I’m completely fascinated with the inner workings of Vegas (like most people) so I really ate up Christina Binkley’s excellent new book titled “Winner Takes All”.

It’s a great read on Las Vegas and how it has evolved over the years to its current incarnation.

Binkley provides all kinds of great stories culled from years of following around primarily three legendary Vegas moguls: Kirk Kerkorian (MGM Grand etc), Steve Wynn (Wynn, Bellagio etc) and Gary Loveman (Harrah’s etc).

One of my favorite parts of the book took place outside the strip and in Harrah’s crappy casinos and riverboats scattered all over the country. I’ve been to all of the casinos in Vegas and I have also been to pale-in-comparison Reno, Nevada, which has one of Harrah’s crappy casinos.

For some reason I wouldn’t expect Harrah’s to be as smart as they are since their casinos look so crappy (the ones that I’ve been to). Just look at their stock price since 1998 (that’s around the time Gary Loveman was named CEO) and you can see how well those crappy casinos perform:

So what makes Harrah’s so smart?

Here are a few things:

1) They were the first ones to introduce those “Rewards” cards that track everything from how frequently you visit their casinos, to what games you prefer to gamble on, to what drinks you prefer, to if you can be enticed to gamble longer with free food or free hotel rooms or show tickets or all of D above etc.

They use the data from the cards to treat gamblers like shoppers. They create “behavior modification reports” on their regular customers showing what each is enticed by and seeing who needs to be sent snail mail, email or phone calls when they aren’t showing up at their usual frequency.

Note: Most Las Vegas slot machines are programmed to keep anywhere from 2 percent to 4 percent of gamblers’ money over time. This is referred to as the “hold”.

2) They found out that could learn tons about their customers and gambling in general by tracking how fast people push the buttons on slot machines. That really made me feel like a lab rat.

3) They even track customers’ live slot machine performance against the normal odds for the game. Why? So if the customers losing streak is below the normal odds a “luck ambassador” will appear and try to cheer them up with kind words and something free like a drink, food, or room.

I could keep going with these examples for days and days but I’m sure you get the idea why Harrah’s is smarter than their casinos look.

For those of you who are intrigued with Vegas and what happens behind the scenes you definitely need to buy Christina Binkley’s new book. It’s a real winner. No pun intended.

Update: Lessig just announced on his blog that he has decided not to run for Congress and instead devote his energies to running the Change Congress movement from outside Congress. He explains his decision in this 5min video.

I don’t get excited about people running for Congress.

But, I have to say that I’m completely blown away with this Lessig guy. He is a refreshing slap across the face.

Who is he?

In short, Lessig is currently a Professor of Law at Stanford Law School and founder of the school’s Center for Internet and Society. He has a massive (and massively interesting) bio that you should view here because there is no room for it in this post.

He just launched his Change Congress movement this month and because of it has been pressured by many close colleagues, friends and Facebook groups to run for Congress.

Lessig’s Change Congress movement wants to change how Washington works by trying to remove the influence of money on public policy.

The movement details three things that will start Washington in the right direction:

1. No $$$ from lobbyist or PACs (Political Action Committees)

2. Ban earmarks

3. Support public finance

He is a 10min video launching Change Congress and mentioning a possible Congress run:

Lessig makes it very clear that the current Washington system not the people plays the largest role in allowing money (aka corruption) to influence public policy.

Here is an excellent lecture he gave on corruption (warning: its about an hour long):

Note: Lessig hasn’t announced he will run for Congress yet. He says he will make the decision by March 1. Until then, check out his new site or join the Draft Lessig for Congress Facebook group.

Also, check out Lessig’s personal blog or OpenCongress’ blog for more.

Update: Anyone interested in running for California’s 44th District? Contact Jason in the comments below.

Bob Wachter, MD is a blogger who also happens to have a day job as both Professor and Associate Chairman of the Department of Medicine at the University of California, San Francisco (he also holds a couple other “Chief” positions around UCSF but I can only fit so many words into this post).

Jay Parkinson, MD is also a blogger who has a day job as both the “IM Doctor” and CMO at Myca. He is also planning to cause some major ripples in the healthcare industry in a couple of months with his new project.

I think they should meet each other.

Consider this an introduction.

They probably don’t need an introduction from me given the impressive connectivity that blogospheres have around certain niche topics (I’m sure they’ve already run into each others’ blogs).

I was reading Wachter’s very interesting and surprisingly frank blog the other day and I came across this recent post that details his observations of spending two weeks doing clinical medicine “on the wards” (he says he does this “sporadically” and it leaves him “well positioned to notice changes in clinical care”).

