Breaking free of activity monitors: affective wearables, digital pheromones, and emotional mapping

taptapChristine Lemke posted a collection of links to wrist gadgets, which triggered a conversation between us on Twitter.

The list had your usual (yawn) suspects, such as FitBit, Jawbone, Basis, and Misfit. It also had the sports players such as Adidas, Reebok (also part of Adidas), Garmin, and Nike (all of these companies, I claim, have been in this wearable business longer than the current darlings in the previous sentence).

But two devices stuck out – Bond and TapTap.

Touch me
I am kinda tired of all these activity sensors that measure activity, sweat, location, acceleration, and so forth. Activity measurement is only scraping the surface. There are so many other ways sensors can enrich our awareness of our surroundings, ourselves, and our social networks.

When I was at Nokia, I was surrounded by these really smart interaction designers. We used to think of all the ways mobile and the internet could come together to enrich our lives (we use to ask “How does our second life [the digital life] enrich our first life [our physical, face-to-face life]).

Ambient and affective
One interesting area for us in those days was about tactile connection at a distance. Hence the two touch devices in Christine’s list are worth noting. They buck the pattern of traditional activity monitors. As Christine says, “Those [tactile connection devices] will likely be far more compelling applications to consumers.”

Christine brought up the Nabaztag, a curious bunny-looking device that could respond in some set ways (glow, move ears, make a noise) based on any digital input. Such “ambient computing” devices could be used to display activity inputs from another person. What happens now when wrist gadgets help us keep ambient awareness of other machines or people?

Achivemint, an activity tracking platform Christine co-founded, uses behavioural analysis to “nudge” folks to better activity choices, better health.

How might such affective wearables*, that tap into more than just activity, enhance Achivemint nudges? How do we go beyond the simple activity trackers to understand patterns of social connections, emotions, empathy? How does this action at a distance bring us closer to one another?

What’s the question?
Folks are chasing the activity sensors because they’re easy – cheap sensors, market awareness, simple algorithms. These gadgets are answering the question of “How active are you?”. And they’re trying to base all our analyses on that.

But the real question is when you step back and ask, “What can we do with sensors and connected devices that can enhance our lives?” To me, that’s the promise of wearable tech (and mobile devices, in general – which is where I’m coming from).

Let’s not get stuck inventing yet another activity tracking device. I want social connection trackers, emotional mappers (see Bond), psyche diviners, digital pheromones. Indeed, when we first started fusing the social web with mobiles, way back when, it was the emotional connection (dare I say, connecting people?) that drove us, not self quantifying.

C’mon, folks. We can do so much better.

Digital Pheromones

Her presence permeated the ordinary,
Lighting our pockets along the way.
We smile, and miss her.
With a sniff of sadness,
She knows we are here.

by: Phil, Riitta, Timo, and Charlie
Espoo – 31jan07

poem back story

*To quote the affective computing group at MIT: “Affective Computing is computing that relates to, arises from, or deliberately influences emotion or other affective phenomena.”

Image from TapTap, which did not make its Kickstart funding goal.

TSA and faux terror theatre

image132.jpgDisclaimer: My family has a long history living in, speaking out against, and escaping trouble from totalitarian governments. So, please understand that I have a terrible allergy towards anything that smacks of police-state bullshit.

They’re Such Asses – shoes set me off
I’ve always called TSA “Faux Terror Theatre”. Looking back at my posts, those times I was ticked off enough to write about, it seems to have started when we were required to take off our shoes.

“What’s with the shoes?” is dated March 2004. The previous two years or so were the start of Bush’s (or should I say, Cheney’s?) “war on terror” and locking down legal and societal tools to make it look like the government was on top of things. Do you remember the red-orange-green status? How about comments that “if you talk against the government, you are unpatriotic”? Indeed, these insidious fear-mongering tactics have poisoned american political discourse to this day.

And I knew it would. Such things are easy to deploy, hard to remove (shame on you Obama).

To this day, it bugs the krap out of me when the PA systems bellow “See something, say something.” That’s so “Nineteen Eighty-Four” (which one day, in fit of rage at the airport, I bought, to read and remember). These “Words of Warning” on fearsome signs everywhere, also do not help.

In(s)anity
But the shoes seemed inane enough for me to step up and call out the baloney the TSA was perpetrating. Not only did it push me to rant, twice (“Airports, shoes, and a horribly screwed up emerging police state”, “I repeat myself“), while at the airport, using only a mobile phone (ouch, thumbs), but also drove me to apologize to the rest of the world (which I still do when I note stupid US security procedures forced upon foreign governments).

All this finally culminated in me writing a short story on where this is all leading. Do read it (“So it’s come to this”).

Baah baah we sheep
While the last post I can find on this blog was in 2006 (“What price Security?“), I do know I have continued ranting on Twitter (I can’t seem to find those easily today). I’ve noticed that the TSA has become more “normal”, as in, we have accepted the dysfunction and faux theatre like sheep. And I’m part of that, sadly, as well: I spent a long time trying to evade the full-body scanners, only to finally give up as everyone now needs to go through it.

