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June 27 2012

Ten years of Foo Camp

The weekend of June 8-10 marked the 10th Foo Camp at O'Reilly's main offices in Sebastopol, Calif. Ten years of evolving connections, experiences, themes and memes. More than 1,500 people have attended at least once and there is no counting the number of connections and ideas that were first seeded among the tents.

Foo Camp is an important part of our idea pipeline. So, every year we carefully curate attendees for their proximity to the topic areas that are important, will be, or should be. But the real goal is to create a space for intentional serendipity. The campers come from data, health, government, DIY, new economy and etc.; and some are invited because they are just interesting people, but when they get to talking around the foo bar the really interesting stuff happens.

There is a frisson when all those worlds collide and the instant buzzes with possibility. We aren't Von Neumann and Wiener at the Macy Conferences, but I hope that in our own place and moment we we are creating interdisciplinary collisions that are similar in kind if not scale of import. The best part of Foo Camp is the collision-induced brain buzz and if we're lucky it keeps on demanding our attention even after we've gone back home to our lives and jobs, until we do something about it.

This year we we hosted:

  • 11 people who are involved in the new economy / creative economy, which includes organizations like Etsy, TaskRabbit and others.

  • 10 with a focus on design, including software, hardware and overall user experience.

  • 13 who are working on big data products, services or projects (that was probably too many!).

  • 16 people affiliated with academic institutions.

  • 7 that are part of the evolution of government.

  • 7 who work in the Make / DIY / hardware hacker/ robotics world.

  • 6 working in education, though they're not necessarily associated with traditional schools.

  • 3 working at the intersection of personal health, health technology and the quantified self.

  • And a whole bunch of others.

    These might not have been that much different last year, but are quite different from five years ago. Much of what works at Foo Camp works because of the ever-changing mix of participants and the interplay of ideas they bring with them. So we work hard to keep that mix fresh. This year 42% (113) of the participants were first timers and many of the previous participants were at least one year removed from their previous visit. That means that at least 75% of attendees hadn't previously camped together at the same event. This camp felt particularly rich with first-time interactions and next year we'll work even harder to increase the proportion of first timers.

    While I listed a few numbers because they signal some of the things we are thinking about, Sara Winge was quick to point out after reading my first draft of this post that Foo Camp really isn't about numbers or topics or anything else that is easily enumerated, named or listed. After all, it put the "un" in un-conference. It's also fun, energizing, ambitiously naive, sometimes silly, stubbornly emergent, occasionally mind blowing, surprising, and unless a camper is particularly blessed, it might just ruin a bunch of the conversations they have when they get home. Not everyone's social circle will be held rapt discussing whether the Internet will Destroy the State or the State will Destroy the Internet.

    One example of surprising themes that we might not have predicted from the invite list was a growing emphasis on life outside of work. Lots of conversations that might best be described as "The Whole Geek." A growing recognition that the technology we make isn't the goal, that it should serve our lives. Lives that have breadth and dimensionality.

    I heard at least one person refer to this as the transition from "quantified self" to "qualified self." I'm not sure that really captures the notion though. "Qualified" seems like the wrong root to me. But at least it makes the point that we are more than the data that describes us. Of course, perhaps it's even more telling about who we are that such a thing requires an aha moment in the first place.

    In any case, it appears that the religion of technology is wearing thin for at least some Foos and they are making room again for souls comprised of an indeterminate ether rather than bits, friendships mediated in person over a beer rather than via the edges of an enormous graph, and a personal life that starts with presence in a moment. If even the alpha-geeks are thinking this in our micro-measured always-on uber-connected techno-deterministic time perhaps the backlash has begun.

    There was also an awakening sense of "what hath we wrought?" best illustrated by a session on "A Hippocratic Oath for Technologists." Privacy loss, centralization of the web, Stuxnet, and the like have left some with bruised web idealism. Foo Camp certainly wasn't an exploration of William Gibson dystopia, but there were new cautionary elements sneaking into the conversations. It seemed, at least to me, like this was the Foo Camp where the philosophers heeded the call and showed up. I think we'll be more intentional next year with our humanities invitations.

    While we definitely learn from Foo Camp, maybe it's fair to say that the event itself is less about idea sourcing than about relationship cementing. It's a chance to establish and strengthen human connections that will challenge us to think about the world just a little bit differently, both at the event and during later conversations. So with that, let me point you to what a few other campers had to say about their experience.

    Finally, this year Mac Slocum sat down with a few Foos to find out what they are working on or thinking about. We've posted two of these interviews already (Kris Hammond and Nina Paley) and in the days ahead we'll be highlighting more. Watch for those here.

    June 18 2012

    June 14 2012

    Stories over spreadsheets

    I didn't realize how much I dislike spreadsheets until I was presented with a vision of the future where their dominance isn't guaranteed.

    That eye-opening was offered by Narrative Science CTO Kris Hammond (@whisperspace) during a recent interview. Hammond's company turns data into stories: They provide sentences and paragraphs instead of rows and columns. To date, much of the attention Narrative Science has received has focused on the media applications. That's a natural starting point. Heck, I asked him about those very same things when I first met Hammond at Strata in New York last fall. But during our most recent chat, Hammond explored the other applications of narrative-driven data analysis.

    "Companies, God bless them, had a great insight: They wanted to make decisions based upon the data that's out there and the evidence in front of them," Hammond said. "So they started gathering that data up. It quickly exploded. And they ended up with huge data repositories they had to manage. A lot of their effort ended up being focused on gathering that data, managing that data, doing analytics across that data, and then the question was: What do we do with it?"

    Hammond sees an opportunity to extract and communicate the insights locked within company data. "We'll be the bridge between the data you have, the insights that are in there, or insights we can gather, and communicating that information to your clients, to your management, and to your different product teams. We'll turn it into something that's intelligible instead of a list of numbers, a spreadsheet, or a graph or two. You get a real narrative; a real story in that data."

    My takeaway: The journalism applications of this are intriguing, but these other use cases are empowering.

    Why? Because most people don't speak fluent "spreadsheet." They see all those neat rows and columns and charts, and they know something important is tucked in there, but what that something is and how to extract it aren't immediately clear. Spreadsheets require effort. That's doubly true if you don't know what you're looking for. And if data analysis is an adjacent part of a person's job, more effort means those spreadsheets will always be pushed to the side. "I'll get to those next week when I've got more time ..."

    We all know how that plays out.

    But what if the spreadsheet wasn't our default output anymore? What if we could take things most of us are hard-wired to understand — stories, sentences, clear guidance — and layer it over all that vital data? Hammond touched on that:

    "For some people, a spreadsheet is a great device. For most people, not so much so. The story. The paragraph. The report. The prediction. The advisory. Those are much more powerful objects in our world, and they're what we're used to."

    He's right. Spreadsheets push us (well, most of us) into a cognitive corner. Open a spreadsheet and you're forced to recalibrate your focus to see the data. Then you have to work even harder to extract meaning. This is the best we can do?

    With that in mind, I asked Hammond if the spreadsheet's days are numbered.

    "There will always be someone who uses a spreadsheet," Hammond said. "But, I think what we're finding is that the story is really going to be the endpoint. If you think about it, the spreadsheet is for somebody who really embraces the data. And usually what that person does is they reduce that data down to something that they're going to use to communicate with someone else."

    A thought on dashboards

    I used to view dashboards as the logical step beyond raw data and spreadsheets. I'm not so sure about that anymore, at least in terms of broad adoption. Dashboards are good tools, and I anticipate we'll have them from now until the end of time, but they're still weighed down by a complexity that makes them inaccessible.

    It's not that people can't master the buttons and custom reports in dashboards; they simply don't have time. These people — and I include myself among them — need something faster and knob-free. Simplicity is the thing that will ultimately democratize data reporting and data insights. That's why the expansion of data analysis requires a refinement beyond our current dashboards. There's a next step that hasn't been addressed.

    Does the answer lie in narrative? Will visualizations lead the way? Will a hybrid format take root? I don't know what the final outputs will look like, but the importance of data reporting means someone will eventually crack the problem.

    Full interview

    You can see the entire discussion with Hammond in the following video.

    Related:

    June 04 2012

    Can Future Advisor be the self-driving car for financial advice?

    Future AdvisorLast year, venture capitalist Marc Andreessen famously wrote that software is eating the world. The impact of algorithms upon media, education, healthcare and government, among many other verticals, is just beginning to be felt, and with still unfolding consequences for the industries disrupted.

    Whether it's the prospect of IBM's Watson offering a diagnosis to a patient or Google's self-driving car taking over on the morning commute, there are going to be serious concerns raised about safety, power, control and influence.

    Doctors and lawyers note, for good reason, that their public appearances on radio, television and the Internet should not be viewed as medical or legal advice. While financial advice may not pose the same threat to a citizen as an incorrect medical diagnosis or treatment, poor advice could have pretty significant downstream outcomes.

    That risk isn't stopping a new crop of startups from looking for a piece of the billions of dollars paid every year to financial advisors. Future Advisor launched in 2010 with the goal of providing better financial advice through the Internet using data and algorithms. They're competing against startups like Wealthfront and Betterment, among others.

