Dec 22 2008

A Strange Trip: Washington DC, Airport “Security,” and Houston Snow

Category: History,Pictures/Graphics,PoliticsTim @ 12:07 pm

Recently, I experienced a truly unique trip to Washing DC. I guess the interesting points came on the way back home, but I’ll get to that in a minute. Washington DC is a great place to visit. For those of us who are history and government people, DC is our Disneyland. Even in early December, the sights of DC are impressive and I rarely miss the opportunity to take in the sites; always making time to visit Abe and see what he has to say:

Lincoln Memorial Night
Other highlights my evening stroll was the World War II Memorial (too cold for the fountains, but still an impressive sight)

World War II Memorial at Night

And the ellipse-side of the White House with holiday decorations.

White House At Night Christmas

A note to the brave, warm clothes and good shows are a must when strolling the Mall. Also, if you see a many with no shirt at night singing and dancing in the center of the Mall, avoid making eye-contact and get out of the way when the Capital Police come racing by.

At the conclusion of my visit, it was time to head home. By this point, the temperature in DC was a balmy 50 degrees and with a short taxi ride, I arrived at Washington National Airport (DCA for the airport geeks in the house) in plenty of time to make it through security and get a bite to eat before takeoff.

Security: Shoes off, pockets empty, jacket off, bag open, laptop out, keys out, no nail clippers, no liquids, boarding pass, ID, don’t even think about making a joke, and get dressed again as quickly as possible while watching those selected for “more extensive” screening sweat it out.

There is always a sense of relief with the airport screeners in behind you; especially when you have plenty of time before your flight. I was in that position, so I stopped in what passed for a restaurant  in DCA, ordered a sandwich and a draught of Yuengling. After all, as my waitress said, “You’re not driving.” Besides, Yuengling is a fantastic brew and it is only available on the east coast. In no time, the waitress was back saying, “The nurse is here with your medicine” and I was set. That’s when I noticed what she brought with the sandwich; a long sharp plastic knife.

DCA Airport Knife

Wait a minute, I can’t bring nail clippers on the plane but we give travelers this instrument of dismemberment with their meals? Does that seem right to you? Look at the thickness of the plastic and the serrated edge! This thing is designed for one purpose, to cut meat! OK, so I was having a bit of fun, but it was sharp.

After a longer than normal flight back home facing stiff head winds, we landed in Houston. My first thought was, it will be nice to not need the jacket anymore and good to be back in more temperate weather. That’s about the point I looked out the window and saw the snow flakes falling. Yes, show in Houston. I’ve lived here almost 19 years and this marks the 4th time I’ve seen snow in my town. Being the fully converted southerner, I took a picture of the snow.

Houston Snow Tahoe

Yes, I admit this is lame, but for us it’s cool. Too cool.


Dec 11 2008

World Healthcare Innovation and Technology Congress Day 3 Wrap-up and Summary

Category: HealthTim @ 9:27 am

The final day of the World Healthcare Innovation and Technology Congress began with a bag, Scott McNealy from Sun discussing how Open Source works for healthcare. McNealy’s presentation was incredibly entertaining; equal parts insightful information and stand-up comedy. Here is a sampling of quotes from McNealy:

  • We must go digital. Just look doctors handwriting and you’ll see, we must go digital.
  • Open Source is a very old concept that we’ve been doing since 1982. If I can go a little Al Gore here, we invented Open Source.
  • Public key encryption schemes are the best option. If you have a secret in your code, it will be discovered and breached. Humans cannot keep a secret. What if the Trojan horse was made of glass? Would they have let it in?
  • When I hear “enterprise license agreement,” I think, “The first hit of heroin is free.”
  • Technology has the shelf life of a banana; it will be outdated before you can roll it out.

McNealy’s message centered around the very real impact Open Source is having on the market and how that success can be brought to healthcare. Sun has spent $26 Billion on research and development and is currently involved in the creation of the Nationwide Health Information Network (NHIN).

