Working The Web: August 2015

Is Google Trying to Make Alphabet Soup Out of its Company?

By Carl Weiss

After being the big dog of search engines for more than a decade, Google has decided to change its corporate moniker to Alphabet. After 17 years of building a $400 billion business that controls everything from the world's most popular search engine (Google) to the world's most popular video portal (YouTube), to life extension research firm (Calico), to self-driving car developer and a host of other acquisitions, Larry Page and Sergey Brin have decided to rename their enterprise. Add to that the fact that CEO Page has turned the reins of Google over to Sundar Pinchai, and many people both in the Internet and on the stock market are wondering what's going to happen next. Even before the soup has cooled, rumors are swirling that Google is interested in acquiring yet more companies, including everything from Twitter to a company that makes pocket toy satellites. So if you are wondering if Google intends to make Alphabet Soup of their company, let’s give the pot a stir.

The Best Soup Starts with the Best Ingredients

Courtesy of wikimedia.org

You’ve got to hand it to Brin and Page. Ever since they went public in 2004, they have spent their money wisely, although in several cases it didn’t initially look that way. Remember when they acquired YouTube for a whopping $1.67 billion in 2006? At the time, a number of pundits thought the deal was questionable at best, being that the fledgling video portal’s only assets were hundreds of thousands of homemade videos and 67 employees. YouTube had yet to turn a profit and it was questionable whether it ever would. This was especially poignant since a number of media moguls were threatening the company with copyright-infringement lawsuits. But Brin and Page soldiered on, betting that the public was sure to migrate from TV to online video. Today, YouTube streams more than 4 billion videos per day, dwarfing the combined output of all the TV stations on the planet. That’s the good news. The bad news is that in 2014, even with $4 billion in revenues generated (according to the Wall Street Journal), YouTube still stubbornly refused to post a profit. Still, I doubt it gave the gurus at Google any sleepless nights, since YouTube only represented 6% of the company’s sales last year. Besides, Google seems to revel in betting on longshots.

A is for Artificial Intelligence

Courtesy of en.wikipedia.org

AI is all the rage these days. Everything from autonomous aerial vehicles to self-driving automobiles relies on artificial intelligence. There are even experiments in search engine technology powered by AI. With that in mind, Google acquired AI startup DeepMind for $500 million. What they plan on doing with the technology is anyone’s guess. The company’s website Says that “DeepMind is a cutting edge artificial intelligence company” to build general-purpose learning algorithms for simulations, e-commerce, and games. While a number of scientific luminaries, including Stephen Hawking has warned that the creation of artificial intelligence could spell the extinction of the human race, Google’s past experiments with turning AI loose online had decidedly non-life threatening implications. Earlier this year when Google trained an artificially intelligent network to view photos, the most terrifying thing it did was transmogrify images based upon the tasks it was asked to perform. For instance, when researchers asked the system what it thought dumbbells looked like, the system created an image that looked like a human arm attached to one. There were also bizarre transpositions of animal heads on humans and embedded in clouds. Read more about it here in this article from the daily main.

B is for Boston Dynamics

Snap Quiz: What looks like an extra from Star Wars, sounds like a chainsaw, and walks like a Great Dane? The answer is BigDog, the quadrupedal robot being built by Boston Robotics for DARPA. Designed to carry more than 300 pounds of gear over rubble, up mountains and through snow and mud, this robot is intended to tote gear for soldiers in the field. Of course, until the company comes up with a quieter source of locomotion other than what sounds like a 2-stroke engine, this is one doggie that won’t be sneaking up on anybody. Still, when you consider the technology in BigDog, including stereo vision, LIDAR, gyroscopic stabilization and the ability to climb 35 degree slopes fully laden, maybe if the technology doesn’t work out for the DoD, it can be retrofitted for the US Post Office.

Courtesy of wikimedia.org

BigDog is only one of nine robots on the Boston Dynamics website. Others include a bipedal humanoid robot named Atlas that competed in the DARPA Robotic Challenge. Designed for rescue, as well as to enter danger zones where humans fear to tread, Atlas can walk, climb stairs, turn valves, move debris, and even drive a rescue vehicle. While his utility can’t be beat, what he gains in mobility he more than gives back in the looks department. Let me put it this way, if you saw him coming to your rescue, you’d probably die of fright. Speaking of death, this brings us to the next letter in the Google Alphabet.