His post goes on to explain the current IT environment at UCSF and also provides some “thoughts on information technology and its impact on day-to-day hospital care.”

Here are some good tidbits from the post:

We don’t yet have Computerized Provider Order Entry (it’s been coming “next year” for the past 5 years), but we do have an increasingly functional Electronic Medical Record (our vendor is GE, which bought the foundering IDX company a few years ago). Our EMR contains all physician and nursing notes, as well as vital signs, labs, and x-rays.

Talking about his Internet-based template system called “Note Writer” for tracking and updating patient progress notes:

More impressively, yesterday I absently wrote, “patient received 4 U PRBCs” (packed red blood cells). The computer, remembering that “U” is a Joint Commission “high risk abbreviation,” balked, helpfully suggesting that I convert “U” to “units.” I simply clicked “OK” and – voila – the substitution was done.

After I expressed my awe, a resident sitting next to me asked a great question. “I can understand why a handwritten “U” would be a risky abbreviation,” he said. (He is right; there have been dozens of deaths when an order “Give 10U Insulin” was mistaken for “Give 100 Insulin.”) “But why would it be dangerous on the computer?”

Here is the paragraph from his post that really grabbed me:

My weasely answer: “For now, we’re in this half-way world between paper and computers, and there is no way that either we or the regulators will be able to manage separate rules for each. So, even though it seems silly to flag “U” and “MSO4” on the computer, I can’t see a way around this.” He nodded the nod of someone thinking “another moronic rule” and went back to his notes.

“We’re in this half-way world between paper and computers…”

Whoa. What an inconvenient truth. :)

Ok, now switch over to the world of Jay.

I’ve been closely following his Tumblr blog for some time now trying to decipher cryptic messages about this new project and also because he shines plenty of light on particular problems with our current healthcare industry (the same industry that he thinks he’s going to provide some solutions for in a couple of months).

The other day he posted this not-so-cryptic tidbit about his new project:

It’s going to be an interesting ride. For a less cryptic explanation of one of my projects I’ve started in the past few weeks…we’re developing an interface for a physician to access a person’s entire medical chart (for example, 80 years worth of every bit of text, radiology, labs, etc, in an individual’s chart) in one screen. But most importantly, all information is displayed in context…the interface shows data, not as individual points of data sectioned off by “Labs,” “Radiology,” etc, but as data that’s all interrelated and visually put in any context a physician wants to view. If you’d like to see the prototype, head out to the Health 2.0 conference in San Diego in March. If you’d like to see the real thing, head out to Williamsburg in 4 months.

Accompanied by this mind-blowing, jaw-dropping demo video (you really need to see this):

For those of you reading this in a feed reader or by email, the video is a TED demo for Photosynth an amazing technology that “creates breathtaking multidimensional spaces with zoom and navigation features that outstrip all expectation.” (See the video here.)

Seriously, it will revolutionize how visuals are browsed, navigated and connected. I can see it having major effects on Internet browsing and it will especially make mobile devices like iPhones so much more usable for real Internet browsing.

Why did I want Wachter to meet Jay?

Because some really cool technology will be making it to the “wards” soon enough. Technology that will vastly improve clinical medicine and patient care.

It will start with Jay in New York. And, it will slowly make its way around the healthcare industry and eventually show up at Wachter’s doorstep at UCSF.

Probably sooner than later since UCSF is ahead of the curve. I think.

Than Wachter will really be able to impress the resident sitting next to him.

Read Wachter’s fantastic blog here and Jay’s cryptic-yet-highly-interesting blog here.

Before I get to Dr. Jay Parkinson’s new job at Myca, I have to say that the healthcare industry has intrigued me ever since I was turned off by its current state while doing a summer internship at Adventist Health my sophomore year in college.

I experienced plenty of aspects of the healthcare industry while doing my short but eye-opening internship that made me not want to jump into its current incarnation:

-How hospitals earn most of their money via the myriad of third-party reimbursers (Shudder).

-Communication amongst hospital departments (Bad at my hospital).

-Relationship between doctors and the hospital (Most want nothing to do with the people that pay their income).

-Use of new non-medical technology for communication, customer relationship management, consumer-facing website, etc. (I found this to be the most backwards parts of the hospital I interned at. However, I’m proud to say that one of my summer projects was to implement a new online invoice tracking system that allowed departments to view and search their invoices from their computer. :)

When I got done with my internship back in the summer of 2005, I started trying to track people that were trying to disrupt the healthcare industry with new solutions. At the time, I didn’t find much outside of Steve Case’s Revolution Health personal health portal.

