Solve Sleep - What Stuck Out?

There was a lot to digest and after a week of incubation I have finally completed this post.

I’m a fan of Richard Branson.

You're probably thinking, "wait, Richard Branson, what does he have to do with Solve Sleep?"

Well, nothing to my knowledge, but he does have an influence on how I want to approach my blog. Branson's approach to his blog and messages from my POV is substance over form and I love that.

Moving on!

First, let me thank the team from HealthXL for inviting me to participate as one of the curious. I had a great time and walked away with a completely different understanding of sleep. It had me asking questions about sleep and each member of my family, my son in particular. The Medical Innovation Summit that followed augmented that understanding, but that’s for another post.

For you insomniacs and others afflicted with a sleep ailment, let me apologize, we didn’t solve sleep.

However, I have some textbooks that I would wager could put anyone to sleep if falling asleep is your biggest challenge. Send me a message and I’ll be happy to forward them your way.

I don’t think the expectation was for 60 people to literally come up with a comprehensive approach or solution to sleep in one weekend.

Ideating the top challenges

Having said that, I thought we were going to do a little more, particularly since there were going to be design thinking gurus present.

I went in with a pretty open mind just trying to absorb everything and ask questions.

After 20-30 years of snoring and nagging, my dad recently went through the process and now sleeps with a CPAP machine, so I came in curious about the process and the options.

Finally, here are the key takeaways and some areas for improvement. The chaps from HealthXL specifically asked for such recommendations and I think that says a lot about them. 

Key Takeaways

1. As I learned this weekend --- the process for diagnosis and treatment is long, arduously and unnecessarily long. For good measure it’s also inconvenient, potentially pricey and all for a result that doesn’t cure you or eliminate the problem. That last tidbit would be very discouraging to hear as patient.   

2. As for the event itself, the format limited the outcome. We were probably never going to solve sleep in one weekend, but splitting up the problem into 3 phases (Diagnosis, Treatment and Monitoring) and 2 perspectives (Doctor v Patient) was a very analytical approach, which is fine for some problems, but sleep is not one of them. Its interconnectedness, which was alluded to throughout the weekend, makes it a prime candidate for a systems thinking based approach. The Medical Innovation Summit had an amazing panel on systems thinking and that cemented this in my mind. 

3. Apnea gets most of the attention, but there’s a bigger story. Most people are sleep deprived and it has a huge impact in the aggregate, some staggering GDP figures were mentioned in respect to lost productivity and/or output; but a lack of concern, understanding and no easy way to tell  how sleep deprived someone is stands in the way of any effort. These barriers will be difficult to overcome without a holistic approach.

4. Design Thinking works. The team from Azul 7 gave great presentations and we did some exercises that showed design thinking’s potential, but we were only scratching the surface without observing patients and doctors live through the problems. I wonder if Azul 7 had designed the event, what would it have looked like? Felt like? While this was a memorable experience, I bet it could have been life changing for many people.

5. Weight loss and the digeridoo are two of the most effective treatments. They won’t cure you (nothing will yet) and they don’t work for all patients, but combined they can reduce the number of episodes for some apnea patients nearly 60%.

Brainstorming

Potential for Improvement

I see the event and the HealthXL team evolving. They want to make a difference and that was plain to see, so here are some thoughts that might help.

William has some fun getting ready to vote - as a patient he's even gone the extra mile in writing a book Sleep or Die, check it out here 

1. The environment or atmosphere was good, but I’m not sure enough was done to let everyone know it should be a safe place for bold ideas. Many of the ideas were safe, ordinary, and lacked the surprising insight that design thinking is known for.

2. Not going out to see what either the patients or clinicians go through was always going to limit the outcome. Where are the insights & surprises supposed to come from without observing the frustrations that they talk about firsthand? Maybe this will be part of the ongoing effort to address the challenge?

3. When individual teams focused on their respective POV, which was a great way to make it personal, the collective group lost some of the work that was done previously as the brainstorming focused on the one POV/problem.

Brainstorming was a painstaking process at our table and by the looks of other tables we weren’t alone. Participants too easily started asking too many questions about ideas. Explanations were too long and conversations that led nowhere were rampant.

