DISCLAIMER — This article was a class assignment I did during grad school. The assignment was to write a policy briefing note to the provincial Ministry of Health about how to leverage technology to improve outcomes for a specific disease condition in the province. I specifically focused on Heart Failure patients.

PURPOSE

To request operational funding from the Ontario Ministry of Health for scaling ‘Medly’ across hospitals province-wide. Medly is a smartphone-based app used for remote patient monitoring (RPM) and was developed by eHealth Innovation at the University Health Network (UHN) in Toronto¹.

This app empowers patients to self-monitor heart failure (HF) symptoms and connect virtually with their care team as needed¹. Medly is ISO 13485 certified and classified as a Class II medical device by Health Canada for its decision support capabilities². A cardiologist needs to prescribe the use of Medly to a heart failure patient before they can access the tool².

OPTIONS

1. Maintain the current standard of care for HF where most of the clinical care, including routine follow-up care for relatively stable patients, is traditionally offered in person.
2. Provide funding to scale the Medly tool to healthcare institutions across the province that serve HF patients.
3. Provide grants to enable hospital-community-academic partnerships whereby research centers at academic institutions will gather evidence as the solution is deployed provincially.

KEY CONSIDERATIONS

With Option 1, maintaining the status quo is riskier than committing to a meaningful change. For context, HF is the fastest-growing cardiovascular disease in Canada with more than 50,000 new diagnoses each year¹.

Continuing with the current standard of care for HF means most eligible patients will be deprived of access to a powerful RPM technology like Medly that has the potential to make their lives easier. The downstream effects are clear and worsen every day in the form of higher hospital costs, more strain on a short supply of healthcare providers, and worse patient outcomes³.

With Option 2, the barrier to implementation is that there is limited evidence to do a large-scale deployment³. However, there is a growing body of evidence from pilot studies to demonstrate Medly’s efficacy²:

• Improved patient-reported outcomes related to satisfaction and quality of life². 
• The app is user-friendly enough for older adults over 70 years of age to use the platform. Users reported more than an 80% adherence rate with the Medly platform². 
• High probability (90%) of being cost-effective, especially in patients with advanced HF due to a reduction in HF-related hospital readmissions by 50 percent². 
• As a digital therapeutic, Medly is scaling evidence-based clinical care and making it accessible to hundreds of patients currently⁵.

The Medly algorithm makes it possible for a single nurse to manage a patient caseload of 350 patients at a time². Fewer than 1% of the clinical alerts are critical. Most alerts can be self-managed by patients².

In other words, it is alleviating the pressure on providers by extending their reach to a patient when and where they need it. This approach also frees up providers’ capacity to focus on more high-risk patients who truly need in-person care⁵.

With Option 3, the start-up costs and time commitment are high but the long-term success of the project hinges on establishing research partnerships.

An arm’s length and independent team of researchers can guide implementation using evidence and develop best practices for what a successful RPM deployment for HF patients looks like. This can solidify Ontario’s position as a leader in Canada and internationally for innovation in medical research and commercialization.

RECOMMENDATION

Option 2 is recommended with the condition that Option 3 be implemented as part of a long-term strategy to ensure the sustainability of this initiative.

It is important to note the net negative vs net positive impact of this initiative will depend on how it is implemented.

Successful implementation depends on leveraging high-quality evidence. Without ongoing applied research, we cannot generate this evidence. That’s why we need academic partnerships to critically evaluate implementation efforts and highlight blind spots (double-loop learning) so we can course-correct our actions according to the latest data.

CONCLUSION AND NEXT STEPS

HF’s prevalence is reaching epidemic proportions and is compounded by a rapidly aging population and an acute shortage of healthcare workers in Canada⁶.

We need a solution that is going to stretch government dollars and optimize for the quadruple aim of 1) improving patient and caregiver experience, 2) improving the health of populations, 3) reducing per capita cost of healthcare, and 4) improving provider satisfaction².

RPM has great potential to meet these criteria. The good news is that Ontario already has an existing RPM tool in the form of Medly. RPM is a one-to-many model of care that is going to redefine how healthcare is delivered⁵.

If we scale this solution province-wide, it can impact a population of close to a million patients living with heart failure. That’s why operationalizing Medly across hospitals in the province is a critical funding need.

BACKGROUND

Heart failure happens when the human heart is unable to pump adequate blood to meet the body’s needs¹. More than half a million Canadians have an HF diagnosis, and the disease burden is projected to increase⁷. HF has a high mortality rate of 30% within the first year of diagnosis⁷.

Among all patient groups, HF patients have the highest hospital readmission rate within 30 days⁷. Yet, 40% of these readmissions are avoidable⁷. Unnecessary readmissions impose high healthcare costs. In the case of HF, the cost is $2.8 billion per year and represents the third most common reason for hospitalization⁷. Hospital readmissions for HF can be prevented by improving the transition of care from the point of hospital discharge to the patient going home⁷.

RPM technology like Medly can improve HF management by giving patients the ability to stay on top of their health when they measure their daily vitals and symptoms⁷. These measurements are transmitted via Bluetooth to the Medly app⁷. The app algorithm personalizes self-care messages to the patient based on their readings and reported symptoms⁷. If there are signs of clinical deterioration, the app alerts the health provider responsible for the patient’s care⁷.

Clinicians can access patient information in real-time, including historical data and trends on a secure Web dashboard⁷. The provider can then guide the patient remotely when possible, so they don’t have to visit the hospital⁷.

REFERENCES

1. Integrating heart failure care from hospital to home. [Internet]. Medly. [cited 2022Oct21]. Available from: https://medly.ca/

2. Pham Q, Cafazzo J. Developing Digital Therapeutics: The University Health Network Experience. Journal of Commercial Biotechnology. 2022;27(1).

3. Gheorghiu B, Ratchford F. Scaling up the use of remote patient monitoring in Canada. Stud Health Technol Inform. 2015 Jan 1;209:23–6.

4. Boodoo C, Zhang Q, Ross HJ, Alba AC, Laporte A, Seto E. Evaluation of a heart failure telemonitoring program through a microsimulation model: cost-utility analysis. Journal of medical Internet research. 2020 Oct 6;22(10):e18917.

