Part 2, Tracking the Course to Innovation with Zahir Abji

Part 1:

- Introduced Zahir Abji, CEO and Co-Founder of Guard RFID Solutions Inc

- Introduced Guard RFID Solutions Inc. and the markets to which they offer solutions

- Told of his family’s risky and dangerous journey from India to Tanzania

- Transitioned into Zahir’s work that helped revolutionize global emergency response and logistics, Zahir spoke of his work there with modesty.  MDI’s contribution was anything but modest.  

Part 2 of 2

Mobile Data International,  MDI, was one of those brilliant companies that sprung up, did significant work, was bought out, and melted into another brand.   MDI gave police and firefighters the ability to communicate through a mobile computing terminal in their vehicles.  This was a great achievement… unless your rap sheet was coming over MDI’s mobile terminal.  

Zahir Abji, CEO and Co-Founder of Guard RFID Solutions Inc

Zahir helped MDI develop mobile computing used by well-known global logistic companies.  He managed design for terminals used in taxicabs and recommended and developed one of the first handheld terminals capable of transmitting data, opening the gate for smartphones.

  

Running operations in Japan, Europe, Middle East, and Singapore with leading-edge technology, reliability, six sigma; becoming head of Research and Development and manufacturing for Motorola Wireless Modems; Chief Operating Officer; President for other companies providing hardware software, and interfaces with ERP systems; all of this coupled with market growth; these deep and broad experiences go into the company.  The roster of Guard RFID executives and board members runs with likewise experience. 

Guard RFID’s customer oriented global view has generated some significant work to support standards. Zahir explains, “The customer who has global operations will be uncomfortable in the absence of a framework of standards.  This is why we are involved in both IEEE and ISO. We helped the IEEE Standards Committee create the 802.15.4F standard.”

The Institute of Electrical and Electronics Engineers (IEEE) 802.15.4F standard states: "To provide a standard for low cost, ultra low energy consumption, flexible and highly reliable communication means and air interface protocol for Active RFID and sensor applications. The air interface should be able to support a wide range of needs for which Active RFID systems can be useful and enable improved performance and flexibility for future mass deployments of Active RFID systems around the world." http://www.ieee802.org/

Guard RFID insured that their physical layer is included in that standard.  Zahir commented, “Because of the attributes, our physical layer is a part of that standard.  One could say that we donated that physical layer royalty-free, without any license to the IEEE.  We also realize that IEEE is only one of the vehicles that’s looked at from a standards’ perspective.

“ISO appeared to be much more known and is respected on the non-healthcare side, especially in industrial areas, and it decided to adopt the same technology as the IEEE Standard to be included in the ISO 18000 – 7:2014 standard.  Dalibor Pokrajac, our Executive Vice President of Engineering, was a driving factor in both cases.  Again, royalty free standards are vital for adoptions and assists customers with global operations in selecting technology sources.  

“Guard RFID’s corporate knowledge, capability, and technology platform has allowed us to make major contributions because of the manner in which our technology is developed.  Healthcare tends to associate 433MHz with infant abduction.  That is within our capability but we are in manufacturing and Defense as well.  We have deployed tens of thousands of tags, helping customers with return on investment and efficiencies with personnel, materials, tools, equipment, and finished goods. 

“One place we believe we have an advantage is the power required to broadcast over a specified range.  Our tags can be smaller than WiFi because WiFi takes a comparatively larger battery due to much higher transmission power required to achieve the same range.”

When asked about the competition of other technologies in comparison to 433MHz Zahir responded, “Beside lower power requirements, there is a huge difference between UHF lower frequencies and frequencies above 1GHz.  UHF frequencies are very long wavelengths. Physically that means lower frequencies have longer range and perform better around large metal surfaces.  UHF has greater penetration. Frequencies above 1 GHz do not perform this way.  It’s just nature.  Requirements for longer range, great performance around metal surfaces, better penetration, and inclusion in both IEEE and ISO standards, those are Guard RFID strengths.”

I asked Zahir to provide some closing thoughts.  He concluded, “There are reasons that our technology has been adopted by these leading standards organizations.  It shows that Guard RFID’s technology is superior to many other solutions out there.”

Tracking the Course to Innovation with Zahir Abji

Tracking the Course to Innovation with Zahir Abji

Part 1 of 2

Zahir Abji is the CEO and Co-Founder of Guard RFID Solutions Inc., a software and hardware provider specializing in tracking people and objects using the 433MHz frequency spectrum.  Though healthcare, mostly, associates 433MHz with infant abduction prevention, RFID Guard offers solutions in Manufacturing and Defense as well.  Understanding Zahir’s path to CEO and Co-Founder is very important to understanding what drives the company’s deep work in developing international standards and delivering reliable and quality solutions. 

