech events, I've found sometimes, other attendees won't speak with you unless you are from a well known corporation or Venture Capital firm. 

I personally prefer the Health 2.0 Europe conference to the one in California. Why? Smaller group and I like smaller groups. As conferences become more popular they grow, it's inevitable. I prefer the 'intimacy' of conversations in a smaller group. When I run my Chapter meetings in London, I limit each event to 40 attendees, which means we aren't overwhelmed by having to meet 150 people during an evening. For me, it's about bringing diverse groups of people together and building a community that makes amazing stuff happen. 

Health 2.0 Europe was in Berlin last year, but this year, it's in my city, London. I'm grateful to have been given the chance to run a pre-conference workshop on Nov 17th on 'Health 2.0 Tools for the Elderly'. The increase in the aging population, and the burden on society as a result is one of the biggest crises in Global Health, the world faces in the next 50 years, and I sincerely believe we need to act NOW! If you are interested in demoing at my workshop and/or want to discounted entry into the entire conference, please get in touch. I'll do my best to help you. 

[Disclosure: I have no commercial ties with any of the companies mentioned above, apart from Health 2.0, which from time to time uses me as a consultant] 

Day 2 - Health 2.0 Silicon Valley

The lure of events in Silicon Valley

The amazing David Ewing Duncan

One of the reasons I love coming to Silicon Valley for events is just how progressive and laid back people are. They are very much focused on business like other parts of the world but Health 2.0 conferences are always informal and friendly. It's one of the few events where I can walk around wearing a Hawaii shirt and potential clients are not expecting you to be wearing a shirt and tie! I remember meeting a CEO of a tech company in a coffee shop in Silicon Valley last year so he could demo his software. Despite being very successful, he attended the meeting wearing a t-shirt, shorts and sandals. It's a small point, but again, it's very different from the traditional attitudes found on the East Coast of the USA and in Europe where where your parent's occupations and where you went to college can often dictate what opportunities come your way. 

Xprize Nokia Sensing Challenge

I'm passionate about the potential of sensors, and meeting the teams from Xprize's Nokia sensing challenge alone was worth flying 6,000 miles for. Many observers are critical that Health Technology is largely developed by the 'worried well' for the 'worried well'. There is an element of truth in that. However, meeting the teams from around the world, it became clear very quickly that each team had designed their solution with the mindset of wanting to impact the health of 7 billion people. For those that haven't heard of the challenge, this infographic does a good job of explaining why the competition was set up. 

Let's meet the teams

First of all I met Silicon BioDevices, who have developed handheld, disposable device that takes measurements from a drop of blod and instantly transfers the results to a mobile phone. And it costs $1 to make!   

Next I met Apollo, who have developed a nano spectrometer-on-a-chip. This tiny chip offers the same functionality as a $10,000 machine and can be embedded into wearable technology.   

Wandered over to i-calQ, who have developed technology that turns your smartphone into a portable laboratory and medical specialist. In addition, they developed a decision support system that interprets the results and then suggests how much medicine should be given to treat the patient.  

InSilixa have developed a CMOS chip specifically for biosensing. Nobody else does that!  

ABUS-urodynamics have developed a wearable device that measures urinary flow, anywhere, anytime in an easy and natural manner. Currently patients have to use toilet-borne equipment in hospitals to do this test. Fascinating stuff!  

Onto Quasar, who have developed a chair pad with embedded sensors that work through clothes to monitor the heart's activity, known as an ECG. Think of the applications for older people. Now, that's the unobtrusive monitoring that I want to see more of in the future.  

The programmable-Bio-Nano-Chip  technology offers the ability to determine if a patient has had a heart attack, whilst they are waiting in the Emergecy Room of the hospital!  

Unfortunately, the battery on my phone died before I managed to meet all of the teams. The other teams are: 

Elfi-Tech - a sensor that can detect blood flow waveform. The sensor could even be incorporated into a watch!

Holomic - Handheld, Quantitative, Point-of-Care, Rapid Diagnostic Test Reader

Mobosens - a smartphone based sensor, provides accurate nitrate concentration measurements. Allows citizens to collect and share environmental data.

Nanobiosym Health RADAR - One drop of blood or saliva can be used to detect presence (or absence) of a disease's pathogen in real-time with gold standard accuracy.  

Owlstone - microchip spectrometer can be applied to smelling breath of bodily fluids for chemical markers of disease long before actual symptoms appear 

Winners to be announced today

I'm so inspired by the genuine innovation from each of the 12 teams. When we registered at the conference on Monday, we were each given a plastic tag to vote for our favourite team. At 9.45am Pacific Time on Wed Oct 2nd, at Health 2.0 Silicon Valley, one Grand Prize Winner and five Distinguished Award Winners will be honored by XPRIZE with cash prizes of more than $1 million. I wonder which team will win the Grand Prize! 

