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Archivo del Autor: Belen De Leon

In healthcare these days, ‘There’s an app for that’… unless you really need it

When a digital health company announces a new app, everyone seems to think it’s going to improve health. Not me.

Where I work, in San Francisco’s public health system, in a hospital named after the founder of Facebook, digital solutions promising to improve health feel far away.

The patients and providers in our public delivery system are deeply familiar with the real-world barriers to leveraging technology to improve health. Our patients are low-income (nearly all of them receive public insurance) and diverse (more than 140 languages are spoken). Many of them manage multiple chronic conditions. The providers that care for them struggle with fragmented health records and outdated methods of communication, like faxes and pagers.

So when companies tell us they will cure diseases, drive down costs, and save lives with state-of-the-art technology, I am often hesitant. 

More than thirty billion dollars have been invested in digital health since 2011. The resulting technological innovations, such as mobile applications, telemedicine, and wearables, promise to help patients fight diabetes, treat chronic disease, or lose weight, for example.

However, we have yet to see digital health drive meaningful improvements in health outcomes and reductions in health expenditures. This lack of impact is because digital health companies build products that often don’t reach beyond the “worried wellâ€� – primarily healthy people who make up a small proportion of health expenditures and are already engaged in the healthcare system.

If we’re designing health apps for those who already have access to healthcare, nutritious food, clean air to breathe, and stable housing, we’re missing the point.

It’s no surprise that health apps are incongruous with the needs of low-income, diverse, and vulnerable patients when these populations are unlikely to be a part of user testing. In addition, the science that technology developers draw from is generated by clinical trials conducted on participants who often do not reflect the diversity of the United States.

Over 80% of clinical trial participants are white, and many are young and male. Women, racial and ethnic minorities, as well as older adults must be included in clinical trials to ensure the results — drawn on not only for product development but also for clinical care and policy — are relevant for diverse populations. 

Research conducted by my colleagues at the UCSF Center for Vulnerable Populations demonstrates that patients who are low-income are unable to access many digital health apps. One of our patients testing a popular depression-management app said, “I’d get really impatient with this� and expressed concern that “Somebody that’s not too educated would be like, ‘now, what do I do here?’� A caregiver testing a different app also voiced frustration, saying “Yeah, it’s an app that makes you feel like an idiot.� Yet, despite these barriers, the majority of our study participants (most of whom have smart phones) also express a high interest in using technology to manage their health.

 While the private sector is great for innovation, it will fail to improve health in a meaningful way without real-world evidence generated in partnership with diverse patients. In addition, these for-profit companies face long odds to benefit their shareholders in a substantial way without learning how to reach the 75 million patients on Medicaid (including 1 in 3 Californians) who stand to benefit from digital health solutions.

 There’s an answer, though, and it’s within reach. To truly improve health outcomes, digital health companies must partner with public health experts and patients to not only ground themselves in evidence-based research, but also build products that meet the needs of all patients. 

Along with the compelling business potential of innovating for Medicaid, infrastructure to support this work is growing. For example, organizations like HealthTech4Medicaid are bending the arc of innovation towards the patients who need it most through advocacy and key partnerships with payers, policy makers, care providers, and technology developers.

To truly revolutionize health, let’s demand that technology creators and scalers include diverse end users early and often. Otherwise, the app “for that� will be for them, not for all of us.


Source: TechCrunch

Don’t hold your breath for the moon

In the house in which I grew up, a single framed newspaper front page loomed over us. “MAN ON MOON“, it declared jubilantly, in an enormous, suitably momentous typeface. Subheadings included “‘It’s very pretty up here … a fine, soft surface’” and, of course, “A giant leap for mankind.”

One leap forward, three steps back. That newspaper was dated fifty years ago today, as I type this. Apollo 17 — “the most recent time humans have travelled beyond low Earth orbit” — took place in December 1972, a date at which a large majority of humanity today was not yet born.

Space travel is not the stuff of science fiction. It is the stuff of history books, of yesteryear, of scratchy black-and-white TV, of that newspaper which was already faded in my youth.

What happened? I mean, lots, but ultimately the costs were too high, the tangible benefits too nonexistent, and the Space Shuttle was too much of an unmitigated disaster from start to finish in every way.

What happens next? Well, there we have a quick answer: we’re going back! America is going to land the first woman on the moon by 2024! Absolutely!