Open Source has tremendous advantages including avoiding “format rot” in archiving information. What happens 20 years from now when someone needs to open a document created in a proprietary tool like MS Word? Or better yet, how does one render a document created in the Wang system? With Open Source you can bundle the files with the rendering agent.

In a nutshell, McNealy says there are 7 reasons to be open

  1. Lower barriers to entry
  2. Increased security
  3. Faster procurement
  4. Lower cost
  5. Better quality code
  6. Open standards last longer
  7. Lower barriers to exit

As a recovering developer, his comments on better code peaked my curiosity. Basically, developers are very protective of their reputations and releasing code into an open environment for the scrutiny of other codes ensures the code is top-notch. Open Source code tends to be written cleaner and documented thoroughly; coders are opening their robes and exposing themselves to the world. They want to look good.

My favorite comments dealt with the privacy question and how it works the same in the Open Source world. First, “Somebody a long time ago someone said you don’t have privacy, get over it. Oh wait, that was me.”  And the second quote, dealt with what is perceived now as a secure delivery system, the US Post Office. “You take an 8 x 11 piece of paper, stuff it in a folded paper envelope, seal it with spit, write unblinded information in the outside in the to and from areas, give it to the Federal Government for a couple of days, stick it into a tin box, all with the hopes that it will get there.” Yet somehow we worry about the level of encryption used on networks or go so far as to print everything and take them out of the secure networks to set them on a desk.

In closing, McNealy had one more comment on healthcare that resonated around the room, “There is only one industry more screwed-up than computers and that’s healthcare. You kill everyone eventually, I know you are working on it.”

I found more in that 30 minutes of Scott McNealy then I’ve found in entire conferences. I’m very appreciative of him and his taking the time to speak with us.

Next up, was a presentation on Direct Practice Medicine by Scott Shreeve and Jordan Schlain, two physicians who are delivering healthcare differently. Their belief is it’s not always about the throughput, it’s not always about speed, it’s about relationships. The business model involves seeing considerably less patients to avoid the “hamster wheel” syndrome of running faster and faster but not getting anywhere. Their patients subscribe to their clinic and have 24/7 access to physicians who actually know them and spend time getting to really know them. To pay for the services, subscribers increase decidable in their health insurance and use the money saved to pay the monthly access fee.

What I found intriguing was the level of detail in the understanding of the patient and access to care provided with their model. I’m not a physician, but I suspect most physicians enter practice to get to know and improve the lives of their patients. Somewhere along the line we have deviated into short episodes of disparate care that may be causing more harm then good. Having said that, I wonder what happens to patients who need care beyond what is being delivered in this manner, but I do like the concept. I’m going to watch the continued expansion of this model in the future and you can go to to learn more.

Unfortunately, after this session, I had to be off to the airport and a return to the real world. However, on the way back, I take a couple of learning with me from the congress

  1. Healthcare is in the midst of a fundamental transformation that is being driven by customers, globalization, economic factors, and an unprecedented influx of technology
  2. Social networking on online communication have a central place in healthcare, both in the delivery of care and the support of the care process not to mention uniting the growing army of reformers who are finding support and ideas in the community.
  3. We still have a long way to go.

I want to thank the organizers of the congress for their hard work in putting together an event that was both informative and entertaining. One suggestion, in the future, you audience members are very tech savvy. Give them tables and outlets so they can document and report on the event, look-up resources being discussed, and possibly participate in events online.  Beyond that suggestion, I look forward to next year’s conference.

For more on the congress, try these:

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Dec 10 2008

World Healthcare Innovation and Technology Congress – Day 2 Wrap-Up

Category: HealthTim @ 10:28 am

Day 2 of the World Healthcare Innovation and Technology Congress started early with a 7:00 AM breakfast sponsored by Alcatel-Lucent. Early morning meetings are usually rough, but many of us were from other time zones and we were less than talkative. They probably needed stronger coffee and an IV drip to get the group going. The main message from Alcatel-Lucent talk; the network is in the path of care. This has many meanings, but it echoed the general theme of the entire conference.

