House Auction

Whipstick Office

I have gotten quite a few email and social media questions about why I auctioning my home. It starts back in 2001 when my wife and I designed the home with an architect, landscape architect, and home automation consultant. We wanted the new home to be beautiful but full of advanced infrastructure and technology. I said I would live there forever. Things change. The big change is with children. We are blessed to have four of them. They loved to visit the Whipstick house at holiday times. The pool table, kitchen, and 102-inch theatre got plenty of use. However, as the children got older, got married, and had children of their own, things changed. Some moved far away, and they did not visit as often. When children get married, they have in-laws. At holiday times, the children need to see both sets of grandparents. 

After being married 50 years, we are happy to live anywhere, but the big house became more than we needed. We decided to downsize to a Toll Brothers carriage house about 12 miles away. We are quite happy there. I miss the office, but was able to get the same cabinet maker to use the same South African ribbon mahogany to remodel a room in the carriage house to be my office. It is not as large, but it has the same ceiling coffers and features. I no longer need so many book shelves and file drawers, since all my documents are all digital. In fact in the new office, I have no file drawers.

Now the question is how to sell such a special home. As I told the Wall Street Journal, I like the auction model because it is action oriented. See quotations in the WSJ article. I learned about Platinum Luxury Auctions from a friend, I checked out their website, and visited a property they were auctioning not too far away. I liked their approach and professionalism. After signing up with them, I was quite impressed with the marketing program they launched last week. The producer came in with some amazing cameras and a high-end drone. See the video from the drone here. The website, video, and WSJ article are getting a lot of hits from all over the world. The showings began this week. A very professional business development manager will be at the house every day for three weeks from 12 to 5. 

Some say an auction is a risky approach to selling a home. I say relying completely on the traditional home selling method is also risky as the carrying costs mount. One is wait and see, the other is make something happen through an aggressive marketing program and professional handling of bidder interest. I will know if it was a good decision on July 28. I am optimistic. If you have a friend who is looking for a Ridgefield, Connecticut outpost, please share this with them.

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Falling in the Hospital

Hospital Bed

Most seniors fear falling more than disease. Hospitals fear falls also. Between 700,000 and 1 million patients fall in hospitals each year, according to the Agency for Healthcare Research and Quality.[i] Most patients who fall are not seriously injured, but the cost of one-third of falls resulting in a serious fall-related injury is more than $13,000, and the patient’s length of stay increases by an average of 6.27 days.[ii] In 2015, medical costs for falls in the U.S. totaled more than $50 billion.[iii]

Qventus, Inc., a Mountain View, California, technology startup is determined to reduce the number of falls in the hospital. The traditional method of prevention is to respond to a call button alarm. If you have spent any time in a hospital, you know the alarms are nearly continuous. It is impossible for the already busy nurses and aides to respond quickly to every alarm. Qventus is applying AI and machine learning to the problem.

The data used to build the software model includes call lights, bed alarms, electronic medical records, patient age, patient medications and when last administered, and the vitals last recorded by a nurse or aide. By applying machine learning technology to this assortment of data, the Qventus software can identify patterns. With enough historical data, the company believes it can accurately identify patients at high risk of a fall. The software would send a special alarm directly to an electronic badge worn by an appropriate nurse for quick response.

At one California hospital, use of the Qventus AI software has resulted in a 29% reduction in falls since 2014.[iv] Some large investors are believers in the Qventus vision, and have invested over $40 million in the company. The cash infusion will enable the company to expand significantly beyond the handful of hospitals it now has as customers.

[i] “Fall Prevention Toolkit Facilitates Customized Risk Assessment and Prevention Strategies, Reducing Inpatient Falls,”  AHRQ Agency for Healthcare Research and Quality (2018), https://innovations.ahrq.gov/profiles/fall-prevention-toolkit-facilitates-customized-risk-assessment-and-prevention-strategies?id=3094
[ii] Lola Butcher, “The No-Fall Zone,”  Hospitals & Health Networks (2013), https://www.hhnmag.com/articles/6404-Hospitals-work-to-prevent-patient-falls
[iii] Emma Ockerman, “AI Hospital Software Knows Who’s Going to Fall,”  Bloomberg Businessweek (2018), https://www.bloomberg.com/news/articles/2018-06-21/ai-programs-fight-medical-alarm-fatigue-with-patient-fall-alerts
[iv] Ibid.

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Regulation or Strangulation?

Internet Regulation

Regulation is needed in many areas, like banking and healthcare. Sometimes,  however, regulators get carried away, and strangle innovation with too much regulation. This almost happened with Bitcoin. The regulation we need I call light regulation. In 1995, I was Chairman of the Global Internet Project. The board and I traveled around the world meeting with government leaders and policy makers to convince them not to regulate the Internet. The Internet was an infant then, and we were concerned the growth and development of the Internet would be strangled with too much regulation. The U.S. Congress was clueless about the Internet (and still is as demonstrated by the incredible questions asked while Mark Zuckerberg testified). The Europeans, however, were aggressive and proposed a number of strong regulations. One was to impose a “bit tax” on all information which flowed through the Internet. A second was to ban the use of caching, which is what enables the Internet to perform well. Fortunately, both of these ideas went nowhere.

