• Location-based iPhone Apps top 300 - The state of location-awareness in the iPhone. 10% of currently released applications. This will be huge in health care.

The United States of Mind, Wall Street Journal

Rentfrow P, Gosling S, Poter, Jeff. A Theory of the Emergence, Persistence, and Expression of Geographic Variation in Psychological Characteristics [Internet]. Perspectives on Psychological Science. 3(5)

If you’re following this blog it’s pretty clear that I have been examining the impact of location for awhile now, partially for personal reasons, (”Why did you move to Washington, DC, Ted?”) and partially for professional reasons - geographic diversity may emerge to be as important as any other diversity awareness we rely on to keep our nation healthy, physically and emotionally.

This is why I was excited to read the attached article, which is the description of a model for personality characteristics, geographic expression, coupled with an extensive survey of our population and correlation to health and social characteristics. In a nutshell - what’s the personality of each State and how does it manifest?

If you want to get right to the conclusions, the Wall Street Journal has prepared an interactive map of the differences, and you can test yourself on the Big Five Inventory of personality here. In the event you’ve done the Myers-Briggs before, I encourage you to read this article about that tool by Malcolm Gladwell, which casts a fairly large amount of doubt on the usefulness of the Myers-Briggs tool.

A short primer on the dimensions of the BFI:

The central aspect of E (Extraversion) that emerged from the results seemed to emphasize social orientation; that is, state-level E seems to reflect the extent to which people in a region socialize with others. The state-level correlates of A (Agreeableness) allude to friendliness, trust, and helpfulness, which is very similar to conceptualizations of social capital. The defining features of C (Conscientiousness) that emerged seem to denote restraint, order, and dutifulness; that is, individuals in high-C states seem to place more value on rules and obedience than do people in low-C states. State-level N (Neuroticism) reflects social, psychological, and physical well-being. Indeed, the patterns of correlations converged, suggesting that individuals in high-N states are socially isolated and generally unhealthy. State-level O (Openness) seems to capture the degree of creativity, unconventionality, and tolerance in a region.

The kinds of differences described in the article hit me in the face all the time - when I step off a plane in California I can feel the difference - the inventory points to an open, tolerant, place but one that is less social. The contrast between the two Washingtons is especially impressive - Washington State, among the least extroverted (#48 out of 51), District of Columbia, among the most (#3), and also the highest in the nation on the Openness scale (we’re #1. Not so much of a surprise after visiting Tech Cocktail DC 3 recently and interacting with the people here for the past year).

The Ted Angle

When I did my BFI, I scored a perfect 5 the Extraversion scale, middle on Neuroticism, high on Openness, high on Conscientiousness and high on Agreeableness. I think the feeling is best encapsulated by something a physician colleague said to me the other day about where he lives. He said, “I like where I live a lot. Now, if I could move to Manhattan, I’d do it in a heart beat.”

This review for me is about the place that gives a person the most energy to achieve their life goals rather than whether the place we are in is enjoyable or not, as encapsulated by that comment.

Interestingly enough, when I ran one of my blog posts through another BFI engine that looks at writing, the results were similar, off the charts Extraversion, but less Agreeableness and off the charts Openness to experience.

The next time someone asks me why I moved to Washington, DC, my answer will be, “Have you seen my BFI scores?”

The Everyone Else Angle

After reviewing this piece and several other pieces on this topic, (additional link cloud here and here) some interesting questions are raised -

1. What’s the personality inventory of someone interested in patient empowerment/engagement/transforming the health care system. Are we alike?
2. What’s the personality inventory of the geography that are the epicenters of this transformation? Where does DC Stand?

Take a look, post your BFI and State correlation in the comments if you’d like. What does this mean for supporting a nation’s health?

Tomorrow is my one year anniversary of arrival to Washington, DC, from the “other” Washington’s City of Seattle.