5. Makin S. The emerging world of Digital Therapeutics [Internet]. Nature News. Nature Publishing Group; 2019 [cited 2022Oct21]. Available from: https://www.nature.com/articles/d41586-019-02873-1

6. Oulton JA. The global nursing shortage: an overview of issues and actions. Policy, Politics, & Nursing Practice. 2006 Aug;7(3_suppl):34S-9S

7. Seto E, Ross H, Tibbles A, Wong S, Ware P, Etchells E, Kobulnik J, Chibber T, Poon S. A mobile phone–based telemonitoring program for heart failure patients after an incidence of acute decompensation (Medly-AID): protocol for a randomized controlled trial. JMIR research protocols. 2020 Jan 22;9(1):e15753.

Investment in Digital Therapeutics Like Medly Can Reduce Strain On Hospitals In Ontario was originally published in Health Informatics 101 on Medium, where people are continuing the conversation by highlighting and responding to this story.

“The successful warrior is the average man with laser-like focus” — Bruce Lee

I was getting my coffee order at Starbucks when I saw the above wall.

I went in expecting to enjoy my Cup of Joe but came out with an anxious brain trying to come up with a solid answer to the question —

Which statistic in your lifetime would you be most curious about?

Thanks, Starbucks for giving me a mini-existential crisis!

To be honest, it’s easy to answer a stat that I’d be curious about. It could be anything from the total # of coffees I’ve consumed to the # of places I ended up traveling to.

But if we take this mental exercise a step further, the deeper question that emerges is:

What is the single most important indicator that you define your life by? Put another way, what is your North Star Metric?

Before you try to answer the question, some history to set the context…

The term ‘North Star Metric’ (NSM) draws its origins in Silicon Valley. It was developed to help tech businesses focus on a singular target that can move the needle on accelerating the business so they don’t get distracted by shiny objects. To qualify as a NSM, a metric needs to have 3 components — be measurable, add customer value and drive revenue.

LinkedIn’s NSM is the number of monthly active users.

Quora’s NSM is the number of questions answered.

Airbnb’s NSM is the number of nights booked.

Spotify’s NSM is the amount of time spent listening on the platform.

Zoom’s NSM is the number of weekly hosted meetings.

Amazon’s NSM is the number of active prime subscribers.

To be fair, each NSM usually consists of a subset of metrics. It’s also possible for an organization to have multiple NSMs especially if they have diverse product lines.

But the point of the exercise is to simplify a complex business down to its bare basics. A single indicator that is most predictive of a business’s success. If the NSM indicator doesn’t perform well, it’s a clear sign the business is flatlining or failing to achieve its growth objectives.

Enough business talk. My point in writing this article is to steal the NSM framework from the corporate world and apply it to your personal life. Why? Chances are that if you’re reading this piece, you’re likely an ambitious person who wants to live a meaningful life.

When I tried to answer what is my NSM in life, I felt stumped. It triggered intense journaling about my values, what I want out of life, and my legacy. Unless you already have your life blueprint figured out, this question will likely introduce chaos and deep soul-searching in your world.

Now that I’ve warned you of the side effects, let’s get right into how I figured out my NSM. Perhaps my story can spark some ideas in you.

I subscribe to humanist philosophy. The best way to capture the essence of humanism is by following the ‘Golden Rule’:

‘Treat other people as you’d want to be treated in their situation.’

Said another way, do not treat people badly unless you want the same to happen to you. It’s a basic principle I use to strive to live an ethical life and to minimize burdens on my conscience so I can sleep well at night.

Humanism embodies values like science, reason, service to humanity, empathy, compassion, etc. Humanism is why I’ve intentionally concentrated most of my academic and professional experiences in the healthcare industry.

Healthcare is unique because it’s one of the few industries where you can create a direct social impact that can either save lives or improve the quality of lives of many vulnerable people.

Health is highly personal and intimate. The reality is that every one of us is going to interact with the healthcare system at some point in life. Usually as either a sick patient or a caregiver of a loved one dealing with health challenges.

With that being said, my NSM is the # of lives I’ve impacted positively. Directly and indirectly.

I find the NSM exercise insightful because it can help you determine the single biggest indicator to evaluate your life. This creates a sense of urgency. The urgency to get your life together. The urgency to orient your daily/weekly/monthly actions in service of your NSM. The urgency to track your progress (or lack thereof) and record wins and challenges.

For some, their NSM might be making loads of money.

OR seeking new experiences in life

OR creating and providing for their family

Whatever NSM you choose, realize that it’s going to take decades of blood, sweat, and tears to meaningfully fulfill your mission. The most important ingredient is the ability to develop an obsessive focus to achieve a singular goal and keep going, especially when times are tough.

3 Key Questions to Guide the Search for Your North Star:

1. Imagine yourself at the end of life and ask yourself what would you regret not doing the most.
2. What is the 1 thing(s) that sparks your curiosity, joy, or any other strong emotion? In other words, what fires the neurons in your brain, or what makes you come alive? Go in that direction.
3. Use the Anti-Goals Framework. This is based on the Inversion Principle (read my blog on this here) — What activities or outcomes do you want to avoid in your life? Once this is identified, work backward to determine your course of action to avoid experiencing said unwanted outcomes. Indirectly, this exercise will help you discover what you value most highly and how to optimize your life to live in alignment with those values. Sahil Bloom wrote an excellent blog post describing the ‘Anti-Goals Framework’ that you can read in more detail here.

Personally, the question that truly unlocked my NSM was visualizing my end. I don’t say this to be morbid. I find thinking about death to be a powerful technique to reframe my mindset. Every problem pales in comparison to our impending death.

Few things are certain in life except death.

Logically speaking, everything that has a beginning (birth) will have an end (death). What’s unknown is the amount of time we have between these two points. This in-between limbo period is where we live life.

If I were to die tomorrow or at the ripe old age of 80, I want to have some degree of peace and satisfaction that my actions counted. That I committed to a cause greater than myself, aka, I followed my North Star and dedicated my efforts to getting one step closer to my mission.

What is your NSM? Do you agree or disagree with this approach to life? Tell me in the comments below!

What Is Your North Star Metric? was originally published in Readers Hope on Medium, where people are continuing the conversation by highlighting and responding to this story.