    Not everyone is convinced of the validity of this algorithmically mediated approach to financial advice. Mike Alfred, the co-founder of BrightScope (which has liberated financial advisor data itself), wrote in Forbes this spring that online investment firms are wrong about financial advisors:

    "While singularity proponents may disagree with me here, I believe that some professions have a fundamentally human component that will never be replaced by computers, machines, or algorithms. Josh Brown, an independent advisor at Fusion Analytics Investment Partners in NYC, recently wrote that 'for 12,000 years, anywhere someone has had wealth through the history of civilization, there's been a desire to pay others for advice in managing it.' In some ways, it's no different from the reason why many seek out the help of a psychiatrist. People want the comfort of a human presence when things aren't going well. A computer arguably may know how to allocate funds in a normal market environment, but can it talk you off the cliff when things go to hell? I don't think so. Ric Edelman, Chairman & CEO of Edelman Financial Services, brings up another important point. According to him, 'most consumers are delegators and procrastinators, and need the advisor to get them to do what they know they need to do but won't do if left on their own'."

    To get the other side of this story, I recently talked with Bo Lu (@bolu), one of the two co-founders of Future Advisor. Lu explained how the service works, where the data comes from and whether we should fear the dispassionate influence of our new robotic financial advisor overlords.

    Where did the idea for Future Advisor come from?

    Lu: The story behind Future Advisor is one of personal frustration. We started the company in 2010 when my co-founder and I were working at Microsoft. Our friends who had reached their mid-20s were really making money for the first time in their lives. They were now being asked to make decisions, such as "Where do I open an IRA? What do I do with my 401K?" As is often the case, they went to the friend who had the most experience, which in this case turned out to be me. So I said, "Well, let's just find you guys a good financial advisor and then we'll do this," because somehow in my mind, I thought, "Financial advisors do this."

    It turned out that all of the financial advisors we found fell into two distinct classes. One were folks that were really nice but essentially in very kind words said, "Maybe you'd be more comfortable at the lower stakes table." We didn't meet any of their minimums. You needed a million dollars or at least a half million to get their services.

    The other kinds of financial advisors who didn't have minimums immediately started trying to sell my friends term life insurance and annuities. I'm like, "These guys are 25. There's no reason for you to be doing this." Then I realized there was a misalignment of incentives there. We noticed that our friends were making a small set of the same mistakes over and over again, such as not having the right diversification for their age and their portfolio, or paying too much in mutual fund fees. Most people didn't understand that mutual funds charged fees and were not being tax efficient. We said, "Okay, this looks like a data problem that we can help solve for you guys." That's the genesis out of which Future Advisor was born.

    What problem are you working on solving?

    Bo Lu: Future Advisor is really trying to do one single thing: deliver on the vision that high-quality financial advice should be able to be produced cheaply and, thus, be broadly accessible to everyone.

    If you look at the current U.S. market of financial advisors and you multiply the number of financial advisors in the U.S. — which is roughly a quarter-million people — by what is generally accepted to be a full book of clients, you'll realize that even at full capacity, the U.S. advisor market can serve only about 11% of U.S. households.

    In serving that 11% of U.S. households, the advisory market for retail investing makes about $20 billion. This is a classic market where a service is extremely expensive but in being so can only serve a small percentage of the addressable market. As we walked into this, we realized that we're part of something bigger. If you look at 60 years ago, a big problem was that everyone wanted a color television and they just weren't being manufactured quickly or cheaply enough. Manufacturing scale has caught up to us. Now, everything you want you generally can have because manufactured things are cheap. Creating services is still extremely expensive and non-scalable. Healthcare as a service, education as a service and, of course, financial services, financial advising service comes to mind. What we're doing is taking information technology, like computer science, to scale a service in the way the electrical engineering of our forefathers scaled manufacturing.

    How big is the team? How are you working together?

    Bo Lu: The team has eight people in Seattle. It's almost exactly half finance and half engineering. We unabashedly have a bunch of engineers from MIT, which is where my co-founder went to school, essentially sucking the brains out of the finance team and putting them in software. It's really funny because a lot of the time when we design an algorithm, we actually just sit down and say, "Okay, let's look at a bunch of examples and see what the intuitive decisions are of science people and then try to encode them."

    We rely heavily on the existing academic literature in both computational finance and economics because a lot of this work has been done. The interesting thing is that the knowledge is not the problem. The knowledge exists, and it's unequivocal in the things that are good for investors. Paying less in fees is good for investors. Being more tax efficient is good for investors. How to do that is relatively easy. What's hard for the industry for a long time has been to scalably apply those principles in a nuanced way to everybody's unique situation. That's something that software is uniquely good at doing.

    How do you think about the responsibility of providing financial advice that traditionally has been offered by highly certified professionals who've taken exams, worked at banks, and are expensive to get to because of that professional experience?

    Bo Lu: There's a couple of answers to that question, one of which is the folks on our team have the certifications that people look for. We've got certified financial advisors*, CFAs, which is a private designation on the team. We have math PhDs from the University of Washington on the team. The people who create the software are the caliber of people that you would want to be sitting down with you and helping you with your finances in the first place.

    The second part of that is that we ourselves are a registered investment advisor. You'll see many websites that on the bottom say, "This is not intended to be financial advice." We don't say that. This is intended to be financial advice. We're registered federally with the SEC as a registered investment advisor and have passed all of the exams necessary.

    *In the interview, Lu said that FutureAdvisor has 'certified financial advisors'. In this context, CFA stood for something else: The Future Advisor team includes Simon Moore, a chartered financial analyst, who advises the startup on investing algorithms design.

    Where does the financial data behind the site come from?

    Bo Lu: From the consumer side, the site has only four steps. These four steps are very familiar to anyone who's used a financial advisor before. A client signs up for the products. It's a free web service, designed to help everyone. In step one, they answer a couple of questions about their personal situation: age, how much they make, when they want to retire. Then they're asked the kinds of questions that good financial advisors ask, such as your risk tolerance. Here, you start to see that we rely on academic work as much as possible.

    There is a great set of work out of the University of Kentucky on risk tolerance questionnaires. Whereas most companies just use some questionnaire they came up with internally, we went and scoured literature to find exact questions that were specifically worded — and have been tested under those wordings to yield statistically significant deviations in determining risk tolerance. So we use those questions. With that information, the algorithm can then come up with a target portfolio allocation for the customer.

    In step two, the customer can synchronize or import data from their existing financial institutions into the software. We use Yodlee, which you've written about before. It's the same technology that Mint used to import detailed data about what you already hold in your 401K, in your IRA, and in all of your other investment accounts.

    Step three is the dashboard. The dashboard shows your investments at a level that makes sense, rather than current brokerages where when you log in, they tell you how much money you have, with a list of funds you have, and how much they've changed in the last 24 hours of trading. We answer four questions on the dashboard.

    1. Am I on track?
    2. Am I well-diversified for this goal?
    3. Am I overpaying in hidden fees in my mutual funds?
    4. Am I as tax efficient as I could be?

    We answer those four questions and then in the final step of the process, we give algorithmically-generated, step-by-step instructions about how to improve your portfolio. This includes specific advice like "this many shares of Fund X to buy this many shares of Fund Y" in your IRA. When the consumer sees this, he or she can go and, with this help, clean up their portfolios. It's kind of like diagnosis and prescription for your portfolio.

    There are three separate streams of data underlying the product. One is the Yodlee stream, which is detailed holdings data from hundreds of financial institutions. Two is data about what's in a fund. That comes from Morningstar. Morningstar, of course, gets it from the SEC because mutual funds are required to disclose this. So we can tell, for example, if a fund is an international fund or a domestic fund, what the fees are, and what it holds. The third dataset is from the datasets that we have to tier in ourselves, which is 401K data from the Department of Labor.

    On top of this triad of datasets sits our algorithm, which has undergone six to eight months of beta testing with customers. (We launched the product in March 2012.) That algorithm asks, "Okay, given these three datasets, what is the current state of your portfolio? What is the minimum number of moves to reduce both transaction costs and any capital gains that you might incur to get you from where you are to roughly where you need to be?" That's how the product works under the covers.

    What's the business model?

    Bo Lu: You can think of it as similar to Redfin. Redfin allows individual realtors to do more work by using algorithms to help them do all of the repetitive parts. Our product and the web service is free and will always be free. Information wants to be free. That's how we work in software. It doesn't cost us anything for an additional person to come and use the website.

    The way that Future Advisor makes money is that we charge for advisor time. A small percentage of customers will have individual questions about their specific situation or want to talk to a human being and have them answer some questions. This is actually good in two ways.

    One, it helps the transition from a purely human service to what we think will eventually be an almost purely digital service. People who are somewhere along that continuum of wanting someone to talk to but don't need someone full-time to talk to can still do that.

    Two, those conversations are a great way for us to find out, in aggregate, what the things are that the software doesn't yet do or doesn't do well. Overall, if we take a ton of calls that are all the same, then it means there's an opportunity for the software to step in, scale that process, and help people who don't want to call us or who can't afford to call us to get that information.

    What's the next step?

    Bo Lu: This is a problem that has a dramatic possible impact attached to it. Personal investing, what the industry calls "retail investing," is a closed-loop system. Money goes in, and it's your money, and it stays there for a while. Then it comes out, and it's still your money. There's very little additional value creation by the financial advisory industry.

