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What can you find in one or two drops of blood?
From the New Yorker:
Elizabeth Holmes — who is thirty, is the C.E.O. of Theranos, a Silicon Valley company that is working to upend the lucrative business of blood testing — started Theranos in 2003, when she was nineteen; she dropped out of Stanford the following year. Since then, she told the [TEDMED] audience, the company has developed blood tests that can help detect dozens of medical conditions, from high cholesterol to cancer, based on a drop or two of blood drawn with a pinprick from your finger. Theranos is working to make its testing available to several hospital systems and is in advanced discussions with the Cleveland Clinic. It has also opened centers in forty-one Walgreens pharmacies, with plans to open thousands more. If you show the pharmacist your I.D., your insurance card, and a doctorâs note, you can have your blood drawn right there. (The sample is then sent to a Theranos lab.) From that one sample, Holmes said, several tests can be runâall less expensive than standard blood tests, sometimes as much as ninety per cent below the rates that Medicare sets. A typical lab test for cholesterol can cost fifty dollars or more; the Theranos test at Walgreens costs two dollars and ninety-nine cents.
Holmes faces a number of challenges as she pursues her vision for Theranos. One is logistical. Holmesâs brother, Christian, a Duke graduate and former management consultant who joined the company three years ago and is now the director of product management, says, âYouâve got to be able to scale this. If we canât, weâll get killed.â Another challenge is the competition. As miniaturization becomes the standard, researchers are finding ways to bring medical tests directly to patients. Many companies are exploring a range of tests that donât require needles, relying instead on lasers, oximetry, biosensors, and medical imaging, such as MRIs.
Holmes says she is acutely aware that technology could disrupt Theranos. âWe focus all the time on disrupting ourselves, and thatâs one of the core tenets in the way we operate,â she said. âSilicon Valley is a great symbol of disruptive technology being able to, one, change the world, and, two, obsolete itself.â
Rainy Roof Days
Sitting in front of this electronic typewriter, letting thoughts drift while rivulets of water create new courses, coarsely, around the small ridges of new architectural shingles on their way to the edge of the roof where nearly laminar waterfalls splatter, scatter, matter and mass rearranged randomly.
Today a pause, a reflection on two weeks (only two weeks?) in a new job, playing the part of the middle-of-the-road student, not the arrogant know-it-all of times past, letting the instructors repeat answers or look puzzled when questions out-of-the-blue are tossed out like hockey pucks at an osteogenesis imperfecta gathering.
How many industries does one get to know in a single lifetime?
How many different careers?
The healthcare industry is the oldest in existence. After all, until recent healthcare technological advances changed where, every one of us are born from a womb — as mammals, we care for the health of our newborn babies from birth.
Life itself is healthcare.
But terminology, whether Latin-based or spun out of native languages, changes from industry to industry.
Healthcare practitioners excel at jargon creation without exception.
So does the IT industry, the space exploration industry, food services industry, ad infinitum, ad nauseum, in museums, the advert business and living history.
Starting over as a two-year old in the second fifty years of life, stepping onto the bottom rung as a grunt in healthcare, one wonders about the future while memorising new words, phrases, policies and procedures.
Is a master’s degree in healthcare management or public health a viable investment in one’s future?
From whence shall the investment funds materialise?
Working for a nonprofit company, one finds funding for employee education is limited to OTJ (on the job) training, especially for hourly workers.
Shall one dip into one’s retirement savings?
Apply for financial aid? Scholarships?
Time to listen to the rain and relax.
The rhythm of the rain will reveal the melody of the universe that shows which path is worth taking for one’s good health.
Already, eight pounds (3.63 liters) have been lost in just two weeks while working at a job that requires a lot of standing and lifting.
The past two weeks have enlightened one’s spacetime horizon.
The future is bright!
Looking like my father, not quite thinking like him
After the third day on the job, what have I learned?
I remember when I taught for three semesters at ITT Tech, I quizzed students about their learning styles:
The students were often amazed at the discovery of what they suspected all along about themselves but could never quite articulate — they did not perform well on tests after studying the material the “wrong” way for their [primary] learning styles.
I am what is sometimes labeled an adult learner, meaning I have two or more high school student lifetimes accumulated in my thoughts as arranged in my set of perpetually-changing states of energy.