In North America, we have a culture of chronically complaining about everything from the weather to the car we drive, waiting a few extra minutes in line, not getting our Amazon Prime delivery on the same day and many other nonsensical things. #FirstWorldProblems

I’m guilty of doing all of the above. I realized when you live a comfortable existence that 80% of the world’s population can only dream of, it’s easy to take things for granted. It’s easy to get lost in the day-to-day details of your privileged life while forgetting how convenient modern-day Western life is and how things have never been easier.

It’s easy to become victims of our success. It’s easy to become complacent and blame the system at every turn. When we should remind ourselves that surviving a global pandemic and getting to live through these historical, unprecedented times is a miracle. So many people’s lives were cut short tragically. So much potential that was never realized….

Now that we have Western privilege out of the way, let’s get right to the point. No matter how rich, beautiful, or smart you are, at some point, you’ll have to deal with the curveballs that life throws your way. This blog is NOT a prescription by any means but my humble attempt to share how I approach challenging life situations.

When faced with a difficult situation, there are only 2 fundamental options.

Option 1 is to change your attitude, expectations, or actions. This is done by auditing yourself ruthlessly and holding yourself accountable to a higher standard. Get resourceful and find alternative ways to fulfill your needs.

A very hard thing to do since it requires radical honesty and discomfort. But still easier than trying to change someone else.

That’s not to say you should give up on other people or not rely on them. But important to remember that you can teach, share, and influence others all you want but you cannot change them. Only they can change themselves if they take the initiative and act.

You cannot do their work for them. You cannot walk their path in life on their behalf. You cannot force a connection. You cannot force an outcome.

As the proverb goes — “You can lead a horse to water but you cannot make the horse drink the water.”

Expecting other people to change is like beating a dead horse. It’s not constructive. It’s a futile effort. A better solution is to change yourself. When you change yourself, perhaps the world will start changing too.

Otherwise, you run the risk of your life being caught in a repetitive loop like a broken tape recorder. The same patterns show up again and again. In different forms maybe but at the core, it’s the same issue that keeps recurring until you resolve it. Each time you expect things to be different. But that’s delusional if you haven’t changed your actions.

Option 2 is to simply walk away from the person or situation that is no longer serving you. Again requires a good dose of honesty and bravery.

A dear friend of mine once said don’t be afraid to lose other people.

I’m not saying to become a cold-hearted manipulative person. I’m saying make yourself the anchor. Instead of letting other people determine your worth and emotional state. No one should have that much power over you.

The most important opinion? It comes from within.

The most important relationship? The one you have with yourself.

The most important indicator of ‘success’? Your quality of life.

Who defines this? You have the power to set the standards that will define what success looks like to you.

But with power comes responsibility. The responsibility to rise to meet those standards. The responsibility to keep your word and show up, especially when you don’t feel like it. The responsibility to enforce those standards when your boundaries are violated.

That could mean walking away from places where you’re not treated for what you’re worth. You decide. But make sure you act. Don’t complain.

A useful framework I’ve found to stop complaining is to visualize what’s in my control vs what’s out of my control.

A cheat code to navigate a chaotic world while maintaining my sanity is to maximize my responsibility in areas under my control while not giving a damn about stuff that’s outside my control.

Full disclosure- I still complain sometimes. I rant about how unfair society can be sometimes. It’s human after all to get down and let your feelings out. But I give myself a timeout. I can complain for X minutes but not a minute more. Eventually, I get sick of my victimhood mentality so much so that it forces me to start thinking ‘do I have the power to fix this issue?’ and if so, what are practical things I can do to address this issue?

In other words, train your brain to look for solutions. Train yourself to get a dopamine hit every time you learn something new. Challenge yourself to solve messy, hard problems.

With the sorry state of the world, it’s easy to get down. But don’t give in to the disillusionment. There is always a way out. There is always a choice to make things better for yourself. When you get better, the world around you will inevitably improve too.

Onwards and upwards!

How I Got Myself to Stop Complaining and Take Action was originally published in Readers Hope on Medium, where people are continuing the conversation by highlighting and responding to this story.

When I first created a Medium account, my goal was simply to establish a habit of writing regularly. Something like 1x/a week so it’s not too intimidating to keep up but also challenging enough to keep me on my toes.

What triggered me to adopt this weekly publishing habit?

I’m at a point in my life where I’m a few weeks shy of turning 25 years old. As I get older, I want to create more than I consume. I want to give more than I receive. Why?

For the past 2 years, I lived a hedonistic lifestyle and reached a breaking point of utter disgust. I don’t ever want to live or feel that way about myself again. I knew I had to stop comforting myself and do hard things to preserve my sanity. To earn my trust and respect, I had to commit to a goal and take ownership. No matter the odds. No matter the results.

I wanted to pursue a goal that I had some natural talent for and yet have plenty of room to learn and grow. A goal that could compound over the long term and make me a better person. Online writing seemed to check these boxes.

Currently, I’m not too focused on the follower count, engagement, and money aspects of writing. I won’t lie it’s a nice ego boost when these vanity metrics do well for my posts but that’s not my underlying motivation.

I write for selfish reasons. I cherry-pick topics that resonate with me. I’m simply following whatever sparks my curiosity and passion for human progress. Kind of like a public diary minus any parts I don’t feel comfortable sharing. Bonus points if it positively influences someone.

A secondary reason for my writing is the hope that it will help me create my own experience that goes beyond traditional credentials. Online writing could help me leverage the power of the Internet to form new connections and unlock opportunities I never thought were possible.

But for now, my goal is simply to prove to myself that I can stay the course even when it gets hard and churn out content every week. The results will take of themselves.

Even if I don’t get the engagement and money I desire, at the very least, I can say I wrote on Medium consistently for a year and have a library of content. That I undertook a permissionless personal project that aided in my personal growth. I may not have the sexy external results to speak of but at least I did something. And not many people can say that since most people just mindlessly consume.

I know this because not too long ago I was one of the “lurkers” on the internet, sitting on the sidelines watching the real action happen while I was still debating if I should join in or not.

Writing on Medium is my way of shutting up that mean inner voice and seeing what happens if I dare to show my work publicly.

Life is too short to let your fears prevent you from doing what you aspire to do. And I know for a fact that I’m going to regret not documenting and sharing what I know. So it felt like a no-brainer to start writing online.

Finally, why did I choose Medium of all the social media platforms?

