The Final Curtain

I struggled with the final project for a bit before I decided to ignore all of the whirling confusion and focus on building an engaging experience around a product I would buy as a consumer. I’ve used quite a few mobile fitness apps over the past few years, most with unsatisfying results. What the marketplace needs is a social app that fill the problem of motivation among those who choose to exercise outside of a structured gym experience. 

So I built the SocialFit Experience. 

Check out the final project at: http://www.pixelsandpolicy.com/socialfit/

Let’s get physocial.

Medicine, Digitally

For 44 million people, health care is still a luxury beyond reach. No wonder, then, that health care reform is the topic du jure across the country this year.

As Washington politicians debate an expansive and expensive universal health care bill, many are looking for ways to bring the cost of health care within reach of those left behind. How many are looking at the ways virtual world technology is evolving to lower the cost of physician consultations and medical screening?

Virtual Health I.T. and the Decreasing Cost of Consultations

One of the major incentives of health insurance comes in the form of low-cost preventive care consultations with general practitioners. With most insurance plans, a concerned patient can see a doctor for between $20 – $75, with any prescription drugs or further medical procedures available at a steep discount.

But what about those bound down by multiple jobs during the day, or those who lack a quality care provider in their area? This is where virtual worlds come in, filling a hole in the medical field by bringing qualified care providers to busy urban households and isolated rural areas alike. U.S. News and World Report ran a great article about the cost-effectiveness of doctors consulting with patients using secure, confidential virtual world software. In other words, don’t expect your medical information to go out to the Second Life community.

The technology isn’t as speculative as some like to think. The Hawaii Medical Service Association currently hosts their own private virtual world dedicated to doctor consultation with patients. By implementing webcams in addition to live chat and virtual representations of both doctor and patient, physicians can make decisions on non-emergency conditions and prescribe pills or limited treatments digitally. It’s both a cost- and time-effective way to conduct routine consultations.

What about cost? HMSA’s program is surprisingly cheap. According to U.S. News and World Report, the cost is nothing more than what you might spend on your cable and phone bill:

Patients in the Hawaii program receive care from doctors scheduled to be reachable at that moment. A 10-minute “visit” costs $10 for members and $45 for nonmembers, paid with a credit card. HMSA says thousands of patients have registered. Health plan members like Gano are pre-enrolled; nonmembers create an account and key in their medical history and other data to establish a record.

Virtual consultations won’t be very effective for emergency conditions, but they provide essential preventive care that can help make emergency room visits less frequent.Some forward-thinking health care providers are even implementing virtual technology into the surgical process. As the New York times reported, potential plastic surgery patients can post their medical histories, requested surgeries, and problem areas online and allow qualified surgeons to compete for their work.

Patients can get consultations on more than just a face lift. The San Francisco Chronicle has an interesting article about how the esteemed UCSF Fetal Treatment Center now offers comprehensive online consultations for expectant parents whose fetus runs the risk of complications. A concerned prospective family need not fly to San Francisco for a potentially pointless consultation – virtual communication saves both time and money.

As the San Francisco Chronicle notes, the people most likely to benefit from these services are those who lack the funds to travel across the country and receive them through traditional means:

“Before we’d have them drive four hours from Fresno to see us. Now they’re getting immediate feedback” said Dr. Ilona Frieden a professor of clinical dermatology and pediatrics at UCSF. “It’s giving a level of care to an underserved population that they wouldn’t otherwise have access to.”

By implementing virtual world and digital communication technology into the medical field, patients are no longer restricted by the quality of care available in their immediate geographic area. An expectant mother worried about an aberration in her ultrasound no longer has to plan for thousands of dollars in travel expenses for a consultation. An elderly Hawaiian with limited mobility needn’t panic if they run out of a prescription and can’t get an appointment with their usual physician.

In new and exciting ways, proactive health care professionals are using the communication power of the Internet to meet with patients too often left out of the medical care loop. Research by the Robert Wood Johnson Foundation finds that expanding preventive care visits creates a more cost-effective medical system by catching preventable chronic diseases. Virtual conferencing lowers the cost of preventive care consultations, expanding the number of patients with access to quality health services before chronic diseases set in.

Roadblocks to Virtual Preventive Care

There are policy roadblocks currently in place that make a full-on transition to digital consultations more complicated than it may seem. Foremost among industry concerns: If a surgeon in California is giving medical consultations to a patient in Iowa, the surgeon must be licensed in Iowa. Providing medical advice to a patient without licensing in their state is a crime that unintentionally limits the spread of virtual consultations.

