Health 2.0 keynote recap – #health2con

I’m excited to be attending my first Health 2.0 conference today to learn more about the trends in healthcare innovation and meet the hackers, entrepreneurs, industry and government leaders who are driving disruptive change in the healthcare industry. As a User Experience designer, I’m pleased to see such a focus on patient-centered thinking. Here’s a quick recap and interpretation of the presentations I saw this morning.

The first session was a “dueling keynote,” two short presentations by two interesting speakers

• author, health futurist, and healthcare industry advisor, Jeff Goldsmith.
• publisher, Web 2.0 pundit, and “alpha geek” watcher, Tim O’Reilly

Goldsmith started off by talking about what he called the “Innovation Drop” across every sector of the healthcare industry, from medical devices and imaging technology to enterprise and clinical IT to healthcare delivery. In one example statistic, Pharma R&D spending has tripled while new drug introductions have dropped by 2/3 over the past few years.

After establishing his point about stagnation in the industry, he moved on to talk about the Boomer generation and the increased demand they will bring as they age and require more from the healthcare system. He illustrated he point by comparing the receding waters before a tsunami to the coming en masse retirement of Boomer healthcare practitioners. The tsunami’s wave, in his metaphor, will hit when that same population places unprecedented demand on a diminished healthcare system.

Goldsmith ended by stating that the industry needs to rethink its approach to innovation to increase the productivity of the healthcare system. He offered five calls to action.

• Tame the documentation problem in healthcare delivery
• Help both HCPs and patients find information effortlessly when and where they need it
• Accommodate the increasing diversity of HCP and patient needs and styles
• Equip patients and families with tools to better manage their own health
• Entertain and honor the patient

O’Reilly then launched into a talk on how disruptive innovation from outside the traditional healthcare industry is coming to change the way the healthcare system works. He characterized the trend of Web 2.0 companies as those who were able to weather the doc com bust by being the best in their industries at harvesting collective intelligence. To this he added the components that have come to characterize Web 2.0, a focus on cloud computing, data-driven applications, mobile interfaces, real-time information and pushing the Internet beyond the browser and into everyday objects and interactions.

He used the example of the media industry as a bellwether for what is coming in healthcare, adding the point that many currently successful companies will be usurped by new entrants and many will fail before reliable new business models are established. He offered a vision for the future in three specific technological trends: the introduction of tablet computing to the point of care, cloud-based services to unify and manage patient data, and the emergence of sensor platforms like smartphones and other connected devices to reduce the burden of patient-contributed information.

Finally, O’Reilly ended by telling the audience that to truly capitalize on the principles of Web 2.0 innovators should seek to harness the collective intelligence emerging from the introduction of new technologies and make smart use of the “information shadows” that result from our everyday actions.

In the Q&A that followed the keynotes, Goldsmith and O’Reilly outlined two fundamental challenges to idling the infrastructure on which a new healthcare system could be based:

• harnessing medical data and getting it to the HCPs and patients when and where they need it
• simplifying the transactional complexity of the existing payment system in healthcare and moving from a “pay for procedure” model to a “pay for outcomes” one.

Design is how it works

The title of the new book, Design is How it Works, on the power of “Big D” Design comes from a Steve Jobs quote: “Design is not just what it looks like and feels like. Design is how it works.” I haven’t read the book (yet), but something struck me as I was reading the Core77 review quoted below.

What Greene does differently than most other business book writers is dig deeper, not just repeating the story anecdotally but interviewing the key players to try to find what drives them. The OXO case study is supportive of one of his main theses, that the way to craft successful products that drive sales is to pay attention to users on the fringes of the customer base. Greene calls these users outliers, but REI, Clif Bar and Nike might call them extreme athletes, while Virgin Atlantic has its road warriors and Porsche has speed freaks. For OXO the elderly or the arthritic may be sensitive to form factors that healthy and youthful users might ignore. Correcting the product for the needs of that outlier population actually enhances the product for the rest of the user base.