I’m not alone!
And where did this whole rant, today, come from?

I really could not get folks to truly understand why all this TSA and Homeland Security* faux theatre bugged the krap out of me.

Then a few months back I stumbled upon Bruce Schneier. I spent the other day perusing his blog posts and articles on TSA. YOU MUST READ THEM. 🙂

Schneier on Security: Beyond Security Theater  (Nov 2009) – He calls it theatre, too! And it blew my mind how similar our thoughts and perceptions are.

Counterterrorism is also hard, especially when we’re psychologically prone to muck it up. Since 9/11, we’ve embarked on strategies of defending specific targets against specific tactics, overreacting to every terrorist video, stoking fear, demonizing ethnic groups, and treating the terrorists as if they were legitimate military opponents who could actually destroy a country or a way of life — all of this plays into the hands of terrorists. We’d do much better by leveraging the inherent strengths of our modern democracies and the natural advantages we have over the terrorists: our adaptability and survivability, our international network of laws and law enforcement, and the freedoms and liberties that make our society so enviable. The way we live is open enough to make terrorists rare; we are observant enough to prevent most of the terrorist plots that exist, and indomitable enough to survive the even fewer terrorist plots that actually succeed. We don’t need to pretend otherwise.

The Things He Carried (Nov 2008) – An article from The Atlantic where Schneier shows how leaky the TSA security system is: fake boarding passes, smuggling liquids, and other failures in airport security.

Schneier and I walked to the security checkpoint. “Counterterrorism in the airport is a show designed to make people feel better,” he said. “Only two things have made flying safer: the reinforcement of cockpit doors, and the fact that passengers know now to resist hijackers.” This assumes, of course, that al-Qaeda will target airplanes for hijacking, or target aviation at all. “We defend against what the terrorists did last week,” Schneier said. He believes that the country would be just as safe as it is today if airport security were rolled back to pre-9/11 levels. “Spend the rest of your money on intelligence, investigations, and emergency response.”

Schneier on Security: Harms of Post-9/11 Airline Security  (Mar 2012) – A post prompted by a discussion Schneier had with former TSA Administrator Kip Hawley. [links below from original article]

At this point, we don’t trust America’s TSA, Britain’s Department for Transport, or airport security in general. We don’t believe they’re acting in the best interests of passengers. We suspect their actions are the result of politicians and government appointees making decisions based on their concerns about the security of their own careers if they don’t act tough on terror, and capitulating to public demands that “something must be done”.

Return airport security checkpoints to pre-9/11 levels. Get rid of everything that isn’t needed to protect against random amateur terrorists and won’t work against professional al-Qaeda plots. Take the savings thus earned and invest them in investigation, intelligence, and emergency response: security outside the airport, security that does not require us to play guessing games about plots. Recognise that 100% safety is impossible, and also that terrorism is not an “existential threat” to our way of life. Respond to terrorism not with fear but with indomitability.Refuse to be terrorized.

Where do we go from here?
I seemed to have found a soul mate who is calling BS on the TSA and Homeland Security. Do read his posts on air travel. There are posts on how folks are circumventing security, calculating excess automobile deaths as a result of 9/11, and the politics of security in a democracy. And here’s an anchor post that urges us not to give in to what the terrorists want.

The surest defense against terrorism is to refuse to be terrorized. Our job is to recognize that terrorism is just one of the risks we face, and not a particularly common one at that. And our job is to fight those politicians who use fear as an excuse to take away our liberties and promote security theater that wastes money and doesn’t make us any safer.

Alas, it’s quite depressing to see such a public figure like Schneier, who is speaking straight to the leaders, getting nowhere in changing the government’s mind. Indeed, it’s also depressing to me that not only did things not moderate when Obama came into office, but I feel things got more paranoic. It’s like the apparatus that Cheney and cronies put into place has a life of it’s own that the government can’t dismantle (again, shame on you, Obama).

But I find hope that Schneier comes out with great articles such as this one in the Atlantic: “The Boston Marathon Bombing: Keep Calm and Carry On“. The effect of those bombs will affect me in some way or other this year – I live in the region and I want to run the marathon as an unregistered runner. But this sums up well what I believe:

How well this attack succeeds depends much less on what happened in Boston than by our reactions in the coming weeks and months. Terrorism isn’t primarily a crime against people or property. It’s a crime against our minds, using the deaths of innocents and destruction of property as accomplices. When we react from fear, when we change our laws and policies to make our country less open, the terrorists succeed, even if their attacks fail. But when we refuse to be terrorized, when we’re indomitable in the face of terror, the terrorists fail, even if their attacks succeed.

Be indomitable. Refuse to be terrorized.

 

*”Homeland”? Really? First time I heard it, made me cringe. To me, it conjures “heimat” ideas from Nazi Germany. Can you blame me for being on edge since the terrorist rhetoric began on 11 Sep 2001?