    It may sound like I'm going out on a limb to say this, but it's generally accepted that the value creation of you and I putting our hard-earned money into the market is actually done by companies. Companies deploy that capital, they grow, and they return that capital in the form of higher stock prices or dividends, fueling the engine of our economic growth.

    There are companies across the country and across the world adding value to people's lives. There's little to no value to be added by financial advisors trying to pick stocks. It's actually academically proven that there's negative value to be added there because it turns out the only people who make money are financial advisors.

    This is a $20 billion market. But really what that means is that it's a $20 billion tax on individual American investors. If we're successful, we're going to reduce that $20 billion tax to a much smaller number by orders of magnitude. The money that's saved is kept by individual investors, and they keep more of what's theirs.

    Because of the size of this market and the size of the possible impact, we are venture-backed because we can really change the world for the better if we're successful. There are a bunch of the great folks in the Valley who have done a lot of work in money and the democratization of software and money tools.

    What's the vision for the future of your startup?

    Bo Lu: I was just reading your story about smart disclosure a little while ago. There's a great analogy in there that I think applies aptly to us. It's maps. The first maps were paper. Today if you look at the way a retail investor absorbs information, it's mostly paper. They get a prospectus in the mail. They have a bunch of disclosures they have to sign — and the paper is extremely hard to read. I don't know if you've ever tried to read a prospectus; it's something that very few of us enjoy. (I happen to be one of them, but I understand if not everyone's me.) They're extremely hard to parse.

    Then we moved on to the digital age of folks taking the data embedded in those prospectuses and making them available. That was Morningstar, right? Now we're moving into the age of folks taking that data and mating it with other data, such as 401K data and your own personal financial holdings data, to make individual personalized recommendations. That's Future Advisor the way it is today.

    But just as maps moved from paper maps to Google Maps, it didn't stop there. It moves and has moved to self-autonomous cars. There will be a day when you and I don't ever have to look at a map because, rather than the map being a tool to help me make the decision to get somewhere, the map will be a part of a service I use that just gets the job done. It gets me from point A to point B.

    In finance, the job is to invest my money properly. Steward it so that it grows, so that it's there for me when I retire. That's our vision as well. We're going to move from being an information service to actually doing it for you. It's just a default way so that if you do nothing, your financial assets are well taken care of. That's what we think is the ultimate vision of this: Everything works beautifully and you no longer have to think about it.

    We're now asked to make ridiculous decisions about spreading money between a checking account, an IRA, a savings account and a 401K, which really make no sense to most of us. The vision is to have one pot of money that invests itself correctly, that you put money into when you earn money. You take money out when you spend it. You don't have to make any decisions that you were never trained nor educated to make about your own personal finances because it just does the right thing. The self-driving car is our vision.

    Connecting the future of personal finance with an autonomous car is an interesting perspective. Just as with outsourcing driving, however, there's the potential for negative outcomes. Do you have any concerns about the algorithm going awry?

    Bo Lu: We are extremely cognizant of the weighty matters that we are working with here. We have a ton of testing that happens internally. You could even criticize us, as a software development firm, in that we're moving slower than other software development firms. We're not going to move as quickly as Twitter or Foursquare because, to be honest, if they mess up, it's not that big a deal. We're extremely careful about it.

    At the same time, I think the Google self-driving car analogy is apt because people immediately say, "Well, what if the car gets into an accident?" Those kinds of fears exist in all fields that matter.


    Analysis: Why this matters

    "The analogy that comes to mind for me isn't the self-driving car," commented Mike Loukides, via email. "It's personalized medicine."

    One of the big problems in health care is that to qualify treatments, we do testing over a very wide sample, and reject it if it doesn't work better than a placebo. But what about drugs that are 100% effective on 10% of the population, but 0% effective on 90%? They're almost certainly rejected. It strikes me that what Future Advisor is doing isn't so much helping you to go on autopilot, but getting beyond generic prescriptions and generating customized advice, just as a future MD might be able to do a DNA sequence in his office and generate a custom treatment.

    The secret sauce for Future Advisor is the combination of personal data, open government data and proprietary algorithms. The key to realizing value, in this context, is combining multiple data streams with a user interface that's easy for a consumer to navigate. That combination has long been known by another name: It's a mashup. But the mashups of 2012 have something that those of 2002 didn't have, at least in volume or quality: data.

    Future Advisor, Redfin (real estate) or Castlight (healthcare) are all interesting examples of entrepreneurs creating data products from democratized government data. Future Advisor uses data from consumers and the U.S. Department of Labor, Redfin synthesizes data from economists and government agencies, and Castlight uses health data from the U.S. Department of Health and Human Services. In each case, they provide a valuable service and/or product by making sense of that data deluge.

    Related:

    May 21 2012

    What do mHealth, eHealth and behavioral science mean for the future of healthcare?

    We're living through one of the most dynamic periods in healthcare in our collective history. Earlier this year, Dr. Farzad Mostashari, the national coordinator of health IT, highlighted how the web, data and epatients are poised to revolutionize healthcare. The Internet is shaping healthcare in many ways, from the quantified self movement to participatory medicine, and even through the threat of a new "data divide" driven by unequal access to information, algorithmic and processing power.

    Dr. Audie AtienzaInto this heady mix, add the mobile computing revolution, where smart devices rest in the pockets of hundreds of millions of citizens, collecting data and providing access to medical information. There's also the rapidly expanding universe of healthcare apps that promise to revolutionize how many services are created, distributed and delivered.

    This month, I had the opportunity to discuss some of these trends with Dr. Audie Atienza (@AudieAtienza), a researcher who focuses on behavioral science and healthcare. Our interview, lightly edited for content and clarity, follows.

    We first met when you were a senior health technology adviser at the U.S. Department of Health and Human Services (HHS). What do you do now?

    Audie Atienza: Working with Todd Park at the Department of Health and Human Services (HHS) was a distinct privilege and an honor. I learned a great deal working at HHS with Todd. I am now at the new Science of Research and Technology Branch of the National Cancer Institute, National Institutes of Health.  My title is Behavioral Scientist and Health Scientist Administrator. In a typical week, I attend health-technology-related conferences and meetings, work with colleagues across HHS and the federal government on health-technology-related initiatives, discuss funding opportunities with extramural researchers, and engage in scientific research related to health technology and/or cancer control.

    How well did your education prepare you for your work?

    Audie Atienza: My undergraduate, graduate and post-doctoral education has provided me with the critical thinking skills and knowledge that is required of a health researcher. My interest in health technology actually started when I was a Fellow at Stanford University, where I was gathering data on cardiovascular disease risk factors using paper and pencil diaries.  Using paper and pencil measures seemed so inefficient. Study participants sometimes forgot to complete the diaries or had incomplete entries — and sometimes the handwriting was difficult to decipher.  So, my mentor, Dr. Abby King, and I collaborated with Dr. BJ Fogg (also at Stanford) and we "went digital" with the cardiovascular disease risk factor assessments. (We used "state of the art" PDAs at the time.)  This fortuitous collaboration and the "there has to be a better way to do this" idea launched me into the field of electronic and mobile health.

    What does "eHealth" mean now?

    Audie Atienza: After my postdoctoral fellowship at Stanford, I accepted a position at the National Cancer Institute (NCI), Health Promotion Research Branch.  The NCI offered me the opportunity to further explore the field of electronic health (or eHealth) on a national (U.S.) and international scale.  The term "eHealth" generally represents the use of electronic or digital information technology to assess and/or modify health behaviors, states and outcomes.

    When I arrived at NCI, I was asked to bring the best and brightest behavioral researchers together to discuss how to assess health in "real-time."  A book was published based on this meeting: "The Science of Real-Time Data Capture Self-Reports in Health Research." Other national and international conferences followed, including the 2010 mHealth Summit, in which I was intimately involved.

    How does behavioral science affect our capacity to understand the causes of cancer?

    Audie Atienza: It is clear that behavioral factors contribute to cancer and many other diseases, like diabetes and heart disease.  For example, the link between smoking and cancer is well established. There is also a solid body of research that has linked obesity, physical inactivity, and poor diet to various cancers. The Centers for Disease Control (CDC) reports that 69% of U.S. adults are currently overweight or obese.[Data on adults: PDF and children: PDF]

    Accurately measuring and changing these everyday health behaviors — including smoking, physical activity, what people eat — is not easy. This is where technology can be of great assistance. Through sensors, cell phones, GPS systems, social networking technology, and web-based technology, we may be able to better assess and hopefully improve these key health behaviors that contribute to cancer and other diseases.

    We are, however, just at the beginning of discovering how to best develop and utilize technology to improve the health of individuals and the public.  There is much work to be done to determine what is effective and what isn't.

    How do mobile devices figure into that work?

    Audie Atienza: Mobile technology is everywhere. We are seeing more integrated devices, like smartphones with cameras, accelerometers, GPS, and all types of apps.  But it isn't about the technology — a phrase I have borrowed from Todd Park. It's really about addressing health issues and improving the health of individuals and the public.  If technology can facilitate this, then great. But using technology may not always be the best way to improve health and well-being.  This is a critical research question.

    How is mobile technology being applied to specific health issues?