The future of sensors

My week is turning into a sensor fest, as after Health 2.0 Silicon Valley finishes, I'm off to Los Angeles to attend Body Computing 2013. Quoting from their website, "We pride ourselves on straight-forward and thought-provoking discussions (not marketing hype)", I attended last year, and the absence of hype was noticeable, which is refreshing. Another event worth flying 6,000 miles to attend.  

Innovation in sensor technology i something I deeply admire, but when I think of life back in England and around the world, one question springs to mind. Who is going to pay for all of this innovation in sensor technology? After all, many countries, especially the USA and those with aging populations very much want (and need) to reduce spend on healthcare. After all, money doesn't grow on trees. 

[Disclosure: I have no commercial ties with any of the companies mentioned in this post] 

Day 1 - Health 2.0 Silicon Valley

Health 2.0: A global perspective

After the talk, we had a lively Q&A session

So the actual conference didn't begin until 2pm on Monday 30th September 2013, but I was giving a pre-conference workshop, Health 2.0: A global perspective at 8am on Monday morning! 

Those that know me, are always hearing me ask why we can't do more in Digital Health for as many of the 7 billion people than inhabit the Earth. Many conferences in Silicon Valley are very focused on innovation in Silicon Valley, let alone New York, or a foreign country. I'm grateful that Health 2.0, who gave me this chance to speak, consider the global picture. You can read more about my motivation for giving the talk in my Health 2.0 blog post from a few weeks back.  

The talk was well received, and you can see the slides below. It was extremely challenging to condense the efforts of 6.7 billion people into a 60 minute talk, but I gave it my best shot!

I asked the audience after my talk a question. I said, "If I was a startup outside of the USA, and I approached you with a new product/service, would you be more or less willing to listen to me, having heard this talk?". It was marvellous to hear people in the audience saying "more willing". That's encouraging, because it demonstrates that people in America ARE open to learning about what's happening abroad. I chose in my talk to move beyond the hype of Emerging Markets, and give practical examples of how doing business in Emerging Markets can be extremely risky. 

I included aging population as one of the challenges facing the world. Timely, as a new global study published today says that the world is NOT ready for aging populations. 

"Global study: World not ready for #aging population" http://t.co/69e8gMiGAw #digitalhealth #health2con

— Maneesh Juneja (@ManeeshJuneja) October 1, 2013

Health 2.0: A Global Perspective from Maneesh Juneja

At 2pm, Matthew Holt and Indu Subaiya opened the conference. 1,700 attendees. There is definitely a lot of energy at this year's conference. I believe it's partly due to the launch of the new online health insurance exchanges launching on Tue 1st October. 

Panoramic picture of the attendees in the Missing City Ballroom 

There was a keynote from Gavin Newsom, Lt. Governor of California. Definitely seemed to be a very forward thinking and progressive politician. One of the points he made stood out, "Let's move from machine thinking to platform thinking. That's what Health 2.0 is all about." 

Tim Kelsey, National Director for Patients and Information in the NHS, from England spoke about plans for spreading innovation in the NHS to make it the best healthcare service in the world. Watch the 5 minute video below to hear more.

One demo that stood out was from Christopher Bradley, who founded Mana Health. They just got awarded the contract to build the patient portal for the state of New York. I love the way they have the sliders that allow you to change who can see your data.  I took a short video of the demo.  

There is a lot of walking involved in this conference, due to the size of the convention centre. It's actually quite a good thing being a health conference. I'm going to track the number of steps I walk today and see just how active the conference has made me!  

Great to meet old and new friends today. In the evening reception, I caught up with Eugene Borukhovich, who runs the Health 2.0 Amsterdam Chapter. Definitely a guy worth speaking to if you spot him.  

Want to replicate the culture of Silicon Valley?  

Many countries are trying to build their own startup ecosystems, looking to beat the Valley. To those policy makers with grand ambitions of one day eclipsing Silicon Valley as a hotbed of innovation, you have to inspire people everywhere, not just in offices of tech companies. When I checked into to my hotel for the conference, I noticed a board that tells you the weather for the next few days. In addition, the board also had a quote by Peter Drucker. That tells me so much about the underlying mindset out here, and helps to explain why you meet so many people wanting to change the world (who often end up doing so). In order to understand the very roots of Silicon Valley, I found this PBS video. It's 90 minutes long, but it's extremely useful for anyone outside of Silicon Valley. It really connected the dots for me.  

Health 2.0 Europe: We know how to innovate too! 

As Health 2.0 London Chapter Leader, the ecosystem of nearly 500 members I have created is due in part to what I have learnt from attending Health 2.0 conferences, not just in the US, but in Berlin, Dubai, and Delhi. The Health 2.0 Europe conference is moving from Berlin to London. I'm really excited about it being held in my city. 