Can Calico Cure Death?

Can you a blame billionaires for trying to live forever? Historically speaking, this isn’t a new concept. Everyone from the first sovereign emperor of China to Conquistador Ponce De Leon have sought immortality. The difference is that with today’s state-of-the-art biomedical research, it just might be possible. Consider if you will that only a few years ago, transplantation was considered the creation of Dr. Frankenstein. Now it is commonplace. With advances in everything from prosthetics to genetic technology, making life extension a reality isn’t such a stretch. Still, some people think Larry Page and Sergey Brin have gone off the deep end on this one. But with a war chest of $45 billion at the ready, if anyone can take a crack at the Grim Reaper, it's Google. Only time and a few billion dollars will tell. (If that doesn’t work, maybe they can figure out a way to transport their mind to a robot like Atlas.)

Google Gizmos Galore


A Lexus RX450h retrofitted by Google for its driverless car fleet

Alphabet will also manage and develop a number of technology gizmos. Everything from diabetes detecting contact lenses, to a 360 degree virtual reality camera, a solar powered drone startup (Titan Aerospace), a delivery drone called Project Wing, to energy harvesting turbine powered kite called Makani are under development. There is also a high altitude balloon named Project Loon that purports to be able to provide internet access to people living in remote areas, and Nest, a company devoted to creating smart home products. Last but not least is Skybox Imaging, another $500 million acquisition that builds microsatellites.

With enough created and acquired companies under management to literally cover every letter in the alphabet, is it any wonder that Google decided to take the name Alphabet for its corporate umbrella? Ever since returning to the CEO spot at Google in 2011, Larry Page has wrestled with the best way to control his sprawling business empire. The problem for this dyed-in-the-wool entrepreneur is that his priorities were becoming divided. A quote from Mashable sums it up best:

"Larry was always more excited about big vision projects than the day-to-day grind of running the company," says Bruno Bowden, who helped build Google Earth. "This structure makes those projects and his role far more visible. Wall Street will only care about Google proper and how Sundar is doing. For Larry, this gives him the chance to focus on a broader mandate as he always wanted."

Y is for Why Now?

Although restructuring the growing Google empire is something that many see as inevitable, the question of timing is something that has many scratching their head. As for whether the name change will hurt or help is something that only time will tell. From an institutional perspective the announcement of the new name actually caused company stock to jump by 4% the very next week. As Alphabet (nee Google) continues to grow through acquisition, the question is whether changing the name of the parent company will prove a boon to the brand or whether Google will ultimately wind up making alphabet soup out of its conglomerate.

In this article I have discussed how and possibly why Google has decided to changed its corporate name to alphabet and how this well effect Googles empire as a whole. I go on to list many of Alphabets many corporate entities (alphabetically of course) that they has swallowed over the years and shared many of the interesting projects these divisions are bringing to fruition.

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If you found this article useful please share it with your friends, family and co-workers. If you would like to learn more about this subject, visit the notes page on this blog for the BlogTalkRadio show dated 9/1/15. I recommend checking out "Can Google Cure Death, Disease and Aging?", "Are Google Glasses the Great Game Changer or a Passing Fad?", or "How to Make Google Your Best Friend". You can also search for other related articles by typing in “Google” in the search box top of this blog.

If you feel your business could use some help with its marketing, contact us at 904-410-2091,We will provide a free marketing analysis to help you get better results. Don't forget to Plus us on Goole+ as well. If you'd like a free copy of our eBook, "Internet Marketing Tips for the 21st Century," please fill in the form below and we will give you immediate access to it. Your information is always kept private and is never sold.

Carl Weiss is president of Working the Web to Win, an award-winning digital marketing agency based in Jacksonville, Florida. You can listen to Carl live every Tuesday at 4 p.m. Eastern on BlogTalkRadio.