Google Maps as traffic cop in the sky?

TrafficI am a very heavy user of Google Maps, even when I know where I’m going. It’s a pretty good* predictor of current travel time and traffic patterns.

A few times lately, I’ve also had to use it to circumvent traffic snarls (one time enjoying rural New Jersey near Pennsylvania).

Then, one day, during a storm, I noticed there was a car in front of me that seemed to be also circumventing the traffic with me. Could it be, I thought, the driver was also using Google Maps, and we both got the same route to follow?

With Google as the oracle, if someone heads off the highway with me, it’s likely that we both will follow the same route via Google Maps.

But what happens when all of us have that info and all of us try to circumvent traffic in the same way. You’ll have streams of cars going off in the same direction.

And what if Google actually was even more clever and only sent a few of us of in one direction, a few in the other, and some elsewhere so that Google actually managed traffic like a traffic cop in the sky?

That’d be weird.

 

*One note on the travel time predictor – it’s only for NOW. I do long 5 hours trips and wished Google could estimate travel for the trip taking into account when I’ll be where and how the usual traffic pattern would be. Do you know what I mean? I’m sure they have the data and the computational power to do this. For instance: imagine picking a route and getting travel time recommendations based on the time you start out.

The chocolate and peanut butter method of ideation

logoJust a thought.

Sometimes for me to generate new ideas I randomly grab different topics (the more different the better) that interest me and explore what they means together. Just like chocolate and peanut butter might not have been obvious (or peanut butter and bananas, or bananas and Nutella), they turn out to be my favorite candy. Hence my choice of method name.

For example, in the area of health and healthcare what might these things result in?

  • microbes and storytelling
  • microbes and mobile
  • mobile and storytelling

I could go on, of course.

I think I do this because I have such varied interests and want to give all my pet ideas a day in the sun or time to play together.

Do you have a technique like this? I think we all do this, just that we have different names for it, if at all.

BTW, what do you think results in the above examples?

Image nabbed from Hershey’s

At HealthFOO this weekend

foo2012I’m so excited to be at HealthFOO this weekend (it had been postponed from April). And I am extremely humbled by the folks who will be there.

Of course, I’ll be there with an open mind to hoover all I can and collide it all in my wee head to see what interesting things come out and excite me.

I am sure, though, I will have a moderate amount of bias looking for things that fuse connected health, mhealth, digital health, mobile, analytics, storytelling, and the like – topics that pull in so much of my background and interests and natural proclivities.

I’ll also keep eyes and ears open for things around precision medicine, personalized medicine, translational research – as that’s an area I’ve concentrated a lot at work lately.

And, I expect to have some (one, at least, I hope) exciting conversation on the practical use of microbes, transfaunation, probiotics, and the kind – it’s a idea that’s wedged itself in my brain for a long time and hard to meet folks in as I stick around digital types too much. 🙂

Though I’ve volunteered an Ignite talk on it.

In any case, if you’re there, look for me – tall, bald, bearded, and with a look of wonder and excitement. You could ask me about mobile, social media, Brasil. But I’d rather you asked me about storytelling, microbes, 777 Labs, and high touch care.

If you’re not there, I am not sure I’ll be tweeting from @molecularist and definitely not posting anything over the weekend. But do come back or follow @molecularist should I get my usual non-stop, over-excited, stream of thought posting when all the FOO ideas start spawning their own thoughts.

Image from stranded attendees in April 2013 tedeytan

One night – a global story of one night in the mobile life

NightOutThere is but one Night, a Night that lives in Earth’s shadow, a Night that covers half the Globe, sliding gradually West in a never-ending run from the Day. Though we are said to be day creatures, descending at dawn from the safety of our trees to hunt and gather, our time, the time when we hunt and gather in a different way, when we no longer hunt and gather for food, shelter, protection, when we hunt for friends, companions, when we gather together for play, song, love, our time when the day creature is put away in a little box and out comes the social creature we really are, our time is the Night.

Our Night has evolved as our life has, becoming richer as more effective ways to mix and match and connect and enjoy have been invented. Granted, every generation thinks they live in the Golden Age, the height of their civilization. And, granted, later generations dwarf previous Enlightenments. Yet, the Dark Ages these are not, the inevitable trumping of our Age by some future Age in no way diminishes the Wonderment of our Hyperconnective Age.

And Life wants to be connected, it wants to build layers upon layers upon layers of connectivity, and the last century has heaped more layers of hyperconnectivity via transport and communication. The narrative we seek here tonight is that narrative of hyperconnectedness, of personal mobile communications, of mind-to-mind connections, of one-handed, background, interruptive, back-pocket, individual, essential, ubiquitous, untethered freedom.

The facts in this narrative are not as important as the participants, the ones who have integrated into the Mobile Lifestyle, the ones who know no other way to communicate, the ones from every walk of life who are united by a piece of metal and plastic.