If you're at Health 2.0 Silicon Valley this week, and haven't thought about attending the conference in London, I want to let you know that there is so much going on in Europe. Partly, the aging populations combined with deep austerity cuts to budgets has led to governments wanting to support entrepreneurs in health technology. Those people willing to take risks and try new ideas, are quite possibly, the very people who may help Europe meet the challenges of the decade ahead.  

If you would like to learn more about the London chapter and/or the Europe conference, please come and find me. I'm here at the conference until Wednesday evening.  

Social Media: Can it really make a difference?

Yesterday, I was part of a panel at Social Media Week London. Hosted by Mairi Johnson of Healthbox Europe, the title of the panel was Digital Healthcare: Pulse Found

 I was joined by a diverse group of practitioners in the space, Jemima Stewart, Manuela Maiguashca, Tim Anstiss, Jorge Armanet and James Norris. 

Data from social media: Where is the value?

Given my data background, I made a few comments. Companies have developed 'social listening' platforms, and often the premise is an organisation such as a pharma company can understand what's being said by patients in real-time about their medicine, particularly relating to potential issues with the medicine, such as adverse events. However, when I speak with pharma, they tell me, knowing 'problems' from social media isn't enough, they want the other side of the coin. What benefits are patients experiencing from the medicine? Now, is social media giving you the full picture, or are you hearing more about the risks, and less about the benefits? 

Whilst finding out what patients are saying on social media could potentially be useful, the true value will only be realised when it's linked to the patient's medical history. A marriage of 'hard' and 'soft' data in healthcare. Finding the signal among the noise. 

Trust and Engagement

Part of the discussion was also about engagement and trust. I recall my own example, I had an issue with a rental car a few months ago. I tweeted about the issue to the car rental company. To my surprise, they followed me within minutes on Twitter, and sent me a direct message asking for my phone number. I did that, and spent 30 minutes with a member of their customer service team, who LISTENED to my issue, and did his best to resolve it there and then. It turns out he and his colleagues spend all day monitoring what is said about their rental car company on social media, and they respond accordingly.  

Now, look at healthcare, imagine you're a HIV or mental health patient, and you receive less than optimal care. Would you really post a tweet to the NHS with details of the problem? Online communities where conversations can be shared privately may provide a way of capturing that information, but even then, how can a patient really be sure their personal data is secure? Healthcare providers work hard to protect privacy of both the patient and the healthcare professional, which allows trust to be a cornerstone of the relationship. As more doctors and patients get social media accounts, what are the risks that this hard earned trust can be broken? All it takes is one public tweet to damage someone's reputation. 

I remember the unforunate events with the Boston bombing earlier this year. Concerned citizens took to social media, utilising Twitter and Reddit to try to help the police find the suspects. One night, citizens believed they identified a suspect, a student who had vanished a few weeks back, and shared this on social media. For a brief period of time, the misinformation that spread so rapidly on social media branded this student as one of the bombers. Reddit had to apologise to the family of the student for what happened.  Naturally, I can understand the caution that many in the healthcare profession have towards embracing social media.  

I also just read today about an airline in the UK, which allegedly tried to prevent a passenger boarding their plane, because he publicly tweeted something negative about their customer service. Now, imagine in healthcare, you express your dissatisfaction using social media about your experience in healthcare? Could it potentially impact who wants to treat you?  

Pulse of the patients: A true representation? 

Many will argue that social media allows us to understand the 'pulse' of patients in real-time. Yes, that's true to some extent. However, what about the 7 million people (15%) in the UK that have never used the internet? Many of which are poor, disabled or elderly.  

The biggest users of healthcare, are typically not the 20 somethings running around creating apps in East London or Palo Alto. They are the elderly. The biggest challenge the NHS faces is chronic disease management. Who are living with multiple comorbidities and taking multiple medications every day? Again, older patients. How many of them are online? How many of them can afford an iPhone with a data plan? How many of them WANT to share via social media, given that did not grow up in the digital economy? 

80% of UK care homes have no access to the internet. Does social media capture what the residents of these care homes are saying about their care? Nope. The National Audit Office has warned the UK government that it's fixation with digital by default agenda could leave people behind. Will this trend mean that the 'Digital Divide' becomes a 'Digital Gulf'? 

Evidence

I believe we need to generate evidence of what works and what doesn't work in social media, so we have the chance to make informed choices. I've observed far too many decision makers adopting new technologies simply because it's this year's buzzword. Every organisation, large or small has a finite budget. Maybe in your organisation, the money you would spend on setting up a social media department might be better spent on hiring two extra nurses?