Facebook is outdated.

Instagram is a photo-sharing app that rewards beauty so posting my writing there made 0 sense.

Since a lot of my writing is personal, LinkedIn didn’t seem like an appropriate platform as it feels more corporate.

Twitter is a great tool but can be a rage machine sometimes. The Twitter algorithm seems to amplify divisive and polarizing content and sometimes this can truly skew your perception of reality.

Plus I have too much stuff to say so condensing my thoughts to 280 characters felt impossible. Also while I enjoy Twitter for its bite-sized content, the trade-off is nuance.

I wanted to write someplace where I could publish long-form nuanced content but still get some social feedback. That’s the reason I didn’t start my personal blog as no one would know of its existence. Medium seemed to be the perfect tool to a) start publishing from Day 1 and b) get some traction. Medium lets you focus purely on writing so you don’t have to worry about building a website and marketing it.

Let’s see how this experiment goes. I’m excited to dive deep into this platform, publish my pieces and get to know other wonderful writers!

Why I Started Writing on Medium was originally published in ILLUMINATION on Medium, where people are continuing the conversation by highlighting and responding to this story.

Freedom is a defining value of North American culture.

I deeply resonate with this value as I always had a strong desire to be a free and independent woman. So much so that it drove my decision to leave home and pursue an education abroad in a country where I didn’t know anyone.

Until I realized (through many hard experiences) that pursuing personal freedom is overhyped. No one tells you the opportunity cost of unlimited personal freedom.

With the freedom to pursue many options, here’s what happened to me.

• I chased a lot of shiny objects (read I was easily distracted)
• My life became ‘busy’ (read chaotic)
• Optimized my life for comfort and convenience
• My focus went to shit
• I started comparing myself to others thanks to social media
• My anxiety went up

Thankfully, my dissatisfaction with life reached a breaking point. I forced myself to do hard things that I knew deep down I should be doing. Wasn’t easy. I still struggle sometimes.

But I made enough progress to realize that:

Committing to a specific change + Setting Limits = Discipline = Freedom

The lesson I learned the hard way?

True freedom comes from setting constraints on what you can do.

True freedom comes from taking responsibility and committing to a cause greater than yourself.

True freedom comes from doing hard things and challenging yourself.

The Paradox of Freedom (Why Personal Freedom Is Not The Win You Think It Is) was originally published in The Unfair Advantage on Medium, where people are continuing the conversation by highlighting and responding to this story.

I moved to Toronto for graduate school.

Of all the information that’s been fire hosed at us over the past few weeks, there is a consistent theme of advice from professors, students, and alumni. They all heavily emphasize ‘networking.’

That’s great. Except for the million-dollar question — How to meaningfully network?

Making connections is the easy part. After all, there are many events, meetups, and conferences to attend. Most people are friendly and approachable. It’s not hard to get a conversation going about X topic.

The challenge is, what happens next? What happens when you go home with a bunch of LinkedIn connection requests? Still buzzing from the event’s energy and engaging conversations.

Life gets in the way. The memory of making interesting connections fades into the background as you go about your daily errands. Being ghosted by a connection you made or falling out of touch is not uncommon.

Learning how to be persistent and follow up consistently is a different ballgame they don’t teach you in school.

I recall being a social butterfly during my undergrad. I attended several events and conferences for networking purposes. I was exposed to a ton of knowledge and people. At the time, I thought I was doing the right things. But looking back, attending those networking events had a very low ROI (return on investment).

Why? Because I don’t remember 99% of what I learned from those speaker events. Plus, all the jobs I’ve held up to this point, I acquired through cold outreach. No referrals.

That’s not to say you can’t find value in attending networking events. Some people have found good connections and jobs through this medium. Maybe I’ll, too, someday.

But so far, this approach of blindly attending networking events hasn’t worked for me.

I’m not afraid to put myself out there. My challenge is being intentional with these networking events. Especially when you’re surrounded by smart and competitive peers in grad school who seem to be networking left, right, and center. This makes me seriously afraid of missing out (FOMO) since I want to be successful and relevant like everyone else.

So now I’ve shifted my thinking. I’m not letting FOMO drive my attendance at these networking events anymore.

Focused networking > Networking for the sake of networking (aka flying blind)

Put another way,

# networking events you attend are a vanity metric.

# of meaningful connections you make is more important.

Audit your network — How many connections do you know can vouch for you personally? How many of them can advocate for you when you’re not present in important rooms where decisions are made?

It seems like common sense but worth noting when it comes to building careers; just like any other relationship, professional relationships take time and effort to compound.

Relationships are often a function of physical proximity. That’s why the relationships you forge through school, work, and sports are the closest.

Relationships forged thru networking events? In my experience, they tend to be shallow and surface level until you take the initiative to follow up and keep it going. And there is a limited number of people you can do that with.

That’s why most traditional networking events are a waste of time. There are more efficient ways to use your time. Here are my three favorite strategies to connect with people who can help you become more successful:

1. The best networking opportunities are in close-knit, exclusive, and smaller-scale communities.

It could be your cohort peers at school. It could be coworkers at your job. It could be an informal community, such as a faith group you’re part of. It could also be a more formal community like Lean In circles for women.

The common thread? Small groups that meet regularly breed familiarity. Familiarity contributes to the strength of relationships. It means more support and people willing to go to bat for you.

2. Start writing online. Show your work publicly. Build something of value and give it freely.

When you broadcast your thoughts on the Internet over a long period of time, you become a magnet to like-minded people who want to connect with you. Also called building an audience. Finding your tribe. Whatever you want to call it, LOL.

My point is to let people find you instead of you chasing people to ‘pick their brains.’ In other words, do something notable that would make people want to network with you.

3. Reconnect with old ties.

This could be former classmates. Former colleagues. Go back to people you haven’t talked to in a while. There is a reason people say — Old is Gold.

These ‘dormant ties’ can offer new information you may not have considered. Because since you last spoke with them, they’ve probably acquired knowledge and connections that could benefit you too. Plus, there is the added benefit of trust and familiarity of reaching out to an existing but old relationship.

The above strategies are easier said than done but still a higher ROI activity than attending a bunch of events and trying to make new connections.

That said, there is still a value proposition for networking events. Particularly industry-specific conferences where the who’s who gather to discuss the latest developments and where the industry is headed.

