brown2020

If you have visited Wikipedia lately, you probably have seen the appeal from Jimmy Wales to donate money. Wikipedia is the fifth largest Internet site in the world, and the only top site operating as a nonprofit. Which means they need to raise money.

Until now, I have ignored Jimmy’s pleas, taking for granted my frequent access to Wikipedia. But this Thanksgiving weekend, as I was cleaning out my home office and attempting to cull my book collection to make some room on the shelves, I realized something that convinced me to make a donation.

If you have ever tried to get rid of some of your old books, you know how hard it can be to pull the trigger.

Some books, like my copy of The Great Gatsby, one of the great novels of the 20th century, are clearly keepers even though it cost just $1.00 at the used book store back when it had an intact cover.

Others books are wrenching decisions. How can I possibly toss out the TED Book Club selection from 2009? I still haven’t read it!

Some books, on the other hand, are easy decisions, headed for the recycle bin because even the library won’t take them. I found a whole shelf of books that I haven’t touched in years. Technology books, software books, reference books.

Information storage, not stories.

I realized that one of the biggest reasons I haven’t touched these reference books in a while, and certainly haven’t bought a new one in years, is Wikipedia.

The information in Wikipedia is fresher, well-written for the most part, and far more extensive than the best reference library. So why buy books that are just information stores when Wikipedia has so much more to offer?

The footnotes on Wikipedia are one of the best parts of the service. With every article on Wikipedia you are one click away from the best bibliography on the web for any topic.

Crazy as it sounds, my kids tell me that their teachers don’t allow them to cite Wikipedia in their research papers, even though it is the first place the go for any new project. Even so, Wikipedia is an invaluable research tool for students because they can go to the footnotes and find original sources that no one argues with.

To my surprise, my kids also had contributed to Wikipedia. What might a grade school kid add to the greatest encyclopedia on the planet? Adding information about the latest MMORPG? In fact, they had corrected and added to some of the topics being taught in their classroom.

I learned first hand the rigor of the Wikipedia contribution process.

A curator aptly named the “Red Pen of Doom” had reversed most of my own additions, self-serving edits aimed at revising and correcting the history of one of my early educational video games. Why the rejection? Insufficient references.

Wikipedia’s gift to education is far more than its reference value. It is the notion of radical participation.

Kids today grow up knowing that they can be active participants in the generation and curation of knowledge. The idea that knowledge is collaborative is quite different than my experience growing up with the old Encyclopedia Brittanica. The old encyclopedias engendered the feeling that knowledge only could be generated by inaccessible experts, and never was subject to question.

The reason I’m giving $100 to Wikipedia this Thanksgiving weekend is not just because I’m thankful to Jimmy Wales in persevering with this project, which has been such a gift to the human race.

It’s also economic.

When I look at my old stale reference books that not even the public library will take off my hands, I realized that I have saved hundreds of dollars over the past few years by no longer buying quickly dated references.

Just knowing that Wikipedia exists, that everything is there, including all the references, I save money — and trees.

Wikipedia has got to be the greatest bargain of the decade. So this Thanksgiving I thought I would give a little of that back.

Keep it up, Jimmy Wales. The world needs Wikipedia to thrive!

The “Share To Win” Experiment

Last month, my company sponsored a “crowdsourcing philanthropy” experiment in which we offered to donate money to causes based on their ability to rally supporters online. Our premise with the Share To Win challenge was that a cause needs two ingredients to be successful in the modern world: An idea worth spreading, and a core group of passionate people to light a fire online.

A recent Harvard study found that just 10% Twitter users generate more than 90% of the content on the popular and fast growing microblogging service. The numbers must be even more skewed when it comes to the much more involved act of traditional blogging. If you have an important idea that you want to spread, and especially if you are a non-profit cause that relies on the generosity of others to back your idea, you are going to need to have some of those Internet extroverts on your side.

