GUEST POST from Arlen Meyers

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GUEST POST from Arlen Meyers

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GUEST POST from Arlen Meyers

Artificial intelligence, like most industries, is diffusing in sick care. Applications in surgery are emerging and can generally be categorized as :

1. Surgical training and education
2. Preoperative assessment and diagnosis and clinical decision support
3. Intraoperative surgical performance and quality improvement
4. Smart OR’s and environment
5. Postoperative care and complication risk assessment and predication
6. Workflow improvement, like OR start time and turnover efficiencies
7. Surgical robotics
8. VR and AR and 3-D printing
9. Telerobotic and teleproctored surgery
10. Human subject trial recruitment and execution

Many of these applications are in the research or demonstration phase and will take a while to become the standard of care or achieve widespread dissemination and implementation.

Biomedical AIntrepreneurhship describes the practice of creating AI products and services to solve bioscience (drugs and devices) and clinical problems. As such, it is the pursuit of opportunity under conditions of uncertainty using scarce resources with the goal of creating user defined value through the design, development and deployment of biomedical innovations that use a predominantly AI backbone, platform or foundation that have a VAST business model. It is a subsegment of digital health products and services.

The use of AI in medicine is evolving rapidly. Here are some updates:

1. Educational platforms, meetings, conferences and magazines
2. Robust investment into development and M/A
3. Coherent applications combining AI, medtech and biopharma
4. Increasing concerns and attention to the ethical, societal, education, manpower development and economic impact of AI in medicine
5. How AI is contributing to the 4th industrial revolution
6. The intersection of AI and robotics
7. The intersection of AI and blockchain
8. The impact and perils of decentralized, DIY medicine
9. Cybersecurity and confidentiality concerns. If you are not worried yet, read this too.
10. Concerns and strategies to make transparent algorithms and mitigate AI bias and “eliminate black box bias”.
11. Stories and organizations about physician AIntrepreneurs.
12. Regulatory, legal and reimbursement challenges

13. Convergence of AI into medical device and biopharma Current emerging applications appear to fall into three main categories:

14. Smart speakers in the OR and examining rooms

Management of chronic diseases – Companies are using machine learning to monitor patients using sensors and to automate the delivery of treatment using connected mobile apps (Example: Diabetes and automated insulin delivery).

Medical imaging – Companies are integrating AI-driven platforms in medical scanning devices to improve image clarity and clinical outcomes by reducing exposure to radiation (Example: GE Healthcare CT scans for liver and kidney lesions).

AI and Internet of Things (IoT) – Companies are integrating AI and IoT to better monitor patient adherence to treatment protocols and to improve clinical outcomes (Example: Philips Healthcare solution for continuous monitoring of patients in critical condition).

As artificial intelligence projects roll out, organizations will need to rethink the definition of the “work” that people will do. The future of work will become one of the largest agenda items for policy makers, corporate executives and social economists, says Sanjay Srivastava, chief digital officer at Genpact, a professional services firm focusing on digital transformation. Here is how doctors and patients can win the 4th industrial revolution.

What is the secret sauce of successful innovators like AIntrepreneurs? They strive to innovate in ways that would have a major impact on markets and society, e.g changing sick care to health care or making the sick care workforce more efficient and effective, and they revamped how their organizations pursued innovation and brought their capabilities together in a single “architecture.” That will mean medtech transforming to techmed will require changing how to collaborate with doctors and patients.

Will AI put society on autopilot? Will surgeons lose their skills in the age of automation?Where is the evidence that robotic surgery adds value and when?

Here are some of the barriers we will need to overcome.

Why is the gap between companies’ AI ambition and their actual adoption so large? The answer is not primarily technical. It is organizational and cultural. A massive skills and language gap has emerged between key organizational decision makers and their “AI teams.” It is a barrier that promises to stall, delay, or sink algorithmic innovations. And it is growing, not shrinking. The problem is that healthcare professionals are from Venus and technologists are from Mars. They have different mindsets and how they communicate.

Here are emerging data security and risk management trends.

Those products and services that add value, particularly those that drive down costs and do not interfere with workflow, have a higher chance of success. Those that don’t will be relegated to the shiny new object pile and red bagged for disposal.

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GUEST POST from Arlen Meyers

Most doctors would agree that medicine, contrary to popular belief, is part science, but mostly art. Most of medical practice is not evidence based.