It occurred to me that I could pick any 24 hours’ worth of events to describe why I heart DC, so I’ll just use the last 24 hours, which started off with me meeting Josh Seidman, President of the Center for Information Therapy, for a walking meeting in Dupont Circle, which was joined spontaneously by Susannah Fox, from the Pew Research Center and e-patients.net. We walked Susannah to her workplace, passing both Hello Cupcake, where we talked about the arrival of the cupcake wars in Washington, walking past the offices of Bisnow.com, where I reminded myself to introduce Curtis Raye from Medical Bisnow to both Josh and Susannah in his profile of local health influencers. Later on, I received a tweet from Jen McCabe-Gorman who met Curtis at the Disruptive Women in Healthcare meeting, and the reciprocal tweet from Curtis (you could just see their twitterstreams coming together) that he met Jen. And so the epicenter of health care transformation becomes a little more epicentric.

This is happening in place with the most walkable areas per capita in the United States and with incredible diversity of cultures and thought. The only thing the District is currently missing for me are an Apple Store. And a Cheesecake Factory. (Both are three metro stops away in Virginia, though).

Place matters. We all deserve to find the best one for ourselves. Who’s yours?

• Urban competitiveness | Washington, DC is #5 Globally | Economist.com - Go BosWash. Place Matters.

This photograph is from a session using Tapulous’ Twinkle software, which is a location-aware version of Twitter. This exchange is evidence that the iPhone’s most powerful innovation is not 3G, it’s GPS, which Apple, Inc., has now seeded into the mainstream, just as it did with a host of other technologies, like Wi-Fi.

What is shown here is community being created with complete strangers based on location - this exchange happened when my tweet was broadcast to everyone within a 1 mile radius of the San Francisco airport.

Some of you out there have been expressing your reservations about Twitter, Friendfeed, and the like. Here’s a nice article about both. Don’t be reserved, these are important technologies that will have applications in healthcare. Get your Twitter accounts now. Post your ideas in the comments, as well, please!

And San Francisco, thanks for being nice. You never disappoint.

Publishing has been a bit delayed on this blog (but not on my TwitterFeed, I am starting to get how each thing fits together depending on what one is doing), due to the distraction of the beauty of the Seattle summer.

As part of reconnecting with friends who are also iPhone users, I ended up participating in an application-downloading binge. “What does that application with the funny name do? I don’t know, let’s just install it and find out.” I did have the sense to stop and create e-mail aliases for some of them before signing up, but it’s otherwise interesting to reflect on the mob mentality’s ability to modulate concerns about identity exchange. That in itself is interesting - the agility of Apple’s application distribution scheme is going to change a lot about the viral use of software.

What happened next was even more interesting. I have been using Tapulous’ software’s Twinkle for a while now. It’s a Twitter-based application that publishes location information along with lifestreaming events. So, depending on where you are at any given time, it will show you your friend’s tweets, and with the press of a button, anyone who is tweeting around you. The interesting part is that if no one has tweeted recently, it will go back in time, to the location where you are.

520, Big Mountain in background (Rainier)

While driving across the WA-520, pushing the button revealed the tweets of the people who had been stuck in traffic on this notoriously congested floating bridge hours and days prior. As we crossed effortlessly in the evening, I saw the frustrations of many a driver in the past few days while in the same place. It was a sort of a “kilroy was here” - a twitter signature of a place with meaning to Seattleites (this is the bridge that connects many Seattle residents to work for a very large software company in Redmond, Washington) that would persist.

Of course there’s a tie in to healthcare. Think about all of the places with meaning in the healthcare temple - the operating theatre, the waiting room, the intravenous infusion center, the intensive care unit. If a person had used the Twinkle application in one of those places, any future visitor could pick up the tweets/feelings/emotions of that space. Kind of like an emotional geiger counter. If we did a sweep now in these places, what would we find about these environments? Would it be good news or bad? Will America’s hospitals and health care settings create “no tweet” policies for staff within their facilities? Or would they do the opposite….

What if a health care organization used this feature with intention, and asked patients to tweet their feelings during these meaningful times in the lives of themselves and their families while physically located in these places. The tweets would remain fixed to the GPS location and would be retreivable forever in the future. It’s interesting to think how this could potentially connect patients and families to each other across time and place. Imagine if you could ask, “what were the triumphs and the sorrow that happened in this room before I came into it?”

