Creating a problem by solving a problem


An interesting article was recently published by the Washington Post – If this was a pill, you’d do anything to get it – that shows how solving a problem so often throws up a new one

Medical research has taken amazing steps towards curing or immunising people against infectious diseases – acute illnesses responsible for high mortality rates. The results are shown in the image below:

Graph: death rate for infectious diseases

The outcome is people living longer. When we live longer, we are more likely to suffer from a chronic condition – an illness that develops slowly over time and often cannot be cured but can be managed through early detection and ongoing medication or lifestyle changes.

And so healthcare is being disrupted by its own success.

In the US (as reported in the article), one healthcare program adopted a new approach. They targeted individuals based on their medical history (had a chronic condition and had been hospitalised in the past year) and instead of waiting for potential patients to phone when they get sick, they arranged for a nurse to visit the patient’s home on a regular schedule (weekly or monthly depending on the severity of the condition).

The results: Reduced hospitalisations by 33% and reduced Medicare costs by 22%.

You should read the article for what happens next. Not quite a happy ending and the clue is in the title of the article. Perfoming house calls is assumed to be expensive and inefficient, despite the success of the program. If the same results had been achieved by giving the patients a pill…

It’s a great demonstration of the need to think differently when solving one problem creates another.


Institutions will always resist change

This is a follow on to the previous post: The Inevitable Collapse of Systems. Clay Shirky recently quoted (posted by Kevin Kelly but without a link, naughty Kevin!):

Institutions will try to preserve the problem to which they are the solution.

This is along the same lines as the great quote by Nicholas Machiavelli back in the 16th Century:

There is nothing more perilous to conduct, more uncertain in its success, than to take the lead in introducing a new order of things, because the innovator will have for enemies all who have done well under the old conditions, and only lukewarm defenders in those who may do well under the new.

The trouble with challenging institutions is the power they wield to help protect and maintain their position, and the fear, uncertainty and doubt (FUD) they will generate about anything new that threatens their comfortable existence. As being ably demonstrated by the music publishing industry. Those who profited from the old conditions would have everyone believe music creativity is dying because of new conditions created by the Internet (i.e. illegal downloads). Watching the recent music awards on TV (US and UK), there are no such signs. People were creating and performing music long before publishing industry came along and will continue to do so no matter what the financial rewards. It is not creativity that is dying, it is the ability to generate money that is being challenged. And here we are in the UK, facing a hastily written Digital Economy bill aimed at protecting an industry’s distorted revenue model.

It is not the fittest or the strongest of species that survive but the one most adaptable to change. – Darwin

When institutions are able to persuade governments to try and protect their status at any cost, they are using their strength to delay the need to adapt. And that presents a huge risk for everyone, because creating legislation or spending tax to prevent change shows all the signs of an economic system heading towards collapse.

It is not necessary to change. Survival is not mandatory. – W. Edwards Deming

Why do we need music albums? We don’t and we never did. They were invented by the music publishing industry because it is easier to make profits from selling albums than singles. That was possible under the old conditions. It isn’t so easy under the new. But with change brings opportunity. If you are selling albums, you only need to support a few performers and are only interested in the ones that generate easy album sales. Now that I buy mostly singles, I purchase from a far more diverse range of performers, often discovered from hearing or watching them online. Well done iTunes, Spotify and YouTube! No surprise that none were the invention of a music publishing company.

Illegal music downloads are wrong. But focusing on piracy and trying to claim it is damaging creativity when what it is really damaging is abnormal wealth that was only possible under the old conditions is FUD that diverts attention away from the industry’s resistance to change.

[Update: 08 Apr 10] Too funny to not include as an update. Just days after rushing through the Digital Economy Bill without proper debate, the two main political parties are both accused of copyright infringement for not asking permission before using images from a TV series as part of their election posters: Labour and Conservative parties accused of copyright infringement


Related blog posts

Did the clouds just get darker?