But before I sign up for a traditional event, I ask myself:

Am I going to this networking event to check a box on my to-do list and to avoid peer-induced FOMO?

OR

Am I going to this event because I resonate with the agenda topics, people, and companies that are going to be in attendance? Do I have a specific goal to accomplish? And no ‘connecting & learning’ doesn’t count. Be specific about who you want to talk to and why. Also, think of how you can add value to these people/companies.

Be selective in who and what you dedicate your energy to. Your time is important. Damn the FOMO. No matter how popular or hyped the event is. If I don’t get a hell yes feeling, I’m not attending.

What networking approach has worked for you? I’m always looking for tips to better connect with others. Tell me in the comments below!

3 Strategies to Combat Networking FOMO was originally published in ILLUMINATION on Medium, where people are continuing the conversation by highlighting and responding to this story.

A lot of people have positively influenced my life. But if I had to choose one person whose story truly moved me, it has to be Madam CJ Walker.

What makes her remarkable? Madam CJ Walker was the first self-made female millionaire in the United States.

She lived during the Jim Crow era. That was certainly not an ideal time to be a black woman. A woman toiling in the cotton fields wasn’t supposed to be successful.

Yet Madam CJ Walker rose against all odds to create a successful beauty empire and set a precedent that anyone can be an entrepreneur. No matter what you look like. No matter your race. No matter your gender.

What actually matters? Your attitude. Your ability to persist despite failure and setbacks. Your ability to help others.

Madam CJ Walker overcame victimhood to create a personal brand that was both profitable and socially impactful. She leveraged her self-made wealth and connections to become an activist philanthropist working to uplift her race out of poverty.

The biggest lesson I’ve learned from the brilliant life of Madam CJ Walker is that there is nothing wrong with wanting to become rich. But once you’ve reached that pinnacle, give a lifeline to other people too. The world needs more talent, more voices, and more representation. Not less.

This Woman Changed My Mind On Having A Role Model was originally published in The Unfair Advantage on Medium, where people are continuing the conversation by highlighting and responding to this story.

I used to be a fake coffee person.

I’d tell people I love coffee. When actually what I loved was having lots of cream and sugar with a side of coffee. I’d dilute my coffee so much that it wasn’t coffee anymore.

Unpopular opinion — most Starbucks drinks are desserts in liquid form.

It’s strange as I’d drink coffee before going to bed. Instead of keeping me awake, it’d help me sleep. Probably because it was super loaded with sugar that it’d make me lethargic instead of active and alert.

I used to envy my friend Julia for drinking black coffee every morning. What a psychopath! Who does that? How can you drink black coffee straight up? It’s so bitter. But secretly, I used to think it was cool.

I heard Julia once say drinking black coffee didn’t come naturally to her. It was an acquired taste.

This was an aha moment for me. I decided to challenge myself by doing an experiment. Let’s drink black coffee for 30 days in a row.

If by the 30th day, I acquire the taste, well then I can consider myself a black coffee person. If at the end of 30 days, I still hate black coffee, I can give it up and go back to my double-double order at Tim Hortons. At least, I’d be able to say then that I tried but it didn’t work for me.

Day 1–10: I hate myself. Why am I forcing myself to drink this god-awful bitter-tasting beverage? My caramel macchiato order at Starbucks was one of the few pleasures in my life.

Day 10–20: I guess I could get used to this. Let’s take it up a notch. Enter double espresso shots and Americano.

Day 20–30: What the hell have I been consuming in the name of coffee for the past few years? Sugar is bad. I started feeling holier than thou.

Just kidding about the last part. I don’t pretend to be somehow better than a regular coffee drinker just because I can take it black. To each their own.

What I discovered from my little experiment:

1. To create a habit, give it 30 days. At a minimum. Gives time for your internal system to reset and adapt to the new habit you’re trying to solidify.
2. My taste buds completely changed. I developed a strong aversion to the sweet stuff. Donuts, Timbits, cakes, pastries, croissants, and chocolates (except dark chocolate) suddenly tasted so sweet that I couldn’t eat the full thing. I’d have to break it in half and share the remaining half or eat it slowly over a couple of days.
3. I made a ritual that every time I drink black coffee, I’ll also work at the same time. My brain would light up every morning craving the intense strong taste of black coffee. It was an indicator that coffee time was also my time to journal/read/work.
4. I tracked my habit. Counting down the calendar days to day 30. Initially, it was out of annoyance wanting to know when I can put an end to this self-inflicted torture. Eventually, it switched to this streak that I was addicted to and didn’t want to break.

What surprised me the most about drinking black coffee is NOT that I could drink black coffee and enjoy it. It was that this tiny habit had spillover effects in other parts of my life.

It made me feel more focused, and productive and gave me an appreciation for the true taste of coffee without its flavor being masked by sugary content. It made me question what other habits I could change or create with a 30-day experiment.

It also hit me that a habit cannot be created in isolation. If you want to sustain a habit, make a fun ritual out of it. Find ways to integrate the habit into your daily life alongside activities you enjoy doing.

For example, I love reading books. Reading on my kindle was my cue to drink espresso. Somehow, the one activity I enjoyed made this other activity more palatable. To the point where I started looking forward to drinking espresso and couldn’t imagine reading without it.

If the habit doesn’t stick, give yourself a free pass. You’re allowed to quit. But. There is a huge BUT. Only once you have given yourself an adequate timeline to work through it. It could be 30 days, 60 days, 90 days, or 1 year. Whatever. There has to be a minimum threshold of participation you need to clear before you consider quitting.

Quit or not quit, either way, you’re winning. If you quit, you’ll walk away a person with new experiences who experimented and realized what they don’t want. If you don’t quit, you’ll walk away a new person with new habits in place that can supercharge other aspects of your life.

Have you ever tried doing an activity for 30 days straight? What were the results? What are your insights on building daily habits? Tell me in the comments below.

I Trained My Brain with Black Coffee: Here Are My Results After 30 Days was originally published in The Unfair Advantage on Medium, where people are continuing the conversation by highlighting and responding to this story.

Healthcare is a risk-averse industry.

