It’s Never Too Late- Conquering Fear of Public Speaking


They say it takes a village.  In my case it took a village’s worth of coaches!

To do what you wonder?  To overcome my fear of public speaking.

Most people who know me, will be very surprised-it’s been a well-kept secret.

I am real people person, who loves networking and connecting people and ideas. Interestingly, people love to tell me their life secrets. Even perfect strangers, including Dick Wolf of Law and Order fame, (who sat next to me on a Southwest flight) as well as many Wall Street corporate executives have given me TMI. (too much unsolicited information)

But put me in front of an audience, and I have flash backs of when I ran off the stage in a school play.

According to the Mayo clinic, fear of public speaking is common for many of us; so here are the lessons I learned.

  1. Get the right kind of help

Since I had been a speech coach as part of my corporate communications work, I felt very comfortable interviewing many of the typical executive coaches.  Because I already knew what they would tell me, I decided to take a leap of faith into unknown territory and get a voice/acting coach.

Yes, it is true, I really had no idea what a voice coach does, but lucky for me, I met Adele Cabot who has been my guiding light in thick and thin. It turns out that my small voice, which I thought was from my small stature was actually due to chronically tight neck muscles.  Bad posture and lack of confidence and experience also contribute. Who knew?  

     2.  Expect failure

When I first created Judy Jetson for my talk: Reimagine Autoimmune Disease, we experimented with dramatic music.  It worked great in rehearsal, but for the talk, there was a technical glitch, where the music was not in synch.  My carefully planned dramatic music, was a technical flop!  Even though I was tempted to quit public speaking, my talented coach Adele Cabot, was able to encourage me to trudge on.  We all have bad days- just keep moving forward.

    3.  Keep at it

I found the most frustrating part of coaching C-level executives was getting them to rehearse, not just the night before in the hotel room, but repeatedly from the time the Power Point deck was roughed out. Just when they had accumulated enough practice to present well, the roadshows would be over. Practice is essential, but no one wants to do the necessary hard work. Try video, get a friend to listen and coach, or even set up a practice webinar so you can review yourself.

    4.  Embrace experimentation

Despite many setbacks (technical, timing, etc.), I have made it a point to surround myself with colleagues and friends who are willing to experiment.  In this case, Ellen Martin, my long-time writing partner, was instrumental in helping me find the emotional resilience to create  ”The Lonely Voices of Autoimmune Disease.

   5.  Find like-minded communities

Being part of several communities such as XX in Health and Stanford Medicine X gave me the necessary support and inspiration to let go of traditional medical approaches and think about new and different ways to help the large and growing autoimmune community

   6.  Dream big-beyond your fears

Right before my talk at Stanford Medicine X, I was chatting with Marie Ennis O’Connor. She told me, “I really felt nervous, but my desire to get my message out was more important than my nerves.” As I began my talk at Stanford Medicine X,  my desire to get people involved in helping to solve the needs of autoimmune patients was foremost in my mind and heart.  To my own surprise, I enjoyed telling the story, without any trace of nerves!

When members of the audience complimented me, I smiled inside knowing that I had climbed a mountain of obstacles.

Have you ever been afraid of something and conquered your fear? 


It’s Never Too Late- Finding Community Support is Key


During the past few months, many of my professional colleagues and friends have asked me how I have been able to tap the resilience needed to reinvent myself many times. Most recently, I have been lucky enough to find several supportive communities.  

As an adolescent girl who loved math and science before it was cool, as a women dentist before it was mainstream, and as a women on Wall Street, I used to often feel like a misfit.  But now, nerds and misfits are cool!

That is why I fell in love with digital health, where I found a community of innovative, creative folks who value new ideas to fix big problems.  Thank you Don Jones, Halle Tecco, Leslie Saxon, Jil Gilbert, and Larry Chu for opening my mind and heart to this new world of possibilities. 


First, I fell in the love with the open spirit of collaboration at Rock Health where their XX in Health initiative encourages women of all ages to learn to speak up and be heard. 

Then, I was inspired by the power of storytelling at the Center for Body Computing  and the Digital Health Summit.  This inspiration ignited my passion to bring my personal awareness of the increasing incidence of autoimmune disease in young adults to a new audience at Greatist.  

Next, I felt compelled to bring the problem to the pharma community at Data to Drugs where “Judy Jetson Reimagines Autoimmune Disease.”

