Book Review of “Inventology: How We Dream Up Things That Change the World”

"Toolbox_LRG", Image by Limor

“Toolbox_LRG”, Image by Limor.

My father loved to tell this story: One of his classmates while he attended the University of Pennsylvania School of Dental Medicine was named Robert Schattner. Several years after they graduated, he went on to invent the over-the-counter sore throat lozenge and spray called Chloraseptic. This remedy has been on the market for decades ever since then.

Schattner first devised this product entirely on his own after someone who had just had some teeth pulled asked him for an antiseptic to relieve the pain. He later sold the formula and the rights to a pharmaceutical company for $4M. (Given the rate of inflation since then, this sum today would have been magnitudes more and certainly nothing to sneeze or cough at.)

Thereafter he left the practice of dentistry and went on became a successful businessman and philanthropist. He also contributed for the construction of a new building for the U Penn dental school named the Robert Schattner Center. A brief summary of his invention and contributions can be found in an article entitled Capital Buzz: Chloraseptic Inventor Offers Remedy for School, by Thomas Heath, which appeared in The Washington Post on October 23, 2011.

Mapping the Inventive Process

This is a classic example of how inventors find their ideas and inspiration. There are many other circumstances, methodologies, environments, personality traits, events, technologies and chances occurrences that can also precipitate new inventions. All of them are expertly explained and explored in Inventology: How We Dream Up Things That Change the World (Eamon Dolan/Houghton Mifflin Harcourt, 2016), by Pagan Kennedy.

The book’s five sections distinctly map out the steps in the inception and realization of things so entirely new. In doing so, the author transports the reader to center of this creative process. She deftly uses highly engaging stories, exposition and analyses to illuminate the resourcefulness and persistence of inventors leading to their breakthroughs.

Some of these tales may be familiar but they are skillfully recounted and placed into new contexts. For example, in 1968, an engineer and inventor named Douglas Englebart demonstrated a working computer for the first time with a heretofore unseen “mouse” and “graphical user interface”. (This story has gone on to become a tech legend known as The Mother of All Demos.) Others are presented who are less well-known but brought to life in highly compelling narratives. Together they provide valuable new lessons on the incubation of inventions along a wide spectrum ranging from sippy cups and water toys to mobile phones and medical devices.

The author has seemingly devised a meta-invention of her own: A refreshingly new perspective on reporting the who, what, where and why of inventors, their creations and their wills to succeed. It is a richly detailed schematic of how a creative mind can conceive and execute an original idea for a new widget and, moreover, articulate the need for it and the problem it solves.

Among other methods, Ms. Pagan covers the practice of conducting thought experiments on new concepts that may or may not lend themselves to actual experimentation in the real world. This process was made well-known by Einstein’s efforts to visualize certain problems in physics that led him to his monumental achievements. I suggest trying a thought experiment here to imagine the range of the potential areas of applications for Inventology to evaluate, in an age of countless startups and rapid scientific and technological advancements, all of the populations, challenges and companies it might benefit. Indeed, this book could readily inspire nearly anyone so inclined to pick up a pencil or soldering iron in order to launch the realization of their own proverbial better mousetrap.

Resources for Inventors

Within all of the lively content packed into this book, the struggles and legacy of a previously little known and tragically persecuted figure who learned to harness and teach the inventive process, springs right off the pages. He was a fascinating figure named  Genrich Altshuller who worked as an engineer, writer and inventor in Russia. His most important contribution to the science of invention was the development of the Theory of Inventive Problem Solving (better known by its Russian acronym of “TRIZ”). This is a comprehensive system for analyzing and implementing inventive solutions to problems of nearly every imaginable type and scale. Altschuller was willing to share this and instruct anyone who was willing to participate in studying TRIZ. It is still widely used across the modern world. The author masterfully breaks down and clearly explains its essential components.

The true gem in the entire book is how Altshuller, while imprisoned in a brutal jail in Stalinist Russia, used only his mind to devise an ingenious solution to outwit his relentless interrogators. No spoilers here, but it is an emotional triumph that captures the heart and spirit of this remarkable man. Altshuller’s life and influence in generating thousands of inventions reads as though it might make for a dramatic biopic.

