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Bill Russell: 00:05 Welcome to this week in health it where we discussed the news information and emerging thought with leaders from across the healthcare industry. This is episode number 34. Today we discuss epic Ugm in Verona, Wisconsin. Uh, diversity and crm. This podcast is brought to you by health lyrics. Health systems are moving to the cloud to gain agility, efficiency, and new capabilities. Work with a trusted partner that has been moving health systems to the cloud since 2010 visit health lyrics.com to schedule your free consultation. My name is Bill Russell. recovering healthcare cio, writer, and an advisor with the previously mentioned health lyrics. Before I get to our guests, I want to make everyone aware of a great resource for your it teams this week in health It has a youtube channel with great insights from industry insiders like our guest today, short segments, complete episodes, all curated for easy access right now, up around 275, 280 videos. I have a team of millennials working to make it very easy to, uh, uh, to identify, uh, videos just on analytics or videos just on Ai. And those kinds of things. So check it out [email protected]/video. Easiest way to get there or you can go to the youtube channel and just search for this week in health it. Today's guest joins us from beautiful New York City. Kristen Myers, SVP for Mount Sinai health system. Good Morning Kristian and welcome to the show.
Kristin Myers: 01:23 Good morning. Thanks for having me.
Bill Russell: 01:25 Well, I'm looking forward to our conversation because you are a freshly back from, uh, the epic Ugm conference. Couldn't have found a better person to have this discussion with. And I'm looking forward to your insights later on the, uh, on the soundbite section. But first, before we get going, tell us a little bit about Mount Sinai health system.
Kristin Myers: 01:45 Sure. So Mount Sinai health system, it's an academic medical center that has seven hospitals, over 6,500 physicians over 300 locations, 30,000 employees. So we're the largest New York City employers and very much focused on an integrated health system and really ensuring that we're able to provide care know from birth to the end of your life.
Bill Russell: 02:14 Wow. Thirty, 30,000 employees. Um, I have a friend who always says that every business is a people business. Every problem is a people problem and when you have 30,000 people, I would imagine coordinating projects, rolling projects out, communication. That's, that's probably one of the biggest, biggest challenges for someone in your role. Um, and well actually give us a little idea of your role. I didn't really cover it. So give us a little idea of your role at Mount Sinai and then I'll go through some of your bio.
Kristin Myers: 02:45 Sure. So I oversee the application strategy and application portfolio here in the technology department and we have over 700 applications that was due to the merger that took place with Continuim health partners around four years ago. And there wasn't a lot of synergies between the application. So what we're doing now is looking at, you know, all of the roadmaps for the applications and working out how do we actually rationalize, come to enterprise platforms and be able to decommission some of the legacy system. Yeah, we have around 700 apps at this point and I think that our approach is really around enterprise platform, so epic for our clinical and revenue cycle, oracle for Erp and we're also looking at a crm, a customer relationship management platform. So I have direct responsibility for the Epic team. Also the IT Program Management Office and Change Management Office. They oversee around $100,000,000 in capital projects a year, uh, interoperability and also clinical ancillary
Bill Russell: 04:06 I mean we could do a whole show just talking about application rationalization and platforms. Platforms is the, is what every it organization is looking to get a, to get to platforms being open, the ability to programmatically access the information, create workflows on it. So yeah, those are some interesting. And I'll look forward to. We're going to talk about crm a little bit later. So Mount Sinai for about 14 years pm at Cap Gemini, but you started your career in Australia are clearly, that is not a New York accent that you're sporting there and you did spend a couple of years with Cerner, although, um, I think we're going to find out here that while we already found out that you are an epic shop at, uh, at Mount Sinai, so, um, so one of the things we'd like to do with our guests and uh, just to just open it up and say, you know, what are, what's one thing that you're excited about or that you're working on today that you just want to share
Kristin Myers: 05:06 So I'm working on the customer relationship management strategy, uh, here at Mount Sinai. And that's really exciting to me because being able to understand our patient population and have a 360 viewpoint on all of our patients I think is so important. And how do we personalize how we are able to communicate with them? What are their preferences in relation to text or email or phone? I mean, knowing that and being able to actually engage them in a better way. I think it's important for health systems to be able to have that knowledge of the consumer. So that's what I'm working on today. We're going to be releasing a crm rfp in the very near future. We have crm already implemented in pieces of the organization such as marketing and a population health group and business development, but we're looking for one platform across the enterprise and the use case is really around the center and you know, how do we provide our call center agents with one platform so that they're able to see, you know, whether it's a patient's first day, how they want to communicate. What was their experience at one of the physicians offices? Did they make a complaint? Did they have a great experience? You know, what does the press Ganey scores, you know, all of that. I think it's so important.
Bill Russell: 06:41 Crm is interesting. When we took a look at it at the health system where I was CIO, you did have multiple, multiple crm systems in place. We had some clinical systems that we're trying to do crm type features and then we had call center systems that we're trying to do some crm type features. Um, but when you try to orchestrate a patient experience across, I don't know, 15, 20 different systems, uh, you know, it was hard to move every patient touchpoint across there so that everyone sounded like they at least worked for the same company. Um, and I assume that's one of the challenges that you guys are facing.
Kristin Myers: 07:24 Yeah and I was reading actually, some of the Gartner reports around crm and you know, only about 20 percent of health systems that actually are implementing crm are able to get an enterprise solution. And I think the challenge is who is the operational owner? Uh, it touches nearly everyone in the health system so I think getting that sponsership around, know who actually is going to be driving these decisions is problematic at many health systems. So we've been very lucky that our executive team clearly understand that this is a priority and they really supported the ability for us to go to RFP and have an enterprise strategy.
Bill Russell: 08:13 So on our show, we do two segments. We do in the news where we each pick a story to discuss. Today we're just gonna. We're just gonna Focus in on the, uh, on the conference and talk about different aspects of that. And then we'll do a soundbite section where I'm more of an interview type thing, just ask you a couple of questions, um, which we've discussed ahead of time. So people don't think I'm just gonna try to stump you here. Um, so in the news, I'm going to have you kick us off since you were there. Give us some idea of, you know, what, what was, I assume it was a festive kind of mood and you know, what was, what was the atmosphere and then what were some of the key themes and topics from, uh, from the conference
Kristin Myers: 08:52 You know I've been there, at Egm for the last 13 years and this year was a great experience as usual. It was great outdoors theme and I think one of the focus areas for a epic is around patient experience and access. And so I was really pleased to see at some of the usability sessions, you know, focus on their, my chart, which is the patient portal and how they are ensuring that the Mughal version of my chart is exactly the same as the web based version and when we've had some issues here where, you know, we have initiatives such as open notes where we're being very transparent about the progress notes that the physicians are writing on my chart, but that's, that can only be seen on the my chart desktop, not on mobile and you know, many of our patients do not have access to the Internet and then not able to see that version of my chart so they only have the mobile version. So I think the ability to have all the functions a consistently is going to improve patient experience dramatically. Uh, they've changed the look and feel. I mean clearly there is a lot more focus on user experience and how to engage the patient. So that was a pleasant surprise that they're really moving in that direction. I was placed with that
Bill Russell: 10:27 mobility. The numbers continue to stagger me. I mean, just case in point, this, this podcast, I think it's like 95 to 97 percent of all listens, will come on a mobile platform, a hits, hits to the website is, is almost a 95 percent from mobile phone as well, which actually I'm not surprised that it leans in that direction, but it's a little high for me considering that a majority of our listeners are healthcare users and healthcare users generally, are web type users. But if that's just the transformation that's going on, people are mobile and so everything we do now, and it has to have a mobile component for how you're going to show notes, how you can show the medical record, how are you going to do scheduling online. So that's really fascinating. So let me, I'm going to tee you up and I'll tee you up with some of the articles that have been written.
Bill Russell: 11:24 Some of the tweets that are out there. We're going to look at four main thing. So, uh, some, uh, Judy's comments early on this, this is really around innovation and startups. A faulkner acknowledge that there's a lot of buzz around digital health today. Many leaders in hospital it departments have words like innovation, uh, and have titles like innovation analytics, digital data, and their job titles. She said most of the titles barely existed 10 years ago. Uh, I assume you're seeing these kinds of titles emerge. Do you, um, are you seeing that people with these titles of chief innovation officer and chief data officer analytics offers, are these reporting into it? Are you seeing them outside of it? And, and what kind of models do you see sort of emerging around these new titles?
