Are you pro-friction or anti-friction? (NYtimes: Is Tech Too Easy to Use?)

I love articles like this that challenge long-held assumptions. For decades, “everyone knows” that technology is too hard to use, and we have spent countless hours designing “frictionless” interactions. Look at books like “Don’t Make Me Think.” As a result, we’re so enamored of our devices, that we prefer to answer the ‘buzz’ of a notification or spend hours developing neck cramps looking down, instead of interacting with our fellow humans, our friends, our loved ones. The pendulum has swung too far. But does this hold true in healthcare? After all, the article states

“No one wants a doctor who prioritizes speed over safety.”

I think our answer must be more nuanced, and less of an epigram.

  • When EHR’s are hard to use, YES, frictionless is an important goal, so that doctors’ intent can easily translate to correct action (order the right prescription, the right test, assemble the important medical data for good decision-making)
  • When computer-generated alerts are important, frictionless MIGHT be a problem: in some parts of our EHR, doctors have learned that pressing “escape button” twice, will bypass the alert, without having to read and respond. In this case, frictionless is NOT good.
  • In those borderline cases, where SOME thought is necessary, but there appears to be a BETTER choice in the vast majority of cases (we use the 80/20 rule, so-called the Pareto Principle), we design the alert so that the EASIEST thing to do is also the right thing (something that Staples made famous with their EASY button)

CMIO’s take: Friction, frictionless, Easy Button. Do you have any stories about designing the future of healthcare IT?

What is a Yottabyte, and How Do You Treat It? (a talk)

I gave a keynote speech late last year at Technology Awareness Day, hosted by the University of Colorado, Anschutz Medical Campus about Big Data, Tech acceleration, and Artificial Intelligence, as applied to healthcare.

I enjoy making my colleagues uncomfortable. How long will doctors have jobs? Will the AI eliminate internal medicine doctors? If Watson can beat humans at Jeopardy, can it beat me at reading medical literature? Can it be dermatologists at diagnosing skin cancer? Can it beat radiologists at interpreting CT scan images?

It is true that the most complex object known to us is the human brain, with its trillions of neurons and extensive interconnections. From this physical matter, something called “general adaptive intelligence” and “consciousness” arises, neither of which we understand or know how to construct or deconstruct. On the other hand, fundamentally though, isn’t a neuron a collection of physical and chemical processes that we DO understand? And then extrapolating upward then, is it not conceivable that we could eventually figure out how to construct a human brain in all its complexity? Hmm.

Reading books like “Life 3.0” and “Superintelligence” gets me thinking about stuff like this. It is both humbling and exciting at the same time.

CMIO’s take? Decide for yourself. I know, it is almost an hour long, and who has an hour anymore, especially if TED speakers can get their point across in 10 minutes? Well, consider my talk a series of 4-5 TED talks. Yeah, that’s it.

Seeing a black hole (NYTimes) is astounding

We are all involved in our little lives, our noses at the grindstone, making a living, trying to make a difference. Sometimes it is worth looking up … wayyyyy up, and see that fellow scientists are hard at work expanding the edges of our knowledge. We have known, based on Einstein’s theories, about black holes, believed in their existence based on indirect evidence from light bent around massively heavy objects. I had never heard of Sagittarius A*, the name applied to the mysterious unseen object at the center of Milky Way, but apparently we’ve been able to track large stars that slingshot around an unseen object with the mass of 4 billion suns(!) and have named that entity Sagittarius A*, and believed it to be a supermassive black hole. Wow, the theories we can craft with the puzzling evidence from our telescopes.

Of course, we still have NO IDEA about such things as Dark Matter, a theoretical construct we need in our understanding of how galaxies stay together (there is not enough matter in the ,mutual gravitational attraction of visible stars to explain why a galaxy spirals and stays together), or Dark Energy, another theoretical construct we need to explain why galaxies are moving moving away from each other at an ACCELERATING rate, when they should be decelerating due to gravitational attraction? Is it like Dark Fiber, those unused cables of internet connectivity? (No) or Dark Mode in the Mac operating system? (No)

And now, this, an actual image of a massive black hole at the center of galaxy M87. We finally see what Einstein saw in his equations half a century ago. Cool beans. Einstein rocks.

