and what sorts of rules you want to put on it. again to my think this is another example where it is what you do with the permission that ought to be subject to laws and policy and play out in the proper law and policy arena. >> anybody else? okay. yes. go right ahead. >> primary-care physician. in my last life i was an attorney. i just wanted to comment on the doctor's observation that there was no way it -- that the doctors are not overwhelmed by the intermission and that the whole thing went pretty well. patience, a small number over a short time. you picked out one problem. in a lupus patients to have five been followed and monitored.

that's, if that were still up, even limited to sick patients as it should be, that is a lot of work. and a $20 per patient per month management fee is not going to cover that. if you want physicians to use it and do it and keep up with the information, which then must. as a lawyer i know a common, something that was missed and it turns out, you know, goes along and turns into something much more serious. >> you cannot afford to overlook things. if you want people to do it it would be a good idea, until we get sued the great ac ellen this guy cannot pay doctors for looking at the information and pay them for telephone calls. there is already a code for it. it saves everybody money. it is convenient for the patient this is the doctor time and

money. it saves the pier time. i don't understand why cms cannot pay for phone calls. there is no congressional law forbidding it. the cassette the administrative thing going to mob. >> my response i guess would be, i don't disagree with anything you said. and i don't think anything i said disagrees. i said that either we have to find a way to pay for this sort, you know, you're probably right that if we had every patient with asthma and diabetes, you name it , collecting this data, that would be impossible. if we have found that, for these 30 -- just a small number of 30 that they said, no, this is too much, that might be a death knell for this kind of work. but i think we have to be selective, and you're right, reimbursed because at the end of

the day takes somebody's time. >> and a co will not take seriously if it is not reimbursed now. there will just be one more thing to do for the same amount you're getting paid today. >> can i just ask, has anybody heard an interest level from a ceo, either private or the ones running cms? adopting any of the use of rodeo or other kind of data that we are talking about? patient generated data. and i would welcome if people have the answer to that question are not. that would be fined since we don't have cms folks on the panel. [inaudible]

>> how that data flows back into the system. [inaudible question] >> i think you were out of microphone range. i will condense that answer by saying, yes. [laughter] >> particularly in minnesota. thank you very much. do you want to identify yourself? [inaudible] >> thank you very much. >> yes, sir? >> marked the mattress. i am an adviser of health information management. strategy paul for disorganization. a form of fda.

the mobile apps. just very briefly. first of all, i'm going to agree. what she said is absolutely right. trying to regulate the whole mobile application platform. they are trying to focus on specific high risk applications that have to do with clinical decisions that affect the patient drastically. this is something we need to regulate. so is that is the application. the mobile device is not just your smart phone. it can be a sensor, monitor data, meet together with other devices, so that is the main concern. so i want to mention just to complement what devon answered, and then the other aspect is some people don't know so well about the definitions of devices according to the government. so biomedical software,

especially when connected to patients' safety is under regulatory authority of the fda. they have not invoke the authority because they give work the last year sticking auction on that. but they can go ahead and regulate software and a lot of areas. of course, for the sake of innovation we don't want to make this affordable. so that is my other point. so, just to give a little clarification, and then my question is this. all of you. i think we have seen that affordable care act already passed. we are looking now for the development. certain provisions, especially in quality importing that has to do with implementation of a information technology.

and i'm going to mention what state has to do, what hospital, and to collect or corporation and -- the performances and measures. they need to implement. other funds that need to be given to innovators to make this work in the quality department. so in this part of information technology your thoughts, what you see as a time line for this data, also for innovators as we know groats the implementation of the health care reform. how would you do this better than what you see in the future? >> that is such a devastatingly complex question. >> i would say, again, since we sort of have ways of influencing

the health care industry and health care policy that are kind of nested within a bunch of different agencies within the federal government if you are even just thinking of the federal government and then you have all of the interesting initiatives that are happening in the private sector. it is not one clear time line. it is kind of, you know, sort of multiple initiatives going on someone simultaneously, each one kind of piggybacking off of the other i can say that at least for now help id policy committee perspective, we are already starting to look at what the criteria would be for the third stage of the ehr incentive program which would include a set of objectives for being a meaningful user as well as with the technology has to include in order to be certified, of the ability for federal subsidy. we are definitely exploring the capability to be able to incorporate patient generated

data from a potentially wide variety of sources with the provider having the option to choose which one works best for his or her particular patient population and starting with a relatively low pressure of the patients taking into account all of the provider issues that are discussed. there is one sort of set of initiatives, again, being discussed very early, states three discussions. it is still hearing and looking at where the potential is to remove the needle on quality and cost issues and trying to drive some incentives in the interaction. >> family practice news. i was wondering if you could go into a little more detail and some of the incentive structures to really encourage physicians to integrate some of these technologies and down the line how that is really going to affect me for use requirements >> sure. we are really at the start of

the incentives that are really sort of more kind of aggressively focusing on bringing the patient you into the process verses, you know, really the focus for stage one and much of what we have seen of proposals for states to which have been about equipping patience with the data that they might need. they can then use it themselves which is, you know, a necessary first step. where the bi directional flows are concerned, that raises, you know, additional issues. from a policy and technology standpoint which is why they're really getting a more meaningful look for stage three. he was elected is way out there, but it is actually not. it is just around the corner if we have an expectation that the technology vendors who are still busy implementing stages one and two will be able to get the product upgrades in time to be really ready for stage three. so first focus being, you know,

the access piece of it, the patients have access to electronic data that they can really use? we have seen the blue button initiative, cms to it. there is lots of discussion about how to make that ability for you to get a view and download of your health affirmation and be able to -- others may want to talk about it. we are just -- and i double care organizations. the financial incentives are driven toward outcomes. said the extent that there are -- you can actually realized that outcome is by taking care of patients better when they're still on their homes, you know, that is something that i think -- it does not surprise me that there is at least one ac of that is exploring it because it is an appealing way to leverage resources and get better outcomes. >> i think the way i would think about it is to remind everyone, very early days on this kind of work. the studies are very small, not

statistically significant, claims to make. o we are seeing as promised, but we are also seen promise not in all patients or all the time or all circumstances. for me the question is less about how you provide incentives for people to do this and more, do you create a policy environment where it makes sense or where you are able to do this when it makes sense and when you can find value in it and not be hampered by a policy that says, you know, don't do this even if it is a good idea because we have structured your payments or restructured the rules to prevent it. so in some ways that is our purpose of trying to share this work at this point to say, you know, this is coming along. there may be real opportunities here. you want to make sure the policy environment and it was as opportunities to be realized. not necessarily create incentives to say you need to be doing this now. >> yes. go at. >> okay. >> the american academy of

astrology. my question is -- i think he pretty much as the same question. i was just thinking, from a provider perspective with respect to the smart phone at like breed easy that was mentioned, it was not clear to me when i was listening to the discussion exactly how this would be implemented or who would be the decision maker. i think you would be great for this or would it be the patient to would be that have been sickened of, we have access and sick and i think this will be a great way for me to kind of managed care. it was a little confusing to me. who was the entry point? is it the position who identifies the patient and then they go from there? and the reason i ask that is because it was mentioned that, perhaps, in the emergency department physicians identify patients who would be eligible, you know, to use the application if you could provide some

clarification on the intent. two is supposed to use this, the physician that identifies the patient or is it the patient? would appreciate that. >> at the end of the day there is going to have to be some big issues in between those two parties. in a medical home world it would not necessarily just be that er physician who was seeing of the patient was in the e.r. i would know that as their primary care doctor. and to me i -- you know, i don't know if they're is a right or wrong answer, but i am, perhaps, being a physician i am thinking more physician center collier and assuming that we would be identifying these people. >> okay. so with that replaced his physician? >> no, i don't think so. it is an integral part. it would just become another tool that we have. >> okay. thank you. >> good afternoon. my name is richard bryant, executive director of under

technology association of america which is an affiliate of the national association for on care and hospice. so i think someone -- and that would give credit to janet as far as health happens outside the clinic. one of the things i heard on the panel that came out today. one of the things that we are trying to do is aligned with a group of providers to provide incentives for electronic health records along with acute care, those providers would -- with acute care providers. so we have identified a huge need to try and make sure that we have alignment across the spectrum of care. i have been working in that regard under the sni framework, a community led initiative to create a longitudinal care plan. and i would -- part of my question is informational just to make sure that you are looking at a model, home health

plan care, our use case was just about the s in i framework, and we will go through age 07. we plan on using and hoping to use across the platform of care providers. in other words, the partnership with them. other partners could use this. an electronic means establishing goals, interventions, and also all those being miserable back-to-back clinical data that can be collected either by remote patient monitors or on-site by clinicians. so i just wanted to, as part of my question asked, more an overarching look. i know we had a very specific look at specific programs and interventions, but what new models of care coordination are going to be needed in order to better in gage's patients. how this is going to happen on sort of a holistic way.

thank you. >> i can take a stab at that. we -- the bipartisan policy center released a report earlier this year looking at the attributes of high performance, you know, reducing cost and quality in health care and the patient activation engage in peace is huge. a common attribute across a number of organizations that we interviewed. i think -- and this relates -- there were two questions around payment. i think looking, as steve mentioned, at specific actions and reimbursing them is very different than actually -- and we are very encouraged to see a number of the delivery system and payment models that are being tested by cn am i, number of states and health plans across our country and providers that are actually providing incentives for better care coordinated care, accountable care. and this is just a piece. so clinician's, doctors, working

with those two provide financial support for these models working with patients that are heavily involved in governance and a number of these initiatives is the way forward. we applaud your lead a round, you know, home care and this is really the wave of the future. >> my question is about daisy aggravation -- aggregation. this seems like we are talking about patients entering, you know, old metrics over a new medium and the physician is the one who aggregate that data. yo know, instead of, perhaps, the firm way of doing things like, perhaps, a target which has more data points that my health care provider, i'm guessing, and you can also figure out what people are pregnant without having to ask them. so what kind of, you know -- are we heading that way? at the same time, the systems

which would necessitate, you know, the computerization of health care allow people to operate at the top of their license, as we say? and also, are there barriers were physicians will feel like, you know, they are locked in technicians which is made to do this sort of thing. >> so that brings a whole interesting area. companies like patients like me and cure together. people enter a lot of information about themselves to metric system experiences, and can sort of see in the average crowd how they're doing relative to others. there are some great stories, you know, patients finding that they were only on 10 milligrams of something because the doctor said that's all anyone should be taken then they find out that 90 percent of people with similar conditions are actually getting 100 milligrams. they can go back to the doctor and say, what gives. i think there is a ton of opportunity there.

