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The Quantified Self and the Future of Medicine

I have a chest infection. I am sure of this without tests because I get one pretty much every year. I’m asthmatic, which makes me more susceptible to infections, and means that they tend to take hold. One year I was taken to hospital in an ambulance when the oxygen reaching my blood got very low. Not a situation I want to repeat.

This morning I called my GP for an emergency appointment to be told they were trialling a new system: triage by phone before handing out appointments. Ten minutes after I called, my GP called me back. This is pretty much our conversation, constructed from memory and edited only for brevity.

Doctor: “What seems to be the problem?”
Me: “I think I have a chest infection again. I’m coughing up some unpleasant day-glo stuff, and wheezing a lot at night and in the morning. It’s been going on for about two weeks and I’ve been doubling up my preventer and taking six to eight blasts of Ventolin each day. My peak flow isn’t down too far but I think that’s only a matter of time.”
Doctor: “Are you allergic to penicillin?”
Me: “No.”
Doctor: “OK. I’ll prescribe you five days of antibiotics. The script will be ready at the front desk.”
Me: “When can I pick it up?”
Doctor: “It’s there now.”

I’ve cut out a brief conversation about whether I needed an appointment and me requesting an extra inhaler but you get the idea. My (always excellent) GP dealt with my problem quickly, and kept me out of the surgery saving time and money.

This process is made easier by the fact that I present my GP with evidence when I say there’s something wrong. I keep a decent record of my inhaler usage and my peak flow. I’m also recording my physical activity at the moment and sometimes (when trying to lose weight) record my calorie intake and daily weight. If everyone could present their GP with this sort of data, we could probably save a lot of time. And money. And lives.

Imagine if there were a cut down version of the device on my wrist (an Oregon Scientific Dynamo) in each of my inhalers. Instead of supplying a new body with each inhaler as they currently do, you get one with your first prescription that contained a tiny low power Bluetooth chip. Every time you took a blast it would sync up to your phone and store the data locally or, if you were happy to share it, in the cloud where it could be accessed by your GP.

You could set flags on this data to take action even before a patient has called in. Much cheaper to intervene when a situation can be controlled than to see that patient land in A&E. For example, if it’s winter and my inhaler usage goes up by a certain percentage, it may be worth giving me a call or even dropping me an email or text, prompting me to call in if I feel unwell.

Whether you like the privacy implications of this or not, the chances are something like it will soon be a reality. The reasons are the simple economics that we hear about every day: we have a large, ageing population who are likely to live a long time and be very expensive to support. We need to do what we can to a) improve their quality of life and b) reduce the burden they place on the health and care services. Monitoring people’s health and intervening early when the outcomes will be best and the costs at their lowest will play a large part achieving this aim.

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Give Your Good Ideas Away

I’m a strong believer that when it comes to start-ups, ideas are cheap. Because the people with the gumption to turn the idea into something real are few and far between. I simply don’t believe a business idea on its own is worth very much.

That’s why I’m always sceptical when people ask me to sign an NDA before they’ll tell me their idea. What do they think I am I going to do with it? Find a team and build a business myself faster than they can? Sell the idea to the hungry crowd of waiting investors who will drop millions on the strength of a few words? Anyone who has witnessed the reality of getting a new start-up off the ground will know that the idea is a small part of the recipe for a successful business. Important, but in itself, inconsequential.

I wish this were not the case. Because I am full of ideas. If I could sell each good one (where I determine what is ‘good’) for a few quid I would be a wealthy man indeed. But sadly that is just not the way business works.

So instead I have decided to give my ideas away. They are yours, freely released under a Creative Commons Attribution licence. In other words: use them, mix and mash them up, make millions if you can. All I ask is that if you do, you give me the credit for being the originator.

Here are the first two, the second of which just came to me over lunch with a fellow (and soon to be very successful) entrepreneur. If they already exist, forgive me. I am not omniscient and it is too time consuming pretending to be so.

Social Seller App

There are lots of ways to sell online. From eBay, Gumtree and Craig’s List to Twitter, Facebook and Pinterest. Just like managing lots of social networks takes time, so does trying to list and sell items across these various networks.

