Personal Health Records

Ever since my involvement with Phase Forward, I have been intrigued by the possibilities of introducing information technology across the health care world. One of the hot topics in this arena right now is the use of Personal Health Records (PHRs).

I am speaking on a panel about business models for PHRs at the '07 Personally Controlled Health Records Infrastructure Conference talking place today and tomorrow. I attended last year's first conference and found myself rubbing shoulders with luminaries from government (HHS, VA, CDC), academia, startups, large employers (WalMart, BP, Intel), technology providers (GOOG, MSFT, YHOO, INTU) and more. There was then, and even more so now (vis Dossia), a feeling that PHRs really can deliver value for all players in the health care system.

The trouble is that there is no clear business model that has emerged. The work on PatientSite at BIDMC, Healthvault from Microsoft, and Dossia illustrate three of many disparate approaches, any one or more of which may take root and grow well.

I am scooping myself by previewing my panel presentation and analysis of the 26 (or more) possible economic models that I have distilled from my exposure to the field thus far... and I expect to hear about more at the conference this year. I will share my thoughts of the conference and the panel later this week.

Goodbye multitasking

The Atlantic Monthly recently ran an article called "The Autumn of the Multitaskers", by Walter Kern (subscription may be required to read the article). He talks about his own conversion from multi-tasking to single-tasking as his car flew through the air towards a telegraph pole as a result of trying to look at a picture sent by his girl friend to his cell phone while driving. He lived to tell the tale, but only tells that tale when he is not doing anything else.

Kern quotes Publilius Syrus, a first century B.C.E. Roman slave: "To do two things at once is to do neither." This old wisdom seems to stand up to modern research. Kern notes that neurologists are finding multi-tasking is bad for the tasks you are doing all at once, and actually bad for your brain, too.

I for one plan to stop multi-tasking, or at least I plan to stop multi-tasking when I am doing something else, anyway.

Brits on Bikes 1955

Someone pointed me to a delightful movie made by British Rail in 1955 to promote day trips for cyclists to get out of London and enjoy cycling in the British countryside. (If you sent this to me, please remind me by posting a comment - I hate not to attribute my sources!) It is in two parts, below.

If your viewer does not show the actual embedded videos, here are the links to part one and part two.

Don't Panic...

I did get out for a ride on Sunday (feels so long ago now)... but first I had to deal with a flat rear tube that had magically appeared since my previous outing. This was no small thing for someone who has only once before had to deal with a flat on my own. The fact it was on the rear wheel was an extra hassle, because of navigating the derailleur mechanism when removing and replacing the wheel.

However, with "Don't Panic..." ringing in my ear (thank you Peter Jones), I happily set about my task, and was able to get going after just a few minutes (well maybe 20). Luckily this all happened at home so I had my trusty stand pump (much easier to get to 120 psi than with my road pump).

I was only planning a short ride and happily went out to Weston and back (about 15 miles), enjoying my sense of mechanical (pneumatic?) mastery, and the fun of cycling in the fall.

Idan Raichel again

Dorit has noticed that favorite songs contain particular sections that are what make the music so wonderful. The sax solo at the beginning of Baker Street by Gerry Rafferty comes to mind, the opening hypnotic bars of Space Oddity by David Bowie, the guitar riffs of Mark Knopfler in Dire Straits' music, and so on. Often it is the chorus, and sometimes the bridge. We love the songs for their "good bits".

However, Dorit went on to comment, with the Idan Raichel project, the entire song is the "good bit". This is so true!

It was only February that I last wrote about going to see the Idan Raichel Project in concert.

They were here again last night, playing at a more hip venue, the Paradise Rock Club in Boston. We went with cousins from Toronto, happened to meet up with other friends at the concert, and we all had a blast.

They played some new material, and they had a fabulous brass section to add new dimensions to familiar songs. My recommendation remains the same: well worth listening to!

A solar light unto the nations

My regular readers know I am a great fan of Yosef Abramowitz. He is a true mensch, an innovator, and an amazing leader.

Earlier in the year, when Jews all round the world were reading the first chapters of Genesis "... and there was light!", Yossi gave the d'var Torah ("sermon") in his kibbutz synagogue that week. It is inspiring in so many ways... well worth a read as we head into the darkest few weeks of the year. And it has a shout out to Nigel Savage at Hazon as well.

Hot globally, cold locally

It is getting colder in Boston.