…you’re absolutely right to be very skeptical.

There are numerous “lunar exploration architectures,” or ways to return to the Moon. My friend Casey Handmer, a physicist, space enthusiast, and former levitation engineer, itemizes them in this excellent blog post from a few months ago. One of them is NASA’s proposed Lunar Gateway, which will place a space station into high Moon orbit, from and to which lunar landings will descend and return.

Is this a good idea? …Well, it’s an idea. But it’s better to have a plan and to be making progress on it than not, right? Right? …Except the last few months have seen a bewildering flurry of chaos and confusion which makes NASA’s lunar program more closely resemble a headless chicken than a smoothly oiled machine.

First, an unsigned five-page document, riddled with spectacular grammar and spelling errors such as

There is no feasible means to redesign it or any other heavy left rocket to more transport the lunar landing elements

(!) was shared by “the Gateway program office at Johnson Space Center in Houston,” reported Ars Technica. (Casey wrote an exegesis of this dubious document, if you want to see it deconstructed in detail.) Then, earlier this month, NASA demoted and replaced its executives in charge of human space exploration.

Does this sound like the behavior of a lunar project accelerating to an on-target, on-time landing? Or more like a bureaucratic catastrophe thrashing frantically while failing to get anywhere at all? “As it stands, few experts believe NASA’s plan for returning to the moon in 2024 is feasible,” says Vox mordantly. You don’t say.

I’d be so delighted to see a woman walk on the moon in 2024. But I’m not exactly holding my breath. By 2032 we will have gone sixty years, three generations, between human lunar excursions. Some people think we shouldn’t go back at all, that there is too much of more importance to do here on Earth. I disagree, strongly, but I think even they might still agree that it would be sad beyond belief if, if and when we next land on the Moon, there’s no one around who remembers the last time.


Source: TechCrunch

An Alien-Hunting Russian Tech Mogul May Help Solve a Space Mystery

Russian billionaire Yuri Milner has invested a fortune to help SETI find the source of cosmic flashes that emit the energy of 500 million suns.
Source: Wired

A Meditation on Moon Shots, a Mid-Engine Corvette, and More Car News This Week

We debate the use of the term “moon shot,� digitally drive the first mid-engine ’Vette, and check in how on Formula E is fueling an all-electric future.
Source: Wired

The Story Universe of Magic: The Gathering Is Expanding

Can a complicated, nerdy card game turn into a cross-media story? Maybe it already is one.
Source: Wired

Are Super Automatic Espresso Machines Worth Buying?

These premium coffee machines promise a hot, perfect cup of espresso, automatically. We tried some out to see if they’re worth $1,000—or more.
Source: Wired

Week in Review: The one-way web and Elon Musk’s Neuralink

Hello, weekenders. This is Week-in-Review, where I give a heavy amount of analysis and/or rambling thoughts on one story while scouring the rest of the hundreds of stories that emerged on TechCrunch this week to surface my favorites for your reading pleasure.

Last week, I offered up some mildly interesting takes on how Waymo was shaping the future of autonomous vehicles inside of a virtual space rather than wholly on physical roads.


The big story

There are two internets. There’s the one where we click through interfaces and hit menu buttons and dive down predictable lines of inquiry and find predictable ends. And then there are ads. We don’t understand why we get what we get but we the content flows from platform to user with asymmetric information of the “how?”.

Advertising is the economic backbone of the free consumer web, but users are haplessly oblivious to where that generated content comes from and why. What intrigues me here is that a few days ago Instagram announced that it was further rolling out a test to hide like counts from users and that it has been further minimizing the prominence of follower counts on profiles.

It’s an (admittedly small) step in the evolution but it hinges a bit more on how internet giants have come to realize UX transparency can actually lead to some negatives.

There’s of course the ethical argument where you think about the responsibility that Facebook has not to make people feel shitty about themselves by offering a dopamine-hit conveyor belt as a platform, but a more fascinating idea is what a change like this opens up to the company in terms of returns and what it means for how platforms portray the nebulous idea of “engagement.”

One of the easy returns I bet Instagram finds as they expand this test is that by eliminating the conforming social pressures inherent to seeing what other users are enjoying, Instagram might paint a clearer picture of its users. Without giving users a groupthink crutch to influence their own decisions on what to click the heart button on, a web of content less-focused on stats might lead them to things that actually break into.

