The Gift of Ascend 2020: The birth of a woman-owned health tech company

Ascend-0304_previewI’ve been called a visionary, a dreamer, an explosively creative person who is always asking, “What if….?” Although my career in the health sector has been successful, I’d still be characterized as a foreign body in highly regulated and structured organizations. I’ve stayed in these organizations because they are safe, which means the ideas constantly swirling in my head have been trapped, stagnant and suffocating.

In spring 2017, I was running out of air. Then I met Melissa Bradley. Melissa is the founder and director of Project 500 and Ascend2020. These programs are both designed to support development and success of minority-owned businesses. Had I not met Melissa, the ideas would have stayed in my head. Thankfully, the Ascend 2020 program helped me get “unstuck”, specifically in three ways:

First, starting a company is scary. Although I am not a risk-averse person, I love the comfort and financial security associated with a steady paycheck. But I craved the freedom to create. My head and heart would battle it out and my head always won—because I was afraid to take the leap. The program gave me the confidence I needed to recognize my potential to become a successful, profitable business owner. I am still afraid but the fear will not impede my progress and forward motion.

Second, the absence of technical resources and infrastructure is intimidating. I didn’t know what I didn’t know about being a business owner. This lack of insight kept me standing still, stuck in a rut. Starting a business requires at the very least, attention to financial health and planning, administrative infrastructure and legal advice. The program provided all three and more. Identifying trustworthy, credible expertise is daunting and thankfully these barriers were removed because this talent and support was identified and provided for me.

Third, leadership is often lonely and feeling alone can be thwart creativity. Throughout my career as a leader, I have struggled with these emotions. Ascend 2020 helped me find a tribe. Having a likeminded tribe provides critical emotional support I need to keep me moving forward. In addition, the tribe is a source of honest, unfiltered, constructive feedback that makes me better and keeps me encouraged and committed to reaching my goals.

Ascend 2020 has changed my life and my perspective. Consequently, I know 2018 will be the year PPH, Inc bears fruit. Of course, I don’t know what’s in store but with this foundation, I’ll give it all I’ve got and reach for the stars. And to Melissa Bradley, my champion who saw potential in me the first time we met and took a chance on me, I will make you proud or die trying.

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Rush hour, tension and F-bombs

The weather was lovely so I decided to ride my bike to my 5:30pm meeting near the White House. Boy was I in for a surprise. Although I am an avid biker I had yet to experience the challenges of biking in downtown DC during rush hour. It was treacherous and unkind…or shall I say commuters are unkind. Luckily there is a bike lane traveling West after 9th St. NW so I thought the quick trip would be a breeze.

Let’s see- a car passed me then stopped in front of me to reverse into a parking spot, a pedestrian walking against the light yelled at me to “f-off” as I approached and yelled, “Hey” and my favorite, a young lady with headphones on blissfully galloping across street. She looked so peaceful as she skipped across the road–not in the crosswalk— without looking for oncoming traffic. As I approached her I thought, “Surely she is going to look this way!” She didn’t. I rang my bell several times but she couldn’t hear me and just as my front wheel nearly impaled her I reached out my arm waving furiously at her in an effort to get her attention, she left her seemingly peaceful state and yelled, “What the ‘f#$%’ is wrong with you?” What’s wrong with ME? Wow. What’s with the F-bombs? And the honking. Oh my. What’s with the honking? People are honking in the most futile of circumstances like failure to drive forward because someone is blocking the intersection or because they are lawfully yielding to pedestrians. Sheesh. The flow of traffic in this city and likely many other cities at rush hour is a study in impatience and tension. It felt like the entire city was on edge—everyone had a short fuse and that at any moment the city was going to blow. Why are we wrapped up and wound up so? I don’t usually swear so excuse my French but this city needs to take a ginormous sigh and chill the ‘f%^$’ out.