Perhaps I am wise. However, I claim no such designation for my thought set.
Instead, I have learned to listen to the sets of selves that morphed into me in this moment — the teenager, the college student, the young adult, the 30-something, the near middle-ager, the middle-ager and beyond.
I can observe the people around me and know they will have general age-related classifications of thoughts.
I can observe people, listen to their stories, and know their backgrounds lead to certain thought patterns.
From these observations, I know that retaining their attention which aids in my absorbing new material while applying the best learning style is easier as I get older.
As I mentioned to my wife at dinner tonight, in most of my adult jobs, I have mapped out the major job functions of my fellow employees, which was also part of my job at the time:
- in my early 20s I was a schedule analyst at GE, which meant I had to know not only the DoD specs of the U.S. Navy contract we were working on, but also what the employees of every department were doing to meet deliverable dates;
- in my 30s I was a data analyst and internal ISO 9000 auditor for ADS Environmental Services, which meant I not only had to know how our sewer flow monitoring equipment worked but also the functions of every department in the company;
- in my 40s I was the coordinator of the engineering level technical support for Avocent Corporation, which meant I had to know how to quickly resolve customer problems by coordinating the activities of the Marketing, Engineering and Manufacturing departments (often with approval from upper management) to get product changes turned around in time to meet customer demands.
In my new job, I find myself proactively encouraged to know all about the whole company because we are one big team which depends on every employee to meet or exceed customer expectations.
To increase this knowledge I have applied various learning styles including everything but music in the graphic above.
There’s nothing like working for a company that wants its employees to take teamwork to heart.
Especially one that would host a holiday party for a whole division of the company as an end-of-year thank you and relaxing get-together.
Having sat at home, worked in the yard or enjoyed the great outdoors mainly by myself for the last seven years (spending many hours each day in the company of two cats), I had forgotten the joys and sorrows of office camaraderie, where working together also means talking about personality fits and conflicts on a daily basis.
At my age, talking about the strengths and weaknesses of fellow employees is not as important as acting upon their strengths to improve the company and figuring out ways to turn [perceived] weaknesses into bonus strengths to make the company better in ways not yet conceived.
There is no such thing as the perfect human or a person who is the perfect fit for a job.
We constantly change.
As a new employee of a nonprofit, lean, just-in-time /manufacturer in the healthcare business, my only focus is how to save more lives with the people, budget and resources we have on-hand through the job skills I am acquiring.
The six rules of business I learned from Neutron Jack at GE in the 1980s still work today:
1) Control your own destiny or someone else will.
2) Face reality as it is, not as it was or as you wish it were.
3) Be candid with everyone.
4) Donât manage, lead.
5) Change before you have to.
6) If you donât have a competitive advantage, donât compete.
Jack’s not the only one with good advice. Warren Buffett has a word or two to add about this matter:
1. Keep calm in the face of volatility. Buffett writes that earnings gyrations “don’t bother us in the least.” After all, “Charlie and I would much rather earn a lumpy 15 percent over time than a smooth 12 percent.”
2. Keep good company. Berkshire has never split its Class A shares. As a result, one share currently costs almost $214,000. That discouraged people from rapidly moving into and out of the stock, and that’s exactly the way Buffett likes it. He wants shareholders who share his long-term view. All the way back in 1979, he wrote, “In large part, companies obtain the shareholder constituency that they seek and deserve. If they focus their thinking and communications on short-term results or short-term stock market consequences, they will, in large part, attract shareholders who focus on the same factors.”
3. Keep your focus. In that same letter, Buffett warns that even a great company can see its “value stagnate in the presence of hubris or of boredom that caused the attention of managers to wander.” The result: a “sidetracked” leadership that “neglects its wonderful base business while purchasing other businesses that are so-so or worse.” In this area, Buffett argues that “inactivity strikes us as intelligent behavior.” In 1982, a year that saw a number of corporate deals, Buffett thought that in many of them, “managerial intellect wilted in competition with managerial adrenaline. The thrill of the chase blinded the pursuers to the consequences of the catch.”
