Blog Archives

Radiologists Should Adopt Disruptive Innovation- via DiagnosticImaging.com

4/24/2012

Blog Post I wrote (David Fuhriman) Posted on DiagnosticImaging.com
You know what would be cool? What if Apple computers leveraged the open source technology, like OsiriX PACS and RIS, and built an open technology that worked seamlessly with all their technology?

The stations would be Macs and now the new iPad that has retina display would be a little portable viewer along with iPhones. Apple would incorporate Siri, the personal assistant, and would leverage the App Store so that developers and other companies could build applications for image transfer, reporting, billing, scheduling and notifications that could work with all of the software and hardware.

Imagine. Radiology would have a complete suite of hardware, software and applications that all work well together — along with a marketplace for constant innovation.

How disruptive would this be to diagnostic imaging? Very disruptive. Think of all the headaches this would solve for radiologists and IT. Radiologists flock in waves to adopt the technology and within one year it’s a dominant player in diagnostic imaging. This would start a wave for other physicians using similar technology to dictate to EHR and create a platform for innovation and adoption of apps that would move healthcare to the cutting edge.

Now imagine another scenario. What if a developer, who is a PACS admin for a radiologist group in Kansas City, developed this same software that worked with Apple products. He called his company "Jim's Healthcare Company, Inc." What happens to adoption of his product? Keep in mind, it is exactly the same technology.

Only, you can't imagine that it is the same technology. Can't be, if developed by Jim in Kansas City. So you don't buy it. And neither do any other radiologists. So Jim never quits his day job. The group he works for uses the technology and they love it. But nobody else develops apps that can work with it and it never takes off.

So why are these two scenarios so different? Well, because of the trust that we have developed in the Apple brand is what helps us take a risk on the new technology. We have come to know what to expect and so when they come out with new technology, we know that we can expect it to work as well as it should.

But does disruptive innovation come from large companies like Apple? Rarely. Often disruptive technology is considered a little risky in structured environments. So, it has to start in a small group who can sense value, like Jim. So too is the adoption of technology. It usually isn't adopted by large industry leaders, but by smaller groups that are open to take the risks in order to improve performance, like Jim's employer.

So, how do these large companies create new disruptive and innovative technology? Primarily by acquisition. Siemens, McKesson, and Phillips add to their product list by buying a technology that was developed by a different company. Take for example the acquisition this week of Coderyte, a natural language coding company, by 3M. There is no chance that this technology would have been developed in house at 3M. But now that Coderyte is growing successfully, 3M has purchased the company, will rebrand as their own — and voila! 3M is producing innovative and disruptive technology.

Here comes the flow of disruptive innovation: These large vendors only acquire successful companies. The companies are only successful if it can get traction. Companies don't get traction, until they have demonstrated value. The innovative companies prove themselves in small arenas first, and then move on to larger, more conservative players.

So next time you see some disruptive, innovative technology — like natural language coding, voice recognized scheduling system, or image transfer technology — remember. It might not work perfectly. The interface might not work perfectly. Nobody you know may be using it. But, this is as it should be and there still may be value in using the new technology.

Deloitte Webcast on Visualization

4/24/2012

Ok- so this is a webcast targeted towards Oil and Gas. But, there are some good things to pick up. I come from the finance/accounting side and in the past few years the advances in being able to push reports and data visualization are amazing. Pushing the reports out to mobile is an amazing advancement. But to get there, you need it in the right format, it needs to be correct, and it needs to be timely.

Those seem to be the constraints and not just a technical concern. Check out the slides below.