Makes sense. After all, countless lives are at stake. Billions of taxpayer dollars are on the line (almost 40% of the Ontario budget was spent on healthcare in 2021). There is intense public and government scrutiny. Constant regulations and policies to keep on top of. Consumer expectations are sky-high but resources (staff, money, and technology) are severely constrained. A clear supply-demand imbalance, worsened by the Covid-19 pandemic. This poses the question:

• How do we innovate in one of the most regulated industries in the world?
• How do we make a massively fragmented and siloed system patient-centric?
• A phrase often heard in healthcare — “We can’t move forward because it’s too complex. There are too many variables and not enough information.” How do we cut through the complexity to make faster, simpler, and more effective decisions?

Well, there is no silver bullet. In fact, there will never be a single right answer. What we can do however is to build a toolkit of frameworks, methodologies, and processes. And apply it based on the context and need of the hour.

Sounds cliché I know. But here’s an idea. What if we let go of this pressure to control? This pressure to predict? What if we focus instead on improving our capacity to respond? Especially when it comes to technology that follows a non-linear exponential growth curve where it becomes impossible to foresee all the consequences.

When confronted with ambiguity and constantly moving pieces (as is often the case when working in healthcare), there is only so much we can control. One of those things is how we react to the unexpected. How we adapt to changes. This is why we need a diverse toolkit. So that we’re equipped with the tools and resources to find order and meaning amid chaos.

One such framework that you can add to your toolkit to start building in the right direction is the model of Design Thinking.

1. Empathize with the end user. Understand their needs and challenges. Listen, observe and engage with them by using:

• Personas
• Map out the user journey

2. Define. Understand the problem and clearly articulate it.

Pitfall to avoid — treat the root cause, not the symptom of a problem

3. Ideate & Collaborate. What are the possible solutions? Brainstorming, mind-mapping, visualizing workflows, and sketches are all viable tools to get ideas flowing freely.

4. Prototype is all about experimentation. The goal? Transform the idea into a tangible product/experience that solves the problem defined in Step 2.

5. Test & Iterate by gathering user feedback. Avoid yes/no questions. Ask open-ended questions to get as much raw feedback as possible. Use the results to redefine the problem and/or the solution.

The beauty of design thinking is that it includes the end users from start to finish in the design process. Naturally, this creates a solution from the patient’s lens, making the process more compassionate and empathetic.

The best part of design thinking? It has room for and even encourages failure. Let’s be honest — nothing meaningful in life comes from a straight line of success. We need to fail and fail fast to figure out the path to achieving X outcome. It’s going to be a zig-zag. So embrace the pivots, the randomness, and the chances. You’ll only be able to connect the dots looking back.

Pro tips when implementing an initiative and you encounter resistance to change which is inevitable:

1. To get leadership buy-in, find ways to ‘de-risk’ a decision for a senior executive. Without leadership on board, no lasting change is going to happen within healthcare organizations.
2. Never present 1 option to decision-makers. Present 3–5 options. Provide evidence of outcomes, not the details. Start small. Design thinking can help your team create a scaled-down version of a potential solution that you can pitch to senior leadership.
3. Present the options as a sandwich metaphor. Here’s what happens if we stay status quo. Here is what’s likely to happen if we make a change. Paint a picture where the pain of not changing > pain of changing.

Want an on-demand private car ride to any destination? We have Uber

Want a one-stop shop for all your shopping and entertainment needs? We have Amazon Prime

Want groceries delivered to your doorstep within a couple of minutes without you spending time shopping and money on gas? We have Instacart

Healthcare is ripe for disruption. Consumers want 24/7/365 instant access to healthcare. This includes doctor visits, pharmacy prescriptions, test results, and more. The convenience aspect of healthcare is here to stay and can’t be ignored.

It’d be naïve to think that the government alone can provide the solution here. It’d also be naïve to think that the private sector can fix the system. What we need is the best of both worlds. A happy medium. Also called public-private partnerships.

The private sector has a track record of delivering innovative solutions to address healthcare challenges. Electronic Health Records like Epic for hospitals and PointClickCare for long-term care and telehealth like Teladoc and Telus Health, to name a few examples.

On the other hand, government entities like Ontario Health were formed in 2019 by merging 22 organizations under 1 umbrella. The purpose? To coordinate care across the continuum.

Given the breadth and depth of their reach across the system, Ontario Health has economies of scale that a health tech startup simply does not have. Even the big established private players such as health IT vendors need the government on their side to increase the adoption of digital health tools.

Governments have been known to implement legislative changes such as the HITECH Act (which made meaningful use of EHR mandatory across the United States), provide grant funding for health non-profits to implement digital tools, and invest in incubators to encourage entrepreneurship in digital health.

The way I see it? Governments have the power to create policy and financial incentives while private companies can leverage those incentives to build practical solutions that solve pressing problems in healthcare. It takes two to tango.

Bottom line? Public-private partnerships are the best way to innovate in healthcare and accelerate digital transformation.

Instead of thinking of private and public healthcare as a dichotomy and mutually exclusive, we need to start thinking of how public and private tiers of healthcare can collaborate. We need to start asking:

How can Ontario Health work with private healthcare like Telus Health, Shoppers Drug Mart, and other healthcare businesses to reduce access barriers to healthcare? make the system more patient-centric? reduce burnout for clinicians?

Less gatekeeping. More collaboration. Healthcare is not a zero-sum status game where 1 party has to lose so the other party can win. Healthcare is a multiplayer game. It’s in everyone’s best interest to create win-win outcomes. Our lives and well-being depend on it.

Vision for healthcare:

Hospitals receive the most government funding and yet continue to remain the most expensive part of the healthcare system. Most patients don’t think of other care settings like Community Care Access Centers (CCACs), primary care, urgent care clinics, etc. so they just go to the one place they know — hospital ERs. Something’s got to change.

We have miles to go but there is a vision for healthcare that we can anchor to when creating change to existing processes or implementing new initiatives. The ‘Medical Neighborhood Model’ —

The patient receives care from both the formal healthcare system (primary care, hospitals, pharmacy, home health) + access to informal supports (employers, schools, community centers, faith-based organizations).

Clinical-community partnership is the defining feature of this vision. It combines medical and social supports necessary to enhance a person’s health.

This holistic approach to healthcare means continuity of care and preventive care can be more than buzzwords. Because the individual in need will be served and linked to diverse supports. no matter their condition(s). no matter at what point of their health journey they’re in. no matter where they’re located.

