Augmented Reality and Virtual Reality - What can Startups do?

If anyone had seen me this morning, I was *that* gym bunny in the Beverly Hills Hilton who stopped running just so she could read the paper.

What had caught my eye was the Financial Time's front page reference to Microsoft and Artificial Reality (full article on p14). It's a highly recommended read. Richard Waters' article is a quick, crisp guide to the Virtual reality (VR) vs Augmented reality (AR) landscape, drawing comparison to the advent of the #Realitywars much in the way the battle forces amassed in the www.Browserwars.com of the 90s and 00s.

There are the usual suspects, the big hardware players (Sony and Samsung), but where it gets interesting is that unlike the battle of twenty year's past, the software makers (eg Microsoft, Facebook and Google) are also wading into the war and arguably have more clout with cross platform applicability in the days of iOS vs Android vs Windows.

This puts the old hardware vendors (and all the startups in the VR / AR hardware space) into an interesting predicament.

To play well, to play beyond the niche, you'll need a bit of cross-platform cooperation from the same platform software vendors entering the VR / AR space.

This then becomes a game of strategy, particularly timing and niche appeal. It helps a little that the whispers around CES '15 for OculusRift's release date was as late as "early 2016".  So what can you do?

I spent the last 10 days in SF and Silicon Valley immersing myself in the AR / VR scene, attending as many AR and VR events, including talks by HealthTech Women, an excellent showcase by UPLOAD and a Meetup by SFHTML5.

Here's what I saw: the VR solutions, for its very ability to create a truly immersive experience, appeal to isolated environment experiences, mostly not requiring typing (feature not yet fully functioning) or interacting with text. VR vendors (small and large) have consequently focused on gaming or situational plays that lend itself to replaying and re-enacting scenarios (which have promising implications for therapy).

AR solutions attempt to walk a middle-ground: a balance of (currently, hardly) unobtrusive access to information when you require it and the ability to interact with your real-life environment. I've seen a variety of solutions and I'm sure there's more to come. The field of visual graphical language is evolving, with no small part being played by the illustrious Tony Parisi and co. The biggest challenges, I think, will be high-quality visual integration (how do you get a screen to be visible and unobtrusive at the same time?), content supply (volume of skilled talent and that old platform chestnut again), integration with existing eyewear and avoiding a completely scary-looking/socially-unacceptable device hanging off the front of someone's face.

For either AR or VR new entrants, the Holy Grail here is a mobile, untethered solution, with text and visual display interaction capabilities, ideally hooked into an augmented audio experience with voice command and bone conduction hearing. It's secure, not heavy on the nose, allows users to wear glasses (I mean, c'mon) and syncs effortlessly with your other devices. The basic features you want of your phone (call coming in, calendar, contacts and battery power) with the entertainment of your TV and the information access of your, well, everything.

And, just like that sacred object, may it endow its bearer with super powers.


Dr Grace Lai (+Grace Lai) is the Founder and Managing Director of a medical software business in Australia. She is an ex-IDC analyst, specialising in Infrastructure Software, Asia/Pacific and Japan business trends, as well as Strategy, Marketing and Operations. She also knows how to do a craniotomy, which nowadays comes in handy during awkward social situations.

+Financial Times +Tony Parisi @sfshtml5 @Healthtechwomen
Augmented Reality and Virtual Reality - What can Startups do?

Finding the edge, SF 11 Jan, 2015

Headed down to Redwood City, to catch up with a friend.

"Over here is Box's new headquarters," she said, pointing to a open walled, multistorey monolith, rising above a suburban supermarket parking lot. "They IPO next month, so.... Once I got lost and found Sandisk around the corner. It's like driving through the Internet."

Ahh, Silicon Valley and its beguiling suburban charm. It is a long way from the rest of the world: its own ecosystem, which makes looking for the edge a little hard if you aren't immersed in the action.

So, I'm here to learn where the edge is in neurological health solutions, both software, device and services. It's partly because my unique career has provided experiences in neurological surgery, business operations and IT market analysis. It is also because it is one of the hottest areas to come in the healthcare IT market. It also helps that I will then join the Abundance 360 mentoring circle and be part of Singularity University's kick off in LA in late January.

The "systematic disruption" of technology through the field of health has a beautiful double meaning: not only has it thoroughly revolutionized the way we practice medicine (remember when the only way to see a film was to fumble through the archive boxes, one by one?), speeding up and informing (?well) our decision processes. Technology is also moving through each system of the body. We see heart monitors on chests, then wrists, then ears, then woven into shirts.... We have musculoskeletal splints then crutches, then prostheses and exoskeletons. Now we can even wire it into the spinal cord.