Analyze This: Streamlining Production Operations Through Better Visualization
File Size:	1376 kb
File Type:	pdf

Download File

Bern Medical Completes Connect Springboard Program

4/18/2012

Announcement from Connect regarding Bern Medical's completion of the Springboard program:

“ Bern Medical has successfully completed the CONNECT Springboard program. CONNECT has assisted in the formation and development of more than 3,000 companies in the San Diego region and is widely regarded as one of the world's most successful organizations linking inventors and entrepreneurs with the resources they need for commercialization of innovative products in high tech and life sciences. The program has been modeled in more than 50 regions around the world. Key to our success has been the unique "culture of collaboration" between research organizations, capital sources, professional service providers and the established industries. CONNECT has been recognized by Time, Inc. and Entrepreneur magazines and last year received the 2010 Innovation in Economic Development Award from the U.S. Department of Commerce for creation of Regional Innovation Clusters. CONNECT manages the San Diego Innovation Hub (iHub) designated by the state of California Governor’s Office of Economic Development in 2010.

For more information, please visit www.connect.org”

10 Things I Didn't Learn in College

4/11/2012

Editor’s note: James Altucher is an investor, programmer, author, and entrepreneur. He is Managing Director of Formula Capital and has written 6 books on investing. His latest book is I Was Blind But Now I See. You can follow him@jaltucher.

I’ve written before on 10 reasons Parents Should Not Send Their Kids to College and here is also Eight Alternatives to College but it’s occurred to me that the place where college has really hurt me the most was when it came to the real world, real life, how to make money, how to build a business, and then even how to survive when trying to build my business, sell it, and be happy afterwards. Here are the ten things that if I had learned them in college I probably would’ve saved/made millions of extra dollars, not wasted years of my life, and maybe would’ve even saved lives because I would’ve been so smart I would’ve been like an X-Man.

1. How to Program - I spent $100,000 of my own money (via debt, which I paid back in full) majoring in Computer Science. I then went to graduate school in computer science. I then remained in an academic environment for several years doing various computer programming jobs. Finally I hit the real world. I got a job in corporate America. Everyone congratulated me where I worked, “you’re going to the real world,” they said. I was never so happy. I called my friends in NYC, “money is falling from trees here,” they said. I looked for apartments in Hoboken. I looked at my girlfriend with a new feeling of gratefulness—we were going to break up once I moved. I knew it.

In other words, life was going to be great. My mom even told me, “you’re going to shine at your new job.”

Only one problem: when I arrived at the job, after 8 years of learning how to program in an academic environment—I couldn’t program. I won’t get into the details. But I had no clue. I couldn’t even turn on a computer. It was a mess. I think I even ruined people’s lives while trying to do my job. I heard my boss whisper to his boss’s boss, “I don’t know what we’re going to do with him, he has no skills.” And what’s worse is that I was in a cluster of cubicles so everyone around me could hear that whisper also.

So they sent me to two months of remedial programming courses at AT&T in New Jersey. If you’ve never been in an AT&T complex it’s like being a stormtrooper learning how to go to the bathroom in the Death Star where, inconceivably, in six Star Wars movies there is no evidence of any bathrooms. Seriously, you couldn’t find a bathroom in these places. They were mammoth but if you turned down a random corner then, whallah!—there might be an arts & crafts show. The next corner would have a display of patents, like “how to eliminate static on a phone line – 1947″. But I did finally learn how to program.

I know this because I ran into a guy I used to work with ten years ago who works at the same place I used to work at. “Man,” he says, “they still use your code.” And I was like, “really?” “Yeah,” he said, “because its like spaghetti and nobody can figure out how to modify it or even replace it.”

So, everything I dedicated my academic career to was flushed down the toilet. The last time I programmed a computer was 1999. It didn’t work. So I gave up. Goodbye C++. I hope I never see you and your “objects” again.

2. How to Be Betrayed. A girlfriend about 20 years ago wrote in her diary. “I wish James would just die. That would make this so much easier. Whenever I kiss him I’m thinking of X”. Where X was a good friend of mine. Of course I put up with it. We went out for several more months. It’s just a diary, right? She didn’t really mean it! I mean, c’mon. Who would think about someone else when kissing my beautiful face? I confronted her of course. She said, “why would you read through my personal items?” Which was true! Why would I? Don’t have I have any personal items of my own I could read through? Or a good book, for instance, to take up my time and educate myself? Kiss, kiss, kiss.

