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Cities aren’t simple, especially mature ones. They are deep and complicated places that require equally deep attention to appreciate fully.  That’s what I get from Stephen Lewis‘ insights about the particulars of present and past urban scenes and characters in Sofia, New York, Istanbul and other cities he knows well. His latest post, titled  The Women’s Market, Sofia, Bulgaria: The Endurance of the 19th Century, Layers of Unwarranted Blame, and the Virtues of Slow Lenses, goes even deeper than most — accompanied, as always, by first-rate photography that speaks far more than words in any sum can tell. A sample passage:

The endurance of the 19th century

In a lifetime of working in and observing cities throughout the world, I’ve noticed that late-nineteenth century neighborhoods are amongst the last to be regenerated.  This is due in part to the resilient endurance of their economic and social functions throughout the twentieth century and into the early-twenty-first.  In such neighborhoods, cheap rents and high vacancy rates in storefront occupancy enable the provision of inexpensive goods to those whose budgets constrict their choices.  The same interstice of factors offers opportunities for marginal entrepreneurship and a shot at mobility to those who might otherwise fall outside of the economy.  The low profit-margins inherent to such entrepreneurship, however, can make for dubious goods and equally dubious practices.  Thus, shopping in the Women’s Market calls for a taste for sharp-tongued banter and a quick eye ever on the lookout for rigged scales and for good looking produce on display but underweight and damaged goods placed in one’s shopping bag.  Still, where else can one buy, for example, persimmons or grapes, albeit on the last legs of their shelf-lives, for a third of the price of elsewhere and serviceable tomatoes for even less?

To live is to change — and eventually to die. Yet cities are comprised of many lives. They are always an us and never just a me, even if we don’t get along. Who we are changes as well, and that too is a subject of Steve’s attention. For example:

Layers of unwarranted blame

There is a fine ethnic division of work and functions at the Women’s Market.  Meat, cheese, and fish  kiosks, and stands offering wild herbs and mushrooms, are run by Bulgarians. Fruit and vegetable stands and peripatetic bootleg cigarette operations are run by Roma (Gypsies).  Storefronts in adjacent streets include honey and bee keeping supply stores run by Bulgarians and rows of “Arab” shops — halal butchers, spice stores, barbers, and low-cost international telephone services — run by and catering to increasing numbers of legal and illegal immigrants from Syria, Iraq, Palestine, Turkey, Central Asia, and Afghanistan. Many Bulgarians, their weak self esteem shakily bolstered by contempt for “others,” blame the shoddier commercial practices of this wonderfully vibrant marginal neighborhood on the presence and “inferiority” of such outsiders.

Blaming others may be among our most human of tendencies. I have often thought that the human diaspora, wandering out of Africa and across oceans and forbidding landscapes, was caused by disaffection between tribes — the dislike, subjugation or dehumanizing of others, and the construction of specious narratives that rationalize a simple urge to blame. In known history there have been countless migrations, some for opportunistic reasons, but many more simply to escape misery. (Or, in the case of slavery, in states of misery dismissed by traders who regarded their captives as mere property.)

Yet cities, perhaps alone among human institutions, invite and thrive on human diversity. What hope I have for our species I get more from living in cities than from being anywhere else, no matter how pleasant. Steve’s photos and essays don’t always give me more hope, but they always give me more understanding, which is the better deal.

Bonus postings:

 

Lately I’ve been patching the roofs of my email inboxes, which leak a torrent of unwanted messages — in addition to the usual spam. I do this mainly by opting out of mailings, most of which I never requested. That’s why, when I received an automated mailing wishing me “a blessed 2014 from the AlwaysOn family,” I thought now would be a good time to opt out of  the large number of mailings I get from AlwaysOn. So I looked down to the bottom of the email, and found this:

Marketing automation is powered by our sponsor Marketo
You are receiving this email because you are a member of the AO Network, or are included in the Jigsaw or Venture Source database. To manage your subscription preferences click here.

I clicked on that last link (which I’ve depersonalized) and was delivered to a page that says this:

I wouldn’t be writing this if it weren’t for that last item. I hate having words put in my mouth.

Here’s the deal: I’m unsubscribing because I’m getting too many emails, and I have other ways of finding out what’s going on. That’s it.

I wish a blessed new year for the AlwaysOn family too. I hope they take this feedback as the positive kind I mean it to be.

And, if I want to get automated emailings from them again, I’ll opt back in.

Merry, Happy, etc.

Fred WilsonI’m bummed that I missed LeWeb, but I’m glad I got to see and hear Fred Wilson’s talk there, given on Tuesday. I can’t recommend it more highly. Go listen. It might be the most leveraged prophesy you’re ever going to hear.

I’m biased in that judgement, because the trends Fred visits are ones I’ve devoted my life to urging forward. You can read about them in Linux Journal (starting in 1996), The Cluetrain Manifesto (1999, 2000, 2011), this blog (starting in 1999), ProjectVRM (starting in 2006) and The Intention Economy (2012). (Bonus links: What I said at Le Web in 2007 on stage and in an interview.)

He unpacks three megatrends, with an additional focus on four sectors. Here are my notes from the talk. Some of it is quotage, but little of it is verbatim. If you want to quote Fred, go to the source and listen.

1) We are making a transition from bureaucratic hierarchies to technology-driven networks. The former is the way the world has been organized for the last two hundred years. Markets, government, businesses are all pyramids. Transaction and communication costs were so high in the industrial era that these pyramids were the best way to organize work and run systems. But now technology-driven networks are replacing bureaucracies. Examples…

Twitter. Replaces the newspaper. The old army of reporters that reported to divisional editors who chose what would appear in limited spaces and distribute through printing mills and trucked to your doorstep was slow moving and bureaucratic. Now all of us are reporters. The crowd determines what’s important. This is an example of a tech-driven network.

