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Apple, Amazon, and Uber are moving in on health care. Will it help?

Big tech is making its opening moves into the health care scene, but its focus on tech-savvy millennials may miss the mark.

Apple COO Jeff Williams discusses Apple Watch Series 4 during an event on September 12, 2018, in Cupertino, California. The watch lets users take electrocardiogram readings. (Photo: NOAH BERGER/AFP/Getty Images)
  • Companies like Apple, Amazon, and Google have been busy investing in health care companies, developing new apps, and hiring health professionals for new business ventures.
  • Their current focus appears to be on tech-savvy millennials, but the bulk of health care expenditures goes to the elderly.
  • Big tech should look to integrating its most promising health care devise, the smartphone, more thoroughly into health care.

Health care spending in the United States reached $3.5 trillion in 2017, roughly 18 percent of the nation's GDP. With so much to gain, big tech companies like Apple, Amazon, and Uber are making incipient moves into the space. Such moves from large economic players will alter traditional models of health care, no doubt in ways we can't fully envision.

But will it help? Potentially. In recent years, big tech has gathered the resources and creative minds to change the way we approach many aspects of our lives, even in conservative fields like health care. But to create lasting change, big tech will need to collaborate with traditional health care players to ensure all patients, not just the tech savvy, benefit.

Big tech's opening moves

Last year, Amazon purchased online pharmacy service PillPack for a cool $800 million. This has Angela Chen at The Verge wondering if we'll see PillPack integrated into Amazon's other services, allowing Prime members to order medication through the company's website. Such a prediction makes sense, but it's some ways off. Amazon just recently announced that Nader Kabbani, an Amazon veteran, would lead the pharmacy initiative.

Other tech giants have been making their opening moves, too.

Apple added a Health Records section to its iPhone, allowing users to view their medical records from participating health systems, and the FDA recently cleared an electrocardiogram accessory for the Apple Watch. Uber hired health consultant Aaron Crowell to head its health business venture to offer medical transport. And Microsoft has introduced a Healthcare Bot to provide virtual health chatbots to assist medical personnel.

Alphabet, Google's parent company, has made several health-centric efforts. These include investing in companies like 23andMe and Oscar health, collaborating with Fitbit to create patient-generated electronic health records, and experimenting with its AI platform Deepmind to improve health services and records.

Eyes on the patient, not the prize

What does telemedicine look like? Dr. Maurice Cates, Orthopedic Surgeon, conducts a live Orthopedic consultation remotely by video with a patient.

(Photo by Brooks Kraft LLC/Corbis via Getty Images)

As is evident, big tech's opening moves are less about disruption and more about positioning. Although we aren't seeing grand overhauls yet, we can predict where these companies plan to make their entry point. And the focus appears to be on their traditional base: tech-savvy, middle-class millennials.

That's a potential problem as Michael Dowling, CEO of Northwell Health, told Big Think:

"I welcome all of these players. Because the more players that you get coming in with a different perspective, the better we can get. But it's important for people to understand that most of these players are focusing in on the easy parts of health care. They're focusing in on non-hospital business. They're focusing in on people that are not that sick primarily. And they're dealing with the consumer who's 30 years old, 40 years old, 25 years old."

But the bulk of health care expenditures, Dowling notes, go to the elderly, specifically people in the last year to year-and-a-half of their lives. And because people are living longer, into their 80s and 90s, they'll spend more years drawing upon health care.

Devising apps for digital watches that generate electronic health records is amazing. But how many people do you know own a Fitbit or Apple Watch? How many elderly people take an Uber to the hospital, and how many Ubers are wheelchair accessible? The market for such devices remains niche, if growing, even among millennials.

Another consideration: Would Medicare cover such costs?

Even when tech is designed for the elderly or ill, it rarely considers their needs and partialities. In another Verge article, Chen surveyed the growing category of "aging tech" to discover airbag belts, smart shoes, and smart lamps, all designed to assist in the case of a fall.