All of them are here tonight, all 2-plus billion of them, all being watched by the next billion, who live mostly in emerging countries aspiring to enter the real net of humanity, the real net of connectivity, the net that keeps growing and will soon encompass everyone able to think, to feel, to share.

Night arbitrarily starts in the Pacific, not far from Auckland, where we pick a thread of this mobile narrative on a mid-winter Friday, early evening, where a young man pauses before heading out the door, empty-handed, with only keys and wallet. In a momentary panic, he turns to look for the object to fill that emptiness, the object that is present even when missing, the object he would more readily report missing than a lost wallet or lost keys.

Night moves on and covers a group of Tokyo teenagers, dressed up in their favorite get-up, a get-up borrowed from movies, manga, magic, a get-up that both removes and enhances their identity through a common language easily read, as easily read from their overloaded keitai straps, the ringtones, the sub-culture in sub-cultures of their text message codes.

Prognosticators watch these teenagers, guestimating the future of the Mobile Life- style effortlessly exemplified by the Tokyo Lifestyle these teenagers don’t consider special, but integral to whom they are. Are their phones their wallets and keys, too, as waving becomes a way to exchange info, connect, pay for stuff, open doors? Will the world be tagged with invisible radio and cryptic 2D tags as a physical to virtual connection, as a way to access more info than could be pasted on a wall, as a way to bring static objects to life, as a way to hide a whole new world under the noses of the adults?

A night in Tokyo will teach you much about the far future, the future made real by only a few million, compared to the almost 2 billion who don’t have or can’t afford the gadgetry to live the Tokyo Lifestyle, who need to be or are content with a gadget that fits their budget, their lifestyle, their culture, their language. The real thriller in Manila is the combined millions of pairs of thumbs that text message in huge numbers, using their thumbs to communicate, using their thumbs for social activism, using their thumbs to organize for democracy, for communism, for Islam, for rebellion, for freedom of expression. One hundred and sixty characters unleashed in a way as in no other country. One hundred and sixty accidental characters, built with a clear goal that no one ended up accepting. One hundred and sixty characters that The People hacked, that The People took as their own, that The People used to show that “we are not passive consumers, we are active participants in our lives”.

No matter what you foist on your “consumers”, you cannot control what they do, so wake up and smell the text message and be open to the creativity and inventiveness of those you provide service to, provide the loam and let them do the gardening, not because you are dumb, but you would never have made millions of Filipinos pound happily and obsessively on their phones, and pay you for it, if you had tried to plan it.

Impressed as we are with billions of text messages a day, we still have no idea as to the scale of things. Take the most populous country, with Mumbai as one of the largest metro areas in the world, and text message is just play as Mumbai youngsters actively chat via their phone browser, winksters all, discovering the power of the Web for the first time via their mobile. With most of the next billion phone users coming from emerging markets, with most of the next billion never having a PC or access to the Web, what will we unleash as they join the throngs of texters, of winksters, of people empowered by the simple joy of text, the joy of voice, the joy of a personal communication companion?

Just look at Hong Kong, where the Night is always hot in midsummer, hot with flashy cars, flashy jewelry, flashy neon signs, flashy high-end phones with all the latest software, all the latest features, all the latest accoutrements that drive high-end use. Whip out the phone at a bar for karaoke, or just look up lyrics on the Web, or sniff for other Bluetooth devices to meet friends, to get laid, to pull a prank, or snap-upload-share in that vicious cycle aided and abetted by a camera phone with flash and finesse.

A far cry from Accra, old city in a young country with even younger people, some of whom can only dream of owning their own wireless tie to the rest of modern humanity, who don’t know if they are ashamed or empowered when approaching these two men in wheelchairs, two men who have spent so much time trying to make a living only to strike pay-dirt by becoming telephone dudes who rent out seconds or minutes or messages of connectivity for those in the eternal waiting line for their own phone. Make your call with ease, let them remember the number for you, even if you are not illiterate, these men are the new phone booth, the new entrepreneurs, the new phone company, the new future of communication. If they are lucky, they might land a micro-loan, a phone, and an antenna, and set up their own provider for a village, for a region, for a people to leap forth into the modern world without the baggage of the 20th century.

Yet, this is not a worry for the birds who flew for a fling in the Canarias, from Finland, where all old enough to write their own number, not the social security number from the government, but the social secureness number that comes with a SIM card, a subsidized 3G handset, a megapixel camera, a Nordic lifestyle, and those little umbrellas in their drinks. Ever free but never far, these Finns enjoy a midsummer of a different sort, on a faraway island, but connected to home islands and lakes via midnight photo messages of bonfires and celebrations back home.

In contrast to Lutheran restraint loosened by midsummer cheer, the hot and sweaty mid-winter of Rio de Janeiro only further enhances the exhibitionism and innocent egotism of snap-happy mobilistas who party early into the morning, their photo trail uploaded on the go for all to see and endlessly comment on through social networking sites. Contradicting reasonable assumptions, the Cariocas snap and share as if there were no tomorrow, no shame, no repercussions, no end to the joys of sharing by voice, by photo, by Web, by mobile.