The New York Times comments on this pre-Internet limitation:

Offering a surgical recommendation to a distant patient may violate state laws, if the plastic surgeon isn’t licensed in the home state of the patient, according to the Federation of State Medical Boards, a nonprofit group representing 70 boards in the United States and its territories.

While it is understandable that doctors and surgeons must be licensed in states in which they plan to perform procedures, it seems unnecessarily restrictive to limit their ability to provide valuable initial recommendations and consultations on procedures patients may need.

The hodgepodge of differing state laws makes it complicated for medical facilities to roll out virtual consultations and adds to cross-border paperwork. Promoting one set of standardized regulations would greatly assist the rollout of virtual medical consultations. This would eliminate the risk of legal liability for surgeons and doctors as well as simplifying an already daunting set of administrative regulations for hospitals in general.

This is not an insurmountable obstacle. In the midst of a massive health care reform push on Capitol Hill, integrating virtual consultations as a cost-cutting, effective measure should be common sense. Pushing full force into virtual consultations provides an opportunity for virtual conferencing companies to innovate, as well as adding new technologically-literate jobs during an economic downturn.

More importantly, virtual consultations offer hope to an entire section of the population previously cut out – by cost or geography – from essential preventive care. That should be reason enough to investigate the technology’s great promise.

The Social vs. The State

Facebook’s servers, spread as they are across the sovereign laws of multiple nations, each unique in their features but bound together by shared purpose, are not merely warehouses of raw computing power. They are the modern bearers of the liberal diplomatic tradition.

Before the rise of modern communication with the success of the electric telephone in the 1870s and, later, Marconi’s wireless telegraph in the 1890s, the state required a physical symbol of its presence on the world stage. The diplomatic embassy and its attendant mass of aides-de-camp, envoys, attachés and career civil servants served as both a physical and psychological projection of power across oceans and national borders.

Embassies came to define the countries they represented beyond the scope of official policy. Embassies provided a platform for public  events like France’s display of its new hot air balloon in 1788, or the secret negotiations between the British and Ottoman Empires, both at the height of their expansion, that led to the ghastly Crimean War campaigns of the 1850s.

Modern Ministers

Looking at a list of upcoming ‘hacker culture’ events at Facebook server facilities in Sweden and Prineville, Oregon, and Google’s ‘Open House’ events in India, Ireland and Germany, one can be forgiven for feeling a touch of the quill pen alongside the omnipresent glow of global social networking. Server center tours, hack-a-thons, meet-and-greets with prominent company employees, displays of new conceptual technologies – the public relations campaigns of the world’s technology firms harken back to the golden age of state diplomacy.

Perhaps this analogy is more apt than first thought. Much like the emerging nation-state system of the 18th Century, today’s global technology firms are faced with an entrenched cultural system undergoing transformative change thanks to their innovations. Instead of roiling the world of political theory with concepts like universal franchise, state borders and the national army, firms like Facebook and Google move beyond a state system. Just as during the Napoleonic Wars, though, there are interests allied against such destabilizing change.

It’s no surprise that the region with the highest rate of staffing growth is also the oldest of the old guard: Continental Europe. Germany and France have responded to the changes in personal privacy and public sharing brought by Facebook and Google by reasserting the power of the traditional state to regulate commerce and public behavior. Germany instituted restrictive laws on social networks’ use of personal data for tracking. No such restriction applies to the German state, which compiles reams of information on its citizens.

Social Media’s Westphalian Moment

This does not, however, make Germany’s actions hypocritical. The policy remedies of Germany need to be considered in the context of cultural combat: the traditional nation-state system, faced with new cultural ideas about information sharing and borderless communication, is fighting for its survival.

Much like the confederacy of the Holy Roman Empire fought the integration and federalization that would make it the nation-state of Germany, now Germany fights against a cultural tide that threatens its long-held traditions of state regulation of communication technology. This trend, forged in the bloody birth of the nation-state system,  holds broadly true for all of Europe.

As is so often the case, the United States stands unique among the nations of the world in terms of their response to social media. Guided by some combination of its individualistic tradition and an ingrained sense of entrepreneurialism and exceptionalism, the United States often defends the products it views as American innovations. Google and Facebook, both American creations, frequently host former and current American presidents, members of Congress, state governors and public intellectuals.

Far from leveraging its state power to weaken the hand of social networking, the United States appears eager to integrate this new wave of global citizenship into its democratic tradition. Legislation like the Stop Online Piracy Act, which seems quaint and laissez-faire by German standards, fell victim to public outrage.

The idea of taxing Internet-based purchases, a common source of European revenue, is regarded by legislators and a large segment of the public as a sign of the much-maligned “big government.” If there is to be a conflict between the nation-state and the social state, the United States appears poised to support its second revolution. The question of what kind of civil society comes from a borderless, endlessly translatable, globalized communication network is now upon us. What kind of world are we creating?