As Chen notes: "So many of these devices seem to rely on the ability of caregivers to coerce their elderly relative or patient into using the solution. But if someone doesn't want to wear your shoe or your belt or your watch, it's hard to make them."

iMedicine v1.0

Despite these hurdles, big tech can still be a benefactor for health care, and its most serviceable offering is already here. The smartphone.

Unlike other devices trying to break in, the smartphone has already been widely adopted. Seventy-seven percent of Americans own smartphones, and 46 percent of Americans over 65 own one. Comparatively, only 18 percent of Americans own a fitness tracker and 13 percent a smartwatch.

The result is a health care device that requires little training for any demographic. Americans already use their smartphones for finances, travel, communications, reservations, photography, and a host of other daily activities. Adding health care to the mix would be a small ask, even for the elderly.

In his book Health Care Reboot, Dowling discusses a Northwell initiative that had patients televisit with their nurse through tablets and smartphones. The initiative hoped to better serve patients at home while limiting unnecessary travel and hospital visits. Initially, there was concern that older patients would have trouble adapting, but even patients in their 80s found the connection intuitive and helpful.

"The use of technologies such as smartphones, tablets, and laptops signals the beginnings of the age of the consumer in health care," writes Dowling. "In a general sense, as patient, a person is subservient to the provider. As consumer, the person is more empowered with greater access to information and an ability to behave as consumers do in other fields."

Like big tech, health care revolves around data — a patient's family history, their medical records, their current prescriptions, and the ever-evolving medical literature. The easier and faster it is to collect and coordinate this data between patient and provider, the better health care can become.

Smartphone architecture is already designed to collect and deliver data in a user-friendly manner. By pointing it in the direction of health care, big tech can help expand its definition beyond hospital visits to make the patient an active participant.

Why health care should start long before you reach the hospital

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A group of meteorites come from 1 single planetesimal

The meteorites suggest astronomers may have small, early planets wrong.

Image source: Madhuvan Yadav/Unsplash
Surprising Science
  • A group of meteorites that have come down all over the Earth have something in common.
  • They all come from one early-universe baby planet, or planetesimal.
  • That planetesimal was apparently not what astronomers expected.

Before planets formed, astronomers believe, there were lots of mini-planets, or planetesimals, many of which eventually broke apart — they're believed to be the source of meteorites that strike Earth. Perhaps surprisingly, a group of meteorites all around the globe come from the very same planetesimal. Not only is that a bit weird, but the evidence suggests that this former baby planet was not what scientists thought a planetesimal could be.

The research, "Meteorite evidence for partial differentiation and protracted accretion of planetesimals," is published in ScienceAdvances. The research was partially funded by NASA.

Planetesimals

Image source: Maria Starovoytova/Shutterstock

Some things are pretty much known about planetesimals. First, it's believed that they formed out of the swirling mass of gas and dust that was our universe roughly 4.5 billion years ago. As the universe cooled, bits began to crash into each other, forming these small bodies. It's been thought that they formed quickly as these things go — in less than a few million years.

Early planetesimals, forming in the first 1.5 billion years of our solar system, would have pulled in radiogenic materials from the hot universe. This material gave off heat as it decayed, and so the cosmic rubble comprising these planetesimals was melted into a relatively homogeneous achondritic mass. Radiogenic materials would less available to planetesimals formed later, and their rubble, though merged into a planetesimal, would be unmelted, or chondritic.

There may have been planetesimals that formed in the middle period, between early and late. The study notes, "This could have resulted in partially differentiated internal structures, with individual bodies containing iron cores, achondritic silicate mantles, and chondritic crusts." However, there's been little evidence of such "intermediate" planetesimals.

Until now, it's been basically a binary proposition: melted or unmelted. Which gets us to the family of meteorites.