The challenge with the brain? That we don't know what we don't know. The majority of the anatomy and physiology of the heart has been well documented for over 200 years. Neurosurgery as a specialty has been around for about half as long as that and as recently as three years ago we accepted that it really did have a lymphatic (or glymphatic) system to explain what it did with all its metabolic wastes.

So, neurological-oriented innovations stands as the Great Challenge because of the nature of the organ, what man has been able to comprehend of it and the complexity of its utility beyond the structure and function we can discern (the role of the mind, for example). Think of the possibilities!!

Looking forward to meeting as many companies passionate about neurological technology, artificial intelligence, cognitive computing, EEG devices, virtual and augmented reality companies... Come one, come all. Maybe we can crack this code together.

Future notes to self as an exhibitor in a conference

Congratulations to all the startups chosen for The Hive at TEDMED 2014.

... these could be general business rules, but here's three observations (and future reminders for me) from Day 1 at The Hive at TEDMED 2014

1. If you're here, be present

The usual tradeshow rules apply: the whole point of this event is engagement. Other words & phrases: networking, mixing it up, acknowledgement, cross-pollination.

So that means, for business owners: get out and shake hands, or at least send your most sociable employees and get off the laptop.


2. If people can't figure out what your product does by your name, or a five second glance at your booth, you may have lost the battle

Think of it like speed-dating: people like the subject, are intrigued by how it looks, how you look using the product, or why the hell people are flocking around it... and want to know more. In exchange, they'll give you their most precious commodity: attention.

Pique their curiousity, make your booth interesting, have data on hand (we are an information hungry lot at TEDMED) and models we can play with and be able to back it up to at least the "Why" x 5 times question.


3. Free feedback is good and bad

We're also an opinionated lot. So don't be offended if we ask a lot of questions and throw out "yeah, but..." or "that's so cool! How did you do it?" A great idea and a great entrepreneur has persistence and resilience. Great opportunity to practice those pitches til they are smooooooooth.

That said, it is feedback, which is good, cos from a marketing research point of view, you have immediate contact with partners, patients and providers all under the one roof. It's also "free" in the sense that we're not paying to use the product, just to hear you pitch it. That also lends itself to biases - we haven't used it in the field and to the nth degree that will find all the bugs for you. Change your entire product on our suggestion? Wellllllll..... maybe not.

What do you think? What other advice would you give exhibiting startups at conferences? 

Enjoy TEDMED 2014!

Does your Government support Healthcare innovation?

Travelling provides many benefits, including the opportunity to see how other countries tackle similar problems...

Encouraging healthcare innovation is one such challenge.

Having attended the HealthXL Global Gathering, I had the opportunity to see the Irish government's passion for attracting and growing healthcare companies. They recognise it is their nation's interest to find new and existing business, and grow a community. They have experience in courting and fostering the pharmaceutical market.

Thus, the latest move by the Australian Government is somewhat baffling... On one hand, they recognise the mining boom is drawing to a close, they see that the nation's future is no longer in manufacturing, for our wages and standard of living are significantly higher than other manufacturing economies.

On the other hand, they have some how fostered a handful of super - healthcare companies: multimillion dollar niche subsector superstars such as Cochlear and Resmed. The university / education and medical research sectors should take a bow.

The latest announcements from the Australian Government and the from @AusIndustry roadshow that followed shows a desperately underprepared  Government and a Department caught by surpriae. The renunciation of funding and the Innovation Investment fund, and its replacement with suggested a non-guaranteed matching fund is ludicrous in its structure. The generation of a large pool of commercial - ready ideas have been dissuaded by length of time to market and the hefty corporate tax.

Some questions:
What qualifies an idea worth commercialising?
What is the Government's plans for creating a healthcare innovation community?
What were the results of the Innovation Investment fund, that it was pulled (and what will replace it)?

Other countries are solving this problem, quicker, faster and more attractively priced than Australia. This is critical for the next twenty years of business that can we learn from them and learn to compete against them.

The Future is Patient-centric EHR

(From the Global Gathering 2014 #hxlgg)

Everyone has already accepted the reality of Electronic Health Records. But the current responsibility for management of EHRs lies with hospitals and health institutions, rather than the patient. Why?

It is the reason why #bigdata has such weight. But to the patient... It's not big data. It is their data. It's personal.

So off the back of this, the critical patient-management issues for EHR and Big Data going forward are:

1. Personal data security - catch and release, temporary or occasion based insight
2. Data synthesis - what does all their personal data sources mean? For some, it will be too much... What does this mean for the role of the doctor?
3. Data motility - where the patient goes, the data flows... 

What does this mean for your business?

Doctor Bashing

Dear Readers,

Let us talk of the popular sport called "Doctor Bashing".

It is rife in the media, amongst patients, health practitioners (alternative and allied) and, let's not forget, lawyers. Doctors have been vilified as ignorant and blind to economic realities. We have been labelled as expendable and replaceable with algorithms.