Also threaded and detailed throughout the book are the current bounty of easily accessible technological tools available to inventors. First, the web holds a virtual quantum of nearly limitless data that can be researched, processed, shared, crowdsourced (on sites such as InnoCentive) and crowdfunded (on sites such as Kickstarter and Indigogo), in search of medical advances, among many other fields.¹ Second, 3D printing² can be used to quickly and inexpensively fabricate and work on enhancing prototypes of inventions. As a result of this surfeit of resources, the lengthy timelines and prohibitive cost curves that previously discouraged and delayed inventors have now been significantly reduced.

Impossibility is Only Temporary

I live in a neighborhood where it is nearly impossible to park a car. An open parking space has a half-life on the street of about .000001 nano-seconds before it is taken. This situation often reminds me of a suggestion my father also made to me when I was very young. He told me that if I really wanted to solve an important problem when I grew up, I should try to invent a car that, at the press of a button, would fold up into the size and shape of a briefcase that could be easily carried away. At the time, I thought it was impossible and immediately put the, well, brakes on this idea.

Nonetheless, as Inventology expressly and persuasively makes its own brief case, true inventors see impossibility as merely a temporary condition that, with enough imagination and determination, can be overcome. For budding Edisons and creative problem solvers everywhere, this book adds a whole new meaning to the imperative that nothing is truly impossible if you try hard enough and long enough to solve it. This indefatigable spirit permeates all 223 pages of this wonderfully enjoyable, inspirational and informative book.

Inventing your own reason to read it should be easy.


For a dozen very timely examples of inventors and their inventions further typifying much of the content and spirit of Inventology, I highly recommend reading a new feature and viewing its accompanying video posted on Quartz.com on April 26, 2016, entitled These Top Twelve Inventions Could One Day Change the World, by Mike Murphy. It covers the finalists in the 2016 European Inventors Award competition currently being run by the European Patent Office.


1.  For example, last week’s Only Human podcast on NPR included a report on how a woman with Type 1 (T1) diabetes, along with the assistance of her husband, had hacked together an artificial pancreas (called a “closed loop” system), and then shared the technical specs online with other T1s in the Seattle area. I highly recommend listening to this podcast entitled The Robot Vacuum Ate My Pancreas in its entirety.

2.  See also these six Subway Fold posts for a sampling of other trends and developments in 3D printing.

New IBM Watson and Medtronic App Anticipates Low Blood Glucose Levels for People with Diabetes

"Glucose: Ball-and-Stick Model", Image by Siyavula Education

“Glucose: Ball-and-Stick Model”, Image by Siyavula Education

Can a new app jointly developed by IBM with its Watson AI technology in partnership with the medical device maker Medtronic provide a new form of  support for people with diabetes by safely avoiding low blood glucose (BG) levels (called hypoglycemia), in advance? If so, and assuming regulatory approval, this technology could potentially be a very significant boon to the care of this disease.

Basics of Managing Blood Glucose Levels

The daily management of diabetes involves a diverse mix of factors including, but not limited to, regulating insulin dosages, checking BG readings, measuring carbohydrate intakes at meals, gauging activity and exercise levels, and controlling stress levels. There is no perfect algorithm to do this as everyone with this medical condition is different from one another and their bodies react in individual ways in trying to balance all of this while striving to maintain healthy short and long-term control of BG levels.

Diabetes care today operates in a very data-driven environment. BG levels, expressed numerically, can be checked on hand-held meter and test strips using a single drop of blood or a continuous glucose monitoring system (CGM). The latter consists of a thumb drive-size sensor attached with temporary adhesive to the skin and a needle attached to this unit inserted just below the skin. This system provides patients with frequent real-time readings of their BG levels, and whether they are trending up or down, so they can adjust their medication accordingly. That is, for A grams of carbs and B amounts of physical activity and other contributing factors, C amount of insulin can be calculated and dispensed.

Insulin itself can be administered either manually by injection or by an insulin pump (also with a subcutaneously inserted needle). The later of these consists of two devices: The pump itself, a small enclosed device (about the size of a pager), with an infusion needle placed under the patient’s skin and a Bluetooth-enabled handheld device (that looks just like a smartphone), used to adjust the pump’s dosage and timing of insulin released. Some pump manufacturers are also bringing to market their latest generation of CGMs that integrate their data and command functions with their users’ smartphones.

