A simple but effective way describing how to go paperless using Evernote (and a scanner).

1. Check the mailbox after work
2. Toss out the junk
3. If anything is left, determine if I need to scan it.
4. Scan to Evernote
5. Do I need to keep the original? If not, shred it, otherwise file it.
6. Check my paper inbox
7. Repeat steps 4-5

Good advice about how to avoid making excuses, that are useful for protecting the self esteem, but ultimately, don't deliver the results. From Psyblog:

In a series of experiments McCrea (2008) tested the effect of these explanations on participants' future motivation. What they found was that making excuses made people feel better about themselves because they were shielded from lowered self-esteem. But, on the other hand, the excuses reduced the motivation to prepare properly in the future. The line between an excuse and an explanation is a fine one, but generally excuses reduce motivation because they tend to:

• Blame others rather than ourselves.
• Make poor outcomes seem better in comparison.
• Lower expectations for the future.

So the first step in avoiding self-handicapping is noticing and cutting out the most obvious self-defeating behaviours, like not trying very hard. On top of this it's important to try not to make excuses as they will reduce motivation. It will mean taking a hit to your self-esteem, which will hurt in the short-run, but will allow better performance in the long-run.

Well, where you were actually. All of last year. Thanks Pete!

Going to a W hotel makes me feel like I've been given a backstage pass to New York Fashion week. All models, intrigue and in crowd. This can be good and bad. Fun to people watch - skinny waifs channelling Twiggy having deep conversations with swarthy looking guys smoking french cigarettes. The music is relentlessly hip, night-club loud and in your face. Design tends to be front and center. It's not a hotel experience for those who want to focus on other things. It's a precocious child that needs your attention, but gets it because it is disarmingly cute.

The W Retreat and Spa Bali at Seminyak is no exception. Open for just over a month, it leaps out with impressive confidence despite its youth. The architecture is very open - all smooth curves and open walls that invites you to gaze out to the pools and the sea beyond. The DJ curated music lures you to the beach bar. The wavy walls, green and purple accents, brightly colored rocking chairs and army of model ducks decorating the place say we don't do convention, and nor do you.

I was only staying one night as part of a multi-city world tour, and i was travelling alone, so not the usual demographic of strutting couples. I wasn't particularly bothered, enjoyed people watching while eating a magnificent brunch buffet then went to hang by the pool. It was only when the waiter asked me where my friend was - a hairy chap with an unpleasant speedo who had sat down next to me - did being single feel like a chore.

First the room. They upgraded me to a "Spectacular" ocean view, even though I only paid for the poor man's view (room was $300+ tax on SPG.com) and it was as promised. Large with a spectacular view, and a L-shaped sofa and table. You could see and hear the rolling surf, recline on the balcony, or shut the door when the disco music got tiresome. There was copious amounts of granite and polished grey wood, with jaunty humorous touches like the flower-bedecked bedspread, cutesy-labels for things (e.g. 'munchies box' instead of minibar) and kaleidoscope (I would love to have been on a fly on the wall when they decided to prioritize that). Media was good - Bose CD/DVD system, 40inch flat screen (with a sliding screen cover) and connectivity panel.  Bathroom was very large, and had a roof light, so you could take your rainfall shower under the sky. Slight glitch when the in-room fire alarm went off due to a faulty switch - the stone walls served to amplify the screech to head-splitting levels.

The rest of the property was as intended - a resort for the cool kids, and those who wanted to hang with them. The business center was more like an airline lounge - Mac computers and cool sofas as well as free coffee. I had the buffet breakfast and kept eating and eating - everything on the menu and a la carte was included for a fixed price of around $30. The eggs benedict was fantastic - they used a blow torch on the béarnaise sauce. I couldn't sleep so went to the gym at 4 in the morning, and that had shiny new cardio machines and soft purple towels that I wanted to take away but didn't.

Unfortunately for a beach resort there was a large No Swimming sign saying that you'd be swept away if you ventured into the water, and the sand was a rather dark brown, not invitingly gold. But that didn't matter to most people - the center of gravity was the beach bar and pool where everyone was watching everybody watch each other, so there wouldn't really have been time for a swim anyway.