Flipping assumptions of a poor country of exhibitionists to a rich country exhibiting restraint in mobile phone use, we see Night becoming mobile as rich and educated Boston evolves from voice-only to discovering the power of the silence of text, the power of an empty message saying volumes, the power of a semi-colon, dash, and closing parenthesis to make someone feel warm, the power of a “yes” in making a young man’s knees shake, the power of a few text messages to coordinate a group faster than a chain of calls, the power that the mobile-savvy have always known, the power that is inherent in all phones, the power that is as basic to modern mobility as is voice.

Yes, the Boston night has become quieter since phones became extensions of thumbs, since voices no longer need to be heard over the sound of the band, since an inoffensive beep or buzz is enough to say, “Uh, excuse me, you have a message, please pull me out of your pocket when you can, it’s just for a moment, then you can just slip me back into your pocket until the next time I chirrup and politely call for your attention”.

But not all want a modest phone, as in Los Angeles, hot and bothered by the mid-summer heat, glitterati parade for their adulators, consort in one hand, mobile phone of the millisecond in the other, thin or flip or color, with no requirement of functionality, usability, longevity. For the jet-set, it’s not about what it does, but how it looks, how it matches the other accessories, because, really, who makes their own calls?

As the afterglow of the sparkle and tinsel fade from our sight, we espy at last the dark underbelly of the mobile world, dark enough to upturn the Mobile Lifestyle, to keep it from growing, to make the bleeding edge coagulate to a stand still, and, for no particular reason except that our Night is ending, we find evidence for this in Honolulu, near the end-point of our Night. There, our night revelers reach for inexpensive landlines to coordinate a gathering, or upload their digital camera photos from their all-you-consume, super-sized broadband PC in the wee hours before dawn, before going to sleep, before the evening joys are forgotten.

Nor do the revelers give out their mobile phone numbers because they need to pay for incoming calls and messages, or open up their browsers to check anything, not because it’s expensive, but because they can’t figure out what plan they’re on, how many minutes they have, how much 1 kilobit is and how much it costs, when the free minutes end or start, why it costs me to get my photos off my phone, why do you charge and disable, why is the real cost of using all those fancy services you are touting never revealed, why is cost the dark underbelly of mobile services?

Oh, it is now Saturday evening in Auckland, a full turn taken, as has been taken for billions of years, different turns for different folks in our narrative, different ways mobiles have impacted their lives, different ways mobiles have progressed and integrated into our existing networks, our existence, our culture, our habits. And it’s only been a decade or two since the mobile phone boom began. How will we continue shepherding all these different threads of the narrative, nurturing each individual evolution, letting a thousand flowers bloom? That’s our narrative for another night.

No longer feeling abandoned, anxious, or lonely, but reassured, loved, and now secure, our young man has remembered his phone this time, placed it in his hand, rolling it slowly in an unconscious gesture mobile phone owners have, fingering it, caressing it, twirling it, checking it, touching it, treasuring it, fondling it in a self-pleasurable sort of way only something that is part of our body deserves.

Indeed, the mobile phone has become more personal than any other tool we have ever created, every Night revealing its true position in our lives, its true impact on our behaviors, its true importance in how we as a collection of cultures, we as a global society, we as a species, have just evolved to a new layer of connection.

 

Background
This was written, by invitation, for Vodafone’s receiver magazine in August 2006. I noticed today the original article had finally disappeared from the web (like other great mobile sites, such as The Feature), but I had a copy and decided to post it once more.

I was excited to be invited to publish in receiver. Lots of cool mobile folks from that era were invited to write for receiver. If I recall correctly, @moleitau also wrote for this issue, though he was @blackbeltjones still at the time, I believe.

The issue was #16 “Connecting to the Future”. The publishers even had someone narrate my story. It was cool to hear a BBC-ish British man read my writing. Thanks to the Wayback Machine, I was able to find a snapshot (go click on the animation a few times) with the recording (I was briefly saddened that I could not find a copy of my own).

Of course, this story was interesting to re-read today. It was written before the iPhone indisputably altered the fate of all mobilistas; though Nokia’s Cloud project (aka Ovi) was already forming in my head. And, at the time, I was mulling a longer book on the mobile lifestyle, of which this is a hyper-concentrated version of what I intended (and, finally getting it all out in this format, sucked out all the desire to finally write that book)

And why the narrative format? When the publisher contacted me, it was for a basic scholarly article type of thing on the topic of ‘night out’. But then she had mentioned she had read and liked “chillin’“, so I offered to actually write the article in that style. I was pleased she like the idea and, lo, the story above was born.

Wow. A trip down memory lane.

