thinkingstring.com

Originally posted in computing.com

Though their lineage dates back to before World War II, ATMs in their modern form appeared widely on the high street in 1973. Since then they have bred like rabbits and spawned numerous cousins in the form of automated ticket dispensing machines and point-of-sale devices. They have also arguably created the payment services backbone that has enabled the “cardholder not present” transaction capability that is internet payment services.

Along the way ATMs have also fundamentally altered the relationship customers have with their banks. Gone are the days of queuing at inconvenient times in actual banks and dealing with real tellers, bank managers and advisors. All replaced with anytime, anywhere banking, in whatever currency of whichever country you’re standing in. Meanwhile branches have closed, and while almost everyone appreciates the convenience, there are many who rue the dehumanising of the bank/customer relationship.

All of this is worth keeping in mind as the NHS, and its international health care counterparts, dabbles increasingly in technology-enabled remote diagnosis and treatment of patients. The efforts of the NHS’ Aberdeen TeleHealth initiative, based in no small part on Cisco’s telepresence technology, have yielded some impressive results.

The NHS trials used high-definition telepresence communications, enhanced with customised cameras, scanners and a wide variety of other electronic diagnostic tools. The patient, normally assisted by a relatively unskilled helper (who may have no more than rudimentary first-aid skills), can be subject to an array of tests as well as being interviewed by the remotely located GP or specialist.

The healthcare service has field tested such diagnostic services in the remote wilds of Northern Scotland, out to the remote North Sea oil drilling platforms and with the communities on the Orkney and Shetland islands. Such communities are remote, sparsely populated, and suffer from a lack of dedicated and local health professionals. If enough trained personnel were to be supplied, they would be underworked - but horrendously expensive to maintain and manage.

The NHS trials have delivered impressive results, with the service reporting that diagnostic accuracy is on a par with in-person capability. While the telepresence approach requires availability of relatively high network bandwidth between the patient location and the remote healthcare professional, as well as a not-insignificant capital cost in technology, it is cost effective compared to providing comparable healthcare to remote communities via traditional means. Telepresence-based medicine makes it possible to more accurately and more rapidly diagnose a patient compared to the service that could be provided by way of the irregular in-person approach that such remote communities have historically suffered.

Such benefits are substantial, and it is clear that remote diagnostics provide important potential benefits in terms of service and cost. That said, it is also critical to remember that effective healthcare ought to be more than just treating patients as “units” to be pumped through an increasingly automated health service factory. Arguably, telepresence-based health services are another step down the path of dehumanising healthcare and turning it into an assembly line for the dispensing of treatments that address mainly the symptoms, and rarely proactively address the causes. The provision of telemedicine to a remote community that previously had no service is better than nothing, but is it the best we can do as a society?

The old bedside manner has to become the new telepresence-side manner. If some of the more mundane reviews and check-ups can be automated out of the health system - such as repeat prescriptions, blood pressure tests and anything else that can be made self service through web interface or remote monitoring - then more time should be freed up for the medical professional to spend in real consultation with the patient. This can then help with preventative treatment, so minimising reactive treatments, and again freeing up more time.

Therefore, technology used correctly can create a virtuous circle - whereas used wrongly can be counterproductive. Let’s ensure that the healthcare beancounters don’t ruin it - and that healthcare professionals can get back to caring more about their patients, and focusing less on the profitability of the service.

Many people would complain already that they are treated as walking wallets rather than individuals by GPs, as they are herded through community clinics in 10-minute appointment increments. We need to be careful as we take this path that we do not end with unintended consequences whereby there is some added convenience to some, at the expense of degraded and dehumanised services to everyone.

Originally posted at http://quocirca.computing.co.uk/

Fog high above London. Boardroom type table Orbited by a dozen or so suited individuals to which any of the following might apply, but all would be modestly denied…clever, thoughtful, experienced, connected, influential, knowledgeable,passionate, engaged. And I got to be there too. The scene is important I think as a form of context for understanding the fascinating nature of the conversation around the table.

Suited business professionals and members of the industry analyst community (some whom scrub up OK too) engaging in a passionate and informed discussion regarding the need to consider the re-engineering of the long established and pervasive capitalist system. Specifically, to examine how we can recognise and reward the value associated with a steady state economic (and business) model, as opposed to only rewarding a constant growth model as we have for the last 500 years or so.

The serious proposal being that the current systemic economic crisis and associated recessions are an opportunity to start on a new direction, especially given the nexus of the economy, climate change and looming petroleum supply shortages.The conversations themselves are fascinating to listen to, and a privilege to have the opportunity to engage with. What is truly interesting however is the type of people having them, and what that signals as far as the debate on climate change has come.