Outliers… It’s a good idea, if not a new one. Designing for outliers equates to designing for people who are particularly sensitive to the performance of your product. The difficult thing about this particular design principle is that the maxim isn’t complete. At least as important as designing for the outlier, is selecting the right one. To which aspects of your product should your outliers be sensitive? Your outlier might be the extreme user who will push your product to its limits (REI), or the frequent user who spends the most time with your product (Virgin Atlantic), or the user who struggles the most using your product (OXO).

It’s a nuance, but it’s one that determines the difference between success and failure. Designing for the wrong outlier can be as catastrophic as designing a bad product. How do you understand which of your users are the right outliers? Well that’s where the research comes in.

Although almost all of the companies profiled by Greene eschew focus groups in favor of ethnography and a guiding corporate structure, each case demonstrates that when the customer is ignored or misevaluated, problems occur. The clearest lesson of Design is How it Works is that the end-user must be listened to, if not in focus groups, at least in spirit.

A good lesson. But which outliers should I “listen to.” I’m looking forward to reading the book to see if and how this question is addressed.

References

Book Review: Design is How it Works: How the Smartest Companies Turn Products into Icons, by Jay Greene – Core77.

Locally grown innovation

I have the good fortune to have friends and colleagues throughout the world, many of them doing very interesting things to move the field of design forward. My friend Sonia, a Director of Idiom, pointed me to this article by Bruce Nussbaum describing an emerging network of innovation consultants in “emerging markets” countries.

As I touched on in a prior entry, the practice of innovation consulting is spreading, and changing as it is interpreted and reinterpreted into new business and cultural contexts. I’m happy to see that Bruce has raised this topic for conversation in the global venue of Fast Company’s new Co. Design channel.

What I find most intriguing in the article isn’t the simple notion that design thinking is happening outside the developed countries. It has been happening for a while, actually. The interesting bits to me are Carlos Teixeira‘s thoughts about:

1. how the global network of locally-owned innovation consultancies is actually networking, and working cooperatively, in ways that are nearly impossible in the hyper-competitive and somewhat adversarial US design space, and
2. the possibility of reversing flow… of changing the polarity of the conversation about innovation. This infusion of new ideas will help all of us to keep our own practice innovative.

We have a lot to learn from our emerging markets counterparts about how to do innovation, both for those markets and back here in the US. I personally welcome the conversation.

Nussbaum: China, India, Mexico, and Brazil Embrace “Design Thinking”

Some friends and colleagues Bruce mentions, I was lucky enough to spend time with at EPIC 2010, some I know from my time at Institute of Design:

• Luis Arnal and Roberto Holguin: In/situm (Mexico)
• Sonia Manchanda: Idiom Design and Consulting (India)
• Charles Bezerra: Gad’Innovation (Brazil)

Apple is the anti-Parc

For those who don’t know, Xerox Parc was Xerox’s formidible R&D center. Until 2002, when it was spun off, Parc did the basic research that created such ubiquitous technological innovations as bitmap graphics, GUI (featuring windows and icons), WYSIWYG editing, ethernet, InterPress (a pre PostScript resolution-independent graphical page-description language) and laser printing. The problem at Parc wasn’t developing viable technological innovations… it was monetizing them.

Apple, on the other hand, is all about monetizing technological innovations, just not their own… and they always have been. 25 years ago Apple released the first Macintosh, and became one of the firms to gain commercial success with a Xerox Parc innovation, the GUI interface. Apple still doesn’t have any significant muscle in basic R&D. What they do have is significant power in design, marketing, and business and the ability to make all the right connections to synthesize the right thing for the market at the right time.

Apple’s super power, I would argue, is introducing new technology to us in easily adoptable pieces–not first but best. Is this the ideal mix for a modern consumer electronics company? Seemingly, so.

5 years ago, who would have imagined that we would now make daily use of accelerometers and magnetometers, or orientation, light, and proximity sensors? It took years of many other companies trying and failing to get interaction with these technologies right, and although Apple continue to claim “no user research,” the world has been their testbed, and observations of how people have used (and not used) these technologies have clearly influenced their design.

