Tuesday, September 27, 2016

Health 2.0's 10th annual conference Day One

A jam-packed, inspiring day. Myriad technical topics to reflect on and write up. But, below, the cut-to-the-chase emblematic slide that jumped right out to me.

That critical "connectivity" spans the gamut, from self bio-monitoring to the breadth of clinical medicine and community/social services resources. Virtually everything presented all day fits within those parameters.

Shot more than 120 photos. Will be triaging them all day as time permits. A few for now.

I'd intended to begin the day attending the 8 a.m. blockchain tech session, but instead went to Dr. Painter's "Intersection of Technology and Public Health" 4-hour forum. Glad I did.

Hope everyone has a great Day Two. Tweet me @BobbyGVegas if you want to chat up. Speaking of tweets...

LOL. No, I don't dig the guy. "Believe me."

More to come...

Sunday, September 25, 2016

Showtime! Health 2.0's 10th annual conference

I could not be in a better mood this morning. We got our dog Jaco back yesterday after 12 days of numbing anguish over his getting loose and disappearing on September 13th. Jaco is safely home with my daughter, and I'm here at the Hyatt Regency onsite hotel at the Santa Clara Convention Center with my wife, who just returned from an intense week-long business trip to Israel. Not even a loud and obnoxious early morning hotel union protest out on the sidewalk could harsh my buzz (and, thank you, Hyatt staff for comping me the lattes as apology for the protest harangue).

As I noted on Facebook yesterday afternoon:
It's been a good day. My wife came home from overseas, my dog came back, and Tennessee beat Florida. I feel a country song coming on.
LOL. I been known to write a country song or two...

Cheryl and I lit into some maragritas and lemon drop martinis and chow at the hotel Evo bar last night, and got to have some nice chats with Health 2.0 co-founders Indu Subaiya and Matthew Holt, both of whom are utter delights.

Provider Symposium
The Provider Symposium is back again this year! This event will bring together hospital & other provider executives with innovators to tackle the biggest challenges facing health systems today.

To truly drive change in health care, innovation needs to occur at both an operational level as well as in the day-to-day workflow of clinical care. The symposium unites those worlds with classic Health 2.0 demos of the latest technology designed to improve the lives of these key stakeholders, as well as meaningful discussion anchored by case studies of pilots using new technology, or developing innovation within from forward-thinking institutions like Cedar-Sinai, UPMC and more! By gathering the right people, technologies, and systems into a single room, the Provider Symposium will foster debate and spark the exchange of ideas between the best minds from leading health care systems in an effort to change the face of health care as we know it...

Patients 2.0 at the 10th Annual Fall Conference
This year’s theme is Patient Match, where we discuss the resources and tools available for patients as they navigate their health journey from diagnosis to long-term care. The Patients 2.0 session is run by Patients and marshaled by Sarah Krug from the Society for Participatory Medicine...
"[I]nnovation needs to occur at both an operational level as well as in the day-to-day workflow of clinical care."

Indeed, which is why, aside from HIMSS and IHI conferences, I also cover The Lean Summits every year. Health 2.0 and Lean are my favorites, gotta say.

Gonna be a great day. My cameras are fully charged and ready to rock. Still ruminating on the myriad implications of "thinking about jobs, education, healthcare, and tech." And, Gerd Leonhard's "digital obesity" amid the broad and deep panoply of health space issues I continue to chew on here at KHIT.

Hope to meet a bunch of you here today and this week. My Twitter handle is @BobbyGvegas.


I should note this USC Center for Health Journalism webinar coming up on Thursday.

I've signed up. Recall my reviews of Ann Neumann's book "The Good Death" here and here.

News item. I searched Google news for "Health 2.0." This popped up:
Insiders: Silicon Valley is blowing its chance to ride the silver tsunami
By Dan Diamond


Health care is being swamped by the so-called silver tsunami: 10,000 seniors are turning 65 and becoming Medicare-eligible every day. But rather than ride the wave, investors in Silicon Valley and elsewhere are too focused on the shallower pool of younger, healthier Americans.
That's according to health care IT leaders and thinkers who participated in POLITICO's health IT advisory forum this week...
And, get off my lawn!


Are we finally getting to or at the uptick elbow of the Health IT innovation traction Hockey Stick curve. Last year at this time I mused on "Free Beer Tomorrow" - "Transforming the Healthcare System."


