Is Brexit a Total Con? And can we Rise Up and be a Nation of Small Shopkeepers Again?

If so, we better get a move on… before we have no shops left that ordinary people can afford to shop in..

Apparently, Napoleon never said his ill-fated and probably correct remark above. The phrase was first used in an offensive sense by the French revolutionary Bertrand Barère de Vieuzac on June 11, 1794 in a speech to the National Convention.

But it’s true nonetheless. The secret sauce of the commercial success of England – is down to to the innate work ethic of ordinary British people, building their little businesses, into larger businesses.

And yet, if you believe the analysis on last night’s UK TV – the Brexit vote to Leave will not deliver, and has never been designed to deliver – the protection and job security for the masses. It will create precisely the opposite, where the very rich become even richer – at the expense of the middle class, who will become lower class, and (as seen on this programme) – Local Councils will no longer be able to afford to house their poorer residents, the single mums, the people who have fallen on hard times, the homeless. The non-availability of affordable housing for our sons and daughters, is a key plank of strategy for enticing very rich non Dom residents not the UK, with the now proven fallacy that their wealth will trickle down to the rest of us.

Because the fact is – no it won’t, and no it doesn’t. In reality it is the opposite. Unless you are very lucky, and happen to work in the key financial and legal sectors, our hard work for the larger corporations or the coffee shops and public services, – simply serves to enlarge the financial gap.

This is due to the fact that non Doms are placing their money into property, at ever increasing prices, – because it is a sound investment – but it takes that property and available pricing, away from the middle class on which Britain depends. Similarly, the low or negligible tax regime, only benefits those who can afford to exploit it. The rest of us don’t have the money to do so.

So why Brexit?

Because the Leave campaign of Brexit is financed by the very high net worth individuals we have discussed above. Leaving the EU will remove us from the social protection that is Europe. In fostering a climate of low taxation, we are deliberately supporting the very people whose interests is theirs, but not those of the UK.

In short, the lower and middle classes who voted to leave – far from voting to protect their jobs, have voted to ensure their own demise.

A key and well referenced Article by Anna Williams, explains this in a nutshell;

https://tweetydoesdemocracy.wordpress.com/2017/03/02/welcome-to-new-britannia-our-green-pleasant-land/

This has gone way beyond simple envy or jealousy. This is now about the key attributes of our valued psyche, the reason that ordinary people still love to come here. The day that only the very rich people can afford to shop in our West End playgrounds of boutique labels, will be too late for our next generation, on whose income we depend for our pensions and other social costs.

The question is – as we walk by the streets of empty shops in all of our local High Streets – is how long will it take us, to understand this Con. Or are we the victims of Fake News indeed!

The Importance of Accurate Data!

We look at the upcoming NCQA’s Digital Quality Summit
 – Using technology to increase quality reporting and reduce the burden of data collection

WASHINGTON, DC— The Digital Quality Summit comprises highly interactive working sessions within three tracks. Attendees will work in teams to solve data challenges using specific quality measures as a use case to demonstrate successful interoperability solutions. Participants will understand how information technology can be used to increase the efficiency of quality reporting and reduce the burden of data collection. In addition, they will engage in hands-on demonstrations for efficiently extracting data for quality reporting.

WHAT: This is not the typical conference of presentations and PowerPoint slides: This is a summit. Plan for interactive work sessions, networking with peers and hands-on demonstrations. Teams will work with specific quality measures to solve data challenges and demonstrate solutions. Attendees will learn how IT can increase the efficiency of quality reporting and reduce the burden of data collection.

WHO:
The Summit convenes quality improvement stakeholders including senior decision makers, measure development experts, clinicians, government agencies, public health officials, data intermediaries, vendors, and payers to advance measure interoperability solutions.

WHEN:
November 1 and 2, 2017. Click here for schedule.

WHERE:
Omni Shoreham Hotel, 2500 Calvert Street NW, Washington, District of Columbia 20008

REGISTER:
Email Ben Hamlin for Media Registration: Hamlin@ncqa.org. Ben is also the Point of Contact during the Summit, please email him directly or call his cell: 240-423-9126 with any questions.

Why is friendship so difficult?

We look at why do your European friends desert you when you need them most?

There’s this girl I know, she found me on Facebook. I don’t know why. She invites me to be her « friend ». I don’t have a problem with that, so sure, I say, why not. Who are you? Tell you what, (I say) – give me your phone number and we can have a chat.