Overall, two thumbs up, and would love to return. But next time will be more prepared - will bring an entourage, a well-thumbed Sartre paperback and a packet of Gitanes.

Apple finally plays its hand with iTravel

After months of filing patents and selling more mobile devices and tablets (remember, no-one thought they needed an iPad just 12 month agos), Apple will introduce iTravel as a core piece of functionality on both products.

via Tnooz Predictions 2011 - the biggest and best list in travel tech | Tnooz.

Haven't heard about this - sounds like more of a consumer service than Apple would normally go for.

It seems that Walt Mossberg's wish for a diabetes product and service that doesn't suck - in fact more like his beloved iPhone - is coming true.

UK based Cellnovo has just announced a hefty $48m Series B for their diabetes management solution - pump, handset and online service. Heck, even the packaging looks like it's designed in Cupertino.

The In Vivo profile on them makes the same point, and has a good quote from Cellnovo CEO Bill McKeon that all large market leaders with established business models and ways of looking at things would do well to heed, before they find themselves on a burning platform:

Established companies have the burden of supporting the legacy product platform. Start-ups don’t have the legacy of having to carry that technology forward. They can start new with new parts, they can start with a mobile orientation, and they don’t have to work with engineers that know how to make pumps but are unfamiliar with cell phones.

There's something rather resilient about the English language - it does a pretty good job of shrugging off silliness. I've noticed a decline in geek-inflicted bastardizations, such as adding 2.0 to anything (yes, guilty as charged) and removing vowels from company names. In today's post-crash world Twittr and Facebk would seem too flimsy.

So too, I predict the 'm' as in mHealth will soon go the way of the 'e' in ecommerce. Recently mHealth discussions have been shifting from the technology (doctors and patients using mobile phones and sensors) to what I think is the most important point - improving patients' service quality and reducing society's costs.

Two recent reports each make (at least) one important point. The first from Research2Guidance talks about the potential for cost savings for integrating mobile solutions, primarily due to better compliance (this graph reprinted by mobilemarketing watch, I don't have $2k to buy my own copy). Diabetes is the clear 'winner' here, and big pharma should be embracing this and driving the change to efficiency.

The second report mentioned in the article is the mHealth report from mobilestorm that provides a readable snapshot of the market and provides a useful summary of the different elements that make up mHealth today:

There are currently eight broad areas of the mHealth market, including general monitoring, personal emergency response systems (PERS), telemedicine, mobile medical equipment, RFID tracking, health and fitness software, mobile messaging and electronic medical records.

Moving on from narrow definitions of mhealth towards broad related categories is part of growing up. Before long the conversation will be less peppered with distracting and ill-fitting monikers, and be more about improving service quality and reducing costs, with technology just as assumed, ubiquitous and invisible as oxygen in the air. Or homeless dudes in San Francisco.

Few people, outside those engaged in the 'oldest profession', have been inside as many hotel rooms as Lonely Planet co-founder Tony Wheeler. His list of top 10 gripes of hotels (forwarded by a travel uber-geek friend) should be required reading for anyone in the hotel business (overly expensive internet and rip off breakfasts to name a couple).

It still amazes me how many simple things even top hotels get wrong. I stayed in the storied, luxury hotel Fairmont in San Francisco recently, and compiled a list of things that didn't fit in with a $300/night experience. There were many, including a complete absence of accessible plugs, a single bar of soap that i had to shuttle between shower and hand-basin, and an aircon setting that was constantly reset by the maid to the 60s whenever I left the room, clearly driven by a policy that thinks the 'environment' is man made.

My company Fordcastle has a new project - am working with a team in the UK looking at the future of hotels for a large chain, so I thought I'd start with Tony's post to put together a list of gripes that you dear reader are welcome to contribute to - either direct or via the comments here. After all, figuring out what the future should be starts with doing less of what doesn't work today.

• Adstruc makes an online market in the large but offline world of outdoor advertising. The team clearly knows their industry and their recent Tech Stars bootcamp training was apparent in the smooth presentation. The product seemed to work; beyond just selling advertising space on billboards, it also lets users use Google Street View to see how your ad would look in that spot. CBS or WPP - make a bid while they're cheap.