By Hector Cisneros

Does the public’s uncontrollable appetite for free smartphone apps also make you vulnerable? Right now there are approximately 4,000,000 apps combined that are available in the top four app stores. Are these apps being checked before being released to the public? Are we vulnerable as users by downloading free apps on our smart phones? Could we be compromising our security and financial information by using these apps? In this episode you will learn the truth about using free apps, how to stay safe, and what to look for when deciding “to get an app for that”. So stay tuned and turn onto this week’s Working The Web To Win and learn “how to safely whet your appetite” for smart phone apps.

Is it Time to Fire the Postman?

By Carl Weiss

As far back as the 19th century, when the telegraph came into vogue, people have been looking for a better way to deliver information and goods more efficiently than the US Postal Service. Today's wired world has created a myriad of electronic delivery systems that do everything from rendering payment, to delivering messages and even packages at the click of a mouse. In today’s blog, I intend to delve into a number of innovative, cost effective delivery options to the USPS, as well as the possibility that in the near future the post office could very well be as dead as the dodo bird.

They Don’t Call it Snail Mail for Nothing

Courtesy of en.wikipedia.org

The US Postal Service can trace its roots back to the Second Continental Congress in 1775. That’s when Ben Franklin, a prominent Philadelphia printer, was appointed as the country’s first Postmaster General. Since that momentous occasion, the USPS staff has mushroomed to 717,254 federal employees, making it one of the nation’s largest employers. In 2014, the USPS generated $67.8 billion in revenues. That sounds impressive until you realize that it represented a $5.5 billion operating loss. This seems odd when you consider the USPS operates a virtual monopoly when it comes to delivering letters. Stranger still is the fact that the post office has downsized considerably during the past few years, closing a number of offices as well as reducing the hours they are open. Of course, the USPS is and always has been a bureaucracy. That explains a lot.

The real problem with the Post Office is that unlike the 19^th and first half of the 20^th century where it had little if any competition, by the latter part of the 20^th century when package and overnight delivery was privatized, the days of the Post Office monopoly was over. But the USPS was still alive and kicking, if at a snail’s pace. (They don’t call it snail mail for nothing.) Sure, since the late 1800’s people could use the telegraph and telegram to send messages quickly. But when one considered the fact that Western Union charged by the word, the telegram was more like Twitter than traditional correspondence. Short copy was the norm. Then came the Internet.

We Don’t Need No Stinking Postage

By the mid 1990’s, digital technology such as fax and email began to slowly but surely erode the postal service’s hegemony. Why wait days to deliver the message when anyone with a phone and a modem could send pages replete with photos across the telephone wires in minutes. (Today we can do this in seconds, but remember how slow dialup connections once were.)

Courtesy of comons.wikimedia.org

Suddenly you didn’t need to pay for postage to send letters, flyers and ad copy across town or around the world. (Spam was born.) All it took was type, point and click. Add to this the fact that within the past few years, most businesses and banks have adopted electronic payment systems that allow customers to remit payment at the click of a mouse and it makes the USPS seem a lot like its predecessor, the Pony Express.

Yet the Post Office still plods on. A number of tech companies such as Netflix still rely on the USPS to ship their products, as do a myriad of other advertisers, many of which we regard as junk mail. However, as competition grows and technology makes much of what the USPS does seem redundant, will there come a time when the public, not to mention the federal government decides it’s time to put the Postal Service out of its misery? A quote from Wikipedia sums it up nicely:

"Since the 2006 all-time peak mail volume,^[5] after which Congress passed the Postal Accountability and Enhancement Act,^[6] (which mandated $5.5 billion per year to be paid into an account to fully prefund employee retirement health benefits, a requirement exceeding that of other government and private organizations ^[7]), revenue dropped sharply due to recession-influenced^[8] declining mail volume,^[9] prompting the postal service to look to other sources of revenue while cutting costs to reduce its budget deficit.^[10] The USPS lost US$5.5 billion in fiscal 2014, and its revenue was US$67.8 billion."

Whoa Nelly! I can hear those telegraph operators of yesteryear crying the blues. Not only have private shipping concerns such as UPS and FedEx continued to chip away at USPS market share, but other major players such as Amazon want in on the action. (Can you say same-day drone delivery?) Being that neither timeliness nor cost-effectiveness has never been one of the Post Office’s priorities, as innovative companies continue to reel in more and more of the fish that USPS once had all to itself, at what point will the feds declare it time to abandon ship?

