Category Archives: Business

Discussions on Business

UX in a Nutshell – 20 minute talk

This is a talk i gave to the Enterprise UX group in San Francisco at General Assembly on February 19th 2015 . About 100 people in the audience. I spoke about what it takes to create a solid blueprint for hand off to development with PDF examples of real blueprints (i have permission to use).


Healing Autism through the NeuroField

I’ve been very blessed to have limited influence of Autism in my life. Nothing direct outside of a gal-friend who was a teacher in a primarily autistic program. A couple other brushes but nothing intensive. I’ve heard various rumors of potential causes, but the most convincing to me are heavy metals (mercury, etc) in our drinking water. It also probably has quite a bit to do with the overwhelming quantity of vaccines we are giving our children at young ages. But as far as I know, no one knows for sure what causes Autism.

Some years back a colleague, Nick Dogris, who is a neuropsychologist, was working with an apperati called the Lens. The Lens is a biofeedback device developed by Len Ochs, that has the ability to send a pulse to a specific point in the brain. The process included taking a QEEG of the brain and treating one of the 19 points that could show an increase or decrease in the delta, theta, alpha and beta wave patterns. The Lens was proving to have some positive affects on balancing these wave patterns. Since the Lens only had a single rhythm or pulse, Nick wanted to get more out of it. He was stuck in the snow one day and had to rock his truck out of a rut. After pulling out he thought to himself, “I wonder if i can do that with the brain”. Nick proceeded to hack Len’s system (with permission) and came up with several new protocols (or rhythms) which he began testing on current patients. The initial one he called Rocking the Brain.

Nick would chat with me about some of the success he was having with the Lens. Most of the Neurofeedback community were now using his protocols in conjunction with the Lens. One day he and Len were presenting to a room full of MD’s and Therapists in Sonoma (i believe). They had a volunteer patient who Nick had never met. The man was around 40 with a trauma to the head. The patient had very little affect and his mother had brought him. Nick touched his shoulder and had an overwhelming feeling the man had been hit by a truck. The mother confirmed that was exactly what had occurred. After the QEEG, Nick asked Len what they should do, Len said “lets Rock him”. They did, and after a few minutes the man basically opened his eyes and woke up. Cognitive and alert. His mom started crying on the spot.

Around this time Nick and I began discussing his Autistic patients (no personal info, just treatments). He’d mention stories about kids who came in with severe Autism and within a limited number of session they would be on the way to recovery. I wondered how many… he mentioned one current patient was on session 17 and was functioning close to normal. Most symptoms absent and no regression.

I’d catch up with Nick in San Francisco or Los Angeles where we’d sit and talk over a meal about his further experiences and that he had come up with an idea for a new apperati that was completely different than the Lens. Nick had hired a Cal Tech engineer, and was designing both the hardware and software. He asked if i would design a website for his new venture called NeuroField. The NeuroField was a unit and a cap that plugged into a PC allowing the operator the ability to both read all 19 points, map any problem spots then write with far greater ability to the brain that the original Lens unit. I asked, “what are you talking about Nick?” He continued by explaining that the brain basically radiates an electrical field and he had found a way to treat the wave patterns (delta, theta, alpha and beta) through this field via the unit and software he had developed. In most of his patient cases there was either an excess or depletion of one or more of these brain waves. In the QEEG this showed up as a Green (balanced), Red (excess) or Blue (depletion). In preliminary testing, he was able to balance several of his patients in a single session by what he explained as replenishing the field. Not doing anything dangerous, just adding where there wasn’t enough, or offsetting where there was too much. What really hit home for me was when Nick said, “you could have had a trauma at 10 years old, and i could still see it, and treat it as it would show up as red or blue on the brain map“. Not only was he having success with Autism, but PTSD, Depression, Anxiety. Anything that shows up as red or blue he can treat. And most everything  abnormal shows up as something other than green, both Physical and Mental.