“No, sorry, (she says) – I only give my number to my friends.“

My colleague in Vilnius Lithuania, is connected. A very smart guy. He calls me and says, « you know what I am hearing Richard? The rumours here are that the local EU people are aiming to make it as hard as possible for the UK to leave the EU with anything much – a sort of deterrent to stop any other countries from following suit. ».

This is not alas the first time we have heard these stories. So, at a time when British troops and planes are currently defending the space of all of the Baltic States – and are committed to continue – what is it about friendship that can be so one-sided? True friendship is a rare thing.

The problem is this. If your « friends » do not support you when you are down – and the UK is in a « down » place at the moment – then what was the point of the relationship in the first place? And it is self perpetuating, because it means that for people like me – who voted absolutely to Remain in our fateful Referendum, and who was not taken in by the lies and total myopia of our Leave cousins – I am now – dare I say these awful words, wash your mouth out Richard – thinking; hey, maybe we are indeed better off out of this Club. They can keep their ball. We don’t want to play any more.

And then you start to think.

The UK culture is at its best when we are in a tight spot. We are an island mentality. Somehow or other, against all the odds (goes the romantic story…)… we somehow survive and keep the home fires burning. We love it when life is unfair. It offends our innate tolerance and sense of fairplay. You don’t need any more motivation that this.

And for sure, the good people of Scotland have already worked out they will sell gallons more whisky if they don’t have to abide by EU rules. And down in Devon/Cornwall, our fishermen and farmers are similarly upbeat. Somehow or other, we have generated a revenue stream that provides for all of us, with quality of life, and that remains a Mecca for immigrants who prefer to set up camp at Calais rather than stop en route a Lille or the tech hubs of Valenciennes nearby.

Which makes me suggest that the guys who do the currency exchange forecasts etc, have got it rather wrong. Now is a great time to invest in the UK, as this is the very time we take off our jacket and actually do some work.

But it is also a strategic time for the colleagues of the EU to reconsider their approach. Your « friend » will have a much bigger chance of coming back, in prodigal son style, if you support them when they leave. And make no mistake, the EU needs Uk money for its grandiose schemes. In the same way that you and I will never shop again at the store that refuses us a refund – so at the end of a hostile Brexit, there is fat chance of us ever wanting to to get back into a relationship with these robbers who have stolen our ball.

That would be a pity for all of us – but then again, it might not. True friendship is a rare thing. In the words of that great Corrs song – Maybe we never liked them anyway.

————

 

Why is paying money – so difficult?

We look at the upcoming keynote conference discussions at Trustech, and ask; do we really need another hotel trip?

I happen to know Copenhagen Airport better than most people who even live in Denmark. I have never been into Copenhagen tho. Business trips are what they are. They are not Tourist trips. Then again – some things need to be discussed, face to face.

For those of us not connected with the intricacies and practicalities and sheer volume, of international payments, how our buying and selling gets sorted out corporatively – then the idea of listening to several of Europe’s leading experts on “payments”, who will be speaking between the 28th-30th November in Cannes – seems a bit unnecessary. A luxury. A junket for jobs for the boys.

The simplistic view is that, well, we all use our contactless card and our Apple Pay, and it all works ok – so what’s there not to love? Why is it all so difficult?

This is not so naive as it sounds, and there are two issues here.
The first is that the absolute importance of making sure payments and money transfers, actually “work” in volume, is essential for any Bank. As one Bank Director told me – “the last thing we want is for pensioners not to get their Giro every Friday”.

Which means that the legacy systems, on which banks still depend – remain untouched. Despite the awareness of mobile disruption in the established order of things (and both Santander and ING refer to this in their recent Presentations) – there is too much risk involved in going back to one’s roots so to say.
The result is a growing level of complexity, based on traditional architecture alongside a slow step by step toe-in-the-water approach to change. This works against what the market – the ordinary guy in the street – is experiencing and now demanding. As life in general becomes more and personalised, in healthcare provision, retail offering, etc – we expect things to “work”, at our own personal level, using the toys we have in our hand.

So when Banks talk about losing their brand identity and perceived value – this is what they mean.

And it creates a problem, because there are just too many individualistic players. There are too many multi-levels of players in the whole process of simply buying a train ticket. Which means that – if there is indeed a problem in the process – well, who is to blame and at what point?

