Category: Devices

Stand up! How I’m incorporating a balance board into my home office routine

published date
April 27th, 2020 by

A few years back I heard that sitting is the new smoking. That concerned me, since I’m the type that tends to stay glued to my seat throughout the workday, especially when working from home. Some colleagues and clients have standing desks –or even treadmill desks!– but they never appealed to me.

The Apple Watch has been helpful in encouraging me to stand up. While I ignore most of its other prompts (like the suggestion to Breathe) I am quite responsive to the notification I get 10 minutes before the top of the hour, imploring me to stand up at least once before the clock strikes.

Recently, FluidStance offered to let me test out its Plane balance board, billed as a product that brings “movement and happiness to your workplace.” Bottom line: I like it and  you might, too.

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The board itself. (Blue part is the bottom but it’s attractive enough that I thought it might be the top!)

With #COVID19 in the air, I don’t get a lot of excitement. So it’s always a highlight to receive a package on the doorstep. The balance board came in a long, thin box; when I opened it up I was impressed with the cloth backpack. I felt pretty cool carrying it up to my home office past my teenagers!

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Dad is so cool!

It took me a couple minutes to figure out which end was up. (I got it wrong at first.) And my initial joy was tempered when I read the label on the board.

WARNING, USE AT YOUR OWN RISK! This product creates an unstable surface. Use of this product may result in injury or death. Use at your own risk.

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Till death do us part!

Injury I can live with. But death? Even if sitting is the new smoking (and that’s actually controversial) death is still the old death!

Although my balance is good, I’ve never had much luck with skateboards, wakeboards, surfboards of anything kind of board. I was particularly good with the pogo stick as a kid, however.

I need not have worried, because the FluidStance board is really easy to balance on. If you do fall off, it’s about 3 inches so no biggie! It does provide a nice stimulus –better than just standing on the floor, and it’s easy to swivel around, too, should the temptation strike you.

I didn’t want to risk messing up my hardwood floor, so I put a mat under my chair. It protects the floor but does make it a little harder to swivel. When I’m not standing (which is still most of the time) I put my feet on it and use it as a footrest.

I’ve always done audio conference calls, but the pandemic seems to be pushing what would have been in-person meetings and even many phone calls into the video realm. Since I’m not even walking from one conference room to another, I’m sitting even more and am making an effort to stand.

The balance board is good to stand on during conference calls, but it presents a couple of challenges. For audio, I’m a bit far from the speaker phone –but I’ve checked with others and my sound seems good. But for video calls my head ends up out of camera range, even if I tilt the monitor up. I could probably do something about that with a webcam or mounting my laptop on a shelf, but I haven’t. These are minor annoyances but it means I don’t use the board as much as I might like to.

I’m not sure whether there are measurable benefits from using the balance board, but in any event I do like it and plan to keep using it. The literature that came with the deck said, “We aim to blur the lines between work and play, making work a more fluid and natural part of our whole lives.” I can feel that.

The FluidStance product is very well built. It’s solid, attractive and durable. Built in California, it’s well positioned to ride the de-globalization that seems likely post-COVID.

I recommend it.


By healthcare business consultant David E. Williams, president of Health Business Group.

Noisy hand dryers – how to cope? Hint: Lower you hands

published date
July 25th, 2019 by
Noisemaker in chief
Noise reduction nozzles. Anyone ever seen one of these in the wild?

Nora Louise Keegan, a 13 year old Canadian has generated great publicity with her recent article in Pediatrics & Child Health (Children who say hand dryers ‘hurt my ears’ are correct: A real-world study examining the loudness of automated hand dryers in public places).

She conducted a rigorous study to measure the peak loudness of dryers at two distances from the wall, both with and without hands in the dryer’s air flow. She measured the sounds at different heights, corresponding to the ear canal height of younger and older kids and of adult men and women.

I encourage you to read the article. It is brief and well-written.

When I saw the write-up in the Washington Post, I immediately remembered writing about this very issue back in 2013 (when the author was about 7 and starting to develop an interest in the topic).

In my post (Hand hygiene and hearing loss. Avoiding the tradeoff) I wrote:

I’m not so fond of the Excel Xlerator. Sure it’s powerful, but it’s also incredibly noisy. I have sensitive ears, and I’m not embarrassed to admit that when I’m exposed to a loud sound I cover my ears with my hands. But of course if I’m drying my hands I can’t use them to protect from the noise. The Xlerator is loud enough that I suspect it’s a threat to hearing. At the very least it’s so annoying that I bet some people skip hand washing to avoid using it. My gym has one of these beasts and after being bothered by it for a while I decided to research the noise level.