• Vyou could hit big. It's a platform allowing people to publish videos in response to specific questions. It is designed to maximize the value of video participation from its publishers by slicing it into small segments and dosing it in metadata. It could work well with celebrities, sports people and other expensive types (e.g. subject experts) as it requires minimum time commitment, maximum reach (videos are embeddable by anyone elsewhere on the web) and content needs only to be created to answer questions that people are already asking for. Want to know what the Pope says about contraception, or exactly how Jamie Oliver avoids curdling the sauce, this could become the reference source to find it. As audience member David Rose said, think of it as Quora for video.

• Dotgo: This was a little harder to parse, but impressive if nothing else for the virtuouso coding coolness (live) of the CEO (Stefan Gromoll) as he wrote - in a language he'd invented - a program in 2 minutes that allowed people to text in answers to a poll, which are then displayed online. The company does something close to my own heart - connect the mobile world, and in particular, its messaging system with the web.  Having worked 6 years at in the telco space I often despaired at the glacial pace of innovation, so this is manna. However, short codes are a jealously guarded resource and it wasn't clear to me how they'll address this, but this is a company to keep an eye on.

Others: Munchly have an excellent idea that roused cheers: order (and sometimes even receive) fast food at a sports game (or other venue) from your seat. Certainly a consumer pain point, but I'd worry about the execution - specifically the cost burden on participating venues and lack of penetration by the other customers to make it worthwhile.  And while sitesimon has a great name (love a pun) the audience winced at the idea of people automatically sharing every site they'd been on. Unless rumors of the death of privacy really are true, this will face an uphill struggle to show more signal than noise.

Final thought - a plug for an interesting startup competition. Aware of its laggard status as a tech hub compared to the Valley, New York has been playing catch-up. This Summer the NYC Investment Fund, together with Accenture, has created the FinTech Innovation Lab with prizes of 25k and (even better) C-level mentors from Big Banks to successful startups focusing on financial services customers. I like this as it recognizes that it's better to build on strengths rather than blindly copy what happens out west. For example, perhaps the predictive modeling techniques of recommendations engines in consumer web services could be applied in reverse to help fraud detection at banks. A perfect opportunity for those having left the big banks in the bust to get an invite back. But be quick, deadline is Jan 31.

A sugar glider, "the world’s most dangerous animal" (because of it's likelihood to be imported and so transmit rare diseases) according to ecologist and TedMed speaker Peter Daszak.

TEDMED is a spinout from TED - events that gather a diverse set of luminaries to discuss ‘technology, entertainment and design’. TEDMED applies the same principles - senior level participation from a range of fields, intimate atmosphere and short engaging talks, in the area of healthcare, innovation and wellness. I participated this year at the event in San Diego which was held October 26-29. This post highlights some broad cross cutting themes, then provides a (non-exhaustive) summary of the key insights from the sessions.

KEY THEMES

Impact of aging populations

Within 40 years there will be 6m centenarians, up from a few hundred thousand today. The proportion of people over 65 is set to triple globally between now and 2050. The key idea here, pushed by Aubrey de Grey and others) is that aging should be considered a disease. His SENS foundation has identified 7 characteristics of pathology - how the cells die - that he thinks should be treatable. In this way not only will people live longer, but more important, their lives will be less ravaged by disease and 'decripitude'. Another points that was made was how there are often different treatment models and drugs for young vs. old people which often is overloooked.

Dramatic need for innovative cost reductions

In 1960 US spent 4% of GDP on healthcare, that number was 18% in 2010, with a value of $2.62trillion. Americans spent $134bn on pharma drugs in 2004, rising to $234bn in 2008. Massive amounts of waste and opportunity for improvements:

1. 1.7m infections in US hospitals causing 99k deaths/year
2. Medical care is the 3rd biggest cause of deah in US!
3. 75% of healthcare spending is on chronic diseases.
4. For every $1 spent on medical research, $400 is spent on care for the patients.