Zahir Abji is the CEO and Co-Founder of Guard RFID Solutions Inc

Zahir was born in Tanzania.  Tanzania is bordered on the north by Kenya and Uganda, on the south by Mozambique, and to the east by the Indian Ocean. His grandparents migrated there from India in the early 1900s, making the 5,100 kilometer (3, 168 miles) journey from Gujarat, India to Tanzania.  “They weren’t sure where they would end up,” remarked Zahir.  Yet, they struck out anyway on an intrepid search for better opportunities.

In those days, automobile ownership by consumers was rare.  Writing a letter and putting it in the post was the way to communicate.  A family member getting on a boat to embark on this type of venture, minimally, meant loved ones would seldom see or hear from him or her.  In some cases, it meant never.  Nowadays, not hearing from a son or daughter for more than a day can send some into panic mode to skype friends or check social media statuses.  Imagine not hearing from someone for months or years.  Britain was building a railroad from Kenya to Uganda.  Zahir’s family, tradesmen mostly, struck out from India to take part in that expansion despite the dangers.

They settled in Tanzania where they built new lives and started businesses.  This includes a restaurant, a bakery, and a factory that made soft drinks.  His family maintained this entrepreneurial spirit though World War I, World War II, and the political upheavals that often comes with transitioning from under a colonial power to independence.  That is the persevering background from which Zahir set off to attend The University of Salford, Greater Manchester, UK.

His choice of discipline was Biomedical Electronics.  This took much study in understanding anatomy, physiology, and the physical and chemical effects different types of energy have on human anatomy.  The course of study landed Zahir his first job in designing avionic systems for tactical and commercial aircraft.  The contrast of medicine versus weapons is not lost to Zahir.  “The availability of jobs in his area of study was not good at the time in England.”  He took the opportunities presented.

His work with military avionics placed him in an environment in which design specifications and the manner in which design was approached had very strict requirements.  He was awash in quality and reliability practice in each phase.

Zahir set his sights on North America where he joined a Canadian company called MDI (Mobile Data International).  This is where contrast turned to irony.  All of the discipline and techniques he learned paid off in work that had global implication for medical and police first responders.

Zahir spoke of his work there with modesty.  MDI’s contribution was anything but modest.  

Part 2 Coming Soon

Part 2, Manufacturing Perspective on Asset Management with Catherine Dacules

In part 1, Catherine Dacules told us about her path to becoming a CFO and shared her experiences on how Asset Managers can help CFOs in the manufacturing sector.

In Part 2,  Catherine shares how the CFO role has changed and her next objectives.

Catherine Dacules, CFO

How has the role of CFO changed over the years?  The length of tenure becomes shorter as CFOs move from permanent postings to interim assignments. This is a predictable phenomenon given the availability of sophisticated ERP systems and flexible, cross-functional IT platforms.  A good CFO has its mind focused on a short turnaround period.  You can’t possibly be going in and out of the ICU with the same diagnosis, can you?  A good CFO bridges the gap to enable the company to proceed to the next performing level.  I look at prospective employers as project assignments – there’s an inception and mutually-set goals culminating upon reaching the desired results.  It’s not an all-seasons engagement for me.  That’s why I go for client companies who really need help.  It could be in any aspect of their financial management, as long as the company is open to the idea of a properly executed turnaround, close to 50% of my job is already considered done.  Based on my experience, the company who admitted to needing real help, benefited the most in the shortest possible time with the turnaround procedures that I instituted for their financial management system.

How do you see it changing in the future?  I seriously believe that the CFO status is pivotal for any finance professional like me.  It is equated to the collective trust that one has gathered from past employers – whether they get to realize it on time or not. 

Second to a bailout, having a good CFO is the next best or worst thing that could happen to you as an owner.  We can paint the picture that you want to see hanging on your wall. Or, you can’t paint the picture as it subject exists. You either lose the company (including the CFO) and pocket a handsome profit or keep it (including the CFO) with just enough to get by.

So it’s no surprise that most CFOs fall out of the corporate finance wagon to build their own.  With a good grasp of their numbers, most finance professionals team with maverick sales & marketing people to transform their visions into reality.  Nowadays there is a current market glut for full-time CFOs, especially in the manufacturing industry.  From the corporate finance industry comes the next breed of CEOs – who knows their costs under different scenarios and are very IT-conscious.

