Matt P

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I love this, Ashley – and all the commenters above! Thanks for illuminating the fundamental problem that hospitals like Partners face.

I want to pull on a thread about patients from several comments above to add a new layer to the supply chain of the hospitals: Namely, the process of working with the patients themselves. Patients are in part the customers of healthcare services, but as Tom’s comments about RFIDs and and Ashley V’s comments about the operating room illustrate, a patient in need of service is also part of a supply chain – a supply chain that hopefully turns as many sick/injured patients as possible into patients with the best possible chance for improved health outcomes. The more people the hospital can achieve this for, the more it can make based on insurance reimbursements, at least in the ideal world. In some ways, the supply chain that Ashley has described in the paper – particularly as it relates to inventory management – is fundamentally about enabling this “patient-outcome” supply chain to function more effectively.

I think that treating this process as multi-layered and linked supply chain might help clarify and illustrate the ways that digitalization can improve patient outcomes and experiences, thereby (ideally) reducing costs and increasing revenues. (I wish I could draw a diagram in the comment, as I think a process flow would be highly beneficial!) Examples of such opportunities abound beyond EMRs, RFIDs, and patient-process tracking: Digital tools that help improve patient diagnosis; less invasive surgical procedures that rely on digital innovations (and robotics!); better patient check-in systems; and many more.

I want to take a devil’s advocate position in the response to the above: I think it is very possible that WB should invest minimally in the maintenance and growth of the theater-driven model of distribution.

It is true that the theater offers customers experiences that being at home or on a mobile device simply cannot – and Phil’s framework is a great way to distill that reality. But the question that WB must ask itself as a firm is whether or not its limited resources are best allocated to the specific projects associated with increasing movie theater attendance. As Ronald points out, innovation in this area is extremely expensive and unpredictable; collaborating with the supply chain intermediaries is also not a straightforward process. To introduce a little finance, I would project that the NPV of projects in digital is significantly higher than the NPV of projects in theaters. Meanwhile, earlier in the supply chain, the process of creating films that meet consumer needs and drive profitability within the theater-driven model is also much harder in an environment wherein there is such easy access to all different kinds of entertainment.

In sum, while I think the loss of theater-based experiences would have negative ramifications throughout American society, I think from a pure profitability perspective, WB should de-prioritize the theater experience and continue the push to distribute more content via other platforms.

On December 1, 2017, Matt P commented on Smartmatic: the role of blockchain in enabling elections :

This is wonderful! Thank you so much for writing.

I want to pick up on Jason Bourne’s and StarrP’s comments about costs to identify a perhaps larger challenge to implementation in the U.S., particularly with the current government: An aversion to investment of any kind. I do not know how much a transition would cost, and how it would affect current government actors’ jobs, but I do think that implementing this would likely require some degree of up front capital that the government might not be wiling to spend.

In addition, I think we have to acknowledge the reality that there may be ulterior motives for people to express concern about voter fraud, which is definitely one of the upsides to this program, as Danny points out. In the case of the United States, many argue that accusations of “voter fraud” are actually tools used as an excuse to suppress the vote of people in low income communities of color, which generally vote Democrat. (This leaves aside the possibility that federal officials may or may not collude with a foreign government to gain an advantage in an election!) The reality is that such individuals might take advantage of Americans’ distrust of change – and distrust of the media – to delay the implementation of such a powerful tool.

On December 1, 2017, Matt P commented on Arsenal Football Club: The Accidental Victim? :

I greatly enjoyed this wonderful essay, Eric! (JJ, couldn’t agree more about Liverpool….)

With that said, I want to push back a little on your analysis regarding the potential negative effects of this challenge for Arsenal. I agree that these changes are likely to cause a loss of talent, and that Arsenal and others should fight them, as others have suggested. However, I am not sure that the results will be as deleterious on the bottom line as you suggest, because it is not clear whether people both in the UK and around the world watch Arsenal (or the rest of the Premier League) because of international players, or because they are Arsenal!

Arsenal’s customer promise – and the customer promise of all sports teams – is to create the best possible product they can. When a team is as good as Arsenal, this entails doing everything it can to win within the Premier League, as well as to complete in the European Championship. But, even when Arsenal loses consistently, Arsenal sells out its stadium. Fan loyalty runs wide and deep, and people will tune in to watch no matter what, whether there are players from all over the world / their home country, or that supply is much more limited. For example, there are no Americans on Arsenal – or on Manchester United, Liverpool, or any of the other top teams – but we still all watch.

In addition, I think the Premier League has become popular not because its teams have won UEFA Champions League – which is where having the best players in the world matter most – but because it is extremely competitive within the league, within which everyone sources players by the same rules, and because they have an incredibly powerful marketing arm. (The Premier League remains the most popular league globally despite having no championships in the last 5 years; Arsenal has never won and has only played in one final!)

With the above in mind, these rules may diminish Arsenal’s ability to compete across Europe, but I think Arsenal need not to be too concerned about lost revenue, even if the British government doesn’t acquiesce to Premier League’s demands.

On December 1, 2017, Matt P commented on Nespresso: Protecting the World’s Best Coffee :

I agree with all those who have already posted that Nespresso will likely be able to pass off the cost increases from their sustainability efforts onto consumers. I wonder, though, whether they might also consider searching for ways to increase the supply of high quality coffee available. Increasing the number of suppliers who are able to produce high quality coffee, whether through improved quality of the trees or enhanced farming practices, will both increase sustainability and create competition amongst suppliers, thus pushing down price for Nespresso while insulating the firm from overdependence on a small set of actors.

With the above in mind, as Nespresso (hopefully) follows Jenny’s wonderful advice to add innovative financing to their AAA sustainability initiative and Helen’s insightful suggestion about the promotion of coffee in new regions, they should also seek to implement a program to improve coffee cultivation practices for their current farmers, while also teaching new farmers to operate with the best possible methods.

On December 1, 2017, Matt P commented on Clear Eyes. Full Hearts. Digital Education. :

(1) EdX, “New report, based on four years of data from edX, represents one of the largest surveys of massive open online courses to date,”, accessed 12/1/2017

On December 1, 2017, Matt P commented on Clear Eyes. Full Hearts. Digital Education. :

Thanks for posting, FCP! I have to say, I agree with Alex and June that the digital degree like will not and should not replace the in person degree for the reasons they articulated. I also want to note an issue internal to MIT’s supply chain: the entrenched stakeholders within and (likely) outside universities will resist a move pure online education at every turn. Administrators and professors in particular have a vested interest in the brick-and-mortar education model, as it enables their livelihoods – and, unlike in traditional businesses, the majority of the labor force (in this case, the professors) cannot be fired.

With that said, I do want to note that we are collectively biased about this because this has been our experience, and our futures depend on the value of degrees very similar to MIT’s. There may indeed be a sea change in the future – and people like ourselves may be in trouble if it does.

With that in mind, I want to take this one step further. The implication of Alex and June’s comments about soft skill development, performance verification, and immersion serving as motive to learn is in part that traditional degrees lead to better outcomes for students. There is significant data to bear this out: Even with Alex’s and June’s comments in mind, at Harvard and MIT, only 5.5 percent of students who enroll in massive ope online courses like those available at MIT earns a completion certificate! (1) While we might expect that to rise if individuals pay, this statistic suggests that this is very far from a cure-all for the problems our education system faces. If EdTech is going to enable the type of results it aspires to, it needs to determine how to increase the yield of its processes dramatically.