Stage lighting at Health 2.0 is generally fine, but today's pre-conference symposium day lighting was a bit weak (yes, I'm a lighting snob; come by it honest). While they continue to know that they should deploy overhead backlighting (unlike my friends at the Lean Healthcare Summits), the Front-of-House spot trees this time were inadequate. Makes for grainier, oversaturated photos. Nonetheless...

Below, the busiest guy in the ballroom. We ran long. It was way worth it.

My running joke with Matthew Holt.


 I took pretty good notes on the day. More later. Fixin' to go to the Redox reception shortly.


Community Health Center Network and Welkin Health Partner to Improve Health Outcomes for Bay Area's Most At-Risk Populations
Health 2.0, with the support of the Robert Wood Johnson Foundation, to award grant to develop complex case management platform for underserved populations

Community Health Center Network (CHCN), a non-profit public benefit corporation, and Welkin Health, a San Francisco-based digital health company specializing in patient relationship management, have partnered to develop a complex case management platform to elevate the success of CHCN’s Care Neighborhood program. The innovative program addresses and supports the health needs of the East Bay’s most at-risk and underserved populations through consistent patient outreach by Community Health Workers (CHWs) embedded in the CHCN health centers.

Selected as one of three national finalists for Health 2.0’s Technology for Healthy Communities initiative, a project supported by the Robert Wood Johnson Foundation, Welkin Health will develop a complex case management platform for CHCN. Emphasizing strong patient coaching and data-driven insights, the platform will help CHCN health centers streamline communication efforts between patients and CHWs, increasing engagement, reducing costs and leading to improved long-term health outcomes for patients. It will also aggregate patient data from EHR systems and claims databases to provide CHWs with optimal clinical decision support, increasing efficiency and the ability to track health improvements of enrolled patients over time.

The platform will launch at three CHCN health centers in the Alameda County with a goal to eventually expand to support Care Neighborhood programs at all eight health centers that are members of the network...

More to come...

Thursday, September 22, 2016

On deck: the 10th Annual Health 2.0 conference

It promises to be very interesting, as always. I'm staying onsite this year, going down Saturday so I can hit the ground running early Sunday. Mercifully, no NFL game across the street at Levi's Stadium this year.

In addition to the breadth of exquisitely-presented cutting edge health care and health tech topics, ten new companies will have their onstage debut.
  • Valeet Healthcares platform gives patients personalized health information while allowing providers to have a rounding tool and giving healthcare systems a dashboard to track metrics.
  • gripAble is an innovative mobile technology that bridges the gap between functional therapy and objective measurement of upper-limb function.
  • Cricket Health works with payor and provider customers to slow the progression of chronic kidney disease (CKD), manage the transition from CKD to End Stage Renal Disease, and improve ESRD care.
  • Qidza is a population health mobile platform that enables parents work with their physicians to track their children’s developmental milestones
  • Docent Health guides health systems to embrace a consumer-centric approach to healthcare by curating patient experiences.
  • Albeado builds Healthcare prediction and optimization solutions based on proprietary data science platform which combines clinical AI and Graph-Based Machine Learning.
  • Siren Care offers temperature-sensing smart socks which provide health data on foot ulcers, hot spots, and more to prevent future injuries.
  • MDwithME integrates soft and hardware components in a suitcase enabling full remote physical exams with an option of instant or delayed physician’s consult with quality of testing that equals or exceeds the current state of art.
  • DayTwo maintains health and prevent disease utilizing a microbiome platform, starting with personalized nutrition based on gut bacteria, aiming to normalize blood sugar levels and cultivate a healthy gut microbiome.
  • Regeneration Health is a health ecosystem powered by artificial intelligence that collects and monitors health in real time and curates free personalized health info and recommendations based on integrative medicine.
I recall my reflection on one of the 2015 launch presentations a year ago.

Among other things this year, Gerd Leonhard's "digital obesity" will be on my mind.

Along with that hardy perennial "interoperability." apropos,

Expand the deck to fullscreen for legibility.

I posted on HL7 "APIs" two years ago, here and here.

In related news, from the National Academy of Medicine:

As reported by FierceHealthCare:
National Academy of Medicine: HIT agenda must be reset

The U.S. has met only one of four federal health IT goals outlined by the White House in 2004, according to the National Academy of Medicine, which notes in a new discussion paper that the agenda for the next five years should be "reset."