So i’m thinking at this point, this guy has the ability to read AND write to the brain. He corrects me but saying he is only treating the field. Ok… the field, got it. i think. I’m starting to think of all the applications for this in terms of design. I’m seeing gestural like crazy, the ability to record thoughts and dreams, a treatment modality in the form of a wi-fi enabled cycle helmet with the 19pt cap installed on sale for $19.95 at every pharmacy, endless possibilities in my mind, but as usual… totally cart before the horse.

During this time Nick was starting to sell and train doctors and therapists. In the first few weeks of managing his site, i was adding to the provider directory daily. That means he was selling units daily. Trainings across the country started, and later internationally at the ISNR and Neurofeedback conferences. The leaders of the time finally started to recognize Nick as a champion, and inventor responsible for a tool that could potentially change Neurofeedback treatment in general.

So what about Healing Autism? We discussed the Lens in a former treatment example but it wasn’t until the last time that i saw Nick that i realized how well the NeuroField was benefitting his patients. I went to visit Nick in Bishop, CA to get my own treatment (which i do a couple times a year for concentration – I deplete delta at a high rate and the re-energization helps bring my concentration levels back to optimal). We had dinner and he was telling me about a very prominent guy outside of the US that asked him out to dinner after Nick spoke at an international conference about the treatment. Over dinner they spoke for about 30 minutes before the man dropped the bomb, “My son is Autistic and i would like you to treat him tomorrow”. Nick showed up and met the boy who was “Autistic”. Nick met then calmed him down to some degree, put the cap on the boy then gave him an initial shot of NF. The boy was calm in a few moments. I believe Nick administered the QEEG then hit him again. The boy looked up and said to his dad in an even and calm tone, “Dad, can we go for a bike ride after this”? I’m not saying its a one time fix, but i am stating that after following the progression of this treatment for some years, it is undeniable what possibilities are sitting here for behavioral health, and the field of medicine (if big pharma doesn’t try to squash it first).

In May 2014 NeuroField was awarded FDA approval and is now a registered medical device.

The design of electronic clinics (introduction)

This is the introduction for a book i have been working on for some time. The content is fairly fleshed out and will be posting chapters with some regularity. The overall concept is that we come from a brick and mortar society. The companies designing for this mildly new medium of bringing healthcare and other services online may be approaching this from the wrong direction. Although Electronic Medical Records are critical, it is the interaction between the providers and patients that is central to the information that goes into the record. A central space where people can meet with their providers is still lacking sorely, and there is a huge underserved population that is rural, time constrained, and or uninsured (also take into account the agoraphobics).


The Mayo Clinic was the first institution to implement paper health records in the late 1800s, they were also first to implement Electronic Medical Records (EMRs) into their clinical system about a century later. During this period both private and public institutions began designing and developing their own EMR systems, which in turn created widespread incompatibilities, lack of standardization, and functional failures. These issues and the fact that EHRs have been improperly prioritized over patient care continue to hamper progress in developing successful Electronic Health Clinics (EHCs).

A better way to approach the issue of online care delivery is to first build an EHC and then integrate the EMR into the system. Approaching the EMR as a component and focusing on customer experience though interaction design and strategic information architecture allows project teams to deliver a far more pleasant, effective and repeatable clinical experience.

This set of posts will provide an overview of the electronic healthcare industry, why progress has been slow as well as some best practices used when designing EHCs – from working with the appropriate development model to building components such as sessions, profiles, scheduling and billing.

A note to Marissa Mayer with a potential fix for Yahoo!

I recently read that Marissa Mayer was planning to focus her efforts on Yahoo’s home page. I understand she was the gatekeeper at Google for years, protecting the branding of their home page. That’s a great responsibility  But I’m not sold on the fact that redesigning Yahoos home is the path to success for the company. Search is one of their core strengths but Yahoo has some big issues. Outside of floundering for years, most people could care less if the actual site went away. We all have our fav widgets. I use the finance section to track my stocks, the IM (which never works just right) and mail for my junk. Other users I’m sure have their fav parts as well but the value just isn’t there at the moment.