Courtesy of en.wikipedia.org

In a blog on Fox News, Amazon CEO Jeff Bezos stated that,

“Amazon delivery drones are still years away, but someday they will be as common as seeing a mail truck. Bezos told the Telegraph in London that the biggest hurdle Prime Air has to clear isn’t related to technology, but regulators.”

Of course, with other bureaucrats such as the FAA, running interference for the Post Office, they might be able to delay the inevitable for a time. And since the US Postal Service has never been one to innovate since Ben Franklin stepped down from office, far from looking for new sources of revenue, it will face an ever shrinking customer base. Combined with bureaucratic bloat and an unwillingness to face the fiscal realities of running a business, the sheer cost of running a dysfunctional shipping conglomerate will inevitably spell disaster. (Or, they can simply print an adhesive strip on the back of a $1 bill.) As with other bygone technologies, the question is not whether the Post Office can survive change, but when will it be time to Fire the Postman?

In this article I have discussed the US Postal Service and how this massive governmental bureaucracy is not only losing money, it is losing ground as a mail deliver system. The massive losses are causing the public and congress to rethink the USPS's role and whether it should be privatized.

If you found this article useful please share it with your friends, family and co-workers. If you would like to learn more about this subject, visit the notes page on this blog for the BlogTalkRadio show dated 8/18/15. I recommend checking out "How to Stop Sir Spamalot", "How to Avoid Being Caught in an SEO Phishing Net" or "Going Postal - With Touch Marketing". You can also search for other related articles by typing in “email” in the search box top of this blog.

If you'd like a free copy of our eBook, "Internet Marketing Tips for the 21st Century," please fill in the form below and we will give you immediate access to it. Your information is always kept private and is never sold.

Courtesy of Microsoft.com

The Good, the Bad and the Ugly

By Hector Cisneros

Ready or not, Windows 10 is finally here. We all know that Windows 8 was a bust. Its ill conceived design, cost Microsoft in a big way. Windows 8 was so bad that Microsoft had to re-release Windows 7 on new PC’s, even after it had withdrawn version 7 from the market. I am sure that Microsoft even had to back burner other initiatives while they hurried to fix this problem. So why should you look at Windows 10? Why place trust in Microsoft? Why not switch to Apple IOS of Google Chrome? Even the way Microsoft released their new operating system gave cause for alarm by sneaking it in as an update that showed up on your “Task Bar” displaying a Windows symbol! In this article we will explore our first impression of Windows 10, uncensored. We’ll look at the “good, the bad and the ugly” of what we have found and pass that information on to you, our loyal readers. So let’s get started.

The Ugly

What the Heck is that Symbol in my Taskbar? Several months, prior to the actual launch, Microsoft snuck in a “Get Windows 10” add on as one of their updates. Unexpectedly, what looked like a Windows symbol showed up in the Taskbar? When I first saw this, I thought it might be some kind of virus. I immediately looked at it by opening the Task Manager to see what it was. With a quick search in Google, I determined it was a legitimate Windows symbol. I also determine that it was not necessary for the operation of my computer. So, I removed it from operation by ending that process. Five minutes later, it was back. I closed it again, and again it came back again. I did this a few more times with the same results. I did another search and discovered that I could turn it off, but not remove it. Microsoft was insistent that their upgrade notice would be on your system, whether you liked it or not.

Finally, I did a full investigation on this upgrade. I read all the announcements provided when you clicked on the symbol to make sure I understood what Microsoft was offering. One of the good points I thought Microsoft had put into their plan was you could cancel your upgrade reservation for up to one year. I made my reservation to upgrade and figured I would be able to select the date I wanted to move forward. This was not the case. My system began the upgrade process the morning of the 30^th. I canceled the upgrade (which was about 30% through) when I noticed it had started. I have canceled the upgrade about two dozen times so far. The only way I have found to stop the upgrade process is to either continue canceling the upgrade or cancel my reservation. However, if you cancel your reservation, you may be giving up your free upgrade!

The reality for me is this: I like the idea of Microsoft giving me a free upgrade. Especially since Windows 8 was such a disappointment. However, I would really prefer a heads-up before I have to spend time trying to figure out if my computer has just been infected by some unknown virus. On top of that, it would also be nice if I could select when my upgrade takes place, instead of having to keep canceling upgrade after upgrade attempt. I hope next time Microsoft gives a little notice before it “unleashes a major upgrade” on the public and that they give the public more say in how the process takes place.