I found myself just writing my own ideas down just to get some real progress. Looking back I probably should have just said, “hey, your line of questioning isn’t going to help us, the patients or doctors, so grab a pen, a sticky note and start writing!”

In the future I would recommend that the brainstorming session be almost completely silent for 30 minutes. Let people write ideas down and after the 30 minutes if there are any questions, they can be addressed and either another silent round can be done or a dialogue round can be done.

4. I mentioned this in the takeaways, but what would a design thinking approach to the weekend have looked like?

5. Something that seems trivial, but could have yielded better results is having the event AFTER the summit. Daniel Kraft’s talk alone would have made a difference as it quickly gave everyone a near complete view of the current cutting edge of health technology & innovation. As I mentioned before, many of the ideas were too safe. From what I’ve read breakthrough innovations are not safe or comfortable.

6. I would have liked to have seen a few high school, college and maybe even younger attendees. They would have asked the beginner’s mind questions. They would have been persistent and they would have challenged doctor and patient assumptions.

7. The experts could have recorded their presentations and posted them online. This could have streamlined questions and increased group knowledge before the event even started. This would make more time for the field and more value added activities. Perhaps, the experts themselves could have seen more design thinking in action and that would have changed their mindsets going forward.

Each team had an expert to answer questions, but our time with them was very limited and what about key findings? There didn’t seem to be a mechanism to communicate insights outside of selecting the top 3 challenges for each phase of the process.

All in all, it was a great event and I'm looking forward to making a contribution going forward. The HIMSS venue was fantastic and even inspiring. 

Generation Z -- are you ready to clean up the mess?

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Millenials and baby boomers are going to leave you with a huge mess. Below are some statements, not facts. You can ignore them or you can take some time to think about what it means. Each statement isn't necessarily that powerful by itself, but when you put them together...

Despite the amazing progress in technology we still have hunger, homelessness, and poverty...even in developed countries. (Is it better? Yes, but it really should no longer be an issue.)

People are going to live longer and there will be more of them. The population will be around 8 billion in roughly 10 years.

47% of jobs will be automated by 2034 (The Economist).

Less jobs, more people, even worse income inequality...

Key resources will only become more scarce and/or more unevenly distributed...UNLESS

You have the resiliency, creativity, wisdom, and courage to ask the right questions, challenge assumptions, learn, and collaborate at levels we haven't even imagined.

Why?

Without dramatic and systemic changes in education and the government worldwide, life is going to get a lot tougher. The current education system isn't preparing you for it and the government is even less prepared.

How do you prepare your kids for a future that's never been less certain?

First, Jeremy Howard does a great job illustrating what machine learning is and what it's capable of.  My only critique of Jeremy Howard's TED talk is that he leaves the big question till the end without pursuing any options of what the future should or may look like. He mentions changes in social and economic structure are necessary, but doesn't explore what kinds of changes these are and what it may look like. Nor does he offer any words of cautions or things to look out for. He leaves it to the audience, perhaps so people like me can speculate.

The only thing that is certain is that the future we imagine and the future that comes to pass are going to be different. 

I take 2 things in particular from his talk.

One, it would seem that the only thing that cannot be automated at this point or in the very near future are disciplines rooted in creativity. While machines can generate text by analyzing images or some other input, it doesn't seem like they can write a poem, story, etc quite yet. This also seems like something that is only a matter of time. If machines can learn and start randomly putting unrelated ideas together, what's to stop them from eventually developing a creative capacity? Especially if they can experiment and iterate quicker than humans? What I mean is maybe it is difficult to try and tackle creativity for machines with a one-prong approach at the front end. What happens when that effort is combined with another learning algorithm that assesses other creative works on the back end? At some point they would learn what makes good writing, art, etc or they could even offer several alternatives based on different tastes and points of view. 

Given that many service industries and functions can and will be automated over the next 2-3 decades, what do you do as a parent? What are considered "secure" industries or functions now, won't be by the time children come of age. And at that point, the current educational system is too rigid and narrow focused. Many may be completely unprepared to adapt. 

Are schools asking these questions?  Are enough parents asking these questions? Are schools even focusing on the right skills for their students in periods of only increasing uncertainty?  Are they working together to design a more flexible approach to education?

