SXSW 2012: The Future of Digital Health

Note, this is cross-posted from the Klick Health blog. I’m posting it here for archival reasons.

South by Southwest is an annual festival of interactive tech, film, and music that started back in 1992 in Austin, Texas. I’ve been coming every year since 2005, and have seen the interactive part of the festival grow from roughly 3000 nerds to nearly 30,000 marketing, culture, agency, government and startup people. There are over 5000 events, talks, and panel discussions this year. With the massive growth has come both diversification and specificity. There are now specific conference tracks for politics, social causes, developers, designers, and for the first time, health care. I’ve been following that track closely, and am going to share a couple of broad trends and observations I gleaned.

Health vs Healthcare

There is a distinct lack of agreement on what we’re talking about when we say “healthcare”. To some, the phrase means “treatment”. To others, it means “wellness”.  In other words: does “healthcare” include preventative actions, stretching from education to urban planning to food policy?

Sensors, sensors, everywhere! “Mobile” is not another word for “smartphone”

Sensors will soon be everywhere. From our phones to our shoes to embedded in our bodies, we will be collecting personal data through everyday activity. Imagine a tooth implant that analyzes the nutritional value of your meal as you chew. Or a watch that measures your stress level. There are huge privacy issues to consider, but the potential for positive behaviour changes that emerge make the effort worthwhile

Successful behaviour changes when we can make informed decisions in the moment. Craving can be mitigated with up to the minute data. The smaller we can make the feedback loop, the more motivating force it presents.

There will be huge technical and design opportunities emerging in this space. In very short order, our definition of “mobile” will need to expand to include devices like Nike’s new Fuel bracelet and Google’s soon to be released head’s up display.

Gaming and health

This is a biggie. Nearly every health related panel included a nod to gaming in one way or another. Why? Engagement. Games tap into something hard wired in our neurology. They hold our attention like few other experiences. I could (and may) write a book on the subject, and can’t possibly do justice to the topic in this overview. Suffice it to say that between sensor driven real world activities (the human joystick) to virtual worlds designed to keep seniors socially engaged, there are a multitude of ways games and game mechanics are becoming integrated into healthcare. Watch this space for future posts on the subject.

Disruptive Stress

Peter Diamandis, the founder of the X Prize, used the phrase “disruptive stress” in his talk on abundance. He was referring to the gap between our human, linear experience and the exponential rate of change presented by information technology. Ray Kurzweil, in his keynote, extended the idea. This is a deep, complex problem, and one worth wrapping our head’s around. I’ll try to summarize it like this:

We humans are very bad at predicting the future, because we look from the present into the past, note the changes, and predict those same changes forward. We are terrible at remembering how things really were, and tend to wildly over attribute present day conditions to past situations. We tend to experience the world in a very linear way, even while the changes around us are happening at a greater rate.

Combine our innate difficulty in prediction with the exponential nature of technology, and we’re simply not naturally equipped to understand what the world of 2022 will look like. Note that I used the phrase “naturally equipped”. It’s not that we can’t predict the future, just that it we have to learn how to do it.

A few examples of exponential technology that will cause disruptive stress?  Biology is now an information technology. Gene therapies are coming online today, and in 10 years will dramatically change the healthcare landscape. Moore’s law (cost and size of microprocessors halve every 18 months) and nanotech will allow us to create devices that live in our bloodstream, actively boosting our natural defences in 20 years. Advances in artificial intelligence and robotics will change the way healthcare and patient support is delivered. Technologies like Siri, from Apple, hint at the very near future.

The digital revolution is coming

The same forces that changed the entertainment industry are marshalling at the base of healthcare. It’s early days, and the healthcare world has plenty of reason to move cautiously. But the move will come, and it will be driven by patients. The points I made above do not exist in isolation; sensors + gaming + disruptive stress = a change in the fundamental ways individuals will engage in and consume healthcare and health services. Health care providers and funders need to get out in front of this change, and quickly. Think about how Apple toppled RIM, Microsoft, and IBM by creating consumer desire. The same thing has started in healthcare, and the rate of change will not be linear.

Drinking the Zeitgeist: SXSW 2011

This post is cross posted to the Sequentia blog. Posted here for my own future reference.