i think the -- again, who is doing what with the insight is always a good question. again, the example of the person who was on an awfully low dose, they can get to their doctor and say, you know, i'm not saying i need 100 milligrams, but evidence would suggest that a lot of other people are hest to muscle let's have a conversation about that. the other thing i would think that this does is it really does open up the question of what professional skills are needed to do what tasks associated with providing care in a coordinated fashion. i think the example of breezy where they had nurses reviewing the data a good example. let's put the right test with the right person with the right skills and to the of the work that way. >> i was just going to add, if i am remembering correctly, didn't

every project and up with a model like that. none of these projects they decide that the physician was going to be the first year of the information. >> there is always some element of team going on. >> you get the last question. >> thank you. >> good afternoon. taking it back to reimbursement. and nice lead in with every model ended up with a different care team may be taking a piece before i got to that provided that might make a decision. each one of those pieces of the puzzle comes with a salary and a need for reimbursement. so a couple of things that came up a round telephone visits is that chapter ten of the broadband plan really spoke about e-visits, and this is now going on for years sitting on a plan. components of that plan. how until we run policy for word that keeps up with the

technology and so we are looking at either update the very antiquated reimbursement for telemedicine which is probably five years behind on the books which means 10-15 years behind in terms of what the technology can do today. so i applaud the model and what is happening with innovation, but how can we raise that discussion at lmcncm have to look at moving their reinvestment -- reimbursement structures forward. then, also, how can we look at other industries and what has happened in the micro finance world? we talked a little bit earlier about copay. if you look at the music industry, one of the ways that apple turned that on its head was you could buy as on for $0.99. well, i could sell an album for $20.15. by $0.199? the way that they made it so easy for people to grab that

music. do we look or have we looked at other industries in the way micro finances used and been used in other parts of the world and not in the u.s. and bring that to bear on health care, what if it meant that a provider just got a very many, many small payments, maybe not out of the insurance industry but directly from patients, i'd be willing to pay. but we don't have those financial structures in place at all in the u.s. or barely. so we have spread has moved in. that is the beginnings, but how we can look at, again, some of the other things happening in other industries that might help move us along. >> i think rather than a question you have just thrown out several really important challenges for all of us who are sort of looking to see that kneele move down health care for patients and providers. you know, we did not come to the table with any experts on

reimbursements, but i think it is fascinating and it's just underscores how we need to be thinking about health information and health care and health differently than the way that we have to start the thought of it. we really hope to leverage technology better and bring patients more into the center of the conversation and make all of it works far better than it does today. rather than questions i will set their good points. good thoughts to follow upon. >> do you have time for another question? >> i'm afraid we don't. and then apologized to all the folks who put questions on cards that we did not get to, but we have run out of time. and i want to come back and think our friends at the bipartisan policy center, our colleagues at the foundation,

particularly steven down. you for sticking with an acronym filled mind stretching discussion, at least for some of us. i want to take a second to note also and thank jackie fitten who had labored for the alliance has and turns this summer, and this will be the final day. i don't know if jackie is going to be around when we have our briefing on friday, but when you join me in thanking the panel for a great discussion, you will also be thinking phase and jackie. [applause] and see yourself in reruns throughout the week. [laughter] >> tomorrow nuclear regulatory commission chairman allin mcfarlane talks about her first

month in the job and what her goals are of chairman. the former college professor succeeds someone criticized by some brave men's style. our live coverage begins at 10:00 a.m. eastern here on c-span2. >> now the soviet bear may be gone, but there are still lows in the woods. we saw that in saddam hussein invading kuwait. the mideast might have become a nuclear powder keg. our energy supplies held hostage so we did set this right and what was necessary. we destroyed a threat, freda people, and locked a tyrant in the prison of his own country. [applause] >> tonight 10 million of our fellow americans are out of work tens of millions more worked harder for lower pay. the incumbent president says

unemployment always goes up a little before recovery begins. but unemployment only has to go up by one more person before a real recovery can begin. >> c-span has aired every minute of every major party conventions since 1984, and this year what the republican and democratic national conventions live on c-span starting monday, august august 47. >> state supreme court justice james nelson and former mississippi state supreme court justice oliver diaz talked today about corporate money influence in state court. from the center for american progress, this is an hour. >> good afternoon. >> good afternoon. >> thank you all for coming. i am the director of legal progress here. it is not a pleasure to welcome you all this morning.

hard as it might actually be to believe, we are going to take a break for the next hour for some presidential politics and talk about the third coequal branch of government. but in doing so we are actually not shifting away from the economic issues that really face all americans and communities across the country every day. in fact and a quick the opposite. whether you are an employee has been injured on the job or a consumer with credit card or a mother whose child was injured by defective products as a buffer or one of the millions of americans to have had their houses foreclosed on, he turned to state courts for protection. indeed, 95 percent of all litigation in this country happens in state courts. but, unfortunately, 39 states and the union, 39 states and the union holds some form of the elections. might not be possible for americans to truly get a fair day in court. following the citizens united decision judges are increasingly

having to choose between starting to fighting with special interests or to side with the law. today we are releasing to reports that highlight the interest of corporate campaign cash and the influence it is having a the american justice system. specifically, we tell how soaring costs of judicial elections, some $230 million spent on court campaigns in just the last ten years have led to a state supreme court decisions that favored corporate litigants over individuals seeking to hold accountable. indeed, we have seen a trend where corporate campaign money has resulted in increasingly conservative pro corporate anti consumer decisions. in a company report highlighting referendum on the ballot this november. the processor which is judges are chosen even more political. ultimately, i think u.s. supreme court justice sandra day o'connor said it best.

we all expect judges to be accountable to the law rather than political supporters or special interests. elected judges in many ways are compelled to solicit money for the election campaign whether or not these contributions actually tip the scales of justice, three of four americans believe the campaign contributions affect corpsman decisions. this crisis of confidence and impartiality of the judiciary is real and growing. real and growing crisis made worse by the supreme court 2010 citizens united decision is the topic of today's conversation. we have with a sedate three people here know well and personally the effects of campaign money on actual governing and judging. today we will discuss once its attempt on the idea that corporations are people and the affect the campaign cash is having across the country. so directly to my right, the

justice on the montana supreme court appointed in 1993 and prior to his appointment worked in private practice and served as a glacier county attorney. he served as a first attempt in the united states army in 1966 to 1969 and graduated from the university of idaho at george washington university law school. a widely noted dissent on the case earlier this year challenging montana campaign finance law after citizens united. the decision that the u.s. supreme court justice reversed a decline in the opportunity to reconsider citizens united. to my right, a former justice on the mississippi supreme court, appointed in 2001 election to keep his see later that year. after several state supreme court's held that these damages are unconstitutional, karl rove and the ads its u.s. chamber of commerce masterminded a campaign to unseat judges instead of the way toward reform which included he and his reelection efforts and even prosecute him on falls

criminal charges. he was acquitted of all charges. the story, the fiction as in john grisham's book the appeal, the historic not truly be more emblematic of the increasing polarization. he graduated from the university of mississippi high school and works in private practice. and leading the discussion today , a counselor for policy for citizens of american progress in the presidency of the account action fund. in addition to being a formal member of congress, a lawyer by training, a graduate of yale law school and has a wide range of experience in issues of law both in the united states and abroad. time manage team working on conflict of volition and democratic transitions in africa, afghanistan, and other regions and in parcourse on justice and security at the university of virginia and the university. acting spokesperson to the international prosecutor for the special court of sierra leone

from the tribunal warrants to the diplomatic that forced. please join me in welcoming all of them today. [applause] >> i want to first start out by saying, andrew and everyone that is part of a little progress team at the rule of law program here for the center of american progress and we will talk today about the report at the back of the room, but i really do encourage everyone to read them. the dripping at the appeal which is to be recommended, but very, very important. i do want to thank them for their rig work and hope folks have a chance to read through them. i am honored to be on the states today with two real heavyweights of the legal community. and are to be with them. really going to let them drive the profited today.

if you could set the stage about where we are and what the stakes are going forward and the wake of that only citizens united, but cases and legal challenges that have come in the wake of that including one in which you offered just the end of last week. this did a play right now, what does it mean? ..

impartiality, fairness, making decisions based upon the rule of law, and giving people their day in court and a fair hearing of their dispute, and i think that's what's in play here. that's what is important about the whole debate, the whole dialogue, is the control of the judiciary. obviously if people can throw enough money into judicial races and effectively represent -- or elect justices and judges who are more interested in promoting some court -- part of an idealogue or some particular special interest philosophy, they're going to do this, because money talks, as we know from citizens united, speech is money, and does affect things.