IIE irons

Image source: Carl Agee, Institute of Meteoritics, University of New Mexico/MIT News

When meteorites are found and studied, the type of planetesimal from which they came is usually clear: melted or unmelted. Not so a family of meteorites called the "IIE irons." (IIE is their chemical type.)

As study co-author Benjamin Weiss of MIT's Department of Earth, Atmospheric, and Planetary Sciences (EAPS) explains, "These IIE irons are oddball meteorites. They show both evidence of being from primordial objects that never melted, and also evidence for coming from a body that's completely or at least substantially melted. We haven't known where to put them, and that's what made us zero in on them."

Researchers had previously established that all of these IIE iron outliers — which themselves can be either achondritic or chondritic — came from the same planetesimal, and that raises some intriguing questions.

As study lead author Clara Maurel, a grad student at EAPS, puts it, "This is one example of a planetesimal that must have had melted and unmelted layers." Did that baby planet perhaps have a solid crust over a liquid mantle? "[The IIE irons encourage] searches for more evidence of composite planetary structures," she says. "Understanding the full spectrum of structures, from nonmelted to fully melted, is key to deciphering how planetesimals formed in the early solar system."

Back to the planetesimal

Image source: Maurel, et al

One particularly interesting question was this, says Maurel: "Did this object melt enough that material sank to the center and formed a metallic core like that of the Earth? That was the missing piece to the story of these meteorites."

If that was the case, the scientists reasoned, mightn't such a core generate a magnetic field in the same way that Earth's core does? Some minerals in the planetesimal might have become oriented in the direction of the field, similarly to the way a compass works here. And if all that's the case, those same minerals in the IIE irons might still retain that orientation.

The researchers acquired two of the IIE iron meteorites, named Colomera and Techado, in which they detected iron-nickel minerals known for their ability to retain magnetic properties.

The team took their meteorites to the Lawrence Berkeley National Laboratory for analysis using the lab's Advanced Light Source that can detect minerals' magnetic direction using X-rays that interact with their grains.

The electrons in both IIE irons were pointed in the same direction, providing additional confirmation of their common source and suggesting their planetesimal indeed had a magnetic field, and it roughly equivalent in size to the Earth's.

The simplest explanation for the effect was that the planetesimal had a liquid metallic core that would have been a minimum of tens of kilometers wide. This implication suggests that previous assumptions regarding the speedy formation of planetesimals is, at least in the case of this one, wrong. This planetesimal must have formed over the course of several million years.

Back to the IIE irons

Colomera and Techado roughly agree on their planetesimal's cooling pattern.

Image source: Maurel, et al

All of this got the researchers wondering where in this surprisingly complex planetesimal the meteorites might've come from. They partnered with scientists from the University of Chicago to develop models of how this all might've gone down.

Maurel's team came to suspect that after the planetesimal cooled down and imprinted the magnetic field on the minerals, collisions with other bodies tore them away. She hypothesizes, "As the body cools, the meteorites in these pockets will imprint this magnetic field in their minerals. At some point, the magnetic field will decay, but the imprint will remain. Later on, this body is going to undergo a lot of other collisions until the ultimate collisions that will place these meteorites on Earth's trajectory."

It's impossible to know for now whether the planetesimal that produced the IIR irons was unusual, or if its history is typical for planetesimals. If so, the simple melted/unmelted dichotomy needs to be reconsidered.

"Most bodies in the asteroid belt appear unmelted on their surface. If we're eventually able to see inside asteroids," says Weiss, "we might test this idea. Maybe some asteroids are melted inside, and bodies like this planetesimal are actually common."

The Anthropause is here: COVID-19 reduced Earth's vibrations by 50 percent

The planet is making a lot less noise during lockdown.

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  • A team of researchers found that Earth's vibrations were down 50 percent between March and May.
  • This is the quietest period of human-generated seismic noise in recorded history.
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  • After reanalyzing the bone, and comparing it with fibulas from a human and another dinosaur, a team of scientists confirmed that the dinosaur suffered from the bone cancer osteosarcoma.
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