4. Keep costs low. In his 1996 letter, Buffett wrote that being a “low-cost operator” is directly responsible for the success of Berkshire’s GEICO auto insurance subsidiary. “Low costs permit low prices, and low prices attract and retain good policyholders.” And when those customers recommend GEICO to their friends, the company gets an “enormous savings in acquisition expenses, and that makes our costs still lower.”
5. Keep employee incentives simple. Buffett doesn’t like what he calls “lottery ticket” arrangements, such as stock options, in which the ultimate value could range from “zero to huge” and is “totally out of the control of the person whose behavior we would like to affect.” Instead, goals should be “tailored to the economics” of the business, simple and measurable, and “directly related to the daily activities of plan participants.”
6. Keep out of trouble. Buffett tries to “reverse engineer” the future at Berkshire. “If we can’t tolerate a possible consequence, remote though it may be, we steer clear of planting its seeds.” (Buffett notes that his partner Charlie Munger often says, “All I want to know is where I’m going to die so I’ll never go there.”)
7. Keep your undervalued stock to yourself. Buffett is especially critical of a company using its stock to make a purchase when that stock isn’t being fully valued by the market. “Under such circumstances, a marvelous business purchased at a fair sales price becomes a terrible buy. For gold valued as gold cannot be purchased intelligently through the utilitization of goldâor even silverâvalued as lead.”
8. Keep it small. In 2006, Buffett wrote that he’s skeptical “about the ability of big entities of any type to function well.” In his opinion, “size seems to make many organizations slow-thinking, resistant to change and smug.” That’s one reason Berkshire’s corporate headquarters still has only a handful of employees, with almost all the managing work left to its unit’s managers. “It is a real pleasure to work with managers who enjoy coming to work each morning and, once there, instinctively and unerringly think like owners.”
9. Keep your reputation. In Buffett’s mind, perhaps the most important piece of advice for businesses, and for everyone else, is to maintain a sterling reputation for honesty by never doing something you wouldn’t want to see reported on the front page of your local newspaper. After taking control of Salomon in the wake of a major 1991 scandal at the financial firm, he famously told a Congressional panel that he had a simple message for employees: “Lose money for the firm and I will be understanding; lose a shred of reputation for the firm and I will be ruthless.”
As he put it in one of his most-often quoted sayings: “It takes 20 years to build a reputation and five minutes to ruin it. If you think about that, you’ll do things differently.”
Also:
Here are some of Warren Buffett’s money-making secrets — and how they could work for you.
1. Reinvest Your Profits: When you first make money in the stock market, you may be tempted to spend it. Don’t. Instead, reinvest the profits. Warren Buffett learned this early on. In high school, he and a pal bought a pinball machine to put in a barbershop. With the money they earned, they bought more machines until they had eight in different shops. When the friends sold the venture, Warren Buffett used the proceeds to buy stocks and to start another small business. By age 26, he’d amassed $174,000 — or $1.4 million in today’s money. Even a small sum can turn into great wealth.
2. Be Willing To Be Different: Don’t base your decisions upon what everyone is saying or doing. When Warren Buffett began managing money in 1956 with $100,000 cobbled together from a handful of investors, he was dubbed an oddball. He worked in Omaha, not Wall Street, and he refused to tell his parents where he was putting their money. People predicted that he’d fail, but when he closed his partnership 14 years later, it was worth more than $100 million. Instead of following the crowd, he looked for undervalued investments and ended up vastly beating the market average every single year. To Warren Buffett, the average is just that — what everybody else is doing. to be above average, you need to measure yourself by what he calls the Inner Scorecard, judging yourself by your own standards and not the world’s.
3. Never Suck Your Thumb: Gather in advance any information you need to make a decision, and ask a friend or relative to make sure that you stick to a deadline. Warren Buffett prides himself on swiftly making up his mind and acting on it. He calls any unnecessary sitting and thinking “thumb sucking.” When people offer him a business or an investment, he says, “I won’t talk unless they bring me a price.” He gives them an answer on the spot.
4. Spell Out The Deal Before You Start: Your bargaining leverage is always greatest before you begin a job — that’s when you have something to offer that the other party wants. Warren Buffett learned this lesson the hard way as a kid, when his grandfather Ernest hired him and a friend to dig out the family grocery store after a blizzard. The boys spent five hours shoveling until they could barely straighten their frozen hands. Afterward, his grandfather gave the pair less than 90 cents to split. Warren Buffett was horrified that he performed such backbreaking work only to earn pennies an hour. Always nail down the specifics of a deal in advance — even with your friends and relatives.
