Tuesday, 25 June 2019

From one thing, know ten thousand things

Japanese swordsman, philosopher, writer and rōnin, Miyamoto Musashi tells us 'from one thing, know ten thousand things' in his Book of Five Rings.

One enriching way to interpret that is to select what you learn to enrich your wisdom, not just to answer one question and from each thing you learn , treat it not as a fact but leverage it to enrich your body of knowledge.

So from my perception, many things in a range of knowledge from physics to psychology hugely enrich our ability to understand not just one things but to master ten thousand or more.

And of course if my interpretation is at odds with others, at least from Miyamoto Musashi ‘s one phrase I’ve derived an interpretation that can be used ten thousand other places.

Monday, 20 May 2019

Innovating Fire

An innovator can't just ask customers what they want and then try to give them that. Incumbents might make incremental changes to existing products that way but it abdicates vision. You are asking them to look back. You can be sure that that didn’t happen with the wheel, fire or even the automobile. Vision involves creating the path ahead and leading them into the new land.

Tuesday, 14 May 2019

Just whos folly is it anyway?

It is arrogance to attribute our own folly to others. To say that “we all do  . . [this bad or stupid thing or that]” or “if we are honest with ourselves we all do/think  . . [this bad or stupid thing or that]” . Like, "we all eat too much fat" It might make us feel better, or at least smugger and wiser, but the truth is that not everybody shares our weaknesses - but it is more humble to understand some people have overcome things that we have not.

Wednesday, 8 May 2019

The vanity of Socrates

The Greek philosopher Socrates is attributed as saying "The only thing I know is that I know nothing". As a kid I would be screaming inside my head - no Socrates - you do not even know that . . . not even that. To be fair, it is only after his time that Aristotle started dabbling in empiricism and we actually got to the stage where we could build up a body of what we know to be false.

So things have actually improved since Socrates and it is false humility to pretend or assume ignorance of all around you (which was Plato’s aim in attributing that quote to Socrates). But don’t think that any of this will stop me challenging your views or models (or learning from you - but building your experience and life knowledge it into a bigger picture).

That's how we make progress on a day to day basis and build a better understanding and structure of knowledge - and from that a better world.

Monday, 6 May 2019

The true cost of innovation.

Steve Jobs reminds us that beyond a basic threshold Innovation has nothing to do with how many R & D dollars you have.

He lets us remember that when Apple came up with the Mac, IBM was spending at least 100 times more on R & D.

The same was true of Tesla vs the whole auto industry, SpaceX compared with NASA.

It's not about money (although of course you need some).

It's about the people you have, how they're led, and how much the leadership “get it”.

Monday, 29 April 2019

Simplicity is the lever that can move the world.

Here is how we do it. Focus and simplicity.

Simplicity is the Genius of Focus on what matters.

Simple is deeper, harder, more profound than complexity.

And when you get there, this is the lever that can move the world.

Friday, 26 April 2019

Understanding everything

There have only been about a half dozen genuinely important events in the four-billion-year saga of life on Earth: single-celled life, multicelled life, differentiation into plants and animals, movement of animals from water to land, and the advent of mammals and consciousness. 

Elon Musk

I would add that our ability to turn that consciousness so that it can understand itself and the universe, that sense in which now the universe is inside the mind as well as the mind being in the universe, is another crucial step.
And of course as we do that we gain the leverage to actually change the universe (or our small part of it), using our own consciousness and that, I think forms a final crucial and significant event. 

Monday, 22 April 2019

Pareto and Kaizen (改善)

Formal methodologies can be process heavy and limiting. While Kaizen (改善) methods aim to implementing continuous improvement in our context they seemed somewhat limiting and add another overhead to a lean, fast, agile operation.

So what I asked was - what happens if we applied the Pareto principle to Kaizen (改善)? And the simplest answers, the 20% of 20% of 20% of input was one that I was told years ago in that world famous explorers club, the Royal Geographical Society in London.

And the simple answer was is that what one needed to do was make sure every person in the organization was constantly thinking about how they could be doing things better, refining processes and questioning themselves.

Thursday, 18 April 2019

Purpose and the addition of quantum mechanical phases.

It is sometimes said that nature has a "purpose", in that it seeks to take the path that produces the minimum action. In fact, nature does exactly the opposite. It takes every path, treating them all on equal footing. We simply end up seeing the path with a stationary action, due to the way the quantum mechanical phases add.