CMIO’s take?

If you want to get better, ask yourself these 2 questions (HBR)

https://hbr.org/2018/11/if-you-want-to-get-better-at-something-ask-yourself-these-two-questions

Ask yourself these 2 questions (from Harvard Business Review):

  1. Do you want to get better?
  2. Are you willing to feel the discomfort of putting in more effort and trying new things that will feel weird and different and won’t work right away?

CMIO’s take? Read the article. It is inspiring, true, and worth repeating to yourself and anyone you’re mentoring.

Steven Strogatz (NYTimes) on a future for AI via AlphaZero

AlphaZero is now the undisputed champion of Go and now of chess. It recently battled Stockfish, the former chess computer heavyweight, and in that series of 100 matches, it won 28, drew 72, AND LOST NONE.

Lets hear that again. AlphaZero, the deep learning computer originally designed to play and beat human players at Go, the ancient board game, has recently been redesigned in a couple ways: 1) to take the original game rules AND NO HUMAN EXPERIENCE as its starting point, and 2) now can receive the rules for almost ANY game (in this example, chess) as its starting point. Then the programmers set AlphaZero to play itself AND LEARN THE STRATEGIES of the game by brute force and whether each strategy led to a victory or defeat. 

AlphaZero, having spent time playing itself millions of times and having discerned and taught itself the principles of chess, it only considered 60,000 moves per second instead of 60 million by Stockfish. It played smarter and faster.

“AlphaZero had the finesse of a virtuoso and the power of a machine.”

But, can it teach us its insights? No. Perhaps the most troubling paragraphs in this article is:

“What is frustrating about machine learning, however, is that the algorithms can’t articulate what they’re thinking. We don’t know why they work, so we don’t know if they can be trusted. AlphaZero gives every appearance of having discovered some important principles about chess, but it can’t share that understanding with us. Not yet, at least. As human beings, we want more than answers. We want insight. This is going to be a source of tension in our interactions with computers from now on.”

I am both heartened and disturbed by this. Heartened in that AI is on the launch pad to apply itself to all kinds of human challenges that have been difficult to solve until now. Disturbed also; how long will AlphaZero and its contemporaries need human insight and input before it’s always-accelerating capability outstrips our brains’ hardware and our ability to keep up and be relevant?

CMIO’s take? I have no take. I’m gonna wait for my auto-correct from Siri to get smart enough to finish writing this post.

Music lessons? Don’t have to drive to Mrs. Bulecza’s house anymore #lifehack

Don’t underestimate the power of the dark side. No, I mean the power of music, in generating happiness and creativity in our lives. I could have the worst day at work, and after a few minutes of ukulele when getting home, it no longer matters. This recent NYTimes article shows the profusion of online services (many free!) to pick up the instrument of your dreams and plunk away.

In my deep, dark past, I rode my bike several blocks away every Tuesday afternoon to Mrs. Bulecza’s house to have my piano lesson. At times, it was a drudgery, to be forced to practice for an hour a day (uhhh! Mom! Whhhhyyyyyy?!?) when it was nice out and your friends were calling for you. (Just kidding, I didn’t actually have any friends growing up). Now, in hindsight, I just regret that my Mom let me STOP taking piano lessons in high school because I had so many more important things to do, and when I want to sit down and sight-read Hiyao Miyazaki’s amazing and beautiful music (Sixth Station from Spirited away), that I can barely do it
(uhhh! Mom! Whhhhyyyyyy did you let me quit lessons?!?) .

My personal favorite, to which I still subscribe, is Ukulele Underground, a fun place to learn ukulele, taught by a former kindergarten teacher (who better than a kindergarten teacher to gently guide you into your ukulele future?) and traveling performer, and full of one minute tips, and more detailed lessons to learn just about anything ukulele. AND, he routinely comes to Denver’s annual Ukefest to perform and teach master classes!

CMIO’s take? What instrument do you play? Or do you PLAN to play? Don’t miss this: it is a COMPETITIVE ADVANTAGE for work! Or tell yourself whatever you need to, to pick up an instrument and make your own life better. And (bonus) sometimes you can torture others with bad music that you made.