Apart from your current involvement with Kratos Consulting firm based in Calgary, what other activities keep you busy career-wise? Well, as I always say, at some point one learns the trick of the trade.  I’m hinting at driving a company from the top by becoming its CEO. I think that is the natural progression from the CFO status. Unleashing my entrepreneurial spirit was by far one of the most challenging if not the riskiest undertaking I have taken so far.  But it was timed properly when I came across a product I believe would truly sell to a larger market across many countries. So when I had the chance to make a go for it, I did with utmost enthusiasm! 

Typical apprehensions were there; however, I had a reasonable level of confidence that I’m equipped to read market analytics and its financial impact on my undertaking.  My company Quartz-R-Us is involved in a projected 100,000 liters/day sustainable spring water distribution with its initial product offering addresses aging related health issues namely Osteoporosis, Arthritis, Alzheimer’s Disease, Parkinson’s Disease, Atherosclerosis, Diabetes and to some degree Psoriasis and Ehler-Danlos Syndrome (EDS).  

A large part of our Twitter followers are athletes and sports nutritionists, so that is worth looking into as well.  In 2015, we plan to exhibit at an A4M event launching QuartzWater as the first anti-aging bottled water in the world.  Currently, we have a serious market base in the US mainland and these are from the healthcare, sports and wellness industries.

Manufacturing Perspective on Asset Management with Catherine Dacules

Catherine Dacules is an experienced CFO  Because of her experience in different vertical markets, I sought out her perspective on Asset Management in the areas of manufacturing.      

Part 1 of 2

Can you tell us something about your path to becoming a CFO?

I have simply assumed that I was a CFO in training since I was 19.  It all started with an assumption that if I evaluate each case study from an owner’s perspective, then I will see the whole picture and better learn everything there is to learn in a short time.  It was my dedication to the management accounting practice that primed me to the CFO path. Coincidentally, that’s the branch of accounting that really kept my interest going for years on end. I have had my share of interesting and risky assignments. Fraud detection, management, and prevention were common to all of them.  

Catherine Dacules, CPA, CFO 

I would say, having a good pulse and intuition about which part of the operations went awry jumpstarts my assignment in a very positive way. It shortens turnaround time.

Was it something that you have always aspired to become? Not really. The dream that I had nurtured up to the point, where I decided to take up accountancy instead, was to become a child psychiatrist.  Because of this previous path, I approached the accountancy degree with a high level of objectivity, looking at it as more of a technical undertaking than anything else. In so doing, I kept my focus.

In what industries have you worked? The bulk of my experience is credited to my exposure in manufacturing companies with various industries, from garments to cosmetics, oil & gas, shipbuilding, logistics, and construction.  My loyalty lies with my company’s growth and not to any single industry.

Have you worked with life-cycle asset managers?  Typically this function is assumed by project managers. In that respect I have worked with a lot of them in various projects in various industries.

Can you share any of your experiences? During pricing decision-making or review, lifecycle cost considerations are hugely discussed and deliberated typically during brainstorming sessions. It was more of a creative process than a structured, scientifically proven method. Before the advent of ERP systems, getting anywhere near a proper lifecycle product cost review would have been next to impossible. And while a sophisticated way of monitoring costs throughout the manufacturing process is offered by major ERP systems, it’s a different scenario once the product is out in the market especially in the FMCG industry like food and beverage.  In contrast, lifecycle product monitoring is almost mandatory if not the norm for most big ticket project executions in the construction and oil and gas industries. On hindsight, it’s no accident that SAP was first created to serve the energy industry.  

Ideas on how our work affects the balance sheet. The balance sheet just like any other financial statement is only a snapshot, a glimpse in time, an image that reflects a single day out of 365 days of collective management success and failures. And while the age-old belief of keeping costs to a minimum gives most top management a certain level of control and assurance, the same belief will hinder the organic growth of the enterprise. Fear of costs is tantamount to fearing growth. Cost and growth are inseparable in a healthy and growing business. Since lifecycle asset management is more of a risk management approach, a large part of that activity – specifically R&D and aftermarket service or maintenance, is not capitalized and thus charged to period costs.

In manufacturing, both research and development and aftermarket costs fail to satisfy the criteria of specific product assignability within the period being referred to and reported on in the balance sheet. These costs are not inventoriable because they carry no identified real benefits beyond the current reporting period and they are not intrinsic to the product during the manufacturing process (the actual physical transformation and realization of the finished product) like materials, overhead and labor costs.