The Bad

Courtesy of Microsoft.com

Being a seasoned tech with 30 years of IT experience under my belt, I was tasked with upgrading my companies' systems. We have several backup systems we use in case one of our primary computers breaks down. I decided to upgrade two of these first to see what kind of problem I might encounter. Microsoft provides a pre-upgrade called, “Check Your PC,” as one of the options on the “Get Windows 10” Taskbar button. The two HP laptops I worked on are both about a year and a half old and had Windows 7 Professional on them. Both of the systems passed all the criteria listed in Microsoft “Check Your PC” test.

I also did a search in Google to see if I could find some incompatibilities that the test might have ” and then move on with my upgrade attempt. This process took me three tries to complete. missed. I found hundreds of application’s that are incompatible, especially older applications. Both installations choked on the fingerprint verification system that many HP laptops come with. Windows 10 immediately tried to uninstall these apps, but it was unsuccessful and I was forced to uninstall them manually. This was difficult to do as the Windows attempt to remove these applications caused some problems since it created a partial uninstall. I was able to force a complete uninstall with”
IObit’s Uninstaller

Courtesy of Microsoft.com

Once my installation was complete, Windows 10 booted up, asked a few questions and I was up and running – or so I thought. The next problem that occurred was figuring out where Microsoft put things. There were also subtle changes as how you could use the Windows explorer, some not so subtle changes to the “Start Button” and I even had trouble finding where the shutdown function was.

Also Windows 10 added some new security features (like a login in pin), a new browser (Windows our notes page on this blog, and look at the notes for the August 11^th show, you will find several articles that list incompatible applications as well as other issues that are associated with this upgrade. Edge) and it also wants you to use Microsoft’s unified login for OneDrive, Office 365 and their new automated assistant ”Cortana”. If you go to

Problems with Your Antivirus

Courtesy of Norton Community blog

Even if you have applications that have been recently updated, they may have problems with Norton AV is incompatible and I had to uninstall and reinstall TrendMicro on one of my systems). I also had some problems with the Cloud service app, Google Drive. Plus, you will have to learn how to navigate the new "Start Button" interface and you will to have hunt down tried and true functions like the control panel. You will have to fumble through until you go through some of the provided Microsoft tutorials or you set up and start using Cortana. It's supposed to be able to fetch everything for you via voice or typed command. Windows 10. You will probably have to reinstall some things like your antivirus applications (current version of

More bad news – Microsoft has killed off Windows RT on its tablets, which means these platforms will not be eligible for a Windows 10 upgrade, essentially rendering these tools as dead end products. Also Windows 10 will not work with Windows Media Center and there is no Windows 10 phone upgrade either at this point. Finally, if you have old hardware and are using old drivers for out of date hardware products, you may be out of luck with Windows 10. Some may run in compatibility mode, but many will not.

Courtesy of ComputerWorld.com

Michael Horowitz article, Defensive Computing in COMPUTERWORLD states “The press likes to focus on shiny new things and the shiny thing of the moment is Windows 10. It's not only new, it's free (if you already have Windows 7 or 8) and it has a bunch of new features. Who could resist? Hopefully, you. Jumping on the Windows 10 bandwagon, now, would be a mistake. “

“The most obvious reason is that the system will ship with a ton of bugs. Not to pick on Microsoft or Windows specifically, all major releases of an operating system are buggy as heck when they are first released. If you want to test out the new features on a system devoted to testing, fine. But the Defensive Computing thing to do is to avoid any new OS for quite a while. Let others be the guinea pigs.”

So is there anything good to say about Windows 10? Is it worth the price of admission? Is Free, really free? The answer is yes and no!

The Good

What's the good news so far? Windows 10 is much closer to the much beloved Windows 7. It will allow most to fumble their way to get around, get started and get most things done without any training. If you have been diligent about keeping your software and hardware up to date, you will have few if any problems with Windows 10. The older your technology the more issues you will encounter.