Next up was the opening keynote address from Microsoft’s Peter Neupert focused on consumer driven healthcare changes on how online communities are creating new points of care. The disparate communications between the patients, care providers, and family and friends cause significant stress on the patients and producing negative outcomes. Online communities can deliver the same message to all concerned with the patient and ease this stress. Neupert’s message, it’s not about the technology, but the outcomes we are trying to enable. Agreed. Just not sure I want to go to the Microsoft Hospital. Probably needs to be rebooted every twelve patients…

Another interesting point was the discussion about using all this data we are collecting on patient treatment and outcomes to create logic and assist the physician in the care of the patient. While this is not a new concept, it was a good reminder of the benefits of EMRs and true interoperability, the utilization of data to improve outcomes. Let’s face it, there is too much to know to be able to handle all situations a care provider may encounter.

Frank Torti of the FDA challenged my thinking and made me look at the role of the FDA in a different light. Torti is a scientist and discussed the infusion of science into an agency that regulates products accounting for 25% of all consumer spending. The challenges to the FDA are growing due to overseas manufacturing of drugs, medical devices and food, bio-terrorism, and the accelerated change in technology. To keep up with these challenges, the FDA is turning more to science and three principles: partner more and smarter, maintain a core of scientific expertise, and be preemptive with their scientific strategy.

Next was a demonstration of “cutting-edge” technologies. The first was a merging of video conferencing and translators from LifeLinks. Their system was impressive, but the most entertaining part of the demo was seeing a member of the audience who recognized and reacquainted herself with one of the interpreters. From that point on, the demo bordered on being more of a dating service, but seeing the interface work in that fashion proved to be an effective illustration of its success. The second demo was an impressive data informatics and business intelligence tool by MedE Financial. However, I’m still left wondering, how do we get good data into systems do perform this type of analysis. We need to remove human error as much as possible.

After lunch, we broke into three executive tracks involving 4 presentations. The first I attended was on a clinical intelligence system for providers that demonstrated an intuitive and powerful tool that could be quite useful. The second was a demonstration from the Social Security Administration and their efforts with the NHIN and finding ways to process claims in hours instead of months.

Next came the two highlight presentations of the day; Consumers at the Center with Greg Matthews of Humana and Second Life and Virtual Worlds with GT Sweeney.

I had the pleasure of meeting Greg Matthews first via Twitter on day 1 of the conference. He was part of the 5 or 6 of us who were live tweeting during the event and building our own little network. When Greg realized his breakout session was in the “big room,” he put out a call to Twitter group to attend his session.

Greg and Humana are working on strange (for an insurance company) and wonderful uses of technology and social networking to improve their customer’s health. From the Free Wheeling bike program ( featured in this year’s presidential conventions to the new efforts with Exer-games, his team of innovators pushed my thinking and challenged me to figure out better ways to reach-out and engage our customers. For more on Greg’s team and their programs, check out their blog The name says it all.

The SecondLife demo was also strong and my favorite part was watching the virtual presenter from London take over the show, talk to us from a podium, display his slides, and even gesture to the slides all within SecondLife. One can always benefit from a live demonstration of technology in action and despite the challenges, live demos are the best way to go. The possibilities for community development and personal interaction were racing through my mind.

These two sessions are why I came here; they illustrate and demonstrate what is possible to stretch our thinking. The event provided me the ability to connect virtually and face-to-face with like-minded individuals who share my interests and deal with the same pains. When you think about it, this really is a massive dating service helping you to find sole-mates who share your interests…

My day concluded with a presentation on the international perspective of healthcare and the global economy. I found two key messages in this talk. First, Denmark has built a very slick and comprehensive health information network and it is being used. They average 4.5 million messages a month from a country of 5.5 million. The second lesson spoke of the challenges in universal healthcare in a global and moving marketplace. It’s great when you have universal healthcare in your country, but what happens when you cross boarders into someone else’s universal system? Add to the mix medical tourism and there could be a steep price in the future.