A recent study at UCLA, recruited 112 men from Los Angeles who have sex with other men, and examined if social media and online communities could increase HIV testing and lead to behaviour change. The results seemed to suggest so. However, the two biggest groups in the study population were 60% African-American and 28% Latino. I'm curious. If that study were replicated in rural North Carolina or rural Yorkshire, would the results be the same? 

Looking ahead

In life, one of the methods for obtaining and retaining power is to not share information with others. Social media promotes sharing, collaboration and transparency. That's bound to make those in healthcare who currently wield power quite nervous. 

Overall, it was a fascinating discussion, with a series of excellent questions. We ran out of time, but the questions being posed by the audience made me feel like we need to have a healthy, sincere and open debate about the role of social media in both healthcare AND social care.  

Are we moving towards a world where one day every doctor, every hospital, every patient will have a social media presence? Will we no longer need people to work in customer service departments, because patient feedback is received and acted on in real-time using social networks? Will the openness and transparency promised by social media prevail over those who would rather keep information locked away in a filing cabinet? 

Beyond the mobile phone?

So, this week has been extremely intense. On Tuesday, I gave a talk to the pharmaceutical industry at the Mobile Innovation Summit in Philadelphia. The talk was on whether emerging technologies can help patients to engage with their own health. I then headed out to Silicon Valley, and I've just attended Day 1 of Singularity University's 5 year anniversary & Alumni reunion.  

Mobile Innovation Summit  

This was a conference with senior decision makers attending mostly from Sales & Marketing functions from the big pharmaceutical firms. My talk was on Day 1 very early in the day.

In my talk, I shared my thoughts on what I've seen in Digital Health, and what I expect to see in Digital Health, from a mobile perspective, but with a focus on increasing compliance and adherence, and reducing medication errors. During my research, I was staggered to find statistics such as 125,000 Americans die each year because they don't adhere to their medications. The cost of non-adherence to American healthcare is $290 billion. Many people believe that Digital Health technologies can solve these problems with a click of a button.

I don't. Much of the technology I come across I consider as hype, with little or no evidence to suggest that it could solve these big problems. Not all new technology is equal. I believe in evidence based Digital Health, not just Digital Health. 

I wasn't prepared for the silence, both during the talk as I engaged with the audience, and afterwards in Q&A. I thought perhaps my talk was not well received, but actually, it turns out that for many attendees, the technologies I cited were downright scary. In the world of startups that I inhabit, smart pills that automatically record that you ingested a pill, smart clothes that monitor your vital signs and apps that know you are sick before you do, are just 'normal' for me. The silence told me that these technologies were not on the radar screen for many members of the audience. I guess that's why conferences invite 'Digital Health Futurists' like myself.

Beddit Sleep sensor that makes your bed 'smart'

Now, the pharma industry are refining their corporate strategy for using mobile phones in their efforts to engage with patients, and I told them that it's not long before Wearable Computing takes us beyond the mobile phone. I also told them that 'unobtrusive' monitoring WILL be the future, not the current crop of crude and clumsy gadgets that track your activity and sleep. Products such as the sleep sensor from Beddit and MC-10's biostamp are definitely are step in the right direction.

The 'biostamp'

If you are a patient, what would you prefer? A monitoring device that you have to charge every day and sync with bluetooth, or something that requires no change in your behaviour to set it up and use it? Ultimately, one of the questions that resonated in nearly every talk given about the use of innovative mobile technology was, "Who's going to pay for it?". Finding the answer is proving to be a challenge.

5 year anniversary & Alumni Reunion

After attending FutureMed earlier this year at Singularity University, I wasn't planning on returning this year. However, the chance to help celebrate 5 years of impact, hear the pitches from this summer's Graduate Studies Program students and to mingle with alumni from around the globe was too difficult to resist. Oh, I got to hear talks from the Faculty including Peter Diamandis. At the end of Day 1, my brain hurts, after absorbing information on the new technologies coming soon that promise to change our world on a dramatic scale. Digital Biology, Artificial Intelligence, Robots, 3D printing and much more. There are innovations heading our way in the years ahead that offer the chance to meet some the grandest challenges facing humanity. Americans, particularly those in California are quite an optimistic bunch, but the folks at Singularity take it to a whole new level. I felt humbled to be in the company of so many smart individuals. 

Peter Diamandis's evening lecture on Day 1

Interestingly enough, in the evening lecture, Peter Diamandis repeated my vision that I had mentioned earlier in the week to pharma, when he talked about 'dematerialization'. He asked the question, "Will 'dematerialization' make smartphones disappear and integrate them into smart clothing?". For those of you, whose products are dependent upon the mobile phone, are you prepared for the shift to Wearable Computing? 

I finally got to try Glass! 

I also tried Google Glass for the first time. For those of you who have not tried Google Glass, find someone who has it and try it for yourself. Most people underestimate the potential of this new era in Computing. People will laugh and say, do we need this particular innovation? Remember, people laughed at Carl Benz in 1886 and asked why do we need motorized carriages when we have horses that pulls carriages. We now have 1 billion cars on the planet. 