The paper, part of NAM’s Vital Directions for Health and Health Care initiative, notes that while the national goal of electronic health record adoption has been reached, the three other goals outlined in 2004--interoperability, supporting consumers with information and public health, clinical trials and other data-intensive activities--have not. It identifies nine central themes in three focus areas that it suggests should be the major goals for health IT over the next five years, including:

Technical underpinnings:

  • Data standards and achieving interoperability at scale
  • Interoperability with consumer health technology
  • Improving patient identification matching to support interoperability
  • Service-oriented architectures and web-based services
...The paper outlines current problem areas, including Meaningful Use’s mixed success and inadequate EHR design. It also identifies opportunities and policy alternatives, such as authorizing the Department of Health and Human Services to adopt and promulgate standards through formal rule making for patient identification and matching.

The authors recommend three “vital directions” to take:

  1. End-to-end interoperability from devices to EHRs
  2. Aggressively address cybersecurity vulnerabilities
  3. Develop a data strategy that supports a learning health system...
Are we finally gonna cut through the persistent fog of "interoperababble"? Or will we see similar papers promulgated  five years out, all making the same recommendations we've been reading for years?

e.g., from the National Academy paper,
Data Standards and Achieving Interoperability at Scale
Many have concluded that the Meaningful Use goals of improved quality, safety, and efficiency cannot be reached until more data are shared for more purposes, with sharing integrated into the routine, health care–delivery work ow. As currently designed, HIT and the applicable regulations can slow the routine provision of health care. Enablers of efficiency—such as accurate, transparent, and actionable payer information available at the point of care; the ability to reuse structured health information for health care operations and administration; and documentation well suited for care in the 21st century—could help to achieve efficiency goals. Sharing data more broadly can enhance care coordination, ensuring that patients’ lifetime medical records travel among all providers. Redundant and unnecessary testing can be reduced. Physician orders for life-sustaining treatment can be communicated broadly. One estimate suggests that $80 billion could be saved annually if a comprehensive program of EHR data-sharing were widely implemented (Hillestad et al., 2005).
"2005"? I'm stuck in Groundhog Day. 2005 was the year I started working in the CMS Meaningful Use precursor DOQ-IT initiative at HealthInsight.

UPDATE: I printed the paper's pdf copy out and gave it the yellow marker / red pen treatment. Again, you could have pulled something up from a decade ago and made a few relatively minor edits to re-tread all of this. With respect to new stuff -- e.g., "precision medicine" and its foundational "omics" science underpinnings, this is all I find:
The Precision Medicine Initiative of the National Institutes of Health constitutes a bold step toward engaging individuals in helping to accelerate biomedical knowledge discovery through the use of electronic health information from EHRs and consumer health technology (NIH, 2016). [pg. 9]

In the era of "big data," the availability of more comprehensive, sensitive, and valuable — but less regulated — data emphasizes the ever present need for standards for encryption. Genomic (and "multi-omic") data used in personalized medicine lack policies and standards. [pg. 13]
That's all? I've ranted about these shortcomings in prior posts.
Got hooked up on Twitter with a company called "MI7" the other day.
Our software Q transforms every Electronic Health Record system into an API.
Sounds great. We'll see. Here's the question I want answered: "Does your app transform PHI metaphorically into the (iteratively, recursively lexically and semantically indestructible) "type-O blood" of health care? Y'know, that whole "data are the lifeblood of health care" thingy?

Interestingly another company, Redox,  -- host of a Sunday evening Health 2.0 Conference reception this year -- is also in this HIT "interop" fray:

Redox is the EHR integration platform for digital health solutions.
We empower healthcare applications to read, write, and query clinical data with any healthcare organization's electronic health record system. The bridge to interoperability is open.

I'm all eyes and ears.

In other news,

Chan Zuckerberg Initiative commits to investing $3 billion to cure diseases
An effort to cure all diseases within the lifetime of their daughter

The philanthropic initiative founded by Facebook founder Mark Zuckerberg and his wife, Priscilla Chan, will spend $3 billion over the next decade in an effort to cure and manage all human diseases. The Chan Zuckerberg's latest effort will begin with a $600 million investment in a project called Biohub, an independent research center located at the University of California at San Francisco that will work on developing new tools to measure and treat disease.

