I think it’s fantastic that Australia has implemented a standard patient record as a starting point for centralizing patient health record information. My background is in EHR implementation and integration, so not surprisingly I have some thoughts on what Australia can do to avoid the siloed data issues that we currently face in the US. One of the biggest challenges that providers will face is in selecting an EHR. The biggest EHR vendors, such as Epic, Cerner, and AllScripts, pretty much all operate on outdated technology that is often highly customized for specific clients and therefore makes standardized integration between systems difficult.
It’s hard to develop a standardized data transfer methodology when every system has a different field that they’re trying to pull that information from, which is in turn stored in a different format and therefore requires customization in the receiving system to transform that data into a usable format for that system. I’m sure what I wrote sounds complicated and confusing, and that’s because it is. The ideal outcome would be for Australia to pick one cloud-based EHR that all providers are required to use, but that seems unlikely, and frankly there is no one EHR that currently exists that would meet the needs of all specialties. It is important to note that My Health Record, from what I can tell, is not an EHR (a system used by providers in their daily workflows to update patient information and record patient visit outcomes) but rather an online health database that both patients and providers can access and update.
The AHDA can mitigate implementation risk by working with providers within different specialties to make the fields within the EHRs as standardized as possible to normalize the data between these systems to the greatest extent possible. The AHDA could also make a rule that providers have to be able to transfer information from their EHR to the “My Health Record” database in a particular format that then updates that record with the most up-to-date information. If the “My Health Record” can act as a source of truth for patient information, then any updates could also be transmitted to other providers who have access to that patient’s record.
I am curious about how Amazon Fresh may try to take advantage of the rising prices for British grocers. While they currently have only about 1% of the market having begun offering their food delivery services in the UK last year, Amazon likely will not face the same challenges with rising costs that British grocers such as Tesco are facing. In addition to likely not having to pass on higher prices to consumers, Amazon offers the additional benefits of convenience and a range of offerings that goes well beyond what most UK grocers have. According to a Financial Times article from January 2017, Amazon offers 130,000 items while one of the UK’s most popular delivery services, Ocado, offers only 40,000 (https://www.ft.com/content/b8f65bf6-dbe9-11e6-86ac-f253db7791c6). I am interested to keep an eye not only on how Tesco navigates the Brexit negotiations, but also how it handles the looming threat from online retail giants such as Amazon.
I find your first question about whether Americans benefit from more manufacturing jobs in the US or lower cost cars a fascinating one. I read an article last year in the New Yorker that argues that despite Donald Trump’s rhetoric, jobs will not actually return to the US when companies such as Ford return their manufacturing plants here. Rather than creating new jobs, at least in the long-term these on-shore investments are driven by automation and the goal of removing as many humans as possible from the assembly process. As the New Yorker article states, “salaries aren’t an issue without the salaried” and argues that discussion of withdrawing from deals such as NAFTA in order to bring jobs back to the US is “like applying leeches to a head wound.” Since the tasks that are moved off-shore are often the most basic ones, these tasks are relatively simple to automate and therefore moving these jobs off-shore “is often just a “way station” on the road to eliminating them entirely.” I would highly recommend giving the article a read — it really opened my eyes to the ways in which automation will (and already is) impact manufacturing jobs: https://www.newyorker.com/magazine/2016/12/19/our-automated-future.
I am in agreement that the FbF is a valuable tool for predicting where storms will hit, but I think the Red Cross needs to adjust their fundraising and relief efforts to align with this model. Based on my knowledge of the Red Cross from working there as a consultant for a year, one of the biggest problems that the organization has is that people are extremely generous in donating to specific disasters, which the Red Cross can then only spend on that disaster. As many have pointed out, including the following Slate article, this often leads to the Red Cross squandering funds and a lack of transparency surrounding where the millions of dollars they typically raise have actually gone.
Rather than fundraising on an almost purely reactive basis, they need to do more proactive fundraising for general disaster relief in keeping with this new predictive approach. One issue with a “proactive” fundraising model is that it makes them the bearer of bad news, but as disasters related to climate change occur more frequently people will come to better understand the need for these broad support measures.
They then also need to further standardize their approach to disaster relief efforts, either using funds exclusively for immediate emergency care and giving the remaining funds to local organizations better equipped to handle long-term rebuilding, or expanding their expertise to include ongoing rebuilding support.
While I know little about Tesla or retail from a supply chain perspective, I do have some experience as a consumer and some perspective to offer on these questions from my experience working at a disruptive healthcare company. From a retail perspective, my biggest concern is whether the quality of the clothing is on par with less sustainable brands. Other than that the clothes are eco-friendly I find the comparison with Tesla difficult since from what I can tell they don’t seem to be truly innovating on styles or offering the highest quality products. I took a look at some of their customer reviews, and they seemed fairly split between customers who love the brand and those who were frustrated by low quality garments that shrunk in the wash. While these reviews often represent the most extreme viewpoints, it does make me somewhat concerned about their ability to scale and compete with high-end retailers on quality, not just sustainability. This is especially important given the relatively high price point these clothes are sold at since, as Grant mentioned, for this model to work customers need to be willing to pay a premium to cover the margins associated with the company’s sustainable approach.
I agree with Grant that they should change their metrics to be more specific. From my experience in healthcare I also learned that it can be effective to call out your competitors on their waste. My previous employer, athenahealth, started posting metrics on its site comparing athena’s ability to help physicians meet quality measures to that of its competitors. While athena did not initially beat its competitors by very much, this transparency provided motivation for both athena and its competitors to improve. While Reformation is implicitly calling out the rest of the industry for its unsustainable practices, I think they could take a broader stand in trying to transform the industry at large through transparency. This could include information either about specific companies that are doing the most harm, or providing general metrics about the industry’s waste to increase awareness on this topic.
I enjoyed this piece as well and had not been aware that auction houses were moving into digital to such a degree. I am in agreement with Katie that blockchain is unlikely to become the unique source of verification for a piece of art due to the changing nature of valuation. One additional aspect of this to consider is that despite Sotheby’s original determination on provenance of an item, these conversations can often be complex and unclear. While high worth pieces and more recent works often have clear provenances, older pieces in particular frequently do not have as clear of a provenance and therefore become more of an art rather than a science to determine (pun intended). While Sotheby’s experts are certainly among the best at determining the history of a piece of art, there may be ongoing disagreement as to the provenance, and especially as new information becomes available over time those determinations could change. For example, this is why certain pieces of art change from being attributed to the artist to instead being by “School of Rembrandt” etc. as additional research reveals that the artist him/herself likely did not make the work, but instead someone who was strongly influenced by their style. One digital technology I think could be helpful would be machine learning, if there were a way to apply that to comparing pieces of art to each other based on content and provenance to anticipate when a piece of art is more likely to be a forgery, which Sotheby’s resources could then further investigate.
As far as cryptocurrencies generally, I believe that given Sotheby’s reputation for being one of the top auction houses in the world, they will resist cryptocurrencies until they are a fully respected currency or sell only low value items through that means to attract first-time buyers. I think the idea you mentioned of selling digital works is an interesting one that would likely attract a new audience, as this form of payment would resonate more strongly with the intended buyers for those works.