The methodology of our challenge was straightforward: Anyone could nominate a cause by creating a note on 3banana.com describing why people should support their cause, and then share that note through social networks like Twitter and Facebook. The five causes that attracted the most endorsements – as measured by unique visitors who left a comment – would win our donations, a total of $10,000. The challenge would give champions an excuse to spread the word about their cause, but without asking for money – which tends to reduce the virality of any idea online. (more…)

Poet Ruth Stone describes her creative inspiration

This June 8, Ruth Stone will turn 94. Author of 13 books of poetry and recognized by just about every literary prize there is, Ruth recently described on YouTube how she actually lost most of the poems that have ever come to her:

“I never felt that I wrote them anyways. I would feel them coming from way off, and then they would come toward me, and if I didn’t catch them they went through me and went on, so I just figured they were part of the universe, and not me.”

In her TED Talk, Author Elizabeth Gilbert (“Eat, Pray, Love”) described creativity as more like a genie than genius, as something that possesses you from the outside and takes hold of you rather than something that you can possibly generate yourself or take credit for.

That the best ideas come in flurries of inspiration and seem like accidents may be a function of how our complex and wonderful brains work. While we are aware of our one focal point of attention at any given moment, billions of parallel connections are still churning. What are they thinking about?

Whether the source of creative ideas is a muse or something equally mysterious that emerges in the neural networks of our brain, what can we do to call our creativity into action and apply it to the very present needs and challenges around us?

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April 20, 2009, Page 9

In “Wrong Prescription,” Dr. Scott Haig correctly suggests that digital medical records are no silver bullet for the costly, inefficient U.S. health system, but for the wrong reasons [TIME, April 6, 2009].

Information technology (IT) improves efficiency with the rules of the game currently in play. If the rules reward treating disease complications but discourage management and prevention, IT will help health-care businesses churn out more complications per hour.

The fundamental flaw in our current system is that despite decades of debate, no one has an adequate stake in preventing those costly complications in the first place.

Steve Brown — Published in TIME

Every song ever written started with a first experimental musical note of the composer. In the same way, every essay, every letter, every book, every blog post, started with that first mental note of the author. Most of the time, our ideas and experiences float away and we forget them. Sometimes, we jot a thought down, remember it, and it leads to new experiences. Sometimes an idea, an experience, a name and phone number, or a note-to-self remembered rather than forgotten, makes the difference in the direction of our lives.

Taking notes can translate a fleeting conception in our brain into action, and that action usually involves sharing our experience or idea with someone else. As we carry more and more powerful technology around with us every moment of the day, might it be possible that we can start to translate more of our otherwise forgotten notes-to-self and fleeting experiences into shared experiences? Into the start of conversations that make our lives richer?

In 1995, Bill Gates concluded his book The Road Ahead with a prescient but disquieting idea: Carrying around mobile technology connected to networks would lead to the fully “documented life”:

“Your wallet PC will be able to keep audio, time, location, and eventually even video records of everything that happens to you. It will be able to record every word you say and every word said to you, as well as your body temperature, your blood pressure, the barometric pressure, and a variety of other data about you and your surroundings.… It will be able to track your interactions with the network—all of the commands you issue, the messages you send, the people you call or who call you.”

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Partners in Health has been improving chronic care in rural communities in Rwanda through an innovative model of care inspired by Paul Farmer. The regional hospital sees its mission as training community members to extend care into the community and monitor patients at home in order to prevent disease complications and the need for hospitalization. The hospital tracks symptoms and medications using electronic medical record (EMR) systems based on open source technologies. Meanwhile, the United States continues to neglect reforming our crisis-oriented health system because “we can’t afford it”, and the cost of chronic care continues to explode as the population ages. With far fewer resources, but with more creativity and courage, innovative leaders in Rwanda are creating new models of care based on prevention because they can’t afford not to. Maybe we can learn something from Rwanda.

Last week I spoke at the On Lok Lifeways Conference on October 22, 2008 in San Francisco, entitled “Sustainable Long Term Care: Ethics, Technology and International Perspectives.” The organizers asked me to draw insights from my experience in developing new models for chronic care as the founder and former CEO of Health Hero Network, and to compare that to what I had learned while traveling in Rwanda with Partners in Health last year. Here is my presentation.

In the most innovative models of care on both continents, health care providers have discovered that delivering better care with fewer resources can be possible with a proactive approach to supporting and monitoring patients at home rather than waiting for the inevitable complications of neglect. On both continents, healthcare providers have discovered that technology can be a useful tool to improve the effectiveness of care providers and to increase rather than replace personal touch.