    Audie Atienza: Mobile technology can be (and is being) applied to address many different health and disease issues: infection disease (AIDS/HIV, tuberculosis, influenza), chronic disease (heart disease, cancer, diabetes, arthritis, asthma), mental health (depression, stress, anxiety), child and maternal health (pregnancy, infant care, childhood obesity), gerontology (healthy living in place, falls prevention, caregiving), health promotion (e.g., exercise, diet, smoking cessation, cancer screening, sun safety), and health-provider-related issues (medication adherence, patient-provider communication, point-of-care diagnostics, vital signs monitoring).

    Mobile technology cuts across the disease and health spectrum with great potential to address problems that have been previously difficult to solve.  It is difficult to say which mobile health technology is most important because they are all addressing distinct and critical issues.  Heart disease and cancer are the leading causes of death in the United States. Others may argue that infectious diseases and maternal/child health are the most critical issues to address globally. Still others may argue for tobacco control and reducing obesity (increasing physical activity and improving nutrition).  The National Institutes of Health (NIH) has 27 institutes and centers (ICs), each with a particular mission.  More than 20 of the 27 ICs are currently funding mobile technology-related research.

    What do we need next in mHealth?

    Audie Atienza: More research. We need to better understand what works and what does not. Researchers who have systematically reviewed smartphone health apps (e.g., smoking cessation, diabetes) have found that most are not based on established public health or clinical guidelines. Very few have actually assessed whether the apps are effective in changing health outcomes. With thousands of apps, sensors, and other mobile health tools currently available, it can be difficult for the user to know what is effective, useful, and (most importantly) safe.

    How close are we to a real tricorder? (There's now an X Prize for that.)

    Audie Atienza: I love science-fiction and "Star Trek"!  Certainly, mobile sensors and monitors currently exist that can accurately monitor physiological states and vital signs. And the technology is becoming increasingly integrated and more powerful.  But, to have an all-in-one mobile device that can assess and diagnose health and diseases as well as, if not better than, a clinical provider is a very tall order. If such a tool or prototype is developed, it will be science and research that will determine if the "tricorder" is effective or not.  Time will tell whether such a tool can be developed.  While I am all for reducing diagnostic errors, I personally would be hesitant to accept a diagnosis from only a mobile device without the clinical judgment of a medical or health professional.

    OSCON 2012 Healthcare Track — The conjunction of open source and open data with health technology promises to improve creaking infrastructure and give greater control and engagement to patients. Learn more at OSCON 2012, being held July 16-20 in Portland, Oregon.

    Save 20% on registration with the code RADAR20

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    May 08 2012

    Think of it like a political campaign: Baratunde Thurston's book marketing

    Since its release in late January, Baratunde Thurston's book, "How To Be Black," has sold more than 15,000 copies, hitting the New York Time bestseller list out of the gate. Thurston, The Onion's former director of digital, and Craig Cannon, his campaign manager, have employed a slew of creative tactics for selling the book. In a recent interview, Thurston talked with me about what's worked, what hasn't, and the secret sauce for their campaign.

    Before you dive in, I'll note that Thurston — in addition to having written a terrific book — has a gift for making people feel like they want to be part of his world. Although I'd read excerpts of the book early on, as he included them in his email newsletter, and although I was given both an electronic and a print copy of the book, I still bought it, just to support him. How can you make that magic happen for your book? Read on.

    Any sales numbers we can share for context?

    Baratunde ThurstonBaratunde Thurston: We went into this with a goal of significant pre-sales to hit the New York Times bestseller list. How many does it take to do that? Anywhere from 1,000 to 100,000 in sales, and it depends on what else has come out that week. The pre-sales all accrue to one week, so you can stack the deck. We had 20,000 pre-sales as a goal. That was insane. We wound up with several hundred pre-sales, which was helpful, but not a juggernaut. We hit the list at No. 21. Mostly, that was useful because The Times had me do a joint interview with Charles Murray that ran in print and online during Black History Month. And that drew some attention.

    What we learned from this is that people do not buy books. They like to talk about books. They like to talk about buying them. But they do not buy them.

    Also for context, how important are book sales for you?

    Baratunde Thurston: Sales are important. I want people to read the book. I want them to spend money. This wasn't a vanity publishing project, but it wasn't a get-rich scheme, either. It was a way for me as a creative person to point to something solid. I speak, I tweet; it's gone. I publish in very forgettable platforms. A book has some staying power. It's a cultural object, a physical object on which you can focus some attention.

    What elements of the campaign worked?

    Baratunde Thurston: We decided to treat this like a political campaign — more about the issues than the politician. We asked ourselves: Can we create a sense of movement that has other people seeing themselves in a book about me?

    There was a process to arrive at the plan, and it equaled me coming up with the marketing. I knew I had to get on it when I was on a trip somewhere, and I got an email from Harper [Collins Publishers]: "Do you think you'll tweet about the book?"

    There was a big research phase, talking to people I know or was introduced to, like Gary Vaynerchuk, Deanna Zandt, Eric Ries, Amber Rae at the Domino Project, and Tim Ferris. There were a lot of conversations had and articles read. There's no excuse to make things up completely or rely on hope.

    We went with a content-oriented promotion strategy — check out this video or tweet or interview. So, for example, we wound up with 50 short videos that we could build into the book and the campaign.

    The book's website was the heart. We posted a daily question every day in February, seeding it with the video I had already shot.

    For speaking gigs I'd already booked, we asked if we could add book sales.

    We had field ops — the Street Team. They were the ideal beta group: 115 people, half active and half of those really dedicated. We thought each street team member would equate to sales, but it's turned out to be more important as a group that lets us test ideas.

    We also identified the high-value donors — people who are going to deliver a bunch of votes or cash. I went through all my contacts manually, about 4,500 people, and scrubbed that down to about 1,800 real people. I tagged them lightly, looking at them in terms of relevance. And then I started reaching out to them one by one.

    "Fresh Air" with Terry Gross worked. MSNBC appearances worked.

    How did the Street Team work out?

    Baratunde Thurston: We tried to build a very loyal, very intense community. People had to apply. We asked them to participate in web video chats. It was like they made it through basic training. And that was kind of the goal: to have a group of advocates you can deploy in different ways. At launch parties across the country, they help out. Craig crashes on their sofas. They provide a support network; they're the volunteer fire department.

    They also became an early-warning system for how the public would interpret the book. They weren't biased the way the other people close to me were. For instance, during Street Team video chats, they asked questions the public would ask. So I'd go to launch parties and interviews really prepared with answers.

    Michael Phelps parody photoThis notion of showing the book cover in the hands of people as an image of value — they helped create that. Somebody Photoshopped Michael Phelps holding it, and that was one of first we saw. We seeded that idea with the Street Team, and they ran with it. The Photoshopping became redundant because actual people were holding the book and people were taking their pictures. It turned into a photomeme as people began to post them [to Twitter and the "How To Be Black" website].

    We had a roadmap of things we had to do, and one thing we didn't miss was the Amazon reviews. We wanted to get them up within hours of the book's availability to set the trend for five-star reviews. We had a video chat with the Street Team right before the Amazon release. Within hours, we had 10 five-star reviews. That signaled to the Amazon buying market that it was a worthwhile book, and the Street Team provided the initial traction. And it's not just the number of five-star reviews, it's also how many reviews were helpful or not. We basically created our own Amazon Vine program.

    What didn't work the way you expected?

    Baratunde Thurston: The goal of 20,000 pre-sales didn't work. Every weekday in February, I should have been doing something for Black History Month. That didn't quite work, because the lead time for booking events is six months to a year, and we weren't on top of it early enough. As I mentioned, having the Street Team directly account for a certain number of units distributed didn't quite work.

    What role did Craig Cannon play?

    Baratunde Thurston: I knew Craig loosely at the Onion [where he was graphics editor]. He invited me to lunch to talk about something he was working on, a project with Skillshare. About five or six months before the book launched, we did a class on how to be black. That was a good test for our relationship.

    We had a huge Google doc with everything laid out. Craig set up the Tumblr, the Facebook page, a private group for the Street Team, the tour support, the admin support. He's running the merchandise business. The black card — he just went off and built it.

    I would have been able to do a lot of that worse. Even the two of us are only hitting 60% capacity. We should have had merch ready at launch. At some of our book events, we didn't have books.

    For people who don't have a Craig, the most important thing is the personal one-on-one outreach. Look at the market of people interested in your topic, interested in you. Start with your inner circle. I had an epiphany with Gary Vaynerchuk. I asked: "Did I ever ask you to buy my book?" He said, "Yeah, I bought it yesterday." I talked about his book, but cash on the table — it didn't happen. He wished he had identified everyone he knows, sending a personal note explaining: "A) buy the book; B) this means a lot to me. You owe me or I will owe you. Here's some things you can do to help: If you have speaking opportunities, let me know. For instance, I would love to speak at schools." Make it easy for people who want to help you. Everything else is bonus. If you haven't already converted the inner circle, you've skipped a critical step.

    What specific marketing technique would you recommend to other authors?

    Baratunde Thurston: You can make everything easier by figuring out what value to attach your book to. We've been working under the over-arching theme of identity. If you blog every week about why your book is so awesome, nobody cares. If you're producing relevant, interesting content, they get attached to you in context. That leads to sales. It's a good model.