Here was the intro receiver wrote for the story:
Charlie Schick currently provides internet strategy consulting to various projects within Nokia. His checkered past includes numerous articles and stories for online and print publications, deep scientific research, a book (co-authored), mobile multimedia products, and some unpublished fiction hidden in his closet. He has recently fooled himself into writing another book, due to be unpublished sometime in the far future. In his contribution to receiver, Schick weaves a global story of one night in the mobile life.

http://cognections.typepad.com/lifeblog/ Charlie Schick’s blog

 

Smartwatches: data freshness, interactive surfaces, and how the old became new again.

suunto-t6If you are an older runner, like me, there’s a high chance that smartwatches are nothing new to you.

In 2005, when I was at Nokia Ventures Organization, there was a team looking into mobile connected devices in sports.[1] At one point they even hired the ex-CEO of Suunto (great guy, great stories[2]). For those who don’t know, Suunto is a manufacturer of “wrist-top computers”. Yes, these are now known as smartwatches (that’s a Suunto T6 in the image to the right).[3]

Back then was an interesting time for mobile sports tech: accelerometers were getting cheaper (Nokia was considering buying a company in that space), ANT was being promised as the ideal wireless networking for personal area networks and various sports watch manufacturers were adopting it, and GPS was becoming more widespread. Also, Nokia had a really cool app called SportsTracker that could use GPS to track your sports activities.[4]

Using a smartwatch in 2005
I bought a Suunto T6 (which comes with a heart-rate monitor strap and a barometer inside) and an accelerometer for €500 (the GPS pod wasn’t available yet). The HR monitor and accelerometer communicated with the watch via ANT wireless. Comparing it to the experience I had with SportsTracker (with GPS pod if phone didn’t have it), I got a great feel for what works and doesn’t in smartwatches and accessories (logging it all in some form in LifeBlog, of course).

What did I learn?

  • The watch is a surface. Small and, by convention, glance-able, the watch has its limitation dictated by its form factor. No big surprise there. For example, having a small screen as a readout for my current HR, speed, and time is crucial for my run. I really never expect to do any deep interaction with the watch, either when in motion or when not, except what could be done with the buttons and small interface the watch has (start, stop, splits, perhaps even review log).
  • Data has a freshness. Every data has its timeframe of usefulness and value. For example, once again, viewing the current HR, speed, and time helps me manage the run as it happens. But then, once downloaded to a computer[5], the HR and speed were relevant as a trend, not necessarily as an instant reading.
  • Data has its time scale. For example, weather changes over hours, not minutes; a run is measured over tens of minutes and hours; HR and speed are averaged over seconds for current reading, but over the course of the run for overall activity performance. When and how data is useful and how you interact with it changes, it’s not a fixed thing.
  • Data integration adds value. Having various sensors (speed, time, altitude, HR, GPS), plus adding other measured data such as temperature, weather, maps, allows calculations of other interesting things at the intersection of all this data. Though it’s not always true that more sensors and measurements are better.
  • The connection to other “surfaces” is critical. Being able to easily view the data on another larger surface, say a PC or, these days, a smartphone, allows greater exploration of the data after the event. The watch is one surface in our overall pervasive computing environment. Use it as such, and take advantage of the form factors of other surfaces.

Where folks will trip up
I think each of these areas listed above will be spots where the “new” smartwatch manufacturers will trip up.

For example, my biggest concern is that smartwatch makers will forget that the watch is a surface on the wrist, thus best suited for certain interaction modes. When I hear things like making calls and texting, I think the manufacturers are missing a trick.

At Nokia, we used to talk about the “usability knee,” that quick fall-off of usability as a mobile device is pushed to do things it really isn’t made to do, due to form factor, interface design, and the like.[6] Really, these smartwatches can’t be more interactive than an iPod Nano. If you think you are going to shove a smartphone into a writwatch, then join the crowd of “cool but failed” tech.

And already I see connected device makers tripping up on the data integration and exploration side, providing interfaces too complex to easily interpret the data that comes off the device (I am looking at you FitBit).

Simple, mobile lifestyle
Simplicity will be key. Understand how the watch is a surface; that the data has a complexity in its value (in time and scale); and how best to interact with that data on various surfaces, from the watch to other larger screens, which also have different usability and interactivity environments.

Back in 2005, when talking about fusion of PC and mobile, I used to talk about the Mobile Lifestyle, that the mobile is not a PC, that it requires a different way of thinking that is consistent with the way folks expect to use a mobile device.[7] PCs are lean forward, flat surface, two eyes, two hands, large screen, keyboard. Mobiles are in-pocket, lean back, interruptive, snippets of time, one-handed, two thumbs, on the move. Does that make the watch, interrruptive, instant, glanceable, one-touch, one-finger, [calm? pervasive? suggest more?]?

Back then, I knew that trying to replicate the computer experience on mobile devices was wrong. Same goes for now: trying to replicate the smartphone experience on watches is also wrong.

Let’s see how these manufacturers do.

What do you think?

 

 

OMG, footnotes?
[1] Alas, after all the thinking and skills that they had, the best they came up with was a fancy pedometer.

[2] Being a measurement geek and an athlete, he told me a story of when he was wearing multiple watches, HR monitors, and other pods on a run. He was worried he was going to be stuck by lightning, he had so many electronics on him. And you thought QS was new.