Marc Goodman talks about 'smart' floors

I'm becoming more curious about privacy and security of our data. It was fascinating to hear an update from Marc Goodman. I had no idea that 'smart floor' technology exists that allows you to be identified based upon the way you walk. So, for example, smart floors could be used to permit access to a room in a hospital only to authorized individuals.  

Not everything about the day was amazing. Just like FutureMed program I attended, the schedule is packed full of talks and demos, and for me personally, I'd like a bit more time for networking and absorbing the often highly scientific knowledge that is being shared on each slide.  

Timeless wisdom

Two very different events this week. One with risk averse pharma companies who work in an extremely complex regulated environment, and another with companies founded at Singularity University willing to take the biggest risks in human history.

Which companies will survive and which companies will become dinosaurs of the 21st century?  

[Disclosure: I have no commercial ties with any of the companies mentioned in this post] 

Who Owns Your Health Data?

"Personal Data will be the new 'oil' - a valuable resource for the 21st century. It will emerge as a new asset class touching all aspects of society”. That's taken from the introduction of a report from the World Economic Forum published in January 2011. It's a fascinating read,  especially when they put forward the vision of a personal data ecosystem where individuals can have greater control over their personal data, digital identity and online privacy, and they will be better compensated for providing others with access to their personal data.

Sounds great, right? Sadly, it doesn't look like we are on the path to that vision.

For this vision to manifest itself, healthcare companies must buy into it, which means that they have to evolve their current business practices and models. The same is true for governments around the world. Given the recent revelations from Edward Snowden, making this vision a reality seems unlikely.

Does anyone believe we should own our health data?

Due to my background, I think a lot about our health data and the steps that we can take as citizens to help in the creation of this vision. I even gave a TEDx talk with my own ideas.

Though some leaders in the industry, such as Walter de Brouwer are stepping forward and bravely advocating that patients should own their own health data,  it's not the norm. Business models for free health apps are based upon users giving permission for those apps to collect, transmit, share and sell their users' personal data.

What are the current risks?

The current estimate is that are 40,000 health apps in the market place. In addition, a recent study by the Privacy Rights Clearinghouse stated that 72% of the assessed health apps presented medium to high risk of personal privacy violation. Additionally, of the free apps they reviewed, only 43% provided a link to a website privacy policy.

When was the last time you read through the terms and conditions, end user licence agreement or privacy policy BEFORE you agreed to download a health app? Take a look at this example of the privacy policy of Fitbit, would you read this?

Now, you may think that your health data alone is not that valuable, and you may well be right. However, if 100,000 people are using a health app, and a corporation accessing that data has heart rate, activity levels, sleep levels etc on all 100,000 people, then that 'cohort' of data becomes considerably more valuable. Whether it's scientists in a pharmaceutical company looking to understand people's health or a fitness company looking to understand which consumers to target for their next fitness product, getting access to this type of data unlocks new value for these organisations. That's not necessarily a bad thing, because we all want society to make progress in improving our health.

Unfortunately, I don't believe that consumers are currently able to make an informed choice. Unless you read through every line of all the policies, it's not that easy to find answers to these 3 questions;

Who owns your data?

Who has access to your data?

Who profits from your data?

Someone must be doing something to help answer these questions? 

The US government has recently published new proposals that lay out a "voluntary" Code of Conduct for mobile application short notices. Whilst it's a modest step forward, it's not enough. With almost 20 years of working with other people's personal data, I knew I had to do something.

As luck would have it, I was introduced to one of the leading  experts in security and privacy of health data, Dr Tyrone Grandison based in the USA. We identified the need for  a simple way of consumers being able to understand what they are agreeing to BEFORE they download a health app.

Dr Grandison and myself are working on a new service, launching this summer, called 'Who Owns Your Health Data?'. We hope that our service will allow each of you to make an informed choice when it comes to health apps. 

We are open to collaborating with others who share the same goal. Feel free to email us at info@woyhd.org

Shit happens, deal with it.

I'm not a doctor. I'm not a nurse. I'm not a politician. I'm simply a curious individual. When I attend healthcare innovation events, I admit I'm not the smartest person in the room but I am one of the most curious at these events. I'm compelled to mention that the more I learn about the NHS, the more admiration and respect I have for the hard working men and women on the frontline, often working with limited resources and under extreme pressure. 

Paper, X-Rays and a nurse's first day at work

I'm curious about why I had to carry a piece of paper to the X-Ray department when I visited Accident & Emergency (ER room) in a London hospital last year. The triage nurse who saw me, decided an X-Ray of my elbow was required. A piece of paper was printed out, handed to me, and I walked down the hall, handed it into X-Ray, got my X-Ray done, and then walked back down the hall. I then had to knock on the door of the Minor Injuries Unit and 'verbally' let them know my X-Ray had been completed, and then wait outside to be called in. 