Kristin Myers: 12:10 No, I think that healthcare as you know, I mean sometimes lags behind the rest of the industries such as retail, ect. You know, this has been going on in those industries for quite a while and we're seeing chief digital offices and chief data officers in the business at other health systems. Uh, we recently actually were able to hire a vice president overseeing a consumer digital and you know, that person is in the business and I think that that is a model that you're going to see more and more of a, not necessarily in the it department.
Bill Russell: 12:57 Yup. Yeah, I think we are seeing them while we're seeing a lot of different models. That's why I put the question out there. I mean, we are seeing it really tied to the business. We're seeing some in it and then we're seeing some departments that are purposely being kept separate so that the, uh, I think, I think how Rod Hochman and described it as the organization, the culture of the organization doesn't crush innovation, uh, is how he described it.
Kristin Myers: 13:24 we're Very lucky. I mean we're an academic medical center and so, you know, we have a lot of innovation occurring not just within the it department but also in operations and also in our research and genomics division. So, you know, there's a lot of innovation occurring here and that's, that's what makes it exciting. And you're able to partner with these teams and actually work to get great solutions out there.
Bill Russell: 13:55 Yeah. And so, which is why I find these so innovation startup. So Judy went on to say, there's so much money in silicon valley for startups. When I go to an innovation conference, I feel like a piece of meat walking around dogs. And I like dogs. She goes on things. I just found these kind of comical. Uh, I assume people laughed at that startup sit at one end of the spectrum of the technology business at the other end are a giant gadgets, gadgets and software makers like Amazon, alphabet, apple, uh, in, uh, in addition a faulkner mentioned ibm, Microsoft, Netflix, Walmart, uh, among others. We've talked about others on this show. It's too early to say how they'll fare, but some big companies from outside the industry who have struggled to impact healthcare in the past. Uh, see Google health and Microsoft health vault inside. Faulkner said in her keynote that it's hard to make meaningful advances in the area as complex it.
Bill Russell: 14:50 And she went on to say that the EHR is the most complex area in the world, which is health operates in the area that's the most complex in the world, which is healthcare. She said, I think it's more complex than rocket science. Um, you know, is epic saying, look, we're in your corner as they're saying to this crowd, which is health systems. We're in your corner. Our intentions are good. We've made good progress together. Don't look somewhere else for a shiny object to solve your problem. Uh, their intentions the silicon valley people may not be good. They've failed in the past as, as has been noted. Um, you know, this stuff is really hard. Uh, do you think these comments are a form of a a fear, uncertainty and doubt around startups and tech companies because they are starting to capture some attention within this space and, and, and do hold some promise. I mean, what, what do you think her thinking was behind it? Really those feisty comments about a tech startups and the established players.
Kristin Myers: 15:52 I think she's concerned around some of these applications not being hipaa compliant. And, you know, I think that we're all aware of what's gone on with facebook and Cambridge Analytica and you know, I think that her concern is around patient data and making sure that, you know, patients aren't being directed to inappropriate services or that the data is being shared in a way that, you know, clearly that the patient doesn't understand and they're being subjected to advertising, et Cetera. So know I think that that was probably one motivation. I think the second would be around fragmentation of workflow. And I think that that is one of the challenges as it relates to digital health is how do you incorporate these applications in such a way that it actually makes the workflows more efficient for our physicians and our other providers and nurses and within a hospital system or a healthcare system, but also from a patient access system. Um, and the consumer experience, you know, just having, putting apps out there. And is very confusing for some of our patients. I think that there needs to be an intentional comprehensive strategy around how do consumers and our patients actually access care at health systems. And it needs to be a very seamless experience and not a lot of healthcare systems are actually doing that from my opinion.
Bill Russell: 17:35 Yeah. So, um, this wasn't one of the topics, I was gonna take you down, but I assume there was a lot of conversation around physician burnout and making the system easier to use. I mean, what, what, what were some of the things that you heard around that topic?
Kristin Myers: 17:48 I think physician wellness is a huge issue and in fact we have a chief wellness officer at Mount Sinai and we've really aligned some of our optimization efforts, uh, with, uh, his efforts also, you know, I think that the way the systems are implemented at times, um, it is a lot of ways to be able to achieve, you know, the same workflow and then needs to be an emphasis on simplicity and efficiency and making sure that the physicians and, you know, their support stuff, you know, really understand, you know, the tips and tricks and the shortcuts to be able to get through, uh, their office visit in the shortest amount of time. And you know, I think that's been an emphasis from epic that been, you know, very much focused on this and you know, being great partners working with us on our own optimization efforts,
Bill Russell: 18:55 Yeah and a lot of the challenge you know 30,000 employees not all of them use the EHR. But what we found in having physician champions around the different hospitals was there was just, there were some physicians that were using the system so poorly. They hated the system, but when you sat there next to their elbow and said, hey, did you know this was available because they didn't have time to go to the full training or they didn't have time to do that. That a lot of it was just, which is training and, and communication of how to use the system better. That just takes time to propagate that.
Kristin Myers: 19:28 Well. And that's the challenge for us is we have over 6,500 physicians in our health system and so we're taking a two prong approach. One is to have optimization teams go out to the practices and actually shadow the physicians, which we find is pretty much the most effective way to teach them at the one on one at the elbow youknow these shortcuts. But we're also taking an approach of trying to push content out in an enterprise way and deliver these 10 minute videos that are very quick that they can watch around these shortcuts and, you know, going to their departmental meetings, but it's a huge amount of work and I think that it's labor intensive and trying to find different ways of being able to do this at scale has been challenging. So we're looking at developing the power users and the departments getting more physicians builders out there who can really work with the departments, you know, not independently completely, but you know, have a lot more autonomy, you know, we'll still have governance that we need to be able to get a more of this configuration work out there in The department.
Bill Russell: 20:48 Yup. Absolutely. So getting onto the next topic. So a interoperability, a judy said, enabling seamless data visibility across epic customers via one virtual system worldwide would improve patient care and allow for idea sharing that could lead to medical breakthroughs. A epic is working to take interoperability globally. Uh, Judy told the attendees, uh, you've, uh, let's see. She goes onto say, you've eliminated the silos from within your organization, said Faulkner speaking at the conference. Now it's time to eliminate the silos from outside faulkner's referring to epics, one virtual system worldwide initiative which launched earlier this year. The initiative enables clinicians across all organizations using epic to more easily gather, share, and interact with health data, no matter the location and presents it in a unified view. So I'm going to, I'm going to spin this a little bit. Let's take this from a different Lens. Um, interoperability, as we've talked about, is really good for patients. We believe it's good for patients. How do you think you and I as patients will benefit from one virtual system worldwide? And are there any risks or drawbacks to us? The patient?
Kristin Myers: 22:02 Well, I get back to not every organization has a, uh, has consent, uh, implemented and in a way that allows a prospective consent, meaning the ability to share that data. And I would also say that many EHRs, especially in the ambulatory setting, uh, don't necessarily have the capability of being able to share that data in a real way. Um, you know, there's a cost associated, especially for voluntary positions that, you know, they may be solo practitioners or a very small practice and having the ability to actually share that data with large hospital system can be very, very challenging. So I think that, you know, while I shared the vision, uh, from an ethics standpoint, I think that, you know, on the ground, there are a lot of challenges surrounding this now when you're going to say if you're working at an epic to epic site, it's amazing. You know, I have been a patient at a different epic sites and the ability for physicians to be able to see, uh, you know, the data from the other sites in a prospective way has been fantastic. Uh, the challenge is, you know, when you're going to these small voluntary offices that don't have that ability to share the data.
Bill Russell: 23:38 I was with a kaiser physician last night, a kaiser permanente and I was just asking, you know, what's the, what's been the biggest challenge in benefit to the EHR? And obviously he was just talking about within Kaiser, but he said, he goes, yeah, we, once we got it implemented across the board, he said it's amazing how much time it saved, how much it, uh, organize the care protocols. But he said, but for the patient, uh, within, within the southern California market for Kaiser, and he goes, you know, we just, uh, the communication is so good. And the, uh, the patient experience has gotten so much better because they, you know, he goes, I am aware of all the tests they've had. I am aware of their history, I'm aware of whatever. And so if we can create that across health systems, that's great. As you said, you know, for an epic to epic shop, uh, I don't have to worry about, you know, does my house have a good HIE strategy, do they have a good a mechanism in place? And uh, at least from, from that standpoint, and even you know cerner has their, uh, their, uh, ability to do that across their partnerships. Um, but it would be nice to see that across all the EHRs. And I think that's what we're. And, and Judy actually noted that they do share across multiple Ehrs with that platform utilizing fire standards, I believe is what she was talking about.