YouTube. TV was hierarchical. Now all of us are video creators.

SoundCloud. Anybody can create audio or music. No labels. No radio or music industry required.

We first saw this trend in media and entertainment. Now we’re seeing it in AirBnB, One Fine Stay. Creative industries like Kickstarter and VHX. Learning with Codecademy and DuoLingo for languages.

We are very early with all of these and more to come.

2) Unbundling. This has to do with the way services are packaged and taken to market. In the traditional world, you only got to buy the thing that had everything in it. Now tech is changing that. More focused, best of breed, delivered a la carte. Now on mobile and internet you get better everything. Best of sports, fashion, classified advertising.

Banking is being unbundled. Banks used to do everything. Now entrepreneurs are picking off services. Lending Club. Funding Circle. auxsmoney in Germany. Taking profitable lending franchises away. Working capital. c2fo. Management services. All new, all based on networks.

Education. It’s expensive to put a lot of students in a building with a professor up front of every class. You needed a library. Administration. Very inefficient, costly, pyramidal and centralized. Now you can get books instantly. Research is no longer as highly centralized and capital dependent. See Science Exchange: collaboration on an open public network.  All this too is also early.

Entertainment. Used to be that you’d get it all on cable. Now we get Netflix and YouTube on our phones. Hulu. A la carte. Airplay, Chromecast.

3) We are all now personally a node on the network. We are all now nodes on the network, connected all the time. Mobiles are key. If forced to make a choice between phone and desktop, we go with the phone. (About 80% of the LeWeb audience did, along with Fred.) In the larger world, Android is being adopted massively on cheap phones. Uber, Halo.

This change is profoundly impacting the world of transportation. Rental cars. Delivery. Payments. Venmo, Dwolla, Square. Peer to peer. You can send money to anybody. For dating there’s Tinder. Again, this is new. It’s early.

The four sectors…

a) Money. Not just Bitcoin. At its core Bitcoin is a protocol: the financial and transactoinal protocol for the Net. We haven’t had one until now. As of today it is becoming a layer of internet infrastructure, through a ledger called the blockchain that is global. All transactions are cleared publicly in the blockchain. Entrepreneurs will build tech and services on this. Payments and money will flow the way content now flows. No company will control it. Others’ lock on our money will be gone.

b) Health and wellness. Health care is regulated and expensive. Health and wellness is the opposite. It’s what keeps you out of the hospitals. (QS is here.) The biologies of our bodies will be visible to us and connected. Some communications will be personal and private, some networked, some with your doctor and so on. Small example: many people today gamify their weight loss.

c) Data leakage. When the industrial revolution came along, we had polluting. It took a century to even start dealing with it. In the information revolution, the pollution is data. It’s what allows Google, Facebook and the government spy on us when we don’t want them to. We have no control over that. Yet.

d) Trust and identity. We have allowed Google, Facebook, Amazon and Twitter to be our identity services. It’s very convenient, but we are giving them access to all we do. This isn’t good. Prediction: a bitcoin-like service, a protocol, that is distributed and global, not controlled by anybody, architected like the Internet, that will emerge, that will give us control over identity, trust and data. When that emerges I’ll let you know. I haven’t seen it yet.

Talk to me, Fred. 🙂

Below is my live blogging, in outline form, of the final presentations of work by NYU graduate journalism students in Jay Rosen’s Studio 20 class, which I’ve served for three semesters as a visiting scholar. Open Studio was the name of the event.

I wrote and posted it with Fargo.io. Blake Hunsicker, on the left, also talked up Fargo and outlining in his talk.

Mike Rothman, one of the students, asked me to live blog the event. Jay also asked me to shoot pictures there. So I got off to a bit of a slow start as those two obligations collided a bit. My notes gradually improved after the first couple of presentations, including Mike’s. Apologies for the slow start.

I finally got into a full groove during Josh Benton‘s closing talk.

It’s now 1:36 in the morning, so I’ll stop editing at this point and pick up the rest after I’ve rested.

Meanwhile, it was an absolute pleasure and privilege to participate in this class. I’ll miss everybody, but I’m also glad to know how well they did and how much better they’ll do as their journalism careers take off.

Links:

Jay’s guidance: “Your presentation needs to rock”
Patrick Hogan (@phogan)

  • Geeks and Glass
  • Alas, was busy shooting pix and doing other stuff. Will fill in later.

Mike Rothman (@TheRealRothman) with ABC News

  • Live Blogging is his topic, and what I’m doing now.

Cecelia Bittner (@MCeceliaBittner)

  • Problem: Can networks of people help in reporting a beat?
  • Partner: Fast Company
  • “A generation of women with the world and all its knowledge at their fingertips.”
  • Hashtag: #FCMobilize
  • High correlation between tweeting actively and moving conversation forward. Branch and Facebook were fails.
  • “Not worth a reporter’s time to force connections.”
  • Nice graphic of a Mobilizing Machine

Nuha Abujaber (@nuabu) and Mélodie Bouchaud (@Meloboucho)

  • Problem: Keeping ‘city life’ coverage current with the way users communicate now.
  • Using short videos and stills to augment the print magazine.
  • Like the many variations on TONY (time out new york), e.g. TONYpreview, TONYnow, OnlyTONY.
  • “Fifteen seconds is enough…”

Simran Khosla (@simkhosla)

  • Partner: Pando Daily
  • Problem: Adding data specialists to a newsroom doesn’t spread data journalism fast enough
  • Solution: data visualization-based stories “We thought visualization first…Doing the chart starts the article.” Helping the data journalist. e.g. with tutorials.