A Colorado original: 10th Mountain Division Hut system

If you said to me a few months ago: “You are going to enjoy spending 5 hours at the brink of your anaerobic threshold, gasping for air at 11,000 feet, carrying a 50 pound backpack to a remote hut in the Colorado back country?” I would have called you crazy.

Having just returned from a long weekend involving a 12 mile round trip to Uncle Bud’s Hut, part of the 10th Mountain Division Hut Association, I can say that it was an amazing, once in a lifetime experience.

Once in a lifetime, because, maybe I don’t need to ever do that again.

For example, a few decades ago (1994!) I trained for and completed the Davis Double Century ride; or 200 miles in one day on a bike. I did enjoy the mind-expanding (and thigh-muscle-expanding) experience. The months leading up to the event were both exciting and grueling (riding 20 to 60 miles on days leading up, just to prepare). The actual event was transformative, and an achievement that I’ll always be proud of. Starting out with thousands of other cyclists, decorating the road with the splashy rainbow of cycling jerseys, chatting as we, amoeba-like, engulfed miles of asphalt with human-powered wheels, devouring hundreds of pounds of cyclist snacks every 20 miles, climbing and descending gentle slopes in the company of adventurous souls.

HOWEVER, the last few hours, the last 50 miles, riding in darkness, our newly-purchased bike lights fading, our legs giving out, the bananas and snack bars and chicken soup no longer filling our always-hungry bellies, the road ahead stretching (literally) into invisible infinity, our saddle sores more urgently uncomfortable, our on-the-road cycling companions dropping away and disappearing. And then pulling in to the start/finish line at 200 miles, and, no longer having strength to unclip from my pedals, falling over in both exultation and exhaustion.

After that ride, I did not get back on the bike for a month, and to this day, still have NO interest in joining another 200 mile ride.

In that spirit, I can report that my Uncle Bud’s experience was also transformative. Here’s how it went down. Come along!