On the other hand, there seems to be some argument whether entrepreneurship is an art, a science or both.

Based on my experience of teaching and practicing both, here’s my two cents:

1. The underlying foundation of science is a body of knowledge believed to be true. That is until it is proved wrong. Take, for example, the idea that the earth revolves around the sun. Sure, there are many examples and “best practices” when it comes to describing entrepreneurial ventures, but, there are no hard truths when it comes to predicting success, other than you need to make more money than you spend.
2. Science “facts” are used to predict outcomes with a high degree of probability. We use math and astrophysics to figure out how to land a man on the moon. It’s harder to figure out how to use “facts” to land a customer
3. There is a difference between science and the scientific method. Creating a hypothesis, doing experiments to test it, gathering and analyzing the data that results and drawing conclusions is useful both in the lab and what goes on out of the building. However, customer discovery data will only get you so far.
4. The STEM basic science curriculum has been iterated for thousands of years. The entrepreneurship or management “science” curriculum is a relatively recent phenomenon.
5. Using lean startup principles, while useful, is no guarantee of the “right answer”. I can pretty much guarantee that 2 x 2 =4.
6. Biomedical science is about finding “truth”. Entrepreneurship is about finding and creating customers or helping beneficiaries, as in the mission driven canvas.
7. In science, all things being equal, there is a high likelihood you will get the same experimental result. In entrepreneurship, there are no guarantees that doing the same thing twice will give you the same results
8. Science is supposed to be cognitive. Entrepreneurship is mostly about emotions.
9. Bias can distort both
10. The value of scientific discoveries and outcomes are much harder to define than entrepreneurial outcomes and they both have different timelines for doing so.

The art of entrepreneurship relies more on best practices than scientific facts. Even then, the problem with best practices is that they make you average.

 
Image credit: viola.bz

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GUEST POST from Arlen Meyers

Business plan. Those two words have been used a lot to kill a lot of innovative ideas. Yet, it persists in the entrepreneurial consciousness. It’s a mainstay in the manager’s tool box. Sure, it you are going to ask for money, you will in all likelihood need to write a business plan. But, so few entrepreneurs actually get to that stage, that it’s putting the cart before the horse. I’m not the only one who thinks so. There are lots of reasons why writing a business plan, or even worse, telling someone to write a business plan, is a bad idea. Here are some more:

1. Business plans are usually smoke and include financial projections that, at the most, are guesses without valid underlying assumptions on which they are based.

2. There is little evidence that business plans are related to business success.

3. Few successful businesses wind up doing what they said they would do in their initial business plan

4. Few investors or sponsors want to see a business plan first. They want a concise pitch that generates further interest.

5. As Guy Kawasaki points out in ” The Art of the Start: 2.0″, business plan competitions are really pitch competitions. It would be a whole lot easier for BP judges to watch submitted 3 minute videos than have to plow through pages of business plan submissions.

6. Business plans are used by dull managers to dissuade innovation. Have an idea that could kill our cash cow? Go write a business plan and get back to me. It’s called triage by inconvenience.

7. Most intrapreneurs don’t know how to write a business plan so it’s another way to kill ideas.

8. Planning is different from writing a business plan

9. Most of what you would put into a business plan anyway can be validated before and if you get to that stage.

10. Better to create and test a business model canvass than a business plan

Distracting you and hoping you’ll get discouraged is but one arrow the in the anti-innovative bureaucrats quiver. There are many more:

Deflection: turfing you to the death committee

Delay: Maybe some other time

Denial: We don’t have a problem

Discounting: It’s really not that big of an issue

Deception: They make up facts that discredit you

Dividing: Divide and conquer

Dulcifying or appeasing: Making meaningless concessions

Discrediting: Sniping

Destroying:Trying to ruin you and your reputation and get you to quit or retire

Dealing: Compromise and give you just enough to make you go away.

There are alternatives to writing a business plan based on :

Prototype: Sketch out your idea quickly with the Business Model Canvas and Value Proposition Canvas.

Question: Ask yourself what needs to be true for your idea to work, i.e. define the underlying hypotheses.

Test: Test the desirability (will customers want it?), feasibility (can I build it?), and viability (will it be profitable?)

Iterate: Adapt your initial rough Business Model and Value Proposition Canvas and refine with increasing evidence from testing.