Returning to the page–The revival of a blog

Overview-Header-ROBIN._CB348164069_After the experience I had today, I decided to return to this personal blog. I’ve abandoned it due to fear of the imperfect. It has to be a certain length, relevant and grammatically pristine. If I couldn’t formulate a string of paragraphs, a story arc and a call to action, it wasn’t worthy of writing. The blog has to measure up to my personal standards before consumption. These attitudes kept me away from my blog and as of today, inspired by an experience on the way to a meeting, these standards have changed. I can save those ‘high’ standards for academic journals, paid blogging opportunities or the Huffington Post. The truth is I always have a thought, an observation or something to say. And whether or not these are relevant is irrelevant. So– I am reviving this space. This is going to be my space to document pieces of my adventures or deposit random thoughts, observations and frustrations no matter how short or long. New rule- I can write two sentences if I want and that will be enough. I am feeling energized and liberated. Let’s see if the change makes me more prolific.

Cavorting with criminals: When Life Imitates Fiction

834513F1-41B5-4D29-9923-D110ACFADB9BPhoto credit: register.co.uk

Last fall I started watching a show on NBC called, “The Blacklist”. The central character, Raymond Reddington, is an eccentric, high brow, international outlaw who has been hunted by the CIA for years. Unannounced he shows up at the CIA and turns himself in to be arrested for treason. Only he is not arrested. Instead, he becomes a CIA informant and while operating as such is deftly able to aid the government in criminal investigations while advancing his personal revenge agenda. A known criminal cavorting—or they’d call it collaborating— with the government. His misconduct is overlooked because his value in solving crimes and subduing the world’s greatest criminals far exceeds any concerns the government has about his own criminal activity. Sounds far-fetched doesn’t it? I thought so too until I read about Julian Assange. Assange’s life mission is to make the world transparent. He aims to achieve it at all costs, unapologetically and without consideration for the negative impact of his actions. According to Assange, “There is an immediate power imbalance, in that readers are unable to verify what they are being told, and that leads to abuse.” It appears both he and Edward Snowden have engaged in criminal acts, yet it appears, just as with our fictional hero Reddington, the government has chosen to look the other way. Why?

First, the government needs to collaborate with cyber criminals. In fact, unbeknownst to me NSA recruits hackers….openly! This really is akin to Ray Reddington. Rather than prosecute hackers, they make them allies. Better to have them in the tent than outside the tent right? They choose to hold their noses and look the other way because what the criminals have to offer is far more valuable than locking them up. Somehow the government’s cyber experience is so anemic they need the hacker skill set to bring them in the technological 21st century and beyond.

Second and related to number one, the government craves the ability to freely amass the types and amounts of data we willingly and somewhat unknowingly provide to social media giants like Twitter and Facebook. Risen and Wingfield describe necessary collaboration between NSA and social media giants to conduct “voluntary data mining operations on a scale that rivals or exceeds anything the government could attempt on its own.” What fascinates me is the government is filled with creative thinkers who unleashed could easily devise innovative and flexible strategies across all sectors, including technology. Yet the bureaucracy is so paralyzing, it forces reliance on the likes of Mark Zuckerberg, Jack Dorsey, Evan Williams, Biz Stone and Noah Glass.

Finally, their power…the ability to expose everything such as the Wikileaks leaked US government cables and videos such as Collateral Murder…creates a risk too great for the US to consider so they must placate them. It’s all in the name of national security. Besides, the American people don’t really want to know what’s going on because if everything was open and transparent, we’d be in a heap of trouble. We couldn’t put the genie back in the bottle. There is so much the general public doesn’t know about cyberspace, power, control and corruption. And we don’t want to know. We are complicit in the conspiracy. Perhaps we are complicit because we are conflicted. We want their product but not their methods. It’s why we are drawn to Raymond Reddington—aside from the fact he is James Spader and the only actor who saves the show. In Hazards of Nerd Supremacy , Jaron Lanier says “the world needs cyber-pranksters to keep old-school centers of power, like governments and big companies, in check”. Is he right? Maybe so.

And here we sit in our confusion, idly watching it all unfold—too busy to get involved or raise a hand in objection. It’s us against the machine, David against Goliath. But I hope we will eventually reach a tipping point when we finally decide to take a side. Emily Parker’s book, “Now I Know Who My Comrades Are”, tells an elegant tale of the personal awakening and hero’s journey of Anti, an influential technological hero from China. The internet opened Anti’s world, helped him find like-minded voices who helped shift the views of his nation. When he’d had enough, he sprang into action. I hope his story will one day inspire us to be just as proactive. Until then, I suspect I, and many others will sit back and revel in the fictional mysteries and adventures of Raymond Reddington and “The Blacklist”.