Wouldn’t it be great it there was a Buffer-style app for listing goods across multiple social networks? One that handled the hosting of pics, the collection of payments (on those platforms where this was not integrated), communication with buyers, and the withdrawal of items from all networks once it had sold on one.

You could even use it to schedule items across different platforms to get maximum returns: e.g. “try auctioning this on eBay but if it doesn’t hit its reserve, withdraw it and put in on across these platforms at a fixed price.” Wouldn’t that be useful?

The app could make money through fees on transactions, advertising on the hosted image pages, and subscriptions for pro level users at a variety of tiers.

Personalised Shopping Mag

Discovery is ugly in eCommerce. It’s great when you know what you want, but there’s no good equivalent of the idle browse of a bookshop or record shop that leads you to unexpected purchases. I do get some geeky pleasure browsing cars or electronic components on eBay, but this is not the niche on which multi-billion dollar businesses are made.

Flipboard has made browsing social networks a much more pleasant experience by turning them into an interactive magazine. Couldn’t someone do the same for online shopping? Take feeds of people’s favourite sorts of item and package them up with pictures and reviews into a personalised shopping magazine/catalogue?

The business model — affiliate fees — is simple and probably lucrative. And the technology isn’t that complex, it just needs a good design job.

Come on someone: I want this product.

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Bionics 2.0: Peaches Geldof and the Fear of Google Glass

As I’m fond of saying, we are all bionic now. We have offloaded memory, navigation and other functions to our smartphones and cloud-connected devices. What wearable technologies really represent is the second wave of mass-adoption bionics. How we adapt and respond to this rapid advance is going to need some thought.

This morning I was up at the Beeb, talking about Peaches Geldof’s Twitter gaffe. It was striking that someone apparently bright and educated, who has worked in the media, can have the nous to acquire 160,000 followers but not to recognise when her Tweets might be illegal. And worse, that they might be damaging to the future lives of two innocent infants.

But I don’t necessarily lay all the blame at her door.

Digital social media is a new technology. We are still adapting our behaviours to its existence and learning our way around its flaws, laws and possibilities. Arguably we haven’t yet got to grips with email — also a social media by many definitions. Etiquette for this now-antiquated form of digital communication continues to evolve, driven in part by changing modes of access.

Every new media has had a challenging introduction. Read Tom Standage’s excellent ‘Writing on the Wall’ for the full story, but from the advent of the letter through the printing press, it has always taken time for societies and governments to catch up with the implications of new technologies.

Hence the fear generated by Google Glass and other coming wearables. It took Peaches Geldof seconds to tap out a series of law-breaching tweets. But at least she had to withdraw the phone from her pocket first and unlock it: a small window in which to consider her actions. Imagine what she could do with a camera strapped to her head and the ability to tweet a stream of consciousness straight from her lips.

I don’t think people are scared of the possibility that someone wearing their tech could be surreptitiously streaming pictures straight to the web. I think they’re scared of the fact that people will. It is going to take at least at least a decade after wearable tech becomes the norm before we get to a recognisable set of rules, defined enough for us to be able to say confidently what is acceptable and what is not. Codifying those rules into laws will likely take another decade.

If that sounds like a long time, bear in mind it is now a decade since the launch of MySpace and I’m still regularly asked to advise and instruct on the use of social media. Though Facebook is ubiquitous, Twitter and LinkedIn are used by fewer than a quarter of people in the UK. I see behaviour I think is odd on all three networks all the time, but rarely do I consider the incidents so clearly outside any accepted ‘rules’ as to upbraid the perpetrator. Others are either more confident or happier to sit in judgement, but the fact remains: we are still learning.

I was one of those people who happily rocked a Bluetooth headset back in the early noughties, until I realised (and others gleefully pointed out) that I looked like a dick. Unless you’re a secret service agent, you do not need to be in hands-free contact at all times. I will also sport any wearable tech I can get my hands on until we decide as a society what works and what doesn’t, what is cool and what isn’t, what is acceptable and what is beyond the pale. I will do so in the knowledge that it is a learning process and mistakes are part of that process. And while everything settles down, I won’t criticise others for their errors, as long as they don’t repeat them. Even if I think, as in the case of Peaches Geldof, they really should know better.

Tom Cheesewright