Windows 10 appears to be much faster than Windows 7. Windows 10, like earlier versions of Windows has a compatibility mode. Many older programs will run in this compatibility mode, allowing you to keep your investment a little longer.

C/net had a good short video that provides a quick overview of some of the new features that I think is worth checking out. It shows you the new “Start Button", the new "Snap" feature, the enhanced "Taskbar button", the new "Virtual Desktop" feature and the new "Action Center". Click here to check it out.

Check out some of the many new features in Windows 10 from ZolloTech

Also, its new security features (the four digit pin and others) could improve security, something much needed today with all the hack fests going on. If its new digital assistant (Cortana) lives up to the hype, it will make it much easier for new comers to learn and use the many features of windows. It will also allow seasoned user to find their favorite Windows tools and apps. I also like the fact that the tiles are now more customizable and designed for both tablets (touch screen) and keyboard users. Another new feature is that windows has provided some free tutorials to help you make the transition to Windows 10. The new cloud enabled features will make utilizing cloud services easier (at least Microsoft’s OneDrive service). Also, these services are tightly integrated with Microsoft’s Office 365, which has shown itself to be a great product. I got the pleasure of listening to one of Microsoft’s evangelistic reps at the Jacksonville Server Group meeting (aka JaxFlSG) the other evening and he hinted that this upgrade is in tune with Microsoft long-term strategy of utilizing “the cloud” for maximum benefit.

If you are new to Windows or are buying a new PC, Windows 10 will be a much better choice than buying a PC with Windows 8 or 8.1. Also, all new Windows PCs with Windows 8.1 will allow for an upgrade to Windows 10 for up to a year from the launch date. As for upgrading your Windows 7 PC that you’re happy with, I concur with Michael Howrowitz. It's better to wait awhile (say 3 to 6 months) before you decide to enter into this adventure.

Courtesy of en.wikipedia.org

I have survived every Microsoft OS launch since the beginning. I started using, working on and selling microcomputers in 1979. I have witnessed the launch of DOS version one and every other Microsoft launch since then. Every new OS has bugs. Some launches are better than others (Windows Millennium, Vista and 8.0 were bad – Windows 3.0 and XP and yes Windows 10 are pretty good). This launch has its share of issues, but it's better than most of Microsoft’s OS launches. Even if you take into account the many software issues mentioned earlier, I rate this upgrade as one of Microsoft’s best. In the long term this product should make most users happy.

The Future

I think the future is bright for Microsoft, even though this new Microsoft Cloud-enabled OS is a little dark right now, it does have a silver lining. As a matter of fact, I already got my first update.

In this article, I explored Microsoft’s latest OS incarnation – Windows 10. I talked about many of the new features, but most importantly, I shared my experiences with upgrading some of our computer systems to Windows 10. This article shares our full story – uncensored, providing the good, the bad and the ugly of the Windows 10 OS launch and offer suggestions for your next upgrade.

You can find more articles about computers and technology by entering “those phrases in the search box, at the top of this blog. I also recommend reading the “Tablet Wars - Choosing Your Battles is What it Takes to Win the War”, "Browser Wars – Then and Now" and “When Will Computers Out Think You?” just to name a few. Thanks for sharing your valuable time with us.

That's my opinion, I look forward to hearing yours.

If you'd like a free copy of our eBook, "Internet Marketing Tips for the 21st Century," please fill in the form below and we'll email it to you. Your information is always kept private and is never sold.

Hector Cisneros is COO and director of Social Media Marketing at Working the Web to Win, an award-winning Internet marketing company based in Jacksonville, Florida. He is also co-host of the weekly Internet radio show, "Working the Web To Win" on BlogTalkRadio.com, which airs every Tuesday at 4 p.m. Eastern. Hector is a syndicated writer and published author of “60 Seconds to Success.”

Courtesy of en.wikipedia.org

By Carl Weiss

As healthcare grows ever more expensive and complicated, more and more people are turning to the Internet for everything from diagnosis to treatment options. More telling still is the fact that doctors are also using the web for everything from consultation to telesurgery. Even computer giant IBM has anted up, retooling their Jeopardy winning Watson computer into Dr. Watson the diagnostician. For those of us who lead active lives, not to mention the mobility impaired, turning to the doc in the “eBox” can not only save time, but lives.

