I was recently featured in the following video about the use of intelligent agents as coaches for health and wellness. It’s an area of much interest to me as I firmly believe that such technologies can assist with reversing the current obesity pandemic:
Yesterday I was well onto my way to clocking up 40 kilometres of barefoot running in 3 days and was really feeling buzzed.
Fortuitously Flo Rida’s Good Feeling popped up on the video screen I was tuned into. It so resonated I had to share it.
Besides featuring two of my favourite past times – running and stand up paddle boarding – it totally captures the way optimised health and wellness makes you feel
Watch. Enjoy. Get Out There!
What is the secret to health and wellness? How can you lose weight quickly and keep it off?
These two relatively simple questions have kept many a man and woman in a state of quandary for aeons. They have been so hard to answer for so many that fortunes have been made off the back of them. Indeed, if you look around you I can guarantee that you will see a preponderance of unhappy, obese to morbidly obese people within shouting distance of you.
And shout is what I want to do. I want to shout out loud that it’s easy!
Weight loss and the subsequent exponential boost in energy and focus that comes with it is so easily attainable that no-one should be overweight.
And the overall sense of well being that flows from achieving optimal health is so incredible that it is totally beyond me that anyone would not want to get their body into trim!!!
Yet here we are. Surrounded by a pandemic of obesity. Fast food is pervasive, as is a societal bias towards overeating to celebrate good times or cope with loneliness.
How can you break out of this cycle?
You know the one I mean. You’ve out on an extra 10 kilograms, you want to exercise, but your inbox is constantly calling, you feel lethargic and frustrated. After a long day in the office the last thing you want to do is go for a run or, heaven forbid, squeeze into your lycras and front up at the local gym. It’s a microwave meal, glass of red and some ‘reality TV’ to cleanse you of the day and get you to the point where you can bear to tackle your inbox for another hour or two before heading to bed.
Once in bed, the situation doesn’t improve. Overtired, you struggle to fall asleep. No sooner do you doze off and you are woken up: by your own snoring. This cycle continues all night until your a alarm wakes you up in the morning. But you feel terrible. You feel cheated, as if you haven’t slept a wink and someone fast forwarded time to the morning.
You head off to work feeling exhausted and wondering how you will get through the day. Best you have an extra strong coffee at work. Once in the office you spend the day flitting between tasks, finding it difficult to concentrate on any one thing for too long before you concentration wavers. Focus is not your strong point.
Sound familiar?
It does to me. I lived this for the past decade. Back in 2002 I was in a similar position. I was overweight and felt like shit. The benefit was I had an opportunity to rethink: I’d been retrenched and had time on my hands.
I decided to tackle my weight problem and lost 16 kilograms in 6 weeks following a diet called the Fat Flush Plan. I felt great. Superb in fact. My energy levels rose, I achieved maximum focus.
I used this new found lease on life to orchestrate an aggressive takeover of the company that had retrenched me and took on the CEO role.
But this wasn’t sustainable. Soon I found myself in high stress situations multiple times a day. The diet I’d been on required a lot of time preparing food and I was now extremely time poor. I started returning to old habits: lots of carbs, little exercise.
Over the course of the next decade I put on the weight I’d lost and even gained a few more kilos. I was frustrated. I remembered how I’d felt when I was slimmer.
It’s not like a lay around like a sloth. I was mountain biking on weekends. Two years ago after a stopoff in Hawaii during my Australia-US commute I discovered stand up paddle surfing and dived into this. But the killers remained : stress, a sedentary workstyle and a diet full of carbs (I loved making pasta and pizza) and minimal exercise during the working week.
Mid 2011 I decided to try and turn things around. I joined the gym at The University of Sydney and so began my journey back to wellness. I would be in the gym three days a week for an hour or so. My usual routine involved a 4 or 5 km run on the treadmill: run 800m, walk 200m, followed by 10km on an exercise bike and 1 km on a rowing machine and a few light weights.
The thing is this did nothing for my weight. Sure I felt a little better and it probably helped a bit keeping me in tone for my weekend stand up paddle sessions, but my running was real tough going. It felt like I had a dead buffalo tied around my waist that I was trying to drag around. In reality that is exactly what I did have. Have you ever picked up a 15 kilo weight and really felt how heavy it is. That’s what I was packing.
After a visit to a naturopath I decided to give up caffeine. I found that when I stopped it for even 24 hours I’d have bad withdrawal symptoms. This was a pointer that my body didn’t process caffeine too well. Stopping was really tough. I felt nauseous and had a splitting headache for four days. However, I did feel much better after the withdrawal symptoms subsided. I didn’t want to go through that again!