Kristin Myers: 25:02 Yeah. I think, you know, there are organizations, other vendors like Athena House that are really progressive. I think that they actually, epic and Athena health have the ability to exchange health records very easily and I know epic has exchanged records with many, many other emrs It's unbelievable. But there's still emrs out there that it is problematic, uh, to share. Uh, some of the data with
Bill Russell: 25:33 yeah. And we're not going to mention any names here on those difficult ones, there's no wall of shame. so research and discovery. I thought this was one of the more interesting and, and, uh, I think hopeful things that was talked about the conference. So that's a, what epic is calling cosmos and that's the world's largest, uh, a clinical database of information, a De identified information that can be used for, um, uh, be used for research and research purposes, which I assume as an academic medical center, uh, you know, this is, this is a huge benefit to organizations such as yours and the Biden cancer initiative and other things like that. Um, you know, I didn't get much from the stories that are out there. I assume this is more aspirational at this point. Not there were there actually. Were there a lot of detail shared. I guess I should just ask the question on, on what cosmos is going to do when you can have access to it and who's gonna who's gonna benefit from it?
Kristin Myers: 26:29 you know, I did not see a lot of information, shared We had out shief research informatics officer, uh, also attend the session and you know, from, from that we decided that we're going to bring epic on site, uh, for deep dive with our research community because, you know, the information that we received, you know, was, it was light on detail at this point.
Bill Russell: 26:59 But it is exciting The more information that's available to researchers such as the ones that Mount Sinai, it's, it really is. It's going to benefit humanity that we just have better research being done based on the data,
Kristin Myers: 27:16 the ability to share the identified data amongst other institutions and being able to collaborate that way is going to improve research exponentially.
Bill Russell: 27:30 There's a lot of arguments over how and who benefits and where does the money go and we're gonna avoid those in this because you have a hard stop and I want to get to the other questions so safety and privacy. The last thing she has, she mentioned Zuckerberg going to the hill, Cambridge Analytica, you mentioned it earlier. Um, so epic plans to develop tools that went third party software applications, healthcare providers and Ehr vendors have being the other party's ask patients for permission to access their medical records. Epic can tell the patient what the application is likely to do with their information. So epic's going to act as this sort of gatekeeper to say, Hey, what, what are your intentions? And then they pass that information along. A critic of epic have previously called the company software closed platform and argue this software was limited and its ability to easily exchange data echo has muffled some of those critiques by configuring and keeping a tools to be able to share information that their participant obviously with apple's health kit, uh, there they participate with fire, they've open API while they have apis through apple orchard.
Bill Russell: 28:38 Um, and, uh, let's see, social norms have changed and if patients want to share their data, they should be able to sit submit. Ronna Ronna said that a typical method, a medical record not only contains identifying information about patients, but also genomic data and information about their family and family history. For example, above all, people should keep in mind that longterm consequences of clicking I agree on a computer or smartphone apps, terms and conditions screen and she closes out by say or consider, consider the implications of uploading the protected health information of a minor as an adult. That could be a, could be very upset to find that mom opted to share their personal data with an APP 20 years ago in exchange for bonus points on their favorite game. Um, so how was this received at the conference? I, I'll give you a, you know, just some, some things that I've heard from the development community. Uh, but how is this received and what your thoughts. I just, you know, how was it received at the conference? I guess
Kristin Myers: 29:46 for the people I spoke to? I think everyone thought that, um, you know, epic's intentions were really good. I think the challenge is going to be around the vendor reaction around this and you know, are they going to be collaborating with Epic a long term if this is the way that you know, is going to be working with the third party. So, you know, I think more to come on that, but I'm interested to hear what you heard from the development community.
Bill Russell: 30:17 Well, it's interesting, the development community is scared of epic so it's, you know, so I get these comments and I'm like, so do you want to come on the show and talk about this? And they're like, no, I don't know if I come on the show and talk about this, it could decimate my company. So I just, I just share what I've heard and really no commentary on it. Just, just, you know, the foundation for this thinking is that the patient needs to be protected from themselves or better yet that the patient no longer holds sway over the record because a, it really holds information about the family. If you get my DNA information, if you have my genomix, you're really getting information about my daughters and my son and, and uh, and I'm, I'm sharing that information or I might share their information, uh, when they're a kid.
Bill Russell: 31:00 So it's an interesting new tech take, but it's the foundation is we need to protect you from yourself. The fear factor being you don't want to be, I mean, the fear factor that she sort of laid out there was, you don't want to be the next one on the Senate floor, like Mark Zuckerberg sweating while you know, you're getting grilled. Uh, and it really is a fear, a fear factor, and it's, it's brilliant marketing. Also sort of pushing people in the, uh, in the epic direction. But here's what I'm hearing is, um, you know, it, it, it really places the attendees in a position of a, first of all, they feel like they're doing the right thing. They're protecting the patient by limiting their options options to access the data. Um, and epic now access to the ultimate gatekeeper in the role. You want to innovate on our data.
Bill Russell: 31:52 Uh, you have to ask permission, pay the toll, and we will determined if your attentions are nefarious. Oh, and by the way, if you read Epics agreement nefarious can be defined as bad for the patient or just bad for epic. If it's competitive to epic, it can be bad. Uh, and so these are the things I'm hearing from the Development Community, which is, okay, so now epic controls that data. Um, and it's not really epic's data, it's the patient's data. And if it's not the patient's data, we can argue that it's this health system's data. At the end of the day, uh, you know, there's, there's, this is a very nuanced argument. I get both sides. I get, I get judy saying, Hey, look, we've got to protect. We've got to create a mechanism where people know what they're agreeing to. We don't want them giving away information to bad parties. I get that. I get epics intentions, but I also hear that the developing development and innovators saying, Hey, wait a minute, do you realize how much I have to pay Epic to get access to this data? And when I do, I have to follow their rules and I can't compete with them and I can't and they could easily come out with something that crushes our company in two years. Uh, so I, I hear both sides of it. I don't have an answer. I'm just sort of teeing it up, I guess.
Kristin Myers: 33:06 Yeah. And I also think for the academic medical centers that, you know, are, you know, doing their own innovation and, you know, working on their own products that they ultimately commercialize, such as, Mount Sanai you know, we're going to have to work through that with epic and how does it impact us as an innovative health system and you know, as well as other third party, uh, because sometimes epic does differentiate between, you know, the health system innovation and the third party vendor, uh, innovation. So that will be a nuance, will have to work through with them. And you know, the devil's always in the detail with Epic and they do listen to customer feedback. So it will be a topic that we engage them on pretty quickly.
Bill Russell: 33:57 Well, we're going to get into the questions, but just so people don't think I'm wishy washy, I've been very clear on this. I believe that the patient owns the record. I believe regardless of if we can trust the patient, uh, it's not really a place to protect me from myself. It's my data. It's my health, it's my children. I don't want the government that tightly overseeing what I do. I definitely don't want epic tightly overseeing what I do. I've been on the record as saying that I just don't want to come off as wishy washy, but what's that being said? I understand. I completely understand Judy's intentions of protecting my parents who don't know technology and can click on things which I get it. I understand where they're coming from. I don't like it, but I get it. It's a very difficult problem to get. So let's, let's go onto the questions. Um, there's a quick section, you know, shorter, shorter answers are great because we're going to cut these up into videos and put them out there on the youtube channel and out on social media. Um, so five questions. Let's just rifle through them. First question, uh, what are some of the new business models that you, uh, you're seeing within healthcare and that are really changing healthcare at this point?
Kristin Myers: 35:06 you know, I think that health systems are moving in a direction of being integrated outcomes based and now being able to really support empowered consumers. And it goes back to some of the topics we were talking about earlier around mobility and customer relationship management and how do you engage the patients and I think that health systems are going to be exploiting digital platforms ultimately to support these business models.
Bill Russell: 35:40 Um, so second question, um, what are, what are some of the digital trends that you're seeing within healthcare?
Kristin Myers: 35:50 We talked about mobility. We talked about crm, definitely telemedicine, um, there's a lot of trends in machine learning, predictive analytics. We actually had the head of our data science team do a great presentation at the epic Ugm, Robbie Freeman on some of the predictive models that Mount Sinai has developed independently of epic and then ingested it into epic around sepsis. So I think that that's definitely going to continue to be a trend, wearables. Blockchain, um, you know, I think that they're probably the major trends,
Bill Russell: 36:37 I was at one day of a conference this week where I got to hear the head of Nividia talk about ai and it was fascinating to me to hear a one of, one of the more fascinating things that he said was, um, you know, that the next generation of data programmers are going to be the data scientists, not necessarily programmers to write code because the AI itself is going to write the code, but what you're going to do is you're going to present the data to the, uh, to the AI in a way that the, the, that is the person that's really going to dictate how a new algorithms and new code gets written. And so I think, you know, the combination of all these trends, digital trends that you're talking about is it's going to be really exciting and impactful for healthcare. A third, third question here is we see some health systems investing in crm.