    Once you've actually articulated what that value is, make everything else consistent with that. For us, it was comfort with yourself and your identity — everybody has an outsider identity. That provides a roadmap for interviews and events. It establishes the brand and reinforces it. This approach requires time and consideration, but not cash. It's not just reactive. For instance, this book is about DIY culture that makes the world a better place. With that approach, somebody like my friend Nora Abousteit can get involved, even though race, per se, isn't her issue.

    Anything else you want to add?

    Baratunde Thurston: There was a very important tactical layer, the secret sauce: Knod.es [Note: this is launching to the public soon]. Ron Williams, Knod.es founder, has been an essential shadow. The types of services Knod.es provides — pre-qualified leads — are going to be important for everything. We were sending targeted blasts around and used Knod.es to augment that. The results have been incredible.

    For example, we wanted people to submit more content to the How To Be Black Tumblr. After launch, it had faded. We recruited 18 people [some from the Street Team] to push a message through Facebook and email. We had a 50% conversion rate on those messages, and got in nine stories without trying that hard. In the same way you approach your network of friends, you can do the same with social networks where you don't know them as well but they still want to help. You still have to make it easy for people to help you, but finding the value in your existing relationships — that's incredibly valuable. "The Today Show" isn't available to everyone.

    This interview was edited and condensed.

    Related:

    March 28 2012

    The Reading Glove engages senses and objects to tell a story

    I encountered Karen Tanenbaum (@ktanenbaum) through friends over on the Make side of O'Reilly Media. Thinking she might be a potential speaker for an upcoming edition of our Tools of Change for Publishing Conference, I contacted her for more information about the cool stuff she's working on, particularly her Reading Glove project.

    "The Reading Glove is a collaboration between myself and my husband, Josh Tanenbaum," said Karen. "I have an interest in adaptive and intelligent systems, his research looks at storytelling and video games, and we both like to explore alternative interfaces: tangible, wearable, and ubiquitous computing environments."

    Read more about the Glove project as well as Karen's take on design education, Steampunk culture and the Maker movement in the interview below.

    How did the Reading Glove come about and what are your goals for the project?

    Karen Tanenbaum: We wanted to see what happened when we gave people a story that was embedded on real, physical objects that could be played with and moved around. Our original vision was an entire room that told a story when you explored it, responding to objects you touched or moved via light and sound responses — sort of like a haunted house, but intended to tell a specific narrative rather than just be spooky. That was outside the scope and the budget of our dissertation work, so the Reading Glove was our first, more constrained exploration of that space.

    Recommender, objects, and glove
    Recommender, objects, and glove.

    We also wanted to explore wearable technology with the glove; the goal there was to invoke the idea of "psychometry," or the psychic power of object reading. When you pick up the objects, you hear the echoes of the past, what these objects experienced, and then you use this power to piece the story back together. I developed a guidance system that helped to navigate the non-linear narrative, adding an adaptive or intelligent component to the experience. We've gotten some really interesting results out of it, such as how people talk about a system that has intelligent components, how much they anthropomorphize it and how accurate their estimates of its "intelligence" are.

    What role does data play in the project?

    Karen Tanenbaum: We collected a ton of data for this project, and I've spent the last year trying to sort through it and make sense of it. It's a real challenge with these kinds of novel systems to figure out what the most important thing is and to see how to correlate all these things together: how many objects they picked up, in what sequence, whether they interrupted pieces, whether or not they followed the system's recommendations, etc.

    The focus of my analysis was on how people talked about the system and their use of it, particularly the notion of "control" and "choice." People would say that they really liked the freedom to choose any object and control how the story went, but would also say that since they never knew what story fragment they were going to get when they picked an object, they wished they had more control. It's interesting how people use technology and feel like they are, or are not, in control of it.

    There's a problem with any simple measure of novel technology, which is that people in general tend to respond positively toward something new, especially if they know they are talking to the person who designed and built it. It's hard to ask someone "Did you like X?" when X is a new experience, like wearing a glove and picking up objects to hear a story. Of course, they're going to say "yes" because they don't have much to compare it to and because it is a fun thing to do. But there are innumerable design decisions that go into the whole experience, and it's hard to disentangle them to see where a different choice might have led to a better experience. That's why I think richer, more qualitative data is important to the field. It gets you beyond "I liked it, I thought it was easy to use, etc.," and you see what aspects of the experience people are really responding to, or what was actually frustrating them but which they didn't mention in the yes/no survey questions.

    Reading Glove diagram
    Reading Glove data diagram.

    As well as being a PhD candidate, you teach interaction design at the university level. What trends are you seeing in design and technology education?

    Karen Tanenbaum: I've taught interaction design at an art and design school and within a research university, and they are very different experiences. The art and design students were much more wary of the technology, but they had great intuition on how to use it to express their points of view. The students at the big university were more naturally technology-seeking, but they had to be pushed to really explore what it meant to say something with the technology. You really want the blend of both of those things: the technological expertise and the desire and ability to express something via technology rather than simply use it. I teach Processing to as many people as I can — basic coding is an incredibly beneficial skill for people in all fields to learn. There are tools to help simplify and automate a lot of the routines of everyone's work if you know how to write some basic code or search string parameters.

    The other side of the coin, which I've had less opportunity to teach directly, is developing a critical stance toward technology. Programming and technical skills are really important, but so are critical thinking and reflective analysis. I don't believe technology is a neutral force; it is embedded and intertwined with a host of other cultural and societal forces, and we have both the ability and mandate to try to shape technical systems that are socially and ethically responsible. It's hard to teach both detailed technical expertise and deep critical thinking at the same time, and it seems that most schools end up focusing on one to the detriment of the other.

    How is technology changing the experience of art and reading?

    Karen Tanenbaum: Despite making a wearable device called the Reading Glove, most of my reading processes are stuck firmly in the last century. The power of technology as applied to art and reading is the connectivity that it can bring about. You can connect to what other people think about the work or you can see related pieces that might lead you to new discoveries. The interesting thing would be to bring that connectivity to the physical books, not to make the books themselves digital.

    What other projects are you working on?

    Karen Tanenbaum: As I finish the dissertation, I’m also doing a year-long internship at Intel Lab's Interaction and Experience Research Group, which is providing me with a fantastic opportunity to pursue some of the research work I've done since the Reading Glove.

    My first project at Intel was to coordinate an exhibition of design fiction work called "Powered by Fiction," which ran alongside Emerge, a conference at Arizona State University on designing the future. We explored how fiction inspires the creation of physical, tangible props, costumes, and artifacts. One of the characters in the show "Captain Chronomek" was developed by me, my husband, and a colleague. The character is a time-traveling, Steampunk-flavored superhero.

    The other related project that I've got going is an academic look at the subculture of Steampunk, picking apart what's driving its increased popularity. I'm a co-author on a paper on Steampunk at CHI this year. That paper looks at some of the implications of the Steampunk movement: the way it re-imagines the Industrial Revolution, the historical story of technology development, and the drive toward customization and artisan craftsmanship in technology.

    And finally, I am now working on Intel's presence at Maker Faire. I had a booth at the Vancouver Mini Maker Faire this year with my husband to represent our fledging production company, Tanenbaum Fabrications. We're putting together a joint booth with some other folks at the Bay Area Maker Faire this year called Steampunk Academy. As with the Steampunk work, there's something really interesting going on with the democratization of technology design and production that is represented in the Maker movement.

    I'm hoping to spend time in the next year working more with the LilyPad Arduino and other e-textile and soft circuitry components since I think that's a really exciting area for open source, tinker-y innovation.

    Who inspires you? Whose work do you follow?

    Karen Tanenbaum: I'm most inspired by the people doing the kind of work I was talking about above in the question about education: critical thinking on technology and the fusing of philosophy with technology design practice. Material like Terry Winograd and Fernando Flores' classic and incisive critique of artificial intelligence work in the mid '80s, and Paul Dourish's work merging Heideggerian philosophy with tangible computing and his collaboration with Genevieve Bell on science fiction and ubiquitous computing. I'm also influenced by all of Daniel Fallman's papers on what interaction design and design research is or could be. I'm also really enamored with some of the more recent work being done in merging "craft" and "design": Leah Buechely's Lilypad Arduino and High-Low Tech Lab at MIT, Daniela Rosner's work applying craft knowledge from antiquarian book restoration and knitting to technology design, and Hannah Perner-Wilson's amazing and beautiful textile sensors.

    Watch a demonstration of the Reading Glove:

    This interview was edited and condensed. Photos: Team Tanenbaum, on Flickr.

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    March 12 2012

    Understanding place and space in a decreasingly English world

    I'm So Confused! by Ian Sane, on FlickrRobert Munro (@WWRob) is a graduate fellow at Stanford University and chief executive at Ibidon who's fascinated with languages that are spoken by very few. At Where 2012, Munro will examine differences in how people express place, distance, and space among the world's 5,000-plus languages. These are differences that location-aware app designers will have to pay attention to as the world's data becomes less and less predominantly English.

    Our interview follows.

    What are some of the ways that space and direction are expressed differently among cultures?

    Robert Munro: We tend to think of spatial distinctions as absolute and clean-cut, but when you scratch the surface, it is clear that we encode space and direction in many very subtle and language-specific ways. If I said, "look in front of the house," do I mean "in front of" relative to you, me, or the house itself? Or if we've been looking at an aerial map together, maybe I just mean to the north, south, or roadside.