In the United States, our healthcare system too often still penalizes rather than rewards prevention, especially in the largest fee-for-service system, Medicare. When it comes to innovation in disease management and prevention, we claim that we “can’t afford it,” while in a much poorer country in the heart of Africa, the government and the health system are working together to embrace innovation in home and community-based care because they can’t afford not to do it.

We have something to learn from innovations arising in places like Rwanda, where necessity truly is the mother of invention. Learning from such innovations can help us expose some of our own false dichotomies that too often have become an excuse to stifle innovation.

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Here are the slides from Steve Brown’s keynote presentation at the Bio-VC BIT Life Sciences’ Bio-Venture Capital Forum 2008, Dalian China, October 11, 2008. The Presentation discussed how to create a winning Life Sciences Innovation Strategy in an Era of Scarcity.

Abstract:

In the last century, technological innovation was propelled by a race to conquer nature and spread a modern lifestyle premised on an unspoken belief in unlimited resources. Now we find with ourselves with depleting resources and unsustainable systems for healthcare, energy, agriculture, water, and the environment. As Plato wrote over 2000 years ago, “Necessity is the mother of invention.” The great unmet needs of the current century relate to sustainability: How can we create sustainable systems for quality healthcare, agriculture, energy, and other sectors? These challenges are uniquely appropriate for innovation in life sciences, with new solutions enabled by the convergence of biotechnology and information technology. With the new challenges of our time, a new generation of entrepreneurs, scientists, and inventors will be inspired to apply their energy and ideas by starting new ventures. This talk will describe an entrepreneurial approach to life sciences innovation and will discuss how to create and foster an innovation culture targeting the great needs and challenges of our time.

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Emerging infectious diseases that start with a fever or a rash can pose a risk to public health because they might not be recognized at the early stages when containment or treatment is possible. After September 11, our fears were stoked by anthrax. Then came SARS, and we still wait anxiously for bird flu.

A patent recently issued to Health Hero Network describes a simple but powerful idea that addresses the pandemic challenge by enabling near-real-time syndromic surveillance that can be adapted on the fly. Easy-to-navigate survey devices collect data from hospital waiting rooms, school nurses, and other points of care. The survey script can be changed and updated remotely by public health authorities based on the latest information. The devices report data to central computers that look for any unusual patterns and then alert public health authorities immediately so that they can investigate further.

Disease outbreaks that look like the flu at the beginning can be hard to detect early because flu-like symptoms are common and are not always reported. The first cases of an outbreak may be spread out over many different clinics, hospitals, and schools in a metropolitan area. Unusual patterns might emerge only when looking at a broader cross section of a region. The other challenge is that we may not know what data is relevant and important at the beginning stages of an outbreak. Where it might have been fever, rash, and working in a mail room for one threat, it might be diarrhea and travel to a specific region or eating a particular food in another threat.

While many efforts have been discussed and may even be underway to facilitate early detection of outbreaks by sifting through electronic medical records and pharmacy data, the most important information might be missed because no one knew to ask the right question. When we do figure out what question to ask, we won’t have time to add fields to medical records or change forms. Our public health authorities need the ability to change the script as soon as they learn new information.

Despite the simplicity of the approach, it is not easy to organize health systems around new ways of doing things. On the other hand, maybe we won’t need to. Public health surveys could be pushed to iPhone users, for example. There just might be enough iPhones out there by now to provide a statistically significant sample size enabling highly sensitive early detection of potential public health emergencies.

More information on Health Hero Network patents.

This is a time of year we sometimes think about starting new journeys. After browsing the graduation speeches on YouTube, I am still drawn to this commencement address at Stanford University in June 2005. Steve Jobs, the founder of Apple Computer, tells us some of his stories to convince us to follow our dreams and not to settle, to “stay hungry and stay foolish.”

Yes, We Can! – Si, Se Puede!

Song & video by Will.i.am of The Black Eyed Peas. Inspired by Barack Obama’s ‘Yes We Can’ speech.

http://www.yeswecansong.com

http://www.barackobama.com

It was a creed written into the founding documents that declared the destiny of a nation.