Derick Dirmaier (@derickdirmaier), Jesse Kipp (@JesseKipp), Johannes Neukamm (@JFNeukamm)

  • Problem: With “Snow Fall” the innovation came after the story was completed. Can’t we do better?
  • Partner: Creativist, digital mag Atavist
  • “Snowfalling” became a term used in newsrooms. Style followed. “The aesthetic was more important than the story telling.”
  • “Story Wars” with scroll kit, hi, sStory, Cowbird, Maptia, Creativist…
  • The solution: Profoundly Digital Reporting. PDP.
  • So they entered the Mongol Rally.
  • Captured motion, audio, video. stills, traced the route, 20k miles.
  • Design tools are storytelling tools.
  • PDP 1) Platform 2) Open Source Tools 3) Photo/Video/Audio Editing software 4) Data Visualizations
  • Preview titled Traverse.
  • 3 persepectives — Jesse’s notes, audio tracks, navigation elements
  • You get a feel for the experience of the Rally, with a map slider. TimelineJS, GeoJSON, D3 Libraries…
  • Not all stories are profoundly digital.
  • New genre of journalism: opportunity, not a threat.

Blake Hunsicker (@BlakeHunsicker, BlakeHunsicker.com)

  • Problem: Most people are coming in the middle of the movie: How do we catch them up?
  • Partner: Syria Deeply
  • Solution: a Deep Reader.
  • Went to Turkey, working on ways journalists can explain. “We don’t get much out of what the news tells us… updates but no context. Where to start?”
  • Need for onramps. Ways to become acquainted.
  • Used an outliner: “I came to this after digging Fargo.io, Dave Winer’s outliner. (Which I’m writing in now, here.)
  • Deep links, annotated comments, expanding, contracting, telescoping to whatever depth you like. You can read two minutes’ worth, or half an hour.
  • FAQ — Syria according to Syrians: “their stories, more than those told to us by pundits or politicians…”
  • Takeaways: 1) Repuurpose what works elsewhere 2) Explore how to change a deep reader as news develops 3) Work with good people

Boryana Dzhambazova (@BoryanaDz)

  • Problem: We’ve got a core group of dedicated fans: what do we do with them?
  • Partner: Narratively
  • Narratively was born as a kickstarter, has grown dramatically since. Fanatical fans, which are also a core market.
  • Introduce a paid model. Membership perks: e.g. personalized search, read later feature, notifications of upcoming themes, ability to comment, ebook collections, member-only events
  • Model: Pay what you want, as with Radiohead.
  • Many pitches come from aspiring writers. So turn a burden into an asset. Hence a fan club page where writers can pitch to other writers, with winners getting hired off submissions. Includes real-time editing.
  • Nice archive of timeless and beautiful stories.
  • Weekender: archived stories. Much higher than industry average open rates.
  • Assignment room. New approach to navigation and browsing. Go by theme, editor, writer, notes…

Danielle J. Powell (@DanielleJenene)

  • Problem: Repurposing TV documentary by putting it on line is lame: there has to be a better way.
  • Partner: Aljazeera America (@ajam)
  • Disruption in cable news. More media used online. Cord-cutting. Meanwhile TV is still the king of news.
  • Harmony where there is disruption. Add value.
  • Worked with @ajam on Faultlines, a documentary series.
  • Create harmony:
  • 1) Identify content that complements rather than mirrors
  • 2) Take other content into account, stuff that can stand alone, and add value.
  • Content that works:
  • Background — explains, like deep reader
  • Conversational — e.g. live tweets
  • Follow-up — info not seen in episode, or current after broadcast
  • Visual — infographics, instagram.
  • Key: production process that takes multiple platform into account simultaneously
  • talk digital and map out projects from the pitch
  • collect digital assets
  • Viewer+ : turn viewers into both viewers and readers, commenters, etc. Expand beyond cable, for example to where it’s not available.