Design thinking, public-private partnerships, and the medical neighborhood model hold promising answers to the challenges plaguing our healthcare system. There is no question we need innovation in Canadian healthcare to solve chronic problems whether it be the wait-time crisis, the opioid crisis, or underrepresented patients falling through the cracks.

The issue is NOT a lack of ideas. The issue is with lack of or poor collaboration that has created siloes where different parts of the system don’t talk to each other. The issue is with lack of or poor execution.

We all are part of the healthcare system — whether it be as providers, patients, businesses, or caregivers. We are all impacted so we all have skin in the game. My point?

Start building. Start connecting. Start advocating. Have a strong bias for action but also be prepared to fail. The next solution to the current healthcare crisis might just come from you.

I’ll leave you with this quote.

“Never doubt that a small group of thoughtful, committed citizens can change the world, indeed it is the only thing that has.” — Margaret Mead

3 Methods to Innovate in Health Care was originally published in Health Informatics 101 on Medium, where people are continuing the conversation by highlighting and responding to this story.

I have an unpopular opinion:

Immigration loses its appeal if you know how to monetize the Internet

Before diving in, a few things I want to clarify:

1. I’m not advocating for anyone to immigrate or not immigrate. That is their choice to make. After all, immigration is a highly personal decision that boils down to one’s life priorities. Plus there will always be perfectly valid reasons for immigration.
2. The goal of writing this article is to share my observation on a trend that is too significant to ignore. Even for typical immigrants like me who haven’t fully capitalized on this opportunity. I also wanted to add a different perspective to the brain drain immigration from the East to the West.

There are 3 parts to this article.

Part 1 is about the factors contributing to this emerging trend that could change immigration patterns.

Part 2 is about the convergence of economies around the world to the point where your location matters less and less.

Part 3 is about why I call this disruptive trend ‘emerging’ and potential solutions to fast-track the process.

Go get a coffee and start reading. Seriously, it might just change your mind! Whether you agree or disagree, tell me in the comments.

So back to my unpopular opinion of how immigration seems less appealing if you can leverage the Internet. What the hell do I mean?

Rise of remote work, content creator economy, and running online businesses.

The Covid-19 pandemic accelerated these 3 trends, proving it’s possible to work from anywhere. More and more people want to pursue location independence and live like digital nomads.

Digital nomad visas are increasingly being offered by countries around the world to attract tourism dollars and top talent. Dubai, Estonia, Portugal, and Spain to name a few places following this model.

Why spend your life living in 1 country when you can work and travel through 4 different countries? Naturally, this is more feasible for younger Gen Z individuals like me who have no dependents and thus have the capacity to be geographically flexible.

But first, what made this possible? The Internet. The greatest invention of our time.

Access to the Internet is a great equalizer. Does it matter anymore which country we were born into?

It used to be that if you were born in a third-world country to a poor family, your future prospects were bleak.

Now I’m not sure if that’s the case anymore thanks to growing access to the internet and owning at least a smartphone.

Anyone from around the world (exceptions for countries with high censorship) can access the best knowledge and information at their fingertips. You can get a degree from prestigious universities through Coursera or EdX for a fraction of the cost and without ever leaving your home if that’s what you want. Nothing can stop a driven person from becoming a successful digital entrepreneur.

Obviously not an easy thing to do but there are tons of tools and resources to help you along. So it’s not outside the realm of possibility.

1. Rise of remote work

Enough has been heard and written about how the pandemic catalyzed a massive shift in work culture by normalizing remote and/or hybrid work. Work From Home (WFH) became this new trendy term no one could stop talking about. It has clear benefits for commuters, caregivers, and mothers while also complicating the ever-elusive work-life balance.

Many tech companies jumped on the bandwagon to announce a permanent WFH policy. Some companies took this a step further by announcing a Work From Anywhere policy. Raising a very important question. What implications does this have for immigration?

In a podcast interview about his book ‘The Network State: How To Start A New Country’, author and former Coinbase CTO — Balaji Srinivasan said Indians today don’t need H-1B visas anymore (a popular class of immigrant visa for Indian tech talent trying to become American), they just need the TCP/IP protocol (the communication system powering the World Wide Web) to be successful.

Srinivasan said you can work remotely, raise money remotely and participate in the global economy from anywhere.

I can’t help but wonder whether it is worth it anymore to uproot your life to go through immigration hassles in the West. Why trade the prime years of your life for the inevitable loneliness that comes with being a first-generation immigrant? What if we could redirect that energy and resources toward finding remote jobs? building an e-commerce business? watering the grass on our side instead of draining talent to other countries?

The world is not like our parent’s time when they were forced to immigrate to make sacrifices for a better quality of life down the road. Unlike our ancestors, we have options. Thanks to the internet, the possibilities are endless.

2. Content Creator Economy

To be honest, I used to roll my eyes every time I heard the term “content creator”. I don’t know about you but in my mind, it had a negative connotation. Those cringe couple videos on YouTube, Instagram influencers indirectly encouraging unrealistic beauty standards, and TikTok dance videos used to come to my mind. If people want to do that, sure go ahead. I guess it fills an entertainment need after all.

However, my perception of ‘content creators’ changed when I discovered Twitter. Twitter is a goldmine of information. There are people freely sharing invaluable lessons about investing, personal finance, startups, leadership, fitness, and more. My suggestion is to mute the news and politics to avoid the rage machine that Twitter can be sometimes. And instead, focus on creating a positive echo chamber of people who spark your interest.

In fact, I learned more from Twitter in the past 2 months than I did from my 4-year undergrad degree that’s collecting dust in some corner of my room. LOL.

Not to say you should not pursue a degree, just that the Internet has democratized access to education. I’m not sure if the legacy education system will stand the test of time in the next 30–40 years if schools and universities don’t fundamentally reform their approach to teaching and the cost of attending school.

Twitter influencers have me convinced that it’s possible to be a content creator while being ethical and genuinely adding value to society. Whether it be helping people become more financially literate, start their own businesses, get fit, or simply how to write better to get ahead in their life.

The content creator economy is booming in contrast to traditional media. Distrust in government, big corporations, and mainstream media are at an all-time high. People want to connect with other people, not faceless entities who don’t have to suffer the full brunt of their actions.