>> justice, you had the unique perspective of being part of the political process and then the judicial process and then the judicial political process. talk a little bit about what it means -- what you're seeing in terms of the state of the judicial election process and from your own experience what that is looking more and more like the political campaigns that fail to inspire so many right now. >> okay. well, you mentioned earlier the appeal. john gresham, aim glad somebody is able to make money off my political career. i certainly haven't. but i am in a unique position, having both been electioned and appointed. some folks say appointed judicial system is somehow superior to an elected process. it's not necessarily so. the appointed process is extremely political as well. you have to be connect, know the right people, have the right

recommendations for whoever is making the appointment, but the political process is entirely different. we heard andrew mention the ranks of sandra day o'connor. three-quarters of the american population feel campaign contributions influence the decisions of the judiciary. that's a sad state of affairs when # 5% of the people in the country believe political contributions influence justice. what even more telling is another statistic and that's a poll of state court judges 50. % of state court judges themselves believe contributions from campaign donors influence the outcome of judicial decisions, and when you get half of the judiciary thinking that -- these are the folks that are supposed to be completely up biased and making decisions based upon the law and the facts so when half of the judges feel that campaign contributions actually influence the outcome of decisions, we got a problem.

>> talk a little bit about who is bringing the money into these races and to what extent has the amount of money has changed. who is spending the money, why are they spending it and to what extent has this changed? recent years. >> i think historically, lawyers were basically the folks who contributed to judicial elections. that's how it all started. lawyers had an interest in the system. both defense lawyers, plaintiffs lawyers. we as supreme court justices and judges like to think that, you know, we're important or we're well-known. people don't know who jumps are. we're anonymous. a few appellate geeks who know something about the -- >> many of them here tonight. >> fellow geeks might be in the audience and i'm one of them. but other than that select group

of folks they don't know who the judges are, don't know much about us in mississippi in 1990 -- of course i'm from mississippi, and winning justice -- somebody running for the supreme court, spent an average of $25,000, in 1990. by 2000, ten-year period, the average winning campaign for the supreme court in mississippi was up to $1 million. that amount of time, ten-year period, you saw exponential amounts of money, and it came about through special interests, and corporations that decided that they -- i think they thought they could see these elections which turned out to be fairly easy picking, and they could pump lots lots of money i. carl rove had a telling quote at one point help said that -- he said a couple million dollars in unanswered tv ads does wonders,

and i domestic think it was the wonders for the judges he was talking about. he had his interests. so, people saw the opportunity there and started putting money into judicial elections, and it was fairly easy to influence at that point. >> justice nelson, what has been your experience? >> i agree with the remarks that were just made. montana has historically been -- there's less people in montana than probably half of washington, dc. it's typically been a low-budget, low-campaign contribution state. when i ran for -- montana, you can be appointed if there's a vacancy in the office and then you have to run for election, and i've run for election three times. one of them, the last one, was very nasty and very contested.

at that time the largest campaign contribution that could be made for a justice on the supreme court was $250. i raised $250,000 for my election campaign, most of which was spent on media. now, this year in montana we have a contested senate race, contested gubernatorial race, we've got one contested supreme court race, the ice noncontested. and the supreme court races are being sort of are in the radar, which is where they typically are, and it's correct that typically it's attorneys that give to these campaigns, but i'll say this. in the montana race there was a primary. we knock out all but two, and then those go on to the general election.

one person was not elected. one of the people who was elected, over half of the money that was spent in her campaign came from outside pac. i don't know what the effect of money is going to be in the general election. that remains to be seen. but increasingly i think that montana is going to join the rest of the states that -- where campaign money and campaign contributions are going to start affecting these races. >> we see what happens with citizens united, when outside interest group dumped a lot of money in a political campaign. they certainly try to influence the outcome of the campaign. when you have this large amount of money coming into a campaign, there's a difference between, say, a race for president or united states senate and the judicial campaign.

in presidential campaign, you see -- we see it right now, it's happening all over the country. the ads by independent groups. mostly negative, but they try to give you some information to base a decision on one of these candidate but no matter how much money they're putting into the presidential election, president obama, we know president obama. these outside groups are not going to be able to define him. we know mitt romney. he has run for president before. he has been running for a while now. we know something about him. he can't be defined by these groups. in a judicial campaign, judges are not known. like i said before, and so the opportunity there is to define a judge, and when you can define that person and they don't have enough money or funds to respond or they don't have their own independent expenditure group behind them, if they're being defined by one group, then it's easy to pick off a judge. so, that's the problem. it's not equivalent to a

national election like for president and when you do the same thing in a judicial election. it's completely different. >> the other thing is, not just citizen is united. republican party in minnesota are verse white. another very important case, and if you're not familiar with that, the supreme court ruled that while judicial candidates could not promise how they would vote, they could at least announce their position on various issues. and most states at that time had what they announced prohibitions in their ethical rules that didn't allow judges to do that. so, now in addition to outside groups defining who judges are, judges can essentially have the constitutional right to go out and define themselves. i'm for this, i'm for that. i'm against this. i'm against that. you can't promise how you're going to vote, but the public isn't stupid. if -- neither are the judgeses. if i announce to people that,

i'm pro choice, pro life, you know, two and two is four and common sense prevails and people are going to take that as well, that's his position, that's how he's going to vote. >> you boast raised issues about differences between the judicial context and the campaign context. one that you noted is the idea that it's actually in some way worse in a judicial case becauseout don't have a megaphone, and politicians can go out and make news, earned media. it's more typical to go out and raise money as a politician than as a judge of this scale, and that is the difference. another, as you said, the idea that typically an element of judging has been not to prejudge, whereas in campaigns it's about voters wanting to know where people stand. one thing that stressed people is the differences between the two decisions, whether the

supreme court essentially, one might argue in a world they actually understood, judicial elections, took a fairly different position than they took in something that they may not really understand as well, the perception of corruption in a political election. do we see an emerging potential ly split jurisprudence between how the supreme court streets elections we'll heat in another direction. >> i don't thing caperton is going go away but it's important to differentiate between what caperton says and citizens united. people can say what they want. they can spend money how they want. caperton was purely a case that said so if much money is spent in a judicial campaign that it is going to affect the outcome of a particular decision for a particular litigant, then that judge has to recuse himself or herself. that's all caperton really

accomplished. >> it and it was very limited, not a broad decision. why don't you give the background. i should have explained about the case as well. >> well, i'm -- caperton basically -- this is very summarily. >> caperton involved a case where a particular person was running for, what, alabama or -- >> west virginia supreme court. >> and a person who had a case penning before the court -- almost like what gresh sham wrote -- the person with the case pending before the court, wanted this particular person to be elected, so he dumped a tremendous amount of -- millions of dollars into that person's campaign. and the person won, and then predictably the person voted in favor of the litigants and it was a split decision so it reversed the lower court decision that was against the litigant, to a supreme court

decision in favor of the litigant. under those circumstances, the supreme court held that it was just too much of an appearance of impropriety. especially given the amount of money that was dumped into the campaign. >> do you see this as being something where there could be a different set of juris prince in judicial elections or a question of bringing due process, perception of corruption charges versus a first amendment issue? >> i think that the citizens united decision is broader than the caperton decision. when you're dealing with first amendment issues, political speech, it's applied to any election, whether it be judicial, city council, up through president. caperton decision dealt very narrowly with recuse sal and -- recusal and when there's an appearance of impropriety or appearance that the judge should recuse, then that's when it

would apply. and the supreme court did not even mandate it. they said that they should send it back for review and let the judge decide. i think the citizens united decision is much broader. >> what makes matters worse is that -- citizen united was written by kennedy, and kennedy was just absolutely dismisssive of the caperton decision,, in te citizen is united case. so, i don't see any light at the end of the tunnel where caperton is going to be the big answer to citizen united in judicial races. >> i might say no findings of fact -- >> actually made the effort to go out and do what -- the way that's supposed to play out. one of the things i would posit about this is that some of the

issues we're talking about here the issue of pro consumer versus pro corporate, what might be the current democrat/republican split in ideology. this is more of a populist to corporatist, or pro citizen verse pro powerful kind of dynamic. the politics of the south has shifted -- i come from virginia, you're from mississippi. the rockie mountain west has a lib bert tearan -- libertarian, and some are surprised not seeing the montana pushing back. what are the lines being drown here and is it one about different ideologies on the court or purely a matter of following the money to understand these divisions? >> on the supreme court? >> on the supreme court, but also trickling into the state elections. in other words, when you see this as -- the montana supreme

court having put a fairly forceful and direct pushback to toe the supreme court on that, why do you see that coming from a state like montana as opposed to something that might be a more traditionally liberal state. >> well, that's complicated, and i'm probably getting way out of my pay grade here. but when i started practicing law in montana, montana was a progressive state. as -- in 1994, or '93, wherever the gingrich revolution took place, montana started going more and more in that direction, and although montana is typically composed of blue collar workers, farmers, ranchers, that sort of thing, that group of people have

followed, i think, the trend nationally that the group of people have been following, towards the more conservative sector. most of the people on the supreme court are not quite as old as i am but close to it. so, we come from different era. and i think this election, at least from my -- the seat i'm vacating on the court will be the first -- well, second person actually -- kind of a new generation. so, we'll -- should be asking that question in 10-15 years from now. >> it's not an easy left-right breakdown, i don't think. in mississippi we have -- we don't -- judicial elections are not run by party sod we're not republican and democrat. judges run nonpartisan, as they do in many states. so, you don't necessarily get the republican -- democratic

breakdown in judicial races and it is a lot about the money, and the groups that back it. the breakdown that we've seen in mississippi, in addition to corporations, is insurance companies, which may be the same thing -- and doctors, medical providers on one side, and lawyers and labor and unions on another side. and it's not an equivalency at all. i think all of the statistics show that the, lack of a better determination left side lawyer grouped and union groups are outspent and many times five or six to one, and so you've got these huge amounts of money coming in, and there's no equivalency to balance those out. >> you know, tom, another factor that is underplayed and not stated enough, is the amount that the christian right has played in this whole thing, too

