Category Archives: Networks and Systems

Jeff Bezos is the anti-unbundler or, can the founder of Amazon make us eat our greens?

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All opinions are may own and do not necessarily reflect those of Novo Nordisk.

h/t to @Frank_S_David for tweeting the link.

People have wondered and speculated and analyzed why exactly Jeff Bezos decided to buy the Washington Post.  Late last week Timothy B. Lee of the Washington Post offered some clues.  He reported how Bezos, in remarks to the Post staff, described wanting to get back to “that glorious bundle that the paper did so well.”  What Bezos wants is to find a way to make the Post such a destination that people will choose to visit regularly and not just read individual articles but stay and scan through many, presumably in one sitting, as people used to do as their morning ritual.

Timothy Lee is skeptical and I’ll just briefly summarize his points and urge you to go read his great article for the details.  Lee points out that news distribution has become unbundled due to the influence of the internet.  (For some nice posts on the concept of unbundling see this one by Leigh Drogan and this one by Frank David).  People consume news in individual article-sized chunks, often following links provided by friends and colleagues and search engines, without much loyalty to specific outlets or writers.  Lee also points out that while the Post has excellent writers, they’re still a miniscule fraction of the writers on the internet and most of the best writers are not on the Post’s staff.  Lee uses this as a launching point to talk about the increasingly important skillset of attracting clicks, largely through evocative headlines.  You know, like the one I tried to write for this post.  Did it work?

Jeff Bezos’ ambition is quite interesting on a couple of different levels.  The first is the basic question of why Bezos thinks he can do this?

The answer, I believe, is that he already succeeded once.

Continue reading →

Hanging with the herd, for the immunity of it all

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All opinions are my own and do not necessarily reflect those of Novo Nordisk.

When I hear about events such as the recent outbreak of measles among a small group in Texas, I am reminded of how complex, complicated and difficult public health efforts can be. In the US, for example, there are conflicting imperatives:  the rights of people to practice their beliefs versus the right of the community to be protected against preventable health threats.  This particular situation involved members of a church congregation, many of whom had not gotten vaccinated for measles due to worries about a link between autism and the Measles-Mumps-Rubella (MMR) vaccine.  While no scientific evidence has been found to support any such link, many had chosen not to be vaccinated “just in case.”

One day I hope to write about the link between the phenomenon of science denial and personal identity (one perspective can be seen here), but for now I just want to point out how this event and a recent publication by the Centers for Disease Control (CDC) on rotavirus vaccines demonstrate nicely the concept of herd immunity (article behind paywall, but writeup here).  There are different usage patterns for the term, so I’ll say up front I am using “herd immunity” to describe not just the proportion of individuals within a population who are immunized to a given pathogen but also the indirect effects for non-immunized individuals.  The term was first used in a publication in 1923, by Topley and Wilson, in the context of how to describe the host side of their studies in bacterial infection among mice.  The concept later gained mathematical underpinnings, including formulas describing how the different ratios of vaccinated to nonvaccinated individuals defines the degree of herd immunity depending upon how infectious a disease agent is. Continue reading →

The “good,” the “difficult” and the “reality”: patients in the digital age

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All opinions are my own and do not necessarily reflect those of Novo Nordisk.

With apologies to Sergio Leone.  And to you, for making you read that really bad pun.  Just move along.

In an engaging and thought-provoking perspective piece in the New England Journal of Medicine, Dr. Louise Aronson described her experience in getting treatment for her father, who was suffering from low blood pressure and other health issues.  Her father was admitted to the hospital and went through examinations and fluctuations in his health during his stay.  He seemed to stabilize but then his blood pressure dropped again and Dr. Aronson asked for someone to come and check on him.  The staff was polite but non-committal and she decided to perform an exam on him herself to check if he had internal bleeding.  He did, she obtained evidence, and her father received rapid care to prevent further blood loss. 

She relayed this story in the context of how health care providers often bin patients and their support networks into “good” and “difficult” categories, based on how much and how often those patients acquiesce rather than challenge or even seek information about ongoing treatments.  As she describes it, the staff “were polite, but their unspoken message was that they were working hard, my father wasn’t their only patient, and they had appropriately prioritized their tasks. ” Her message was that the medical profession needs a cultural shift,in which patients and their families whom are more actively engaged in their care are seen as an asset, not a detriment to medical practice.  She also suggested some practical elements that would help this, including tracking more clearly when patient engagement occurs and rewarding it through changes in billing codes and practices. Continue reading →

Internet access is a public (and private) health issue

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All opinions are my own and do not necessarily reflect those of Novo Nordisk.

If the Founding Fathers had lived today, they would surely have included internet access as one of our inalienable rights.  No, scratch that, because if they had lived today they would have used Google Docs to crowdsource the Declaration and the result would probably have been much more generic and middle of the road than it actually is.  Also, the Declaration would also have been limited it to about 500 words so readers wouldn’t get bored and surf somewhere else, and it would have had embedded GIFs. Preferably animated.

Still, the ability to access the internet and everything that comes with that is, if not a right, an incredible advantage.  So I was stunned when I read in the Seattle Times the other day that a significant fraction of people in the US–about twenty percent–have little to no internet connection, although those numbers have recently begun to creep up, presumably due to smartphone uptake.   But of course, being a good Seattlelite with a liberal bent, my next reaction was to say, well, let’s not rush to judgement or conclusions.  Maybe those people just don’t want the internet.  Not that there’s anything wrong with that…

Except the article goes on to say that while seniors generally did not feel they were missing anything, the majority of other respondents did feel they were missing something important and were being left behind because of their limited access.  So it’s not a life decision; it’s a question of cost, access and education. Continue reading →

Enter citizen science

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All opinions my own and do not necessarily reflect those of Novo Nordisk.

h/t to @engagedethics for the heads up.

What do you think of when you think of citizen science?  Maybe dads buying Geek Dad and helping their kids build Lego robots that can manipulate a lego binary clock.  Maybe people tracking their health, thoughts, bodies, or other things in a really granular way in an effort to get at their quantified self.  Maybe hobbyists building and flying drones to sample atmospheric particle levels or track neighborhood traffic patterns.  Maybe patients groups banding together and funding research into cures, like the Cystic Fibrosis Foundation did with Kalydeco.  Maybe birdwatchers helping researchers track the migration patterns and populations of North American birds.  Maybe it’s something else, something you know about or have heard about or are planning to do right now.  Choose any or all of the above and you’re completely right.

Because citizen science, like a lot of movements these days, isn’t something legislated or codified or directed from on high. It’s something organic and crowd-based and bottom up, and it’s going on everywhere.

This is the world that’s being enabled by technology.  Whether it’s 3D printing, DIY Bio, computer modeling, personal monitoring or other kinds of tools, the barriers to experimentation are falling rapidly, and interest in figuring stuff out is on the rise.

The Citizens Science Association has been working on ways to support this new way of doing science.  They’ve been convening groups to look at topics like Governance, Conferences, ways to publish, and ways to communicate via other means.  There will be a webinar on September 17th to report on progress and it sounds like a worthwhile thing to listen to.  I haven’t been involved in the Association, but I’m planning to listen in.  Because technology keeps lowering the barriers to entry, and I’m really excited to see what comes out.