SXSW is huge. Tens of thousands of people descend on Austin for two weeks of Interactive (aka web), Film, and Music programming. It is the largest web conference in the world. Media, pundits, and bloggers have written a million words or more covering SXSW over the past few years, and with good reason: SXSW offers a unique view of where the web (and culture in general) is headed.

When I first attended SXSWi in 2005, the emphasis was squarely on web design and development. This was pre-Twitter, when you still needed to explain what a blog was, and the Palm Treo was the hot gadget. As the web has matured, so has the conference. Today, the web touches most aspects of our lives. Design and development are still covered, but the keynotes, talks, and panels on business, marketing, community, non-profits, journalism, startups, psychology, culture, storytelling, games, etc outnumber the once dominant conversation by a huge margin.

There are 3 main reasons I go to Austin every year: to spark ideas and inspiration from the talks, to meet brilliant and inspiring people, and to bathe in the zeitgeist.Not much is written about this last point, probably because it’s hard to quantify. Rather than give a highlight reel of the talks I attended, this post will attempt to capture some of the energy and trends one observes by simply being at the heart of SXSW.

Geek culture = popular culture

While no one was looking, the geeks inherited the earth. As global culture has shifted online, the people building and designing the software, hardware, and interfaces we use have been elevated from fringe to centre stage. Mastery of digital tools, once a reason for derision, has become table stakes just to sit at the big kids’ cultural table. By building the tools and platforms the world uses to talk, share, learn and entertain, the geeks dominate and direct popular culture.

Game mechanics in the “real” world

Games engage humans like few other non-survival activities. Strategists, developers, and marketers are figuring out how to use the very things that make games so engaging in non-game scenarios. I’m not talking about making everything into a game, rather the application of certain motivational hooks to move people through a process. This will be absolutely fascinating to watch.

We live in a post-PC world

There were more iPads and smartphones being used to take notes than laptops. There were tens of thousands of photos taken, and very few dedicated cameras. The age of the PC is moving past us. Tablets and smartphones have taken over. SXSW attracts an early adopter crowd. Within 18 months, laptops will start to vanish from most business meetings.

Group messaging is the next big thing and Beluga were two of the “winning” apps this year. Both programs allow the user to send short messages to a group via SMS, email, web, or directly in the app. This simple fact has huge implications. It allows for the creation of cross platform ad hoc social networks. In Austin, the main use was to coordinate meeting places with friends. In the near future, we’ll see these apps used for news reporting (topic specific updates), collaboration, permanent small-group networks, and ad-hoc event based networks. The ability to create segment specific networks (all my vegetarian friends in Austin) opens a whole new world of social media.

Location, location, location

First there was Foursquare and Gowalla. Then came SCVNGR, Facebook Places, and now Google Latitude. Despite a growing ennui from some, the money’s on Location Based Services exploding over the next couple of years. And with good reason. The combination of loyalty incentives (check in to a store three times to unlock 25% discount on your 4th purchase), growth in smart phones and new sensors and protocols like NFC that will allow auto-checkin makes for a potent mix of culture and marketing. Lots more action here in the coming years.


Everyone is talking about it. No one really agrees on how to measure it. To some, an influence score is the holy grail of social media. To others, it’s a terrifying reduction of the human experience into a single metric. One thing is for sure, influence and the conversation about it are not going away any time soon.

Information overload

Too. Many. Options. How do you reach your audience when they are increasingly scattered (in both attention and location)? This year, there were hundreds of just-launched apps vying for eyeballs. Noise, distraction, and infinite choice characterized both the streets around the Austin Convention Centre and the web in general. The number of destinations we can visit and the devices we visit them with are going to continue to increase. Organizations are going to have to become very adept at monitoring and engaging in multiple locations and in multiple formats in order to reach their audiences.

Is it worth it?


The Day that Facebook Took Over the Web

Note: this is cross posted to the Sequentia blog.

Ladies and Gentlemen, yesterday the web changed. At their F8 developer conference in San Francisco, Mark Zuckerberg and a few colleagues from Facebook got up on stage and announced a number of changes and features that promise to overhaul the very fabric of the world wide web. This is not hyperbole. This is fact.

What’s unclear is whether the changes are good or bad for the health of the web. It’s way to early to guess how this will play out. I can say with certainty though, that Facebook is about to get a whole lot bigger and more important. Just how big is Facebook already? They have nearly half a *billion* active users, and their rate of growth is accelerating.