No specific balance sheet account will indicate with close accuracy whether an instituted lifecycle asset management approach has been working effectively or not.  For example, a dramatic increase in post-sales service and maintenance does not necessarily mean that the product is faulty (translated to poor R&D).  It may only be an effect of a seasonal increase in demand for the functions of that product, thus its breakdown may have resulted to overutilization of performance capacity.  Sometimes an increase in maintenance was a result of a fortuitous event. 

It’s only during massive recalls (in the automotive and pharmaceuticals industry, respectively) where significant losses will be booked and reflected in the balance sheet.  While the common perception in this instance puts the blame on faulty R&D,  poor procurement and supply chain management could equally be as guilty if not more. 

Ideally, an effective product lifecycle management is best measured by market surveys in the short term and translated to actual dollar terms through the increase or decrease of the enterprise’ share market prices over a considerable period of time. Or it could all happen overnight. And that’s the tricky part.

Read Part 2 or click here, http://assetmanagementhc.blogspot.com/2014/11/part-2-manufacturing-perspective-on_28.html

Emory Press Conference “Press * 1"

Emory University Hospital and Amber Vinson held a press conference today, Oct 28, 2014. My intentions were to listen and learn about her experience with Ebola, how press conferences were handled, maybe FB and tweet a little, you know - enter cautiously. This was high-level. I set in a hotel lobby and dialed into the conference.

I informed the host that I would not be asking questions. He put me on a listen only line. I muted the microphone and put on headphones. The line went silent for a while. Later, the connection clicked. I heard “press *1”. I did. The conference call went live. I listened intensely. The connection seemed a little dicey though I was on 4G, 4 Bars. Slowly, the connection became very clear.

After Ms Vincent spoke, the Emory physician took questions from the audience. I considered possible tweets. Then… I heard an announcement that the next question comes online from Al Hardy at Asset Management for Healthcare. Not the best situation but what are you going to do? Ask a question of course. More on that later.

Do Ebola Cases Point to Further Weaknesses?

It was through BBC News, May 2014, that I first saw reports on the current Ebola outbreak.  That led me to track the outbreak through Doctors Without Borders/Médecins Sans Frontières, the World Health Organization, and the Centers for Disease Control and Prevention (CDC).  One could follow the spread toward population centers and the estimated deaths.  After a lack of media coverage and a lack of a much broader international response to theirs calls for help, my first social media post of the Ebola outbreak went up late June 2014.

Also, BBC and CDC websites led me to a list of infectious diseases categorized the same as Ebola.  All had personal protective equipment (PPE) requirements the same as the initial CDC guidance for Ebola.  I wondered if that PPE was sufficient for anything on the list. Please provide feedback on:

- Do you believe the U.S Ebola cases points to weaknesses with PPE and protocols for all infectious diseases?

- What is your view on whether we really know how well nurses are protected from hospital acquired infections?

I appreciate your response.

Non-Capital Equipment Programs

A pithy pitch flawed by pitfalls

Non-Capital equipment purchases bundled with supply quotas are a problem.  Finance departments may not know that some of these agreements are capital leases.  Second, the cost of the debt can be far more than a healthcare facility’s borrowing rate or a lease through a finance company.

Non-capital equipment programs, no-cap as they are sometimes called, are equipment purchases or rentals tied to quotas written into a supply contract.  Vendors offer healthcare customers non-capital programs to help with their own sales and to fill a need for cash-strapped customers.  Anything from glaucoma removal kits to catheters have been used to get needed equipment.  Just because each party gets what it wants does not mean that each party wins.  In general, there are a couple of different versions of non-capital programs.  One results in a lease; the other results in a straight rental. 

Vendor marketing may package the program with branding that appears lightweight and easy to carry; however, if a finance fee is added to each unit of purchase, and ownership transfers to the buyer upon meeting a quota, the non-capital purchase is actually a capital lease.  And yes, some hospitals get audited annually without a finding even though the lease liabilities aren’t captured in financial reporting.  Also, these types of transactions can circumvent the equipment acquisition processes as written in the Environment of Care and never get caught in The Joint Commission surveys.

No findings on an audit, no findings from The Joint Commission, so, what’s the problem, Al?  The problem is… there are these vendor letters that float from department to department, looking to be managed by someone.  There can be dozens even for 250-500 bed hospitals.  Accounts payable doesn’t want these letters.  The letters are not invoices.  Credit memo isn’t written in any of the text.  Clinical departments send the letters off to contract managers because the letters don’t have anything to do with patient care.  Contract coordinators call finance and the circle starts over.  The vendors that send the letters do not expect any action on the part of the buyer.  So, people just stop bothering.