The one thing that banks cannot afford is the risk of failure – but that in itself misses the point, because we are equating “personal transaction – with “corporate transaction”. And whilst Banks accept the way things are going – there is a fear factor in actually “doing something” and throwing out the old and truly embracing the new.

But customers themselves don’t see it that way. Whilst we absolutely “get” that in the big high volume world, there need to be proven systems, and if they are old – but they work – well, where is the problem? – We also absolutely “get” that if at a personal level, we want to be cool and use our smart individual Toys, then we will balance that risk with the state of the art benefit.

So what’s the answer?

It is not necessarily the disruptive rise of the Neo Banks, because their own lifespan and implicit credibility is still too young and under review.

In short – the fear of losing brand awareness is actually the reverse; Those banks that do not live at the cutting edge at a personal level – which is where the increasing volume of personal business exists, and which drives corporate business – are losing their raison d’être because they are not visible.

The fact is, disruptive “mobile” technology – is here to stay. So; in that spirit if we “get” that mobile technology is the way things are going – then why the Conference? Why not just do everything on Skype? Well then again – somethings just have to be said – face to face. At least I’m not travelling via CPH.

American View of the World

We look at the misunderstanding of Western Media towards the Trump Presidency.

I am having breakfast in an airport hotel just outside Hartfield Atlanta airport, and the middle aged man a few seats away, leans over and offers his hand.

“Hi, I’m Dave”. He says; he is one of the many Delta pilots who regularly stay at this hotel – their Training Centre is just a few blocks away. And we start talking. The man is clearly educated, middle class, and well travelled. And then he says something strategic; “it is not what Trump is doing, that is bad – it is his delivery”.

And we open along discussion that goes way beyond the waffles and bacon and eggs. We explore every avenue of American life, and how our civilised media, whilst routinely criticising Trump, is missing the essential point that, Trump America is not divided into blue collar rose coloured spectacled workers who long for the good old days, – and the liberal educated white collared Managers on the other. Trump America has its fare share of ordinary people who are looking at what Trump is doing for Americans if not America.

I am sitting on my premium seat from JFK back to London and next to me, my middle aged American offers his hand. He is a financial adviser for a large Bank. And he says; “you know, our medical situation with Obamacare, is so messed up”. Taking each issue in turn – we have six hours to spend – what he says is an enlightenment:

North Korea – America has for twenty years been trying to be the “nice guy”; and it has been misread as a sign of weakness. Trump is the first President to get bombastic and actually do something about it, or give that impression. His speech to the UN was “the best this man has heard”.
Nato Support; – Trump was right to ask Europeans to pay their fair contribution. And my colleague has a point – many European States have grown used to the idea that the rich nations of the world owe them a living.

Immigration – why can’t we have immigrants who apply to settle, in the normal way? My colleague recounts the story of his father in law, who himself fled from Cuba, and waited in line etc, to go through the proper channels. And on we go…

There are various counter arguments to all of this, of course, but the single biggest issue that will conceivably bring down the Trump presidency, is completely missing from my colleague’s philosophy. The Russian connection and Trump does not have any real significance in either of my new friends’ way of seeing things, and the threat to the US democracy and freedom of values and truth, does not figure for them.

How so?

Because Russia is not on their doorstep, and because the USA essentially is a nationalistic mentality, that looks after the rest of us because it sort of has a moral responsibility rather than any absolute obligation. The conspiracy theories that we are well aware of, and believe are true, in our European society, and that US Media bang on about – are simply not getting through to the average and even many levels of the general middle classes of the USA.

So, what to do?

The answer is to keep on portraying the balanced view that we have become used to in Europe, and to include the USA in discussions. We on this side of the Atlantic are far more European than American, but their friendship and levels of reaching out, are the best in the world. As my colleague in Atlanta says; “Welcome to good ol’. Southern Hospitality!”

 

Friendship is a Wonderful Thing

We look at the English National Opera friendship programme, and ask; why did it take us so long to find this?

As concepts go, – friendship is a valued treasure. Apparently, we only have no more than five “real” friends, in our entire life. The people that put up with us, the people where we feel comfortable. It’s an overused term.

There was this girl I used to know, who wanted me to become her “friend” on Facebook. Why sure – I said – tell you what; “ “give me your number and we can have a chat”. “Oh no”, she said; “I only give my number to my friends”.