This post deals with Open Graph, one of a handful of announcements made yesterday. In future posts, we’ll look at Community Pages and their implications. Open Graph is a new set of APIs and plugins that will allow every site on the web to enable Facebook features, such as clicking a “like” button, or seeing your friend’s activities on the site you’re visiting. Here’s a photo from Facebook’s presentation that shows the like button in action:

(source: Facebook)

Now, the geek and marketer in me is screaming “cool!!!” You can be darn sure that I’ll be recommending implementing this asap for virtually all of our clients. This ability to “like” pretty much anything on the web promises to have huge implications for traffic, discoverability, recommendations, and much more.


The ability to see what my friends have been reading, watching, and playing on any given site changes web surfing. Let’s say you visit (one of the first partners to roll our Open Graph). Once there, you see that your closest friend has commented on a recent story. Odds are, you’ll click through to see what that story and comment are about. Another example: you click through to the NYTimes to do the Sunday crossword (’cause your smart like that). Once there, you see that your cousin completed the puzzle with 99% accuracy in 25 minutes. After your jealousy subsides, I bet you either abandon the puzzle or double down your efforts to beat your cousin. In both examples, Open Graph changed behaviour. Good or bad? Unknown.

What is known, is that every time someone clicks “like”, or visits a site with Open Graph enabled, Facebook collects a little more data. Facebook is a privately held company; one who’s interests are not necessarily aligned with it’s users. Open Graph is going to tie Facebook users in so tightly to the company that it will be nearly impossible to quit the service. This is a *brilliant* move for Facebook. They will simply own more data about more people than anyone else in the world, and do so in a way that ties users even more deeply into their system.


So what are the implications for Facebook Fan page owners? I see four main issues. First, expect your fan page to become more active. Beside the Open Graph announcement, Facebook changed the language for following a fan page from “fan” to “like”. This may seem small, but I think it will have big implications. The threshold for clicking “like” is much lower than clicking “fan”. I’ll announce to the world that I like Tide far sooner than I’d announce I’m a fan of the brand. It’s a purely semantic change, but I think it’s important.

The second implication for Fan page owners is the increased integration between their Facebook fan page and their own web properties. We know this is going to become tighter, but we don’t know exactly how quite yet. I can see a ton of value-add features built on top of the “like” data. For example, a list of the most “liked” content on site A listed on site A’s Facebook page (and integrated back into site A itself). Facebook fan pages will become ever more important, as Open Graph drives data and new users onto the system.

Third, content – already important – will become supreme. In a world where anything can be “liked” and shared, site owners and marketers need to provide share-worthy content. This is *critical*. The “like” button basically says “hey marketers, if your content doesn’t match your audience’s requirements, induce a smile, or make them feel smart, you’re screwed” (not to put too fine a point on it). Creating share-worthy content is what Sequentia Environics is ultimately all about. For nearly a decade, we’ve been helping our clients build value and community around killer content. Obviously, we’re excited that the rest of the world is coming around to our way of seeing things 😉

Finally, analytics and the interpretation of data as it relates to content and behaviour is another huge change. Open Graph, and the like button are going to open a new window into real-time audience behaviour. Marketers will be able to adjust content and offers on the fly, and see the implications on behaviour almost immediately. Sure, we’ve been able to do this already, but largely in single silos, ie one site at at time. We’ll now be able to do this for each content piece, regardless of it’s location!

For example, you write a blog post and post it on your site. Currently, you can measure traffic to that article and how often that article is shared (assuming you use a service that tracks this). Once that article is off your site though, it becomes very difficult to track both it’s movement and user’s interaction with it. No longer. “Like” changes this. We don’t know what the analytics tools will look like yet, but I think we’re a huge step closer to tracking behaviour and content as it moves across the web.


Facebook hasn’t announced when Open Graph will be available to the general public. Many of the details of the system are still being ironed out, according to Bret Taylor, Facebook’s new Director of Product Management for Platform. My bet is this is three months away from public launch. Once it’s available, expect to see it spread fast.

The reality is that having access to one’s social graph (aka your friends and their friends) on a website changes the experience. Usually, it results in a richer experience (imagine reading the news; now compare that to reading and discussing the news with intelligent friends and colleagues). Open Graph offers very appealing upsides to site owners and to individual users. What remains to be seen is what Big Brother, sorry, Facebook will do with all the data.