Category Archives: Collaboration

Blockchain in Healthcare

The application of blockchain technology in the healthcare industry will bring great benefits, most important being accuracy of data and lowering of cost.

Just as a reminder, blockchain technology provides these key facets:

  • a low-cost decentralized ledger approach to managing information (replicated at each node without any central hub),
  • giving simultaneous access to all parties a single body of strongly encrypted data (almost impossible for hackers to get to data),
  • creates an audit trail each time data is changed helping to ensure the integrity and authenticity of the information,
  • patients can see their data and will authorize other parties (doctors, hospitals, insurers).

Current problems in the healthcare industry is all about multiple sources of data for the patients and hence incorrect information which adds to cost. The various entities like hospital, doctor’s office, and insurance all maintain their own database and synchronization becomes a real issue and often causes error. Blockchain is a real solution to these ills. Several examples of applying blockchain are in the development stage.

  • Change Healthcare, a Nashville-based health network has introduced a blockchain system for processing insurance claims. While not all providers in the system are using it yet, the shared ledger of encrypted data represents a “single source of truth”. All involved parties can see the same accurate information about a claim in real time (rather than sending data back and forth). This relieves a patient from having to call multiple parties to verify information (a practice we all are familiar with). Each time the data is changed, a record of it is shown on the digital ledger identifying the responsible party. Any changes also require verification by each party involved, again enforcing the record’s accuracy
  • Last April, a group of companies like Humana Inc., Multiplan Inc., Quest Diagnostics Inc., and United Health Group’s Optum announced a pilot project using blockchain to have online directories of doctors and healthcare providers. Typically doctor groups, hospitals, insurers and diagnostic companies maintain their own online listings of contacts, practices and biographical details. Not only it is expensive, but they have to continually check and verify the accuracy of these directories. Using blockchain, a substantial saving (almost 75%) will occur. The goal of the pilot program is for providers to update their information themselves into the blockchain where all parties in the network can view it.
  • The MIT Media lab is developing a system called MedRec based on blockchain. Patients can manage their own records and give permission to doctors and providers to access and update the records. Success of the system or any such system will depend on large number of providers and doctors opting in to the program.

Most of the early efforts are in the “proof of concept” stage. But the potential of blockchain to help lower the healthcare cost and provide timely accurate information is very promising.

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Vitalik Buterin & Ethereum

Many of you may not have heard of this 23 year old Russian-Canadian, Vitalik Buterin. He is one of those geniuses who started loving computing and Math from an early age. His parents immigrated to Canada from Russia when he was 3 years old. After attending a private high school in Toronto, he joined the University of Waterloo (my alma mater), but dropped out after getting the Peter Thiel fellowship of $100K to pursue his entrepreneurial work in cryptocurrency.

After trying to persuade the Bitcoin community for a scripting language which got no support, he decided to start a new platform to serve cryptocurrency plus any asset like a smart contract. His first seminal paper in 2013 laid the foundation and the same year he proposed the building of a new platform called Ethereum with a general scripting language. In early 2014, a Switzerland company called Ethereum Switzerland GMBH developed the first Ethereum software project. Finally in July-August of 2014, Ethereum launched a pre-sale of Ether tokens (its own cryptocurrency) to public and raised $14M. Ethereum belongs to the same family as the cryptocurrency Bitcoin, whose value has increased more than 1,000 percent in just the past year. Ethereum has its own currencies, most notably Ether, but the platform has a wider scope than just money.

You can think of my Ethereum address as having elements of a bank account, an email address and a Social Security number. For now, it exists only on my computer as an inert string of nonsense, but the second I try to perform any kind of transaction — say, contributing to a crowdfunding campaign or voting in an online referendum — that address is broadcast out to an improvised worldwide network of computers that tries to verify the transaction. The results of that verification are then broadcast to the wider network again, where more machines enter into a kind of competition to perform complex mathematical calculations, the winner of which gets to record that transaction in the single, canonical record of every transaction ever made in the history of Ethereum. Because those transactions are registered in a sequence of “blocks” of data, that record is called the blockchain. Many Bitcoin exchanges use the Ethereum platform.