After 11 straight hours of sitting, listening, tweeting, and taking notes, my back told me it was time to go. I’ll have to watch today’s closing address on the CD-ROM that I’m ordering. Overall day 2 of the World Healthcare Innovation and Technology Congress was a smashing success and well worth my time. I only wish there were more people here to listen to these presentations and share the growing excitement.

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Dec 09 2008

World Healthcare Innovation and Technology Congress – Day 1 Wrap-Up

Category: HealthTim @ 8:44 am

The first day of the World Healthcare Innovation and Technology Congress provided abundant information and gave a glimmer of hope to those of us trying desperately to improve healthcare through the infusion of IT.

I arrived at the conference after the opening keynote address and and entered the conference during a presentation called: How the Current Economic Challenges are Changing the Future of Innovation Investment. Understanding where the business opportunities are in healthcare and specifically where venture capitalists are seeing opportunities, is a telling case as to where things will be heading in our industry.

The first question, is there still VC money out there was answered with a qualified yes; there is money, but it is more discerning in the selection process. What was interesting to me was the amount of individual investments seems to be increasing. If you have a good concept and business model, you will not only be funded, but will likely find more funding then prior efforts. Part of the higher awards may be a by-product of the recommendation for “more realistic” timelines in business models.

Other learning from the presentation, treatment will continue to dominate attention over prevention because the aging population, blockbuster drugs are still out there and even incremental improvements can create tremendous opportunities in drugs, personalized drugs will grown in importance, and 1/3 of all prescriptions are not fulfilled and many patients do not follow the regiment prescribed.

Next, I went to a panel presentation called: Moving Connectivity Across the Healthcare Spectrum: Contemporary Approaches to Collaboration Management and Web 2.0 Technologies

One theme: In social networking, the individual is seen as a node and the tools are designed to connect nodes together. This makes sense, but lacks the personal feeling that is the true driver in social networking, but it helps from an IT perspective. I believe it is that individual’s need to connect is what drives nodes to other nodes. It was also suggested that social networking can be used in medical education to allow students to “experience” health events by following patients who are using social networking to cope with their care. Interesting….

The key message here was, patients are feeling increasingly empowered to access their patient information and the greater liability may come from those who are NOT embracing these technologies. Sharing medical information with patients is no longer an option, but a requirement.

Next was the highlight of Day 1: Newt Gingrich. Newt is a politician and politicians, the good ones, always seem to give excellent presentations. Newt is a good politician.

Favorite Newtisms:

  • I worked very hard to defeat John Kerry because he was left of Kennedy and I was afraid he would nationalize the banks
  • The Bush stimulus package is just dumb. It’s like giving a teenager amphetamines so they could get even crazier before they crash
  • It will be virtually impossible for Obama to make health a real priority. It will take 6-9 months just to sort through the wreckage.
  • We are in a great time of discontinuity in world. It is not a time of marginal change

You get the idea. Bottom line, we are in a mess, but things are moving forward. Expecting fundamental and instantaneous change is not realistic and will likely cause more problems then solutions.

The final presentation was from the iRobot company showing how in-house robots could be used to reestablish physician house calls with a 21st century twist. Your doctor is giving you an examination via robotics, video, audio, and health monitoring tools. Interesting, but a bit creepy. The best quote from the presenter when displaying an elderly woman smiling at a robot in her home, “Some people find this image disturbing.” The times they are a-changing.

The evening reception proved to be very interesting as well. As fate would have it, a physician from University of Oklahoma sat at my table and we struck-up a conversation. Being both an employee and a fan of the University of Texas, I opened with 45-35. For those of you who don’t know, OU is in the national championship even though UT defeated them. I guess this is another example of how IT can make a mess of things.

Once we moved on, we had a very interesting discussion about the challenges facing both our institutions and in the end, I think we are going to work together to help them start working on their own physician portal. Funny how things work out.

At the end of the first day, I was very glad I came to the conference. To find time to think, I decided to do what must be done in DC; I went to talk to Abe. Even without the cold temperature, I always get goose bumps.