Dark clouds over Bournemouth from

In February 2010 three Google executives were convicted of a privacy violation in an Italian court and received suspended prison sentences. The reason for the trial and conviction: they allowed people to upload a video to Google Video showing someone being bullied. It was two hours before the video was removed following complaints.

“It is like prosecuting the post office for hate mail that is sent in the post”

The BBC covers the story in more detail here.

The trial sets an interesting precedent and could have far-reaching consequences for social media and cloud computing services. In particular the costs to provide such services if content is supposed to be pre-screened and the viability for organisations to use them for business data. Will Internet Service Providers be held to the same level of account if an employee complains about data an organisation stores using online business services? China is not the only country with a government wielding local power to disrupt global Internet services. And although Italy is singled out in this example, Australia has been planning to introduce strict filtering controls that could restrict access to social networking sites. The UK is exploring how to prevent illegal downloads and considering blocking broadband access for those accused. The list goes on… Providers of online ‘cloud computing’ services will find more turbulence as they cross political borders.


Image courtesy of licensed under Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License

Life, Death and Twitter in Africa

A quick note. I tend not to blog about news unless it is something worth munching over (and preferably not being bounced around the Techmeme echo chamber). Instead, I share links through Twitter and FriendFeed (most come via Google Reader) and roll them up into a weekly post. If you want real-time updates, join in the fun on Twitter and/or FriendFeed

But this link on Wired deserves a post all to itself – Life, Death and Twitter on the African Savannah – talking about how social media is being used to raise awareness about and donations for a wildlife park in Kenya. Funds have dropped due to the recent political turmoil affecting tourism. Some sound bites here, but I recommend reading the full article.

…the blog raised $40,000 from donations in March. Kimojino’s Facebook page drew about $2,000; and a handful of safari companies bought advertising on the blog in exchange for sponsoring rangers. “All the rest has been from single donations from individuals around the world, from donations as small as $5 to our biggest, which was $5,000,”

The man who helped set the blog up was discovered in the wilds of… Rotherham, a town up North here in the UK. Thanks to his blog attracting attention, he switched life as an office temp for life Stood in the Congo. I am truly envious 🙂

Beyond blogging:

On a game drive one morning, the ranger stops his car in front of a herd of antelopes and whips out a camera. “I have never had a Coke’s Hartebeest on Flickr,” he says, taking a picture.

(If a certain fizzy drinks company had any sense, they’d donate some of their advertising revenue and sponsor that picture.)

What is most amazing – big companies reluctant to change should take note – is how traditions are adapting to blogging:

Getting online has not been without its risks for Kimojino. He explains that for him to be speaking about the park to the public, instead of his boss, breaks traditional Kenyan decorum and was at first difficult for him.

And balancing needs for digital and physical life:

…after a few months of this online activity, Kimojino went to the optometrist – he was worried the computer would damage his eyesight, hindering him from spotting, for example, a leopard in a tree two kilometers away.


Open versus closed disasters

The news coming in about the cyclone in Burma is terrible, with reports that the number of lives lost is likely to exceed 100,000. BBC News has coverage and links. David Weinberger has posted that donations may get to those who need them quicker if sent through International Burmese Monks Organization. See Donate to Burma.

What’s weird from an information and context perspective is how remote this disaster feels, compared to other events such as the Tsunami, Hurrican Katrina and Sept 11th. (A similar effect happend with the earthquake in Pakistan.) Is that because Burma is such a closed society, meaning there are very few first-hand on-the-spot-as-it-happens pictures and videos? Research has proven that people connect more when shown a specific story rather than massive (no matter how scary) statistics. The tsunami also occured in a region with strict controls. Perhaps having a tourist spot complete with Westerners and their camcorders helped.

If one good thing comes out of this disaster, maybe it can show the benefits of having open rather than closed societies. Let’s hope the Burmese military and government relax their grip and allow outsiders to help. Sad to write, the reports are not optimistic.

Finding solutions

It’s a funny old world.