Coupled with aging populations, this is unsustainable. Alzheimer’s will collapse Medicaid and Medicare by 2015 if no new drugs. Need for innovative and cost effective treatments and behavior change.  30% of patients starting a long term course of medications stop taking them after the first month. Mobile healthcare has the potential to deliver massive cost savings - e.g. stated mission of the new West Wireless Institute.

Consumerization of healthcare

Walt Mossberg put it succinctly “the most important electronic device is my glucose monitor, and it’s a piece of crap”. For more info on this, see Section 3 below, including his pleas for change. More generally, the impact of consumer empowerment underlies many of the emerging innovations on display such as the easy to use web accessible genomics tools of Knome and 23andme, and ubiquity of smart phones as human controllers.

Importance of information (re) design

“Healthcare is not a science problem it’s an information problem”. Need to help people make better decisions –relevant (personalized) information at right time will lead to better outcomes. Create change through emotion People change because of what they feel, not what they know. Quest earns $730m profit last year, Labcorp earned $543m profit - the redesign done by the Wired editors cost less than $10k and resulted in much more effective information that can lead to behavior change.

Solving diseases with genomes (and proteomes)

Massive decrease in cost of sequencing a human genome. 2227 genes are highly predictive and medically actionable. 0.004% genetic difference between humans and neanderthals. However, genes are not deterministic – can be turned on and off. Lifestyle / environment has the ability to turn on and off genes - epigenetics.

Holistic health vs. chronic illnesses

81% of Americans take at least one medication a day. Only 3% of Americans lead healthy lives (no smoking, good diet, exercise). 35m deaths globally/year could be prevented through diet, exercise and quitting smoking.

Whole body approach to diagnosis and treatment - body is a system and a process - not static.  Cancer should not be a noun – it’s a verb. A symptom of a problem with the system.  “Unhappiness comes from spending money you don’t have on things you don’t want to impress people you don’t like” - Deepak Chopra.

Non-pharma techniques to improve health focus on diet, exercise, sleep, stress and relationships. Evidence that changing diet and lifestyle reversed disease in cancer and heart disease patients. 62% of an average US citizen’s calories come from processed foods, 20% from animal products. Around 10% from unprocessed fruits and vegetable (should be about 90%).

Going mobile

Everything is moving mobile - which means being untethered from the traditional model and location (e.g. of a hospital). Mobile technology described include mobile ECG readers - reading a patient’s heart rate in real time to lab on a nano-chip technology (Nanobiosym’s Gene Radar) that will be able to determine diseases on the spot. But mobile doesn’t only mean mobile phones - the next generation of bionic machines (prosthetic arms & legs, pace makers) have wireless sensors embedded in them so can be controlled with smart phones.

SUMMARY OF KEY TALKS

This review covers the majority of the most interesting - but not all - talks at TedMed 2010.

Shef Keshavjee, Senior Scientist, Toronto General Resarch Institute (link)

He’s developed a technique where for the first time you can keep the donor organ outside the body at room temperature for up to a day. This means that you can then repair it (for example if it has an infection) or even potentially genetically modify it (for example to reduce the cance the the recipients body rejecting it).

Nathan Mhyrvold, Founder, Intellectual Ventures (link)

Talked about a few of their health-focused innovations such as: self-disinfecting surfaces using UV light. Lght-activated nitric oxide bandages that kill bacteria. Back-scatter X-ray to provide a view of 1" below the surface. Talked with great enthusiasm about his new 2400 page cook book Modernist Cuisine.

Dr. Nathan Wolfe, Director, Global Virus Forecasting Initiative (link)

Massive increasing in interconnectivity. Use of social tools e.g. Facebook / Twitter updates can be used to predict and manage viral spread.

Global airline networks facilitate the spread of disease.

Thomas Goetz, Executive Editor, Wired Magazine (link)

Healthcare is not a science problem it’s an information problem. You can dramatically improve healthcare by helping people make better decisions. This will come from providing (personalized) information at the right time that lead to better outcomes. Information’s power to enable behavior change when it’s personalized, has relevance, highlights choices, and prompts action. Redesigned Quest’s lab forms - traditionally unreadable - to a new format that made it clear to extract meaning from the numbers.  Four questions for your doctor: Can I have my data?;  What does it mean?;  What are my options?; What’s next?