Valuing a mature sustained state economic model will highlight the value of efficiencies in the service delivery production chain. Currently efficiiencies are only lightly rewarded, at best second to margin growth derived through territory expansion. The correct valuation of efficiency gains would be enabled to no small degree by including the currently externalised economic, social and ecological costs associated with an activity into the financial balance sheet where it all belongs.

Those still debating whether climate change exists, or pointing to sunspots as the cause have unfortunately been left behind in the debate. It is critical to remember that that group is large in size (arguably the majority) , and non optional as far as the need to include them as we further engage, educate and encourage appropriate action around climate change.

Who said what around the table shall remain unattributed for now, but it was all good and thank you everyone.

Thank you and kudos to BT for organising the event, inviting us all along, and having the maturity to encourage unbridled discussion.

More.

Please.

Dear Mr. Branson,
I am writing to you in the hope that you will actually put some serious business effort toward being environmentally friendly. No, I am not talking about the use of biofuels in the Virgin Atlantic fleet. I am sure that you know what I, and numerous leading environmentalists know; biofuels are not an ecologically sound nor sustainable replacement for petro-based aeroplane fuels. Even with oil priced above $130 a barrel, amidst calls for the UK government to scrap the £10,000,000,000 a year subsidy they currently provide to the airline industry, you still can’t seriously think biofuels are the answer.

I am sure that you know as well as I do that there isn’t enough arable land in the world to feed the fueltanks of the world’s current aeroplane fleet, while leaving any land left for food production or forests to act as carbon sinks. What, I ask myself, would you feed all those Virgin Upper Class passengers once all the land has been turned over to fuel production? That biofuel flight was, permit me to suggest, a marketing stunt that permitted a little green washing of the red Virgin brand. No, the maths and the science don’t add up, and I don’t believe you can get to be the head of a brand like Virgin without enough intelligence to crunch the numbers and come up with the same conclusion; biofuels are not the answer.

But I also believe that you do recognise the reality of, and danger inherent in climate change. After all, you did pledge £1,600,000,000 to help fund action. There you were, standing smiling with Al G and Bill (you remember - the other Clinton) promising to put all the profits from Virgin’s air and train operations for the next ten years toward reducing reliance on petroleum. So we agree that there is a need, and we both share a will. It just seems that we don’t share an understanding of the way. Two out of three is surely enough for you to consider my suggestion.

Mr. Branson, let me lay it out. I’ll say it quietly so as to not scare the Virgin Airline shareholders: we need to drastically reduce the number of flights. Not fuel them with algae or babassu trees; don’t fly them at all. So here’s my suggestion; how about putting some of that £1.6 billion toward establishing a world wide network of business executive meeting suites, interconnected with state of the art high-definition video conferencing capability.

You know better than I that there are basically two classes of traveller; the holiday maker and the business person. In one move you could take all those business travellers out of the skies and enable them to conduct their meetings online. Lets face it, business travel isn’t really even any fun any more, what with all that hassle of stripping down to the silk socks; no Perrier passed security; lost baggage and hassle. Not to mention the lost productivity, what with not even being allowed to Blackberry in the air.

How much more preferable it would be to book meeting time in an executive suite, in my own city, and to avoid all the hassle of flying. How much more productive to be able to avoid all the time wasted checking in, traveling whilst having to be “off the grid”, and then having to deal with hotels and all that at my destination. And how much more profitable for the Virgin group of companies? Think of all the cross sell opportunities that present themselves. The basic service comprising two suites in two cities (for say, half a day) could be priced just under the price of a business ticket. Meanwhile, business people could travel to and from the city centre in a Virgin train, while staying online using Virgin broadband. Of course people will expect the same excellent class of service they currently enjoy on Virgin Atlantic. Those massages in Upper Class really are a nice touch; but just think how much cheaper it must be to employ a professional masseuse if you don’t have to train and pay them as a flight attendant too.

Of course this isn’t a new idea; lots of companies are talking about the power of video conferencing. But I do believe that the Virgin brand of companies is in a uniquely powerful position. Unlike your competitors in the air travel business (say, like BA) “Virgin” isn’t really an airline; its a brand umbrella. It is already diversified into a whole range of areas that complement each other. Meanwhile, unlike teleconferencing technology companies like Cisco, Virgin is already synonymous with business (and holiday maker) travel. Doing business is really all about communicating, while the travelling is just an enabler for that communication. “Virgin Business Telesuite” does have a certain ring to it; don’t you think?

So how about it Mr. Branson? How about a little innovative thinking toward climate change? Biofuels? You wouldn’t last five minutes with Alan Sugar with that one. Thanks for your time and all the best.

Regards,
Simon Perry
Sustainalyst
ThinkingString

PS. If you need some help with the business plan I have some time next week.