On Monday this week, I had to travel to meet a client – I know, life is full of surprises. I’d spent the previous evening trying to decide whether to use the car or the train. The travel distance was just over 100 miles. In theory, the train should take 3 hours door to door and the car should take 2 1/4 hours door to door. The train route is notorious for delays and cancellations (it’s got Birmingham in the way) and the car route is also notorious for long delays (it’s got everyone avoiding Birmingham on it). In the end, the car won. Sure enough, no sooner had I set out than along comes a traffic alert on the radio – a car fire on the M1 (that’d be my road) was causing major tailbacks.

Hmpffing and sighing away as I beavered along towards the beloved M1, I flicked on Radio 4 to check if there was anything worth listening too…. and there was! And now we’ll get to the point of this blog post 🙂

Dr James Martin was a guest on the show. I’ve been a big fan since I heard him present at Microsoft a few years ago. One of the topics of discussion was the debate about climate change, in particular carbon emissions. The focus fell on the challenges presented by growing nations with their growing demand for cars, in particular China.

The natural conclusion to draw is that China experiencing exponential demand for cars would be an exceptionally bad thing for the climate, with visions of exhaust fumes enveloping the planet. And then Dr Martin dropped in an alternative viewpoint:

“…suppose that the president of China said that everybody should be able to have the good things in life, just like America, and everybody who wants a car should have one, but it cannot be a petroleum car. Now that would have an enormous effect on the world.”

Wow! Just imagine it. If China banned all petroleum cars whilst still encouraging car ownership, how long would it take car manufacturers in the world to start massive investment in research and development to design cars that do not emit carbon? Like it or not, the potential to make money, and lots of it, has a habit of incentivising commercial organisations to act far quicker than when forced by government policy and regulation to do something (unless that something has a whiff of 5+ years in prison about it – anybody need more sox?). Imagine what this outcome would do for China politically? To take the lead in managing to grow economically whilst sustaining the environment…

I don’t doubt that I’m over simplifying the situation and people will point out all sorts of problems and reasons why it could never happen. But alternatve view points can provide a new perspective and highlight that nobody knows for certain how the future will play out. (Cue tie-in for what this post has in common with information systems, in particular business intelligence and why using foresight to make decisions is so hard no matter how compelling the evidence.)

Historically, we have been notoriously bad at predicting our demise (fortunately!) I still remember reports issued during my school years. First it was that we would starve due to population growth outstripping food supplies. Then we would freeze to death because we were entering an ice age. Then it was that we would fight over, and run out of, oil before the end of the 20th Century (well they got half of that prediction right), but only if we made it through the inevitable nuclear winter that would likely happen by the end of the 1980s. And when the Cold War failed to ignite and a wall fell down instead, well then it was that we were going to fry due to global warming. And if climate change doesn’t get us, well no worries ‘cos the world is ending on 21st December 2012. (Well, ending for humans at least. I’m not sure there is any suggestion that the planet itself will cease to exist)

The debate between predicting the future and learning from history cropped up throughout the recent technology management conference I attended at Cambridge University. Scenarios can provide a valuable tool to highlight the possible effects different routes could lead to and avoid focusing on only one possible outcome. But learning from history remains a crucial art that should not be forgotten. As the old quote goes – “those who cannot remember the past are condemned to repeat it” (George Santayana)

If you are interested in the full broadcast, the Radio 4 show is currently available for download – Start the week


Final note: joy of joys, I’m back off to see the client again on Friday. Now Friday and M1 are two words that should never share a sentence (same goes for Friday and M6, Friday and M25, in fact Friday and any blinkin’ road in the UK), so I’ll be risking the train this time.

[Update:] And would you believe it, the trains all ran on time. Not only the trains I travelled on, but every single train on the display at the various stations was listed as running on time… Thank goodness the weather continues to be miserable – I would think I accidentally got on the Eurostar and left the country if there wasn’t something to moan about 😉