But Judy needed to grow up for the Stanford Medicine X audience and I was stumped, until I saw Ed Saxon after my Bar class and the concept of the “Lonely Voices of Autoimmune Disease” videos was born!

Most recently at Stanford Medicine X, which values new ideas and experimentation, I let go of “wanting to be accepted by mainstream medicine.” Instead, I used my deep research and personal experience to guide my big picture vision of how we might make “The Lonely Voices of Autoimmune Disease” less lonely.

When Dennis Boyle of Ideo complimented me on my creativity and analysis of the autoimmune market, it was a moment of personal triumph. Although I still do not think of myself as a creative type, I knew I had found “my people.”

 Do you have a story of community support leading to personal triumph?


Is there a “Platform gap” in Healthcare? A Stanford Medicine X Panel

How will healthcare data business models evolve around new “Platforms”?

 by Bonnie Feldman, Ellen M. Martin


Personal data is changing the way we work, live and play.  As consumers, we expect to receive personalized recommendations in a variety of areas, from shopping at Amazon, music from Spotify or movies from Netflix. 

I have been wondering how this type of data personalization can change healthcare, especially in the arena of chronic disease management. 

Some early initiatives include some simple data mashups:

In creating a panel for Stanford Medicine X,  I have been thinking about how long it will take these data mashups to become richer by including genomic, microbiomic, metabolomic and other -omic data. At the same time, I have been thinking about what business models are evolving with the growth of personal health data.  

Will new platforms bring different business models to healthcare?

A moment to define terms before we return to health data:

“Briefly put, a Platform is a business model concept, an O(perating) S(ystem) is a technology concept and an Ecosystem is a marketing concept.”

The concept of a multisided platform, which can be a service, technology or product that facilitates direct interaction between two or more parties as  seen in Airbnb, eBay, Etsy and others. 

Recent news about open API platforms for healthcare from Google FitApple Healthkit, and Samsung’s Sami  points to a growing number of giant platform companies seeking to enter the healthcare data ecosystem.  

In addition, Amazon’s recent meeting with the FDA may point to interest from another platform giant, while Apple’s discussions with Mount Sinai, the Cleveland Clinic, John’s Hopkins and Allscripts may indicate aspirations beyond consumer data.

Earlier platform entrants into the healthcare ecosystem are forming alliances to use consumer and clinical data in new ways such as:

In addition to new and expanding entrants, existing platforms from the healthcare side include:

On the other hand, Aetna closing Carepass represents an unexpected exit by a large healthcare payer/provider that was considered a segment leader.

Will the evolution of platforms outside of healthcare provide a template? 

Looking outside of healthcare may give us some pertinent insights on how IT platforms and associated business models, using open and closed data systems with a data monetization approach, have evolved. 

Outside of healthcare, open, closed and hybrid platforms, along with iterating business models, appears as a theme, evidenced by the robust merger and acquisition activity pictured below. 

Closed Platforms

Apple is probably the oldest successful closed IT ecosystem. It created a new paradigm—consumer IT—at a time when all IT was corporate.

By establishing the first consumer technology platform through its killer product, the iPod, users could live entirely in an iPlatform ecosystem of Apple products, all using a single operating system-the iOS- for desktop, tablet, mobile and music.  Apple was also the first platform company to use APIs to attract a large developer community to write applications for products in their ecosystem pictured below.


Open Platforms

Google appears to be multiple platform companies. First in search, later in advertising, then Gmail, and most recently, through Android, an open OS platform in competition with Microsoft and Apple. In mobile,  Android competes with Apple. In search, browser  and mobile, Google competes with Microsoft. In social media, Google+ competes with LinkedIn and Facebook.


Hybrid Platforms

Amazon started as an online bookseller and developed its own infrastructure to facilitate ecommerce—a platform suitable for any keywordable product, not just books—and so Amazon expanded into selling everything.  Subsequently it developed an ecommerce infrastructure-as-a-service called Amazon Web Services.  Originally developed by and for Amazon, it now generates $2B in revenues with an estimated $10B in 2016 as the backbone for digital-cloud conveniences such as dropbox. 

How will data business models evolve around these new platforms in healthcare?

Rapidly evolving business models are shown by the very active merger and acquisition activity pictured below as well as the current investor filings.

Google receives most of its revenue from online advertising.  Insight into their future plans can be seen on page 28 of the 10K  “We expect that our revenue growth rate will continue to be affected by evolving consumer preferences, as well as by advertising trends, the acceptance by users of our products and services as they are delivered on diverse devices, and our ability to create a seamless experience for both users and advertisers in this multi-screen environment.” 