"Mark and I spent the past two years talking to scientists ranging form Nobel Prize laureates to graduate students," Chan said during an emotional talk at UCSF. "We believe that the future we all want for our children is possible. We set a goal: can we cure all diseases in our children's lifetime? That does't mean that no one will ever get sick. But it does mean that our children and their children should get sick a lot less. And that we should be able to detect and treat or at least manage it as an ongoing condition. Mark and I believe this is possible within our children's lifetime."...
Bears watching.


Day 9, no Jaco. It has been difficult to get motivated to do anything this week. Starting to despair that we'll never see him again.

"The benefit of being a Futurist is that you never have to change your slides."
LOL. Ian Morrison, Tuesday's Health 2.0 Keynote speaker, in an earlier interview with Matthew Holt. "I've got Powerpoint slides that are older than some of my clients."

More tech news...

Robot Nurses Will Make Shortages Obsolete
By 2022, one million nurse jobs will be unfilled—leaving patients with lower quality care and longer waits. But what if robots could do the job?

For years, the U.S. has experienced a shortage of registered nurses. The Bureau of Labor Statistics projects that while the number of nurses will increase by 19 percent by 2022, demand will grow faster than the supply, and that there will be over one million unfilled nursing jobs by then.

Those aged 65 or over comprise a bigger percentage of the U.S. population than ever, and by 2030, 20 percent of the U.S. population, or roughly 69 million people, will be senior citizens. While enrollment at nursing schools is up, these programs aren’t big enough to accept the number of applicants required to fill these positions.

So what’s the solution?

"Machines of Loving Grace"?


Saturday, Sept 24th, a young man found our Jaco this morning a couple of miles from our house, captured him, and turned him in to Animal Control. They scanned his chip and called us.

Apparently no worse for the wear. We are SO lucky. The kid didn't want to take the $100 reward I'd offered, but I insisted.

More to come...

Repeal and Replace

"We have to come up, and we can come up with many different plans. In fact, plans you don't even know about will be devised because we're going to come up with plans, -- health care plans -- that will be so good. And so much less expensive both for the country and for the people. And so much better.” 

- Donald Trump, September 14th, 2016 on the Dr. Oz show

Well, that's reassuring.

Sunday, September 18, 2016

On "Digital Obesity"

First, the annual Health 2.0 Conference draws nigh. I will be there loaded for bear this year. The central topic of this post, below, is of particular relevance.

Next, I was reading this interesting book ("neurophilosophy?" Lordy),

when this one jumped to the head of the line. (Compelling -- finished it in short order; back to "Touching a Nerve" shortly):

Yet another in my lengthy and growing list of reading and reviewing these "futurist" writers, apropos of Health IT writ large.

This one really rocks. (Interestingly, I cited an earlier Gerd Leonhard book some ten years ago back during my days hustling my friends' band in Las Vegas. See here as well. Probably a lot of "link rot" on that latter one by now. I've not checked.)

While there are a breadth of timely and important issues set forth in Gerd's book worthy of citation and discussion here, let's start with "digital obesity."

Chapter 7
Digital Obesity: Our Latest Pandemic 

As we wallow and pig out on a glut of news, updates, and algorithmically engineered information that may be anything but, we entertain ourselves in a burgeoning tech-bubble of questionable entertainment. Obesity is a global issue, and, according to McKinsey, it’s costing an estimated US $ 450 billion per year in the US alone, both in terms of healthcare costs and lost productivity. The Centers for Disease Control and Prevention stated in 2015 that more than two-thirds of Americans are overweight, and an estimated 35.7% are obese.

I believe we are reaching a similar or bigger challenge as we gorge on technology and bring on digital obesity.

I define digital obesity as a mental and technological condition in which data, information, media, and general digital connectedness are being accumulated to such an extent that they are certain to have a negative effect on health, well-being, happiness, and life in general.

Perhaps unsurprisingly, and despite those shocking health factoids, there is still little support globally for stricter regulation of the food industry to curb the use of addiction-building chemical additives, or to stop marketing campaigns that promote overconsumption. In America’s never-ending war on drugs, harmful foodstuffs and sugars are never so much as hinted at. Just as organic foods now seem to be largely the preserve of the well-off and wealthy, so too can we expect anonymity and privacy to become expensive luxuries— out of reach for most citizens.