What could Yahoo do to get people to come and use it in force? Give people a compelling reason to return because they want to, not just because they have something that is convenient and free. On top of that challenge, what could the company do to create a stream of revenue so solid, it would bolster the stock value and add value for its users?

In the late 90’s I had an idea to open an online mental health clinic. This was my first dive into User Experience, wire-framing and working with developers directly (outside of some website design work I was doing and managing). At the time i was a clinic administrator at UCSF so understood clinical workflow. Designing an online clinic was challenging but it was a matter of figuring out how the workflow differed from a physical clinic and transposing that into a virtual environment.

The effort took about 5 years front to back including domain registration, initial wires, finding a developer and a business partner. I wont get into the thick of it, but starting a service based self-facilitation clinic where therapists could sign up, and post a profile, specialties, and pricing for 15, 30, and 60 minutes sessions was half the battle. Bringing in visitors was the second challenge. I spent a lot of time on Ad Words and in mid 2004 started driving a ton of traffic in. The site hit profitability in mid 05 and we closed early in 2006 due to some unforeseen liability issues and nowhere near enough legal backing or funding for it. The secret most people don’t know about health care online is that there are a lot of crazy’s out there and they want to blame you for all of their problems.

Reflecting on that experience i realized a couple things about business. First off, there are very few places you can get solid advice online or at least at that time there were only a handful (Keen, Kasamba, and About).

Services aren’t easy but they are rewarding for all participants (providing the service provider is offering an affordable, easy to access, easy to use solution). Bringing services that require no physical support online (i.e. law, mental health, golf advice, astrology, etc) are prime if served via the right interface.

In the case of Yahoo, they have a huge customer base, or at least a semi-regular user base. Mrs. Mayer is focusing on the home page but we know now that it’s all about the landing page. Getting people from point A to G with the least steps possible is critical to a sites and businesses success.

If Yahoo became a service provider with an agnostic self-facilitation tool (imagine Amazon product pages for a service), they could basically write a new chapter. And Marissa would not be off-base in focusing on the home page. That could be a conduit to the service providers.

Now you’re asking… how do they make a profit?

Service providers charge a fee for their service offering. At our online mental health clinic we took 25% of all transactions, and cut a check end of month. 2 things have changed since 2005. Money is much easier to transact, and more people have high-speed connections. Yahoo could create an interface for facilitating (a listing of providers for a certain domain in list and grid format) with excellent yet simple elegant filtering. “I want to talk to a lawyer for 15 minutes, and i have $25 to offer”. Natural language search right off Mrs. Mayer’s new home page takes you to a list of just those providers with contextual filtering. Then once they pay off some debt, and get some money in the bank??

Become a financial institution where the providers can access their cash, and either use it for purchases through Yahoo (where Yahoo gets a kick back), leave it in the bank where Yahoo makes interest, or pull it. Yahoo in turn creates greater financial stability and gives back to the community of not only its service providers and merchants, but also the users that have for so long hoped in the back of their minds that Yahoo might potentially become a destination again.

A Message to Mark Zuckerberg via Nate Bolt Regarding Marketing and Facebook

I attended an IxDA all star usability discussion this week over at Yelp. The MC was Nate Bolt who is a usability manager over at Facebook. For the past several months I’ve wanted to write two letters. One to Mark Z, and one to Marissa Mayer. Both of these letters are thoughts on what I believe could change the course of how Facebook and Yahoo Interact with the public, potentially creating better relations between you and the company, and create great profitability. I’ve been procrastinating, busy working days and studying in the evenings, but… this connect to Nate seemed like a great way to break the ice on an idea I’ve had to change how Facebook negotiates ads with us.