Speaker: Josh Benton of Nieman Lab

  • Jay: “Josh is almost as obsessive as I am.”
  • Topic: The Year in Innovation. Twenty slides/topics
  • Mobile
  • Customizing Breaking News. Out of NBC. Can mute some topics, e.g. Miley Cyrus. All about interrupting you properly. Breaking news is not the same for every brain. The app will evolve over a year.
  • Still lots of news used on desktops and laptops. Still just for Mac and Safari. Still a way off from this being generalized.
  • You get an inbox, everybody gets an inbox. Latest: Instagram direct. Move your sexting from SnapChat to Instagram. “I cannot tell you how terrifying” this is. Too many inboxes. The more we move to closed networks, the more problematic access becomes for journalists.
  • Reporting: building beats beyond geography. Buzzfeeds fascinating. Building a beat structure from scratch. Construct reporting structures from the ground up.
  • Global cooperation. Level of what we have now was impossible in the past. You can make it work now. Example: offshoring. New thing: “collaboration fatigue” 86 journalists in 44 countries.
  • (A fire alarm went off. Ignored. Interesting: not news… not anything.)
  • Robot reporting. Algorithmic, that is. (There are no good pictures of algorithms, but are of robots.) LA Times had a story with a map up in seconds or minutes (8 in this case), thanks to an algorithm that picks up news from data sources. “Our robot friends are allies and helpers.”
  • Incentivizing truth. Rise of politifact, et. al. People are more likely to believe false negatives based on ideological bent: believing wrong info about the other side. “What if we gave small rewards” they remember X was not the case. Rewards raises likelihood of admitting they don’t know. We talk about polarization. But there is potential for seeing a thinner layer of wrongness.
  • Presentation. Snow flurries following Snow Fall, which was so big, intense and developed that everybody now has one. Or more. Remarkable that these can now be produced at a high rate. Nicely designed articles are one side effect of the flurries. Stories get more special presentation than in the past. Future will feature nicely designed articles than full-blown Snow Falls.
  • Adding structure to comments. Venn-ish diagram of overlaps in responses to the Supreme Court’s decision on gay marriage. Gives people a moment to pause before issuing vitriol.
  • Infinity comes to radio. NPR’s infinite player. (Not many knew about it, me included.) Creating a radio-like experience that leverages content backlog, and gives NPR a way to see what people like. Pandora-like “more like this” and “less like this.” Mention of PRX, with the Remix service and app.
  • Responsive and unloved redesigns. One code base that works for all formats. Great solution to terrible mobile websites. Led to a lack of info density on websites. So you have one giant story, with a few other items. Take a moment to consider that it is possible to think too much about mobile. 85% will still be on a tablet or desktop, not a smartphone.
  • Social. Event Parrot (@eventparrot): a Twitter experiment. Permission to be interrupted by Twitter, for news. “By the way, Mandela just died.” An interesting moment because news orgs have invested in Twitter, which is mostly non-prejudicial. But::: when you live on somebody else’s platform, you run risks.
  • The triumph of the morning email. e.g. Quartz. 2013 had the rise of the stream. Design choices toward the steam, and a counter-movement toward digest-y summary by email. Qz has story after story online, yet has a success with the daily email.
  • Everybody has a TinyLetter. A little mailing list for newsletters, in addition to other methods. Reporters now work not only for publishers, but for their own “brand.” The idea is to personalize communications with readers or audiences.
  • New York Times’ Fourth Down Robot. Real-time notification of success rates in those situations. Punt or not? Remarkable that this is a twitter account and a news service. Find how your team’s coach made a poor decision.
  • News video for social and mobile. e.g. Now This News. Mobile/Social. Looks like MTV in 1983. Seems a bit alien at first. They can create, on the spur of the moment, create a :15 video for Instagram and :06 for Vine.
  • Money. Paywalls 2.0: Build the paywall you want. NYTimes set the pace, made it okay for everybody else. We can assume that others will follow the Times’ moves in 2014. They got 750k people to pay. Nice, but slowing. And can you get revenue from those not subscribing. They plan a super-premium level, with access to Times events. Editors will come over and wash your car. Headed toward lots of pay products.
  • A local television paywall. WCPO in Cincinnati will be the first to put up a paywall. Vetting for Scripps. Hiring dozens of new journos to work there. Until now local TV has not been nearly as disrupted as other news orbs. Many potential problems. Uptake, for example.
  • The Boston Globe’s Airline pricing. Already has comfort with many Web products. After investing in responsive design, they came out with an iPhone app, that’s just $4 month. The bet is that if you pay $4 for iPhone, you won’t pay $15 at all. So it’s like airline seat pricing this way. Trying to undercut their own model.
  • Packaging. Putting content in new containers. e.g. The Guardian’s robot newspaper: the long god read. Have a small batch paper that culls successful pieces from the last week, algorithmically, and then lays it out, again algorithmically, in a form that works for readers in a coffee shop. This is the seed of an idea that will have other applications in the future.
  • Today’s paper. e.g. NYTimes’. If the President gets shot mid-day, it won’t be in here. In this sense it’s like the print paper. It’s a reaction to the constant stream of content, which is still in NYTimes.com. With this you know hundreds of thousands are reading the same thing. (Also, presumably, not personalized.)
  • Retro Report. Stories covered 20-30 years ago. e.g. Garbage Barge. 12-minute videos. Bracing reminder that coverage is often terribly mistaken. Nice to see archives put to use. The archives are there.
  • Civil Beat’s Law Clinic. An Omidyar project that covers stuff differently. What can a news org be and stand for in a different way? One answer: fighting for the readers. A legal aid center for a constituency. Civil Beat will provide help in the form of real legal assistance. Example of a forced rethinking of what a news org does. Fulfilling information needs in a different way.
  • Overall, optimistic.
  • Started Nieman Lab in ’08. Been uphill since then. Continued growth and institutionalization. Seeing that old dogs as well as new ones have new tricks.

RadioINK reports that Rush Limbaugh is switching stations in three markets:

Clear Channel Los Angeles says Rush will be moving from KFI to KTLK-AM in January. KTLK-AM will become The Patriot AM 1150, home of Los Angeles conservative talk radio, featuring Rush, Hannity, Glenn Beck and others. A similar move is being made in San Francisco where Rush will be moving from KKSF-AM to KNEW-AM. And as expected on Rush will move from WABC to WOR. The Clear Channel strategy is to move Rush off an established station, in the case of L.A. and San Francisco, to anchor a new station and help build that station up. Clear Channel recently purchased WOR-AM in New York and he’s being moved off WABC, a Cumulus station.

In all those cases the move is to a station with less coverage. Technicalities:

I’m also wondering how much the temporary move of Rush in Boston from WRKO/680 to WXKS/1200 helped “build up” the latter.  These days WXKS is running Bloomberg business news, which fills a niche but isn’t a big ratings winner.