A New York Times article in January said, “The true believers behind blockchain platforms like Ethereum argue that a network of distributed trust is one of those advances in software architecture that will prove, in the long run, to have historic significance. That promise has helped fuel the huge jump in cryptocurrency valuations. But in a way, the Bitcoin bubble may ultimately turn out to be a distraction from the true significance of the blockchain. The real promise of these new technologies, many of their evangelists believe, lies not in displacing our currencies but in replacing much of what we now think of as the internet, while at the same time returning the online world to a more decentralized and egalitarian system. If you believe the evangelists, the blockchain is the future. But it is also a way of getting back to the internet’s roots”.

Vitalik wrote the idea of Ethereum at age 19. He is the new-age Linus Torvalds who fathered Linux that became the de-facto operating system for the Internet developers.

Serverless, FaaS, AWS Lambda, etc..

If you are part of the cloud development community, you certainly know about “serverless computing”, almost a misnomer. Because it implies there are no servers which is untrue. However the servers are hidden from the developers. This model eliminates operational complexity and increases developer productivity.

We came from monolithic computing to client-server to services to microservices to serverless model. In other words, our systems have slowly “dissolved” from monolithic to function-by-function. Software is developed and deployed as individual functions – a first-class object and cloud runs it for you. These functions are triggered by events which follows certain rules. Functions are written in fixed set of languages, with a fixed set of programming model and cloud-specific syntax and semantics. Cloud-specific services can be invoked to perform complex tasks. So for cloud-native applications, it offers a new option. But the key question is what should you use it for and why.

Amazon’s AWS, as usual, spearheaded this in 2014 with a engine called AWS Lambda. It supports Node, Python, C# and Java. It uses AWS API triggers for many AWS services. IBM offers OpenWhisk as a serverless solution that supports Python, Java, Swift, Node, and Docker. IBM and third parties provide service triggers. The code engine is Apache OpenWhisk. Microsoft provides similar function in its Azure Cloud function. Google cloud function supports Node only and has lots of other limitations.

This model of computing is also called “event-driven” or FaaS (Function as a Service). There is no need to manage provisioning and utilization of resources, nor to worry about availability and fault-tolerance. It relieves the developer (or devops) from managing scale and operations. Therefore, the key marketing slogans are event-driven, continuous scaling, and pay by usage. This is a new form of abstraction that boils down to function as the granular unit.

At the micro-level, serverless seems pretty simple – just develop a procedure and deploy to the cloud. However, there are several implications. It imposes a lot of constraints on developers and brings load of new complexities plus cloud lock-in. You have to pick one of the cloud providers and stay there, not easy to switch. Areas to ponder are cost, complexity, testing, emergent structure, vendor dependence, etc.

Serverless has been getting a lot of attention in last couple of years. We will wait and see the lessons learnt as more developers start deploying it in real-world web applications.

Data Sharehouse?

This is yet another new term in our lexicon. The San Mateo, California-based startup Snowflake announced this week a new offering with this name, as a free add-on to the data warehouse it built for cloud computing. Now companies using Snowflake’s technology, officially called Snowflake Data Sharing, can share any part of their data warehouses, subject to defined security policies and controls on access, with each other.

Snowflake’s data sharehouse allows companies to provide direct access to structured and unstructured data without the need to copy the data to a new location. Current approaches include file-sharing, electronic data interchange, application programming interfaces and email, but all of them have issues ranging from lack of security to cumbersome methods of providing data access to the right people. Jon Bock, Snowflake’s marketing chief compared the difference in data sharing on Snowflake versus other methods to the difference between streaming music and compact discs. “It looks [to the data recipient] just as if the data resides on their own data warehouse,” he said.

The catch is that every participant must be a Snowflake customer using their data warehouse in the cloud. So this is another way to grow their market. We have seen this approach in the 1990s when Exchanges were introduced by the likes of Oracle for B2B data interchange. That did not go very far. Of course cost was a big factor, but the policy agreement on common formats and security for data exchange was another issue. Snowflake claims to solve this by having one source of truth in the cloud.