Is putting the e in the doc’s inbox, helping or hurting Americans?

Whether it’s to order non-prescription drugs, diagnose what ails us, or get the lowdown on practitioners, the web is rapidly becoming to go to resource for medical issues. With malpractice in this country at an all-time high, who can blame the public for doing their homework online? The problem for physicians is that while they have a medical degree, patients and parents do not.

From a special report aired by TV station WVVA entitled: E-medicine, helping or hurting?

Courtesy of it.wikipedia.org/wiki/Telemedicina

"We have a lot of patients who have done their homework. They have concerns. They've done the research and when they come in, they have solid information and questions. Very often, the patient may be right. They may say, I'm worried my child has this, and sometimes, they're dead on," said Rainbow Pediatrics physician John Fernald.

But sometimes, they're dead wrong. The most common mistake Fernald sees are patients who quit necessary medications after reading about a rare side effect. "Every patient is different. And for your child, the benefits may very well outweigh the risks."

Check out the video at: http://www.wvva.com/story/29589613/2015/07/20/when-to-call-the-doctor-health-experts-issue-warning-as-more-americans-turn-to-the-internet-for-answers

The report goes on to state that while 60% of Americans now use the Internet for self-diagnosis, 40% never follow up with a trip to the doctor’s office. This can lead to misdiagnosis, mistreatment, complications and possibly death.

Not What the Doctor Ordered

Even worse is the public proclivity to order pharmaceuticals online. While taking the wrong medication is dangerous enough, the National Association of Boards of Pharmacy (NABP) reports that thousands of websites distribute illegal or even counterfeit drugs. A press release on PRWire reported that;

NABP has reviewed over 11,000 Internet drug outlets, finding that 96.13% of the sites reviewed operate out of compliance with US pharmacy laws and practice standards, and identifying these sites as "Not Recommended." Approximately 85% of Not Recommended sites are selling prescription drugs without requiring a valid prescription. Nearly 50%, offer drugs that are either foreign, or not approved by the US Food and Drug Administration. Further, of the 10,588 Not Recommended sites, 87% can be traced to affiliate networks of rogue Internet drug outlets.

If you have ever ordered a drug online, what you need to ask yourself is whether you are absolutely certain that what you received in the mail was what you paid for. The US along with Great Britain and China have recently cracked down on Internet “drugstores” that were selling everything from fake weight loss pills to bogus cancer drugs. A sweep by Interpol netted 156 arrests in 115 countries, which resulted in a whopping 51 million Euros worth of fake pharmaceuticals being confiscated. Interpol reported that organized criminal networks were switching from dealing in illicit drugs to manufacturing and distributing fake pharma, since the penalties are far less if they are caught and the profits are as good or better.

Return of the House Call

Courtesy of littleblackbagmed.com/

That being said, legitimate medical practitioners are taking advantage of a number of niches being created by the Internet. A number of physicians, nurses and other medical professional are embracing the Home Health movement, offering everything from in-home therapy and treatment to the return of the house call. Many large metropolitan areas around the country have physicians that offer in-home care. After Googling “House Calls Jacksonville, FL,” I found a handful of practitioners, including one called Little Black Bag Medical. Their homepage offers the following:

Although it may seem anachronistic, physicians seeing sick patients in their homes is quite natural. It was only in the past 50 years with increasing large pieces of technology and insurance pressures on physicians to see more patients that house call medicine disappeared. Now, thanks to miniaturization of technology and increasing desire of patients to have more meaningful time and relationship with their doctors, House Calls are back. http://www.littleblackbagmed.com/

Not only is home healthcare more convenient for people who lead busy lives, the elderly and the mobility challenged, it’s a highly profitable business for those who practice it. In an April 2013 report by ABC News titled, “Boom predicted for At-Home Industry,” it was reported that,

Watch it on abcnews.go.com

The BLS's Occupational Outlook Handbook says the median yearly pay for home health and personal care aides is $20,170 ($9.70 an hour). That's less than the rate for other personal care and service workers ($20,420) and well below the median for all occupations ($33,840). But though the pay may be low, so are the barriers to entry: a starting job requires "less than high school," says the Handbook.