5. Watch Small Expenses: Warren Buffett invests in businesses run by managers who obsess over the tiniest costs. He one acquired a company whose owner counted the sheets in rolls of 500-sheet toilet paper to see if he was being cheated (he was). He also admired a friend who painted only on the side of his office building that faced the road. Exercising vigilance over every expense can make your profits — and your paycheck — go much further.
6. Limit What You Borrow: Living on credit cards and loans won’t make you rich. Warren Buffett has never borrowed a significant amount — not to invest, not for a mortgage. He has gotten many heart-rendering letters from people who thought their borrowing was manageable but became overwhelmed by debt. His advice: Negotiate with creditors to pay what you can. Then, when you’re debt-free, work on saving some money that you can use to invest.
7. Be Persistent: With tenacity and ingenuity, you can win against a more established competitor. Warren Buffett acquired the Nebraska Furniture Mart in 1983 because he liked the way its founder, Rose Blumkin, did business. A Russian immigrant, she built the mart from a pawnshop into the largest furniture store in North America. Her strategy was to undersell the big shots, and she was a merciless negotiator. To Warren Buffett, Rose embodied the unwavering courage that makes a winner out of an underdog.
8. Know When To Quit: Once, when Warren Buffett was a teen, he went to the racetrack. He bet on a race and lost. To recoup his funds, he bet on another race. He lost again, leaving him with close to nothing. He felt sick — he had squandered nearly a week’s earnings. Warren Buffett never repeated that mistake. Know when to walk away from a loss, and don’t let anxiety fool you into trying again.
9. Assess The Risk: In 1995, the employer of Warren Buffett’s son, Howie, was accused by the FBI of price-fixing. Warren Buffett advised Howie to imagine the worst-and-bast-case scenarios if he stayed with the company. His son quickly realized that the risks of staying far outweighed any potential gains, and he quit the next day. Asking yourself “and then what?” can help you see all of the possible consequences when you’re struggling to make a decision — and can guide you to the smartest choice.
10. Know What Success Really Means: Despite his wealth, Warren Buffett does not measure success by dollars. In 2006, he pledged to give away almost his entire fortune to charities, primarily the Bill and Melinda Gates Foundation. He’s adamant about not funding monuments to himself — no Warren Buffett buildings or halls. “I know people who have a lot of money,” he says, “and they get testimonial dinners and hospital wings named after them. But the truth is that nobody in the world loves them. When you get to my age, you’ll measure your success in life by how many of the people you want to have love you, actually do love you. That’s the ultimate test of how you’ve lived your life.”
= = = = =
Now that we’re millionaires on paper, as they say, my wife and I know that our wealth and success is in our happiness, not in our possessions or social status. I am happy blogging here in the cool air of the sunroom and my wife is happy relaxing with our cat under the fleece blanket on her lap in front of the tellie on a cold November evening. Affluence is relative. We are satisfied that we can afford to replace our 20-year old three-tab shingles with new “architectural” asphalt shingles before we have to pay more to repair our house from broken roof water leaks, knowing a lot of people can’t afford a home of their own or don’t live in an area secure enough to own a piece of land without large fences or border guards to protect them from intruders.
I looked in the bathroom mirror on my third day at work and saw my middle-aged father. Not something I desired when I was younger but something I am learning to accept as part of the privilege of living into my middle age years. In other words, “face reality as it is, not as it was or as you wish it were.”
What’s a’peeling?
Peel away the layers of an onion to find out what causes your eyes to burn.
We uncover mysteries to discover new ones, all the time, every day.
Congrats to Dr. Emil Jovanov, named Alabama Launchpad’s Inventor of the Year!