[3] Garmin, Timex, Suunto, Polar – all well known wrist-top computer manufacturers. Products range from dive computers (where Suunto got its start) to running and swimming and climbing wrist computers. And all started many years before folks got excited over the Pebble, or even the FitBit.

[4] Before the phones had GPS (remember the N95?) I used fobs like these. And yes, I was using apps on a smartphone long before the iPhone and the App Store came out. Another example how the old became new again.

[5] The Suunto T6 connects to the PC with a USB cable that clipps to contacts on the watch. In 2005, the PC software was atrocious (I eventually stopped using it for many years). These days Suunto has a website where all the data goes (via the PC, though) and only in the last two years or so has it become usable.

[6] A term I picked up from my old Nokia Ventures Organization boss, Christian Lindholm, long before we started working together.

[7] A great example of folks not getting the way these interactive surfaces need to fit their “lifestyle” is in iPads. No, you do not put a keypad on the iPad. That defeats the purpose of the tablet. If you want a small surface with a keyboard, buy a Mac Air. Pet peeve of mine.

 

Combination therapy vs single-target therapy

mosquitoI feel that single-target drugs are getting harder to make.

I remember years back, when there were three AIDS drugs going through clinical trials. We were all shocked when all of them failed. But some smart soul realized that when combined, the three were a miracle cocktail. Indeed, fast forward to the present and this cocktail has basically turned AIDS from a death-sentence to a background disease (of course, I simplify – the point is the success of the cocktail, combination therapy).

Combination therapy in this sense, should not be confused with drugs that are not complementary. For example, MMR and DPT vaccines are mixes of individual independent vaccines.

I claim that we need to explore how combinations of drugs, say antibiotics or antivirals, can work better than the constituent drugs alone.

Alas, as far as I can tell, this will complicate clinical trials, trying to deconvolute the contribution of each individual component. But I am hopeful that tools that can munge and analyze large data sets might able to do this deconvolution.

What do you think?

Link 1: PLOS ONE: A Longitudinal Trial Comparing Chloroquine as Monotherapy or in Combination with Artesunate, Azithromycin or Atovaquone-Proguanil to Treat Malaria.

Link 2: Access : New TB drug cocktail : Nature Reviews Microbiology

The development of novel combination therapies is one of several strategies that are currently being pursued to combat tuberculosis TB. Recently, researchers at the XIX International AIDS Conference presented the results of a groundbreaking clinical trial which showed that a combination of three drugs can kill more than 99% of Mycobacterium tuberculosis in infected patients.

Image from Wm Jas

Are EMR systems in the 10s like AOL in the 90s?

aol_cd_too_difficult_computer_helpI’ve been getting a feeling that EMR systems, while here, are a decade late.

While I am totally in favor of digitizing the patient, what EMR vendors set out to do – capture patient encounter information in a structured way – is no longer appropriate or scalable, at least in the way they chose that predates the internet boom of the 2000s.

The tools, such as the social web, mobile, and unstructured text mining (all developed to a high extent in the last 10 years), mean that we no longer have to create long forms and forced workflows to capture rich information on patients.

In fact, I feel that we are collecting less and irritating the care giver and patient in the process.

Where does the connection come in with AOL? In the 90s, AOL led the way in creating a interactive online experience of content, exploration, and apps. Except, when the open internet came around with a better, more dynamic, faster, and more scalable experience of content, exploration, and apps, AOL ended up, by comparison, looking formulaic, overly structured, and confining.

Kinda like what I hear about EMRs these days.

Link The EHR debate: fighting the last war?
Yes we’re having the wrong fight by focusing on old problems. The EMRs that are producing the studies we’re fighting about are the current equivalent of 1990s EPR implementations. In general they’re hard to use and require lots of money and training to produce halfway decent results.

What do you think? What is the alternative?

Image via TooDifficult.com

“Welcome to the Post-Pasteurian Age” (my HealthFOO Ignite talk that never happened)

I was blessed with an invitation to HealthFOO this year, here in nearby Cambridge. Alas, the event was cancelled due to the intense events after the Boston Marathon.

But not only was I bummed out that I wasn’t going to spend a fun weekend with follow health enthusiasts, but I also had to cancel my Ignite talk.

Microbes!
Of course, I was going to talk about the practical use of microbes. Below, I’ve written what I was going to talk about, with the sides I was going to use. (No, this is not my verbatim script, so it’ll not be exact to the timing usual of an Ingite talk)

Enjoy.

Slide1

Hello, my name is Charlie Schick. By day, I work for IBM as a sales consultant in healthcare and life sciences. By night, I am a fermentos, a practitioner and promoter of the practical use of microbes.

Tonight I want to welcome you to the Post-Pasteruian Age. But, for some historical perspective, a Post-Pasteruian Age suggests two preceding ages. Let me tell you about them.

Slide2

When we think of the Pre-Pasteurian age, we think of  a scary time of plagues, food poisoning, death by simple infections, and poor public health systems (can you say miasma?).