Bill Russell: 37:30 So let's go into the crm conversation a little bit, uh, more. Um, where do you guys seeing it? Where do you see it fit within your health system? And, uh, and actually I'd love to hear you answer the question of who does own it within a health system that has been one of the more interesting challenges. Is it a marketing initiative? Is it a pop health initiative? Is it a medical group, a initiative? Is it a, the call center initiative? Um, you know, where, where does it fit in healthcare and, and, and who owns it?
Kristin Myers: 38:01 Yeah. I don't think that it fits into one particular group that really is the challenge. I think that it all comes back to governance and you've got to be able to work with a number of responses. So in our case it is the chief strategy officer and also the head of population health and ambulatory care who are driving this initiative that again, we've got governance that brings in every group across the health system to engage them. So we have a marketing there, network development, our access center, a hospital operations, you know, all represented in this governance model. So, you know, I think that we've got the right engagement. But again, this is why enterprise crm, sometimes fails in health systems, because there isn't one owner, um, as you correctly identified,
Bill Russell: 39:05 so you're going to have your Ehr, you're going to your Erp and now you're going to have crm and these are going to form a, a pretty strong platform foundation across the board. And as we've become more customer centric, I see a lot of health systems looking at crm. I don't see a lot of them implementing crm, uh, on a, on an enterprise scale. So we will definitely check back with you after you get done with the, uh, after you get done with the, uh, uh, the RFP and see how the implementation goes because I think a lot of people want to hear success stories around how it gets, how it gets done. So a fourth question, what challenges do you, uh, are you seeing it departments face and, and, uh, and how do I, do it departments really need to adapt or change, do you think?
Kristin Myers: 39:57 Few areas. One is many it organizations have built in a functional model and they're organized in that way and not necessarily aligned with a service type model which is aligned with the business and I think that sometimes organizationally it needs to change to be more aligned with the business and I also think that the competencies and skill set of seeing when the it department is changing rapidly and we talked about both those digital health technologies and trying to get a, the technology teams up to date on what's going on in the marketplace and educated in these technologies and again, giving them other skills. I think that the soft skills around emotional intelligence, communication, understanding strategy is going to be more and more important as time goes on and know many organizations are going through this where you know, infrastructure and legacy applications become commodities and become managed services or even offshored. So we need to focus on where the value is and the values with the business?
Bill Russell: 41:21 This is becoming a recurring theme. So Ed Marks from Cleveland Clinic, talked about embedding it in stand up huddles and I know that Dr Anthony Chang, when he was talking about Ai, talked about how the analytics teams in those, uh, those lean huddles and those does rounding with the physicians as well.
Kristin Myers: 41:43 We, uh, we have business relationship managers that are rounding with hospital operations every single morning at every site.
Bill Russell: 41:51 Yeah, it should become harder and harder to identify, you know, who the it people are and who the business people are. And we're seeing a lot of clinicians, um, you know, head in this direction of an analytics career path or a or, you know, making, making sense of the Ehr or even programming the eHR. We're seeing a lot of, uh, you know, people take that, that degree in and head in those directions. It's, it's fascinating to watch. Um, and, and you know, this is a topic I want to give you some time on because I know that you're, you're an advocate for women in leadership and diversity. We talked about this last time we were on the phone. Uh, why do you think diversity is so important to promote? And I think the following question for me on this, it's going to be, you know, what, what's some advice that you would give women in healthcare it at this point? So why, why do you think diversity is important and advice for women in health It,
Kristin Myers: 42:49 I think diversity is important. You know, we need to have different opinions at the table in order to solve really complex problems. And as you know, in healthcare and this specifically it, we've got a lot of complex problems to solve. I also think that, uh, you know, at the leadership level we need to have representation of our patient population and when you think about it, 60 percent of healthcare decisions are made by women. And so that's why I feel pretty passionately that, you know, the leadership has to reflect, you know, outpatient population and where the decisions are being made. Um, in order to engage our patients. Also. And you know, I'm very lucky to be working in an organization where we have great examples of strong executive women. Uh, we had a number of them, uh, recognized recently in cranes and you know, we also the number one health system, uh, according to diversity or diversity and inclusion, and we've got a great diversity and inclusion program here. So again, an honor to work at Mount Sinai.
Bill Russell: 44:08 Yeah, well that would have to be the case in New York City. It is literally the epicenter of a melting pot. Um, you, the, the patient community is very diverse and your care community is, is there anything you, any advice you would give to women? I mean, I saw, I saw a post, I think it was linkedin post where a health system team said just finished our strategy session are setting our strategy, whatever. Great meeting and a picture had a picture of all the people that were attending and I kid you not, I think it was like 14 men and two women. I thought, uh, that's uh, that's problematic. Um, but what would you, what would you tell, what's your advice to women to get more women in that, uh, in that, you know, executive level, um, you know, a seat at the table talking about strategy. How are we going to do that?
Kristin Myers: 45:02 Well, I think ultimately it starts with the recruiting and the pipeline and you know, if you are an executive, it doesn't matter what gender you are and you're receiving the same resumes over and over. Uh, the question is why. And so you've got to go back to hr and you've got to look at the pool of resources that you're trying to pull from. And that's not just the gender, it's also for underrepresented minorities. And so I think that that's where it stopped. Um, I would also encourage female leaders to engage the men in their department as allies because just having a discussion with other female leaders is great and I think that it helps other women in the department. But ultimately we have to engage the men, um, in this endeavor. So if there is a room full of men, um, I think that, you know, the question would be where are the women?
Kristin Myers: 46:13 And I think that women leaders and men leaders need to bring in other women into the meetings, even if they're, you know, directors or senior directors, just to give them that exposure. Gives them the seat at the table and hear what their opinions are and I think if more and more happens like that, we'll get some progress. And I also think mentoring is huge. I know that, uh, you know, sometimes it's a challenge for a women. I've heard many, many women say there's not been mentored by a female leader, so I really encourage mentoring at our health system and you know, we've got a great program here, but I would encourage other health systems and hospitals have a mentoring program and have a women to women mentoring. It helps.
Bill Russell: 47:07 Yeah. Be a montor seek a mentor. Um, and I think that's a great way to, to end the show. Kristen, thank you very much for coming on the show. I know you're very busy coming back from the conference and then your first day back in the office, uh, are, are you active on social media at this point?
Kristin Myers: 47:25 Um, mainly linkedin
Bill Russell: 47:28 so people can follow you on Linkedin. Not too hard. A Kristen Myers a m Y, e r s at Mount Sinai health system. Find her on Linkedin a click follow and you could see what, what things she's talking about. Uh, you can follow me @thepatientsCio on twitter. You can follow the show @thisweekinhit. Uh, you can check out the website thisweekinhealthit.com. Catch all the videos on the youtube channel that we talked about earlier thisweekinhealthit.com/video. And don't forget to come back every Friday for news information and commentary from industry influencers. And that's all for now.
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Temple University football players and instructors reported to the Owls' practice area on Thursday for the start preseason camp.
The American Athletic Achieving preseason media poll projects this Owls to finish third in the East Division for the second year or so in a row. Temple, however, includes New Year's Six tank aspirations.
The Owls finished with a 7-6 history last season and was over their first year under Trainer Geoff Collins with a victory towards Florida International University while in the Bad Boy Mowers Gasparilla Pan on Dec. 21.
Here's what's happening at the start of the season.
Go to major
Offensive Coordinator Dave Patenaude expects a large jump in production
Last season, Temple began with a 2-3 record. Temple's offense obtained more than 20 points just the once in its first five online games, a 29-21 victory against the University of Massachusetts on Sept. 15.
This season, Patenaude said he expects the offense for taking a huge step up.
"Going into the 2nd year of any offensive method, you always see big progression," Patenaude said. "Players understand a lot of the scheme. We can run additional plays since everyone is being received by the season knowing what to expect. I have come across the most improvement from year or so one to two everywhere I've been."
"You will be able to see a lot more overall flexibility with receivers helping while in the run game, getting the functioning backs out of the backfield to play even more in the slot, moving the particular tight ends more given that now everybody understands extra," Patenaude added. "Now we aren'testosterone teaching the 'what' anymore. We're also teaching the 'hows' and 'whys' of the offense."