Yes we can.

It was whispered by slaves and abolitionists as they blazed a trail toward freedom.

Yes we can.

It was sung by immigrants as they struck out from distant shores and pioneers who pushed westward against an unforgiving wilderness.

Yes we can.

It was the call of workers who organized; women who reached for the ballots; a President who chose the moon as our new frontier; and a King who took us to the mountaintop and pointed the way to the Promised Land.

Yes we can to justice and equality.

Yes we can to opportunity and prosperity.

Yes we can heal this nation.

Yes we can repair this world.

Yes we can.

We know the battle ahead will be long, but always remember that no matter what obstacles stand in our way, nothing can stand in the way of the power of millions of voices calling for change.

We have been told we cannot do this by a chorus of cynics…they will only grow louder and more dissonant ……….. We’ve been asked to pause for a reality check. We’ve been warned against offering the people of this nation false hope.

But in the unlikely story that is America, there has never been anything false about hope.

Now the hopes of the little girl who goes to a crumbling school in Dillon are the same as the dreams of the boy who learns on the streets of LA; we will remember that there is something happening in America; that we are not as divided as our politics suggests; that we are one people; we are one nation; and together, we will begin the next great chapter in the American story with three words that will ring from coast to coast; from sea to shining sea –

Yes. We. Can.

Featuring: Jesse Dylan, Will.i.am, Common, Scarlett Johansson, Tatyana Ali, John Legend, Herbie Hancock, Kate Walsh, Kareem Abdul Jabbar, Adam Rodriquez, Kelly Hu, Adam Rodriquez, Amber Valetta, Eric Balfour, Aisha Tyler, Nicole Scherzinger and Nick Cannon

Gastric bypass surgery is a rapidly growing procedure in which the stomach is reduced from its normal football-size to something between the size of a thumb and a hardboiled egg. In each case, the stomach itself is healthy: the purpose of the surgery is to force the patient to change behaviors that are leading to obesity.

The images above came from a live Webcast of a gastric bypass surgery performed at Tufts-New England Medical Center in Boston by Dr. Scott Shikora, Chief of Bariatric Surgery at Tufts-NEMC, along with bariatric surgeons Dr. Michael Tarnoff and Dr. Julie Kim. Click on the images to watch the complete video on YouTube.

You also can watch Dr. Stan Hoehn perform a minimally invasive gastric bypass at Shawnee Mission Medical Center in Kansas by clicking on the image below.

A Consensus Panel convened by the National Institutes of Health (NIH) indicates bariatric surgery for people with a body mass index (BMI) of 40 or higher, or people with a BMI of 35 or higher with one or more related comorbid conditions such as diabetes, hypertension, and cardiovascular disease.

Bariatric surgery is regarded by leading physicians on the panel as a lifesaving tool that enables, or in fact forces, the patient to change lifestyle and eating habits.

With 100 million Americans struggling with at least one chronic condition, and over 60 million Americans considered to be clinically obese, we can expect a lot of bariatric surgery ahead. Can we really address the issue of obesity by forcing ourselves to change behavior under the knife, or are there other ways to address this epidemic?

Patrick Goschy recently became a mini-hit on YouTube and then just made the evening news with a video shot in June 2000 demonstrating his invention of a hand-held accelerometer-based video game controller. Wearing only boxer shorts and a tee shirt, Goschy demonstrates his motion control unit playing Ready 2 Rumble on a Sega Dreamcast in his living room, Nintendo Wiimote style, years ahead of his time.

Much has been blogged about the ex-employee of video game company Midway and his purported plan to sue Nintendo for stealing the idea for the Nintendo Wii controller. Bloggers and commenters are raising two lines of questions: First, if accelerometers for detecting motion were around before 2000, how could Goschy claim to have invented the accelerometer-based game controller? Second, if Goschy did invent the video game motion controller over seven years ago, why did it take so long for this to come out?