The larger picture here, and the reason I bring this story up, is that the real stations aren’t the stations at all, but the shows and the talent. Rush’s listeners care about Rush, not where they find him. As this fact becomes more obvious over time, look for the Clear Channels of the world to become routers of talent and programming through any available medium (especially the Net, which is where everything is already moving), rather than a collection of radio stations.

And let’s face it: Rush isn’t on any one station. He’s on SCAN. Keep hitting that button and you won’t miss him.

Not missing is the future of radio. And, maybe, of all media.

 

Obamacare matters. But the debate about it also misdirects attention away from massive collateral damage to patients. How massive? Dig To Make Hospitals Less Deadly, a Dose of Data, by Tina Rosenberg in The New York Times. She writes,

Until very recently, health care experts believed that preventable hospital error caused some 98,000 deaths a year in the United States — a figure based on 1984 data. But a new report from the Journal of Patient Safety using updated data holds such error responsible for many more deaths — probably around some 440,000 per year. That’s one-sixth of all deaths nationally, making preventable hospital error the third leading cause of death in the United States. And 10 to 20 times that many people suffer nonlethal but serious harm as a result of hospital mistakes.

The bold-facing is mine. In 2003, one of those statistics was my mother. I too came close in 2008, though the mistake in that case wasn’t a hospital’s, but rather a consequence of incompatibility between different silo’d systems for viewing MRIs, and an ill-informed rush into a diagnostic procedure that proved unnecessary and caused pancreatitis (which happens in 5% of those performed — I happened to be that one in twenty). That event, my doctors told me, increased my long-term risk of pancreatic cancer.

Risk is the game we’re playing here: the weighing of costs and benefits, based on available information. Thus health care is primarily the risk-weighing business we call insurance. For generations, the primary customers of health care — the ones who pay for the services — have been insurance companies. Their business is selling bets on outcomes to us, to our employers, or both. They play that game, to a large extent, by knowing more than we do. Asymmetrical knowledge R them.

Now think about the data involved. Insurance companies live in a world of data. That world is getting bigger and bigger. And yet, McKinsey tells us, it’s not big enough. In The big-data revolution in US health care: Accelerating value and innovation (subtitle: Big data could transform the health-care sector, but the industry must undergo fundamental changes before stakeholders can capture its full value), McKinsey writes,

Fiscal concerns, perhaps more than any other factor, are driving the demand for big-data applications. After more than 20 years of steady increases, health-care expenses now represent 17.6 percent of GDP—nearly $600 billion more than the expected benchmark for a nation of the United States’s size and wealth.1 To discourage overutilization, many payors have shifted from fee-for-service compensation, which rewards physicians for treatment volume, to risk-sharing arrangements that prioritize outcomes. Under the new schemes, when treatments deliver the desired results, provider compensation may be less than before. Payors are also entering similar agreements with pharmaceutical companies and basing reimbursement on a drug’s ability to improve patient health. In this new environment, health-care stakeholders have greater incentives to compile and exchange information.

While health-care costs may be paramount in big data’s rise, clinical trends also play a role. Physicians have traditionally used their judgment when making treatment decisions, but in the last few years there has been a move toward evidence-based medicine, which involves systematically reviewing clinical data and making treatment decisions based on the best available information. Aggregating individual data sets into big-data algorithms often provides the most robust evidence, since nuances in subpopulations (such as the presence of patients with gluten allergies) may be so rare that they are not readily apparent in small samples.

Although the health-care industry has lagged behind sectors like retail and banking in the use of big data—partly because of concerns about patient confidentiality—it could soon catch up. First movers in the data sphere are already achieving positive results, which is prompting other stakeholders to take action, lest they be left behind. These developments are encouraging, but they also raise an important question: is the health-care industry prepared to capture big data’s full potential, or are there roadblocks that will hamper its use

The word “patient” appears nowhere in that long passage. The word “stakeholder” appears twice, plus eight more times in the whole piece. Still, McKinsey brooks some respect for the patient, though more as a metric zone than as a holder of a stake in outcomes:

Health-care stakeholders are well versed in capturing value and have developed many levers to assist with this goal. But traditional tools do not always take complete advantage of the insights that big data can provide. Unit-price discounts, for instance, are based primarily on contracting and negotiating leverage. And like most other well-established health-care value levers, they focus solely on reducing costs rather than improving patient outcomes. Although these tools will continue to play an important role, stakeholders will only benefit from big data if they take a more holistic, patient-centered approach to value, one that focuses equally on health-care spending and treatment outcomes.

McKinsey’s customers are not you and me. They are business executives, many of which work in health care. As players in their game, we have zero influence. As voters in the democracy game, however, we have a bit more. That’s one reason we elected Barack Obama.

So, viewed from the level at which it plays out, the debate over health care, at least in the U.S., is between those who believe in addressing problems with business (especially the big kind) and those who believe in addressing problems with policy (especially the big kind, such as Obamacare).

Big business has been winning, mostly. This is why Obamacare turned out to be a set of policy tweaks on a business that was already highly regulated, mostly by captive lawmakers and regulators.

Meanwhile we have this irony to contemplate: while dying of bad data at a rate rivaling war and plague, our physical bodies are being doubled into digital ones. It is now possible to know one’s entire genome, including clear markers of risks such as cancer and dementia. That’s in addition to being able to know one’s quantified self (QS), plus one’s health care history.