Still not convinced? Here are some more innovation killers – try these too.

Look out for killer phrases that start with “That’s a good idea, but…”

1. It’s against company policy
2. It’s not practical
3. It’s not necessary
4. We don’t have the resources
5. It will cost too much
6. We’ve never done it that way
7. Our customers (or vendors) won’t like it
8. It needs more study
9. It’s not part of your job
10. Let’s make a survey first
11. Let’s sit on it for a while
12. That’s not our problem
13. The boss won’t go for it
14. The old timers won’t use it
15. It’s too hard to administer
16. Why hasn’t someone else suggested it before?
17. Let’s form a committee
18. We should wait until the economy improves
19. Who else has tried it?
20. Is it best practice?

No business pllan survives the first customer, and it is definitely helpful to plan. However, writing it as the first step is another story and just discourages innovators. Stop it.

Maybe those two words will help.

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GUEST POST from Arlen Meyers

Sign up here to join 17,000+ leaders getting Human-Centered Change & Innovation Weekly delivered to their inbox every week.

GUEST POST from Arlen Meyers

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GUEST POST from Arlen Meyers

There’s No Better Time to Be a Doctor

Victor Fuchs and Mark Cullen published an article in JAMA questioning the impact changes in health care systems have on doctors. The authors argue that the medical education establishment should respond to such changes with curriculum reform that includes, among other things, health economics and population health. They further provide a short history of health care policy and structure and discuss how it has evolved from an unregulated industry to one that is now increasingly corporatized. They note the rise in employed physicians and state: “Physicians might become less professional, but their professional role could increase as their entrepreneurial role decreases.”

It seems to me there is confusion about physician entrepreneurship, its definition, and whether it represents a threat to professionalism. I’m not alone in my speculation. Is a physician entrepreneur someone who starts and runs a business, or is it something more?

1. Entrepreneurship is the pursuit of opportunity with scarce, uncontrolled resources. The goal of all entrepreneurs, including physician entrepreneurs, is to create user-defined value through the deployment of innovation using a VAST (click here for more info) business model.
2. Innovation has both a qualitative and quantitative component. It refers to doing something new, or something old in a new way, that creates user-defined value that is a significant multiple of the competitive offering. Sick care sorely needs innovation that is not incremental or sustaining, but rather significantly adds at least 10 times the present value to have an impact.
3. Physician entrepreneurship is not the same things as private practice nor is it fundamentally about practice management. The increasing rate of employed physicians should not be interpreted, as Fuchs and Cullen imply, as decreasing the professional role of doctors . To the contrary, when entrepreneurism is done properly, it enhances medical professionalism.
4. There are many different goals and roles for physician entrepreneurs (a category that includes small- to medium-sized business owners in private practice, technopreneurs, social entrepreneurs, intrapreneurs (i.e., employed physicians acting like entrepreneurs), freelancers and consultants, and physician investors). Social entrepreneurship has a long history of physician involvement, and business school courses in social entrepreneurship are expanding. (Here is an example of how one doctor can make a difference.) Roles can vary as well. Some physician entrepreneurs are problem seekers, others are problem solvers. There are also storytellers, money finders, scorekeepers, social connectors, risk managers, and business developers.
5. Employed physicians, whether academic or non-academic, have the potential to be as entrepreneurial as their colleagues who are in independent practice.
6. While medical education reform is necessary, expecting medical students to master health economics and population health is unrealistic. Medical schools need to be part of entrepreneurial universities, with the goal of instilling an entrepreneurial mindset in all graduates, including health professionals. To that end, medical schools and their affiliated graduates schools should rethink how they teach. They should practice technology transfer and commercialization, and give faculty innovators the tools, incentive, and recognition to pursue innovation scholarship.
7. Physician entrepreneurship enhances medical professionalism. It does not degrade it, so long its practitioners understand and resolve the conflicts between the ethics of medicine and the ethics of business. Violating the patient or public trust by self-dealing or not disclosing conflicts of interest degrades any profession that has a fiduciary relationship with its customers or clients.
8. Physician entrepreneurs create value for patients in many ways outside clinical care. The upcoming generation of medical students, residents, scientists, and engineers understand that better than graduate school faculty and administrators—and they have engaged in bottom-up efforts to fill the gaps in their education and experiences.
9. Every threat to the existing practice of medicine represents an opportunity for physician entrepreneurs to help patients by adding value.
10. Every industrialized country is grappling with how to provide its citizens with health services given scarce resources. Innovation and entrepreneurship, fostered by rules that catalyze them, will be the solution. Physician entrepreneurs are making a difference. This non-profit group that is trying to eliminate the stigma of mental illness in Nigeria is just one of many examples.