 

As goes print media, so goes medical care: Maintaining relevance in the digital age

A series of readings focused on whether or not print media can maintain relevance and their challenges in doing so exemplifies the growing need for the medical world to hop aboard the digital train quickly and with both feet.  In a previous blog I discussed my own sluggishness in embracing the shift to social media. The current readings particularly, Post Industrial Journalism and yet another offering by Clay Shirky helped me see parallels between print media and healthcare institutions. I now realize how drastically my work and the work of many medical institutions need to shift to comply with the digital age.  The field of medicine and health informatics has become incredibly dynamic and there are two specific parallels worth discussing.

First, the patient medical record must become like Web 2.0….not hardware driven and especially not paper-based. The costly redundancy in documentation, diagnostics and treatment is largely because of inability to communicate across healthcare facilities nationwide about a given patient who hops from facility to facility or doctor to doctor.  Although the ACA has mandated transition to electronic health records, we still lag far behind in achieving the desired outcome of improving accessibility and efficiency and eliminating duplication.  In fact, we are far off track because each institution has autonomy to install and design its own system regardless of whether or not it communicates with another system.  Furthermore, despite the deadline, some institutions are still making the transition from paper to electronic records.  Just as the print news outlets are struggling to adjust and adopt to the changing landscape, so too are we dazed and confused about how to optimize sharing of health information. Even some places in Africa are light years ahead of us because medical records are maintained on a device the size of a credit card and in the patient’s possession.  If they can achieve this, why can’t we?

Second, the infrastructure of medical institutions is just as archaic as news institutions. They are longstanding bureaucracies and institutions that often lack flexibility to meet the needs and preferences of today’s patients.  There is confusion about regulations and resistance to adopt online mechanisms to communicate with and diagnose patients.  In 2012, at a hospital in Washington, DC, I was forbidden by hospital bylaws to communicate with patients via email—truly draconian. Now people are even consulting doctors online and conducting visits via the web! Part of the problem is many of our medical institutions are led by “old guard” bureaucrats who are smothered with red tape and outdated SOPs.  Just as Dave Winer described print media leadership executives as out of touch, so too are the leadership of too many of our medical institutions. They are far too entrenched with little ability to conduct objective self-evaluation needed to adapt strategies and approaches to achieve patient-centered, modernized healthcare.  Sure some offer the latest catheterization techniques and robot surgeries but this is not the norm outside large academic institutions. Even many academic institutions suffer from old leadership that’s outstayed its relevance and who are just fine with print media even though the patients are reading from their phones.  Consequently, the changes to meet ACA regulations have been arduous and painful. Despite escalating healthcare costs and inappropriate service utilization, I am convinced our medical institutions would never have changed had they not been forced by federal legislation and the threat of reduced reimbursements.

I realize comparing medical care and medical institutions to print media is a bit trite and may be forced because I need to reflect on what these readings mean to me—practically. I get it. The point I make is just as print news is struggling to find its footing in a swiftly changing digital landscape, so too are our medical institutions. We need to assess and pivot to become more responsive to changing needs and do so with more impact for less money.  The world is changing whether we like it or not. Everyone cares about health and for this reason alone it will remain relevant ad infinitum.  But this doesn’t give us a pass. It’s our responsibility to step up and meet the 21st century mandate and this means deftly integrating and embracing all the digital world has to offer in achieving delivery of high-quality, patient-centered care.  If we don’t, India is making a play and they will beat us to it.

