Silicon Valley

Silicon Valley

Peter Paul Yu, MD, FASCO, FACP

Apr 16, 2012
It seems that every nephew or niece of mine who has an engineering degree is busy creating the next killer app for a mobile device. Usually it starts with way cool technology, but comes up short in figuring out why enough users would want it or what a sustainable business model might be. On the other hand, when last week's headlines were about a couple of 20-year-olds and their 40 employees whose start up for a photo-sharing app was purchased for $1 billion dollars, it would be a brave soul that would dismiss any idea outright. Still, a successful app needs to be based on well-worked-out technology, a sustainable business model, and most important, meet the needs of the user with an easy to user experience.

Yesterday though, I saw another way to develop really useful apps. Hackathons are events where developers meet to address an important problem in need of software solutions with the goal of creating on-the-spot breakthrough apps. In a variation of this, the initial event is devoted to developing concepts, and the coding occurs over the next several months before a second event, where apps are judged and prize money awarded. In a third accelerator phase, the app is put to the test in the real world.

Participants in a recent hackathon were asked to address the health problem of nutritional deserts. Nutritional deserts are parts of the U.S. that lack access to fresh fruits and vegetables or other high nutritional content food. The U.S. government has mapped such areas and made this information publicly available. The winning idea was an app that allows nutritional desert residents to use their smartphones to place an order for groceries that are aggregated by a distributor. The distributor tells the residents what location, day, and time they will bring their groceries. Residents improve their health through better nutrition, and distributors are able to sell their inventory in three hours without the unsustainable overhead of maintaining a grocery store. A commercial venture based on this is now operational.

The Palo Alto Medical Foundation held a hackathon this weekend where the objective was creative solutions in caring for an aging population. The session began with three presentations to frame the problem for the developers, who generally have little medical background. Paul Tang, Chair of the Meaningful Use Workgroup for HHS, presented the global problem of an increasing elderly population and the need to build a social network/village of family, friends, health care providers, and public and private organizations to combat a patient’s perception of isolation, which leads to deteriorating health status.

Todd Park, the newly installed U.S. Chief Technology Officer for HHS discussed the government’s objective of making its vast database of health information available to developers with the data machine ready and accessible through application programming interfaces (API). Finally, Eric Dishman, Intel’s executive responsible for Intel’s global strategy, research, and policy initiatives in health care spoke of Intel’s efforts to create mobile technology that helps to keep an elderly person with deteriorating functional level in their home and out of an institution. Developers then spent the rest of the weekend developing story boards and concepts. Three months from now they will re-convene to present their ideas and a panel will select the best concept. That app will be tested at the Palo Alto Medical Foundation to help accelerate its development and adaptation.

One of the underlying concepts driving this hackathon was attributable to Bill Joy, a co-founder of Sun Microsystems, who said that “the smartest people don’t work for you.” They are out there though and giving them access to your ideas, data, and needs is the best way to get them to work independently to your benefit. The natural tendency for health systems is to jealously guard their data, having invested considerable sums in the acquisition and storage of that data. Perhaps the real value of that data cannot be realized without the willingness to share it.


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Michael A. Thompson, MD, PhD

Apr, 18 2012 1:50 PM

Peter -
I've been very interested in the Hackathon concept.
Especially for physician partipation in IT innovation with a limited window/burst of time involvement such as 24-48 hours in a Hackathon.

Somewhat tangential, but an interesting thread on Quora about how innovation happens...

Why has Silicon Valley proved difficult to copy?

Thanks for the interesting post,


Peter Paul Yu, MD, FASCO, FACP

Apr, 18 2012 9:46 PM

Hi Mike,

I actually never thought about the question of how to copy Silicon Valley before, which essentially begs the question of what drives innovation.  When I moved into my present house, I met my my next door neighbor, an obviously retired gentleman, so we got to taking about what his life in the Valley had been.  Turns out, it was his idea to slow jet planes down after landing by reversing the engines, and since he worked for Lockheed as part of the military industrial complex that transformed fruit orchards to elecronics, he got to prove it.  And I'm glad he did.

People think differently out here compared to my native NYC.  They are not afraid to fail, to fail often or to fail early.  Failure in a start up is taken as a positive sign that you have the right stuff.   People are also very open to collaboration and finding the next big thing.  I'm not saying that this is always a good way to think, but it does seem to lead to transformative change more often and more rapidly.  The stuff that newspapers print, the free food and soda, blue jeans culture and stock options are fluff.  The real substance is in the mind set and cultural perspective that changing your world for the better right now is possible.


Michael A. Thompson, MD, PhD

Apr, 19 2012 7:55 AM

Peter - 

Great insights.
I had the same thoughts reading that thread about trying to understand innovation and disruptive thinking rather than SV itself.
I recently had the opportunity to meet some SV MD's and engineers while in California and agree with the open and collaborative mindset.  
Good stuff.


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