In late November I took a few days off and went to Singapore. I had a great time staying at the Marina Bay Sands, which has a range of awesome restaurants in walking distance. Not to mention all the other delights of this fine city.
It was only on my last day that I made a tour of the hotel’s gym facilities – for like five minutes. I began to feel really bad. Essentially I’d squandered a real opportunity to exercise flat out for five days.
By the time I returned to Sydney I felt awful. I was bloated and I hadn’t done any exercise of note for a week. Stupidly I pushed myself hard in the gym for two days. Something was going to break and by the third day I could feel an ache developing in my right shoulder that arched up into my neck. At first I thought this was simply stiffness from the exercise and that it would ease. It did the opposite. The intensity of the pain grew to such a point where I had to seek help.
I first thought a massage would help, but if anything it simply intensified the pain further. Feeling like I had a knife in my shoulderblade I turned to physio. This helped to ease the pain, but it soon returned. I’d never tried acupuncture, but my wife had a painful ligament fixed by it a few years ago. I was ready to try anything and thought I’d give it a go.
The hard part was finding a reputable needle sticker. The first lady I saw relieved the pain for a day or two, but it soon came back. I also wasn’t comfortable with her set up – she seemed to operate from a range of venues and her operation felt tacky.
December arrived and I’d arranged a session with the naturopath ages ago. By now I’d made up my mind. I wanted to go on the diet. The fact that Xmas madness was only a few weeks ago did not deter me. Instead it spurred me on. I did not want to think about how I’d feel after a few Xmas parties, dinners and lunches.
My naturopath Sheena was surprised at my decision. She had not seen it coming, but credit to her she was ready to let me dive in.
I started the very next day. The first two days are about eating as much fatty food as possible so as to line your organs and protect them from the shock that soon follows. It turned out that on the second day I had a lunch planned with some patent attorneys. We had a great meal in an Italian restaurant – loads of carbs washed down with plenty of red wine and even a shot of grappa. By now though I was already starting to lose my appetite and left the restaurant feeling elated, knowing that it was the last time I’d be eating like that for while.
Besides the strict regimen of the diet I was also taking some special drops three times a day. There were some logistics to deal with given that mobile phones and computers could deactivate the drops, but I worked out a routine pretty quickly. I stored the drops in a cupboard in our common room in the office, with a note saying they were mine, in case someone else came across them and wondered what they were. I had a second bottle stored in the downstairs bathroom at home.
Even though I’d started the diet and was soon into the restricted calorie part, the pain in my neck and shoulder had not gone away. In fact it had intensified over the course of a fortnight and I was in agony.
It was Saturday morning and I had to be driven around. Going over speed bumps was total agony. I was supposed to be hosting a dinner that evening and boy did I need help! I was adamant that I wasn’t going to take pain killers. I knew how important an optimized liver was to weight loss and felt they would set me back and counteract the diet. Not to mention that I hated the woozy feeling they brought on.
I found an acupuncturist in Gordon and he could fit me in at 2pm that afternoon. I arrived skeptically, but desperate for some relief from the pain. I was in luck – this guy really knew his stuff.
A few hours later I was hosting the party pain free. In fact, the next morning I even felt strong enough to go for an hour long stand up paddle session on Pittwater. Admittedly I did take it easy on the paddle, but together with the added energy I was getting from the diet I was soon on a high. I felt so good.
I’d initially planned to return to the acupuncturist a few days later. However the pain had totally dissipated and I cancelled the appointment.
I could now concentrate totally on the diet and optimizing my health. The first week or so of restricting my calorie intake to 500 a day was a bit of a shock to the system. It was analogous to being in a foreign city with really bad jetlag – my body was still getting used to it. That said I could feel the kilograms of excess weight falling off, my energy levels rising and my focus sharpening.
I had no qualms about doing the diet. Xmas party season arrived and I successfully navigated through by drinking lots of water and staying away from the inevitable snacks that circulated.
By Xmas day I had already lost 10 kilograms. We were hosting a big family lunch and I was determined to stay the course with the diet. One trick I’d picked up was that humor was a great food/drink deflector.
For example at one cocktail party I was attending someone asked me what was in my glass, water?
I replied, “Of course not, it’s pure vodka!”
We both knew this wasn’t true, but it allowed the conversation to move on and not get stuck with me being seen as a party pooper.
So on Xmas day I found a set of 10kg barbells I had lying around and handed one to my sister. She had recently also lost 10 kilograms. I quipped that to remind us of our recent weight loss and ensure we didn’t stray, we would have to each carry one of the barbells around all day.
This was met with much laughter.