Mike Barber, GE HealthyImagination (link)

Talked about new mobile ultrasound VScan - used in Olympics and allowed athletes and supporter not to miss the games, and proving effective at paces like Indonesia with 1000 islands. Spending $6bn on GE Healthymagination programme. GE has just launched a large healthcare initiative with Intel to be launched in 2011.

Jon Mackey, CEO, WholeFoods (link)

Gave a review of the bad food Americans were eating - of the appx 10% of calories in our diet that come from fruit and vegetables, half of that is from potatoes and half of those are fries. He talked about some innovative incentive schemes in the company - greater discounts (20% is standard, up to 33% is possible) for being healthier. They have an optional residency program where the very unhealthy e.g. obese can go - great results impacting morale and lowering insurance costs.

Frances Jensen, The Children’s Hospital (link)

Focused on the adolescent brains. Found that adolescents treated by a pediatrician had higher survival rates than those treated by a regular doctor. Kids and adolescents brains are wired differently - epilepsy drugs for adults are less effective on kids since they have more excitors and less inhibitors, each react differently to these drugs.

Juan Enriquez, Former HBS Professor, MD Excel Venture Management (link)

Presented the concept of “Homo evolutus” - a new human species created by humankind itself. “There have been at least 25 prototype humans. We are but one more model, and there is no evidence evolution has stopped.”

George Church, Professor of Genetics, Harvard Medical School (link)

Worked on the human Genome Project, create synthetic life. Has now created the PersonalGenomes.org project - monitoring the genomes of 16,000 volunteers.

Craig Venter, Chairman, Craig J Venter Institute (link)

Sequenced human genome in 2001, announcement of the 1000th genome sequenced in Apri this year, but ‘what we need is 10million’ . Craig’s institute made the first synthetic life last year - put together bits of DNA to create a new organism. Multiple uses for synthetic life Craig proposed reverse vaccinology - using the synthetic genome to create new vaccines. He also thinks they can create new solutions for food, water and rewnewable fuels.

This is in the DNA of the first synthetic organism - peppered with existential quotes.

Peter Daszak, Founder, Ecohealth Alliance (link)

Most viruses jump from animals to man (HIV: monkeys, SARS: birds). Use of modelling techniques to predict next global outbreak. “Most dangerous animal” in the world according to him - the cute sugar glider, since it is imported direct from disease hotspots around the world direct to people’s homes, and laps.

Walt Mossberg, Wall Street Journal (link)

Walt has been a life long lover of technology - and a diabetic. He railed against the state of medical devices today compared to his beloved iPhone and iPad, and called out his own glucose monitor - the Accu-Check Aviva, and said ‘it’s a piece of crap’.  In a follow up interview, I asked Walt to provide more info and he made three clarifying points - that he was pessimistic about innovation from within due to the industry's revenue model ($1 per test strip); that the holy grail is to detect glucose levels non-invasively (and non wearable for type II patients who don't need continuous readings) and third, to make devices as "sophisticated, accurate, and connected to the computer, smartphone, tablet and -- importantly -- the web (securely) so that both patients and doctors have easy access to the data". I'd suggested that Apple should be the benchmark that pharma companies (e.g. the one that's currently my client) use, and he thought that was right.

Walt Mossberg expressing his frustration with the poor quality user experience on his glucose monitor.

Alex Berenstein, Director,  Center for Endovascular Surgery, Beth Israel (link)

He is a pioneer in the emerging field of interventional neuroradiology, a specialty that utilizes minimally invasive procedures to treat conditions related to the vascular system of the brain, head, face, spine and spinal cord. He reviewed state of play of catheter’s etc, how technologies have evolved.

Henry McCance, Greylock Partners, Founder Cure Alzheimer’s Fund (link)

Henry is using a VC-approach to accelerate research in Alzheimer’s at the Cure Alzheimer’s Fund, and he coined the term “Venture Research”. Current research is inefficient (30% of time filling out forms), ineffective ($1 on research for every $400 on care) and incremental (risk averse studies, moving one stage at a time.)  The approach at the CAF is based on the following principles: Proactive, Frugal, Collaborative, Outsize ambition.  Other business people creating innovative organizations include Steve case (ABC2) & Jamie Heyward (ALS-TDI). Rudi Tanzi from Harvard talked about the Alzheimer's genome project.