Those letters are notices of balances on debts though the vendor is not requesting money.  The letters are a reminder that those debts have a bite when the buyer just stops bothering.  Don’t meet the quota over a given period – Accounts Payable will get an actual invoice.  Move to another vendor before the debt is paid in full – Accounts Payable gets an invoice.  One response I hear often goes something like this explanation, Oh! When we get one, we don’t know what it’s for.  So, we send the letters to purchasing. When they figure it out, they blame the account executive and negotiate out of the bill. We have that sort of market power.  Just hold that thought for one paragraph and a double-space.

The Asset Ledger Manager may never know the equipment exits let alone track the capital lease or bring the equipment onto the asset ledger.  Even if he or she becomes aware, tracking is a pain.  Payments toward the lease fluctuate because the fixed finance charges are tied to supply orders.  Purchasing Departments order supplies based on demand and demand fluctuates over time.  Monthly finance charges may add up to $2,500 one month, $1,750 the next, $3,000 the month that follows.   Thus, the statement looks nothing like an amortization schedule.  Tracking all those letters for all those assets can take up most of a person’s time.  That is an added expense.  

Now, let’s go back those pithy negotiation tactics to get out debt.  Normally, with these types of non-capital programs, the buyer never sees a tax bill.  Early terminate and take possession of the equipment, the tax men cometh, city and county property taxes.  Depending on what transfers and the quantity, the tax men could put a dent in the hospital savings from the negotiations.  After the tax men leave, the insurance man shows up.

Recapping the non-capital program resulting in a capital lease: the lease is not visible because it is part of a supply contract.  Not meeting quotas for one reason or the other results in a bill for the debt owed on the capital.  It is nearly impossible to accurately project when the lease will be paid in full.  Negotiating out of early termination result in tax and insurance issues.

Cost is an issue for both types of non-capital programs.  In both cases, understanding the payout over the term specific to the equipment is important.  Rental programs tend to be the far worst proposal.  Rental programs take ownership off the table if the buyer does not lose the asset.  Rental programs can still have taxes.  Rental programs tend to be easier to track because there are usually purchase orders and matching invoices.  Yet, I have seen rental costs over the term of a supply agreement equivalent to 145% over the purchase price.  Upon renewal, the buyer has basically the same units plus a few upgrades.  Supply agreements containing supply cabinets can have fall into this category.

Non-Capital Purchase programs can be helpful for getting needed equipment.  Meeting each challenge requires knowing where to look in a supply contract, how to approach alternative financing , and great understanding of the asset life-cycle.

Want to talk more, contact me over linkedin, https://www.linkedin.com/in/alhardy or send an email to gsawriter@gmail.com

Fibers of Change - Andrey Ostrovsky, MD Part 3 of 3

In Part 1:  Dr. Andrey Ostrovsky (CEO of Care ^atHand) described Care Coordination as, “improving the communication between the care team members with an emphasis on patient cleanliness and insuring that things don’t fall through the cracks.”  This helps keep people where they want to be - at home. And it reduces admissions into skilled nursing facilities or hospitals.

He considers himself a social entrepreneur.  We talked about the definition.  Simply put, a social entrepreneur often sees success as both:

- a resolution of a “social” issue in a way that benefits the targeted populations

- the solution will still render good returns for investors

In Part 2:  We followed Dr. Ostrovsky’s extraordinary path through college, his work at the World Health Organization, the Doris Duke Foundation, and the reason he became the CEO of Care ^atHand.  The company became one of the top startups and was mentioned as such in Time Magazine, April 2013.

Part 3 of 3

I asked Dr. Ostrovsky how he felt about Care ^atHand’s mention in Time Magazine.

“It is a double-edged sword.  Sometimes the really meaningful work isn’t the most sexy work that the media wants to pay attention to.  We happened to be one of the top startup incubators.  GE is one of our investors.  There are all these big names; so, Time Magazine picked it up.  The article had to do with ObamaCare.  There were a lot of trendy things all referenced in one place.  Where I am the most proud is when we are published by local blogs.  Like the fact that we were picked up by a local blog when Congresswoman Katherine Clark, on behalf of the state of Massachusetts, awarded us for helping community nursing.  Those are the things I am most proud of-- that mean something.  Care ^atHand is going to change the way care is delivered.  Care ^atHand does this by leveraging big data outside the hospital environment with the low paid workforce currently hired by the industry.  That’s not sexy.  Those are not the thing media cares about but Care ^atHand is going to change the way a low income workforce uses technology to deliver really high quality work.”