So, I patiently waited for hours after my X-Ray had been completed. The same triage nurse walked past and asked me, 'Have you still not been seen?'. Off she went to check, and then within a few minutes, I was called into the Minor Injuries Unit. When I asked the guy looking after me, why it took so long, I was taken aback by the response. My notes were in one tray, and were supposed to be moved to another tray by a nurse once I had 'verbally' let them know my X-Ray was done. The nurse hadn't moved my notes to the other tray. It was her first day, and she wasn't fully up to speed with procedures, I was told. A shrug of his shoulders, and a look on his face that said, 'Shit happens, deal with it'. Maybe we should have 'Open Data' that lets us know on what dates, there are new starters in the hospital? Someone can develop an app using that data that informs us exactly when to avoid the hospital. 

I understand that the NHS is looking to go paperless by 2018, that's still 5 years away. I'm curious why as a consumer, it was so easy for me to have a paperless office, and it was simply a case of buying a Doxie Go, an Eyefi SD card, a LiveScribe Sky pen, and an Evernote account. All bought on Amazon.  

Data driven decisions - Easy for supermarkets, difficult for hospitals?

I'm curious why the NHS isn't using predictive analytics to understand exactly who is most at risk of diabetes, heart disease etc and sending out a personalised series of messages? I worked at DunnHumby (who came up with the idea of the Tesco Clubcard to collect data on shopping habits) in 1997, looking after the data for 8 million customers of Tesco. Even all those years ago, they were able to profile the customers, segment them, and personalise offers for each customer segment. The level of insights from the data means that Tesco now can predict a couple divorcing, 6 months before it actually takes place. Target in the USA can predict when one of their customers is pregnant, all based upon their data. Maybe the NHS could do the same to reduce the rate of teenage pregnancies? [Note: UK has highest teenage pregnancy rates in Western Europe] Let's foster a culture in the NHS of using data to drive decision making and to learn how to optimise the communication strategy to target those people most at risk. 

NHS engaging with startups

Last week I was kindly invited to give a 5 minute talk at the NHS Entrepreneur's Day in London, hosted by Tim Kelsey and Beverly Bryant. We heard from Tim, Beverly and others on their plans for making it easier to do business with the NHS. My talk was about the Health 2.0 London Chapter I started last year, as well as the Health 2.0 Europe conference taking place in London, and what both the Chapter and the Conference can offer to entrepreneurs and SMEs wishing to innovate in the NHS. [Note: If you would like to register for the Health 2.0 Europe conference, you can get a 15% discount off the advertised prices by using promo code of MJ2013. The Chapter is free to join though, and the monthly events are free to attend]

I was seriously impressed that the NHS wishes to make it easier for innovators to engage with them. I'm glad they are building bridges with the innovators. Let's hope those bridges allow two way traffic, have multiple lanes and no speed limits. The event also educated me on the challenges, Tim, Beverly and others face everyday on the inside as they do their best to bring the NHS into the 21st century. I can empathise, having worked in a team looking at transforming Leadership Culture for 11,000 scientists around the world, when I was at GSK. Change within large, complex organisations that are heavily regulated does take time, at least 3 years, and sometimes an entire generation. However, one thing we don't have right now is the luxury of time. Every day that we sit and discuss how to spread innovation within the NHS, patients continue to be at risk. 

Ideas for engaging with startups

Moving forwards, I have 3 ideas for how the NHS could build upon their existing plans to engage with entrepreneurs and startups. 

• A website that lists the current 'wants' by area. Something along the lines of the Open Innovation website from GSK Consumer Healthcare. Imagine being able to search a website to see if your technology is what the NHS is looking for?  

• Reverse hackathons! I'm not impressed by the majority of hackathons I have attended in healthcare. I recently came across a company in the States, called Prebacked. They ran an interesting event in May 2013, where the a US health insurer shared their problems and how much they were willing to pay for technology that solved those problems, and then the hackathon began. 

• Getting more innovators from the private sector inside the NHS. I've been reading about the Presidential Innovation Fellows program that they have started in America. Perhaps NHS Innovation Fellows? I know some very talented people in the UK who could make a real impact on the inside. 

The vision for the NHS in 2078 - where is it? 

The NHS had just celebrated it's 65th birthday. I'm curious how the NHS will look in 65 years time, in the year 2078. I would be 105 years old at that point, if still alive. Whilst I appreciate that there are short term challenges to meet (and lots of initiatives underway already), we also need courageous leaders with a strong vision, who acknowledge that the decisions we make today will have an impact on generations to come. The proposal to create a National Health Service by Aneurin Bevan back in the 1940s was 'radical' at the time, and initially opposed by the BMA. I'm curious what type of health service we want our children and grand children to inherit.