Danny Hillis, Founder, Applied Minds (link)

Looking at cancer research and treatment from a different perspective. Traditional genome approach is static, whereas proteomics is dynamic, and more able to help you understand what is actually happening in the disease. Analogy of the body as restaurant, the list of ingredients are the genes and the meals actually being created and served are the proteins. Created Applied Proteomics company and partnereed with David Agus for a new department at USC. He estimates it will take 5 years – to get to a predictive model of what happens, that will include neurodegenerative diseases.

Hugh Herr, Professor, MIT (link)

Skilled rockclimber who was caught in a mountain got frostbite and had to have both legs amputed above the knee. “I wouldn’t have it any other way - before the accident i was a below average student, with my new bionic legs i’m now a professor at MIT” (who has the cool title Director of Biomechatronics)

Dean Kamen, Founder, Deka (link)

Updated the crowd with his innovative prosthetic limb robots - displaying a complex model ship that someone with no arms had built using the Deka prosthesis. He described an innovative water filter that creates perfectly clear water from any type of water however dirty. He’s in negotiations with Coca Cola to have it distributed with their soft drink machines globally. He’s also passionate about his FIRST training kids to build robots and enjoy science. Funded with a $3m grant from Google, getting kids to sell energy efficient light bulbs door to door, (similar to the girl scouts selling cookies).

Stephen Oesterle, MD, SVP, Medtronic (link)

Stephen talked about next generation pacemakers - tiny, no wires. Allow for wireless monitoring and direct interrogation by cellphone from anywhere. He noted that electronic signalling could be useful for other diseases - e.g. Parkinsons - and potentially controllable with machines.

Craig Fugate, Administrator, FEMA (link)

Emergency management should be more of a public-private partnership rather than the government coming and and doing everything. Use of social media e.g. Twitter by FEMA to assess situation and whether it should be attended to. Urged disaster management to be more integrated into society - to improve the ‘immune’ system.

Marc Koska, Inventor (link)

Described his 20+ year journey since hearing a story about unsafe reuse of syringes to creating a safety syringe (it automatically disables itself after one injection) and selling to globally to developing nations, who tend to reuse the same syringe and spread disease. It is credited with saving over nine million lives.

Scott Parazynski, Astronaut and mountaineer (link)

Scott is the only person to have flown in space and summitted Everest. He talked about the coming commoditization of space travel and urged everyone to do it if they can.

Greg Lucier, CEO of Life Technologies (link)

Greg unveiled a new gadget that can sequence a genome in a few hours (rather than days as currently the case).

Ozzy and Sharon Osbourne, Entertainers (link)

Discussing the results of the sequenced DNA - he has higher tolerance than the norm for alcohol, and has many traits that would make him a good mother (not sure what that means). Their family disagreements mirror societal angst - Sharon wants to know if she carries the genes for Parkinson’s and Alzheimer’s etc (it’s in her family), whereas Ozzy doesn’t.

Conclusion: Outstanding.

I highly recommend making the trip to TedMed 2011 if you want to hear - and meet - fascinating  leaders in the healthcare field who are passionate about innovation.

A parting comment - the ticket is not cheap - $4k, and if you only go and listen to the lectures you're wasting your money. It's about being part of the community - the real value is in the gaps, not the talks. The founder Richard and his business partner Mark really make a sterling effort with excellent dinners (the lobster bake on the beach was fantastic), generous munchies at the breaks and a warm, inviting ambience at the Hotel Del Coronado (especially valued for an East Coaster settling in for a cold winter). I'd recently read Never Eat Alone, and his main takeaway is to think of networking not as what they're doing for you but as what you can do for them. It  changed how I thought about networking from a rather unappetizing - and unBritish - quest to being about helping people. Spread the love, man.

Anyway, well worth it, and if you're interested, get your skates on. Rumor has it that tickets for next year's jamboree - which are non refundable or transferable - will probably sell out by end of Q1.