Amid the Covid pandemic and fears of recession, people were confined to the 4 walls of their homes and were forced to think outside the box. How to convert their hobbies and interests into something monetizable?

YouTubers, bloggers, online writers, podcasters, influencers, and curators popped up and comprise a rapidly growing creator ecosystem. In fact, 50 million people around the world consider themselves creators. The barriers to entry are low.

On the internet, everyone is on the same level playing field. The internet doesn’t discriminate based on your nationality. The internet doesn’t require you to have a certain visa or passport to participate. Location doesn’t matter. What matters is your willingness to practice in public and engage with others.

3. Running online businesses

Internet entrepreneurship dovetails nicely with the content creator economy.

In a sense, all content creators are entrepreneurs because they’re taking the risk of showing their work publicly over a long period of time. In the process, they attract like-minded people, a percentage of whom convert into paid clients who buy the creator’s online products such as books/courses/consulting.

The content creator or rather I should say ‘solopreneur’ — a term popularized by LinkedIn influencer Justin Welsh are a new but growing breed of people taking back control of their lives. How? By building their audience. Generating their own opportunities and income on the internet. Escaping the rat race. The corporate hamster wheel. One content piece at a time.

The beauty of creating an online business is rooted in the flywheel effect where the business grows almost by itself. There is no single big event leading to success. It’s a system of different levers that drive growth.

In the case of online business — social media, email, and websites are the most popular vehicles of user growth on the Internet. You could publish content once and repurpose it across various distribution channels to reach wider audiences. Creating a flywheel where various online channels feed into each other to generate more traffic and growth for your business on autopilot.

The issue with Points #2 & #3 — the success rate is not that high.

You’ll likely fail more than succeed. It’s a trial and error process. But it’s not a waste of time. You’re testing the waters and figuring out what you don’t like. You’ll pick up on vital skills that will lead to the path you ultimately want to pursue.

Internet entrepreneurship is not for everyone but it’s an alternative worth exploring. It’s incredibly hard to do. But so is immigration. Immigration is crazy hard too and a very uncertain path with no guaranteed outcome. Pick your hard. After all, nothing meaningful in life comes easy.

Convergence of economies

Very recently, India overtook the UK as the world’s 5th largest economy. That is a big leap forward. There is also a rising trend of Indian cities flipping American cities. The rapid development of Indian cities contrasts with the decline of Western cities that are losing their allure.

My point is NOT that the West is doomed. My point is there is a global improvement in living standards. To the extent that immigrating to the West is NOT necessarily the golden ticket to upward social and economic mobility as it used it be once upon a time in the 1960s.

My theory is that if your basic needs are taken care of, your location doesn’t matter so much. Needs such as food, shelter, clothing, and safety. Once this is nailed down, focus on building. On creating a side hustle or a business. On creating your own experience that goes far beyond traditional credentials.

Leverage the internet. The internet can be a free marketing machine once you put out your work and continue to feed the system. Your content works for you 24/7 every single day attracting attention and dollars while you sleep.

You could live outside the West and have clients from around the world, including the United States, and get paid in $$$. Another tweet to get you thinking:

Why do I call this Internet trend ‘emerging’? Two reasons.

1.The unfortunate reality is that the digital divide is a very real issue. Both in developing countries and developed countries.

There is a big difference between high-income and low-income individuals when it comes to accessing high-speed Internet and owning digital devices. More than an access issue, the digital divide also refers to a lack of digital literacy skills.

A Pew Research Center study noted that 24% of American adults with household incomes below $30,000 a year don’t own a smartphone and 40% of those with lower incomes don’t have home broadband services or a computer.

2. We’re still early in the adoption cycle of the creator economy and WFH. It’s not as widespread as we’d like it to be.

Often called the ‘second-level digital divide’, there is a gap between producers and consumers of information on the Internet.

Most people mindlessly scroll and consume information. That information, however, is produced by a tiny portion of internet users.

This is a clear supply-demand issue. Tremendous demand for high-quality content but not enough supply of credible content creators.

What is the solution?

The statistics don’t look pretty. But I’m optimistic because of these promising developments:

1.Non-profits doing critical frontline work to bridge access to digital technologies. Community access centers and drop-in centers have popped up offering computers, computer assistance, and training.

2. Big tech companies like Google do outreach work in underrepresented communities and promote digital skills through their coding boot camps and educational courses.

3. There is a growing educational and economic emphasis on data literacy. Amplified by government grant programs and employers highlighting a talent gap in the tech industry. This is driving more people, especially the younger generations to take up STEM careers. Knowing how to use the internet and code could be your ticket out of poverty.

4. Thanks to social media influencers like Justin Welsh and Arvid Kahl, there is greater awareness and changing social attitudes toward being a content creator and solopreneur. The interesting thing about their work is that their online courses have attracted global audiences.

Someone living in Asia could implement their playbook to become a content creator on LinkedIn/Twitter and earn decent money if they play the game long enough to see the compounding effect kick in. In fact, I won’t be surprised if some of their cohort students have already accomplished this.

In a recent LinkedIn post, Justin Welsh introduced the ‘purchasing power parity’ (PPP) on his digital products. This means that anyone from around the world can access his products at a price that is relatively affordable in their local currency. Instead of paying in USD which is often the default standard when pricing services on the Internet.

PPP is a very promising idea to narrow the digital divide and democratize access to information for more than 80% of the world population residing outside North America and Europe.

A final thought — The internet can be very polarizing. This is a pitfall to avoid if you choose to build a following online and monetize your skills.

It is possible to use the Internet intentionally where it can be a force for good and unlock many growth opportunities. I suggest reading ‘Digital Minimalism: Choosing a Focused Life in a Noisy World’ by Cal Newport for ideas on how to set constraints around internet use so you can get the benefits of technology while bypassing the addictive design of social media algorithms.

Knowing what I know now about the power of the Internet, I might have acted differently. Don’t get me wrong, I don’t regret immigrating and wouldn’t trade this experience for anything but perhaps there was a middle ground I could have explored.

Anyway, this is definitely going to guide my thinking as I make future decisions about where to live and work. And I hope you consider it too when moving places.

Why This Emerging Trend Will Disrupt Immigration was originally published in ILLUMINATION on Medium, where people are continuing the conversation by highlighting and responding to this story.