Lincoln Memorial

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Dec 03 2008

From Bad to Worse, Plaxico Burress is Done with the Giants for the Season

Category: Pro SportsTim @ 7:37 am

Are the New York Giants going to return to the Super Bowl? If so, they will have to make it without last year’s Super Bowl star Plaxico Burress

The New York Giants fined and suspended Plaxico Burress on Tuesday for four games — the rest of the regular season — after he accidentally shot himself in the right thigh over the weekend at a Manhattan nightclub. The team also placed him on the reserve non-football injury list, which means the wide receiver couldn’t come back for the playoffs.

So Burress is finished with the Giants this year, but that may only be the beginning of his problems. In 2006, New York passed anti-gun legislation with mandatory minimums and Burress could be looking at some real jail time:

[The anti-gun law] eliminated a provision that gave judges the option of not imposing jail time on people found guilty of illegally possessing a loaded firearm.

Instead, the three-and-a-half year minimum sentence was established. As a result, legal experts said Tuesday, Burress may have little wiggle room as he tries to avoid prison time.

“Even if he pleads down, he can only plead down one count and he would still face a minimum of two years in prison,” said Robert C. Gottlieb, a New York-based criminal defense lawyer and a former prosecutor in the Manhattan district attorney’s office.

“The other wiggle room is that he could try and prevent the district attorney’s office from charging him with this crime and charge him with a lesser crime.”

Charging Burress with a lesser crime would like spark a wave of criticism in New York and around the country. Considering we just elected a president who is pro gun control, this may not be the best time for a more “relaxed” charge. New York’s Mayor Bloomberg appears to be in no mood for a lesser sentence:

Mayor Michael Bloomberg, who Monday stressed in no uncertain times that Burress made a “a sham, a mockery” of the law and that he should be fully prosecuted, was less vociferous yesterday.

What a mess. All from an athlete believing that the rules did not apply to him and who didn’t take the time to learn about the proper way to handle a handgun.


Dec 01 2008

New York Giants Receiver Plaxico Burress Surrenders to Police

Category: Pro SportsTim @ 11:19 am

In today’s dose of What’s Wrong with the NFL, the headlines read “Plexico Burress Surrenders to Police.” Why would the NY Giants star wide receiver and hero of Superbowl XLII be surrendering to police?

Nearly three days after accidentally shooting himself in the thigh at a Manhattan nightclub, Giants receiver Plaxico Burress turned himself in at a New York City police precinct in midtown Manhattan on Monday morning to face charges of criminal possession of a handgun.

At 8 a.m., Burress, escorted by his lawyer, stepped out of a black Cadillac Escalade and walked calmly into the 17th Precinct station house at East 51st Street and Lexington Avenue — three blocks north of the night club where the incident took place — as throngs of onlookers, some of them heckling, and reporters stood behind metal barricades. Dressed in jeans and a white shirt with a collar, Burress did not appear to be limping, and said nothing as he entered the precinct.

Yes, he shot himself in the leg. I’ve heard the saying I shot myself in the foot, but that was in reference to getting out of something bad and making a mistake. Why would Burress want to jeopardize his pro career and millions of dollars? What are his options?

Burress plans to plead not guilty to a weapon possession charge during a Monday afternoon court appearance, his lawyer, Benjamin Brafman, said outside the police station. Conviction on the charge could result in at least 3 1/2 years in prison.

“He is standing tall. He is a mature adult,” said Brafman. “I think any professional athlete in this situation would be concerned.”

And there is the problem. “I think any professional athlete in this situation would be concerned.” Why do professional athletes get into these situations? Why do the insist on hanging-out with the “wrong” crowd and decide to arm themselves? In the case of Burress, he was obviously in greater danger from himself than from others. Why do these stories keep coming?

I’m sure more will come out of this, but it is just another example of why I need to explain bizarre behavior to my kids and remind them that professional athletes are NOT role models…again.