because that i think has made a difference in my state. in 2004, i guess it was, we had a marriage amendment pass in the constitution. 62% of people voted in favor of it. i was dumb founded. it doesn't reflect what i think most people actually believe in montana about that issue, but -- >> one of the interesting things is when the groups -- the outside groups come in, i've noticed they don't normally -- the ads they run don't normally support their position. they -- when they attack a judicial candidate they do so on grounds other than, oh, he's supporting plaintiffs or not voting probusiness enough. what they do is use issues that will inflame the public. usually using decisions from the

judge's past career. i don't now if you saw the movie "coffee." it was an expo say on corporate influence in the entire judiciary mitchell wife tells the story about how these groups came into our campaign. they start running these massive amounts of ad talking about what a horrible person i was, that they piled money bags on a bench, a judge's ben, and said, justice diaz is accepting tens of thousands of dollars from lawyer groups and he went ton allow a cocaine dealer to be set out of prison. that's an appellate justice's job is to review criminal cases and if there's error you overturn and a judge can't do it by themselves. in mississippi we have nine judges and have to heave five votes. so these ads were horrible, and we didn't want our kids to see it. we had very young kids and we didn't want them seeing this on television, and so we kept the

television off as we were getting ready for school, and one morning we forgot and were getting ready for school, and my daughter is in the other rom and all of a sudden we hear her yelling, yay, yay, yepee, daddy, we're rich, we have lots of money being given to us. the ads didn't necessarily have the effect they wanted on my household, but they did on the public. >> well, you know, certainly something that comes across strongly, which i should mention from double day press and doing pr for john gresham. but it guess in detail there about the fact that in many cases the money is spent based on those looking for return on investment, based on specific corporate liability case or more generalized issue of liability, consumer protection 0, or arbitration laws and the ad end up being spent largely on the culture or criminal issues, and

that the groups that are spending the money don't care. they just want a justice that's going to decide they're way. part of the question back on that is where you went with it, which is, does this also affect not just the balance of the scales between corporate and consumer interests, but the politicalization of the bench affect hearings in criminal cases in the sense that as a -- when i was briefly a politician, you always think about the 30-second spot. you don't think -- you balance the nuance of good public policymaking against the death panel ads and hopefully we have politicians willing to do what would be a matter of good public policy even if that risks a cheap shot in an ad. but for that to come into a criminal case you talk about it. what do you think is the impact of this, and is the problem money and politics or money and judicial elections or elections themselves, the judges. >> it's a combination.

when you have large amounts of money coming into the campaign, it's going to influence both public and the candidate's running, and you're going to tailor your campaigns to winch that's what a campaign is about. and one of the horrible results of the campaign against me and they used these terrible ads, talking about drug dealers and things -- a fellow member of the mississippi supreme court that i served with saw those ads and after that point, he refused to vote to overturn criminal cases at the mississippi supreme court. i thought it was a horrible, horrible thing for him to do. he lost his next election anyway. i think maybe it showed his character regardless of the way he went. but, yes, judges who are running for election do keep in mind what the next 30-second ad is going to look like, and unfortunately, it does have a spillover effect. i knew what was coming when i

voted. i wrote a dissent, actually calling for the abolition of the death mentality mississippi which was not a popular stance in the south, and i knew what was coming about i did it anyway. you have to have principled people that run for these positions. >> that's the problem. if you don't, if you get big money in these judicial elections and montana is nonpartisan like this state was, and you're not going to get principled people that are willing to run for these offices and get crucified in some high funded campaign, and that's what this amounts to. >> one of the things i was asking beforing are we had an issue where the president of the university of virginia was attempting -- there was an attempt to push her out by certain members on the board, and what was interesting, it wasn't just -- wasn't a liberal

versus conservative thing. you saw southern conservatives didn't like the idea of someone trying to come in and use money to determine the outcome or direction of academia. academia and academic liberty, like judicial independence, is anary ya both conservatives and liberals feel like this is a place that shouldn't be about who has the most money or influence, this should be about -- there should be a sense of fairness or independence. there are certain areas we treat differently in that way. do you see the conversation going forward being one connected to that, primary live about the corporate personhood question? is it about speech or is it about this idea of corruption and influence in a process that should be above that? >> well, i don't know if it's going to be about corporate personhood. it shouldn't be because that has absolutely nothing to do with

the decision in citizens united. the personhood thing is a holdover from the time that the 14th amendment was adopted. it should be about corruption, and the crosssive effects that big money has. i used to think that the judicial process was sack row sanction, and i have been proven wrong on that, and i don't think that -- as long as -- i use the phrase in my dissent in the traditions case about corporatism and as long as i think our national philosophy and economy is dominated by the free market concept, free market

will solve all our problems and take care of all of us -- i don't think anything is sacrosanct. because the best way to control that philosophy is controlling everything, and you control rid by controlling the money. >> ile avoid this to make this about the vice presidential pick based on this answer and keep it on the judiciary. you mentioned, justice diaz, that the issue about -- one of the things we talk about is good people not bothering to run anymore. you mentioned people that you know in the legal community around the country. do you think that there's some impact here of people say, why bother? die really want to go -- you probably in most cases are taking a salary cut to go on the bench. it tenned to be something that you did out of a sense of civic duty and honor. but now that it starts to look more like running for office, is that going to affect whether

good people run, the kind of folks that want to put. thes in harm way? a bit of a leading question but i'll ask it. >> no doubt about it. a lot of good lawyers out there who simply don't want to get involved in the political process. you could -- in the past we could recruit these wise old lawyers to cap their career with a judicial appointment and maybe have them run for election, and it seemed to work for a while. but i think folks looking at it now -- if you got some guy that has had a tremendous legal career, stellar reputation, why sully your reputation, potentially your family, knowing your background is going to be combed through just like any other election. you certainly are going limit

the pool of candidates who are interested in seeking these higher judicial positions especially. fortunately, you do have trial bench, but even the trial judges -- they're somewhat removed from a lot of the large funding that comes into some of the higher judicial positions, and even your good trial judges don't want to leave their local trial bench to run for a higher appellate office because they -- they're not blind. they see what's happening, and they know that every decision they've made in the past is going to be combed through and if they let a rapist go one time in the past because the prosecutor brought the wrong case, it's coming up in an appellate race, so, yes, you're going to limit the pool of candidates who are willing to subject themselves to that scrutiny. >> we're going to open it up to the audience in a second. last question before we do so. you mentioned that you didn't see the corporate personhood

challenge as being a particularly promising direction to go with this. we see new ballot initiatives this year in several states that are going to make the process more political -- less political for judge selection in several states. what is the right thing? if one believes that the corporate in financial influence on our judicial process is corrupting, having a corruptive effect, what is the best way for us to prevent that from happening. >> the best way is to get actual facts out before the public. not a bunch of sound bites. not a bunch of hocus-pocus about corporate personhood. all organizations have free speech rights, and you have much more speech rights now since citizen is united so use them. get the facts out. show how big money is being dumped into a particular

judicial race unfairly. show how these ads were false and misleading, and i think that's the best way to combat it. i hope the public is not swayed by all the sound bites i see happening now, but at least -- i think the best way to it is the attorneys get the facts out, get the truth out, make it prominent. >> there's some other solutions as well. i don't think there's any debate now based upon the united states supreme court ruling that correspond are entitled to speech but there are things we can do about it. it's great britain they have a law if corporations want to get involved in politics they have to have a vote of the shareholders. let the shareholes vote and approve expenditures or political campaign.

at least make that decision known to folks who are holding stock in the corporation rather than just a few on the corporate board. so, we have to look at all sources of different options as well. >> disclosure is important. >> disclosure is in full play, even after citizen is united, and the states, if they can do any one thing i think is important, they can beef up and enforce their disclosure laws. make people aware of who is contributing. i mean, who individually, is funding these things. don't let them hide behind corporate shields and layers of corporate organizations. make them disclose, because at least in the case we had in montana, these people don't like transparency in government. they want to do their dirty work in private. and you don't let them do that. >> in this day and age there's no reason to have a media disclosure either. we have the internet. if you make donations, you can

make it public that day or candidates receiving contributions make it known that day. disclosure is extremely important and no reason we can't do it quickly and openly. >> i will just note on that debate, for much of the last 15-20 years, that has been the conservative's position, at long as you disclose, then you're just letting people decide, there shouldn't be limits. there should simply be transparency now. that the limits have been taken away, disclosure is no longer considered by some to be the conservative position. >> two lawsuits in montana right now, one in federal court, one in state court, attacking that. >> i would say the vast majority of people i know certainly from central and southern virginia, regardless of political affiliation think they have the right no know who is spending the money and what they want for it in return. so perhaps we'll open it up and we'll have someone come around with a microphone here. if you can state your name and affiliation if you have one. >> i'm mitzi with the nato post

graduate school. i was married to a judge for 23 years, but he is here in the district. how long are your terms terms at is it like campaigning? if you don't do it through a party -- i don't understand this process at all. >> well, -- ours is eight years, we run nonpartisan, and basically what you do -- what i did is go out and tout my experience and -- my reputation for fairness and work ethic and things like that, and i even -- even though the i campaigned after republican party versus white, i tried to stay away from implying i was -- took any position on any particular thing. people would ask me, i would just say that matter may come before the court and i'm not going to discuss it.