You could say that friendship, is hard to find. In that case, the ENO Friends Programme, ticks that box. It takes at least six clicks to even start the process of becoming a Member, and that’s assuming you actually know where to start.

But when you get there – it is the best value for money we have found in London. Nowhere else can you have a face to face chat with a West End star, listen to them talk about their work, and get a glass of wine, for no more than a few quid.

It’s an irony because Opera per se has an image of being elitist and rarefied – and yet here I am sitting in my jeans, with other people who are both elegantly dressed and equally laid-back, and we talk and share experience because we value the opportunity to share that experience. It is part of the ENO philosophy of reaching out across cultural boundaries, but it does so in a non-political way. If you value what it does, then you will take the trouble to find it.

The ENO Friends Programme in essence is a meeting of minds. Who needs Facebook anyway?

Better Management of Clinical Appts and Theatre Processes.

We continue our study of better ways to reduce the costs of clinical and theatre processes, and better ways to automate the whole situation. Beatriz Agrana sent us this compelling announcement from Seattle. This is what she says:

The founders of macro-eyes, a machine learning company that personalizes patient care, today announced the introduction of Sibyl, a predictive scheduling solution that cuts the financial and operational impact from patient No-Shows without relying on patient behavior change.

We’ve all called to book a medical appointment to be told that the first available slot is in 5 to 6 weeks. That day, 10 appointments may go empty, even 20; often more. No one shows up to ~15% of all scheduled appointments. At many sites, No-Shows can constitute nearly 40% of appointments. A schedule filled with No-Show appointments prevents the greatest number of patients from accessing the care they need when they need it most.

“No-Shows and lack of optimization in scheduling costs healthcare providers billions, hits morale, strains operations and has implications on care that can cost lives. We developed Sibyl to solve the problem with cutting-edge machine learning and deliver long-needed, massive improvement in cutting the damage from No-Shows. Sibyl is AI that learns when to schedule individual patients to increase utilization overall,” said Benjamin Fels, CEO of macro-eyes. Healthcare is increasingly data-driven, scheduling is not. It’s mission-critical infrastructure, yet the decision-making that determines scheduling doesn’t benefit from data-driven insight or predictive analytics.

Sibyl is a predictive scheduling solution that machine learns the appointment times that are best-fit for both the patient and provider, increasing utilization overall. The software functions as an add-on to existing scheduling systems, showing schedulers appointment recommendations for each patient.

“It’s extremely difficult to change patient behavior,” explains Fels. “Likely the reason No-Shows continue to cost providers >$100B each year. Sibyl offers a proven approach based on solid science. We use patterns in behavior to learn when patients are most likely to show and the mathematics of optimization to build schedules that enable the greatest access to care.”

Sibyl uses macro-eyes core AI, refined over years at leading academic medical centers in NY and California, to analyze appointment histories and thousands of data points across provider, patient, location, time and type of care as well as weather patterns, air quality, traffic and transport data and state and federal data on the region where the care will occur. “The schedule is like a puzzle, and Sibyl is an expert at fitting together the schedule to minimize gaps,” Fels explains.

Sibyl works like x-ray glasses for the calendar, seeing through the chaotic schedule to understand where there are gaps that would otherwise be impossible to see. By integrating predictive analytics with schedule optimization, Sibyl provides a peerless tool for healthcare organizations, improving the bottom line as well as the patient experience.
During the software’s late-stage testing, macro-eyes worked with 20 clinics across the United States to analyze 2 million appointment records. The anonymized records contained reams of information, including scheduled appointment times, but the testing temporarily eliminated whether or not those appointments were kept. Sibyl churned through the records and generated its own recommended schedule. With that done, the real Show/No-Show results were compared side-by-side with Sibyl’s results.

The outcome? Sibyl predicted actual patient outcomes with 76% accuracy. Sibyl incorporated more than 60 factors to build each prediction. The appointment start time, the patient’s age and the zip-code of the clinic were frequently predictive. Sibyl is prediction + optimization. Sibyl demonstrated schedule optimization that would increase utilization by >20% without increasing investment to add hours or providers. For one group of clinics, that would translate to nearly $10 million in revenue.

At least one other scheduling platform exists for clinics and hospitals, but its core algorithms are rules-based. It ascertains an “average patient” profile and then makes recommendations based on this profile rather than learning, adapting, and making ranked predictive recommendations, as Sibyl does. Sibyl delivers the most accurate, effective results of any healthcare scheduling platform on the market.