In the meantime, the next time I am in a health care environment, I will have my location aware device “on” and listening…

If anyone else here has used Twinkle or any other location aware lifestreaming application, feel free to post your experiences here.

Who’s Your City?: How the Creative Economy Is Making Where to Live the Most Important Decision of Your Life, by Richard Florida

The world is not flat; place matters.

I couldn’t agree more with the latest work by Richard Florida. This book looks at the importance of place not only in the global economy but in a person’s life. I personally had a good idea that this made a huge difference some time ago, despite living and working in a world where colleagues work for organizations for which home base is irrelevant.

On this, my 300-day DCVersary, I can confirm that my experience bears this out. Moving from one of the smaller “mega-regions” (Cascadia, Portland, Seattle, Vancouver, 9 million people, $260 billion light-based regional product) to the second largest one in the world (Bos-Wash, Boston-Washington, DC, 54 million people, $2.2 trillion LRP) has undeniably made a significant difference in everything I do, even in a technology-related occupation. As Florida describes, people cluster:

(There is) the tendency of creative people to seek out and thrive in like-minded groups, and (there is the) self-perpetuating economic edge that comes from doing so.

Florida does a good job of reviewing the evidence that place matters, and the idea that its impact on personal and professional happiness has been underemphasized. He combines original research as well as data currently available to create a compelling picture of both the importance of place and the factors about it that matter. One of the interesting explorations in the book is about the personality of cities - extroverted people and agreeable people tend to be localized east of the Mississippi, where “open to experience” people tend to be localized to the coasts, with dominance in California and Bos-Wash (okay, maybe the extroversion doesn’t stretch as far east as DC, and maybe the “open to experience” doesn’t stretch as far South, but I’m pretending they do - you always see the best in something you like).

Throughout, It’s nice to imagine where you might “fit” but also how your own experience stacks up, because an important criteria of a place its aesthetic.

I have been using a curious measure for the past few years to judge aesthetic, the “touch-down” measure. It is, “In what city do you say to yourself, ‘I’m home,’ when the plane touches down on the runway.” I think you can’t fake that. Alternately, it’s the city that when the plane touches down, you say to yourself, “I can’t believe I don’t live here.”

I give strong kudos to Florida for acknowledging the role of diversity and tolerance in a place, not just for minorities, but for all people. He says:

It’s not about tolerance for tolerance’s sake. As my previous research has shown, places that are intolerant simply do not grow. And, as the Place and Happiness Survey confirms, people in intolerant places are less happy and less fulfilled than those in tolerant an open-minded ones.

This finding is similar to research that shows the same thing about organizations. As a patient said to me a very long time ago, “We don’t tolerate diversity (within the organization I work for). We LIVE diversity.” That describes a place that has a better chance of thriving, and one that most people (including me) want to be involved with.

A book by an author that writes a blog is a better read

It is worth mentioning that as I read the book, the positive impact of Florida having experience writing a blog came across, because (a) he brought his personal experiences and those of his colleagues into the story and (b) he crowd sourced several of his ideas, bringing in commentary from blog entries. This made for a much more engaging read, and I can’t help thinking that without this experience, the work might feel less connected to the experience of real people. I think this is an interesting way that blogging is changing traditional publishing because those who blog are forced to become more personal in their communication to be successful. I like it. A lot.

And the winner is…

I have experience living in three mega-regions described in the book: Bos-Wash, Nor-Cal, Cascadia and it was interesting for me to compare the decisions I’ve made with the characteristics of each. All of them offer so much. My recent experience with Bos-Wash has been, well, fantastic, both in terms of livability, ability to be extroverted, and exposure to diverse populations and cultures. Nor-Cal scores high in my book as well as it shares many of the livability and diversity attributes, as well as strong dominance in technology and innovation. Cascadia was definitely enjoyable for the time I spent there.

Who’s Your City? Feel free to post your experiences…