>> were you doing that before we go to justice diaz, were you doing that at county fairs? was it garden clubs? what was -- >> i was doing it everyplace, and in montana, the -- each major party has dinners in the spring of the year jefferson-jackson day dinners or lincoln day dinners and most of the judicial candidates felt compelled to go to both. some were important, some not so important but i took those position at those dinners -- or didn't take a position. >> mississippi is the same way. eight-year terms. i. i served on both the court of appeals and the supreme court. and in past it was just like any other political campaign, without taking real firm stands on issues. you tout your experience.

i ate lots of chicken in mississippi and fried fish and lions clubs, rotary clubs, jefferson-jackson day dinners. but we also relied on lawyers. lawyers generally know the judicial candidates. they're the ones who appear before us, they have cases and watch the decisions of the court, and in my races i relied on my friends who were lawyers throughout the state. lawyers actually served as leaders in their local communities and a lot of folks look to the lawyers in their community for guidance, especially in judicial election. the problem we have now is that system is antiquated. when you have television ads coming in in my race, the u.s. chamber of commerce came in -- the bottom of the ad said-paid for by the u.s. chamber of

commerce. they don't do that anymore. they were getting a bad reputation so they started these other groups. when you get a million dollars, as they did in my campaign, it actually influences the election and it takes away the traditional support of meeting folks in the community and relying on recommendations and things of that nature. >> -- living with a judge as long as you dumped it's not easy. my wife knows ace well. >> thanks, tom, with the american bar association. given the situation now, the elections that are going on, the money going into the campaigns, what can judges and courts do to try to combat or overcome the public perception and the judicial perception, that money buys decisions?

>> it's a good question. i think if i had the answer, i might be still a judge. but, no. it's a tremendous problem that we have got to do something with can judges self-police? the problem is, you've always got somebody wanting to be a judge who is not going to play by the same rules. and bar associations should -- we have greater control by bar associations in judicial elections. public financing rather than just this open financing from the public at large. then you get back into the free speech issues of independent campaigns. there's no easy solution. >> i can just quickly say, i think sometimes it's easier to

get people excited about a solution that's bigger than smaller. in certain areas we think about needing to get agreement on marginal change. if you look at most of the polling -- this is true plate clay not just -- judicially -- if you look at citizens united, almost no one agrees. most people believe it's money in politics. it's always going to be corrupt and always broken. so in some ways we are arguing not against the consecutive position but against skepticism that we can make it better, and therefore, bolder ideas sometimes get a better response. whether that's just cities o'connor's position that says none of these positions should be elected. then you get into the question about the merit based approach. i think this is a moment, and i think the reports you'll get in the back, ask the questionses, too. we actually win more people by thinking big than necessarily by saying, you know, small.

now, disclosure is an example. incredibly important, almost everybody agrees on it. even if we can't seem to get it through the heads of some of the people down the street. but it's still -- do we can't even win what should be the easiest, everyone agree s on it position. so we need to fight that and sometimes that can take away from thinking more broadly about the questions of how broken our politics are, and i think finally, i have to go back to justice nelson's point, there's a lot of education and instead of burying one's head in the sand and saying this is people being too easy to manipulate and too much money involved, there are people outraged by it. they want something better than what they're seeing, and i think you could see in some cases acts of personal leadership and courage as these two men have shown that by having people who stand up to -- maybe they lose an election or lose their seat

on the bench but over time the legal community and the american community more broadly see them as having been the heroes of the rule of law in the process, and that can have an effect as well. >> it's important to note, too, it's said that all elections are local, and that's true. and it's imculp bent upon people in each state and city and county and judicial district to do this education process. those are the people who are going to have credibility in their own groups and communities and areas and those are the people on the ground, know the facts in that jurisdiction, and to get those facts out. >> my name is stacy, i'm a native of northern virginia and actually a victim of the pharmaceutical companies. a 30-day sample of abilfy y killed my fiancee in 30 days.

the problem i fine, now that we have tort reform, they put a cap on your bane and suffering and you have to approve the pharmaceutical companies were negligent order to sue you. mentioned something about following the money. i followed the money and where it leads to, it's a dispickable place and if their decisions are based on money given to them in a contribution and it affects people, whether it kills hundreds of thousands of people or wounds or injuries, will there be any criminal time for those legislators, for those judges? will they be disbarred or limits, term limits set on them? will there be any repercussions for their actions? >> yeah. it's a horrible situation when people are impacted as personally has you have by this generic tort reform label that you hear. again, i'm going to plug the movie "hot coffee" and the

family was highlighted in there, and there were caps on damages in nebraska, and even though their son was born brain damaged as a result of a negligent delivery by his doctor, he has to live his entire life on a fixed amount of money lower than the jury determined was a reasonable amount. we're seeing people impacted personally by these decisions. there's also a story in "hot coffee" a guy in texas who campaigned for tort reform, and he also suffered a medical negligence generals problem and tried to bring a suit, and someone said that, well, you know, texas has this law now and you're not able to sue your doctor because of this. and he said, no, no, no, we were campaigning against the frivolous lawsuits, not mine. and -- frivolous lawsuit is in

the eye of the beholder and it's only through people like you telling your story that others realize that, hey, this might affect me and my family as well, and that's what we've got to do. >> your story is heartbreaking because it's a reoccurring theme and i think judges are hearing all over the country, and again, i think it's important to get those stories like yours out before the public. i mean, nobody wants to have their loved one or their child or themselves -- they want to have their fair day in court. they want the damages for their pain and suffering, and just compensation for their injuries they've want these things. and i think if people like you -- you get your story out, that this is what's happening

because of corporate money, and believe me, you've never heard anybody whine louder than when one of these big corporations gets bounced out of court. my god, it's -- they just -- it's the end of the world. and i don't recall who do the study, some credible organization a few years ago. talk about frivolous lawsuits. most of the frivolous lawsuits are between corporations. >> exactly. >> lexus, the automobile, suing lexus, the legal research engine and things like that. >> i'll notice that the same people who are always talking about judicial activism seem to have no problem with it when it's overthrowing and goes to the jury -- >> one of the greatest growth injuries in the mississippi legal community right now is business on business lawsuits. they don't want to give up their rights to sue each other but i'll be darned if a person can actually sue a corporation.

>> thank you. roy, retired from georgetown law center. terrific program. terrific report. indeed it's the best report i've seen in a long time because the fullness of the information about the independent spending is really striking, and you all are to be really commended for it. i thought exactly the right question wassed and, what's the best way to do something about this, and i thought exactly the right answer came from justice nelson when he said, if it's one thing, it's disclosure mitchell question is this. what if any followup are you all -- that is the center -- going to do about this? twice in the report referred to strong disclosure. without a word about what that means. what it means in fact is that we have either -- no states as far as i know, or maybe one or two -- where the disclosure of

the independent spending is effectively required. in the states that have any reference it to they use the magic words hurdle, which means, you joust don't get anything. so what if any followup will the center be engaging in? >> well, thank you for the plug on the report, and for the softball question. [laughter] >> we -- perhaps this is going to be a 24/7 project. andrew who gave the introductory remarks and others will continue to do both the research and the advocacy. one of the unique things about this institution is we have both a think tank and an advocacy arm because we believe that actions without ideas can be as empty and problematicses a ideas never put into action so we try to be at the intersection. i think we need to think about disclosure in two stages. one is to do the research which should be easy in this day and age, who is writing the checks

to whom. it's a little more complicated with independent expenditures and the abuse of the c4 loophole for those running paid advertisements. the second component is the research of connecting those donations to the impact on people's lives at the kitchen table, which you heard about in stories today. one of the things that shifted in the political wing is what i would consider ideological giving on the right and left. you might have a billionaire on each side,to what you might call return on investment giving in the political process. post-citizen is united. which isn't based on the case. it's based on how the case changed norms in our society, whether it's okay to write a 10 mental check or pledge $400 million. we're looking at how these donors see a 30-40-50 percent return on investment, and a first year. and based on actual policy changes. on the judicial level, as we

heard, we want to make sure we do the research not just on where the money is coming from and how much, which i think is shocking to people -- but what that means, and i think the caper continue case, we keep coming back to the appeal of holiday pot coffee" because when people come to see they, they may rub an ad about gay marriage or letting a criminal out but this is about overturning a case where people died and got sick because of corporate negligence, and it was cheaper for them to buy a justice than to pay the liability. so, i think the disclosure is not just the giving but doing the research to show what this means means for people in their everyday lives. so that's thing we're committed to doing. i guess both these gentlemen will be continuing to fight for this, and i can give them a second to give their abc. >> i agree, and one thing -- i wasn't trying to be rude here. this is an amicus brief filed in

the american tradition in the appeal mounted by former retired justices of the supreme court, but the -- amy o'letty, the attorney who wrote the brief, detailed in one part of it the extreme difficulty that was faced when people were interested, tried to follow the money, and i think it was the michigan supreme court race that justices were thrown out of office, and it was like working in a cayman bank account. layer upon layer upon layer upon layer of protective corporations. and again, it just points up what i said. these people do not like

transparency, and it's -- i think it's important but it's difficult. >> all goes back to disclosure and focusing light on the problem. i'm out here constantly speaking on these issues. i was in seattle this past weekend, and just had a tremendous reception. folks had no idea what's happening in the judicial system, and the influence that corporations are attempting to have on the judicial system. so we've got to educate and disclose. those are what we have to do. as a result of what i've gone through, i was a justice on the mississippi supreme court, subject to a lot of negative advertising. i feel i'm compelled to speak out and help educate. the worst thing that happened to me is i'm in private practice and now making lawyer money instead of judge money, which is not a bad thing, and i'm one of

the most well-known lawyers in the state of mississippi, which may not be a big thing here, but it -- my career is not diminished because of it. and i certainly have been able to take a stand and a principled stand and people have respected that. i mentioned the gorily family who live with their medical malpractice problem they have for the rest of the life. "hot coffee" tells the story of jamie rejoin. she was brutally raped and abused in iraq when she want to work for halliburton in iraq but she signed an arbitration agreement and couldn't sue directly. al franken took her cause up on capital hill and she ultimately -- because through his efforts and thefts of others, was able to bring her

case but she has to live with that constantly. so we have these problems, and disclosure and education are the solutions, and we have to do that. >> well, we really appreciate everyone coming. when you think how deeply this is integrated into the american story, from to kill a mocking bird and 12 angry men and hot coffee and the appeal, when we think about how many shows on television are about something noble in law and order or csi, we think of how much we value this idea of an independent judiciary-these are two gentlemen who are fighting to make sure that remains a great part of the american tradition and we want to thank them deeply for joining us today and for their courage in their profession. [applause]

>> you can get a copy of the full report oner in for american progress.org. >> coming up, a look at the american technology on the rest of the world. ... ...