    Even in English, location can be difficult to embed into technology. If you ride the light rail in Portland, Ore., you might hear an ethereal voice saying, "The doors on my right side will open." Is this the (somewhat creepy) disembodied voice from the train that you are inside, meaning the doors on the right in the direction of travel? Is it from the virtual driver facing the passengers, meaning the doors on the left in the direction of travel? Portland recently hosted the annual conference of America's top linguists; even they had to wait for the train to stop to figure it out.

    Why are these differences important for geo developers to consider?

    Robert Munro: The majority of the world's digital information is now in non-English unstructured text. There are some 5,000 languages in the connected world, each of them spoken by people operating potentially location-aware devices.

    The location-based applications on those devices are abstracted from space, time and direction, using visual and verbal metaphors for each. Every language encodes space and time differently and there is a direct relationship between visual spatial metaphors and language. Recent research has found this link to be much stronger than once thought — even short-term changes in language can drastically alter the way we perceive space and time. For some languages, the future is in front of us, but for others it is behind us. Some languages use length is a metaphor for time (a long time) while some prefer volume (a large amount of time). Some languages will prefer relative directions (turn left) while others will only permit absolute directions (turn north). Location-based applications use every one of these metaphors, so it is important for developers to understand the rich breadth of spatial and temporal metaphors that they are (often unconsciously) coding into their applications. As the applications often have a visual language of their own, it is safe to say that they can also have a direct influence on their users' sense of space and time. After staring at a map before exploring some new place, did you ever feel like you then had an augmented reality view of the place thanks to that map? In a sense, you probably did.


    Can you tell us about the work you did after the Haiti earthquake to crowdsource local information from a global diaspora of Haitians?

    Robert MunroRobert Munro: Mission 4636 was a crowdsourced information service established in the wake of the 2010 earthquake in Haiti. People within the country were able to send free text messages that were then translated and mapped by crowdsourced workers and streamed back to responders within the country. We launched in 48 hours. I ran the actual crowdsourcing component — finding and managing thousands of Haitian Kreyol and French speakers globally who could help.

    It taught me two important lessons. The first is that nothing beats local knowledge. Members of the Haitian diaspora thousands of miles away were quicker at geolocating vital locations in Haiti than many international workers on the ground. The second lesson that it taught me is that it is hard to find those who have the crucial local knowledge. At the time, I needed to reach out through social media, looking for (mostly) ad-hoc groups of people with Haitian affiliations. There simply wasn't a unified resource that links people by languages spoken.

    This has influenced me greatly. For every corner of the world, there is a global network of largely untapped local knowledge, and it is just as applicable to travel and trade as it is to crisis response. It gives us one solution to the problem of encoding location in technology. For a given problem, there is probably someone online right now who does have the necessary local linguistic and geographic knowledge. In addition to making technology smarter across languages, we also need to be making technology that can better engage these individuals. With Idibon, we are doing both, building language-processing algorithms that can parse unstructured data in previously unknown languages and linking this to a global network of language speakers. In Haiti, we were able to transfer the system to local, paid workers within the country, continuing the local knowledge and providing employment where it was needed most. I would love to see this kind of approach adapted more broadly, turning people's knowledge of less well-known languages to their advantage.

    Where Conference 2012 — O'Reilly's Where Conference, being held April 2-4 in San Francisco, is where the people working on and using location technologies explore emerging trends in software development, tools, business strategies and marketing.

    Save 20% on registration with the code RADAR20

    How is location used in viral forecasting by health organizations?

    Robert Munro: Location is the oldest and newest component in viral forecasting. In the 1850s, John Snow founded both modern epidemiology and geographic information systems (GIS) when he mapped the location of a London cholera outbreak to a single water pump.

    Today, unfortunately, the dynamic maps that you see in outbreak movies outpace the technologies of actual epidemic-tracking organizations. But this is rapidly changing on the back of communication technologies. While HIV took decades to be isolated, Bird Flu and Swine Flu were isolated weeks or months after they first appeared. We can go back and find early, open reports about Bird Flu and Swine Flu with the key signatures of a new virus. This could have enabled us to identify and contain them even earlier, and smarter information processing will allow this for future outbreaks. Within Global Viral Forecasting, a spin-in called epidemicIQ is doing just this, looking to track outbreaks as early as possible. (Disclosure: I was the CTO of epidemicIQ until recently and continue as an adviser.) Local knowledge is vital here, too: 90% of the world's outbreaks come from 10% of the land; 90% of the world's languages also come from 10% of the land. It is the same 10%.

    Geographic information systems are finding their way back into real-time outbreak tracking, too. Open data about flight paths and transportation networks allows us to track the potential spread of an outbreak with a precision that was never before possible. At the moment, we are quickly closing the gap on how quickly we can track the spread of outbreaks. Will we soon be able to use the same technology to get ahead of outbreaks? I hope so.

    Who else is doing interesting work in this area?

    Robert Munro: For almost half a century, most language researchers assumed that the cross-language differences in space and time were more or less arbitrary. Within the last few years, a number of researchers, the Stanford psychologist Lera Boroditsky in particular, have produced strong evidence showing that they can manipulate people's sense of time and space by changing their language, even over very short periods. It has turned many people's assumptions about language and world-view right around.

    In health, Nicholas A. Christakis at Harvard and James Fowler at the University of California San Diego have made some very interesting discoveries about the spread of disease, using online social networks as a powerful stand-in for geographic/interpersonal connections. They have been able to make reliable predictions about the spread of outbreaks and other communicable phenomena to several people out along social networks. It is a really exciting new approach.

    This interview was edited and condensed. Photo: I'm So Confused! by Ian Sane, on Flickr

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    March 01 2012

    Permission to be horrible and other ways to generate creativity

    I met Denise R. Jacobs (@denisejacobs) the old fashioned way, not through Twitter or LinkedIn: a mutual acquaintance introduced us. We corresponded via email and actually got together in person a few months later at Web 2.0 Expo, where Denise was speaking. I was impressed both by her passion for giving people the knowledge, tools and resources to feel more empowered in their work as well as the breadth of her experience. Denise wrote "The CSS Detective Guide" and co-authored "InterAct with Web Standards." She also develops curricula for the Web Standards Project Education Task Force and was nominated for .Net Magazine's 2010 Best of the Web "Standards Champion" award.

    I spoke with Denise recently about her experiences writing her book, how that led her to new ways of thinking, how she got started the web design, and other projects.

    You're known for your web design work. What motivated you to explore the more non-technical topics of creative inspiration?

    Denise JacobsDenise R. Jacobs: During the writing process "The CSS Detective Guide" I had a huge epiphany about myself and my ideas of creativity. I had to do battle on a daily basis with my inner critic and figure out ways to silence it, so that I could just get the work done.

    In an industry where people are constantly producing wonderful things, it's really hard not to compare yourself to others. In terms of the creativity and the inspiration, it's easy to have panicky moments when you feel as though you can't come up with another idea, a new design, more content. I wanted to formulate ways to access creativity and channel that amazing feeling that you can take on the world, both for myself to help other people. So I wrote an article as a way to solidify my own techniques and to help anybody else who may need to silence a mean voice in their head as well.

    Creativity isn't always associated with the technical community. Why is that?

    Denise R. Jacobs: It's because there's such a limited definition of creativity in our culture. People treat artists as if they're off in their own world or put them on a pedestal. But it's a misconception that technical people aren't creative. Developers and coders and database architects are extremely creative, just as scientists are. They have to come up with solutions and code that have never been written before. If that's not creativity, I don't know what is.

    I'm reading "A Whole New Mind" by Daniel H. Pink, which explores how right-brain is the new wave. We're entering a new conceptual, high-touch era whereas before we were in a very analytical era. Our industry, the technical industry, is actually a perfect in-between point of left brain and right brain. You have to have both, a whole-brain approach, to be successful in our industry.

    What steps can people take to bring creativity into their professional and personal lives?

    Denise R. Jacobs: One of my favorite techniques for being creative, and productive in general, is to give yourself permission to be as horrible at something as you possibly can, to even mess it up. That permission actually lowers inhibition filters and allows you to take chances that you would normally not take. Often that ends up making it good because you're not as invested in it and therefore not as self-conscious about the process.

    Another important technique is to set aside time where your brain is resting, where you're not actually trying to produce something. Give it space to be able to make connections that it wouldn't necessarily have made before. Insights come when you're taking a walk, sitting on the beach or the park bench, playing with your dog. Because your brain is relaxing, it can go places that it doesn't usually go when you're concentrating or you're thinking hard.

    In this industry, there's a subculture that is always on — on the computer, on social networks, connecting with people. There is never a time to not be on. When you're at dinner with a friend, you're checking in on Foursquare. You're tweeting. You're taking a picture to upload to your Facebook profile. Texting friends. To just be off is huge and can make all of the difference in the world.

    With social media and other tools for people to come together, both in real life and virtually, what do you think about the state of communities today?

    Denise R. Jacobs: I could be biased, but one thing I do see is that despite all of our virtual connections, in real life, it's kind of awkward. People are so used to communicating with each other digitally, texting for instance, that they're starting to lose the capacity to have genuine in-person connections to some degree. People aren't engaging with each other. Yet they try to depict it as such to keep themselves entertained.