Graduate student quarterback Frank Nutile believes the last six matches of helped the Owls be comfortable heading into the second year of Patenaude calling runs.
"Last year, I was able to skin gels with the offensive line,In Nutile said. "We have [senior running back] Ryquell Armstead, [graduate university student wide receiver] Ventell Bryant, different heirs and a bunch of new men. So my experience by those games last year, I'll really carry over into in 2010 to help the new starters available."
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Armstead and Bryant are 100 percent healthy designed for camp
Armstead and Bryant had to persistently battle injuries last time of year. Armstead played in all 13 games, while Bryant suited up for 10. Although they dressed for a majority of the season, the injuries still affected their own performance on the field.
Armstead, the Owls' second-leading rusher in every of the past two seasons, gathered 604 yards in more than More than 200 yards less than his sophomore comprehensive. Bryant saw his wedding party total nearly cut in 50 % last season with 28 receptions for 280 yards, compared to a team-high 54 catches to get 895 yards in
It took a great deal of preparation week to 7-day period for Armstead to be ready to play each week. Armstead said he wasted most of his week gaining extra treatment and sleep to ensure he'd be ready to engage in.
"We were always walking a fine line of, 'Is [Armstead] good to go, or simply are we only going to further injure him?'" Patenaude said. "What Ryquell definitely needed was a couple-week period the place he just sat straight down and did nothing but relax up. But, we didn'big t have the depth where all of us felt comfortable in having him on the shelf for a few several weeks."
Armstead primarily shared carries previous season with David Cover, who opted not to returning for his final year at a doctor's recommendation. The senior is ready for his / her last preseason.
"I feel good," Armstead claimed. "I'm just super enthusiastic for camp to start."
Patenaude stated it's important that Armstead and Bryant are fully healthy for the start of camp.
Bryant will be regarded as one of the top options to stuff a production void still left by graduates Keith Kirkwood and Adonis Jennings in the receiver position.
Kirkwood, who autographed as an undrafted rookie with the Saints, and Jennings, who signed while using Green Bay Packers, each caught more effective touchdowns for Temple last time.
"It is critical for Ventell to come during and have a healthy camp,Inch Patenaude said. "He wasn't really healthier going through camp last year, thus he never truly got on track to start the season. Together with, with Keith and Adonis playing so well, he never got his or her chance to fully step in and convey at a high level."
"Ventell has had incredible winter workouts, spring ball and summer workouts,In Nutile said. "He came in and is to become great leader and teacher to the young players. Everything he has done over the last 6 to 9 months has really set him up to have a huge year."
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Kareem Ali's career ends caused by injuries
Collins said former defensive returning Kareem Ali is no longer on the team because of injury concerns. Ali will work together with the athletic department this year to remain involved in the program, Collins said.
"We all love Kareem as a person and also as a teammate," Collins claimed. "But unfortunately, after having talks along with him, his family as well as the training staff, we feel similar to it's best if he won't play anymore."
Ali did not perform in and only played your five games in his career. He / she joined Temple in soon after his career at Solid timber Creek Regional High School within South Jersey. Ali, whose mom and dad were Temple athletes inside the 1990s, was ranked as being a four-star recruit out of high school through Rivals.com.
Go to best
Coaches believe the roster offers 'elite depth'
An NCAA rule change before this period increased the maximum number of competitors a school could have during preseason get away from 105 to One hundred ten.
With more players, a common motif in Collins', Patenaude's and defensive director Andrew Thacker's press conferences Thurs was the depth for the roster this season.
If a player would get into the same injury predicament as Armstead this year, the mentoring staff might be willing to snooze them for an extended period of your time, Patenaude said.
Last season, the Owls got five players with more than 15 receptions. This season, Patenaude believes he has got "six to seven" wide receivers who will contribute to the offense. Patenaude explained there's a possibility of being able to get in line in four-receiver sets to spread out this opposing defense, which was a luxurious Temple did not have last year or so.
Patenaude said if Temple had two to three running backs they believed comfortable starting, the Owls will have rested Armstead last year. After redshirt junior Jager Gardner suffered a season-ending knee injury throughout September, the Owls' running to come back depth decreased.
Collins said the running back situation was "scary" past season, but he is more at ease this year with seven tailbacks stepping into this year's camp.
"We went through the complete season last year with only only two scholarship running backs,Inch Collins said. "At times, it was just a little dicey. Each of the running supports we have this year all are quite different and brings a different variety of game, which is hard to protect."
Gardner, redshirt sophomore Tyliek Raynor and redshirt freshman Jeremy Jennings are players the coaching staff is excited to see this camp, Collins claimed.
Raynor has battled the injury pest since coming to Temple however , is now finally healthy for any start of camp, Collins said. Like a walk-on, Jennings caught Collins' eye the week the Owls played Central Florida final November. Collins said Jennings did an admirable job of mimicking the Knights' swiftness in practice as Temple all set to face Central Florida and also showed he could be a productive managing back.
Collins added that their team has great detail at linebacker. Temple is moving back all of its starting linebackers from last season. leading tackler senior Shaun Bradley, junior Sam Franklin in addition to redshirt junior Chapelle Russell will return while second-year starters.
"I think by the end of [last] yr, our linebacker core was among the best in the conference," Collins stated. "I think going into this year, it may be the best in our conference. And I would argue that it is the most effective in the country depth-wise."
Temple will have Twenty-three practices before its period opener at Lincoln Personal Field on Sept. 1 against Villanova.

subset: commoncrawl


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Planned Giving and Bequests
Simply put, when a person leaves this world to enter God's kingdom, his/her money and other assets will go to people, organizations, or the government. 84% of people pass on without a will. Now is the time to make sure your estate goes where you desire.
Halifax Urban Ministries can work with your own advisers or assist with linking you to people who can help with PLANNING to make sure that your loved ones and your cherished ministries are the primary beneficiaries of the blessings that God provided for you during your lifetime.
Halifax Urban Ministries partners closely with Thrivent Financial – a faith-based membership organization whose purpose is to strengthen communities by helping members be wise with money and inspiring them to live generously. Your will and various life income agreements are ways that you can include Halifax Urban Ministries in your estate planning.
Charitable Gift Annuity
Charitable Remainder Trust
Pooled Income Fund
Your Will
Planned Giving Options:
Charitable Gift Annuity
A Charitable Gift Annuity arrangement with Halifax Urban Ministries is a gift that will also provide you with a guaranteed annual income for the rest of your life. Upon your death, the remaining portion of the annuity becomes a gift to the work of HUM, helping the poor and homeless. In essence, your gift keeps on giving even after the end of your life. A Charitable Gift Annuity can provide for the future of HUM, generate a life-long income stream for you and give you a substantial tax deduction.
Charitable Remainder Trust
A Charitable Remainder Trust involves irrevocable gifts placed in trust with the named beneficiary(ies) receiving a fixed income (in the case of an annuity trust) or a variable income (in the case of a unitrust) for life or for a term of years not to exceed 20. Like all charitable gift annuities and the pooled income fund, you avoid tax on capital gains when appreciated assets are placed in trust. Upon termination, the remaining corpus is made available to the mission and work of Halifax Urban Ministries.
Pooled Income Fund
A Pooled Income Fund is somewhat like a mutual fund except that withdrawals cannot be made. Each gift to the pool is assigned units and the value of these units changes with market conditions. Donors receive payments for life and avoid capital gains taxes on gifts of appreciated securities. The amount of payment can increase over time Upon your death, Halifax Urban Ministries withdraws the units and puts them to work according to the wishes you expressed at the time you made the gift.
Your Will
Every person, regardless of the other estate planning tools they may have, should prepare a will. If you don't have a will, your state has one for you and, upon your death, the state will distribute your estate according to law. Special needs of your family and your personal wishes will not be taken into consideration nor will the state consider your charitable interests. Everyone who owns property, has investments or savings, has dependents or who wants to gift our ministry or other charities at death needs a will. A will is flexible. You may change it at any time.
If you would like more information on the options available please fill in the form below and we will have a planned giving adviser contact you.


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Smart Contracts: The Blockchain Technology That Will Replace Lawyers
A Beginner's Guide to Smart Contracts
TLDR: A smart contract is a computer protocol intended to digitally facilitate, verify, or enforce the negotiation or performance of a contract. Smart contracts allow the performance of credible transactions without third parties.
One of the best things about the blockchain is that, because it is a decentralized system that exists between all permitted parties, there's no need to pay intermediaries (Middlemen) and it saves you time and conflict. Blockchains have their problems, but they are rated, undeniably, faster, cheaper, and more secure than traditional systems, which is why banks and governments are turning to them.