“About your application, what’s your philosophy on outsourcing and crowd sourcing building an application?” I asked.

“If you are going to call yourself a software company you have to own it.  You have to control the quality of your products and services.  You have to have a hustler who sells and learns from the customer.  You need the hacker to build.  What you are building has to reflect the core competences of the founders of the company.

“Essentially we concentrate on community organizations philosophically and on a business case perspective.  I think community organizations are the future of healthcare.  They are our customers:  area agencies on aging, quality improvement organizations, managed care organizations.  Care ^atHand is expanding.  We can work with skilled nursing facilities that want to create their own care transition program. We have four area agencies on aging in Massachusetts and one in Kansas City.  In New York, we have a managed care agency.  We have two national contracts, including one with a software company.  Everyone can do or should be doing care transition.  The challenge is linking non-clinical people and the community health worker with the clinical nurse supervisor.  Without our technology, the link is incomplete.”

“Are there any parting words on either social entrepreneurs or  Care ^atHand?”

“I don’t think becoming a social entrepreneur is for everyone.  There are a lot of really talented people who can bring some lessons to bear.  I welcome them to the new frontier of innovation, community based well-care, and not sick care.   And as far as Care ^atHand, the data will speak for itself.”

Click Here to Visit Care ^atHand's Website
Click Here to Read Population Health and Andrey Ostrovsky

Served Up

This is unexpected, I thought.  I came to the Shelter to help cook for the hundred or so people expected that afternoon.  Granted, I was shamed into guilt for not acting on good intentions.  I stood, gazing toward the far end of that small kitchen.  I felt as contrite as a little boy whose mother had baked him sweets despite his slothfulness in doing something for her.  

So, here’s what happened.  Weeks before, my wife, Stascia, and I were making arrangements with another family concerning our kids.  The other family’s schedule conflicted because they were going to help out at a place called Inner City Night Shelter. 

My wife is an educator.  She helps people every day by just having a conversation about a personal issue or helping someone attain an educationally related goal.    The family to which we spoke helped feed people trying to get their lives back.  Me, I give to causes.  I write about causes.  My articles support those on the ground doing the work.  There is a need for those types of things, but I am not on the ground with them.  In this sense, I am removed and impersonal to those whom I am ultimately trying to help support.   My perch has me away from following the timeless principles of a more personal presence like visiting, serving, and helping to bear a burden.  My more “physical presence” efforts were sporadic and far… very far between.   So, there I was defenseless against words that really weren’t directed at me or meant to cause conviction.  People were just talking.

On Saturday, March 15, 2014, I arrived at Inner City Night Shelter, Arnold St, Savannah, GA.  The shelter provides services for men and women.  Individuals can spend the night, take a shower, and have a meal.  Through transitional services, the shelter provides help into a more stable situation.  This includes helping former inmates as well.  

I took a moment to look around the room.  The door was about ½ meter behind me to the left.  A walk-in refrigerator and a walk-in freezer made the wall directly behind me.  White cabinets lined the walls to my front left – doors up top, drawers and doors on the bottom topped by a counter.  The counter had a sink in it.  A stainless steel table stood in front of me.  To my right, there was a gas stove with a hood.  Next to the stove was a small sink.  About six steps away, on the far wall, was a three-basin stainless steel sink with a commercial dishwasher to the left of it.  And there I was, staring at the dishwasher, dumbfounded and undone by what should have been obvious.  That is, in this one place, as in many other places, there are many needs.  Those needs range from something as simple as putting a sandwich on a plate to something more complex that actually required a philosophically dyed in the wool life-cycle asset manager. 

Dishwasher All Shiny and Back In Action

I walked over to do a visual inspection.  The detergent lines were cut.  I figured the device wasn’t working.  The Shelter is not a place to just let something that works go unused.  Someone had probably used the lines to serve another need.    I asked some of the other food preparation team members about it.  They said it had been broken for some time.  The team introduced themselves and went to work preparing sandwiches and a hot meal.  They told me to connect with the center’s director, Yvonne Pryor.  The machine would have to wait until we were done preparing food.   

Later, Ms Pryor and I spoke about the dishwasher.  She had planned to purchase a new one because of the information she received that it was better to buy a new one.  We made arrangements for me to come back and troubleshoot the machine.  