The Invisible Hand: Facing the Illusion of control in the digital age

My digital education continues and I love what I am learning but the learning from this past week has me agitated because I am a control freak. I certainly don’t mind input and advice. I welcome it. I just don’t want other people, especially invisible ones, making decisions that affect my life without my input, knowledge or approval. Hence, this week, I’m beyond disturbed about what I’ve been learning about the internet and the digital age. Prior to now, I was ok with the illusion of control because I could ignore it. It was an invisible hand that wasn’t staring me in the face. They say ignorance is bliss. Well, I am no longer blissful. Here’s why:

For starters, when I read about and heard and the phrase, “The right to be forgotten”, I was catapulted back in time to four years ago when I discovered my cell phone number was on the internet. Random people were calling me to make appointments. I tried to call the “internet” to ask them to change my number. How naïve to think I could find a phone number for the Internet! I had no idea where to start or how to go about doing so. Turns out you have to file a lawsuit– against who I am still not quite sure– and the information about me on the internet doesn’t belong to me. I gave up “being forgotten” after a few folks told me it was impossible. Now I learn, you CAN delete information from the Internet. This control is centralized in the hands of few and the decisions are at the mercy of group like the Delete Squad, who I suspect are 20 to 30-something computer geniuses with little real world experience. How does one access the delete squad and more importantly, what gives them the credibility and authority to decide what should and shouldn’t be deleted from the internet?

Next, it turns out information is willfully being withheld from me on the internet because of a Filter bubble. This bubble is created based on a computer algorithm’s best guess about what I am interested in. Little does it know I am quite eclectic, defy convention and would much rather see the exotic and unconventional. The reason the filter bubble irritates me is because I am a dreamer. I like to think about new ways to solve problems, especially old problems that need new solutions. Given that, with me, anything goes. Just because I am surfing the web in Cambridge for a socially-innovative solution to a problem in inner city Boston, doesn’t mean I am not interested in solutions that have worked in Peru or India. I want to see the universe of possibilities. I want to decide when I have information overload, not a computer.

Finally, lately I have been thinking of ways internet access and technology could yield solutions to help balance our social inequalities. Then I learn rich, corporate giants are fighting to decide who gets what kind of internet access and at what cost. This Net Neutrality fight is something I had heard about in passing but had given NO thought to or its implications for poor people. It means, if the corporate giants win, the poor, yet again are shortchanged. Sociologists have shown that poor communities are becoming more and more disconnected and fragmented. This is largely due to social challenges burdening inner cities like gang violence and other crime. The internet and technology could potentially become a powerful mechanism to build social capital, form groups and demand action from local politicians. If access to the Internet becomes limited and doled out based on ability to pay, what other resources can poor communities rely on to improve their environments? This lesson hit me hardest because nearly every day I am thinking about how to improve access and social conditions for people living in poverty. I still think technology and the Internet are part of the solutions.

It was rough week—an eye-opening week. I was reminded I am invisibly being controlled in one way or another every day, all day. I can accept it and learn to maneuver in my new reality or I can fight back because I have also learned the digital age has given us the power to respond. But in the end, the Internet and its control will win because I like most us are too busy juggling life and have become completely dependent on the Internet and its gifts. It seems we are inextricably linked. But the question is do I, do we, relinquish all control to the invisible hands or find the time and will to push back against the illusion.

Off with laggards

News flash everybody–I’m finally being dragged into the digital age. As many of you know, I have had no love for technology or the Internet. The email never lets up, texting has replaced real conversations, and everyone is communicating in Facebook posts and 140 character sound bites. Ugh! They call people like me laggards. We are the last ones trying to hold out hope for a return to the good old days when the house phone rang and you answered it because you had no idea who was on the other end and you might miss something exciting. But now, resistance is futile. Recognizing the professional need to become more tech savvy, I enrolled in a class at HKS call Media and Politics in the Digital Age. After a week of readings and lectures, I realize what a dinosaur I am and the near certainty of being left behind professionally if I don’t embrace this wave of the future. I now appreciate the power function and utility of the internet beyond the most basic ways I am using it, such as sending email and posting updates on Facebook! I must admit, I didn’t expect to become as enthralled with the information about the digital age and have learned a few lessons about the power of the internet and social media.

First, social media and the Internet have revolutionized and simplified group formation and social mobilization. The ease and strength these have been demonstrated numerous times including Arab Spring and the Boston bombing but until now, the true power of nearly instantaneous group formation escaped me. The internet has provided a mechanism to influence and provoke responses from leaders and governments around the world. I never took the time to absorb how remarkable this is. Ironically, while group formation and connectedness via social media and Internet are becoming pervasive, ironically, it seems people are more disconnected than ever. It’s a trade off I am wrestling with more than ever. Clay Shirky, author of Here Come Everybody says, “Once something becomes ordinary, it’s hard to remember what life was like without it, but it’s worth remembering that before e-mail we had few tools for group communication, none of them very good. ” Maybe so, but I don’t think social media can ever replace face-to-face social interaction and I don’t want it to.