    A trend I'd like to see is for communities and people who make connections virtually to solidify that with an in-person connection. And if you make an in-person connection, then further solidify that with a virtual connection. Let there be a constant ebb and flow, a circuit going back and forth between both real life and virtual connections so that you can't really rely completely on either one. That's why we have these tools — we crave connection. We don't really have enough of it, but we can't depend solely on tools to create all of the connection that we need and vice versa.

    What trends and people are you following?

    Denise R. Jacobs: Location and self-publishing are trends I watch popping up all over the place. There are so many things going on that it's kind of overwhelming. I rely on serendipity and I focus more on concepts, ideas, and people because they are what underlie the trends. I am inspired by unapologetic creativity and unapologetic cleverness. I admire the younger people coming into the industry who are developing and innovating like crazy.

    I admire the work Jane McGonigal is doing, her "Reality Is Broken" book and her whole gaming productivity movement. She takes ownership for being a woman in an industry where that's not typical and doesn't tone herself down at all. She's very feminine and a badass, has a PhD and awesome ideas and that's just the way it is with her.

    I also admire Kathy Sierra because she's been around for a while and she's also an incredibly intelligent and clever person, a great speaker, and also someone with a lot of really wonderful ideas.

    Tell us about your Rawk the Web project.

    Denise R. Jacobs: There are a lot of diverse experts in the tech industry, women and people of color, but they're not very visible in terms of speaking at conferences or writing articles or books or whatever. It's not that conferences or publishers don't want a more diverse lineup, but often they just don't know who to get or how to go about it.

    I was at a conference last year and the organizer asked me to fill in for a speaker who had to cancel. Afterwards, I ended up talking to a woman who really wanted to become a speaker but didn't know where to start. This was a perfect example of what people are probably saying to themselves. "I don't know enough. How do I get started? It seems really imposing. There's no room for anybody new."

    I started Rawk the Web to give people actual information and have experts share their story about how they got started so that other people can see that they can do it, too. I also want to provide resources to people who may be inclined to give women and people of color more visibility, a network of people they can talk to and get inspiration from to take that first step. This is a really good time for it because people see me at conferences and notice I'm often the only brown person there — they're very conscious of it and glad to see me on stage. I'm hoping to launch it in June and that there will eventually be a Rawk the Web Conference. I know I'm not the only person working on this issue, but I'd like it to be more of a concentrated effort.

    How did you get started with CSS and what do you see in its near future?

    Denise R. Jacobs: Back in late 1996, nobody was updating the website at the place I was working so I volunteered to take care of it. During that process, I taught myself HTML — it was actually before CSS had really been widely embraced. Over the course of the next few years, I worked in localization for a Microsoft product, then I was a web group product manager at another software company, then later an instructor at Seattle Central Community College in their web design and development programs. Around 2002, web standards started becoming more popular. It was so much better and so much easier. One file to control the whole website — brilliant! It was an amazing, exciting time, to see the changing of the guard, what the web was moving from and what it was moving toward.

    I couldn't call myself a web design instructor in good conscience without knowing CSS and I couldn't send students out into the world with outdated and inefficient skills. So I keep up with the trends, particularly by reading articles on A List Apart, and blogs by Dave Shea, Andy Budd and Doug Bowman.

    As for the future of CSS, there's going to be a lot more reliance and trust of browsers. Browser vendors know what an important role they play and that browser wars don't do much good. More browser companies are working together with the W3C to establish and embrace standards.

    Because of that, changes are happening faster. There's a big push for people to get up to speed with current best practices and develop new ones. For things like page layouts and CSS3, there are some really neat properties that are going to change the way people think about their approach to web layouts and the craft of building websites. It's going to be interesting to see how long those properties take to be adopted and what people come up with for them.

    This interview was edited and condensed.

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    February 21 2012

    Building the health information infrastructure for the modern epatient

    To learn more about what levers the government is pulling to catalyze innovation in the healthcare system, I turned to Dr. Farzad Mostashari (@Farzad_ONC). As the National Coordinator for Health IT, Mostashari is one of the most important public officials entrusted with improving the nation's healthcare system through smarter use of technology.

    Dr. Farzad MostashariMostashari, a public-health informatics specialist, was named ONC chief in April 2011, replacing Dr. David Blumenthal. Mostashari's full biography, available at HHS.gov, notes that he "was one of the lead investigators in the outbreaks of West Nile Virus and anthrax in New York City, and was among the first developers of real-time electronic disease surveillance systems nationwide."

    I talked to Mostashari on the same day that he published a look back over 2011, which he hailed as a year of momentous progress in health information technology. Our interview follows.

    What excites you about your work? What trends matter here?

    Farzad Mostashari‏: Well, it's a really fun job. It feels like this is the ideal time for this health IT revolution to tie into other massive megatrends that are happening around consumer and patient empowerment, payment and delivery reform, as I talked about in my TED Med Talk with Aneesh Chopra.

    These three streams [how patients are cared for, how care is paid for, and how people take care of their own health] coming together feels great. And it really feels like we're making amazing progress.

    How does what's happening today grow out of the passage of the Health Information Technology for Economic and Clinical Health Act (HITECH) Act in 2009?

    Farzad Mostashari‏: HITECH was a key part of ARRA, the American Recovery and Reinvestment Act. This is the reinvestment part. People think of roadways and runways and railways. This is the information infrastructure for healthcare.

    In the past two years, we made as much progress on adoption as we had made in the past 20 years before that. We doubled the adoption of electronic health records in physician offices between the time the stimulus passed and now. What that says is that a large number of barriers have been addressed, including the financial barriers that are addressed by the health IT incentive payments.

    It also, I think, points to the innovation that's happening in the health IT marketplace, with more products that people want to buy and want to use, and an explosion in the number of options people have.

    The programs we put in place, like the Regional Health IT Extension Centers modeled after the Agriculture Extension program, give a helping hand. There are local nonprofits throughout the country that are working with one-third of all primary care providers in this country to help them adopt electronic health records, particularly smaller practices and maybe health centers, critical access hospitals and so forth.

    This is obviously a big lift and a big change for medicine. It moves at what Jay Walker called "med speed," not tech speed. The pace of transformation in medicine that's happening right now may be unparalleled. It's a good thing.

    Healthcare providers have a number of options as they adopt electronic health records. How do you think about the choice between open source versus proprietary options?

    Farzad Mostashari‏: We're pretty agnostic in terms of the technology and the business model. What matters are the outcomes. We've really left the decisions about what technology to use to the people who have to live with it, like the doctors and hospitals who make the purchases.

    There are definitely some very successful models, not only on the EHR side, but also on the health information exchange side.

    (Note: For more on this subject, read Brian Ahier's Radar post on the Health Internet.)

    What role do open standards play in the future of healthcare?

    Farzad Mostashari‏: We are passionate believers in open standards. We think that everybody should be using them. We've gotten really great participation by vendors of open source and proprietary software, in terms of participating in an open standards development process.

    I think what we've enabled, through things like modular certification, is a lot more innovation. Different pieces of the entire ecosystem could be done through reducing the barrier to entry, enabling a variety of different innovative startups to come to the field. What we're seeing is, a lot of the time, this is migrating from installed software to web services.

    If we're setting up a reference implementation of the standards, like the Connect software or popHealth, we do it through a process where the result is open source. I think the government as a platform approach at the Veterans Affairs department, DoD, and so forth is tremendously important.

    How is the mobile revolution changing healthcare?

    We had Jay Walker talking about big change [at a recent ONC Grantee Meeting]. I just have this indelible image of him waving in his left hand a clay cone with cuneiform on it that is from 2,000 B.C. — 4,000 years ago — and in his right hand he held his iPhone.

    He was saying both of them represented the cutting edge of technology that evolved to meet consumer need. His strong assertion was that this is absolutely going to revolutionize what happens in medicine at tech speed. Again, not "med speed."

    I had the experience of being at my clinic, where I get care, and the pharmacist sitting in the starched, white coat behind the counter telling me that I should take this medicine at night.

    And I said, "Well, it's easier for me to take it in the morning." And he said, "Well, it works better at night."

    And I asked, acting as an empowered patient, "Well, what's the half life?" And he answered, "Okay. Let me look it up."

    He started clacking away at his pharmacy information system; clickity clack, clickity clack. I can't see what he's doing. And then he says, "Ah hell," and he pulls out his smartphone and Googles it.

    There's now a democratization of information and information tools, where we're pushing the analytics to the cloud. Being able to put that in the hand of not just every doctor or every healthcare provider but every patient is absolutely going to be that third strand of the DNA, putting us on the right path for getting healthcare that results in health.

    We're making sure that people know they have a right to get their own data, making sure that the policies are aligned with that. We're making sure that we make it easy for doctors to give patients their own information through things like the Direct Project, the Blue Button, meaningful use requirements, or the Consumer E-Health Pledge.

    We have more than 250 organizations that collectively hold data for 100 million Americans that pledge to make it easy for people to get electronic copies of their own data.

    Do you think people will take ownership of their personal health data and engage in what Susannah Fox has described as "peer-to-peer healthcare"?