Enjoy a free lesson from the Blockgeeks Library!
In 1994, Nick Szabo, a legal scholar, and cryptographer realized that the decentralized ledger could be used for smart contracts, otherwise called self-executing contracts, blockchain contracts, or digital contracts. In this format, contracts could be converted to computer code, stored and replicated on the system and supervised by the network of computers that run the blockchain. This would also result in ledger feedback such as transferring money and receiving the product or service.
What are Smart Contracts?
Smart contracts help you exchange money, property, shares, or anything of value in a transparent, conflict-free way while avoiding the services of a middleman.
The best way to describe smart contracts is to compare the technology to a vending machine. Ordinarily, you would go to a lawyer or a notary, pay them, and wait while you get the document. With smart contracts, you simply drop a bitcoin into the vending machine (i.e. ledger), and your escrow, driver's license, or whatever drops into your account. More so, smart contracts not only define the rules and penalties around an agreement in the same way that a traditional contract does, but also automatically enforce those obligations. If you are looking for a more detailed walkthrough of smart contracts please check out our blockchain courses on smart contracts.
As Vitalik Buterin, the 22-year-old programmer of Ethereum, explained it at a recent DC Blockchain Summit, in a smart contract approach, an asset or currency is transferred into a program "and the program runs this code and at some point it automatically validates a condition and it automatically determines whether the asset should go to one person or back to the other person, or whether it should be immediately refunded to the person who sent it or some combination thereof."In the meantime, the decentralized ledger also stores and replicates the document which gives it a certain security and immutability.
Suppose you rent an apartment from me. You can do this through the blockchain by paying in cryptocurrency. You get a receipt which is held in our virtual contract; I give you the digital entry key which comes to you by a specified date. If the key doesn't come on time, the blockchain releases a refund. If I send the key before the rental date, the function holds it releasing both the fee and key to you and me respectively when the date arrives. The system works on the If-Then premise and is witnessed by hundreds of people, so you can expect a faultless delivery. If I give you the key, I'm sure to be paid. If you send a certain amount in bitcoins, you receive the key. The document is automatically canceled after the time, and the code cannot be interfered with either of us without the other knowing since all participants are simultaneously alerted.
You can use smart contracts for all sorts of situations that range from financial derivatives to insurance premiums, breach contracts, property law, credit enforcement, financial services, legal processes, and crowdfunding agreements.
A Smart Contract Example
Here is the code for a basic smart contract that was written on the Ethereum blockchain. Contracts can be encoded on any blockchain, but Ethereum is mostly used since it gives unlimited processing capability.
An example smart contract on Ethereum. Source: https://www.ethereum.org/token
The contract stipulates that the creator of the contract be given 10,000 BTCS (i.e. bitcoins); it allows anyone with enough balance to distribute these BTCs to others.
Here's How You Can Use Smart Contracts
Jerry Cuomo, vice president for blockchain technologies at IBM, believes smart contracts can be used all across the chain from financial services to healthcare to insurance. Here are some examples:
Insiders vouch that it is extremely hard for our voting system to be rigged, but nonetheless, smart contracts would allay all concerns by providing an infinitely more secure system. Ledger-protected votes would need to be decoded and require excessive computing power to access. No one has that much computing power, so it would need God to hack the system! Secondly, smart contracts could hike low voter turnout. Much of the inertia comes from a fumbling system that includes lining up, showing your identity, and completing forms. With smart contracts, volunteers can transfer voting online and millennials will turn out en masse to vote for their Potus.
The blockchain not only provides a single ledger as a source of trust, but also shaves possible snarls in communication and workflow because of its accuracy, transparency, and automated system. Ordinarily, business operations have to endure a back-and-forth, while waiting for approvals and for internal or external issues to sort themselves out. A blockchain ledger streamlines this. It also cuts out discrepancies that typically occur with independent processing and that may lead to costly lawsuits and settlement delays.
Case history
In 2015, the Depository Trust & Clearing Corp. (DTCC) used a blockchain ledger to process more than $1.5 quadrillion worth of securities, representing 345 million transactions.
Smart contracts work on the If-Then premise so, to put in Jeff Garzik's words,
"UPS can execute contracts that say, 'If I receive cash on delivery at this location in a developing, emerging market, then this other [product], many, many links up the supply chain, will trigger a supplier creating a new item since the existing item was just delivered in that developing market.'" All too often, supply chains are hampered by paper-based systems, where forms have to pass through numerous channels for approval, which increases exposure to loss and fraud. The blockchain nullifies this by providing a secure, accessible digital version to all parties on the chain and automates tasks and payment.
Case history
Barclays Corporate Bank uses smart contracts to log a change of ownership and automatically transfer payments to other financial institutions upon arrival
There's no doubt that we're progressing from slothful pre-human vertebrates to super-smart robots. Think of a future where everything is automated. Google's getting there with smartphones, smart glasses, and even smart cars. That's where smart contracts help. One example is the self-autonomous or self-parking vehicles, where smart contracts could put into play a sort of 'oracle' that could detect who was at fault in a crash; the sensor or the driver, as well as countless other variables. Using smart contracts, an automobile insurance company could charge rates differently based on where, and under which, conditions customers are operating their vehicles.
You can get more money through smart contracts. Ordinarily, if you wanted to rent your apartment to someone, you'd need to pay a middleman such as Craigslist or a newspaper to advertise and then again you'd need to pay someone to confirm that the person paid rent and followed through. The ledger cuts your costs. All you do is pay via bitcoin and encode your contract on the ledger. Everyone sees, and you accomplish automatic fulfillment. Brokers, real estate agents, hard money lenders, and anyone associated with the property game can profit.
Personal health records could be encoded and stored on the blockchain with a private key which would grant access only to specific individuals. The same strategy could be used to ensure that research is conducted via HIPAA laws (in a secure and confidential way). Receipts of surgeries could be stored on a blockchain and automatically sent to insurance providers as proof-of-delivery. The ledger, too, could be used for general healthcare management, such as supervising drugs, regulation compliance, testing results, and managing healthcare supplies.
Smart Contracts are Awesome!
Here's what smart contracts give you:
Autonomy – You're the one making the agreement; there's no need to rely on a broker, lawyer or other intermediaries to confirm. Incidentally, this also knocks out the danger of manipulation by a third party, since execution is managed automatically by the network, rather than by one or more, possibly biased, individuals who may err.
Trust – Your documents are encrypted on a shared ledger. There's no way that someone can say they lost it.
Backup – Imagine if your bank lost your savings account. On the blockchain, each and every one of your friends have your back. Your documents are duplicated many times over.
Safety – Cryptography, the encryption of websites, keeps your documents safe. There is no hacking. In fact, it would take an abnormally smart hacker to crack the code and infiltrate.
Speed – You'd ordinarily have to spend chunks of time and paperwork to manually process documents. Smart contracts use software code to automate tasks, thereby shaving hours off a range of business processes.
Savings – Smart contracts save you money since they knock out the presence of an intermediary. You would, for instance, have to pay a notary to witness your transaction.
Accuracy – Automated contracts are not only faster and cheaper but also avoid the errors that come from manually filling out heaps of forms.
Here's how Jeff Garzik, owner of blockchain services Bloq, described smart contracts:
"Smart contracts … guarantee a very, very specific set of outcomes. There's never any confusion and there's never any need for litigation."
"Smart Contracts are where the rubber meets the road for businesses and blockchain technology. While a few highly specialized distributed financial services use cases for blockchain have appeared—for example, payment ledger services for the Yangon Stock Exchange in Myanmar. Its services on top of the blockchain that are really interesting. In the Yangon Exchange, it solves the problem of distributed settlement in a trading system that only synchronizes trades twice a day. But the autonomous execution capacities of smart contracts extend the transactional security assurance of blockchain into situations where complex, evolving context transitions are required. And it's this possibility that has Amazon, Microsoft Azure and IBM Bluemix rolling out Blockchain-as-a-Service (Baas) from the cloud." – Patrick Hubbard, Head Geek, SolarWinds
Now for Problems
Smart contracts are far from perfect. What if bugs get in the code? Or how should governments regulate such contracts? Or, how would governments tax these smart contract transactions? As a case in point, remember my rental situation?
What happens if I send the wrong code, or, as lawyer Bill Marino points out, I send the right code, but my apartment is condemned (i.e., taken for public use without my consent) before the rental date arrives? If this were the traditional contract, I could rescind it in court, but the blockchain is a different situation. The contract performs, no matter what.