Yet all of that data is scattered and silo’d. This is why it is hard to integrate all our available QS data, and nearly impossible to integrate all our health care history. After I left the Harvard University Health Services (HUHS) system in 2010, my doctor at the time (Richard Donohue, MD, whom I recommend highly) obtained and handed over to me the entirety of my records from HUHS. It’s not data, however. It’s a pile of paper, as thick as the Manhattan phone book. Its utility to other doctors verges on nil. Such is the nature of the bizarre information asymmetry (and burial) in the current system.

On top of that, our health care system incentivizes us to conceal our history, especially if any of that history puts us in a higher risk category, sure to pay more in health insurance premiums.

But what happens when we solve these problems, and our digital selves become fully knowable — by both our selves and our health care providers? What happens to the risk calculation business we have today, which rationalizes more than 400,000 snuffed souls per annum as collateral damage? Do we go to single-payer then, for the simple reason that the best risk calculations are based on the nation’s entire population?

I don’t know.

I do know the current system doesn’t want to go there, on either the business or the policy side. But it will. Inevitably.

At the end of whatever day this is, our physical selves will know our data selves better than any system built to hoard and manage our personal data for their interests more than for ours. When that happens the current system will break, and another one will take its place.

How many more of us will die needlessly in the meantime? And does knowing (or guessing at) that number make any difference? It hasn’t so far.

But that shouldn’t stop us. Hats off to leadership in the direction of actually solving these problems, starting with Adrian Gropper, ePatient Dave, Patient Privacy RightsBrian Behlendorf, Esther Dyson, John Wilbanks, Tom Munnecke and countless other good people and organizations who have been pushing this rock up a hill for a long time, and aren’t about to stop. (Send me more names or add them in the comments below.)

towerRadio used to be wireless audio on a broadcast band. That’s still the short version of every dictionary definition.

But now radio is streamed audio. That was already the case when webcasting* showed up in the ’90s, and even more so with the rise of Last.fm, SiriusXM, Pandora, rdio, Spotify and every other audio service delivered over the Net.

And now Apple delivers a crowning blow, with this:

This isn’t just the height of presumption on Apple’s part. It’s a body-snatch on all of radio, as well as a straight-up knock-off of Pandora.

But it’s actually worse for radio than it looks here.

What used to be called Radio (iTunes’ collection of webcasting radio stations), which had already been pushed down one directory level to “Music,” is now available only under a new button called “Internet.” (See the screenshot above.) Worse, it won’t appear unless you open preferences in iTunes and check a box to turn it on.

So Apple clearly hates radio as we’ve always known it, and could hardly be more passive-aggressive about subordinating it to their own closed, exclusive, silo’d and proprietary service. (Here’s some bonus evidence.)

So where does this leave plain old over-the-air radio — you know, the kind that fades away when you drive out of town?

Simply put, in a new context. That context is the Net. That’s the new broadcast band. Here on the Net (where you are now), audio servers are the new transmitters and mobile devices are the new portable radios.

So, some advice.

For stations, networks and chains:

  1. Normalize to the Net. That doesn’t mean just “digital first.” It means recognizing that the Internet is your coverage area, and the new native land for all forms of radio, including Satellite. This is the lecture that @JeffJarvis has given for years, correctly, to his friend @HowardStern and to @SiriusXM, where Howard (also correctly) anchors the whole link-up.
  2. Recognize that the Net does not belong to the cable and phone companies but to nobody, which is why it covers the world. Think of it as a world of ends (where every audio source and every listener is a separate end), and NEA — nobody owns it, everybody can use it, and anybody can improve it. Including you.
  3. Choose a streaming URL (or a set of URLs) for your station(s) that will be as permanent as your over-the-air dial positions. Make sure you’re streaming in .mp3 or some other standard codec that all mobile apps can receive. (Right now the burden of finding a streaming URL in the first place is a pain in the ass.)
  4. Transmit over the air in HD. Yes, HD has problems, and the adoption rate is still low. But it’s an all-digital bridge between net-casting and over-the-air.
  5. Continue to use RDS (RDBS in the U.S.) with your analog signals. That way it will display your identity and content on radios equipped to do so, most of which, so far, are in cars.
  6. Support every possible app that moves toward re-creating the old dial-based radio experience. The closest I’ve seen so far is the BBC’s iPlayer app, which isn’t available in the U.S.
  7. Have truly unique programming. If you’re running what dozens or hundreds of other stations are running, you’re just a relay.
  8. Look toward making more money from subscriptions and voluntary donations than from advertising. More about that below.
  9. Think in terms of relationships, and not just listeners. This is essential because listeners have communication power now too. Don’t waste it by looking at them only as populations. This isn’t easy, because the grooves of one-way-one-to-many non-relating are nearly a century deep. But those who relate best will win biggest.
  10. Make podcasting a normal and easy part of your mix of offerings. More listeners will listen, more of the time (which they will make for themselves.) And, if you can’t easily podcast because you’re doing music, see the last section below.

For app developers:

  1. Keep up the pioneering work done by Tune InWunderradioPRX’s Public Radio PlayerStitcher and the rest. But note this…
  2.  No app yet (to my knowledge, at least) re-creates the simple experience we got from knobs, dials and uncomplicated read-outs on good old-fashioned radios. In effect we’re still stuck where mp3 players were before the iPad came along with its scroll wheel. Only now the shitty experience is on our mobile devices, including our Apple i-things.
  3. Ease the experience of listening, and recording (like with DAR.fm), across everything possible. I know this isn’t easy, because chains like Clear Channel (with its iHeartRadio) and the BBC like to limit listening within their app to their own stations. But this isn’t what most listeners want.
  4. Work toward a single easy non-proprietary way to support subscription services (such as SiriusXM) and volunteer-pay services, (such as public radio stations in the U.S). Everybody with that model will make more money, much more easily, if the process isn’t different for every station, every network, every service.
  5. Symbolize relationships (especially paid ones) with UI elements that are easy to read and universally used and accepted. I recommend the r-button, which the VRM development community came up with, and which is there for the taking. The ⊂ represents the person’s side of the relationship, while the ⊃ is the ‘caster’s. If you’re interested, talk to me about it.
  6. Think relationships, not just listeners.

