What’s Next on the Grid (Healthcare Edition)

There is a lot of activity in the Smart Grid space these days, particularly in the buildout of the infrastructure necessary to get going on at the least the initial vision of the Smart Grid whereby utilities will monitor home and commercial building energy consumption to optimize the generation and distribution of energy during times less stressful on the same generation sources, distribution networks, and ultimately pocketbooks of those purchasing the energy. However what is beyond the infrastructure and what are truly new services that can overlay or be completely new experiences for the end users and monetization opportunities for the service providers, which may include the utilities but not be exclusive to them? I argue that these new services need to be thought of in terms of the target “consumers” of the services and new lifestyle attributes created from these services. As the first in the What’s Next on the Grid series, this article will discuss at a high level how Healthcare is one of these many new services and lifestyle impacts that the Smart Grid++ will create.

What do Healthcare and the Smart Grid have in relation to each other, apart from the fact that the same end consumers of the Smart Grid services are all human beings (Ed.: machine-to-machine applications on the grid notwithstanding) that need to lead healthy lives? At first glance, pretty much nothing in common. However let’s look at a few characteristics that the two have in common.

  1. Both use wireless technologies. In Smart Grid, AMI is implementing Zigbee and Home Area Networks (HANs) are implementing several wireless technologies such as WiFi. In Healthcare, hospitals and clinics are implementing WiFi for voice and data communications (and other proprietary wireless) and the Healthcare vertical has been an early adopter of wireless technologies due to complexities with running wired infrastructure for connected devices.
  2. Both are connecting their devices. Meters, appliances, thermostats and TVs connected to a network is the first step to monitoring their energy consumption. Similarly connecting X-ray machines, home dialysis machines, medicine carts, patient tracking badges and in-home heartrate monitors are the first steps to creating anywhere, anytime patient monitoring.
  3. Both see mobile devices and technologies as game changers. Whether it is iPhones, iPads or other mobile Internet devices and displays, remote and on-the-go manageability is an absolute need for doctors, nurses, building managers, or utility operations personnel. We’re seeing the traditional closed NOC center become more and more distributed as mobile becomes pervasive.
  4. Both are seeing significant innovations in the cloud. This dimension is more of a When and not If it will happen. But also How it will happen. Scalability and reliability of the cloud has been proven time and time again. However both Smart Grid and Healthcare have requirements for privacy of consumer/patient information, massive data management of petabytes and exabytes of detailed data (real-time energy consumption data from dozens of devices in a home to large MRI and other diagnostic imaging data from radiology departments), and strict regulations of who can access this data.

Rather than looking at each of the above dimensions individually and in a vacuum of minutiae, let’s look at them from a couple of fictional usage scenarios centered around how they benefit the lifestyles and livelihoods of the users. Fictional only in that I’ve not heard they’ve been actually implemented but technically very feasible.

I’ve Fallen and I Can’t Get Up

Babyboomers are the largest new segment of the population entering their “golden years” but with both financial capability and a desire for wellness not just visit their doctors when they catch a bug. Many are staying proactively healthy with exercise, activities and good dietary habits. Imagine their stationary bicycles and Stairmasters connected to a converged wellness management system that also gives them suggestions or implements automated rules that reduce their energy spending. The stationary bicycles send their physicians and dietitians real-time and historical information of how they’re exercise program is going, their heartrate range from at-rest to peak performance, weight, etc. If the users also included some anaerobic cardio such as swimming in their programs, wouldn’t it be nice if the pool heater and pool pump energy consumption were activated according to the people’s schedules? If there were changes to the schedule, they can enter the new schedule via their mobile smartphones or simply via their locations the schedules can be altered.

Code Blue in Room 305

There are many critical systems within a hospital environment such as the intensive care wards, radiology departments, patient and asset tracking systems, access to medical records and so forth. Some, but not all, hospitals have backup generators to weather through power outages but the rise of renewables such as solar and other alternatives could make the hospital environment its own micro-grid with these various power source subsystems that can be tapped and utilized in optimal times and conditions. However a holistic view of all the critical systems WITH the available alternate power subsystems implemented in a Critical Intelligence and Rules service ensures that all of the patient care and hospital management systems are available at all times in the most efficient manner. The MRI machines draw a lot of power so they wouldn’t necessarily be switched to a battery bank while the 900 MHz Asset HAN can easily operate on duty cycles conducive to drawing from the batteries during peak tariff periods.

Check On Grandma

Many of us having aging parents and grandparents who we’d like to be able to check on from time to time, given our very active lives with traveling, taking care of kids or running companies. In comes the mobile phone as the portal to many of these personal facets of our lives. I can see to ensure the temperature is comfy for Grandma in Miami because there happens to be a major cold chill sweeping through the area and she doesn’t know how to work that new programmable thermostat the utility installed. At the same time I can see that she’s up to date on her heart medication because she’s been taking the pills at the same times every day (RFID on the pill container with an integrated alert) and her in-home heart check monitor is giving me a green indication stating all is well. I’m on vacation in Europe with the kids so I sleep much better knowing this. We’ll give her a call tomorrow after the gondola ride.