What happens after 2018? 

I believe we are too focused on short term goals in healthcare, be it in the UK or abroad. Be it a politician thinking in 4 year electoral terms, a CEO thinking of their 3 year stock options, or a VC backed startup with their 3 year exit strategy. Not all of our problems in healthcare can be solved in just 3-5 years, and Digital Health, despite it's potential, will alone not be the panacea. Furthermore, 'Innovation' shouldn't just be this year's favourite buzzword to add spice to white papers. Solving problems in healthcare shouldn't just be the remit of senior leaders and entrepreneurs, everyone should be able to participate. Only by putting our differences aside, having candid and authentic conversations with a focus on genuine collaboration, can we even stand a chance of meeting the immense challenges that lie ahead of us.

If this doesn't happen, I'm curious if we will have to get used to a culture of 'Shit happens, deal with it'. 

[Disclosure: I run Health 2.0 London as a volunteer, but I do have commercial ties to Health 2.0 in San Francisco. Apart from this, I have no commercial ties with any of the products/services mentioned in this post] 

39 reasons to buy a Round The World plane ticket

In 2010, I took 6 months off from my job to travel on my own around the world, managing to visit 14 countries (Egypt, Nepal, Cambodia, Vietnam, Thailand, Singapore, Malaysia, China, South Korea, Japan, Australia, New Zealand, USA and Canada. I had planned to include Ecuador, Peru, Argentina and Brazil, but after attending the Burning Man festival, I decided to spend the remainder of my trip in the States. [Note: 3 years later, I'm still digesting the experience of Burning Man, it completely blew my mind. More about that adventure in a future blog post]

Definitely one of the craziest things I have done. Granted, I now have far less 'material wealth' than most of my peers, but I've experienced significant personal (and professional) growth as a result of taking one of the biggest risks of my life. Plus, my bucket list is now a lot shorter! 

Some of my experiences 

Far too many to list in one blog post, but here are a few: 

• Hot air balloon ride at sunrise over Valley of Kings

• Trekking towards Everest Base Camp (had to turn back at 3,440m due to altitude sickness) 

• Sunrise at Ankor Wat

• Taking out money at ATM in Ho Chi Min City and observing the maximum amount available was 2 million in the local currency 

• Arriving in Thailand during the riots, and as a result, stayed in a bungalow right next to the beach for next to nothing as tourists had disappeared

• Riding on the world's first commercial operating Maglev train in Shanghai

• Wandering around Jiuzhaigou Valley [Considered by some to be the prettiest place on Earth] 

• Walking along the Great Wall of China

• Local people asking to have their picture taken with me [This was happening every day in China, no matter where I went. I believe it's because I'm brown, tall, and relatively hairy. Many Chinese had never met someone who looked like me, I was a novelty] 

• Visiting the most heavily militarized border in the world and having a bottle of North Korean beer 

• Staying in a tropical fruit farm in the oldest surviving rainforest in the world 

• Meeting Aborigines, Maoris and native Hawaiians and learning about their history and culture

• Driving from San Diego to Vancouver along the Pacific Coast Highway in a Ford Mustang convertible (and using AirBnB for accomodation)

• The Grand Circle tour, including a full moon tour of Monument Valley

• Spontaneously renting a Cessna 172 plane and pilot to take pictures of Garibaldi Provincial Park from 10,000 ft  

• Tried weird and wonderful meats along the way such as Crocodile, Kangaroo, Ostrich, Bison, Shark, and Sea Snake (was offered Dog and Cat burgers in Beijing night market, but refused)

What was it like? 

Every day was an adventure. At that point in my life, I'd already visited over 25 countries, so I wasn't afraid of new places and new people. I remember meeting someone in Japan who told me that simply contemplating the idea of travelling to so many countries, and needing different currencies made her very anxious. I didn't really plan much apart from knowing that I had certain stopovers along the way. Most of the 6 months was quite spontaneous. For example, I was flying from Siem Reap to Bangkok, without any idea of where to stay or visit. Sitting next to me was an American guy married to a Thai lady. We got chatting, and they recommended flying to Krabi from Bangkok and staying in Railay West, as that was their tip as locals. So, I did that, and had a brilliant adventure there. I got many of my tips on where to stay or what to see from local people. What was surprising was how many other travellers you meet along the way, and how helpful people in general can be. The world is considerably less dangerous than you've been led to believe [especially if you pay attention to mainstream media such as Fox News]

What did I learn?  

I learnt to express gratitude for everything that I have been given in life. That humanity can exist in the most unexpected of places and there is more that unites us than divides us. Only by working together can we improve the lives of 7 billion people. 