The list of challenges goes on and on. Experts are trying to unravel them, but these critical issues do dissuade potential adopters from signing on.
And here's To the Future of Smart Contracts…
Part of the future of smart contracts lies in entangling these issues. In Cornell Tech, for instance, lawyers, who insist that smart contracts will enter our everyday life, have dedicated themselves to researching these concerns.
Actually, when it comes to smart contracts, we're stepping into a sci-fi screen. The IT resource center, Search Compliance suggests that smart contracts may impact changes in certain industries, such as law. In that case, lawyers will transfer from writing traditional contracts to producing standardized smart contract templates, similar to the standardized traditional contracts that you'll find on LegalZoom. Other industries such as merchant acquirers, credit companies, and accountants may also employ smart contracts for tasks, such as real-time auditing and risk assessments. Actually, the website Blockchain Technologies sees smart contracts merging into a hybrid of paper and digital content where contracts are verified via blockchain and substantiated by physical copy.
Blockchains Where You Can Process Smart Contracts
Bitcoin: Bitcoin is great for processing Bitcoin transactions, but has limited ability for processing documents.
Side Chains: This is another name for blockchains that run adjacent to Bitcoin and offer more scope for processing contracts.
NXT: NXT is a public blockchain platform that contains a limited selection of templates for smart contracts. You have to use what is given; you're unable to code your own.
Ethereum: Ethereum is a public blockchain platform and the most advanced for coding and processing smart contracts. You can code whatever you wish but would have to pay for computing power with "ETH" tokens.
As to the potential of smart contracts itself, there's no end to the range of industries it can impact, from healthcare to automobiles to real estate and law. The list goes on and on. Says, Ethereum CTO, Gavin Wood
"The potential for [smart contracts] to alter aspects of society is of significant magnitude. This is something that would provide a technical basis for all sorts of social changes, and I find that exciting."
Like what you read? Give us one like or share it to your friends
1) Q : What is a smart contract?
2) Q: What can a smart contract be used for?
3) Q: Who invented smart contracts?
Thanks for the article! I was searching for a perfect guide to know about Ethereum and came across this. I hope most of the future Ethereum Tokens can provide a good amount of funds! You can know more about Ethereum here!
very usefull block!
Hi, I am an engineering student from South Korea. I've found this article very helpful, understanding smart contract. Can I translate this article in Korean for a blog post? I'll link this url, of course.
A "smart" contract is a legal contract. It is just in a different form. An oral agreement is (apart from some special instances) a contract. There is no need for it to be in writing. And, with the invention of the telephone, a contract could be made by phone! And later by email! The process that you outline has all the ingredients of a typical contract, though formed by a different medium. There will still be, somewhere, written terms and conditions, though these terms and conditions may be reduced to code, but maybe not. The legal principles of forming a contract are all there - and need to be for the agreement to be legally-enforceable. (And a "smart" contract is not at all smart). Excellent article, by the way.
great block
Hello Sir, Your Article is really a gold for starters, I am a Beginner working on Smart contract but have some question which is continuously roaming in my mind question are 1. How smart contracts takes inputs from external world? 2. How should systems know the certain conditions are fulfilled in smart contracts? 3. How real-world business expectation work on Smart Contract?
This is clearly the future of every aspect of our lives. Being the first mover in this aspect of blockchain technology it is my view that Ethereum will continue to be the trend-setter and the platform to go to for institutions, governments and corporations adopting blockchain technology for efficiency, utility, security, due diligence capabilities, etc. At around $300 a coin (19 October 2017) Ethereum is massively undervalued. Time will tell but from this end the revolutionary and massive disruptive nature of Ethereum is as clear as crystal.
I think the smart contract just like any new form of technology that needs to iron out the bugs. Start testing those scenarios first, and then let the brainstorming begin. I'm sure we had all kinds of questions and legal issues about the horse and buggy moving into the automobile era...and yet here we are. We can start testing with small dollar transactions and move from there.
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Season 2, Episode 2: Warp and Weft / The Sins of the Father
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Discontent is growing in the country; an unexpected grief finally forces Victoria to put childish things away. Despite the healthy birth of an heir, she's paralyzed by an inexplicable sorrow. A tragedy in Coburg plunges Albert into his own torment.
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DALLAS (MarketWatch) -- Shares in oil companies rallied at Monday's close, as crude futures retreated, boosting the broader market, and Weatherford International said it would pay $2.3 billion for Precision Drilling's energy services and international contract drilling units. The Amex Oil Index $xoi rose 0.2% to close at 845.06 points, the Amex Natural Gas Index $xng gained 0.5% to close at 336.32 points, and the Philadelphia Oil Service Index OSX, -0.51% closed at 137.97 points, up 0.5%.
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Doesn't everybody?
I finally caved and switched over to winter tyres. Now obviously the summer wheels need a good wash before being stored, but the garden hose has been put away. So what to do.
There's always the sauna!
I advised my mum to stay away from there till I'm completely finished, I told her she probably won't like it when she sees it, and she agreed.
Gave them a quick wash today, off to buy wheel wax in the next couple of days after which I can do tar removal and finish the job. I suppose I could probably have them done in a workshop for much the same price and far less time, but where's the fun in that?


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« August 2012 |
| October 2012 »
Posted by Chris Chronic on September 07, 2012 at 11:59 PM in Dave Ross, Great Moments in Blather, HUMOR IN A JUGULAR VEIN, Old Seattle Radio Saturdays, radio biz, Talk radio | Permalink
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"KOMO radio weekend anchor Val Stouffer has resigned to take a
full-time gig at KIRO FM. For Val, it's a homecoming, of sorts. She
formerly anchored the KIRO Afternoon News with Tony Miner, but was fired
when the station jettisoned the 3 p.m. - 6 p.m. news-block in Jan.
2005. In the ensuing years, Val did fill-in at KPLU and KZOK before
moving to KOMO.
KOMO has also cut Gary Burleigh's weekend sportscasts, opting for
canned sports from Total Traffic (formerly Metro Traffic). Gary brought a
seasoned broadcaster's personality, energy and style to the weekend
programming, (and notwithstanding the fact that he's an old friend, it
seems a shortsighted, cheap decision) .
Posted by Rachelle Robbins on September 07, 2012 at 09:37 PM in KIRO FM, KOMOAM, Open thread, radio biz, See You on The Radio!, Talk radio | Permalink
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As tipped off last week( but we wanted to wait until they flipped again) The Fisher twins, KOMO and KVI have updated their format in favor of more news at the former and another taco stand for the 570 call, by using second tier conservative syndication and the spare parts of whats left over.
Carlson is back in at KVI with "Commute with Carlson", possibly the only live host. Ken Schram is out but still has daily commentaries on KOMO am and will remain on KOMO TV. Micheal Savage, Laura Ingraham, Mark Levin, Lars Larson and Don Imus, albeit mainly taped shows, are part of the lineup along with the junkier Red Eye Radio for the warehouse elite.
KOMO stays with news but adds new anchors, Bill Rice from 4a-5 and then 9-noon, Brian Calvert from Noon to 3p, with the current KOMO Morning News team of Manda Factor & Gregg Hersholt and KOMO Afternoon News with Jane Shannon & Tom Hutyler staying in place. At Midnight, Dial Global's Overnight America lulls us until America in the Morning from 3a-4 starts the cycle over again.
Posted by Chris Chronic on September 05, 2012 at 06:32 PM in John Carlson, Ken Schram, KOMOAM, KVI 570 am, Laura Ingraham, Michael Savage, radio biz, Republicans, See You on The Radio!, Talk radio | Permalink
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The Stephanie Miller show joined by voice diety Jim Ward
and FOX radio's Alan Colmes.
The first day of the Democratic National Convention has opened in Charlotte NC, including more than 100 talk show hosts, along with news organizations who will broadcast over the next 3 days.
Progressive hosts broadcasting from Radio Row include The Stephanie Miller Show, Thom Hartmann and Ed Shultz along with most of broadcast TV and the blogsophere.
We think FOX news may be there too, since they confuse the right to protect the President with the right to vote and the GOP meme of 'voter ID'.
From the HuffPo:
TVNewser was the first
to report the news. An MSNBC spokesperson confirmed that it was the
network's first-ever convention victory, and the first time that it beat
its rivals head-to-head while all three were covering the same
political event.