Apple is adept at packaging technology in adoptable products that consumers not only understand, but desire. This is their true key to success. I’m looking forward to what comes next…

References

Apple Buys Swedish Facial Recognition Company Polar Rose

Creativity Is Just Connecting Things

A day worth blogging about

Yesterday I had the good fortune to be invited to “Made in India.” a lecture put on by Carlos Teixeira at Parsons School of Design. The reason I had that good fortune was by the grace of Sonia Manchanda of Idiom, my collaborator and co-curator for the workshop series at EPIC 2010.

The lecture was fascinating. It was the first in a series related to Carlos’ current project, to understand how Design is developing in emerging markets. Of particular interest is his observation that Design is developing differently in those markets. The lecture put facts to that observation. Much of their recent work at Idiom has been in the “design of business,” through a collaboration with The Future Group, a company dedicated to bringing to the masses what only the rich had before, through a fusion of modern retail business models with Indian culture.

Idiom and Future Group take a particularly aggressive approach to scenario and prototype testing, quickly turning out realistic concepts for introduction to real users in real situations. Some of their innovations include BigBazaar, a big box food retailer that incorporates the local seasonal vendors that Indian communities have come to rely on, and Home Town, a Home Depot / IKEA mashup that makes home design and construction available in a cultural context that does not do DIY.

But that’s not all, earlier in the day, I spoke briefly with a collection of the brightest minds working at the intersection of ethnography and business from Latin America, the US and Europe, some of whom are old friends and some I hope will be. That call was to begin the planning process for the EPIC 2010 program, for which I’m the workshop co-chair. Here’s a secret: the papers deadline is going to be extended. If you’re so inclined, submit something… There’s still time.

Working backwards, I spent the morning doing secondary research on the current state of the Healthcare IT arena here in the U.S. and identifying opportunities for innovation in software and services. I found some inspiring new work and personalities like Dr. Jay Parkinson, a physician entrepreneur whose own pediatric practice has been described as

“Geek Squad with doctors and a Netflix-priced monthly membership subscription fee — it is a branded healthcare “experience” that mixes “concierge service for all,” with house/office calls and web visits via email, IM, video chat, and text messaging.”

This is why I love what I do… It was a good day.

The Death and Life of Journalism

Outlining the current and future state of the news media. Some great lessons here on organizational vs. entrepreneurial innovation and strategic focus.

Newspapers and Thinking the Unthinkable
Clay Shirky’s article is a solid analysis of the evolution of the news media. In particular, I like the points he makes about the dynamics of the old-guard enterprise re: innovation.

When reality is labeled unthinkable, it creates a kind of sickness in an industry. Leadership becomes faith-based, while employees who have the temerity to suggest that what seems to be happening is in fact happening are herded into Innovation Departments, where they can be ignored en masse.

Then he paints a picture of how ‘the journalism we need’ will exist in the future, brought into being by the former consumers of corporate journalism.

For the next few decades, journalism will be made up of overlapping special cases. Many of these models will rely on amateurs as researchers and writers. Many of these models will rely on sponsorship or grants or endowments instead of revenues. Many of these models will rely on excitable 14 year olds distributing the results. Many of these models will fail. No one experiment is going to replace what we are now losing with the demise of news on paper, but over time, the collection of new experiments that do work might give us the journalism we need.

Old Growth Media and the Future of News
Steven Johnson offers a complimentary outlook on the future of the news. He points out some of the sources of the new journalism, and how user needs may be better served by the new model.

I think in the long run, we’re going to look back at many facets of old media and realize that we were living in a desert disguised as a rain forest. Local news may be the best example of this. When people talk about the civic damage that a community suffers by losing its newspaper, one of the key things that people point to is the loss of local news coverage. But I suspect in ten years, when we look back at traditional local coverage, it will look much more like MacWorld circa 1987. I adore the City section of the New York Times, but every Sunday when I pick it up, there are only three or four stories in the whole section that I find interesting or relevant to my life – out of probably twenty stories total. And yet every week in my neighborhood there are easily twenty stories that I would be interested in reading: a mugging three blocks from my house; a new deli opening; a house sale; the baseball team at my kid’s school winning a big game. The New York Times can’t cover those things in a print paper not because of some journalistic failing on their part, but rather because the economics are all wrong: there are only a few thousand people potentially interested in those news events, in a city of 8 million people. There are metro area stories that matter to everyone in a city: mayoral races, school cuts, big snowstorms. But most of what we care about in our local experience lives in the long tail. We’ve never thought of it as a failing of the newspaper that its metro section didn’t report on a deli closing, because it wasn’t even conceivable that a big centralized paper could cover an event with such a small radius of interest.