(The links in the previous two paragraphs are to Wikipedia pages with detailed pages and photos on CGMs and insulin pumps. See also, this June 27, 2015 Subway Fold post entitled Medical Researchers are Developing a “Smart Insulin Patch” for another glucose sensing and insulin dispensing system under development.)

The trickiest part of all of these systems is maintaining levels of BG throughout each day that are within an acceptable range of values. High levels can result in a host of difficult symptoms. Hypoglycemic low levels, can quickly become serious, manifesting as dizziness, confusion and other symptoms, and can ultimately lead to unconsciousness in extreme cases if not treated immediately.

New App for Predicting and Preventing Low Blood Glucose Levels

Taking this challenge to an entirely new level, at last week’s annual Consumer Electronics Show (CES) held in Las Vegas, IBM and Medtronic jointly announced their new app to predict hypoglycemic events in advance. The app is built upon Watson’s significant strengths in artificial intelligence (AI) and machine learning to sift through and intuit patterns in large volumes of data, in this case generated from Medtronic’s user base for their CGMs and insulin pumps. This story was covered in a most interesting article posted in The Washington Post on January 6, 2016 entitled IBM Extends Health Care Bet With Under Armour, Medtronic by Jing Cao and Michelle Fay Cortez. I will summarize and annotate this report and then pose some of my own questions.

The announcement and demo of this new app on January 6, 2016 at CES showed the process by which a patient’s data can be collected from their Medtronic devices and then combined with additional information from their wearable activity trackers and food intake. Next, all of this information is processed through Watson in order to “provide feedback” for the patient to “manage their diabetes”.

Present and Future Plans for The App and This Approach

Making the announcement were Virginia Rometty, Chairman, President and CEO of IBM, and Omar Ishrak, Chairman and CEO of Medtronic. The introduction of this technology is expected in the summer of 2016. It still needs to be submitted to the US government’s regulatory review process.

Ms. Rometty said that the capability to predict low BG events, in some cases up to three hours before they occur, is a “breakthrough”. She described Watson as “cognitive computing”, using algorithms to generate “prescriptive and predictive analysis”. The company is currently making a major strategic move into finding and facilitating applications and partners for Watson in the health care industry. (The eight Subway Fold posts cover other various systems and developments using Watson.)

Hooman Hakami, Executive VP and President, of the Diabetes Group at Medtronic, described how his company is working to “anticipate” how the behavior of each person with Diabetes affects their blood glucose levels. With this information they can then “make choices to improve their health”. Here is the page from the company’s website about their partnership with IBM to work together on treating diabetes.

In the future, both companies are aiming to “give patients real-time information” on how their individual data is influencing their BG levels and “provide coaching” to assist them in making adjustments to keep their readings in a “healthy range”. In one scenario, patients might receive a text message that “they have an 85% chance of developing low blood sugar within an hour”. This will also include a recommendation to watch their readings and eat something to raise their BG back up to a safer level.

My Questions

  • Will this make patients more or less diligent in their daily care? Is there potential for patients to possibly assume less responsibility for their care if they sense that the management of their diabetes is running on a form of remote control? Alternatively, might this result in too much information for patients to manage?
  • What would be the possible results if this app is ever engineered to work in conjunction with the artificial pancreas project being led in by Ed Damiano and his group of developers in Boston?
  • If this app receives regulatory approval and gains wide acceptance among people with diabetes, what does this medical ecosystem look like in the future for patients, doctors, medical insurance providers, regulatory agencies, and medical system entrepreneurs? How might it positively or negatively affect the market for insulin pumps and CGMs?
  • Should IBM and Medtronic consider making their app available on and open-source basis to enable other individuals and groups of developers to improve it as well as develop additional new apps?
  • Whether and how will insurance policies for both patients and manufacturers, deal with any potential liability that may arise if the app causes some unforeseen adverse effects? Will medical insurance even cover, encourage or discourage the use of such an app?
  • Will the data generated by the app ever be used in any unforeseen ways that could affect patients’ privacy? Would patients using the new app have to relinquish all rights and interests to their own BG data?
  • What other medical conditions might benefit from a similar type of real-time data, feedback and recommendation system?