Apple’s future plans reflect continued investment in R & D.  “Company continues to believe that focused investments in R&D are critical to its future growth and competitive position in the marketplace and are directly related to timely development of new and enhanced products that are central to the Company’s core business strategy. As such, the Company expects to make further investments in R&D to remain competitive.” 


What type of data monetization strategy will evolve in these new platforms?

Conceptually, data monetization is of the essence for platform business models.  Because the data monetization concept is relatively new, even the ways to describe the evolving business models are evolving.

Three different ways to parse data value include:

1.  Accenture analyzes the value of data ranging from raw, processed, insights, presentation to transactions.

2. O’Reilly’s Book-“Business Models for the Data Economyprovides a framework to segment monetization strategies as follows: 

  • Collect
  • Store/Host
  • Filter/Refine
  • Enhance/Enrich
  • Simplify/Access
  • Obscure

3. University of Cambridge has created a data-driven business model framework shown below.

Key activities include data aggregation, analytics and generation.  Key data sources could be free, customer-provided or tracked and generated.

These business models range from “multi-source mash up and analysis” to “data aggregation-as-a-service,” “data generation and analysis,” “analytics-as-a-service” or a  “free data collector and aggregator.”


More open questions for the panel “Open versus Closed Data- Where are the business models?”

In addition to the different types of data monetization strategies, another open question is will healthcare data platforms be narrow, broad or both?

Where will the medical device industry play?  How will hardware and software ecosystems evolve? 

The panelists, Chris Hogg of Propeller Health, Jonathan Hirsch of Syapse, and Jason Oberfest of Mango Health, will address some of these  questions with a focus on chronic disease management.  

See the next post to learn what the panel discussed.

Research Initiatives Around the Microbiome


What does a “healthy” microbiome look like? Who is part of a microbiome? How can we quantify and analyze our microbiome?

The Human Microbiome Project (HMP), a $173 million project by the NIH, was initiated to address these questions. It focuses on a comprehensive characterization of the human microbiome and the development of computational tools for the analysis of microbiome data. In 2012, NIH announced the first referenced data of a normal bacterial makeup in healthy individuals. Tissue samples from different body sites of 242 people were collected and sequenced to understand the structure and diversity of the healthy human microbiome. Scientists found that the microbiome contains 360 times more microbial genes than human genes that are involved in vital metabolic functions like digestion or the production of anti-inflammatories. Read the original article published in Nature to find out more.

The American Gut project follows another approach. Rather than carefully selecting test subjects, the founders wanted to involve the national and international public. So far, several thousand people have followed their call. If interested, you can still join the American Gut project!

Earlier this month, American Gut published preliminary results for more than 3,000 participants which described microbial composition and factors that affected the gut habitat, such as age and diet.

Individual Findings- Lone Fighters

Large studies are not necessary to contribute to the understanding of our microflora. Larry Smarr gathered information from blood and stool samples that showed early signs of the disease process, years before the first detectable symptoms of his late onset Crohn’s disease.

In another self experiment, Jeff Leach, founder of the Human Food Project and collaborator of American Gut, studies the effects of various dietary patterns on his gut microbiota.

And lots of unanswered questions

The research on the human microbiome is just getting started. Although important steps have been made towards defining the human microbiome and its role in diseases, many questions remain to be answered. Are associations with health and disease causal? How can this newly generated knowledge contribute to the development of interventions? In which diseases does the microbiome play a causal role?

Group Findings

A few years earlier, in 2012, an NIH press release announced the definition of a normal bacterial makeup in healthy individuals. This provides a much needed reference in order to study the role of the microbiome in diseases. This research article by Bäckhed et al.  elaborates on how understanding the properties of healthy microbiota could contribute to the development of interventions. The results of HMP have implications for other research fields such as epidemiology, as described by Foxman and Rosenthal.

Although science has provided important insights into the role of the microbiome in some diseases, it is still unclear whether these relationships are causal. 

Next time you look at a fellow human, pretend to be Neo from The Matrix, only try to see the trillion cells and around 23,000 genes that make up his or her body. Then, take a second look and try to imagine that the microbes within his or her body outnumber the human cells by a factor of 10.

Stay with us to find out in the next post, how scientists deal with this vast amount of information that would blow even Neo’s mind.

What questions would you like to learn more about next?