Consumers are buying gadgets and apps that will supposedly help them reduce food consumption and increase fitness, such as the Fitbit, Jawbone, Loseit, and now Hapifork— which alerts you by trembling if you eat too fast— very useful indeed. It appears the idea is to buy (download) and consume yet another product or service that will miraculously, and without much effort, fix the original problem of overconsumption. 

Cravability means prosperity

The obvious bottom line is that the more people eat, the better it is for those who produce and sell our food— for example, growers, food processors, grocery stores, supermarkets, fast-food joints, restaurants, bars, and hotels. In addition, we may be shocked to find that, every year, every consumer in developed countries unwittingly ingests an estimated 150 pounds of additives— mostly sugar, yeast, and antioxidants, as well as truly nasty stuff such as MSG. These substances are the lubricants of overconsumption. Not only do they make food prettier and more durable, they also make it taste better— as debatable as that is. Thus consumers are strung along by cleverly engineering a “need-for-more” so that it becomes very hard to find the exit from that kingdom of endless, happy consumption.

If this sounds like Facebook or your smartphone, you are getting my drift. The food industry actually calls this cravability or crave-ability. In the world of technology, marketers call it magic, stickiness, indispensability, or more benignly, user engagement.

Craving and addiction— tech’s business model

Generating this kind of craving, or fueling our digital addictions in such a seemingly benign way, is clearly a powerful business model. It is easy to apply the cravability concept to the leading social-local-mobile (SoLoMo) super-nodes such as Google and Facebook, or to platforms such as WhatsApp. Many of us literally crave connectivity as we conduct our daily lives, and when we disconnect we feel incomplete.

Yet somehow, I wonder if it really could be in the interest of big Internet firms that a large number of their users end up with digital obesity issues? Is that really in the best interests of the predominantly US-owned technology and Internet giants? At the same time, we should not underestimate the strong temptation to make consumers dependent on these marvelous digital foods— to addict us to that serotonin-producing tsunami of likes, comments, and friend updates...

Leonhard, Gerd (2016-09-08). Technology vs. Humanity: The coming clash between man and machine (FutureScapes) (Kindle Locations 1767-1802). Fast Future Publishing. Kindle Edition.
'eh? Is "digital obesity" a real thing -- i.e., "clinically"? Or is this just a clicky-sticky metaphor?

Stay tuned. Keep checking back. Just getting started. A lot to discuss, including "Digital Ethics."
Chapter 10: Digital Ethics – In this chapter, I argue that, as technology permeates every aspect of human life and activity, digital ethics will evolve into a burning, un-ignorable issue for every individual and organization. At present we do not even have a common global language to discuss the issue, let alone agreement on accepted rights and responsibilities. Environmental sustainability is often brushed aside by the developing economies as a first world problem and is always sidetracked during economic recessions. In contrast, digital ethics will force its way to a permanent position at the front and center of our political and economic lives. It’s time to have the ethical conversation about digital technology— a potentially greater threat to continued human flourishing than nuclear proliferation. [ibid, Locations 109-114]
Recall our recent look at "ethics" in the case of Hurricane Katrina.

Again, much to discuss here going forward.


Day five. My Jaco remains lost. I'm starting to fear I will never see him again. A continuing kick to the gut. Difficult to get motivated to do anything this weekend.

Monday update: Some prior KHIT posts of relevance to Gerd Leonhard's book;
to cite just a few that jump right back up. Also, most recently, In the wake of Labor Day, thinking about jobs, education, healthcare, and tech.


In the simplest categorical tabulation, "ethics" (arriving at the "should/should not") comes in three flavors: [1] Consequentialism (utilitarianism), [2] "Deontology" ("duty theory"), and [3] "Virtue Ethics." The latter comes fraught with a bit of question-begging circularity to many. to wit,
Virtue ethics is currently one of three major approaches in normative ethics. It may, initially, be identified as the one that emphasizes the virtues, or moral character, in contrast to the approach which emphasizes duties or rules (deontology) or that which emphasizes the consequences of actions (consequentialism). Suppose it is obvious that someone in need should be helped. A utilitarian will point to the fact that the consequences of doing so will maximize well-being, a deontologist to the fact that, in doing so the agent will be acting in accordance with a moral rule such as “Do unto others as you would be done by” and a virtue ethicist to the fact that helping the person would be charitable or benevolent. [Stanford Encyclodedia of Philosophy]
Aristotle waxed eloquent on the subject of "virtue." One becomes "virtuous" via habituation -- by consistently performing "virtuous acts." Noble enough, in the unremarkable cases, where knowing a priori what counts as virtuous is an easy call. The petitio principii problem is a potential liability here ("begging the question"). "Charitable," "benelovent?" I'm down with those moral principles. I can readily think of others, though, who are not. A big part of the core purpose of moral deliberation is the rational determination of what counts as "virtuous." The "appeal to tradition" (which accounts for the bulk of "social/moral norms") does not summarily equate to "evidence" in support of an argument.