…and offers the suggestion that the news media shift to a curatorial function, editing and endorsing the best of what the web already provides, and focusing journalistic effort on what it may be more challenging to cover.

Measured by pure audience interest, newspapers have never been more relevant. If they embrace this role as an authoritative guide to the entire ecosystem of news, if they stop paying for content that the web is already generating on its own, I suspect in the long run they will be as sustainable and as vital as they have ever been.

Now I suppose it’s possible that somehow investigative or international reporting won’t thrive on its own in this new ecosystem, that we’ll look back in ten years and realize that most everything improved except for those two areas. But I think it’s just as possible that all this innovation elsewhere will free up the traditional media to focus on things like war reporting because they won’t need to pay for all the other content they’ve historically had to produce.

Overall, both articles are required reading. The effect of the current economic situation on the news media has accelerated the evolution that the web began and the speed of change in this industry provides rare glimpse into how innovation really happens.

Hulu, Boxee, and the threat of user experience

I’ve been following the developing Hulu/Boxee situation closely because I believe the real issue here is one of user experience. In case you haven’t been following along:

…two weeks ago Hulu called and told us their content partners were asking them to remove Hulu from boxee. we tried (many times) to plead the case for keeping Hulu on boxee, but on Friday of this week, in good faith, we will be removing it.

Full Post: the Hulu situation

That good faith didn’t last for long:

Early this morning, Boxee rolled out a workaround that let Boxee users watch Hulu shows again, which they haven’t been able to do since last month when Hulu pulled its shows off Boxee’s browser. Late this afternoon, Hulu squelched that workaround.

Full Article: All Things Digital

If you are in the business of serving web video content, why block one particular browser, one that could potentially be your largest channel? Because, when it comes down to it, Boxee provides a superior user experience for watching internet TV, superior, quite possibly to watching regular TV. In fact, Boxee, and it’s brethren could very well be the tipping point in the great public switch to internet television. The networks apparently agree:

Why does the TV industry need to keep Web video off your big-screen TV? Not because it hates technology. But because it hasn’t figured out how to make money off Web video yet — and needs you to keep watching TV on your TV.

NBC Universal CEO Jeff Zucker all but admitted as much in a keynote this morning: “What we’ve lost in viewers and advertising dollars on the analog side isn’t being made up for at all on the digital side. We want to find an economic model that makes sense.”

Full Article: Silicon Alley Insider

Television is being tivoed all over again.

Empathy is the new black

It’s good to see empathy making the rounds in the business publications again.

The key to delivering a great experience for is to have empathy for your customers. And the best way to develop that empathy is obvious, yet it requires constant repeating: Go to them. It’s shocking how many methods companies have for learning about customers (surveys, focus groups, phone questionnaires), and how hesitant they are to engage in the simplest approach. I suspect its because they’re afraid of what they’ll find when engaging customers directly, and prefer to hide behind the reports and charts those other techniques produce, and which provide endless opportunities for interpretation.

Full Article: Harvardbusiness.org

It’s become fashionable in the last decade to prescribe innovation as the cure for every ill facing business. If companies could only start creating compelling products and services on a regular basis, they would never need to worry about next year’s growth figures. While that might be true, such talk tends to focus on design or even flashy marketing. In the process, a critical factor gets left out of the conversation: empathy, the ability to see the world through the eyes of another person. Unless new products or services connect with the lives of real people, design or marketing can’t do much to make them succeed.

Full Article: BusinessWeek