>> on wednesday, u.s. airways doug parker on his efforts to merge with american airlines. followed thursday by meteorologist jim can torreon was 25 years covering the weather. wrapping up on friday with filmmaker ken burns on his documentary prohibition. this week on c-span2. >> earlier this month, the influence of american technology around the world.

they are part of this year's aspen institute summer gala that looked at the increasing use of mobile video, social media censorship and other countries, and the use of twitter during the olympics. this is just over one hour. >> thank you all, and welcome. let me ask you to take your seat, if you may. i want to thank jerry murdock who put this together and gina murdoch. the chairs of our bench tonight. on behalf of our chairman, we welcome you to our summer gala event. we have to conversations here. i am going to moderate the session, but on the theory that you have seen enough of me, zoe baird and pad warrior.

>> thank you. some of you know mean as zoe baird budlinger. i am really pleased to be introducing you today. gina murdoch is a real scientist and one of the way and one of the stories that i can tell you to confirm that is took place almost 20 years ago now when pamsd padma warrior sent her off to

the drugstore to get a pregnancy test because she thought she was them. and he dutifully went off and came back with a pregnancy test and she took the test and it was positive. most of us would've started celebrating, but not padma warrior. she sent him back to the drugstore for another one. because the to her, it cannot be true unless it can be replicated. so she got the two data points and her wonderful child who is now 19. tell us very briefly, what are you doing your day job? >> we are a company that does switches and we make the iphone of the internet. the physical infrastructure that you don't see behind every time you send a message or a reed it is something that will go

through in the background. it is a global company it is about 50 or 60,000 employees on a worldwide basis. including our partners. $40 billion in revenue. at my day job at cisco is to double up the technology strategy for the company and engineering as well as being the chief technology officer, just about three weeks ago i moved here for cisco and cisco is a company that is about acquisitions and is about a 26 your company. we have acquired and integrated about 152 companies. i am amazed at what is going on right now. >> your background includes being a major force in the development of mobile technology when you are at motorola.

you now have been a company for a number of years that has been a major force in creating the network that is the internet. as you look out at how profound those changes have been, and you think about your strategies going forward and what you see happening in the expansion and explosion and data and the ability to network and connect data in the explosion of social networking do you think this will be profoundly impactful on our lives with social an election with the mobile technology in the wait has been? and if so, in what way? >> i started in the industry making chips that went into into at the time, two-way communication devices which then led to the beginnings of my

coming to cisco. and then it kind of migrated into google print the whole migration of technology. the cell phone was first invented. it was meant to be a businessperson's device. the idea about him leaving the office, he would feel that he needs to call back to the office. that is why the cell phone was invented. there is now probably about five times as many cell phones sold for every baby born every second, about five babies born on planet earth in the world. it is a device that week i'll use and cannot live without. the internet, as we know, plays a huge role in connecting person-to-person and now actually starting to become a platform to connect machine

communication. those two worlds are emerging. mobile and internet. it is interesting to see what data will create. some interesting data points for us to keep in mind to think about this next evolution, you know, i think media will be a big opportunity for us going forward. we are just beginning to see the use of media, it is beyond what we can do with the media, you can put things on youtube. cisco estimates that by the year 2016, in four years we will see huge amount of video traffic. about 1.2 million minutes are uploaded in megabytes every second. the network has to deal with all of this and figure out how to get it at the same time. we also expect in four years of the wireless data will actually

exceed what lifeline data is. all of the data that we are consuming on mobile devices, there are still things combined, telling us that the combination of what mobile means in the future is going to be huge. we just did a survey on college students in 15 countries. two out of every five people said that they would take a lower paying job and work for a company that doesn't allow them to bring their own device will have access to access like twitter and facebook. freedom of being able to connect and use social networks and the device of their choice is more important to them than what they get paid for doing their job, which is really interesting. the other data point does one out of three of the students, they said internet was as

important to them as air and water and food. [laughter] i imagine my grandfather turned over in his grave somewhere. i think the mobile device and how it has changed and i was born in india and raised in india before i graduated and when i go back there, my husband and i go to visit our families come everyone everyone has a cell phone and they use it in very different ways and how we work. it is going to have a huge impact. in the next decade we will begin to see what -- lots of low bandwidth data constantly being sent through the network. one will be media ready and the

other will be small bits of data that continue. we begin to see that already. there are certain protocols, electrons moving to ic networks in that transition will be huge transition going forward as well. >> do you think about whether those transitions can be integrated into enabling people -- creating new kinds of jobs that people are doing today, when you think about how to enable that, someone wants to be able to bring their iphone work, or their devices work. rather than all of a sudden we can do new things to create ways

of making a living but they've never done before? >> cisco has a lot of what we call networking experts. we have 10,000 academies where we bring in people and train people to understand how the network works. we want people to be on the network. technologies at a deeper level right now. the deeper level, we can think about job creation. we need to get the right kind of policies driven and those infrastructure being put in place that can be leveraged. and there then there is the other aspect of what happens when things we are used to having in the physical world turn to the digital world and what does that mean.

there is an article in "the new york times" that talks about how our brain is now -- we become habitual to using technology in a different way. it changes the way our brain actually is going to function. what that means in the future is also going to be interesting as an aspect. it talks about how it takes about 21 days for an action to become a habit. and 66 days for something to become a good habit. if you want to start climbing the stairs every day after lunch i may have to do that for 66 days before you can stop thinking about it as a habit. these things become habitual. i think it is changing the way people's brains will function. that in itself creates new drives to be different, but they will be able to drive different kinds of industries.

[inaudible] this reminds me of when i was a kid i used to cut out pictures from magazines and pin it on a bulletin board and now i do it digitally. these sorts of things will allow us to work in a different way going forward. the interesting data article that i was reading about, 700 billion hours of gaming and every week that happen online. video games are online video games. some people might think that that is insane. 7 billion hours. but at the same time, california

in san francisco has done some research that is actually improving creativity and being very focused. i think some of the things we are doing, we are at the early pages of figuring out what it is really like. >> when you think about being, you know, your own trajectory and one of five women in the class of 215, at the very prestigious institute in new delhi, and you look at where you are now in the women around you how you feel that things have changed for women in engineering and sciences, i know you spent a

lot of time mentoring women and encouraging them to develop in the field. >> yes, so when i read her college i did my interning at the institute of technology in new delhi. it is a very important engineering school. there were only five women in my class, about 250 of us total. i went to college when i was 17. and i went thinking is the smartest person on the planet and thought i knew everything -- and i quickly realized that there were people that were very smart, smarter than me and it was very intimidating. what helped me get through microfilaments the fact that they were women, too, we were a community that helped each other.

in technology and sciences is very important to be there for each other and help each other. in fact, especially women entrepreneurs starting companies, connecting them with women that are more experienced so we can kind of stick together. there is no press or media, it is an informal way of sharing experiences. how has it changed? i think it has changed. from the time i started working, just the notion that as a woman you can be yourself and truly be recognized and be a leader. it is accepted more now than it was when i started working almost 20 years ago. when i started working and i started my career at a hard-core technical industry, we were told to dress a certain way and talk a certain way, you were told to stand up so people would see you. there were just certain behaviors that were imposed on you as a woman.

hopefully these days women entered the workforce can feel like they can be themselves. that is what i tell the men that i mentor. -- that's what i tell the women. if he fancies you, and don't try to be someone you're not. and i don't think that they are very particular -- there's not a particular weight you have to be. that is what has changed in the last 20 years or so. >> i thought one of america's great global competitive edges is a great competitive edge that would be our ability to take advantage of the 50% of our population that was women. and that if we would be able to draw on that talent in a way that other countries would not, do you think that is true? is that it plays where america has a competitive edge, or do

you think it is the same in other countries with which we compete. >> i think we do have a competitive edge. women, by and large, are few. when i came to the united states and state in the united states and i came here to go to graduate school, i tell women and others, my story about $100 and one-way ticket. my original plan when i came was to finish my phd and go back and teach. and i started working and felt like i could have a great family. and i think that is in general, too, think we do provide an alignment were people, both men and women, can be competitive and rely on contributions to become partners. i just participated in research that we did, the research

university, we did it for the congress. we were looking at the university research and talking about the american research weakening. but it was weakening from her was 10 years ago. participation of companies or contributions by the federal state government. the combination of both. i do feel concerned that we need to do more to maintain our edge in the higher universities and research. it is a trend. i think it is important to maintain our competitiveness in higher education and i would say higher levels of research at the university. >> in addition to taking advantage of the talents of women in this country and investing more in research, what

else do you see as potentially competitive edge for this country, as we compete with india and china and others? >> i think entrepreneurship and innovation is truly an edge. even the notion of silicon valley, there have been lots of case studies done on if we could replicate it, now we are seeing more pockets of innovation, it is extremely important. i was on a state department trip to russia and russia is now thinking about, you know, creating a concentrated effort where they can have entrepreneurs start companies. i think we need to maintain this magic formula of creating great risk-taking with great ideas