We seem to be on the cusp of an educational revolution, at least when it comes to technology, and that is very exciting. This is great for extending the reach of quality education to those who would otherwise be hard pressed to find such an opportunity on their own. Quality courses are available online with absolutely no charge or very little cost in terms of what you receive, I'm thinking Coursera, edX, and NovoEd to name a few.  Even the stakeholders who have the most to gain other than employees are getting involved through platforms like Udacity where companies like facebook and Google are offering courses  directly to students/workers. This approach seems to validate that some thing is missing from higher education. 

But, I wonder, is technology even the biggest problem? 

As a parent of a toddler, these are just some of the questions always running in the back of my mind. 

An award you don't want to win

The 2014 Luddite Award Winners - the states of Arizona, Michigan, Texas, and NJ (see here for the post) for blocking Tesla's attempts to sell directly to its customers. The award essentially calls out those who are opposed to new technologies. 

The NRA took second place for their opposition to smart guns. 

In both cases this is a matter of continuing the status quo. I have another musing on Tesla that very briefly explores both sides, here.

I will probably tackle the NRA issue in a later musing or blog post. Some research needs to be done on what the arguments are for the NRA's stance, but some questions that people, including myself, are asking include:

• how many school/public shootings need to occur before we do anything? 
• what does the rest of the world think when they hear about these stories? 
• what is it going to take to for change to happen?
• if smart guns (and diligent background checks) aren't part of the answer, then what is? 
• is it possible to design a system that prevents the tragedies from ever occurring...without smart guns and background checks?

Cyber-bullying, youth suicide, and the 14 year old dedicated to stopping it

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I originally intended for these daily musings to be short, but…sometimes the topic warrants more.

Over the weekend I saw yet another saddening headline about a youth suicide. I will spare the details, but like so many others in recent times there was cyber-bullying involved.

Cyber or not, bullying of any kind has always bothered me. That’s not to say that I have never been guilty of bullying another person. I like to think that it wasn’t a big part of who I was during my youth, since I was so busy trying to get better at soccer, school, and video games. If anyone from my grade school days would like to comment otherwise, I invite you to leave a comment or get in contact with me.

I have been on the other side as well. Luckily, that was in the early to mid-90’s, so the internet was painfully slow and bullying was limited to analog. Since the bully was older and in a different class, it was also limited to recess. As I reflect on it, I was even luckier in that the bully was more of a 1-on-1 kind of bully rather than one who gets others to participate. I don’t know a whole lot about cyber-bullying, but I know a fair amount about social media and this is where I imagine cyber bullying can be dangerous.

Side-question: I’m curious if the cyber-bullying is an extension of in-person efforts or limited to the internet.
 

Once a post is out there, it must be very easy for others to jump in. Even more concerning, with the ubiquity of technology and social networking it’s probably very hard for the victim to ignore. It was this thought and my recent entrepreneurial awakening that made me wonder if there are any efforts to thwart cyber-bullying, particularly on a preventive scale.

This led to something amazing.

Given my affinity for the show @midnight on comedy central, I started my google search with the simple query, “anti-troll.”

Side-note: Before this post I thought trolls and bullies are one and same. However, I think there is a slight difference, not that it really matters since both behaviors are off-putting. Trolling is when one “makes a deliberately offensive or provocative online posting with the aim of upsetting someone or eliciting an angry response from them.” Bullying on the other hand I think is more targeted and can stretch over an extended period of time.

Back to the matter at hand…one of the first results you will see is that a 13 year old, Trisha Prabhu, has developed an effective and preventive software for cyber-bullying. Her thought process, the scope of her research and testing, and execution is impressive. Prabhu determined that current solutions don’t address the issue until the damage has already been done, a particularly keen observation.

Here’s a link to her project, Rethink. It should come as no surprise that she’s interested in neuroscience and the brain.

To sum up, Prabhu developed a “Rethink” system that triggers an alert mechanism that gives the poster a second chance by offering an opportunity to re-think their words and the potential effects. Her research sourced from ikeepsafe.org explains that this process hasn't been fully developed in adolescent brains.

Her abilities don’t stop there. She recently gave a TEDxTeen talk this past October.

Well done Prabhu. 

Hopefully, we see her efforts soon. Look out for her Chrome plug-in extension, app, and whatever else she comes up with.