I didn’t do any original research but I found a paper by Jeffrey Fullerton and a colleague from an acoustical consulting firm and corresponded with Jeff about the subject. He told me that the airstream is a major factor in the noise level and advised me to lower my hands a foot or so below the nozzle , which helps make things quieter. This is the approach I use to this day, with some success –although sometimes the sensor doesn’t see my hands and it does take a bit longer to dry.

The new research by Keegan quantifies the difference made by placing hands in the airflow and also identified the Xlerator as the number one bad boy.

When I read the article I circled back to my original sources. The article I cited is gone (maybe the firm snuffed it when the author moved on) but the Acoustical Society of America still has a summary on its site.

My favorite tidbit is that there is (was?) a noise reduction nozzle for the Xlerator. Presumably the manufacturer understood there was a problem.

I’ve never seen one of these in use. Have you?

By healthcare business consultant David E. Williams, president of Health Business Group.



Off your walker? Foray’s founder Dr. Kavanagh takes a new approach to an old need (podcast)

published date
August 7th, 2018 by

What’s worse than needing help with gait, mobility and balance? Being told you need a walker. No wonder, when the typical walker basically screams “frail elderly,” and is difficult to use as well.

Neurologist Patricia Kavanagh was struggling to get her patients with Parkinson’s and other movement disorders to use a walker.  So she teamed up with a design and production team to found Foray and create the Spring, a modern device that is more functional and stylish.

In this podcast interview we discuss:

  • (0:13) Dr. Kavanagh’s clinical practice and the types of patients she treats
  • (1:19) Key challenges she faces working with patients with movement disorders
  • (3:24) Problems with current assistive devices like canes and walkers
  • (6:11)  Whether walkers are unique in their poor design
  • (7:26) The story behind the birth of Foray and the development of the Spring
  • (8:42) The target audience
  • (12:04) Price point for the new device
  • (12:50) The thinking behind the branding of Spring and Foray
  • (13:31) Potential line extensions
  • (15:20) Impact of burden of chronic disease on mobility and exercise tolerance

By healthcare business consultant David E. Williams, president of Health Business Group.

Reducing variance in medical device and drug utilization. Podcast with Lumere CEO Hani Elias

published date
March 26th, 2018 by
Lumere CEO, Hani Elias

To succeed in value based care, providers must reduce unwarranted variance in utilization and cost. Medical devices and drugs are good places to focus, since they represent big slices of the spending pie that are rarely optimized. In this podcast interview, Lumere CEO Hani Elias describes how his company deploys evidence based software and services to help health system clients take on variation.


  • (0:12)What are some of the key challenges in healthcare?
  • (1:31) What do you mean by “unwarranted” variation?
  • (2:45) Are you able to tell which variation is appropriate and which is not?
  • (4:30) How does the decision making process differ between drugs and devices?
  • (6:42) Drug and device companies are large and are influential with physicians. How do you operate effectively in that environment?
  • (8:45) How do you differentiate from others who work on reducing cost and improving quality?
  • (10:30) What’s new, and what’s the same in this administration in Washington compared to the prior one?
  • (11:41) The company has a new name. Why?
  • (12:35) What does the future hold for Lumere?

By healthcare business consultant David E. Williams, president of Health Business Group.

eCOA in action: Podcast interview with iCardiac CEO, Alex Zapesochny

published date
March 6th, 2017 by
Alex Zapesochny, CEO, iCardiac Technologies

Electronic clinical outcome assessment (eCOA) platforms collect data from patients, clinicians and caregivers to make clinical trials more efficient and accurate. iCardiac Technologies, an innovative core lab where I am a board member, just introduced its QPoint eCOA platform to complement its existing cardiac safety and respiratory function product lines.

In this podcast interview, iCardiac CEO Alex Zapesochny shares more about the launch.

  • (0:11) What are some of the key trends you are following in clinical drug development?
  • (1:04) You started with cardiac safety testing and then added pulmonary function testing. How do those fit together?
  • (3:00) Now you have a new platform, QPoint. What is it, and why is it the next logical service?
  • (4:44) For those who are less familiar with eCOA, what is it? And what are some of the challenges that are typically encountered?
  • (7:09) Compliance is often an issue with patient reported outcomes. Do you address compliance with QPoint?
  • (10:30) How important is eCOA for drug development? Is it a major change or incremental?
  • (12:20) You have explained the move from cardiac safety to respiratory to eCOA. What can we expect next from iCardiac?

By healthcare business consultant David E. Williams, president of Health Business Group.