For equipment makers:

  1. Quit making shitty radios. The receiving circuitry and antennas for most home and portable radios have been awful for awhile now, and I don’t expect them to get better. But I think there is room for some companies still making radios to put out a few actually good ones. And include HD. (The best makers of portable radios, C.Crane and Sangean, don’t do HD — yet. And Sony, which used to make the best portables, hasn’t cared about radio in decades.)
  2. Ibiquity (developer and licensor of HD Radio technology): change your game. Adoption by equipment makers is clearly too slow and too hard. Hell, you’ve been around since 2001, and now you’re bragging on just the first car to feature it. This search on Amazon for “HD Radio” should bring up lots of results, rather than a few hens’ teeth. And do whatever it takes for the champions of good reception — C.Crane and Sangean — to jump on board.)
  3. Make radios that hunt easily from over the air analog to HD Radio to streams on the Net. That’s key to The Transition.

For everybody:

  1. Lobby to overhaul the complex and market-hostile royalty system for webcasting, and its inequities with over-the-air broadcasting. Replace it with something sane and respectful of the all-digital world to which we are moving.
  2. In respect to the link above, note this language: Sections 112 and 114 require that rates for the statutory licenses for webcasting and for ephemeral recordings must be the rates that most clearly represent the rates that would have been negotiated in the marketplace between a willing buyer and a willing seller. That boldfaced language is a relic of the DMCA, which was passed in ’98 — just three years after the dawn of the graphical browser, before anybody could imagine that the Net could support willing buyers and sellers of streamed music. The effect of this has been to marginalize or kill music podcasting, to name just one victim. Nobody wants the rights-holders to get screwed, but everybody should recognize by now that its the music itself, and the relationships between artists, distributors (including radio service operators) and listeners that are getting screwed by the current system. We can do better. Hell, it’s almost 2014. Let’s get this done.

* “Webcasting” should have been called “netcasting” in the first place. As Wikipedia says at the moment (at that last link), “Essentially, webcasting is ‘broadcasting’ over the Internet.” The difference is important because the Web is something that runs on the Net, rather than a synonym for the Net.

Fuse is more than a device and a smartphone app to go with it. The world is full of those already.

Fuse is the first product in the digital age that can blow up every one of the silos built to trap personal data and limit personal independence.

Fuse does that by putting you — literally — in the driver’s seat of your life.

Fuse is also the first product to show how your own “Internet of things” can be fully yours — and truly integrated in ways that work for you — without requiring that you become a serf in some company’s castle.

Fuse is an invention of Phil Windley and his team at Kynetx, who are committed to the freedom,  independence and self-empowerment of individuals: to making you a driver of your own life and your own stuff, and not just a “user” of others’ products and services. And to letting you be “social” in your own ways, as you are in your everyday life outside the Web.

This is why Fuse is Net-native, not Web-native (though it uses the Web too). This matters because the Net was created as a decentralized World of Ends, where every node can be sovereign and independent, as well as zero functional distance from every other node. The Web could have been the same, but instead it grew on top of the Net, along lines defined by client-server architecture (aka calf-cow), which makes everything there centralized: you’re always a client, and always at the mercy of servers. This is why the browser, which started out as a vehicle on the Information Superhighway, turned into a shopping cart that gets re-skinned at every commercial site you visit, and carries tracking beacons so you can be a better target for advertising.

Fuse drives under and away from that model, which has become terribly corrupted, and toward what Bob Frankston (sitting next to me as I write this) calls the “boundary less” and “permissionless” world.

If Fuse succeeds, it will be a critical first step toward building the fully independent vehicle for the fully independent human being on that same old Information Superhighway. And it will do that that by starting with your own car.

There are only a few hours left for the Fuse Kickstarter campaign. The sum required is only $60,000, and contributions have passed $50,ooo already. So help put it over the top. It could be the most leveraged investment you’ll ever make in the future of personal independence in the networked world.

More background in my first post on Fuse.

[Later, same day…] Goal reached:

294 backers
$63,202 pledged of $60,000 goal
Looking forward to seeing Fuse’s pudding prove the headline above. 🙂

Quote du jour

Overheard: “I would rather not do this the VC way.”

In Google sets out future for Maps — Lays down gauntlet to Nokia with plans for personalized, context-aware and ’emotional’ maps in future, in Rethink Wireless, Caroline Gabriel begins this way:

Google may be feeling the heat from an unlikely source, Nokia, at least in its critical Maps business. The search giant has put location awareness at the heart of its business model, but Nokia has overtaken it in several respects with its cloud-based Here offering – based on the acquisition of Navteq in 2007 – and has also licensed its mapping platform to some powerful partners such as Microsoft, Amazon and a range of car makers.

Google is promising dramatic changes to its own maps to help fend off the Nokia/Microsoft alliance and also, in the Android segment at least, the challenge from Amazon to a Google-centric experience.

As usual with stories like this, the issue is framed in terms of vendor sports: big companies doing battle over some market category. Lost, also as usual, is what the individual user, or customer, might actually want.

That’s what I’m here for.