Why can’t they have a good college course called BETRAYAL 101. I can teach it. Topics we will cover: Betrayal by a business partner, betrayal by investors, betrayal by a girlfriend (I’d bring in a special lecturer to talk about betrayal by men, kind of like how Gwynneth Paltrow does it in Glee), betrayal by children (since they cleverly push the boundaries right at the limit of betrayal and you have to know when to recognize that they’ve stepped over the line, betrayal by friends/family (note to all the friends/family that think I am talking about them, I am not—this is a serious academic proposal about what needs to be taught in college)—you help them, then get betrayed – how to deal with that?

Then there are the more subtle issues of betrayal – self-sabotage. How you can make enough money to live forever and then repeatedly find yourself in soup kitchens, licking envelopes, attending 12 step meetings, taking medications, and finally reaching some sort of spiritual recognition that it all doesn’t matter until the next time you sink even lower. This might be in BETRAYAL 201. Or graduate level studies. I don’t know. Maybe the Department of Defense needs to give me a grant to work on this since that’s who funds much of our education.

3. Oh shoot, I was going to put Self-Sabotage into a third category and not make it a sub-category of How to Be Betrayed. Hmmm, how do I write myself out of this conundrum. College, after all, does teach one how to put ideas into a cohesive “report” that is handed in and graded. Did I form my thesis, argue it correctly, conclude correctly, not diverge into things like “Kim Kardashian will never be the betrayer, only the betrayed.” But this brings me to: Writing. Why can’t college teach people how to actually write. Some of my best friends tell me college taught them how to think. Thinking has a $200,000 price tag apparently and there is no room left over for good writing.

And what is good writing? It’s not an opinion. Or a rant. Or a thesis with logical steps, a deep cavern underneath, beautiful horizons and mountaintops at the top. It’s blood. It’s Carrie-style blood. Where everyone has been fooling you until that exact moment when now, with the psychic power of the written word, you spray pig blood everywhere, at everyone, and most of all you are covered in blood yourself, the same blood that pushed you out of your mother’s womb, until just the act of writing itself is a birth, a separation between the old you and the new you—the you that can no longer take the words back, the words that now must live and breathe and mature and either make something of themselves in life, or remain one of the little blips that reminds us of how small we really are in an infinite universe. [See also, 33 Unusual Tips to Be a Better Writer]

4. Dinner Parties. How come I never learned about dinner parties in college. Sure, there were parties among other people who looked like me and talked like me and thought like me—other college students of my age and rough background. But Dinner Parties as an adult are a whole new beast. There are drinks and snacks beforehand where small talk has to disguise itself as big talk and then there’s the parts where you know that everyone is equally worried about what people think about them but that still doesn’t help at those moments when you talk and you wonder what did people think of me? Nobody cares, you tell yourself, intellectually rifling through pages of self-help blogs in your mind that told you that nobody gives a sh*t about you. But still, why don’t we have a class where there’s Dinner Party after Dinner Party and you learn how to talk at the right moments, say smart things, be quiet at the right moments, learn to excuse yourself during the mingling so you can drift from person to person. Learn how to interrupt a conversation without being rude. Learn how to thank the host so you can be invited to the next party. And so on. Which brings me to:

5. Networking. Did it really take 20 years after I graduated college before someone wrote a book, “Never Eat Alone.” Why didn’t Jesus write that book. Or Plato. Then we might’ve read it in religious school or it would’ve been one of those “big Thinkers” we need to read in college so we can learn how to think. I still don’t know how to network properly so this paragraph is small. I’m classified under the DSM VI as a “social shut-in”. I’d like to get out and be social but when the moment comes, I can only make it out the door about one in ten times. I always say, “I’d love to get together” but then I don’t know how to do it. Perhaps because not one dollar of my $100,000 spent on not learning how to program a computer was also not spent on learning how to network with people. [See also, my recent TechCrunch article, "9 Ways to be a Super-Connector"]

6. Politics. My very first girlfriend, the girl who first laughed hysterically when I showed her a piece of chewing gum I found on the ground that had sculpted itself into the muddy shape of a heart, took me to a movie called “Salvador”. Then there was a discussion group afterwards about how the Contras are bad, or good, I forget, and everyone was nodding and speaking in a Spanish accent. And afterwards my girlfriend was upset, “why aren’t you talking?” Because truth was I was so tired I couldn’t think but nobody ever taught me how to tell the truth so I lied and said, “it moved me so much I’m still absorbing it” and my girlfriend said, “yeah, I can see that.” And nobody ever taught me that there’s more than one acceptable opinion on a college campus.