  • Go get your stuff. We headed out to Bent Gate, apparently one of the few stores in Denver Metro (Golden actually) that will rent AT ski’s and backcountry gear (All-terrain, for us newbies). $800 for 2 of us for 3 days: avalanche beacon, avalanche 20 foot collapsible probe, shovel, boots, ultra-light skis that somehow behave BOTH like alpine downhill skis with good edges for sliding down and have lockable heels for a stable foot platform, AND are lightweight and can be made into cross-country, pivoting-toe attachment skis. Don’t ask me more. They’re both like telemark skis and also not. ?!?
  • Read the map (OMG 6 miles to Uncle Bud’s, along a fire road and then UP for the last 3 miles). Stress.
  • Plan on making dinner for 17 people on the trip on Sunday night (what to make? will it cook at 11,500 feet? Where is the online cooking guide and adjustment for time/temp for much lower boiling temperature at 11,500? what will taste good at altitude? Are there vegetarians? vegans? allergies? who’s gonna carry all the materials?). Stress.
  • Watch the weather dump an additional foot of snow the week before going. Stress.
  • Carbo-load the night before. Stress.
  • Borrow my daughter’s hike/camp backpack and stuff it with 50 pounds, including sleeping bag and clothing and lunch and dinner supplies and 4 liters of water. Why would I need 4 liters of water for ONE measly hike? 50 pounds is not bad, but that is without skis on the feet. Son and daughter have plenty of advice for “old dad.”
  • Get up at 4:45am, STILL GET CAUGHT in I-70 skier traffic on the way out of town, and instead of taking 2.5 hours to get to Leadville, take 3.5 hours and arrive around 9am. AND, leave behind a winter shell and have to buy a replacement in Leadville. Stress.
  • Get to trailhead as everyone is ready to head up. Buckle up quickly, half-remembering what they guy in the store said about all the boot settings. Wonder how to use the avalanche probe and beacon, trust that 15 of 17 people in your group are Colorado natives and have done this several times a winter for a decade. Start sliding toward the trail.
  • Hey, this is … fun? It is snowing lightly, the sun peaks through occasionally. Even though it is 7 degrees, I’m wearing plenty of layers and a 50 pound backpack. My last-minute winter shell is bright GREEN which goes great with my bright RED ski pants. I’m focusing on pushing with one leg, bending the other knee and pausing to slide for a second before taking a second step. On flat terrain or a slight downhill, this works well for forward motion (I can slide about 1-2 feet for NO ADDITIONAL EFFORT), but side to side balance is a different thing. I nearly topple several times. Just moving toward the trailhead in the parking lot. Stress.
  • Trailhead! OK, this is just a fire-road; the dirt road that trucks in the summer and snowmobiles (and trucks) in the winter go up to service some parts of the forest. The snow is fluffy, nice, not scratchy or icy. There are ruts in the road from recent passage of snowmobiles, but no problem. My feet start to notice that the rental boots are not a perfect fit. Surely this won’t be a problem later…
  • Sloping uphill: Hey! This is hard work! Most of the team has “jogged” out of sight up the hill, whooping it up on the way; they’re in their native element. On the other hand, the bi-coastal transplant to the Mile Hi City is huffing and puffing. Why hasn’t living in Denver for 2 decades translated to growing a second set of lungs? Nice think about the gasping for air as I slide up the trail is it takes my attention of my increasingly painful feet. I also ask my trail-buddy (who has been left behind to guard me against falling to the pack of wolves that pick off slow, enfeebled members at the back of the convoy): “hey is the rest of the trail ahead also this steep?” Reply: “Oh, don’t worry, it gets much steeper ahead.”
  • Lunch! At 3 miles (hey! almost halfway!) we pull over, take off our backpacks, snarf down some snack bars (and my lifesaving colleague pulls out a Banh Mi Vietnamese sandwich and generously donates 1/2 to me) and I have never had such delicious food in all my life. Ambrosia.
  • Then, off the fire road and the REAL trail starts. I become aware of the value of Skins, the unidirectional fibers sticking out of the carpet-like attachment to the bottom of my skis that allow me to slide forward, “catch” the fibers and essentially walk straight up the slope without sliding back, unlike in alpine or even regular cross country skis where a major “herringbone” diagonal walk up the hill is necessary. This is like a stairclimber exercise, but at 11,000 feet with 50 pounds on your back and 30 pounds strapped to your legs. I can feel my heartbeat in my throat going about 170 and my lungs scrabbling for every single O2 molecule. “Hey, isn’t this beautiful, CT?”
    =pant pant= “Huh?
    =pant pant= “Wha?”
    =pant pant= “Where?”
    =pant pant= “Lemme”
    =pant pant= “Catch”
    =pant pant= “My”
    =pant pant= “Breath”
    =pant pant= “Yeh. Nice.”
  • In another 2 miles, my guardian and I catch the 9-year old daughter of friends who is finally starting to get tired. Wow, what an amazing backcountry expert she’ll be growing up! Then some of the teenagers, having reached the hut, dropped their gear, started the fireplace, have come down to help some adults with carrying backpacks the rest of the way. I resolve to carry MY OWN BURDEN the rest of the way.
  • Arriving at the hut is perhaps the sweetest sensation of the past few years. I go in, shuck off everything, swap out clothes, and sleep for a solid 2 hours.
  • We end up making dinners (although cooking is a challenge with water boiling at a lower temp and having to melt all your own snow for drinking water, the food is extra delicious for being so hungry), singing campfire songs accompanied by the ukulele, teaching some kids some ukulele strumming chords, skiing through untracked powder in the coming days and generally having a blast. Moleskin becomes a second skin on my feet.
  • Our slide down is heavenly. There are sections of trail up to a 1/4 mile that qualify as a Maslow’s Peak Experience for me; gliding effortlessly downhill through a glade of trees, the sunlight filtering down, a fine drifting mist of fresh powder, the temperature perfect, my pack and everything balanced just so, knowing that I CLIMBED THIS MYSELF (about 30 minutes of climbing for every minute of gliding down), glimpses of the San Juan mountains encrusted with snow…Wow.
  • Then, back to the car, returning the gear, merging back into I-70 traffic, back to reality. It is something I will never regret having done.

CMIO’s take? I think all Coloradoans should do this. The cameraderie, the triumph of effort over gravity, the cleverness of technology to overcome natural obstacles, the pure transcendent beauty, the sense of achievement and teamwork, and of course, the singing. Have you done a hut trip? Let me know.