A couple of weeks later, Ms Pryor and I looked at the dishwasher again.  She helped watch the detergent pumps to see if they were all cycling while I watched the camshaft that controlled the pumps, listened for solenoids, and checked the hot water pressure.  I hadn’t been able to find a service manual for the ten to fifteen year old machine.  Yet, there was still a certain amount I could tell about its operation.  The hot water flowed.  The water pumped worked.  The camshaft turned.  The detergent pumps cycled.  The water drained.  Granted, without a manual, there was no way of telling if every cycle was correct.  But, it did not look like Inner City Night Shelter needed a new one.  From previous research, I saw that parts were still available.  Only a minor repair was required.  What Ms. Pryor needed was an economical, simple, and self-sustaining method that maintained the machine, trained the staff, helped with continuous health department certification, all in a manner that was basically effortless for her to manage. Without going into the detail, that’s what we accomplished.

Writing about causes and helping to support those on the ground in places I cannot be present are still very important.  I continue to do them.  As they say, the rub is the commitment to take the time to be present where I can.  In the hustle of taking care of family, of bridging a strategy to results that generate revenue, of filtering the noise to meet a customer’s needs, of writing, posting and supporting the next blog post, of marketing my novel, of just hustling from one moment to the next in a calm and collected manner… how do you turn good intentions into physical presence at a place that serves others.  Those already on the ground need more team members.  As in the case of Inner City Night Shelter, it may require physical tasks and your professional know-how.

Fibers of Change - Andrey Ostrovsky, MD Part 2

Andrey Ostrovsky is a pediatric physician, CEO and co-founder of Care ^atHand, and social entrepreneur.  While there is a place, he believes, for healing one patient at a time, he wants to affect entire populations, starting locally, then regionally, across the globe.  Read Part 1

Begin Part 2 of 3

Dr. Ostrovosky set out on an unusual thread right out of high school.  While his “not so tactical grandparents” were happy that he decided to go through medical school.  The seams zigzagged well outside the pattern.  

“What did you do after high school?”

“I went to Boston University for undergraduate.  I took six month off to move to Geneva and work for the World Health Organization as a data analyst.  That was my first large scale, high-level work experience.  There, I started to get a better understanding of health systems and just systems thinking in general.

“During my time at the World Health Organization, I helped organize a conference.  The memorable from that conference was a nonprofit called the Health Systems Action Network.  Throughout the end of undergrad and into medical school, I had been an advocate for involving trainees into global health to help strengthen health systems.”  The program came about from meetings in 2005.  “I was invited by the board to run that organization.  I ran that organization while I was in medical school.  My pathway of early acceptance into medical school allowed me to do that.”

In his third year of medical school, he went to work with the Doris Duke Foundation.  He moved to San Fransico, California to work on a technology project for the health department in finding correlation between brain volume using MRI and neurodevelopmental outcomes in neonates with congenital heart defects.

Yet, another break, he spent six months of his senior year working for U.S. Senator Ben Cardin of Maryland.

It was during the stretch of time he spent in San Francisco to the time he spent in the U.S. Capitol that Care ^atHand began to take shape.  The idea came about when Doctor Ostrovsky’s friend, Jeffrey Levy, came to understand the challenges of caring for aging parents. It wasn’t until April 2011, that Andrey’s friend contacted him.

            “I knew he had ideas and frustrations regarding care for his parents.  He reached out to me as a physician and someone who had done some technology stuff in the past.  He quit his very lucrative job in Silicon Valley.  He asked me over.  I flew to San Francisco for a full day of brainstorming and meetings.   That was the beginning of Care ^atHand.

            “The name came from simplicity. We had a vision of something lightweight, something mobile.  We focused on a mobile, low-skilled workforce.  A mobile device would be carried in these caregivers’ hands, helping them to collect and communicate important information on patients they encountered in the community.”

            “How has that changed over the years?”    

“Initially, we wanted to automate workflow within home care. Typical home Personal Care Assistance services - we wanted to help with the activities of daily living.  We thought there was a big opportunity in this community to introduce mobile into that workflow and workforce.  We had a very innovative scheduling system.  We had very simple design, easy to deploy.  It was easy to use by a workforce that may be technology illiterate.  We saved a little money for our customers in homecare   but we did not have the impact we imagined. 