My roommate for instance would tell me, “Reagan is definitely getting impeached this time.” And I visited his dad’s mansion over Christmas break and he told me all about Trotskyism and the proletariat and I had to work jobs 40 hours a week while taking six courses so I could A) graduate early and B) pay my personal expenses and when I would run into him he had long hair and would nod about how a lot of the college workers (but not the lowest-paid, poorest treated ones—the students who worked) were thinking of unionizing and he was helping with that. “Do you have a job?” I asked and he said, “no time”. And that’s politics in college.

What about the real politics of how people try to backstab you at the corporate workplace or VCs never properly explained the “ratchet” concept to you before they kicked you out of the company and then re-financed. Nobody told me a thing about that in three years of college and two years of graduate school. I wish I would’ve known that for my $100,000.

7. Failure. Goes without saying they don’t teach you this. If you are going to pay $100,000, why would you fail? You might think you were wasting your money if the first mandatory elective you had to take was about failure. About wondering how you were going to feed your family after you got fired when something that was not your fault: Post-Traumatic-Lehman-Stress Syndrome, a common medical condition coming up in the DSM VII.

8. Sales. When I was busy learning how to “not program” nobody ever taught me how to sell what it was I was programming. Or sell myself. Or sell out. Or sell my ideas and turn them into money. Or sell a product to someone who might need it. Or even better, sell it to someone who doesn’t need it. Some business programs might have courses on salesmanship but those are BS because everyone automatically gets As in MBA programs so that the schools can demonstrate what good jobs their students get so they then get more applicants and the scam/cycle continues. But sales: how to demonstrate passion behind an idea you had, you built, you signed up for, so that people are willing to pay hard-earned after-tax money for it, is the number one key to any success and I have never seen it taught (properly) in college.

9. Negotiation. You’ve gotten the idea, you executed, you made the sale and now…what’s the price. What part of your body will be amputated in exchange for infinite wisdom. Will you give up one eye? Or your virility? Because something has to go if you are up against a good negotiator? What? You already thought (like most people without any experience do) that you were already a good negotiator. A good negotiator will skin your back, tattoo it with “SUCKA” and hang it up above the fireplace in his pool house if you don’t know what you are doing. The funny thing is, the best sales people (who are just aiming for people to say “Yes!”) are often the worst negotiators (“it’s very hard to say “No” when you are trying to get people to “Yes”). These are things I wish I had learned in school. I’ve been beaten in negotiations on at least five different occasions, which fortunately became five valuable lessons I’ve learned the hard way, instead of studying examples and being forced to think about it for the $100k in debt I got going to college.

People will say, “well, that’s your experience in college. Mine was very different.” And it’s true. You joined the sororities and learned how to network and dinner party and be political and know everything there is to know about betrayal. My college experience was sadly unique and probably different from everyone else’s so you would be completely right to quote me that inane statistic about how college graduates earn 4% more than high school graduates and are consequently 4% happier .

(Another thing, 10. Happiness. We never learn how it’s a combination of the food we eat, our health, our ability to be creative, our ability to have sound emotional relationships, our ability to find something bigger than ourselves and our egos to give up our spiritual virginity to.)

So I can tell you what I wish I did. I wish I had gone to Soviet Russia, and played chess, and then gone to India and learned yoga and health, and I wish I had gone to South America and volunteered for kids with no arms, and did any number of things. But people then say, “haha! but that cost money.” And they would be right. It would cost less than $100,000+ but would still cost some money. I have no idea how much.