When it's cold, I hear jokes about global warming (and there not being enough of it). I am well aware of the complexity of understanding human impact on the environment, but these jokes no longer sound funny to me. My work with Hazon is one reflection of my concern, but that work has many facets, and I am well aware that Hazon's impact is unlikely to register on the global warming thermometer.

As an optimist, I hope that new technologies will both slow the speed of our impact and ameliorate the damage that has already been done. The speed with which large developing economies are increasing their energy usage will overwhelm all our efforts to use energy efficient lightbulbs. Breakthrough technologies seem to me most likely to provide the biggest opportunities for change ... Just as some late-developing countries went from no phones to all mobile phones (without landlines in between), perhaps we can hope for escaping ahead with new infrastructures built on low-carbon energy sources.

Think globally, act locally: I got on my bike today for some carbon neutral exercise.

I rode 30 miles with Guy in the middle of the day, through Needham and Dover, and we could definitely feel the chill in the air (low 40s). The ride was great, nonetheless, with beautiful fall foliage lit by sun from a cloudless sky. The talk was of French cinema and cold weather gear. My thoughts are about staying fit in the winter, and I am glad of the new spinning center that has opened in Newtonville. Now, I just have to find time to get over there on a regular basis.

VC:VC The Exit

This is a VC:VC post - comparing venture cycling with venture capital. I am going to talk about "The Exit", which is a focus of attention in the venture capital world, and much less in the venture cycling world.

This week Sigma celebrated with portfolio company EqualLogic, which announced a definitive agreement to be acquired by Dell Computers, for $1.4b. Congratulations to Greg Gretsch who was the Sigma lead on this deal! This transaction is a particularly successful exit for the company and for Sigma, who gets to share in the proceeds. The company has exited its VC stage and moved on to being part of a larger story (assuming all goes well and the regulatory and shareholder approvals follow as planned). Although many startups fail, those tend not to be called exits (yes, we do call them failures). An exit is generally an IPO ("going public") or being acquired. As it happens EqualLogic was fairly close to going public when this acquisition was announced. Other good exits for Sigma over the last year or two included Broadware being purchased by CISCO, Topio by NetApp and M-Qube by Verisign. At the end of the day a venture capital firm is always working towards a successful exit. When this happens, we all do well: the founders and management of the company, the VC investors, and those whose money we invest (charitably and university endowments, and others).

Venture cyclists don't have "exits". I have no plan to trade in my bike for a cash payout (although I suppose it depends on the offer!). Instead, as a venture cyclist, I see the returns from investments show up in my own well-being, and in the impact of the work in which I am involved in the community. Sometimes two non-profits merge with each other, but this is not an exit - just a better position to do the good work. I think in fact that non-profit work is about entrances, not exits. Non-profits like Hazon (or even JCDS where I also serve on the board) are about bringing people in to something that brings benefits. The benefits accrue the more entrances there are, not the more exits.

Evoking place

Two of the books I read over the summer this year evoked their place particularly strongly. This was no accident: both were written with the place as a strong character.

The first was Midnight in the Garden of Good and Evil by John Berendt, set in Savannah, GA. This is a fun read even though it ends up being a journalist's recounting of the investigation of a murder, and his interactions with many of the characters. He demands that you treat Savannah as the protagonist in the story, despite the other strong characters. Based on this book, Savannah scares me a little, but should chance take me there, I believe that having read the book will bring me some sense of familiarity with its mood.

The second book, Hillel Halkin's A Strange Death, is about Zichron Ya'akov in Israel. Zichron of the past (from its founding) is a strong presence in the book, and its more modern incarnation from the 1970s or 1980s also shows up, but with less impact. In this book, the founders of the town and their children are really the protagonists, but the feel of the place is well drawn. The story itself meanders around the strange deaths of four women after the first world war.

In both books the mystery remains a mystery. In the first, the strength of Savannah outweighs any need for a resolution. In the second, Zichron is overgrown with real and fictional memories the same way the old buildings are overgrown with weeds. We wish for a resolution but realize it has disappeared with the crumbling remains.

For those looking for recommendations. Midnight in the Garden of Good and Evil is a great read. A Strange Death is less compelling for me to recommend, but worth it if you are interested in a parochial history set in Israel exploring both the toil of pre-state settlement and the complex view of past memories from the present.

In the news

I posted previously in this blog what a great time we had at Hub on Wheels. Now, you can see us in glorious monochrome on page 44 of this weeks Newton Tab.
Click on the picture to see a bigger version.