"We did this for about a year, year and a half and decided to take a step back.  We looked at where our passion was, where our strengths were.  When we looked at the intersection of the two, we realized that we were definitely on the mark with the workforce.  We are on the mark with the non-clinical folks.  Especially those that were unaccounted for, the gray workforce that’s not official.  It doesn’t have a MEDICARE reimbursement code behind it, a family care giver, a community health giver.  So we knew a lot about that workforce .  We are experts in that workforce and we are already experts in care coordination and transitions.  We are experts in big data, at least from the financing side of it.  So, what don’t we fit all this expertise together and focus in on digitizing care coordination.  We wanted to make care coordination a smarter process and in doing so, always emphasizing - how do we leverage the benefit of the community health worker and at the same time a clinician like a nurse?  That is the germ that led us to where our software application is now. “ 

Fibers of Change - Andrey Ostrovsky, MD

The Fiber of Andrey Ostrovsky, MD Part 1

by Al Hardy

“When we left Ukraine, I thought I was on a field trip.”  Dr. Andrey Ostrovsky chuckled.  This was the type of chuckle that only retrospection can bring.  The type that emphasizes a few things: first, it’s really not all that funny;  second, sometimes, life was pretty tough; third, there is still only a partial understanding of how we made it through.

Dr. Andrey Ostrovsky, CEO and Co-Founder of Care ^atHand

Dr. Andrey Ostrovsky is a pediatric physician, CEO and co-founder of Care ^atHand, and social entrepreneur.  While there is a place, he believes, for healing one patient at a time, he wants to affect entire populations, starting locally, then regionally, across the globe.

But what is a social entrepreneur?  For that matter, why does the designation even matter?  We will not even bother to drift into the deliriously distracting debate as to the value of social entrepreneurs in capitalistic societies.  A social entrepreneur’s initiatives may be focused on people or problems that are not seen as prime for investors.  Simply put, a social entrepreneur often sees success as both:

- a resolution of a “social” issue in a way that benefits the targeted populations

- the solution will still render good returns for investors

Dr. Ostrovsky understands the criticality of patient by patient treks back to health.  He even goes to the point of helping patients understand the interactions with her/his environments.  He will get down to the dirty details to figure out what’s going on within the patient’s ecosystem.

            Dr. Ostrovsky remarked, “I am not just concerned about treating asthma in a child.  I want to know about what is setting off the asthma.  For example, are there cockroach feces in the apartment?”

The value of the work at Care ^at Hand as a social entrepreneurial venture may be best understood through Dr. Ostrovsky’s journey to becoming a physician.  Dr. Ostrovsky was born in Ukraine.  Just before the infamy of the Berlin Wall was transformed into market demand for pieces of collectible relics, Dr. Ostrovsky’s parents were classified as refugees and fled to the U.S.  His father, who ran a construction company, buckled down into the hard hustle life of a cab driver.  His mother left her position of running a metal refinery to being paid under the table in a pizza parlor.  Imagine this transition for his parents.  Dr. Ostrovsky was a child and had a child’s perspective.  
   

“When we left Ukraine, I thought I was on a field trip.  Later, we lived in Baltimore City Housing Projects. I thought it was normal hearing gunshots. I remember going to work and having to make pizza boxes in the back room.  I was awful.  I was terrible because I kept eating pizza.” 

The family lived in Baltimore City Projects for three years.  That could have been the perpetual ending of the story.  Not everyone wins the fight to find a way out.  Not everyone wins the fight back to the semblance of a previous life.  His parents did.  I am sure with great costs and great rewards.  Those of us, who have never had to escape home and permanently settle in a foreign country and call that home… we may never really be able to appreciate the depth of those losses or gains.  I certainly would not want to experience such a thing just to gain that appreciation.  But, I can surely appreciate those who do live that experience.

His parents built new careers.  His father owns and manages Network Solutions of Maryland. His mother is the Vice President of Technology at Deutsche Bank.   It is obvious that Dr. Ostrovsky did not follow in their footsteps - career wise.  I asked how that happened.

           “You don’t have much choice as an immigrant child.  You have to be a doctor, lawyer, or engineer,” he gave a quick laugh. 

            I asked, “Were you resistant to it?”

            “I had no idea.  It is only in retrospect did I come to understand the grooming that was laid out before me.” He chuckled.  My parents were very supportive and always said they would be proud of me no matter what.  I see, though, the subtle suggestions by them… and the not so subtle suggestions from the not so tactical grandparents.  They said.  You will shame us unless you become a doctor, lawyer, or engineer.  It was never anything I was forced into.

“I was very lucky at the time.  When I was about eight or nine years old, my mom and my then step-father were running one of the largest Russian restaurants in Baltimore.  It kept them very busy.  During my most formative years, I grew up raising my sister, this small child.   I coached basketball for several years.  I was good in science in high school.  I fell in love with being around kids and voilà, pediatrician.

“But, when I look at all the privileged kids or the kids that were able to escape that environment and compare it to all the kids that weren’t able to escape that environment, why is that?  These are the things that piss me off on a daily basis and why I do what I do.”

Part 2 Coming Soon,