For starters, its no secret that at its core, Facebook is an advertising agency. Actually its more of a publisher but I keep hearing people call it an ad agency. I’m still on the fence. But if they are, they are one of the few places in the world that are truly both an Agency and a Publishing space.

Lets do a brief review of how marketing works.

Marketing has 2 sides:

1. Publishers are those with space for sale including magazines, radio, TV, website with ad space, billboards, etc.

2. Advertisers are the people who want to buy that space.

3. I said two but there is a third party called the Media Buyer. These are the middle men who buy lots of Pub space and sell to the Advertisers at a premium, or via their “service” which allows them to bundle these in tiers (1, 2, 3 usually, with 1 being great prime time and position, and 3 being that 2-6AM time slot).

One of my passions is designing Advertiser Interfaces. These would include Campaign managers, Ad Creation and Modification tools, and especially self-service product creation and campaign management dashboards. The key word here is “Self-Service”. There just aren’t any out there that work and handle the Media Buyer role properly. I’ve got three under my belt. One didn’t go into production, but was an awesome experience. One for Quantcast was a 2 week under-supported effort around the holidays in 2008, therefore a fail. The other one is in process. We’ll see if it goes anywhere. Its all about funding the dev portion.

So i at times think about Advertising in my sleep. It would make sense that I’d think about the way to cut out the Media Buyer and make it all just work. Sad as it is, I’ve done so many interviews with Media Buyers, i know i could cut them out of the deal. And to design the ultimate Marketing and Publisher Dashboard, I’d do it. How would i do it? Its all about the API feeds

So what does this have to do with Facebook, Mark Zuckerberg, and Nate Bolt?

One of my recurring dreams (both day and night) has to do with Facebook’s inability to get prognostic results (Ads and Deals) to their people. Yes, you and the other Billion members. They know more about you only shy of your bank. If your bank served you ads, they’d be Spot On. Because they know your spends. But Facebook doesn’t have that info yet. They know what you like to some degree; what your friends like to some degree, prob your DOB, and several other items that set them way ahead of the curve. However They have yet to serve me an Ad in 6 years that I’m willing to act on. Facebook Ads have a 0% conversion ratio with me. And I’m guessing a ton of other people share similar results. Sad but true. So how do we fix this and make it both beneficial for the user and the site owners? How do we make Facebook the first true Publisher that really, really gets what we want to us and just in time?

Here is what I suggested to Nate on Wednesday.

Create and interface that allows users to interact with advertisers directly by setting their preferences. Make it simple. Model it on Netflix but gamify it.  Let people scroll through rows of items in each vertical such as: Clothes, Electronics, Cars, whatever. As long as the brands are specific to the user or user friends interests. Do you remember your first time (and second and third) using the Netflix preference section? The one where you side scrolled through and rated movies? Yes that one, with the stars? Create that for us and make it fun. We’d probably use it with some regularity  That way you could gather our data passively, but also activate us. This creates a relationship between your users and your company. This is something Facebook doesn’t really have right now, and its sad. They tried some years ago to create a direct conduit to the Dev team, but I’m not sure where that really went. Dodo.

Engage us. Create something great that allows us to swipe through products and give them a grade. If you’re afraid of using stars, then use ABCDF. Maybe a  –   +  scale we slide on each one. No need to save, its all in HTML5. Done Asynchronously. Netflix did a great job here with movie prefs, but Facebook can potentially secure their spot as the greatest Publisher in the world. When they get a certain amount of hits for a certain product, they start buying that product and offer a deal on it to those individuals that graded it highly. However they serve that is beyond the scope of this afternoon, but its a big question.

Can Facebook create a fun and engaging interface that will allow users to engage with the company in a passive/active way, put in their product preferences, helping secure the relationship, finally instilling some trust, and in turn everyone wins?

Nate mentioned… That would need to become a product initiative. I said the idea was a gift.

Next up… A Note to Marissa Mayer. How she can change Yahoo, create profitability and not just focus on the home page.