When an archer shoots an arrow through the air, the aim is made possible by all the other arrows taking all the other nearby paths, each with essentially the same action. Likewise, when you walk down the street with a certain destination in mind, you're not alone.

When walking, I know that my aim
Is caused by the ghosts with my name.
And although I don't see
Where they walk next to me,
I know they're all there, just the same.

Monday, 15 April 2019

"Are we nearly there, are we nearly there?"

People also ask, “Are we too early?”, “Are we too late?”, “What do we see for the future?”, “Will we change the world?”.

Well just remember what Bill Gates had to say . . . that “We always overestimate the change that will occur in the next two years and underestimate the change that will occur in the next ten. Don't let yourself be lulled into inaction."

So will we change the world? Well someone will, and by starting now we shape the future. The start of the journey is hard but you should never try to look grounded and cool cynical by underestimating the change that will occur in the next ten years or throwing up the listing of the tiny fraction of the challenges that lie ahead as though you uniquely recognize them and that if you can't solve them then no-one can.

It might seem like experience and wisdom, but it’s often the root of the problem that has trapped the incumbents. And of course, to many, the challenges of the past always look easier, because someone else overcame them and we underestimate what it took to do that...

Monday, 8 April 2019

Understanding our goals.

People work better when they know what the goal is and why. And they need to share in why this is important. And understand how we do things. It is important that people look forward to coming to work in the morning and enjoy working.

Tuesday, 2 April 2019

How physics helps us help the world.

Like Elon Musk I tend to approach things from a physics framework. And, as Elon says, physics teaches you to reason from first principles rather than by analogy. But, I explain by analogy. It allows people to hang ideas onto pre-existing frameworks that they already understand and even emotionally accept.

But the physics based path allows you to apply tools which greatly exceed the instincts of our “ape-descended” emotions, tools like logic, mathematics and analytical tools.

Add these to modeling (we call it vision - vision without a testable model is just fluff), then rapid, iterative testing and cross domain learning and you start to really have something.

Sunday, 31 March 2019

Who comes first

By putting the consumer first (both patient and doctor in our case), and recognizing the need to make the team feel intimately a part of that by default, and in the end, the tokenholder will come first by default as well.

Wednesday, 27 March 2019

True Magic

When you read or dream of Hogwarts, the Marvel Universe, Tolkien or Narnia, just remember this. 

There is a real Magic, that drives all human life, all happiness, all deep satisfaction, and it is called evolution. It doesn't always tell us what we think it will, the foolish associate it with all manner of nonsense, but its path is true and its power irresistible.

Every pleasure you feel, every emotion positive or negative has been shaped by this magic and only when it is aligned does it give deep lasting happiness. To understand this is an essential step on the path to enlightenment.

Monday, 25 March 2019

We need to put the patient, the customer, and their needs back into the centre of healthcare.

Most people have no concept of how a gearbox, an automatic transmission works, or understand the works of Nikolaus Otto or Maxwell yet they know how to drive a car. You don't have to study physics to understand the laws of motion to drive a car.

You should not have to understand the byzantine depths of medical administration or thread the labyrinth of a historic health system for a doctor to get you better.

We need to put the patient, the customer, and their needs back into the centre of healthcare.

We need to delight, not disgust.

Saturday, 23 March 2019

On mass extinctions.

"If you look at our current technology level, something strange has to happen to civilizations, and I mean strange in a bad way. And it could be that there are a whole lot of dead, one-planet civilizations."

Elon Musk

No doubt stimulated from the new evidence that suggests that there are more than a hundred thousand million stars with planetary systems in this galaxy, many of which are in a potentially habitable 'Goldilocks zone' and yet no sign of alien civilizations. So why? And how does it affect us? Mr Musk clearly thinks that it does.

Incidentally, less focused individuals think that Elon Musk has a slightly random collection of transport companies in his portfolio. If you look more carefully what you see is that he is collecting the skills and technologies needed to colonize Mars (and other planets and satellites) in a large scale.   Not just rockets (SpaceX), but electric vehicles (, solar power and energy storage. Enclosed, high performance mass transit systems (Hyperloop), tunnel and subterranean structure making (Boring company), through to Neuralink and OpenAI - none of it is random.