The report goes on to say that by 2020, the ranks of home healthcare workers is expected to swell by more than 1.3 million. That’s the good news. The bad news is that Medicare typically picks up none of home healthcare expenses and Medicaid only picks up some, providing that the provider is Medicaid certified. However the added out-of-pocket expense has to be taken with a grain of salt. According to ABC News, while the cost of having a part-time home healthcare worker can average $18,000 per annum, the typical cost for full-time nursing home care runs $70,000 per year or more.
That doesn’t mean that other major players aren’t itching to get into the healthcare business. The birth of the Internet of Things (IoT) is already a multibillion dollar industry with everything from medical devices to wearables that monitor vital signs. According to Dr. Safavi of Accenture, “

“The technology that allows us to sense the human body is being used in two ways. Part of it is for general fitness and awareness and part of it is really deeply connected to biological care.

Courtesy of siliconrepublic.com

“For example, there is a very specific electronic device that is put on a pill and when you ingest it the digestion sets off a small wave that allows you to know the pill has been ingested. That is used to monitor patients with serious conditions to figure out if they are taking their medicine.

“Then you have the Apple Watch on the other side which a healthy person might wear to monitor sleep or activity and have no input to a doctor.” https://www.siliconrepublic.com/machines/2015/07/31/iot-could-be-the-right-medicine-says-accentures-health-chief-video

More to the point, where much of modern medicine is concerned with treating illness, IoT devices are being used by the public to stay healthy and avoid winding up in either the doctor’s office or the hospital. Today’s healthcare practitioners, including those who labor in hospitals are using Internet technology to remotely monitor and in some cases treat their patients.

Is There a Doctor in the Mouse?

Even more incredible is the fact that a doctor can be a dozen, hundreds or even thousands of miles away, and still be called upon to diagnose disease with new Telepresence devices such as the TouchHealthRP-71 Telepresence robot pictured below.

Unlike typical videoconference screens, the RP-71provides physicians with mobility enough to make the rounds at a busy clinic or hospital. Even better is the fact that patients can see, hear and interact with the doctor. This allows physicians to work at a number of far flung locations during the same day. Until recently, organizations like Doctors Without Borders were the only way in which many people in the Third World could receive advanced medical care. This necessitated a number of physicians to uproot themselves to fly onto foreign and sometimes hostile shores in order to treat patients. With advances in Telepresence and telesurgery robots it is now possible for US doctors to diagnose, treat and if necessary operate on patients around the world without having to leave town.

Dr Watson - Courtesy of cio-today.com

Recently, a new class of artificially intelligent computer has begun assisting doctors in diagnosing disease. IBM’s Watson, famous for beating the world’s best human players on the game show Jeopardy, has been repurposed to serve the healthcare industry. In a July 30 blog by CIO Today entitled, “Dr. Watson Will See You Now,” Watson is being re-tasked to assist healthcare professionals and insurance providers to better diagnose and treat chronic disease. What gives Watson a technological leg up is that unlike humans, he has the capability of sorting through and comparing millions of pieces of data in order to arrive at a clinical decision. Also, unlike human clinicians, Watson is cloud-based, which means that he, unlike busy pathologists is available 24/7 anywhere in the world he is needed.

Of course, with every technological advantage there is a complimentary disadvantage. Like any other computer-based system, Watson, as well as telesurgery and Telepresence robots, along with web-enabled medical devices such as patient monitors, surgical devices and defibrillators are subject to hacking. As far back as 2013 the FDA issued warnings tomedical device makers to beef up their cybersecurity.

Love it or hate it, the Internet has become an integral part of modern healthcare. With the costs of healthcare rising much faster than wages, technology might just be the shot in the arm that will make medical care available to one and all. Either way, just like the mythical genie of lore, once out of the bottle it will be all but impossible to put the “eDoc” back in the box.

In this article I have discussed how telemedicine is changing the way healthcare is being deliver in the US and around the world. New developments in remote medical monitoring, devices and software are having a positive impact helping lower medical care cost. Like all technologies, these are double edged swords, they can help to cut cost but also bringing vulnerabilities as well. Even the use of AI software like Dr. Watson is proving to be a big help. The future of Telemedicine is changing rapidly and will have long term implications that cannot be undone.