Medical Researchers are Developing a “Smart Insulin Patch”

“Spinning Top”, Image by Creativity103

In an innovative joint project at the University of North Carolina and at North Carolina State University, medical researchers are currently developing a “smart insulin patch” that can both measure blood glucose levels and then administer insulin to regulate it as needed for people with Type 1 diabetes. This is yet another approach at the core of much academic and commercial research and development at creating a “closed loop” system that senses and responds to changes in blood sugar.

Other ongoing research in this field is attempting to integrate continuous glucose sensors with insulin pumps, both of which are available on the market but not yet working together in a viable product with regulatory approval. Both of these approaches are efforts to create a biomedical system that can act as a fully functioning artificial pancreas for people with Type 1 diabetes.

The ongoing work on the smart insulin patch was covered in a fascinating article in the June 22, 2015 edition of The Washington Post entitled The ‘Smart’ Insulin Patch That Might One Day Replace Injections for Diabetic Patients by Brady Dennis. I will summarize, annotate and add a few questions of my own. (Two other recent Subway Fold posts on  October 3, 2014 and June 16, 2015, clickable here and here, respectively, have covered one project to upload glucose monitoring data to the mobile devices of friends and relatives, and another by a medical device manufacturer using social media to reach out to people using insulin pumps.)

This new smart insulin patch is a square shape as small as a penny and is word on the skin. One side of it contains numerous tiny “microneedles” that the face the skin and contain “both insulin and a glucose-sensing enzyme”. Thus, when an increase in blood glucose is detected, the patch can release insulin into the patient’s system “quickly and painlessly”. As a result, the necessity for the delivering insulin by traditional means of a syringe or insulin pump is eliminated.

To date, the development team has only tested the patch on mice. Early test results, published here in The Proceedings of the National Academy of Science (subscription required), showed that the patch worked on the test animals starting within 30 minutes of its application and then lasting for up to nine hours.

Dr. John Buse, one of the co-authors and the director of the UNC Diabetes Center, finds this “exciting”, but he also believes it will take years to determine if this will work in humans. A very informative and detailed news release with photos of the patch and the microneedles, entitled Smart Insulin Patch Could Replace Painful Injections for Diabetes, has recently posted on the UNC Diabetes Center website.

Using current technology requires people with Type 1 diabetes to check their blood glucose levels a number of times each day and then corresponding regulate their insulin to balance the effects of these up and down readings. Other researchers have endeavored to “closed the loop” between insulin pumps and continuous glucose monitors, but these systems still require close attention and adjustments by the patient

The smart insulin patch, if proven safe and viable, could one day dramatically change protocols for the care of Type 1 diabetes. It is an attempt to more directly emulate the human body’s own insulin regulatory system. As well, the microneedles in the patch are designed to be far less invasive and nearly painless than today’s use of injections, pumps and sensors, all of which require larger needles to pierce the skin. It is designed to directly “tap into the blood flowing through the capillaries” in order to become activated.

The researcher team has also found that they could “fine tune the patch” to attain blood glucose levels within an acceptable range. As a result, they are hopeful that, in the future, the patch could be adjusted to each individual patient’s system (including, among other things, weight and insulin sensitivity), and the duration of the patch’s effectiveness could be extended to several days.

My questions are as follows:

  • How exactly will the patch be personalized to meet the biological needs of each user? How will patients manage and regulate this from patch to patch? Is the goal to calibrate a single patch for the user or a series of patches as the user’s needs and environment changes?
  • Can the patches be customized and fabricated using today’s commercial 3D printing technology?
  • Will blood glucose levels still need to be checked regularly using current methods in order to assess and align the patch’s effectiveness and accuracy?
  • Can the patch’s data on blood glucose levels and insulin dosages be uploaded onto mobile devices in order to be monitored by the patient’s health professionals and family members?
  • Might the patch be used in conjunction with or even integrated into the Apple Watch as a medical app?
  • Can other medications that a person with diabetes is taking also be administered, monitored and regulated with the patch, perhaps making it even “smarter”?

New Startups, Hacks and Conferences Focused Upon Health Data and Analytics

The intersection of digital technology, the Web and modern medicine seems to produce new innovative approaches to health care on a very steady basis. Three reports have appeared within the past ten days that I believe typify the imagination and dedication of the companies and individuals in this space. While the following articles barely scratch the surface, they nonetheless provide an informative sampling of some very interesting trends that likely would not have been possible until quite recently.