Are Virtual Communities Helping Indians and Pakistanis Come Together?

You may not be familiar with The Hindu, India’s national newspaper. I recommend it to anyone who wants to read some insightful work from an up-and-coming world power.

A fascinating article by The Hindu’s reporters looks at how the technology powering virtual worlds is evolving, and how the way people communicate is evolving with it.

Let’s take a look at why India has such an interest in virtual communication, and what their research tells us about the importance of the Metaverse across cultures.

Building a Virtual Life, India-Style

India is far from where it once was as a nation. As a consumer culture, India is reaching developed-world levels. But many in India are left behind, and both poverty and illiteracy tend to hit young women more than any other group. Though boosted by a booming service sector and an increasingly mobile generation of well-educated engineers and health specialists, India has far to climb.

It’s little surprise, then, that the idea of being anything one wants is a powerful draw to young, wired Indians:

The virtual world arena opens tremendous opportunities for being whoever you want to be, meeting people from across the globe, living the lifestyle you always dreamed of, performing the feats that you are otherwise incapable of performing. People who participate in it live, not as who they are, but who they would like to be.

The synthetic world therefore offers you a virtual life which is not a product of your circumstance. Most of all, it may make some of you feel like you have erased everything in your past and started all over again. Kind of like a second chance at life.

A second chance at life is a powerful offer in a culture where an entire class of “untouchable” Indians still faces de facto discrimination over everything from access to education to job placement. With easy-access internet cafes and accounts in free worlds, some Indians suddenly have a sense of control

The Hindu wonders whether the availability of posh virtual lifestyles might make young Indians long for something better. This longing could promote real social and cultural change.

The Hindu notes with worry that the newest generation of tech-savvy Indians might depart for greener pastures after having a taste of the digital cornucopia available around the world. From the article:

Our current young workforce is a generation that grew up on video games and its consequent blurring of lines between games and real life. This is also the generation that grew up on Star Trek and the notion that Space is the final frontier.

In other words, workers raised on the ethic of possibility inherent in virtual worlds won’t sit around and listen to government excuses for why education is poor, infant mortality is high, and jobs are scarce. Ascompanies like IBM begin to offer call center jobs in virtual worlds, many Indians are leaving the traditional office in favor of the comfort of their homes. The status quo simply won’t suffice anymore.

Rich Experiences, Poor Communities

I was invited by a few Pakistani friends to attend what they called a “comedy night” in the virtual world of Second Life. You can excuse me for not knowing these types of events existed, as every time I log in I’m confronted with a sea of idle players soullessly grinding against each other in a stew of flying penises. I jumped at the chance to talk shop with friends in the virtual field.

Pakistan’s laggy, unreliable internet connection has been a problem for serious virtual worlds users since at least 2007, when the Musharraf regime made a real effort to expand broadband access. But still they come to see comedians like Sami Shah, a breakthrough Pakistani stand-up artist who bucks the nation’s conservative religious trends through pointed observational comedy.

Shah is one of a growing number of world-minded Pakistanis turning away from the schizophrenic political state of their nation in favor of the idealism of virtual reality. In Second Life, Pakistanis – anyone, for that matter – can access a universe of over 600,000 active players for nothing more than the cost of an internet connection. Once inside, the possibilities are limitless.

But the virtual world isn’t just for stand-up comedy. Ambitious avatars from developing and wartorn nations in the Middle East and South Asia have constructed replicas of Baghdad’s city streets, photorealistic mock-ups of a spacious Middle Eastern market, and the Kingdom of Saudi Arabia. Yes, theentire Kingdom.

Virtual Worlds: Upending the Communication Paradigm in Pakistan

As I could tell from my experience at the night club, the citizens of developing nations will find ways to connect. Whether through internet cafes or priated Internet, the feeling of uninhibited interaction is an addiction not easily shaken. The virtual nightclubs where Sami Shah performs his routine are rare in Islamabad, where freedom of speech has waned over the years.

In other parts of Pakistan, notably its tribal West, wearing a shirt open at the collar and riffing on the Taliban can be dangerous to one’s health. But discussions in Second Life run the gamut from comedy to philosophy and politics. Even the heavy weaponry some players wear is more theater than threatening – there is no death in the virtual world.

If the history of previous tools of communication is any guide, Pakistanis could soon see their desire for communication leak across the virtual boundary. The advent of mass printing and the telegraph changed written communication by greatly expanding the pool of literate citizens.

This literacy blossomed into books and messages of all types: Political awareness entered a Renaissance at the same time creative fiction and journalism entered the households of millions. Expanding communication through virtual communities is the next logical step in literacy’s long evolution.