Of course companies, like manufacturers and suppliers, advertisers and publishers have been sharing data for quite a long time, but it has been cumbersome via technologies like EDI (electronic data interchange, developed in the 1940s), email, file sharing, APIs and more. That kind of sharing takes time and wasn’t created for the current situation, in which businesses need live data processed in real time to keep a competitive edge.

According to Bob Muglia, Snowflake’s CEO (ex-Microsoft), the data sharehouse changes the game and democratizes the possibilities, because anyone can access the service. Rather than being charged a subscription fee, users pay only according to the amount of data they have processed. Snowflake’s data sharing service is free to data providers, data consumers pay for the compute resources they use. Not only that, but data providers and consumers make their arrangements independent of Snowflake Computing which is the infrastructure provider.

In an increasingly collaborative world there is little doubt that sharing data easily, and in real time, without sacrificing security, privacy, governance and compliance is of great value. Whether it will create entirely new markets has yet to be seen, but actionable data-driven insights are likely to be huge differentiators in the digital economy.

It is a clever move, but time will tell if this will enable smooth data exchange or create more chaos.

Online Marketplace and Flipkart

I listened to Professor Ramesh Johari of Stanford University last night talking about the dynamics of online markets. He spent 18 months at a company called oDesk (now part of eLance, online marketplace for freelance workers) and tried several models to understand what creates successful online markets. Besides complex matching algorithms and collaborative filtering, there are other interesting factors such as human behavior that can affect such markets. Let us look at what is happening in emerging markets like India.

Yesterday, Flipkart, an Indian e-commerce site for commercial goods got an infusion of $1B from investors from Russia, South Africa, USA, Singapore, and India. The two founders came from Amazon and no wonder they are following the same model- start with books, then open your fulfillment engine to other merchants and charge a fee. Flipkart is the fast rising e-commerce site in India and its founders just joined the billion dollar club on paper based on the latest valuation at $7B. India’s e-commerce market is currently at $13B, poised to grow to $76B by 2021, according to Technopak. Out of this total market, travel sector is 70% and type of goods sold through the likes of Flipkart and Amazon yields $1.6B. By comparison, e-commerce sales in China will likely surpass $180B this year!

Speaking about Amazon, Jeff Bezos just announced that he will invest $2B  in India, via five more warehouses (doubling to half a million square feet), same day delivery, and aggressive marketing. In a statement this morning he said, “With this additional investment of $2 billion, our team can continue to think big, innovate, and raise the bar for customers in India. At current scale and growth rates, India is on track to be our fastest country ever to a billion dollars in gross sales.” Amazon makes its money in India by charging third-party suppliers to use its website to sell 17 million different products including books, electronics and clothing.

The government is considering allowing foreign retailers to sell directly to customers. It recently took a step in that direction by allowing retailers to sell online products manufactured in India. Amazon and Flipkart are also joined by Snapdeal, another e-commerce site backed by eBay and Jabong (fashion designer). The new prime minister Mr. Modi wants to open up rural markets to such brand names for easy access without building physical stores. It will also enable growth for small town stores as front end to such goods.

Alibaba’s success in China is also an example for other such emerging markets. The founders of Flipkart dream of a $100B valuation for their company some day. But as Ramesh Johari pointed out yesterday, what is illusive is the secret formula for success and many unknown factors. Earlier this week, Lyft (online taxi service like Uber) users got highly frustrated when they could not get cars fast enough and trashed the company in social media.

Online markets are hot for sure and Flipkart will see some real competition from Amazon and eBay.

Facebook valued higher than IBM?

Yesterday Facebook with its stock soaring to new heights, exceeded IBM in terms of market value. This morning, it’s slightly less (IBM at $194B vs Facebook at $193B). However Facebook is higher than Oracle’s value and is the third largest company in the valley after Apple and Google. For enterprise software folks like me, this is very hard to explain. Value of what? – the photographs, likes and connected friends?