Even better, are blithe remarks like this one by Alex Green, wealth author and weight loss columnist:

The best medicine, of course, is preventative. Unfortunately, too many doctors are inclined to prescribe a pill rather than a healthier diet.

Market forces would dictate that demand usually determines supply.  Doctors (amongst others) will tell you the basic principle of weight loss is: "Less energy in!! More energy out!!". Basic maths, folks. But as soon as there is a hope of an "easy" cure, a miracle in a pill form... the rest of the advice is conveniently forgotten. The same doctor-bashing patients flock: "I could lose weight by taking this pill? And I don't have to stop eating??". Give me the pill! With fries!

It's easy to vilify doctors. Like teachers, we are seen to be keepers (sometimes, accused as withholders) of knowledge, softies for a good cause, confusingly committing years of study and accepting decidedly less pay than what we could have earned privately or in other sectors, all "for the benefit of mankind". We make choices voluntarily to help others. Like teachers, we have responsibilities to current and future generations. And like teachers, we have somehow become the cellar-dwellers of society and yet, we are one of its most important building blocks.

New colony on the Moon? Really? They're not going to put a stockbroker, or magazine editor up there? They want whom?

When it comes to health outcomes, particularly obesity, the need for patients to acknowledge their role on the demand side is palpable and critical.

The completely befuddling thing is that most people realise the consequence of years and years of flagrant spending without saving. Even with the presence of a credit card, which helps to bring the consequence home sooner, spending without saving becomes a bit of a drag. It's also basic maths. Reasonable people don't turn up to the doorstep of their banks and accountants after years and years of such behaviour and demand that they "SHOW ME THE MONEY!!!".

It is a curious thing that when the health equivalent shows up: the obese, smoking, hypertensive, hyperlipidaemic, diabetic, non-exercising, non-medication compliant patient turns up in Emergency with crushing left-sided chest pain, their family members turn to the emergency physicians and say: "Do everything you can! Please don't let him die!".

Preventative health is critical. Doctors have been focused on treatment and "unhealthy" management because that is where the demand for their supply is most critical. The shift towards incorporating preventative health is here. For success, it requires joint cooperation (and mutual respect) between doctor and patient. Just basic maths, folks.

Joint effort for Patient-centric Medicine

Much is spoken of patient-centric healthcare, providing more information to the patient, the coming revolution in doctor-patient / doctor-paramedical relationships.

Robin Farmanfarmaian, of Exponential Medicine, writes about the emerging shift in healthcare - the shift to patient-driven healthcare and "joint effort". The foundation of this patient-driven healthcare evolution is access: the increased access to up-to-date information via tools, gadgets, platforms and programs. This spans access to their own biometric data, access to information resources on their diseases as well as increased access to practitioners. 

Critical to this is each patient's knowledge on how to access it and their ability to use the information once obtained. For example, did you know that the Cleveland Clinic offers an online service called "My Second Opinion"? Using this service, people from around the world can tap the knowledge of Cleveland Clinic's specialists in the USA to seek another assessment of their diagnosis, investigation or treatment.

Why is this important? 

The other important piece of a joint-effort pie is provider of health information. The Doctor, and the role of the Doctor, has taken some battering in recent years. Watch this video from Stanford Medicine X of Vinod Khosla, who highlights the shortcomings of doctors and the art of solo-effort (and even team-effort) diagnosis.

The exact quote that Mr Khosla references in part during his talk is:

“There are in fact two things, science and opinion; the former begets knowledge, the latter ignorance.” ― Hippocrates

My interpretation (opinion!) of this is the level of humility both patient and doctor must retain when casting an opinion on the profoundness of the disease. An opinion implies certainty, but as Nassim Taleb asserts in his book "The Black Swan", it is the temptation, the arrogance of certainty that blinds you to the possibility of other explanations. 

Patients are looking for certainty and consistency, both of which arise from the assumption that medicine, as a science, can provide both. This also implies their desire of exactness, singular explanations and the absence of grey. Much like a simple math problem, eg 2+2, it is assumed that when abiding to the rules of arithmetic, the result must always be 4.

But Mathematics is a language, and is thus also an art. It has levels of sophistication and complexity. There can even be widespread debate and consternation on the seemingly simplest of problems. In part, thus, it governed by rules but is opened to interpretation, based on the skill and prior experience of both speaker and listener.

The same has been argued about Medicine being a science and an art. 

Why might people receive multiple different diagnoses, investigations and treatment plans? It is because the application of different skill levels and prior experiences of different doctors to the solution of a range of simple to complex problems will naturally lend different perspectives on the identity and solution of the same problem. 

Which means doctors need to collaborate with other doctors (read: all health practitioners) as well as patients to deliver on this patient-centric medicine.