Empowered by their idealism and encouraged by their successes in building virtual communities like Second Life, young Pakistanis will increasingly question why so many seemingly basic infrastructural and political fixes are met with government dithering. A young Pakistani who successfully prototypes a public water system in a scale model of his village will be less likely to accept her government’s claim that such engineering feat simply cannot be done.

Building Virtual Community in Rural Pakistani Regions

The shared sense of purpose and community created by virtual worlds will give rise to the same groupings of concerned citizens that printing presses made possible.

Public interest groups could easily span Pakistan’s wide and rugged terrain when tribal leaders who may live hundreds of miles apart no longer need to be physically present to speak with each other. In a community where only one household may own a computer, enabling such long-distance conferencing with visually familiar representations of tribal leaders or government officials may create substantially more interaction and teamwork than now exists.

Once many young Pakistanis from across the nation are connected in one visual, virtual community, old dependences on an ineffective central government will melt away in favor of group problem solving.

In other words, Second Life and virtual worlds may well streamline and improve Pakistani government not because it allows Pakistanis a means to protest, but because it gives them an alternative to potentially corrupt government: They now have each other, and as the network grows, so does the potential for the group to take on ever more ambitious problems.

Whether letting their hair down in virtual comedy parlors or showing Western visitors the ropes of virtual Islam, Pakistanis – and those across the developing workd – have a larger cyberpresence than ever before. If the governments of developing nations fail to satisfy the growing desire of young, wired citizens for national modernization, it is entirely possible that the old ways could fall to the wayside. We can hope.

How the Economic Downturn Fueled Broadband Telecommuting

The sputtering global economy could have a silver lining – companies looking to cut travel costs are turning to the virtual world for more business services than ever.

As CNN reports, companies are increasingly turning to telecommuting and virtual conferencing in graphical virtual worlds as a means of shaving costs and remaining competitive in an economy where credit is still tight and government life preservers are harder to come by.

Taking the Work Day to the Web

Graphical interfaces like ActiveWorlds and Second Life have always hosted at least a small business presence, but few companies have gone so far as to conduct wide-ranging business dealings through the virtual world. According to CNN, the corporate winds are changing:

[Linden Lab's] Enterprise tool will let employees’ avatars — animated alter egos — meet in virtual worlds from the privacy of a company’s own network, rather than the public networks used in standard Second Life. That extra security could encourage more companies to take up the technology.

The ability to collaborate effectively using virtual tools may now become an increasingly important skill as technology offers more options than, say, video conferencing.

The move from real to virtual business communication is larger than just Second Life. Some forward-thinking companies are even developing their own virtual business worlds in the same style as Second Life Enterprise. These are in-house virtual worlds, so they don’t compete directly with Second Life Enterprise, but the possibility for cross-pollination is an interesting thought.

There are obvious cost benefits to working in the virtual world that stand out at a time of global recession and rolling bankruptcy. Travel costs are reduced to zero as avatars from around the world come together in one central space.

Collaborative projects can be built and prototyped in a synthetic space instead of committing real-world resources. Information can not only be shared, but manipulated in three dimensions by an entire meeting.

There are, of course, very successful non-graphical competitors to the virtual business model -GoToMeeting is perhaps the best known, and its intuitive interface has likely drawn clients away from virtual environments with higher learning curves. But one part of the formula remains constant through graphical virtual meetings and more streamlined voice conferencing – cost reductions are real.

The Benefit of Building a Virtual Company

Of course, the flexibility of virtual work makes it ideal for companies spread across continents and time zones, but what about small start-ups with minimal staff and no international presence? In this case, there is something even bolder on the horizon.

Pioneered in Vermont to much acclaim and publicity, many companies are solving the problem of financing expensive office space by moving their entire business into the virtual world. According to a bill passed in 2008, companies registered in Vermont no longer need physical addresses or physical incorporation forms. They can register to conduct business in Vermont entirely through virtual means.

According to an article by Inc. Magazine:

Vermont plans to charge fees of up to $275 a year for each virtual company registered, with state income taxes applying only to income generated in Vermont itself. The hope is to mimic the success of Delaware, which collects some $700 million a year in incorporation taxes and fees by offering low taxes, few regulations, and a business-friendly judicial system.

Pro-business legislation like this will almost certainly have an impact in Vermont, as small businesses are freed from the confines of a physical space. No more expensive office space, desks, water coolers, commutes, or coffee runs.

For $275, a company can market its real-world product or provide its services from a hub on the Internet. As business loans dry up and financing is hard to come by, moving a business entirely into virtual space could mean the difference between a promising company folding up or thriving through the remainder of the global recession.