It made me realise that the 3 biggest challenges our world faces are water, energy and food security. I was able to witness changes in certain Emerging Markets with my own eyes, particularly visiting 8 different cities in China. Most of my peers in the West still don't realise the profound economic and cultural changes going on places like China. In all my life, I've never witnessed the pace of change that I experienced in my trip to China. 

In my opinion, the 21st century will not be a unipolar world with the USA standing alone as a superpower, I believe it will be a multipolar world, with more voices at the table. I've always been curious about the world, but this trip really pushed me to think globally every moment of every day.

Self-reliance is one of the biggest skills I developed. It's 2am in Cairo, I was looking for a taxi, and when I found one, I had to persuade the driver to take me, and if he agreed, to then barter for the fare as he won't use the meter. He spoke almost no English, and I just knew how to say 'Thank You' in Arabic. I pulled out my phrasebook, but there were no streetlights, so I was bartering with the driver, from the front of the car, using the light from his headlamps so I could read from my phrasebook. One also learns to trust one's gut instinct, because in that moment, the only person you can rely on is yourself. 

Oh, I packed lots of stuff that I might have needed into one backpack. I estimate I used probably 20% of the items (including clothes). You'd be surprised what you can pick up in local markets along the journey. I'd definitely take less next time. 

What next? 

Well, since that trip, I've also managed to visit Finland, to visit the Arctic Circle to witness the Midnight Sun (A period where the sun never sets, i.e. 24 hours of daylight) and Russia to attend the White Nights Festival in St. Petersburg, and pop over to Moscow too.

So, 44 countries now.

I read about the Travelers Century Club which admits people who have visited 100 countries, so my goal is to visit another 56 countries over the next 10 years. Alternatively, another RTW trip with just a toothbrush? Rolf Potts travels round the world with no luggage! 

I leave you with two quotes that have inspired me to change how I live my life. 

'Money comes and goes, but time only goes' 

'Don't be possessed by your possessions'  

There are 39 pictures in the slideshow below which show some of the highlights from my trip. Hover over the images, and the description will appear. I hope this post inspires you to pursue your own travel adventures. 

The Temple of Kom Ombo (Egypt)

Sunrise hot air balloon ride over Valley of the Kings (Eygpt)

A police man gazes at the Great Pyramid. (Giza, Eygpt)

The view of Mount Everest at 11,286 ft (Namche Bazaar, Nepal)

Buddhist Stupa en route to Everest Base Camp (Nepal)

Sunrise view of the Annapurna range (Nepal)

Monks have their own waiting rooms (Bangkok Airport, Thailand)

Sunset at Railay West Beach (Thailand)

A girl volunteers to be part of the "Birds of Prey" show in Jurong Bird Park (Singapore)

The Kek Lok Si Temple (Penang, Malaysia)

The Petronas Twin Towers (Kuala Lumpur, Malaysia)

Kek Lok Si temple - The 30.2m bronze statue of Goddess of Mercy (Penang, Malaysia)

Daily Mass at Cao Dai temple (Vietnam)

Ho Chi Minh mausoleum (Hanoi, Vietnam)

This tradition is over 1,000 years old (Ho Chi Minh City, Vietnam)

Royal Palace (Phnom Penh, Cambodia)

Sunrise at entrance to Angkor Wat (Cambodia)

Faces of Bayon (Angkor Wat, Cambodia)

Nan Lian Garden (Hong Kong)

Pit 1, Terracotta Warriors (Xian, China)

Panda Breeding Research Center (Chengdu, China)

A couple have their wedding photos taken (Jiuzhaigou National Park, China)

Starbucks in Houhai district (Beijing, China)

Royal Guard changing ceremony at Gyeongbokgung Palace (Seoul, South Korea)

North Korean "Taedonggang" beer, only sold at the border (Demilitarised Zone, South Korea)

The largest store in the whole world (Busan, South Korea)

A rare glimpse of Mt Fuji summit in summer (Japan)

Beware of 6ft tall Cassowaries "The most dangerous bird in the world" (Queensland, Australia)

Had to remember not to go near the water (Queensland, Australia)

View underneath the Harbour Bridge (Sydney, Australia)

The amazing peaks of the Southern Alps (New Zealand)

Hiking up the Franz-Josef glacier (New Zealand)

Maori performance at Mitai Village (Rotorua, New Zealand)

The view of the Grand Staircase (Utah, USA)

Sunrise view of Mitten Buttes in Monument Valley (Utah/Arizona, USA)

The MAN @ Burning Man Festival (Black Rock City, USA)

Sunrise at Waikiki Beach (Honolulu, Hawaii)

The Alpine scenery of Garibaldi Provincial Park (Canada)

"Fall" at the Japanese Sunken Garden (Butchart Gardens, Canada)