While a lot of ethics debates dwell (interminably?) on abstract (or the difficult, sometimes far-fetched "use case" scenario) "thought experiments" in pursuit of ostensibly rational moral guidance, as we've encountered in the 2005 post-Katrina "Playing God?" dustup at NOLA's Memorial Hospital, applied normative ethics in the bio-clinical space frequently require time-pressured dispositive decisions and action in exigent circumstances, lest people be injured or die.

What of Gerd's "Digital Ethics?"
Chapter 10 
Digital Ethics 

Technology has no ethics— but humanity depends on them. Let’s do some exponential math. If we continue on the current path, in just eight to 12 years— depending on when we start counting— overall technological progress is going to leap from today’s pivot point of four to 128. At the same time, the scope of our ethics will continue to limp along on a linear, step-wise, and human scale of improvement, from four to five or six if we’re lucky; it will improve just a little bit as we adapt to a new framework. 

Even if Moore’s Law may eventually cease to apply as far as microchips are concerned, many of the fields of technology, from communications bandwidth to artificial intelligence (AI) and deep learning, are still likely to grow at least exponentially and with combinatorial effects— the changes reinforcing one another.

Zoom forward another ten years, and we may indeed end up 95% automated, hyperconnected, virtualized, uber-efficient, and much less human than we could ever imagine today. A society that sleepwalks down the exponential growth-path of the Megashifts (see chapter 3), a society that does not pause to consider the consequences for human values, beliefs, and ethics, a society that is steered by technologists, venture capitalists, stock markets, and the military, is likely to enter a true machine age. 

So what are ethics? Going beyond the simple answer, how one should live, the Greek word ethos means custom and habit. Today, we often use ethics as a synonym or as shorthand for morals, values, assumptions, purposes, and beliefs. The primary concern of ethics is to question whether something is right or not in a given circumstance. What feels right to you is governed by your ethics, and in many cases it’s hard to explain why something does not feel right. That is clearly one of the challenges of agreeing on even the most basic ethical rules for the exponential age we are about to enter... [Leonhard, op cit, Kindle Locations 2318-2333]
Leonhard gives much deliberation to the speculative relative merits of technological "precaution" vs "proaction." He goes on to call for establishment of a "GDEC."
Creating a Global Digital Ethics Council: How would we define ethics that are fit for the exponential age?
I would like to address two main concerns: Firstly, to try and define what a globally agreeable set of ethics could be for an exponentially Digital Age; and secondly, to try and define what we would need to do to ensure that human well-being and ethical concerns actually remain on top of the agenda globally, and are not taken over by machine thinking. We need to define a set of bottom-line digital ethics— ethics that are fit for the Digital Age: open enough not to put the brakes on progress or hamper innovation, yet strong enough to protect our humanness. A compass, not a map, towards a future that will see increasingly powerful technologies first empower, then augment and then increasingly threaten humanity. 

To this end, I propose that we create a Global Digital Ethics Council (GDEC) tasked with defining what the ground rules and most basic and universal values of such a dramatically different, fully digitized society should be... [ibid, Kindle Locations 2401-2409]
Very intriguing stuff, all of it. Gerd clearly comes down on the "humanist" side of things
 If we don’t want to become technology ourselves; if we don’t want to be increasingly assimilated into the powerful vortex created by the Megashifts; if we want to remain “naturally human” in spite of the powerful lures of those magical technologies; if we want to safeguard what truly makes us happy and not just what makes us function, we must take action while we still have the wiggle room. That time is now. 

We must start asking why, followed by who, and when, not just if and how. We must ask questions about purpose, not just about profits. We must increasingly question industry leaders and especially technologists and the firms that employ them. We must compel them all to take a more holistic view, to consider the good as well as the not-so-good implications of what they are proposing. We must also ask them to acknowledge and address those unintended consequences, and to include the externalities of whatever they are creating in their business plans and revenue models. 