that people -- young people, can come up with ideas and create companies that are going to be big companies like google and cisco and twitter. i think that is what sets us apart from the rest of the world. we need to do everything that we can. that is a combination effort. [applause] >> going onto the next question. when president obama was elected, he was very interested in you being his chief technology officer. for family reasons, that's not the option to u.n. if you take it now, what would your priorities be? >> you know, i think there's a lot we can do, first and foremost, investing in big problems that we need to solve, i think there is a lot we can do as a country and understanding

the research that happens in universities now. i am a scientist, so maybe i'm biased. but going back to creating new kinds of things, it is important like the internet, and maybe i say this as i work at cisco, but it is important to look at innovations we can drive, as well as areas like energy and those types of things. where the government can really sponsor large-scale research projects working with research universities and companies will benefit from not and they can create intensive industries. that would be something that i feel, you know, wherever the president has to have is a technology point of view. >> well, we won't get into the question of whether you can have it all. [laughter] >> it gets talked about a lot. an analogous question is, how is it that you managed to keep

fresh and to succeed in at it all. family from your wonderful husband and child. you have an extraordinary career, you're out hiking this morning. "the new york times" story recently said that every saturday morning, you take a digital detox. you want to tell us what that is? is that part of you that is it enabling for you kavanagh? >> every friday morning and make a rule. i made this rule about a year and half ago. i was working all the time, virtually, and it was really getting to me. about a year and a half ago, immutable that on saturday mornings it is my time and i write haiku zen poetry and acting. it's when we went hiking. i want to do something that keeps me away from all devices and all people. and i really am disciplined about doing that and i'm trying

to make that a habit. i've done it for more than 66 days, so it is definitely a good habit. i think by and large, it is really important. it's a reboot for my brain. things happening constantly, just like when you exercise pacific route, i feel when i meditate and paint or if i am writing poetry, i can think more clearly. when i am more kind. it is a disciplined way for me to think clearly. >> that is great privilege for all of us to have you here. we thank you and we look forward to you getting your award. [applause]

>> thank you, zoe baird budlinger. while they are getting seated and all, let me say that this evening we are honoring the three of them for their service to technology society, but the reason that my old hero, eric schmidt and dick costello, my longtime friend -- young and longtime. it is not only to talk as a technologist, but something that we have been talking about a lot this summer, which is the effect of technology on democracy and on world affairs. the best book to be written next year, will be written by eric and derek cohen about the effects of technology in the arab spring, but also the democracy movement in this

country, obviously, dick, if someone had said on twitter, is looking about how it changes our society, our democracy, and for that matter, the world. at dinner a night or two ago, he is the head of usaid, and he said that gigi abraham sitting there, tweeting the location of a demonstration in kinnaman square, it is something that she had learned at a class, the american university in cairo, called social media under authoritarian regimes. and then of course, one of eric's employees, at google, really did help start a revolution are out here. i will start with eric. how much do you think that the revolutions of the arab spring were affected by technology?

>> a revolutionary uses the tools and technology that is available to them. i went to libya right after qadhafi was killed. what was interesting in talking to people is that they had tried to overthrow the evil dictator, and then he had died from it. so the dictators in tunisia have learned that you have to censor the media and radio lines that were tapped and so forth. they failed to censor the internet because they were too old. all right? [laughter] theory and dictator has learned that lesson in serious and is censoring the internet today. i believe that as much as we would all love to take credit for this, we should give the credit to greatest people who risk their lives. we were simply a tool for them to start something. i should also say that it is much easier thanks to twitter,

facebook, and youtube, to start a revolution, but it's not easier to fix it. so we are a small part, i think, -- the thing is that you use twitter to get people out on the streets and you use facebook to organize them and youtube to record the results. i will take that. >> you made a very good point, which is its harder to enter revolution. i remember in 1989 when i covered eastern europe and they were using taxes and satellite tv, but they had organize, and -- they created revolutions that have leaders, so when the revolution succeeded, you who would be in charge. do internet revolutions inherently wrack the capacity to create leaders and centralize authority's? >> great leaders are rare.

they are rare in countries and also in the u.s. as well. seriously, somebody who can overcome the many voices the many voices and chatter. many people are following themselves on social media and news coverage brings. the fact of the matter is you need somebody who can unify this. in libya, there were 80 militias that came together that fought the battle. if you look in syria today, there is something like 10 or 15 they're unified. they have unified using the tools that were available to them. but there is no obvious or natural leader who has spent 30 years fighting the great fight and so forth. how will that -- assuming how this dictator goes -- how will the new leader be replaced? maybe they will end up with a great one or a series of rotating near civil war can governments. you just don't know.

>> it is the muslim brotherhood that was organizing the street for 30 years. >> it is very interesting. because they were secretive and because many of them were jailed and because they are highly religious, they are very organized and very charismatic. and so they are the logical place for a charismatic leader would come from. what is interesting about the brotherhood is that they don't actually tell you what they're going to do. we are very careful to select our politicians, right? to not actually say what the trade-offs are going to be made off. ..

>> he is heavy the interior

minister of use and this boards. you have to start somewhere. we found out how they use twitter to organize protest where to me. while it washes over you. nothing we anticipated airplane and or promoted but in this how people use it to. >> have you had difficult decisions with the state department assuming of the crowd but it was it tough decisions have you made that twitter is such a political tool? >> we are blocked with iran and china. and make lots of decisions

what you will and won't do. people in china use it. >> we will not go there in the way we have to to provide access and allows them to sensor and we will but do that. i imagine with the new government to it will be worse for the company is already there is. >> we were in pakistan for a couple-- did remove some treats and we didn't ultimate leave they brought us back up anyway. in turkey it is considered a

egregious to ridiculed and get the occasional messages and say you need to delete these were wary will take down the service. you figure what you have to relatives. >> walk us through the tough decisions on china and other places. >> you have a situation the citizens of x country want. but the government does not want it on your terms. it is the power play. we were blocks and nine munn

s in turkey over youtube because of one video. but they were concerned of others but nobody would tell them. it has been invoked which allows them to our richer early sensor. >> do you try to circumvent? >> the more read to the more we end up in jail. the broadband is not very fast. it is a fine line. our employees are called a and syringe. but china is a long story as we tried, it did not work. >> you have foldout of it.

>> a bit? [laughter] >> we felt it was better to engage rather thin be a strain to prepare and we wanted to provide such great value of the government will be forced if the censorship is not okay. we did that five years. censorship got worse. after the proxy government attack us we publicized that , after a long and severe campaign we said the enough is enough. we like the hong kong system

better we are moving to hong kong. the firewall is a censorship that we solve a problem by making the chinese government to do this censorship. >> the mayor's son is arrested. the police calls and says the lead to it to. they are things that are personally embarrassing to leadership for senior leadership. >> i don't think people understand the magnitude how hard the different of china

will come to. a woman was asking budget and put up at another joke from a local official and she was said to to the labor camp for one years. >> the guided pakistan to tweets a comment about muhammed and immediate the deleted and announced his a location and we have not heard from him cents. >> example after example of what you think of as the tiniest remark that you consider to be cruel punishment. >> is it better or worse?

>> censorship in aggregate is worse. it is reasonable to believe even if twitter was bought bought, the way they block it they make it to impossible to get there. then the government lied and then in a dictatorship he haccp ego and cares. so twitter and the inspired followers change the government. >> do you think the advent

of the information technology and the free throw -- free flow enables democracy? >> it definitely helps to empower individuals. we're going roughly 2 billion devices for six out of seven. within the next 10 years all have smart phones and debris simple data connection connection -- reasonable data connection. you cannot approve the democracy connection. >> but individual empowerment and choose your own leaders? >> it is the western view.

>> the other is chaos at. >> that is a western view. [laughter] >> it does not follow the extraordinary impairment. that it leaves to free elections and the parliamentary system. my own view in fact, the future will be much more predictable and bizarre. there was nothing new going on. then mark invented the web browser. all of a sudden i discovered there were voices i had not heard before.

know we have the same phenomenon and globally. we honestly have not heard from them. the rate at which scenes are happening willis salary. we assume everything is static but it is false. the platforms will have many such platforms and will empower whole new forms of social activity at a global scale modeling personal behavior. >> do you see people using

twitter in different cultures and do use -- learn from matt? >> yes. in japan specifically the japanese use it as the form of communication or a phone call at other thing and paying attention to what your hiro says. it may be the case that is in reaction to fukushima and the tsunami but used as alternative personal communication they and the rest of the world. in brazil almost exclusively indexed to following celebrities.

of is absolutely the case people around the world views it differently. >> the olympic ties have been fantastic. one fascinating saying is if people understand the changes we're going through where there is a broadcaster and they interview michael phelps before or after. there is a linear progression. but now you have the non felt third inside out view

from participants taking a pitcher and tweets. >> every athlete same to be on twitter. it brought a tear to my eyes. [laughter] >> that will fundamentally change the way media delivers the events. it will start to get to board of their i's of multi perspective you. >> been is hard to for the nbc full costs to do the time delay inserting narratives and feature stories but the alternative

is watch the olympics via twitter. it is a different choice. how do think nbc's feels that you almost trump's some? >> we have a partnership working with the olympics with them. i a make no claims how they broadcast but the partnership has been fantastic also with the ioc, london organizing committee that have cameras inside the offense just tweeting them. a pool camera at the bottom tweeting photos of the fed diapers as they hit the

pool. a fascinating insight out prospective. it enhances what they are doing then they have a broadcast as it relates to everything real-time. >> what should america of the doing now to stay competitive? >> i am part of the science of buys three for the president. ameripath fed technological leadership came with a lot of help from the government. after world war ii seeing the underlying science

infrastructure is what created everything dick and i represent. in the forties and fifties say led to the semiconductor revolution, all of that. they don't understand how it really works. it is clear america's leadership is the key part of that. but the facts this something about the american educational system, college and beyond that produces people that can create things of great value.