But one of these days when the scars of college go away and I truly learn how to think. I might have better comebacks for these people. Or if I truly learn, I would learn not to care at all.
http://techcrunch.com/2011/11/12/10-things-entrepreneurs-dont-learn-in-college/

Hospital Deaths from Infections More than AIDS, breast cancer and auto accidents- Combined

4/11/2012

Hospital infections kill more Americans each year than AIDS, breast cancer and auto accidents combined. Wow, great article on reducing these deaths through washing hands. The world is so complex that sometimes it is hard to grasp.

http://opinionator.blogs.nytimes.com/2011/11/24/an-electronic-eye-on-hospital-hand-washing/

Hard Questions

4/6/2012

The host of the show in the stadium says "We are all here today to prove to the world that Accountants are not stupid. Can I have a volunteer?" One Accountant steps up. The host says to him "What is 15 plus 15?" After 15 or 20 seconds he says "Eighteen."

Obviously everyone is a little disappointed. Then 80,000 Accountants start cheering "Give him another chance, give him another chance." The host says "Well since we've gone to the trouble of getting 80,000 of you here and the world wide press, I guess we can give him another chance."

So he says "What is 5 plus 5?" After nearly 30 seconds he eventually says "Ninety?" The host sighs - everyone is crestfallen and the Accountants starts crying and 80,000 accountants start yelling "Give him another chance, give him another chance."

The host, unsure whether or not he is doing more harm than damage, eventually says "Ok! One more chance. What is 2 plus 2?" The accountant closes his eyes and after a whole minute eventually says "Four."

Around the stadium 80,000 accountants start yelling "Give him another chance, give him another chance."

Definition of an Accountant

4/6/2012

Someone who solves a problem you did not know you had in a way you don't understand.

Bern Medical- Press Release

4/5/2012

In medical imaging when a procedure is performed, like an x-ray, the images and physician notes are stored digitally in one software system. A report is sent to billing, who uses another software system to assign a code to be able to send the bill to the payer, typically Medicare or insurance companies. This is an important part of the business because significant costs were incurred to provide the services and the incoming revenue is the life-blood of the company.

Recently a radiology group knew that they were having problems with their billing process. The number of procedures was constant but revenues were declining over the previous few months. They needed a way to compare millions of transactions from their billing and image databases. This started the development of software used by Bern Medical to reconcile the billing traffic. Bern uses its proprietary software to reconcile what has been done to what has been billed. This radiology group discovered that over the previous 18 months they had missed billings of $4 million. They resubmitted the charges to the insurance companies and were able to recover $2 million.

Development of the analytical software began in 2009 and undergoes constant revision to improve the algorithms and the results. During the initial development and testing another 12 groups used the services and were able to recover an average of 2% of their annual revenue. In August 2011 Bern Medical, a San Diego based company, was formed to take the services to market across the country. To perform the analysis a provider uploads a data export from their systems to Bern's HIPAA compliant server. Bern then performs the analysis and delivers back a report of missed opportunities and analytics that can help the provider correct the errors going forward.

The founder of Bern Medical is David Fuhriman. He graduated from Boise State University with a degree in Spanish and Economics. He earned an MBA from Northwest Nazarene, is a California licensed CPA, and a Six Sigma Greenbelt. Recently he worked at a fast growing San Diego based telecom company. During his 5 year tenure revenue grew from annualized revenue of $20M to over $160M. David was responsible for business intelligence, financial consolidation and development and maintenance of corporate budgeting.

David says the most important thing is that its services are risk-free and doesn't cost anything out of pocket. "Our proposition is that we provide an independent billing review for free. If we discover that the billing process is perfect, then our clients pay nothing. We only take a fee based on dollars we actually help recover. So it is a win-win situation." When asked if this means that it is an easy sale, David replies, "Yes and no. Many people see the value immediately. When some don't they usually fall into one of two camps. The first is the assumption that they don't have any errors. The second is that they are afraid that we will expose the errors that they have personally made. The answer to both of these concerns is that there will always be errors. We expect to find a 2% error rate. This means that there is a 98% accuracy rate."