Summary

There are no lack of opportunities where the Smart Grid is more than just a grid for distributing energy at the right time of day. The ultimate uptake by consumers will be in the many layered ways they perceive these services touch and improve their lives. Some parts will be slower than others but beyond the infrastructure, the services need to be developed in a very user and customer-centric manner if they are to make good business sense as well.

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The Cloud Completes the Connected Experience

Owners of iPhones are probably tired of hearing all the AT&T “network issues”, dropped calls, or other user experience degrading issues. I’m certain AT&T is also tired of hearing the complaints. I know the customer service agent who took my call last week had a fair bit of experience with iPhone customers calling in to complain. But this post is not yet-another bitchfest about AT&T’s network or how I love the iPhone…except for the phone! In experiencing the stellar experience with the iPhone platform and its extreme dependence on the network, I’m reminded of just how important the carrier experience is for the overall positive user experience.

Google’s CEO, Eric Schmidt, agrees with this. He delivered an engaging keynote appearance at Mobile World Congress stating the importance of the cloud, i.e. operator network, in the device and application experience.

“We feel very strongly that we depend on the successful business of operators globally,” he said. “We need advanced, sophisticated networks.”

Eric was reacting to an audience member’s statement that Google would basically make the operator network a “dumb pipe” and all the value would be over-the-top. But I disagree with this mindset. The connected experience that we are increasingly engaging with our smartphones, app stores, data, and social media would incur a tremendous amount of friction and dissatisfaction without the right networks in place and operating properly. Good session and roaming management will yield great experiences to end users, and that results in sticky, ARPU-rich subscriptions to all kinds of services and applications.

“Applications are sharing-intensive, and the cloud is all about sharing and replication,” Schmidt explained. “An application that does not leverage the power of the cloud is not going to wow anybody.”

It’s hard to find a successful application on an iPhone or Android device that does not have some sort of persistent or recurring network connection. Whether it’s location, gaming, messaging or productivity, the application experience is enriched with a great network. It seems that I’m stating the obvious however the notion of Over-The-Top has been on the minds and desired of users and application developers ever since the first walled garden went in place. Yes, many mobile computing platforms will have a variety of applications on them and accessing services in the cloud that are relatively transparent to the billing platform of the wireless operator (maybe the application specifics, but not the bits). The ultimate Always Connected User Experience will happen only with the integration and cooperation of the end-to-end value chain elements. This includes the pipes!

Floating Among the #Cloud…#Services

The importance of device characterization, content adaption, and cloud services is absolutely critical to a positive Always Connected User Experience (ACUE). Today I bounced back and forth between my iPhone and Kindle 2 reading snippets of The Lost Symbol by Dan Brown (GREAT book so far, as usual from the author of The DaVinci Code).

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Without getting verbose, these were the essentials of my positive Always Connected User Experience while waiting for my car’s oil change.

  1. The page sync is automatic between the 2 devices so I never have to worry about remembering where I was. It wasn’t always this seamless…back in the stone ages of Kindle 1 I had manually sync many if not all the time.
  2. The adaptation of the content is performed to the device’s capabilities (screen size, display technology, I/O, dynamic features such as accelerometer). Obviously Apple (obvious, I think) would not have approved the Kindle for iPhone app if it had not met the specs for what they typically consider as a stellar user experience. In a nutshell, it just works!
  3. Yes, the content does in fact reside locally on both devices, so it’s not what I’d call a classical “connected cloud service”, but the content originates and remains available in the cloud no matter what I do locally on the devices. If I wipe my iPhone, I just reload the app and book, and I’m right back to the same page I left off on.

One key element of the overall ACUE equation is the transport media, but since the content is cached locally on the device (probably always will be) this is not as important other than the time to download. Where this becomes important is when less of the content resides locally and what the device side gets is rendering of the content. So if Amazon were actually rendering the book content and pushing me each page as I flip to the next page, I will be begin to care very much whether I’m connected over HSPA, WiFi, or EDGE. I’ll also care about the quality of the connection if I’m moving. Imagine the sorts of outages or failed calls on the iPhone in some of the dreaded “coverage holes” in the San Francisco bay area when I’m immersed in a really good publication or book.

There are many other items such as security, authentication, e-commerce, and so forth that I’m leaving out and of course must be built into the equation. But from the non-technical users perspective, once they signed up for their account on Amazon and purchased their Kindle, they just want it to work without needing any knowledge of an unreliable cellular network, fading, channel congestion, or roaming.

Are we there yet? Ehh, kinda sorta. We’re definitely getting there as users push the capabilities of the applications, services and devices. Apps, services and devices push the capabilities of the network. And the networks push the capabilities of the carriers to react innovatively and expeditiously. Do you agree or disagree?