Great news:
UAH professor, Dr. Emil Jovanov, who created smart pill bottle named Alabama Launchpad’s Inventor of the Year
A LOOK BACK:
13 Sept 2013 Dr Emil Jovanov. UAH alumni lunch ‘n’ learn. Opening by David Kingsbury, UAH Alumni president, welcome and intro of guest speaker:
BIO: Dr. Emil Jovanov, received bachelor and doctorate from Univ of Belgrade. http://www.ece.uah.edu/~jovanov; emil.jovanov@.edu
Dr. Jovanov teaches and supports realtime and embedded systems, wearable and ubiquitous monitoring, senior student design: education and playground, technology commercialization, new products and businesses such as SmartBottleâŚAdhereTech (http://www.adheretech.com)
Ubiquitous Health Monitoring â wireless body area network [WBAN] (2005) Journal of NeuroEngineering and Rehabilitation
WBAN via Zigbee connects to personal server (smartphone) integrates via GPRS/Bluetooth/WLAN with Internet for access to/by weather forecast, emergency, caregiver, medical server and physician
diabetics monitor blood sugar level, doctor can see if you walked as much as you said, when you ate, etc.; ECG
mHealth â http://portal.mhealth.uah.edu/public/index.php
â stress monitoring for nurses, etc.
WBAN includes SmartBottle approach:
in 1994, est. that $100B cost to economy for taking medicine incorrectly; $300B increased costs, $100B lost revenue
MDs/pharmacists need accurate monitoring method; patients need secure system.
â typical use: pill boxes donât account for âTake on full/empty stomachâ
â automated pill boxes based on time
â RFIDs â acid in stomach will activate chip in pill; smartphone will record info; expensive approach, good for specialised drugs
Great potential for smart pill bottle
â Robert Gold, R. Ph, MBA, Newburgh, Indiana
â Prototype development, senior design team:
=> Sreca Jovanov -HW and Sensor Dev
=> Charles Acker â Embedded and PC SW
=> Michael King â Embedded SW
UAH Patent; MBA Graduate project at Wharton School of Business
Completely wireless system; communication between SmartBottle, Reminder Unit, Home Server, and Remote Server; automated reminders and monitoring of medication
Approaches: initial idea â weight measurement but mechanical issues were potentially problematic; breakthrough â capacitive measurement of pills in bottle C=A*e/d (conductive plates (A) sandwiching dielectric medium (d)); measuring capacitive response of empty bottle; smart bottle prototype in spring 2007, connected CVS bottle with unit including wireless module â proof of concept worked â good linear plot of data with 2-3% error (e.g., 2 to 3 pills out of 100); US Patent issued in 2011; SmartBottle Development 2012 update: Test system, AD7745 capacitance to digital converter, accuracy: +/- 4 fF (femtofarads (10 to minus 15th power)); evaluation of patterns and designs â have to compromise total capacitance against accuracy of pill measurement
AdhereTech â winner of 2013 Healthcare Innovation World Cup
Readerâs Digest, September 2013, one of 20 MindBlowing Medical Breakthroughs, technology should be available by September of 2014
Wireless in the bottle (Verizon); measures and send open/close of bottle; 45 day battery = no charge
Nontech savvy â use bottle as regular bottle
Tech savvy â text/email reminder, etc.
Helps monitor: Forgetfulness; purposely omitted pill taking; low priority conduct
Pharma: captures percentage of increased revenues, especially for clinical trials of extremely-expensive medication
Hospitals: used to make money on readmissions but no more â want to reduce readmissions; hospitals penalised 1% CMS payments for readmissions (`$14000/year) with higher penalties in following years; poor adherence to drug plan is most common reason patients are readmitted. CHF: 25% readmission rate; heart attack: 20% readmission rate; pneumonia:18% readmission rate; more diseased states penalized every year
Provides aggregate adherence data for healthcare pros; personal data for patients
Examples of Secured deals: Walter Reed Natl Military Med Ctr; Weill Cornell Medical College; Univ of Michigan
Competitors: Vitality GlowCaps; Proteus Digital Health; plain/automated Pill boxes; Adherence smartphone/tablet apps
Pilot clinical trials start in 2014
Benefits include passive intrusion, no change to current pill usersâ behaviour.
Strong IP, team, business models and traction in media!
==> info@AdhereTech.com: Featured in WSJ, TIME, WIRED, TEDMED, Fast Company, TechCrunch, MEDCITY, the Atlantic, StartUpHealth, Blueprint Health, GIGAOM, Xconomy
Sent from my iPad
Free to be Me 