We must hold the creators and financiers of tomorrow— and of course ourselves, as users and consumers— responsible at every turn. We need to start denying customership to those companies that don’t care enough, and we must stop being the content for those platforms that are seeking to automate us. We must stop being silent contributors to machine thinking because everything else is less convenient. 

If we don’t want to end up with what I call the Oppenheimer Regret— named after the famous physicist J. Robert Oppenheimer, whose inventions made the atomic bomb a reality, and who subsequently regretted his actions and their consequences— we must commit to being on “team human,” to put humanity first and above all... [ibid, Kindle Locations 2719-2731]
"We must start asking why..."

Yeah. But, at Health2con next week, I'm sure the "why" is gonna mostly have to do with money, -- frenzied VC spending and market capture opportunities.

A highly recommended read. I know that he will get pushback on the "humanism" ethos, as some equally smart futurist thinkers regard the coming "Singularity" (which Gerd discusses) that eclipses biological humans as an inevitable next step in evolution (should we continue to survive). Cultural evolution, moreso than biological evolution, is firmly in the driver's seat these days. And, "first-world culture" is all about exponentially advancing technology, much if not most of it digital.

Amazon is gumshoeing me, unsurprisingly, mining my purchase and browsing histories. Got this recommendation in my email today.

A noted Harvard professor, no less. Hmmm...

But, hold on a second. There's but one reader review, a 4-star.
...the cases in the book are entirely retrospective — there isn't any speculation about the sorts of hypotheticals that philosophical ethicists love to worry about (and which don't have to be as tedious as the infamous trolley problems). While she doesn't mention the quote I cited above, SJ does invoke the famous Rumsfeldian "folk epistemology" of "known knowns / known unknowns / unknown unknowns" when criticizing risk assessment; her excellent point is that "scientific" risk assessment is limited to known unknowns, and ignores what often is most troubling to people, the unknown unknowns. So it's ironic that her book does the same thing, or even stick to known knowns (though arguably matters dealing with values aren't really "knowns"): every problem she mentions is illustrated with a case that occurred in the past. One of the benefits of philosophical ethics, though, is that an imaginative author can often pluck problems from the realm of the unknown and bring them into the realm of the known unknown, at least. Here are some junior high school-level examples: suppose some mad genius or company really invents robot warriors, or an AI that could bring about the "singularity," surpassing human intelligence by orders of magnitude — what are the ethical choices they ought to consider? Suppose someone invents some new creature or microbe in her bathtub and thinks it would be fun to release it into the wild? How do we deal with the fact that many inventors are loners, and far from the reach of governance institutions? People are really trying to do such things, so these aren't idle questions. As SJ herself points out, experts often cop out on these questions with expressions like "But that seems unlikely for now": she notes that "silenced in this account is the what-if question" (@252). She's right, and yet I felt the book was doing something similar. Movies like Scarlett Johansson's "Her" and TV shows like "Person of Interest" actually do a better job of raising the ethical issues I was hoping to see more soberly considered here. And even some here-and-now examples, such as private drones, military drones, and driverless cars, don't get analyzed — perhaps because there hasn't yet been a lawsuit about them...
Lordy. Think I'll pass, notwithstanding the four stars net. There are only so many hours in the day, and only so many dollars in my bank account.

Maybe I'll do this one next (after I finish up with "Touching a Nerve").

From the Amazon blurb:
...Nicholas Carr cuts through Silicon Valley’s unsettlingly cheery vision of the technological future to ask a hard question: Have we been seduced by a lie? Gathering a decade’s worth of posts from his blog, Rough Type, as well as his seminal essays, Utopia Is Creepy offers an alternative history of the digital age, chronicling its roller-coaster crazes and crashes, its blind triumphs, and its unintended consequences.

Carr’s favorite targets are those zealots who believe so fervently in computers and data that they abandon common sense. Cheap digital tools do not make us all the next Fellini or Dylan. Social networks, diverting as they may be, are not vehicles for self-enlightenment. And “likes” and retweets are not going to elevate political discourse. When we expect technologies—designed for profit—to deliver a paradise of prosperity and convenience, we have forgotten ourselves. In response, Carr offers searching assessments of the future of work, the fate of reading, and the rise of artificial intelligence, challenging us to see our world anew...
 I've cited Nicholas Carr before on KHIT (scroll down), re "The Glass Cage."

More to come...