Of course we didn’t do anything as ludicrous as carry the barbells around, but the humor deflected any further conversation about what I did or did not eat or drink all Xmas day.
Before I knew it the first three weeks were drawing to an end. To celebrate I decided to buy myself a pair of Vibram 5fingers running shoes and get back into running.
Many years back, when we lived in Cape Town, I’d run a few half marathons and really enjoyed the feeling of a solid run. I had run in a pair of Nike Free shoes a few years back, so I was not a total stranger to barefoot running. However, this was in an era before barefoot running started getting a cult-like following and back then I didn’t think of heel striking or shifting my style of running.
And so, when the Vibram info sheet said to take it real slow the first month…I did the exact opposite. As the new year started I shifted to the high protein phase of my diet. This totally increased my energy levels exponentially. I translated this new found energy into my running and by the end of the first week I had run about 42 kilometers. This is the length of a full marathon and it felt like a good weekly target.
Things were going swimmingly as I reached the end of the diet. I’d lost 15 kilograms in 6 weeks, reduced my blood pressure and increased my energy and focus massively.
However, as I transitioned from the diet onto a balanced nutritional plan I was floored with an injury. My left foot began hurting one morning on a run and the pain would not go away. Tendonitis had struck.
The only cure is rest. I found it extremely frustrating not being able to run and every time I thought it was better enough to get back out there it would seize up again and I was back at square one. I did some lap swimming and slow walking on the tread mill and within a few weeks it receded.
The good thing about this phase and of the injury is that it forced me to really be ultra conscious of what I ate as I moved off the diet. I found that my nutritional plan mapped very closely to what I had been eating on the high protein phase. I avoided carbohydrates like potatoes, white rice and stayed away from sugars as much as possible.
In fact, the really good news is that my weight continued to drop a few bars and I was able to reach my target weight comfortably.
Fast forward to early April and today – Easter Monday. My weight has stabilized at its optimal setting, I am still following a strict nutritional plan and loving it. I managed my longest run this morning of just over 2 hours and feel fantastic.
I’m keep to help others achieve this level of health and wellness and I’m thinking through how best to do that. For example I did notice how clunky it was recording my food intake, exercise and weight in different apps, getting inspiration from a range of disparate sources and not being connected to others in a similar situation. Yes, there are some great tools around like SuperBetter, Fitocracy, Pinterest et al, but I kinda think something’s missing.
I hope this post, even though it is a bit long, inspires others to consider optimising their health!
Paul Graham penned a wonderfully inspirational post recently in which he discussed a number of ‘frighteningly ambitious startup ideas’. Given his proclivity for software and the Internet it is not surprising that the ideas he raises were things like replacing Google’s search engine dominance and delivering us from inbox evil.
Quite separately, a colleague at The University of Sydney, Matthew Todd, forwarded me an article overnight that he co-authored in Nature on “open science as a research accelerator’.
In the article Matthew and two others discuss how open source-inspired thinking led him on a journey to produce an off-patent drug that could help millions of people around the world deal with bilharzia, a silent pandemic.
From their perspective the key benefit of their open approach was the acceleration of the research:
Experts identified themselves, and spontaneously contributed based on what was being posted online. The research therefore inevitably proceeded faster than if we had attempted to contact people in our limited professional circle individually, in series.
While Matthew was working on open sourcing process chemistry, he posits the question whether a similar approach could be applied to drug discovery.
The pharmaceutical industry is currently undergoing somewhat of a pipeline-related crisis and so the timing could not be better for such an approach to work.
In line with Paul’s thinking this is one of those frighteningly ambitious ideas. As Matthew points out, “There has been discussion of open-source drug discovery, but no coordinated efforts at compound discovery.”
This seems to me to be an area ripe for investigation. One that could herald a new age of abundance (read Peter Diamindis’s new book on this) in health and wellness.
I hope this is a topic that will be covered at the upcoming Founders Fund future conference!
Earlier this week John Doerr, Bing Gordon and Mark Pincus took the stage at TechCrunch Disrupt in San Francisco to talk about Internet treasures [an Internet-related company that makes us all proud to be alive now, a company that should be nourished and curated and that brings to life products that we can't imagine life without].
In the course of the discussion Mark revealed an interesting insight into his social gaming company, Zynga. In essence they are data junkies–they’ve taken a different approach to games and are very data-driven rather than hit-based. For example, they monitor in real-time each user’s net promoter score–a measure of value that the companies bring to their users, based on a standardized survey of the user base measuring whether each user will promote or detract from one of their games at any given moment.
You might be wondering at this stage what this has to do with health and wellness? As the conversation progressed between the two Kleiner Perkins partners and the CEO of one of their portfolio companies, a really interesting point emerged:
“Health is waiting for someone to turn it into a product that’s useful.”