Wednesday, 20 March 2019

On Humility

There is nothing more arrogant than to demand humility of others who have achieved more and gone further. Sure it's good for them to be humble, but it is not for us to judge their self regard or feel smug about our humility until we have matched them in what they have achieved.

Monday, 18 March 2019

On how you spend your life.

You’ve probably realized work is going to fill a large part of your life, that you’ll spend more waking time in it than any other part of what you ever do. And you’ve probably heard that the only way to be truly satisfied is to do what you believe is great work. We want to provide the canvas for truly creative, passionate people to gain that satisfaction.”

Friday, 15 March 2019

On getting things right every time

If you want to grow a giant redwood,
you need to make sure the seeds are ok,
nurture the sapling,
and work out what might potentially stop it from growing all the way along.
Anything that breaks it at any point stops that growth. 

Elon Musk 

When you are growing a new enterprise that could change the world, all this is true.  And all along people are trying to pick the leaves, cut wood from the sapling, aggressively challenge your nurturing environment in a dozen mutually contradictory ways that have little or no reason, and that they will walk away from when they fail.

Thursday, 14 March 2019

From a discussion with Drs Saqib Mukhtar and Mark Baker

1. First of all MediChain’s doctors will be registered on the GMC (General Medical Council), will be on the GMC performers list and have 5 yearly revalidation cycles. This primarily ensures that the pool of doctors available are appropriately qualified.

2. Once this is established it is followed by a rigorous interview process where the doctors have to go through 3 different clinical scenarios to ascertain their level of understanding and competence in managing patients over video-call. As part of the revalidation cycle each doctor will have yearly basics life support, anaphylaxis and child / adult safeguarding training as mandatory. Without this no doctor can work for MediChain. The purpose is to make sure that the doctors are practicing safely and according to good medical practice guidelines from the GMC. This is very important as there are a number of GPs that work only in the private sector this therefore means that they are not part of the 5 year revalidation cycle. It is expected that MediChain will not employ these GPs, as the quality of care provided cannot be validated. In essence each GP employed will also be working in and for the NHS, thus being able to transfer these skills over telemedicine/video call.

 3. There will be pre-interview training guidelines and materials to guide doctors on required standards and skills. This will allow doctors to prepare effectively, making sure that they know what is expected of them and allowing them to practise or think through how they will need to perform.

4. This will be performed by the Clinical director of MediChain. Reading material and guidelines include:

4.i GMC guidance on good medical practice.

4.ii Safeguarding policies.

4.iii Prescribing policies.

4.iv Managing conflict of interest

4.v MediChain’s best practices for consulting via video call. Each policy will need to be signed with a short self assessment to ensure that the doctors are compliant and competent. The above are necessary standards for CQC (Care Quality Commission) compliance.

5. The process is equitable to online personal professional development, and will count as learning hours for the doctor that they can put in to their appraisals. This can be done in house with MediChain or using an external provider.

6. Any concerns or questions will be directed to the Clinical Director, this will help promote a positive open and sharing environment where everyone learns from each other. Furthermore this will also drive Improvements in system processes.

7. Once we have ensured that the doctors are competent and fully compliant, an interview process shall be conducted by the Clinical Director, with three different scenarios/clinical consultations to be performed over video call. This will assess not only the clinical skills of the doctor but how well they adapt and perform in consulting patients in this manner.

8. Once the candidate has been provisionally accepted the following training takes place:

8.i System training - ensuring that the doctor is competent at working and using the MediChain system.

8.ii Video call training- performed by the Clinical Director I.e the basics of consultation including good lighting, broadband connection, confidentially to minimise disruption/interruption etc.

8.iii Bi annual audit of all calls with an annual appraisal for each doctor. This will maintain quality thus improving standards of care.

8.iv Regular MediChain Clinical meetings to discuss issues, significant events etc.

9. User Experience is key to acceptance and growth of Hypatia and so every part of the interaction needs to delight both patient and doctor. To this end we've been talking to and designing processes for this with the orchestrater of one of the world biggest retail chains going online, to make sure that the processes exceed patient (and doctor) expectations in a way that previous telemedicine systems have not done.

Monday, 11 March 2019

From pain and suffering to a better world.

Bill Gates tells us that

“The first rule of any technology used in a business is that automation applied to an efficient operation will magnify the efficiency.

The second is that automation applied to an inefficient operation will magnify the inefficiency.”

We think that the world has seen too much of the second part in healthcare and not enough of the first.