Accelerometers may have been around for a while, but Pat Goschy’s video still looks like it could be full of inventive ideas given the fact that this was over seven years ago. It is not the invention of the accelerometer that is in question, and maybe not even the accelerometer as a game controller. The inventive steps may have been a series of innovations around design, coding, and calibration that would give game players the agility and speed to take on B. Knoximov in Ready 2 Rumble from the comfort of their living rooms.

Inventing is about taking that next creative step past the current frontier and making things a little better. The fact that Goschy was building motion-based controllers and hacking a Dreamcast interface in what looks like a very workable system seven years before the technology matured and became popular tells us there probably could have been some patentable material back in 2000.

There are two patents that list Goschy as a co-inventor: Patent 6,545,661, filed on June 21, 1999, entitled Video Game Systems Having A Control Unit With An Accelerometer For Controlling A Video Game, and patent 6,315,673, filed on October 5, 1999, entitled Motion Simulator For A Video Game. Both patents are assigned to Midway. These patents do not appear to claim the motion controller from the Goschy video. The 661 patent is the closest, but it is really about sensing light from the screen to know if you hit your target with a game controller gun.

The light sensor is required in all the claims. Here is the exact text of the first independent claim:

1. A video game system comprising:
a game controller;
a hand-held control unit coupled to the game controller and housing an accelerometer and a light sensor,
the accelerometer sensing tilt of the control unit with respect to an axis, the accelerometer producing an acceleration signal indicating the tilt of the control unit with respect to the axis,
the game controller processing the acceleration signal to control the movement of a game character on a video display coupled to the game controller and further processing the acceleration signal to control directional navigation of the game character through a game environment, said navigation corresponding to the tilt of the hand-held control unit,
the light sensor detecting one or more light pixels from the video display corresponding to a direction in which the hand-held control unit is pointing, the light sensor producing a detection signal to the game controller, the game controller determining from the detection signal the light pixels from the video display detected by the light sensor.

The question is not how did Goschy get a patent on this. He didn’t. The real question is why didn’t Midway patent the controller that Goschy is showing in the video? That would have been valuable, but then again, hindsight is always 20/20.

According to some of the blogs, Goschy circulated the video among Midway employees back in 1999 to show his idea, but the company obviously didn’t file patents and didn’t develop the technology either. This is a common fate of many great inventions. If you are early enough to have something truly new and innovative, and you are sufficiently ahead of the crowd to get great patents, chances are you are way ahead of the market and way ahead of the marketing people as well.

Great ideas and great patents need to be five to ten years too early, and they are usually only recognized in hindsight. Thank you, Pat Goschy, for reminding us of the many years of innovation and creative work that leads up to what most people see as an instant sensation when a product like the Nintendo Wii becomes a hit. We also shouldn’t forget that Nintendo has been a grandfather of the modern video game field, at it for the past two decades, and who knows what they also have in their labs that started many years ago.

The question is not why the video took so long to come out. The market has only just now emerged. If the video had come out earlier, we never would have found it.

At TEDGlobal 2007, William Kamkwamba showed us how necessity is the mother of invention, making a windmill out of simple scrap materials to power his home in Malawi. Without any money, but armed with a book from the library and some ingenuity, this teenager from a rural village in Malawi gave a fitting answer to an earlier speaker’s opinion that renewable energy is “too expensive” for developing countries.

I had the opportunity to visit the district health center in Rwinkwavu, Rwanda, where Dr. Michael Rich explained why the Partners in Health model of care is able to achieve better medication adherence in Rwanda than even our best practices in the United States.

It is not just the fact that Bill Clinton and The Clinton Foundation negotiated a deal on antiretroviral (ARV) drugs. It’s not just the fact that the once complex cocktail regimen of pills can be combined into one generic pill. It is because an army of community health workers visit patients in their villages every day, checking in to make sure everything is OK, and to make sure that everyone is taking their medicine.

Daily support and monitoring at home, working with informal caregivers in the community to surface problems early so that bigger problems can be prevented: That is the key to improving quality of care with limited resources.

Dr. Paul Farmer, as chronicled in the book “Mountains Beyond Mountains” by Tracy Kidder, realized this in Haiti a decade ago, and now the Partners in Health “accompagnateur” system is being rolled out in developing countries around the world. Is there something we might learn from Rwanda?