The Takeaways: Week 41 of 2021

A periodic review of articles, newsletters, and podcasts that I found interesting, inspiring, or otherwise worth remembering.


Melissa Perri, host. Product Thinking. Episode 37: Dear Melissa - Answering Questions About Compromise and Collaboration (October 13, 2021)


Gordon Brander, Subconscious. Saving copies of everything is like low-budget p2p (October 15, 2021)

Hard to excerpt, but includes a very compelling reference to the window afforded by the "extreme user...someone who has a set of needs outside of the mainstream."

Extreme users reveal needs, use-cases, opportunities that everyone might have, but are invisible within mainstream behavior.... [They] can be harbingers... [or] push the boundaries of technologies... Solutions for extreme users will usually work for mainstream users, often better than mainstream designs.

Followed by a rapid turn through the possibilities suggested by an example user who, lacking reliable on-demend access to the Web (at sea!) saves what they need locally.

What if the browser was local-first?

John Cutler, The Beautiful Mess. TMB 42/52: The Integrator Burden (October 13, 2021)

"Management" is well-trodden territory. So is "Influence Without Authority". Even "Managing Up" gets its fair share of books. But we don't discuss connecting, caring, and cohering nearly as much. Part of that is that integration often falls on underrepresented and marginalized groups. These individuals know that organizations are not an idealized Venn diagram of "aligned incentives" glued together by meritocracy. They sense the cracks and the edges and want to help and support, and know if they don't, no one will.

See also: Tanya Reilly, Being Glue

Ted Gioia, The Honest Broker. The Music Critic Who Tried to Disappear (October 15, 2021)

At first glance, the details in a Balliett portrait might seem pointillistic or mere scene-setting—until you realized later how much they had a bearing on music and artistry. In his profile of pianist Dorothy Donegan, he points out how she answers the phone with a “Hello” that hits the note C on the first syllable and rises to a D on the second—something no other journalist would catch, but immediately conveys the subject’s round-the-clock musicality. When Balliett wrote up his encounter with Henry ‘Red’ Allen, he described the trumpeter’s apartment in a yellow-brick building on Prospect Avenue, and their walking up five floors to the family residence, noting that when they got to the top, Allen wasn’t in the least winded—once again a detail others would miss, but signaling in this coy, indirect manner that the portly 58-year-old horn player had lost none of the wind-power necessary to his vocation. After Balliett enthused over the extraordinary view from Marian McPartland’s New York apartment, he made sure you knew that the piano was placed so she wouldn’t face the window. Again, no one else would be paying attention to such a small point, but it conveys in an instant the sober austerity with which the often free-wheeling McPartland (very different in private life from her public persona) adopted when banter ended and the music began.

Chas Roades and Lisa Bielamowicz, MD, The Weekly Gist. October 15, 2021

What we’re more confused by: isn’t achieving back-office scale one of the big reasons hospitals join a larger system? What does it say about health system value if an organization of this size still feels the need to outsource to this extent? Further, if you’re outsourcing your digital platform (i.e., how you engage with patients), care management (how you take care of them) and revenue cycle (how you get paid)—what’s left? The question of how best to leverage scale to deliver value seems to us to be one of the big unresolved issues facing healthcare. Meanwhile, we continue to be awed by the audacity of UHG’s Optum strategy, at least as it appears from our outside perspective: assemble the nation’s largest collection of delivery assets, which, when coupled with the insurance arm, allows you to both compete with and commoditize hospital systems—all the while selling those same hospitals services and data.

Ernie Smith, Tedium. (October 15, 2021)

Were there no nerds on Missouri Gov. Mike Parson’s staff to tell him that HTML is incredibly easy to parse? In that spirit, today I’d like to ponder the democratizing power of HTML, web browsing, and why, if you’ve never done it, you should build a website. Especially if you’re a politician. Better late than never.

Olivia Webb, Acute Condiiton. Why don't Epic and Cerner go all-in on telehealth? (October 14, 2021)

The real answer is that Epic and Cerner have leveraged policy changes and the fundamentals of the market to dig a moat around hospitals so deep that they don’t have to pay attention to major changes on the outside. Epic and Cerner won’t try to compete with Teladoc because they don’t have to. Far from heralding their downfall, Epic and Cerner’s lack of attention to telehealth is a sign of their entrenchment and market power.


Maddie Bender, STAT. 5 health tech startups working to address chronic pain without opioids (October 11, 2021)

Increasingly, startups are trying to address chronic pain with digital health tools like phone apps. They offer physical and psychological treatment such as cognitive behavioral therapy and telehealth counseling, representing a growing consensus that effective pain treatment is multimodal. Their revenue models tend to rely on long-term subscriptions, some of which may be reimbursed by insurance — but many of which won’t be, a potential barrier to their widespread and equitable adoption.

Rebecca Pifer, Healthcare Dive. Best Buy's latest health acquisition builds on plan to expand at-home care (October 12, 2021)

The proportion of care being offered inside the home was increasing even before the coronavirus as the population ages and patients look to address medical needs away from the expensive inpatient setting. But experts say COVID-19 has accelerated the trend, with proponents of at-home care arguing it improves access while reducing downstream costs.

And demand for care delivered in the home is likely to continue, resulting in at-home care startups seeing rising deals and major infusions of cash over the past year and a half.

Diane Selkirk, BBC. An underwater mystery on Canada's coast (October 14, 2021)

[Nancy] Greene, [now a research archaeologist, then an undergraduate anthropology student,] realised that the 150,000 to 200,000 stakes, representing more than 300 fish traps, filled the shallow wetland. Radiocarbon dating placed the ages to range from 1,300 to just more than 100 years old. For [Cory] Frank, [manager of the K'ómoks Guardian Watchmen, a role that oversees all aspects of environmental stewardship for the coastal Nation, ] the most impressive thing about the system is the precision of the designs. "My ancestors were amazing engineers," he said.

He explained that once he started studying how it all worked, he realised the traps are based on a deep knowledge of fish behaviour and the region's large tidal ranges. Laid out in two styles – one heart shaped and one chevron shaped – the traps were lined with removable woven-wood panels that let water through but not the fish. During a rising tide, the fish followed the centreline of the trap, which mimicked the shoreline they'd naturally follow, through an entrance and into the enclosure. When the tide receded; the fish inside the trap were stranded in shallow pools.

Corinna Stukan, Product and Systems. The next evolution of Product Management (September 1, 2020)

With more competition and more choice for the consumer than ever, it’s not enough to just build great products and hope for organic growth or crazy tech valuations. Product Managers will need to become true operators - they need to focus on all parts that are connected with the product to create successful outcomes for the business.