    Farzad Mostashari‏: I think that it will be not just possible, not even just okay, but actually encouraged for patients to be engaged in their care as partners. Let the epatient help. I think we're going to see that emerging as there's more access and more tools for people to do stuff with their data once they get it through things like the health data initiative. We're also beginning to work with stakeholder groups, like Consumer's Union, the American Nurses Association and some of the disease groups, to change attitudes around it being okay to ask for your own records.

    This interview was edited and condensed. Photo from The Office of the National Coordinator for Health Information Technology.

    Strata 2012 — The 2012 Strata Conference, being held Feb. 28-March 1 in Santa Clara, Calif., will offer three full days of hands-on data training and information-rich sessions. Strata brings together the people, tools, and technologies you need to make data work.

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    January 11 2012

    Can Maryland's other "CIO" cultivate innovation in government?

    Bryan Sivak at OSCON 2010When Maryland hired Bryan Sivak last April as the state's chief innovation officer, the role had yet to be defined in government. After all, like most other states in the union, Maryland had never had a chief innovation officer before.

    Sivak told TechPresident on his second day at work that he wanted to define what it means to build a system for innovation in government:

    If you can systemize what it means to be innovative, what it means to challenge the status quo without a budget, without a lot of resources, then you've created something that can be replicated anywhere.

    Months later, Sivak (@BryanSivak) has been learning — and sharing — as he goes. That doesn't mean he walked into the role without ideas about how government could be more innovative. Anything but. Sivak's years in the software industry and his tenure as the District of Columbia's chief technology officer equipped him with plenty of ideas, along with some recognition as a Gov 2.0 Hero from Govfresh.

    Sivak was a genuine change agent during his tenure in DC. As DCist reported, Sivak oversaw the development of several projects while he was in office, like the District's online service request center and "the incredibly useful TrackDC."

    Citizensourcing better ideas

    One of the best ideas that Sivak brought to his new gig was culled directly from the open government movement: using collective intelligence to solve problems.

    "My job is to fight against the entrenched status quo," said Sivak in an interview this winter. "I'm not a subject expert in 99% of issues. The people who do those jobs, live and breathe them, do know what's happening. There are thousands and thousands of people asking 'why can't we do this this way? My job is to find them, help them, get them discovered, and connect them."

    That includes both internal and external efforts, like a pilot partnership with citizens to report downed trees last year.

    An experiment with SeeClickFix during Hurricane Irene in August 2011 had a number of positive effects, explained Sivak. "It made emergency management people realize that they needed to look at this stuff," he said. "Our intention was to get people thinking. The new question is now, 'How do we figure out how to use it?' They're thinking about how to integrate it into their process."

    Gathering ideas for making government work better from the public presents some challenges. For instance, widespread public frustration with the public sector can also make citizensourcing efforts a headache to architect and govern. Sivak suggested trying to get upset citizens involved in addressing the problems they highlight in public comments.

    "Raise the issue, then channel the negative reactions into fixing the issues," he said. "Why not get involved? There are millions of civil servants trying to do the right thing every day."

    In general, Sivak said, "the vast majority of people are there to do a good job. The problem is rules and regulations built up over centuries that prevent us from doing that the best way."

    Strata 2012 — The 2012 Strata Conference, being held Feb. 28-March 1 in Santa Clara, Calif., will offer three full days of hands-on data training and information-rich sessions. Strata brings together the people, tools, and technologies you need to make data work.

    Save 20% on registration with the code RADAR20

    Doing more with less

    If innovation is driven by resource constraints, by "doing more with less," Sivak will be in the right place at the right time. Maryland Governor Martin O'Malley's 2012 budget included billions in proposed cuts, including hundreds of millions pared from state agencies. More difficult decisions will be in the 2013 budget as well.

    The challenge now is how to bring ideas to fruition in the context of state government, where entrenched bureaucracy, culture, aging legacy IT systems and more prosaic challenges around regulations stand in the way.

    One clear direction is to find cost savings in modern IT, where possible. Moving government IT systems into the cloud won't be appropriate in all circumstances. Enterprise email, however, appears to be a ripe area for migration. Maryland is moving to the cloud for email, specifically to Google Apps for Enterprise.

    This will merge 57 systems into one, said Sivak. "Everyone is really jazzed." The General Services Agency saved an estimated $11 million for 13,000 employees, according to Sivak. "We hope to save more. People don't factor in upgrade costs."

    He's found, however, that legacy IT systems aren't the most significant hindrance to innovation in government. "When I started public service [in D.C. government], procurement and HR were the things I was least interested in," said Sivak. "Now, they are the things I'm most interested in. Fix them and you fix many of the problems."

    The problem with reform of these areas, however, is that it's neither a particularly sexy issue for politicians to run on in election years nor focus upon in office. Sivak told TechPresident last year "that to be successful with technology initiatives, you need to attack the underlying culture and process first."

    Given the necessary focus on the economy and job creation, the Maryland governor's office is also thinking about how to attract and sustain entrepreneurs and small businesses. "We're also working on making research and development benefit the state more," Sivak said. "Maryland is near the top of R&D spending but very low on commercializing the outcomes."

    In an extended interview conducted via email (portions posted below), Sivak expanded further about his view of innovation, what's on his task list and some of the projects that he's been working on to date.

    How do you define innovation? What pockets of innovation in government inspire you?

    Bryan Sivak: Innovation is an overused term in nearly every vertical — both the public and private sectors — which is why a definition is important. My current working definition is something like this:

    Innovation challenges existing processes and systems, resulting in the injection, rapid execution and validation of new ideas into the ecosystem. In short, innovation asks "why?" a lot.

    Note that this is my current working definition and might change without notice.

    What measures has Maryland taken to attract and retain startups?

    Bryan Sivak: There are a number of entities across the state that are focused on Maryland's startup ecosystem. Many are on the local level and the private academic side (incubators, accelerators, etc.), but as a state we have organizations that are — at least partially — focused on this as well. TEDCO, for example, is a quasi-public entity focused on encouraging technology development across the state. And the Department of Business and Economic Development has a number of people who are focused on building the state's startup infrastructure.

    One of the things I've been focusing on is the "commercialization gap," specifically the fact that Maryland ranks No. 1 per capita in PhD scientists and engineers, No. 1 in federal research and development dollars per capita, and No. 1 in the best public schools in the country, but it is ranked No. 37 in terms of entrepreneurial activity. We are working on coming up with a package to address this gap and to help commercialize technologies that are a result of R&D investment into our academic and research institutions.

    What about the cybersecurity industry?

    Cybersecurity is a big deal in Maryland, and in 2010, the Department of Business and Economic Development released its Cyber Maryland plan, which contains 10 priorities that the state is working on to make Maryland the cybersecurity hub of the U.S. Given the preponderance of talent and specific institutions in the state, it makes a ton of sense and builds on assets we already have in place.

    What have you learned from Maryland's crowdsourcing efforts to date?

    Bryan Sivak: We've really just started to dip our toes in the crowdsourcing waters, but it's been very interesting so far. The desire is there — people definitely want to contribute — but what's become very clear is that we need a process in place on the back end to handle incoming items. On the public safety front, for example, most of the issues that get reported by citizens will be dealt with by the locals, as opposed to the state. We need a mechanism for issues to be reported and tracked in a single interface but acted upon by the appropriate entity.

    This is much easier on the local side since all groups are theoretically on the same page. We are also building ad-hoc processes on the fly to handle responses to other crowdsourced inputs. For example, we recently asked citizens and businesses for ideas for regulatory reform in the state. In order to make sure these inputs were handled correctly, we created a manual, human-based process to filter the ideas and make sure the right people at the right agencies saw them. This worked well for this initiative, but it is obviously not scalable for implementation on a broad scale.

    The conclusion is that the desire and ability for people external to the government to contribute is not going to decrease, so if we are proactive on this issue and try to stay ahead of or with the curve, everyone — government, residents, and businesses — will benefit.

    What roles do data and analytics play in Maryland's governance processes and policy making?

    Bryan Sivak: They play huge roles. The governor [Martin O'Malley] is well known for his belief in data-driven decision making, which was the impetus behind the creation of CitiStat in Baltimore and StateStat in Maryland. We use dashboards to track nearly every initiative, and this data features prominently in almost every policy discussion. As an example, check out the Governor's Delivery Unit website, where we publish a good amount of analysis we use to track achievement of goals. We are now working on building a robust data warehouse that will not only enable us to provide a deeper level of analysis on the fly, and on both a preset and an ad-hoc basis, but also give us the added benefit of easily publishing raw data to the community at large.

    What have you learned through StateStat? How can you realize more value from it through automation?

    Bryan Sivak: The StateStat program is incredibly effective in terms of focusing agencies on a set of desired outcomes and rigorously tracking their progress. One of the big challenges, however, is data collection and analysis. Currently, most of the data is collected by hand and entered into Excel spreadsheets for analysis and distribution. This was a great mechanism to get the program up and running, but by building the data warehouse, we will be able to automate a great deal of the data collection and processing that is currently being done manually. We also hope that by connecting data sources directly to the warehouse, we'll be able to get a much more real-time view of the leading indicators and have dashboards that reflect the current moment, as opposed to historical data.

    This interview was edited and condensed. Photo by James Duncan Davidson.


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