This comment, together with the emphasis that Mark’s business places on data really got me thinking. We are so data-driven in so many areas of our lives, but when it comes to US, as Individuals, we know next to zero about our bodies, our health and wellness, how we are tracking, how what we do or don’t do impacts on how our body operates and how our minds feel–this is a major issue.
It is good to see, however, that activity is starting to emerge where the meaning [from a design point of view] within health and wellness is taking the individual more into account. Take for example the video below, in which Worrell brings together a doctor and a patient to discuss the future for health.
[Via Fastcodesign]
Analysts are predicting huge growth in the mobile health applications arena. However, I believe the market is chasing its tail and it is only those players who are bold enough to venture beyond the status quo and seek step change innovation who will succeed.
THE NUMBERS
Firstly, what are the analysts saying:
Drilling down, Juniper Research expects mobile remote patient monitoring to be a $2bn market by 2014 and Parks Associates believes wireless home health monitoring will be a $4.4bn market by 2013.
All in all, if the analysts are correct, this is a sizeable opportunity.
BUSINESS MODELS
What though, is the right model for achieving success in this market?
Jane Sarasohn-Khan has some interesting insights in this respect. Traditionally, consumers rely heavily on some form of medical aid to cover all or some of their medical costs. She says, “When it comes to mobile health, consumers aren’t yet connecting the dots towards “my health” and value.”
She believes that it is perhaps better to be asking consumers not what they’d pay for a mobile health app, but instead, “What’s your health worth to you?”
I think she is right, but only partially. My theory is that we need to turn the entire health + mobile app paradigm on its head.
AN ANALOGY
Let me explain what I mean by way of an example from the bricks and mortar end of the healthcare spectrum. Healthcare these days is more sickcare: 70% of the total healthcare cost is spent on the management of chronic diseases.
Faced with this reality and the desire to set up a new hospital, Nancy Schlichting, the CEO of the Henry Ford Health System, made an interesting choice. She recruited one of the world’s most successful hoteliers, Gerard van Grinsven, to design and run the new hospital in the township of West Bloomfield, which lies within the metropolitan area of Detroit, Michigan.
Gerard was previously a VP with the Ritz-Carlton Hotel Company, and freely admits that prior to his appointment in 2006 he had no exposure to the health industry. Yet there he was, tasked with bringing to fruition a 300-bed, $310m hospital.
Rather than following in the footsteps of countless other hospitals he took his inspiration from the Blue Ocean Strategy theory that to succeed you need to differentiate yourself so much from your competitors that you make them obsolete and force them to change. He wanted to create the Cirque du Soleil of healthcare.
His research uncovered that in healthcare 90% of the purchasing power lies with women. He also found that women are not satisfied with traditional medical care, they want programs that help them in their physical and mental well being.
HEALTH COACH
Armed with this knowledge he set out to challenge the entire industry by creating an entirely new vision that would position his new facility in a completely different way. His premise was that rather than treating chronic health, a hospital should be more of a healing campus and their role within the community should be one of a health coach.
They set out to create an environment in which healthy people actually want to come to their facility to partake in activities and programs that will help them to stay healthy.
The result: the Henry Ford West Bloomfield Hospital is more of a community centre for well being than a typical hospital. For example, the main entrance looks nothing like a traditional hospital entrance. Drawing on his hotel industry insight that first impressions are what it is all about, Gerard created a northern Michigan small town main street effect – lots of activity, lots of nature coming in. In essence, the main entrance communicates wellness.
There is a wellness institute with 11 healing rooms, a body and mind studio, water therapies and alternative medicine practitioners. There is a 90 seat auditorium with a state of the art kitchen line that does cooking classes for people with diabetes, cancer, and heart conditions, but also for healthy people wanting to stay that way.
There is a retail space. There is a healthy cafe that seats 300 people a day, 300 people who come there for the food and ambience, not because they are visiting a clinic. Walking and biking paths are being built on the surrounding acres to let the community come and play. And finally, they are creating a Culinary Learning Institute for Healthcare in which they intend to teach other hospital chefs how to positively change their food culture.
Gerard believed his obligation was to change the way healthcare is delivered by really focusing on how they could become a health coach.
It seems he has succeeded. The hospital became cash flow positive after 12 months, has an extremely high retention rate amongst its 1,800 staff and is rated in the top 1% of hospitals in the United States.
INNOVATING mHEALTH
I find Gerard’s story totally inspirational. For me the trick is taking this analogy and applying it to mHealth applications. I hope that as we explore this exciting arena you’ll keep Henry Ford in the back of your mind.