1. User Survey Data Mined to Provide Consumer Information on Prescription Drugs: A new company called Iodine has created a database based built upon 100,000+ surveys provided taken from people who have been prescribed medicines. Visitors to the site can use it to look up the consensus findings about the effectiveness, potential side effects, warnings, pricing and other practical information about a vast number of drugs. (Of course, consulting first with your doctor about them is always of primary importance.)

The full details of the Iodine’s origin, current operations*, investor support, use of Google Consumer Surveys and other data sources, and its potential benefits to patients and the pharmaceutical industry was the subject of a very engaging article published in the September 23, 2014 edition of The New York Times entitled To Gather Drug Data, a Health Start-Up Turns to Consumers by Steve Lohr. (See also another brief article entitled Iodine: A Platform to Help You Choose the Best Medicines for You by Ben Woods, posted on TheNextWeb.com on September 24, 2014.) I also highly recommend a click-through to Iodine’s site to view and test out their new approach to producing and presenting this specialized consumer information.

2. Hackers Modifying Medical Devices: A group of engineers have joined forces online to provide a useful hack to the continuous glucose monitor produced by a company called Dexcom. As reported in an article entitled Hackers Tinker With Medical Devices in the September 27, 2014 edition of The Wall Street Journal, by Kate Linebaugh (a subscription to WSJ.com is required for access), this hack is called NightScout. To briefly sum up this story, NightScout enables data from this device to be uploaded online to permit parents and other concerned individuals to remotely check the blood glucose levels of family members and friends who have Type 1 diabetes, from their smartphones. The Dexcom monitor currently on the market does not do this, although such a connection is planned for a subsequent release possibly next year.

The monitor itself consists of two parts: A small plastic pod which is worn by person with diabetes that transmits the blood glucose readings on a continuous basis to a handheld device within a 20-foot radius (which is nearly the same dimensions of a typical smartphone). This system is used to look for and alert the user to certain helpful patterns in the changes to their blood glucose levels and to record this data. In turn, the data is also quite helpful to the person’s medical providers.

This is indeed a very data-driven approach to treating Type 1 diabetes, which has always required close monitoring by the patient in an effort to maintain normal blood glucose levels. Doing so helps to avoid long-term complication and maintain good health.

Neither the manufacturer nor the FDA has approved NightScout, but they have not tried to stop it. Rather, they are closely watching its ongoing improvements by the NightScout online community and how this is affecting the quality of care for the users.

3. Industry Conference Presentation on Data-Driven Medical Technologies: An article entitled Can a Computer Replace Your Doctor? by Elizabeth Rosenthal in the September 20, 2014 edition of The New York Times, reported on other advances and growing interest by doctors driven by big data collection and analytics. These developments were the subject of a presentation called Health By Numbers at the recent 2014 Health Innovation Summit in San Francisco. This article opens with an account of a doctor asking his audience whether they would prefer an AI to an actual doctor.**

To briefly summarize this story, some of these systems and methodologies discussed, among others:

  • An iPhone app to diagnose ear infections
  • Home kits to check cholesterol levels
  • The above mentioned blood glucose monitoring devices
  • Wearable fitness trackers

Moreover, the attendees discussed many key issues about pursuing these lines of medical treatment and administration including high expectations and mixed outcomes, challenges in quantifying exactly what “health” means, that sometimes good data does not always equal a healthy patient, and how to most meaningfully process and analyze all of the available data. I highly recommend a click-through and full read of this very informative and thought-provoking piece.

My follow up questions concerning all three of these stories include:

  • Will the privacy patient and user data be adequately protected by current laws or do the rapid emergence and adaptation of these systems require new legislation and regulation to ensure patient privacy?
  • Whether and how the roles of doctors and other medical service personnel will be changed? If so, how will their academic training need to be revised?
  • What, if any, will be the impact on the costs, quality, policies and politics of medical care in the US and elsewhere?

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*   No stitches were involved as these concern business, not surgery.

** Compare and contrast to this September 1, 2014 post here entitled Possible Futures for Artificial Intelligence in Law Practice.