What’s the most interesting — that this change sort of lightly grazes across — is that we’ve spent the past few decades with the necessary evil of a web predicated on a cause and effect interface. We’ve had a decent idea of why we’re coming across some piece of content and the statistics of why are often user-facing. But do we need to know how the internet works? Do we need to know why we’re seeing anything?

We’ve been thrust fully into this world of algorithmic feeds and while we’re seeing variation across platforms, we’re seeing the potential and pitfalls of the various platforms. Instagram has flirted with serving users content more boldly outside of things they’ve specifically followed with the Explore feed, but the question is when that smartly-sourced content that will come to dominate a user’s central feed and be their main touchpoint with the platform.

We’ve also seen the dangers of algorithmic content where the “why” is invisible to users, YouTube’s platform has grown immensely based off  ad-like invisibly sourced “watch next” suggestions, but can social platforms pull this off as well or are the fundamentals of today’s algorithmic feeds based around user actions and follows going to stay true down the road?

Send me feedback
on Twitter @lucasmtny or email
lucas@techcrunch.com

On to the rest of the week’s news.

Trends of the week

Here are a few big news items from big companies, with green links to all the sweet, sweet added context:

  • Musk’s Neuralink makes its first promises
    The SpaceX founder is known for his moonshots, but this one kind of takes the cake. On Tuesday, Musk spoke about the progress and long-term goals of the company he hoped would allow humans to “achieve a sort of symbiosis with artificial intelligence.� Read more about the promises made in our report.
  • FaceApp goes viral, again
    If you used the internet at all this week, chances are that you saw somebody posting an old-looking photo of themselves that was algorithmically generated by an app called FaceApp. There was an awful lot of backlash to the app’s Russian ties and its user permissions, but we tried to break down what was actually happening.
  • SpaceX’s ‘Starhopper’ bursts into flames
    It was only a test vehicle, but uncontrolled explosions generally aren’t the best sign when it comes to testing components for space flight. Check out the video and the company’s explanation here.

GAFA Gaffes

How did the top tech companies screw up this week? This clearly needs its own section, in order of badness:

  1. Libra shortcomings:
    [Congressional testimony reveals some faults in Facebook’s digital currency plans]
  2. Facebook continues to contradict itself:
    [Facebook accused of contradicting itself on claims about platform policy violations]

GettyImages 1091991690

Extra Crunch

Our premium subscription service had another week of interesting deep dives. This week, we showcased the beginning of our deep dive on Roblox, the wildly popular kids gaming platform that has grown beyond unicorn status.

How Roblox avoided the gaming graveyard and grew into a $2.5B company

“…In some ways, Roblox stayed trendy: for instance, it launched sales of its Robux currency in 2008 and virtual goods for developers in 2013, adding microtransactions at a time that much of the game industry was still trying to come to grips with the idea of free gaming. It also supported and nourished a community of unpaid content creators during a time that few other companies had done so, with a few exceptions like YouTube.

Still, the activity taking place in gaming was a philosophical threat. When a company in Roblox’s space hit it big, years before Roblox itself had any hope to, that winning strategy became a temptation. “There are friends, acquaintances, competitors chattering in your ear and saying, maybe you can just do that,â€� says Dusek…”

Here are some of our other top reads this week for premium subscribers. This week, we talked about seed stage dilution and startup profitability.

We’re excited to announce The Station, a new TechCrunch newsletter all about mobility. Each week, in addition to curating the biggest transportation news, Kirsten Korosec will provide analysis, original reporting and insider tips. Sign up here to get The Station in your inbox beginning in August.


Source: TechCrunch

Adware Is the Malware You Should Actually Be Worried About

For all the attention on sophisticated nation-state attacks, the malware that’s most likely to hit your phone is much more mundane.
Source: Wired

'Snowpiercer' Trains an Eye on TV—and Its Genre DNA Runs Deep

Under the watch of the creator of ‘Orphan Black,’ the post-apocalyptic thrill-ride folds in elements of ‘Westworld,’ ‘The Leftovers,’ and more.
Source: Wired

Don't put up with a slow PC, fix it yourself – CNET

A sluggish computer is something you can fix on your own.
Source: CNET

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