MSNBC's victory came on the first night of the Democratic convention
in Charlotte. The network was first in both total viewers (4.107
million) and in the coveted 18-49 demo (1.432 million.) CNN came in
second, with 3.88 million and 1.368 million in both categories. Fox News
trailed far behind, drawing just 2.398 million total viewers and
550,000 in the demo -- a far cry from its ratings on the first night of
the Republican convention, when it drew a whopping 6.87 million viewers.
MSNBC was also the only channel to grow its ratings from 2008. All of
the other networks saw their ratings drop sharply.
NBC was the overall victor for the night, drawing 5.02 million viewers.
Posted by Chris Chronic on September 05, 2012 at 10:20 AM in Alan Colmes, Barack Obama, cable teevee, Democrats, Media, Politics, radio biz, See You on The Radio!, Talk radio | Permalink
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Posted by Rachelle Robbins on September 03, 2012 at 09:40 AM in Open thread | Permalink
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Mark and Irene Harris (left, frolicking in the Florida surf), delegates to the GOP convention, wrote this on their blog Rock Star GOP : "Prior to National Republican Convention we visited Disney for three
days. During our time at Epcot we visited the different countries. It
was neat seeing each country and the employees were from that individual
country. Then we visited America . . . one would think you would find
American employees. We were offended to find a person from Mexico
working in America. Mark spoke up and told them he was highly offended
after visiting the other countries and seeing employees from that
country and then come to America and find a Mexican. He was very civil
but his point was well made." They don't allow comments on their blog, but someone must have gotten to them, because a few days later, they posted: " For those of you who have not taken the Epcot experience, it is a trip
well worth taken. Epcot gives you a real world experience all in one
day. The shops, the buildings, the shows, and the food is all inherent
to where you are. Each staff member is identified by a name tag,
referencing their country of origin. As noted, only in the country of
the United States, within Epcot, was a staff member representing and
working, who did not have a name tag representing that country. I would
say being offended may been too harsh, disappointed or dismayed may
have been a better choice of words."
Ya think?
The saddest thing about Clint Eastwood's embarrassing performance at the
Republican National Convention is that it seemed so out of character
for a man who always has been more nuanced and complicated than his
macho film persona would suggest. In fact, many of his films have been
more nuanced and complicated than many realize, often demonstrating a
sensitivity to cultural diversity that is anathema to most Republicans,
once making the case for end of life choice, and once even revealing the
pettiness and empty false mythology behind the violent Westerns that
first made him famous.
Eastwood has come out in favor of gay marriage, but he supports a
presidential candidate who would ban it, and spoke to the convention of a
party that is openly bigoted against the LGBT community. Eastwood last
winter cut an ad that expressed appreciation for the auto bailout that
Mitt Romney opposed and President Obama created. Eastwood is an
environmentalist in a party that sees nature as nothing but a commodity
to be exploited and exhausted. Eastwood in his speech decried the
ongoing war in Afghanistan, seemingly oblivious to the fact that the
Republicans oppose even the limited withdrawal President Obama signed.
Eastwood mocked liberal Hollywood, but has a history of working well
with noted liberal activists such as Morgan Freeman, Ed Harris, Sean
Penn, Tim Robbins and Hillary Swank. He has been known as a man of
dignity, unpretentious, widely respected, well-liked.
Clint Eastwood is 82 years old, but there is no evidence that his
mental faculties have been suffering. He still directs substantial
films, and he still demonstrates wisdom in his choices of films to
direct. If there is any lesson to be drawn from his public
self-immolation it is that even a nuanced and complicated and normally
respectable man cannot stand in the GOP spotlight without being soiled
by it. This was a self-inflicted disaster, and Eastwood has no one to
blame but himself. It was, nevertheless, sad.
From Bloomberg Businessweek: On the final morning of the Republican National
Convention, Karl Rove took the stage at the Tampa Club to provide an
exclusive breakfast briefing to about 70 of the Republican party's
highest-earning and most powerful donors. During the more than hour-long
session, Rove explained to an audience dotted with hedge fund
billionaires and investors—including John Paulson and Wilbur Ross—how
his super PAC, American Crossroads, will persuade undecided voters in
crucial swing states to vote against Barack Obama. He also detailed
plans for Senate and House races, and joked, "We should sink Todd Akin.
If he's found mysteriously murdered, don't look for my whereabouts!" Then Rove pleaded with his audience for more money—much more.
And finally, we admit to missing this story (We have an excuse. You don't want to know) and we thank those of you who kindly wrote in, asking us to post the information we have gathered:
The once and future format will begin at 5 a.m. on Tuesday with the
familiar voice of John Carlson, 2000 Republican gubernatorial candidate
who has lately been heard on crosstown KOMO radio. Carlson is a talk
radio veteran and onetime communications director for the Washington
State Republican Party.
Carlson will air until 9AM. Then it will be Laura Ingraham. Lars
Larsen will occupy the 6-9 p.m. slot, starting 9/24, followed by Michael
Savage from 9 p.m. until midnight."
Posted by Rachelle Robbins on September 02, 2012 at 09:22 PM in Evangelicals, freaky dancing, KVI 570 am, Republicans | Permalink
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Change is good


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The last two days were hectic with a lot of lows. All day Saturday she was in discomfort after the Tracheostomy and also because they had changed the continuous drip of pain and sedatives to as-needed. She was very restless with aches in the feet, chest (chest tube), the neck (trach), and the nose (feeding tube). Her fever was also hovering around 101 all day. Then around 10pm on Saturday she spiked a fever, was breathing very quickly and the heart rate jumped to around 160. They changed the ventilator settings but that didn't help. After an x-ray they decided to pull out the chest tube as it had slipped a bit and not inside the chest cavity completely. They were talking about pulling the chest tube a few days ago too for the same reason. The thinking was that maybe the hole in the lung has healed and removing the chest tube will relieve some pressure and pain. They pulled the tube out and tapped up the wound, which got the heart rate a little lower. A few minutes later her vitals spiked again. They repeated the x-ray and saw that the lung had collapsed again after removing the chest tube. So they made another new hole a put a new chest tube. A repeat x-ray showed the inflated lung. Basically the lung was still leaking air from a hole and the first chest tube was not fully in the chest cavity to pull that air out and that was causing pressure on the lung and perhaps the heart. These are all critical procedures and can lead to very serious consequences if not dealt with quickly. This was all done by around 2am. After the second chest tube her heart rate got to 140s for the rest of the night, which was still high. The doctors also commented that Rachana was very brave and took the procedure with incredible poise. Before the procedure we explained to her what was happening and why they are planning another chest tube. She heard it all, seem to understand what they were going to do and why, and nodded to go ahead. I was pretty shaken up, but yet again, found strength in her behaviour and reaction.
Rachana's left index finger tip had a small cut when we came into the hospital, that has now grown into dark hard wound. The top portion of the left index finger is all purple and dark. Most of her fingers and all her toes are turning blue/purple. When it started we were not showing much concern, though it would reverse, and the doctor also said they were monitoring. Now the situation is pretty serious and she is in fact at risk of losing some portions of her fingers and toes. In the last couple of days we have been pushing the doctors as they seemed quite nonchalant about this situation and also commenting, perhaps casually, that she might lose some of her digits. They were basically saying that there is nothing much that they can really do to reverse the situation and we'll all just have to wait and see if it fixes itself or gets worse. After talking to some of our friends who are doctors, two teams of ICU doctors, two teams of cardiologists, an infectious disease control specialist, and a team of hand and leg surgeons, this is what we know. The fingers and toes are going purple because of either or both of these two reasons. 1) When she was on pressors (meds to manage low BP), the body uses the available blood pressure to support the vital organs and the first part of the body that gets ignored are the tips of our fingers and toes. Although she is now off the pressors for more than a week, we are now seeing the effects of the damage that was done to her digits when she was on pressors. This situation is called ischemia affecting her fingers and toes and this is not reversible. We just have to wait and see how much damage was done when she was on pressors and how much of the tissues in her fingers and toes is already dead. 2) The original staph infection that infected her blood and caused the infection in her lungs, also caused blood clots that block blood flow. So basically there might be clots that are stopping the flow of blood to the fingers and toes. They can surgically remove clots from major arteries and veins but not from smaller vessels in her fingers and toes. They cannot give her blood thinners as her platelets are already low she will have internal bleeding. The have to cure the underlying reason, i.e the infection, which they are with all the antibiotics. As the infection reduces and her body gets healthy the blood clots gets absorbed by the body. But again, if there is some damage already done, it cannot be reversed. This condition is called DIC (Disseminated intravascular coagulation).
So, we now understand what is happening and just have to wait and watch, and hope her blue/purple digits turn pick again. It's just difficult and disheartening to accept that there are very few medical options for this situation.