Brussels shifted its efforts to privacy. The result was The European Data Protection Regulation which went into effect on May 25th, 2018 in all member states to harmonize data privacy laws across Europe. It also applies to any company in the world which has European customers or users. This is why you have been seeing so many privacy policy pop ups and emails. Unlike how I felt in the mid-1990s, the time is right and the need is strong for privacy regulation of the Internet. The only question is whether the GDPR may be overkill. The 261 page beast has 11 chapters and 99 articles. Lawyers and consultants love it. I am cautiously optimistic it will be tolerable and helpful worldwide.

On a happy note, on Thursday, July 5, the European Parliament voted down the Copyright Directive, which had been approved by the EU’s Legal Affairs Committee. The goal behind the legislation was to change how copyright works on the Internet. There are many parts to it, but the two I was most concerned about are Article 11 and Article 13. With the strong pressure from media companies and publishers, it is possible the articles could be modified and voted on again.

Article 11 would have enforced strict checks on links within articles. For example, if I write a post about artificial cartilage and provide a link to an article at The Mayo Clinic, I would have been required to pay for a license to do so. Article 13 would have made publishers responsible for the content they post on their site, including comments posted by readers. So if you posted a comment about an article and included a picture of a link to another site which included copyrighted material, the publisher website would have been liable. This issue has been fought for decades.

Article 11 & 13 could have been a disaster for the Internet. Big publishers, media companies, and Internet giants have the resources to manage the regulations with big resources – but not so for small ones.. Although the regulation was European, millions of web sites of all sizes have European customers or readers (as I do). Small companies and thought leaders would not have been able to pay to provide links. The result could have been a global reduction in the sharing of ideas and innovation. Good ideas and thoughts do not all come from big organizations. One might argue to the contrary.  Without verifiable links, the regulation could have given rise to the spread of real fake news.

The really good news this week is members of the European Parliament agreed to allow internet voting. This will allow EU citizens to vote from non-EU countries and, presumably, allow expatriates in the U.S. or Asia to vote. In the U.S., we continue to disenfranchise 100 million potential voters because of our antiquated system, and a United States Senator sick at home cannot cast a vote in the Senate. Read more in Election Attitude – How Internet Voting Leads to a Stronger Democracy.

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The Stethoscope for Health Attitude

Stethoscope

AI will have a major impact in all industries and all aspects of our lives. However, one of the most profound may turn out to be in healthcare. Delivery of safe, high quality, affordable healthcare is a large challenge, but AI can provide assistance in many areas. For example, consider the ubiquitous stethoscope.

Connor Landsgraf, CEO of San Francisco startup Eko Devices, believes it is time to upgrade the stethoscope, which he pointed out has not changed since the 1880s.  He claims many physicians do not get adequate training on how to interpret the sounds they hear with a classic stethoscope. He says the result is “rampant misdiagnosis”. Eko has developed CORE, an FDA cleared complete electronic stethoscope with analog and digital capabilities which can amplify heart and lung sounds and reduce ambient noise.  CORE includes a computerized insert for stethoscopes which provides data from the stethoscope to a smartphone app. The app can record, visualize, and save all data with robust data management. The app offers live streaming and HIPAA-compliant sharing to make it easy to share your condition with your health team. In addition, you can sync with your EHR to help provide a more comprehensive picture of your overall well-being.

Adding AI to the digital stethoscope data could have a profound impact. Every time a practitioner listens to a patient’s chest or stomach, the sound is digitized and sent to the cloud. Over time there will be millions of sets of data. The data can be enhanced by adding what the confirmed diagnosis of the patient was. The reason diagnoses are not always accurate is because the listener may not have enough experience to recognize the diagnosis. With the application of neural networks and machine learning, both subsets of AI, the patient data can be compared to the millions of datasets and produce an accurate diagnosis. Physicians who make data-driven decisions will achieve improved patient outcomes. Learn more from Health Attitude.

La Sagrada Familia Correction

arithmetic

As I read and write about artificial intelligence, perhaps I should think a bit more about real intelligence — like arithmetic. Construction of La Sagrada Familia began in 1882 and is expected to be completed in 2026 or 2028. How could something take more than 140 years to build? (not 40 years as originally posted) If you get to go see it, you will understand. The highest part of the church will be 500 feet tall. The details on the facades are mind boggling. Barcelona was a great experience. You could easily spend weeks there seeing the incredible architectures of Gaudi, the parks, and an abundance of good food. See some of our Barcelona photos here.

Many thanks to my friend Charlie for catching the arithmetic error. Thanks to all for reading my weekly e-brief. Tell your friends about it, and encourage them to subscribe

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