Second, the internet is beginning to equalize voices. Shirky says, “We are living in the middle of the largest increase in expressive capability in the history of the human race.” This is because any person with access to the Internet has the power to spread information. Up to now I had not considered how profound this is. A voiceless person in an unknown corner of the world can now potentially has access exponentially more people because of the ability to post on the Internet or send an email. Equality is wonderful but unfettered access to the Internet and ability to spread information of any kind is a threat to the integrity and veracity of information. For example, to my horror, I learned ANYBODY can edit a Wikipedia entry, therefore making it subject to vandalism! Up to now, Wikipedia felt like a mysterious yet easily accessible and credible information repository. I have been warned more than once about the potential inaccuracy of Wikipedia postings but having no context for or understanding of these remarks, the criticism never resonated. I will never look at Wikipedia the same way.

Finally, Shirky relates a story about a stolen phone that sent me on an emotional rollercoaster and ended with me feeling badly about my rush to judgment and willingness to take a side because I was swept up in a social media movement. I was initially thrilled to read about the utility of social media to help mete out justice in the case of a stolen phone I until reflected with the author about the potential for far reaching and stigmatizing outcomes when acting in the moment. I wanted to justice to be served but after assessing the long term impact on Sasha, I was disappointed about our inability to control persons fate as a result of engagement on social media. Shirky also asks a critical question: “Do we also want a world where, whenever someone with this kind of leverage gets riled up, they can unilaterally reset the priorities of the local police department?” It is a fascinating question with far reaching implications beyond this case. But whether we want it or not, it’s what we’ve got and yes it’s here to stay. Off with laggards.

Disrespecting the Elderly

I was walking out of the hospital and an elderly woman, 80 years old, called out to me and asked if I could give her a ride home.  She was a dialysis patient and said she had been waiting for her transportation for 3 ½ hours.  It was 745pm.

I told her I would be happy to drive the car around to get her. As I approached in my car, my heart sank as I watched this feeble woman hobbling to the curb with her cane.  Her movements were so slow and deliberate, it was almost as if she was intentionally moving in slow motion.  I had to assist her to enter the car.  As if her circumstances were not appalling enough, the conversation we had in the car on the way to her Columbia Heights apartment upset me even more. 

She told me how she called her grandson  earlier that day to ask for a ride home and how he refused and cursed her out because she would not give him money.  She lives alone and when I asked who looks after her she said, “I look after myself”.  She does have some assistance.  They are young female “helpers” who come to assist her a few times a week.  It turns out they come to “help” themselves more than they help her. She related how they systematically and consistently pilfer her belongings and daily essentials.  Toilet paper, food,  laundry soap, small change—each disappearing little by little. She doesn’t refuse the help but knows that she would probably be better off without them. She sent one of them to the grocery store. The young lady bought some of the things she needed and then spent or took the rest of  the money for herself.

In the less than 10 minute drive to her home, she told me at least a half dozen stories about opportunistic and selfish young people who have taken advantage of her.  I then asked about whether or not she was linked into the District’s support system for the aging.  Well she was. In fact, it was the District’s transportation service that facilitated our chance meeting.

Our elders are among society’s most vulnerable.  I am horrified by the disrespect shown to our elders.  I am ashamed and embarrassed for us as a society and more importantly as a city.  It is time for us to teach our young people to respect our elders and to bolster the support and elders’ access to these services. We must appreciate the paths they have paved and opportunities they have afforded us.  We are indeed standing on the shoulders of giants and our elders  deserve the respect of kings and queens.

I helped her out of the car then gave her my number.  I told her she could call me if she needed assistance.  As I drove away, my heart ached for the hundreds or maybe even thousands of invisible elders, frail, feeble and alone just like her who need an honest, helping hand. I am grateful she had the spirit and courage to ask a complete stranger for assistance.  We have to do better.  For them and for ourselves.