Market value is the total number stocks multiplied by the stock price. Sometimes, it can be a huge multiple of the current revenue – as is the case for Facebook. It’s projected annual revenue for this year at $12B is minuscule compared to IBM’s $100B in 2013. Facebook is 10 years old with 7000 employees compared to IBM’s age at 103 with more than 400,000 employees. The market value indicates the “projected” growth of a company and a higher demand of its stock increases the value. Sustainability is another issue.

Facebook reported stellar performance earlier this week, exceeding the analyst’s projection. It’s mobile advertising revenue was impressive, compared to zero two years ago. This pushed the stock to almost $76, twice the price of its IPO at $38 and four times the low of $18 at one time. Mark Zuckerberg is worth almost $33B at the ripe age of 31, adding a whopping $1.6B yesterday to his net worth.

I guess social networking is a huge force. With 1.2 billion users, Facebook owns a great treasure called the “social graph” of a huge population. Advertisers would bet all their money to reach such an audience. This year, the net spend on mobile advertising would exceed that of TV and print media spending. Every time, you use Facebook, it keeps track of you and your connections, plus photographs, links, timeline, etc. There are privacy issues being debated.

Facebook is growing very fast in countries like India and Brazil. No wonder Sheryl Sandberg visited India last month and met the new prime minister Mr. Modi to discuss how Facebook can be used for better governance in the largest democracy of the world. Incidentally, IBM’s largest number of employees now are in India, bigger than the US. 

It is still hard to digest the fact that Facebook is almost equal to IBM’s value!

The High Tech Indian Election – lessons on Big Data, Social Media and 3D Holography

The recent national election in India that spanned over 5 weeks and concluded on May 12th. was unique in terms of  sheer numbers. The total size of the electorate was 815m (more than the population of USA and European Union combined), of which 550m actually voted. Half the electorate was below the age of 25 (voting age is 18). The sheer size and complexity was mind-boggling – it was the greatest democratic process on display!

The final results came out on May 16th., where the former opposition party BJP (Bharatiya Janata Party, or the Indian People’s party) had a land-slide victory, not seen in last 30 years. The leader of BJP is Mr. Narendra Modi, the chief minister (like a state Governor) of the state of Gujarat for last 13 years. He comes from a poor family and climbed up the ranks by sheer hard work and total focus on high growth development of his state. India puts a lot of hope on Mr. Modi to bring speedy growth back to the economy.

Here I will point out how he used technology during the election.

Mr. Modi found a smart technologist from London specializing in 3D Holography. He experimented with that during the state elections in 2012 where his 3D holographic image was beamed to many locations simultaneously. The system was debugged and was ready for effective use this time – broadcasting his image in full 3D to 100s of locations thus reaching millions of people and conveying his message very effectively. Physically he spoke at over 400 rallies, and each one was attended by at least one million people or more. But combined with the virtual presence via holography, his outreach was the maximum compared to any other candidate. Such an experiment of using 3D Holography has never been used before in any election around the world.

The second approach was putting together a crack team of smart Data Scientists  who took a page from president Barack Obama’s election process. Data about the electorate was gathered and dissected like never before. Based on behavior and past preferences, they were segmented and targeted very carefully. This was a bottoms-up approach. Thousands of volunteers followed up the Big data analysis and reached out to the voters in a door-to-door fashion, thus influencing their choices. Without such analysis and pin-point targeting, this would have been impossible within such a short time-frame of 4 months. All this effort was focussed primarily on 2 major states (UP and Bihar) where BJP’s electoral victory was going to be the game-changer (as they had poor record in the past). The results came out as proof of the effectiveness of this approach – BJP got 71 out of 80 in UP, and 31 out of 40 in Bihar (totally beyond any projections and expectations).

The third focus was on fully exploiting the social media such as Twitter, Facebook, and Blogs. The urban population with access to the Internet were constantly reached out via these new communication tools. Mr. Modi has one of the largest followings in Twitter.

It was the clever use of technology by Mr. Modi’s team that clinched their unprecedented victory. The other contesting parties including the current ruling Congres party for last 10 years were nowhere in using technology and hence they lost badly.

Some lesson for all future elections!