let's start with investing in education at every level. that does not mean higher raises for the union members. [applause] we will go back to producing students as good as the panese and koreans. if you're not willing to take that it is hard to have a conversation. >> i do not understand the debates but some political leadership that the facts are optional. [laughter] we have a demographic challenge with asia and global competition and the automation talent. the old the jobs are not

coming back. the new jobs are correlated with hy-vee educational achievement and what we are good at. figure out how to fund that is what we should be doing. [applause] >> you get the $0.2 -- acute sense we recruited this young woman from princeton. she was using between twitter and google and facebook. she went to google. this ceo calls her that

makes me look bad weather 51 i did fact and i had a half-hour conversation with her in the issue said they key for taking the timeout mr. costolo. nobody calls me that. [laughter] is his wing great to speak with executives from google and twitter and facebook that it is that hard to find a woman is engineering in america. it is a real problem. >> what happens is the new machines rtc's -- sophisticated to operate we do not produce

enough. because we do not allow foreigners to work here i am sorry. i will stop. [laughter] and. [applause] let's get to the stupidest policy of the government. [laughter] the digital revolution to talk about disruption the one place that has not is the indicate -- education industry. most of still have a textbook there is stood teach your

standing in front of the blackboard. >> think of the educational system is run for the benefit of the adults and not the children. [applause] >> there are many possible solutions. we should try them all and measure the outcome. >> they teach statistics in high-school. we should apply them. [laughter] >> show me how technology could disrupt the classroom. >> i am now on the board of the con academy. he does between eight and a

10 minute videos. big numbers. bru-ha-ha what happens that when the student goes home they watch the videos and do homework and the class? year earlier results indicate a materially significant improvement of middle and high school class is. you would immediately adopted by can assure you it will take 30 years but to do it in america. there is proof that it can work. if you build knowledge and you get stock you lose the

year. everybody moves forward. come up with technology as it is self-taught, you've would excel. they just had trouble with long division. >> county think of twitter in a social contests -- context. >> we have talked about technology removes the barriers almost to talk about it but to his now collapsed with the communication platform is eliminating the barrier of time and distance so barriers of socio-economic

status, that's affords all sorts of opportunities in the government to and education and. sandra she uses twitter all the time and gets into room. conversations. how they think about character and why they per for this. so other these remarkable all buyers who give a price for free. >> but we try to facilitate

the seven have a collection of conversations. there are so many remarkable conversations that take place on the platform. my favorite conversation of all time sarah silverman said when your family drives you crazy pretend you are and the woody allen movie. mia farrow said i tried that. it did not work. [laughter] it is fantastic.

she is my hero. i did not know about that until four months later. >> what is the next phase? with the accounts people should dissociate for those that did not have the beginning and then and? >> do you worry social media could be polarizing court alienating? >> no. >> we have had that for hundreds of years. go back to the 18 90's and britain. you just see old behavior with new forms. think of voices you never

would have heard that with 1,000 more like it. >> one challenge is fed by an two nation of who tweezer under slim of 404. budget there are two sides to anonymity. maybe facilitates political speech of foster's his and then just three days speak frankly to foster political speech but we have to keep in mind there is another

side to that. >> slightly different, we would answer the question to say it it should be relative easy for what you like you see the age and the stuff that you want. anonymity has a negative asarco there are places where it is a problem but an incredibly important. look at mexico we require

real name policy. is the be3 real name policy. is the behavior appropriate and twittered did a fantastic job on this. the example of how to do it right. it is much easier to

liberalize the and to restrict. >> does anonymity lead to dialogue? >> lots of evidence people say things they wouldn't or shouldn't the think before you press send. if you have to think then you probably should not press send but now people don't understand there is no delete but 10. -- button. the guy who's not deleted the comment within five seconds but that to is long enough you are in trouble

with saudi arabia. the generation will be defined the his that want to go away. >> the last two revolutions and through the web dominated losses been a those and what do you see as the next big thing to happen >> i think it will be something the rich saying that mobile computing is close its to being in a beckett and -- ambiguous sell the way people always have the device with them

sensitive to all the information. that will foster innovation we cannot conceive. >> with their be a natural interface with machine learning? >> absolutely. there will be some test pass same the touring test that this behind it closed partition you can ask questions and not determined if it is a human our machine. i am amazed already. is say hop skip and jump

that our great. >> vanna white to think as as supercomputer so and 514 years it is a $50 device. what will life be like? you would never look at it with their permission. and again, with your permission, these devices can decipher where you

should go, who you should be a, your choices coming things going on around you. the perception of local commerce on a single platform and not but the hottest area is in this young and entrepreneurs to see how lives can change. backs have their very good is to imagine eventually man or machine? if we do what we're good

then you remember everything. thank you very much. [applause] you can see why we are honoring them. if you are having dinner proceed to the table.

>> i am with the alliance of floor health reform may have generated health information and in a consumer devices and processes to transmit rates were glucose level. electronic health record the physician can use it andy advances say are encountering. we have two partners today.

somewhere in my briefcase. i have little but in. of project of four senate majority leader's the only d.c. think tank we are glad to have the chairs from the information technology initiative. >> it is a great pleasure to

be here today to talk about what is important to us at the bipartisan and policy center. we were established in 2007 to focus on a broad range of issues and we are talking about how they could more erred effective leave encage the shade patients using electronic tools. we focus on of that all lot to from the task force to deliver customer reform. we are experiencing a number of pressures in include

a-year road dain coverage. look at the initiatives moving across the country whether sponsored by the federal government or states or private sector health plan, all activate or engage at a much higher level. we have a tremendous opportunity to make that happen. had in fact, there has been research who like to use the smart phone if they could access their medical records of the you don't commissions

>> it article published while 64 physicians never use the electronic health record but 42 percent are willing to try. stage ii o there is a proposed roll to have to further engage patients but using the tools. but things that make it to exciting that a more

accelerated pace. how between how we can continue to support and to provide with patience. 1/8 tariffication needed maybe a little about security but the need to a lion the incentives further. we've made to buy awareness that nobody gets left behind

due to the technology. there are some technical issues that need to be figured out. a few talk to the folks in the use records in the five have different sets of data data, where did it come from those are my comments. i look forward to the discussions. >> before we introduce a the panel let's go through the checklist. there is a webcast and podcast available tomorrow

to who we're grateful to provide that service. then you can view a transcript of our website. cease -- c-span broadcasting live probably at the 2:00 a.m. rerun. [laughter] you can catch it this week. if you are watching right now with access to a computer go to all health.org and if you punch up the briefing you can follow along with the power point* slide presentation. there are our -- r. green question cards and the evaluation form so we can

improve the briefings. this is also on twitter with the cachet patient info you we have a terrific panel assembled. i want to thank steve and his colleagues but turned to him now. chief technology and information officer to make sure it is a mind he helped

with project health design that will be front and center. >> good afternoon. start with health is becoming digitized. i said house. not to health care. we think if they care is becoming digitize with increasing option of electronic health records. but it is your day today experience. it is understood as a function of the environment and in the decisions you make and the context.

there are two drivers. the first is the smart phone. the first company holds on through everyday use and the gps data where you have been. they can analyze that but you may have a behavioral signature is and look at the deviations. you could be sliding back into the depressive attitude. this is not a secret

experiment right now. controlled studies and secret patience. it is the power and the increase -- incredible existing things. the second driver is about sensors. green goes takes takes an expensive assessors and packages them in little stickers to slap on everyday objects then have a competition who does a better job to push their teeth. there are things you can do as a powerful center. her this plays out with the fitness tracking industry.

it to blow track your activity, put it on a wristband and it will launch your weight and then you could go on twitter with it. >> will figure out how far you went and also put to on the wireless heart monitor. when dr. asks a few lourdes getting exercise, you can go out turrets where you have run, how often and how fast and extra credit how fast your heart beats.

don't try this at home. i don't recommend it right now. stay probably don't need to know all the details but what used to be a precise answer could now me answered with great precision. now you increasingly see trackers cover your diet, sleep but the big question is in conveying access to that day negative of really matter? with project health designed it is run out of the university of wisconsin. we've funded five teams to

work with real clinicians with the observation of daily living. think of it as said data with day-to-day experience diet, exercise, stress level, paying, and the medicine you take. and they have treated services for patients to capture and store data. then integrating into political care. bringing it to the doctor's office. breeze easy worked with low

and come with the zero populations with the man melts health insurance. >> talking about crimes disease but a special act on itunes and a journal to record thoughts how you are feeling. said david is turgid then they discuss it with the doctors but lowe's sens works with seniors but it illustrates the power of sensors. 3e general day leed can

tat -- contest and we put sensors on them and people may have more confusion and making more mistakes. >> it worked, with an offense who are born prematurely to:home and to those tapers changes why is there mood in day today? >> km is pretty intense refco but to work with young

women coming teens and they have the mobile add up the also their mood. they would review with the health coach for feedback. i want to emphasize the project. >> is s but and depression. but it is because of the complication. farrah not affluent to a lot are from low-income backgrounds and have very

little familiarity. also the projects are wrapping up and we don't have a clear findings yet to. but good preliminary observations are would people do this? yes by and large. not everybody who did would track it all the time they substantial number did we could gain value. >> fed direct feedback made a difference. showing day to day medication adherence brought

real insight. i thought i was doing well. but i am not. there are cases people who track their diet to made changes and lost a lot of weight to. there are differences of but one that wanted to share is a quote is there a way to extend the filter? >> i find this very helpful and as a result i have

changed the medication and i am on. quality of life has gone up and my health has gone up. that is the good thing in this case. it is a good example howl it could make a difference in treatment and on a person's health. >> it represents a challenge. doctors are extremely busy. but second with electronic health records, they're not well-positioned for herb patient data. so