Slide3

 

But it wasn’t all the bad.

Folks were using bugs practically, for food safety, mostly. Most cultures were fermenting foods – milk, vegetables, grains – to preserve them and improve nutritional value.

Slide4

Indeed, microbes can be credited for the start of civilization. The magic that converted a warm mash of grains into a well-preserved intoxicating food drove humans to settle down to ensure a steady supply of grain to ensure a steady supply of intoxicant.

Slide5

Then Pasteur and gang came along.

Hello, Pasteurian Age.

John Snow (upper right) figured out crucial pieces of germ theory. And leading scientists gave us anti-microbial terms like Pasteruization (Pasteur, upper left) and Listerine (Lister, bottom right).

Science!

Slide6

The progress of science also led to Fleming’s accidental discovery that microbes (fungi) themselves were good at killing bacteria, setting us on a long path of conquering microbes through antibiotics.

Slide7

And we can’t deny that we’ve we’ve become healthier overall. Vaccines, antibiotics, public health, food safety have all been components of our improving health, increased longevity, and reduction in microbial deaths from childhood to old age.

Slide8

But what have we wrought?

Enter the Pasteurian Age! An age of disinfectants at every turn, on every surface, in every process.

Slide9

But this age is now an age of sterile, processed food. This isn’t the real cheese.

And this age has led to a reduction of biodiversity in our environment, foods, and, most importantly, our bodies.

Slide10

And the only things that can survive this harsh aseptic environment are the super bugs – bugs that have learned to resist every tool we can throw at them to eradicate them.

MRSA, XDR-TB, C diff – you know it’s bad when non-scientists know what these bugs are and what havoc they can wreak (sometimes first-hand).

Slide11

And our ability to keep our environment so clean is thought to be leaving our immune system with nothing to fight. The thought is that our immune system has turned against us in boredom and is causing a rise in allergies.

Slide12

But it’s not all bad.

We are now entering a Post-Pasteurian age where there’s a resurgence in the practical use of microbes based on biology and technology and science.

*by the way, I got the term Post-Pasteurian from MIT anthropologist Heather Paxson, in a paper on the US politics of raw-milk cheese.

Slide13

I would be remiss if I didn’t mention Sandor Ellix Katz’s amazing paean to fermentation:  “The Art of Fermentation”. It’s a celebration of experimentation, chock full of stories and recipes beyond the usual yogurt, beer, cheese, and sauerkraut.

And fermentos (a term I picked up from the book) talk about the bacterial terroir, the mix of native bacteria that is used to naturally ferment foods, as contributing to the final product. Much like the vinyard’s terroir contributes to the flavor of the wine.

Slide14

And you know there’s a resurgence of microbes in daily living when you see probiotics getting to be vogue. The idea behind probiotics is that competition of good bugs can put the bad bugs in check.

Ok, so some of these claims might now hold up in a clinical trial. But look at the creativity of these vendors. For example, if there are now vagina salves, how soon until we have armpit or acne salves?

Slide15

Indeed, I’ve played with some of these probiotic supplements that are purported to have therapeutic effect. I didn’t make vagina beer (beer with the right yeast to control vaginal infecions), but I did make a tummy beer (using Florastor on left) and tummy yogurt (using VSL#3 on right).

If you need to know, the tummy beer was yummy. The tummy yogurt wasn’t so tasty, possibly due to the not having a full complement of a yogurt culture.

Slide16

I also see an increased interest in extracting value from biowaste. For example, dairy farmers are turning into electricity suppliers, learning the art of anaerobic digestion. And municipalities are realizing the value of compost (and the reduction in landfill needs) for recycling all the biowaste we thoughtlessly throw away.

Slide17

And there have been huge changes in microbiology. It feels to me a total rediscovery of the wonders of microbiology. Technological changes in gene sequencing and analytic algorithms have led to a growth in microbial ecology studies – in the environment and, most importantly, on our body. For example, we are trying to see patterns  in what microbes individual carry while healthy or sick.

Slide18

And this understanding can lead to bacterial cures, cures where bacteria are applied to restore microbial function in the patient.

For example, in whole bowel transplant for bowel inflammatory diseases. It was found that leaving the donor’s microbes intact rather than flushing them out led to better outcomes.

Another popular example, Clostridium difficile is a nasty infection, usually acquired in a hospital after a patient has had a course of antibiotics. Current standard antibiotics are not too good at eradicating this infection, leading to a high rate of relapse.

Slide19

Understanding the ecology of the bacteria in the gut and C diff’s role in this ecology has led to an interesting solution – transfaunation. Or, transferring poop from a healthy individual to someone with C diff.

Initial tests have been promising. And scientists are now trying to better characterize the sets of bacteria that help C diff patients recover.

Slide20

Welcome to the Post-Pasteurian Age.

It’s an exciting time for the resurgence of the practical use of microbes in food, products, and health.

But don’t be passive in this age. Go out and ferment something!