I have to admit that I slowly lost interest.

That is until I ran into a shout out for Dr. Jay Parkinson’s (aka darkshapes) new practice on Noah K’s Flickr. I have been tracking Dr. Jay Parkinson via his blog ever since.

About two weeks ago, he leaked via the comments under one of his Flickr photos that he was working with a company from Quebec and that the new project would be “a big middle finger to the Industry”.

He than let us know on his blog that the company’s name is Myca.

Well, I’ve done some research and it turns out that Myca is a pioneer of Telemedicine 2.0. It looks like they are working on two new products called DoctorPhone and BabyPhone that will offer patients and parents instant videoconferences with physicians via cell phone (thanks Business 2.0 Magazine).

The product features lineup on their website look really interesting. Can’t wait to see how doctors other than Dr. Jay Parkinson implement this.

Myca’s previous product called MyFoodPhone let subscribers get biweekly videos via e-mail offering personalized dietary suggestions based on their phone snapshots. Interesting.

Healthcare disruptors are going to get a lot of coverage on BUZZYEAH in the next year or so as I said in my New Year’s post.

I’m excited about Health 2.0 its focus on Web 2.0 technologies transforming the relationship between healthcare providers and consumers.

I’m new to all of this so if you know a major disruptor or somebody with a great Health 2.0 blog let me know!

Right now, here are a few blogs I’m following: Health 2.0 Blog, Dr. Robert Wachter’s blog (had an excellent post recently that touched on Health 2.0) and ChangeNow4Health.

Update: Nice! Jay promises that Myca is “much, much bigger than BabyPhone or DoctorPhone.” See his comment below for more.

Photo: darkshapes

Back in October, I wrote a post about Dr. Jay Parkinson who also goes by the name of darkshapes on the photo site Flickr (he’s a pretty popular Flickr photographer).

In short, he took the news world/blogosphere/doctor care world by storm with his innovative use of technology in his small Brooklyn-based practice. He is known as the “IM doctor” in those parts because his patients can contact him around the clock via IM, email, cell phone etc.

He provides both health advice and basic diagnosing using those technologies and also helps his patients find affordable medicine and health services like X-rays.

Anyways, I was just on his Flickr page viewing the above photo and came across this comment left by Dr. Jay Parkinson AKA darkshapes. Here is the comment he left:

What?

I can’t wait to see what he has brewing with this Quebec City company.

New solutions for our less than optimal healthcare industry is something I’m highly interested in. I will definitely be visiting his Flickr page more often for tips and also his Dr. Jay Parkinson website.

Update: I totally forgot to give Dr. Jay Parkinson’s blog a shout out. He updates it regularly and will definitely be a great place to find updates on his new project. Here is a teaser post he wrote for his new project.

Update 2: He just posted that he will be moving his blog from WordPress to a new address at Tumblr.

Photo Cred: Noah K

I phlog (photo+blog) my photography over on world-renowned (not really) photo collective TUFTS vs CITS regularly. A lot of the kids over at TUFTS vs CITS are big fans of the Flickr photographer darkshapes, especially me. I regularly check his new stuff out along with other big Flickr photographers Noah K and bennybedlam.

A couple of weeks ago, I was looking at Noah K’s photos and I came across this shot he took of darkshapes on the streets of Williamsburg, Brooklyn. I read the caption under the photo and it said:

Dr. Jay Parkinson will see you now.You might also know him as darkshapes
here on flickr. www.darkshapesprowl.com/

If you live in or close to Williamsburg, Brooklyn you should definitely check
out his services.
www.jayparkinsonmd.com

My first thoughts were “What the hell, darkshapes is a doctor?!?” Than I followed the link to his site JayParkinsonMD. The guy not only takes great photos but he’s also decided to completely embrace and integrate Internet technology into his practice.

He is planning to have roughly 1000 patients in the Williamsburg area. You enroll for his services online and he makes an initial house visit to make sure you guys are right for each other. From there on, you can contact him at any time during the day via email, phone, IM or snail mail. When you break something he helps you find the cheapest x-ray in the city and if you need some medicine he helps you find it at the best price. If you want a house visit you can schedule yourself into an open space on his online calendar (he provides two more free house visits along with his $500 yearly fee).

It’s amazing how he has embraced technology to provide almost instant doctor advice to his patients while actively helping them find the best prices on everything from x-rays to medicine to insurance. You can follow his thoughts on his JayParkinsonMD blog. He recently had a great post on the tricky things dermatologists try to pull.

The WSJ Health Blog had a great interview with him a couple of weeks ago.