So let me start by saying I don’t want a “Google-centric experience,” whatever that is. Nor do I want Google’s (or anybody’s) Matrix-like approach to satisfying what its robotic systems think I might need. Here’s how Caroline explains that ambition:

Bernhard Seefeld, product management director for Google Maps, told the GigaOM Roadmap conference this week that future software will “build a whole new map for every context and every person”, incorporating all kinds of information about the individual and updating this constantly. He added: “It’s a specific map nobody has seen before, and it’s just there for that moment to visualize the data.”

Pushing a major theme at Google this year, Seefeld talks about applications creating emotional connections for users – “emotional maps that reflect our real life connections and peek into the future and possibly travel there”. This will involve context-aware maps that combine location and personal data, some of that taken from other Google apps, particularly its Google Now personal digital assistant – mainly seen as a response to Apple Siri, but in fact far broader in scope, and with a powerful artificial intelligence engine.

Context-aware is fine, provided I provide the context, and the context is as simple as, for example, “I am here” and “I want to go to this other place.” I don’t want guesswork about my emotions, or anything else that isn’t on the vector of what I alone know and want. Paper maps didn’t do that, and the best electronic ones shouldn’t either — not beyond what still feels as hard and useful as paper maps always did.

See, maps are fact-based descriptions of the world. Their first and most essential context is that world, and not the person seeking facts about that world. Yes, map makers have always made speculative assumptions about what a map reader might like to know. But those assumptions have always been about populations of readers: drivers, aviators, hikers, bike riders, sailors, geologists, etc. That they don’t get personal is a feature, not a bug.

A brief story that should tell you a bit about me and maps.

In October 1987, on the way back to Palo Alto after visiting my daughter at UC-Irvine, my son and I noticed it was an unusually clear day. So we decided to drive to the top of Mt. Wilson, overlooking Los Angeles. On the way we stopped at a fast food place and ate our burgers while I studied various AAA maps of Southern California and its cities. When we arrived at the top, and stood there overlooking a vista that stretched from the San Bernardino mountains to the Channel Islands, four guys from New Jersey in plaid pants, fresh from golfing somewhere, asked me to point out landmarks below, since I already was doing that for my son. The dialog went something like this:

“Where’s the Rose Bowl?”

“Over there on the right is Verdugo Mountain. See that green stretch below? In there is the Rose Bowl.”

“Oh yeah.”

“On the other side of Verdogo is the San Fernando Valley. South of that are the Hollywood Hills.”

“Is that where the Hollywood sign is?”

“Yes, on the south side, facing Hollywood. Mulholland Drive runs down the spine of the hills on the far side of the Sepulveda Pass, where the 405 passes through. The Malibu Hills are beyond that. You can see the buildings downtown to the left of that. Long Beach and San Pedro, Los Angeles’ port cities, are to the left of the Palos Verdes peninsula, which are the hills over there. You can see Santa Catalina Island off beyond that.”

“Where was the Whittier Earthquake?”

“Over there in the Puente Hills. See that low ridge?”

“Yeah. Wow. How long have you lived here?”

“I don’t. This is only my second trip through. I live up north.”

“Where are you from?”

“New Jersey, like you.”

“How do you know so much about all this around here?”

“I study maps.”

Of which I have many, now mostly mothballed in drawers. Maps collection on my iphoneI have topo maps from the U.S. Geological Survey, sectional charts from the FAA, maps atlases from the Ordnance Survey in the U.K., and many more. When I fly in planes, I follow the scene below on my laptop using Garmin Road Trip (an app that is sorely in need of an update, btw.) That’s how I can identify, literally on the fly, what I see out the window and later detail in my aerial photo collections on Flickr.

So, having presented those credentials, I rate Google’s Maps mobile app at the top of the current list. Google’s search is great, but substitutable. So are many other fine Google services. But I have become highly dependent on Google’s Maps app because nothing else comes close for providing fully useful facts-on-the-ground. Here are a few:

  • Transit options, and arrival times. Here in New York one quickly becomes dependent on them, and they are right a remarkable percentage of the time, given how uneven subway service tends to be. Hell, even in Santa Barbara, which is far from the center of the public transportation world, Google’s Maps app is able to tell me, to the minute, when the busses will arrive at a given stop. It’s freaking amazing at it.
  • Route options. Even while I’m on one route, two others are still available.
  • Re-routing around traffic. It doesn’t always work right, but when it does, it can be a huge time/hassle saver.
  • Timeliness. It couldn’t be more now, and a living embodiment of the Live Web at work.

I also like Here, from Nokia. (As you can see from my collection of maps apps, above. Note the second dot at the bottom, indicating that there’s a second page of them.) I also have enormous respect NAVTEQ, which Nokia bought a few years back. NAVTEQ has been at the map game a lot longer than Google, and is at the heart of Here. But so far Here hasn’t been as useful to me as Google Maps. For example, if I want to get from where I am now to the meeting at NYU I’ll be going to shortly, Google Maps gives me three options with clear walking and riding directions. Here gives me one route, and I can’t figure how to get the directions for taking it. (Both are on my iPhone, btw.)

So here is a message for both of them, and for everybody else in the mapping game: Don’t subordinate pure mapping functions to a lot of “emotional” and other guesswork-based variables that advertisers want more than map readers do.

This might also help: I’m willing to pay for the maps, and services around them. Not just to avoid advertising, but to make those services accountable to me, as a customer, and not as a mere “user.”

As advertising gets more and more personal, and more creepy in the process — without any direct accountability to the persons being “delivered” a “personalized experience” — a market for paid services is bound to emerge. I’ll enjoy being in the front of it.

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