The “golden age” of medical practice is being replaced by the “golden age” of physician entrepreneurship. Entrepreneurship offers another way to help patients—arguably, there is no better time to be a doctor.

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GUEST POST from Arlen Meyers

In 2004, Stanford Professor Robert Sutton published “More Trouble Than They’re Worth” in the Harvard Business Review. His subsequent book, The No Asshole Rule, expanded on the theme and described how toxic the syndrome can be and whether you are one or not. Are you one? Here is a test to find out and the accompanying survival guide for assholes.

Prof. Sutton now has a new book that offers some ideas on how to dealt with assholes.

Taking a page from that book and others like it, medical schools are confronting the issue of medical professionalism and issues that derive from student abuse and mistreatment. They are creating Offices of Professionalism that offer guidance, counseling, dispute resolution alternatives and education to faculty,staff and students to address and prevent unprofessional behavior that interferes with education.

So how do you know one when you see one? Prof. Sutton offers two tests:

1. After talking to the alleged asshole, does the “target” feel oppressed, humiliated, de-energized, or belittled by the person? In particular, does the target feel worse about him or herself?

2. Does the alleged asshole aim his or her venom at the people who are less powerful rather than at those people who are more powerful?

French and Raven described 5 sources of power:

1. Legitimate – This comes from the belief that a person has the formal right to make demands, and to expect compliance and obedience from others.
2. Reward – This results from one person’s ability to compensate another for compliance.
3. Expert – This is based on a person’s superior skill and knowledge.
4. Referent – This is the result of a person’s perceived attractiveness, worthiness, and right to respect from others.
5. Coercive – This comes from the belief that a person can punish others for noncompliance.

In medicine, these sources are not much different and there are three main power imbalances that play out in practice and during training : the faculty-faculty imbalance, the faculty-student imbalance and the doctor-patient imbalance. If not managed properly, these interactions can have significant organizational, legal and educational implications.

The syndrome is even more pervasive in entrerepreneurial circles, where, in many instances, being labeled a toxic, bullying, annoying troublemaker is a badge of honor, when , in fact, you might simply be an asshole. Silicon Valley has made a cottage industry helping assholes via the radical candor movement.

Discovering you are an asshole can create existential questions that go to the core of your being. But, sooner or later, you will have to deal with your demons. If you don’t, you will be destroying your personal life and career, living in the veil of marginalization and career suicide. You choose. Good rebel or bad rebel.

Here are some words others might use to describe you: annoying, troublemaker, arrogant, bully, direct, hot-headed or, you are an asshole. Like crafting a value proposition, it really does not matter whether you think you are an asshole or not. . The only thing that matters is how others feel about being around you. So, if you finally admit that you are an asshole, here are some things you can do about it:

1. Practice being considerate and caring. You might need to fake it ’till you make it. Start with using these five tricks to remember people’s names.
2. Stay away from toxic assholes at work and in your personal life
3. Do something that scares you every day and learn from it
4. Ask for help
5. Stop comparing yourself to others
6. Give people the right to show you the yellow card or red card whenever they think you are acting like an asshole
7. Listen more and don’t interrupt. Don’t say all that stuff in your mind that you want to blurt out when others are talking. Instead, write it down and either forget it because it wasn’t all that important anyway, send it someone who might be interested in your ideas, or wait for the right time to chime as long as you have not already talked more than anyone else.
8. Use “we” not “I” and “us’ not “me”
9. Like a contagious virus, quarantine yourself periodically until you have mutated into a less harmful form. Spend time in nature. She is forgiving.
10. Jerks can be effective in organizations. Just don’t step over the line.
11. Learn better feedback techniques.

Here’s how to survive a jerk at work.

Most people think power is a dirty word. However, it is an i nevitable part of organizational behavior and managing to use or not use power in the appropriate way is a core skill for doctors and teachers. Refusing to work with assholes is important. So is recognizing one in the mirror.

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GUEST POST from Arlen Meyers

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