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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.
- 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."
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.
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Our family tree is complicated, and some of the branches are still unlabled.
- A new study of the genomes of Modern Humans, Neanderthals, and Denisovans suggests the three were interbreeding quite often.
- The study also found DNA from an unidentified, archaic human ancestor which we inherited from the Denisovans.
- Homo Erectus is the most likely source of this DNA.
Some of our evolutionary relatives never really left, genetically speaking.<p>The paper, <a href="https://journals.plos.org/plosgenetics/article?id=10.1371/journal.pgen.1008895" target="_blank"><em>Mapping gene flow between ancient hominins through demography-aware inference of the ancestral recombination graph</em></a><em>, </em>was published in PLOS Genetics. It's authors used a new statistical method to analyze the genomes of two Neanderthals, a Denisovan, and two modern humans.</p><p>The new method allowed the researchers to determine when segments of one individual's DNA are worked into the chromosomes of another. These occurrences are called "recombination events" and can be used to determine when specific genes entered our genome and provide evidence of where it came from. As an example of how this can be <a href="https://www.livescience.com/mystery-ancestor-mated-with-humans.html" target="_blank">used</a>, if Neanderthal DNA contained genes from another pre-human ancestor that they then passed to us, this method would identify it. </p><p>The analysis confirmed previous studies that showed that Modern Humans interbred with Neanderthals and Denisovans. However, this analysis suggests that some of this mixing took place between 200,000 and 300,000 years ago, long before what previous studies had suggested. It also indicates that more instances of interbreeding occurred than previously suspected.</p><p>Most interestingly, the researchers noticed that one percent of the DNA in the Denisovans from an even more ancient human ancestor. Fifteen percent of the genes that this ancestor passed onto the Denisovans still exist in the Modern Human <a href="https://phys.org/news/2020-08-dna-ancient-unidentified-ancestor-humans.html" target="_blank">genome</a>. </p><p>Exactly who this ancestor was is remains unknown, but some clues point to who it was. The fact that this ancestor separated from the linage that would lead to modern humans about 1,000,000 years ago is the most useful one we currently have. This led the researchers to suggest Homo Erectus as the most likely candidate. </p>
Who was Homo Erectus?<div class="rm-shortcode" data-media_id="oZzgXq4d" data-player_id="FvQKszTI" data-rm-shortcode-id="0007d6c597f8cc6c95d9d3b5fae7c1ad"> <div id="botr_oZzgXq4d_FvQKszTI_div" class="jwplayer-media" data-jwplayer-video-src="https://content.jwplatform.com/players/oZzgXq4d-FvQKszTI.js"> <img src="https://cdn.jwplayer.com/thumbs/oZzgXq4d-1920.jpg" class="jwplayer-media-preview" /> </div> <script src="https://content.jwplatform.com/players/oZzgXq4d-FvQKszTI.js"></script> </div> <p>The bane of all school teachers focusing on human evolution and the original "missing link," <a href="https://en.wikipedia.org/wiki/Homo_erectus" target="_blank">Homo Erectus</a> was the first human ancestor to leave Africa. They spread widely throughout the old world, with their remains found from Spain to Java. They resembled modern humans, though they were a tad shorter. They were the first to control fire, made tools, created artwork, and likely had rudimentary language.</p><p>It should be repeated that while Homo Erectus is the probable source of this ancient DNA, the jury is still out. We would have to sequence its genome to know for sure. </p><p>Studying human evolution leads us down some very strange roads. It is increasingly clear to us that wherever there was an overlap of human species, there was interbreeding and that a considerable amount of the genetic remnants of this endure to this day. While this might get in the way of the old view of evolution as a slow climb to the humanity, the pinnacle of biological achievement, it does provide us a richer view of who we are, where we come form, and where we might be going. </p>
Some of the most extreme weather in the Solar System just got stranger.
- The Juno probe orbiting Jupiter has observed lightning at impossibly high points in the Jovian atmosphere.
- The findings, combined with other atmopsheric data, led to the creation of a new model of the atmosphere.
- The findings answer a few questions about Jupiter, but create many more.
Shouldn’t be all that surprising really, the planet is named after the god of thunder….<p>The findings are described in the study, <a href="https://www.nature.com/articles/s41586-020-2532-1" target="_blank"><em>Small lightning flashes from shallow electrical storms on Jupiter</em></a><em>, </em>published in <em>Nature</em>. Previous missions to Jupiter, including Voyager 1, Galileo and New Horizons, all observed lightning, but without the benefits of the equipment on the Juno probe or more recent developments in models of the Jovian atmosphere.</p><p>In this case, the lighting is notable for how high it is occurring in the atmosphere. While previous observations suggested lightning in water-based clouds deep inside the gas planet, the new data suggests lightning exists in the upper atmosphere in clouds of water and ammonia. This lightning is dubbed "shallow lightning." </p><p>According to a <a href="https://news.cornell.edu/stories/2020/08/ammonia-sparks-unexpected-exotic-lightning-jupiter" target="_blank">press release</a> by Cornell University, where two of the scientists involved in the study hail from, the ammonia is vital in creating the lightning, as it functions as an "anti-freeze" of sorts to keep the water in the clouds from freezing. The collision of droplets of mixed ammonia and water with ice water particles creates the charge needed for lightning strikes. <br> <br> This is different from any process that creates lightning on Earth.</p><p>That wasn't the only bit of strangeness the probe noticed. While Juno saw plenty of ammonia near the equator and at lower levels of the atmosphere, it was hard-pressed to find much anywhere else. To explain this, researchers developed a new model of atmospheric mixing. They suggest that the ammonia at lower levels of the atmosphere rises into storm clouds, interacts with water to cause the aforementioned lightning, and then falls back down in the form of <a href="https://phys.org/news/2020-08-ammonia-rich-hail-jupiter-weather.html" target="_blank">hailstones</a>. </p><p>The scientists gave these ammonia and water ice hailstones the name "mushballs<a href="https://www.inverse.com/science/jupiter-mush-balls" target="_blank"></a>."</p><p>This model explains many things, including why Juno couldn't detect ammonia where it expected to: the mushballs would be more challenging to detect than ammonia or water vapor. The scientists further speculated that the weight of the mushballs pulls the ammonia to lower levels of the <a href="https://scitechdaily.com/nasas-juno-spacecraft-reveals-jupiters-unusual-electrical-storms-shallow-lightning-and-mushballs/" target="_blank">atmosphere</a> where it is detected in more significant amounts. </p>
A NASA designed graphic demonstrating the weather systems theorized to create "mushballs." The liquid water and ammonia rises in the storm clouds until they reach points where the extremely low temperatures cause them to freeze. Freezing into semi-solid "mushballs" causes them to fall where they redistribute ammonia throughout the lower atmosphere.
How can we possibly know all of this?<div class="rm-shortcode" data-media_id="DywYHLlW" data-player_id="FvQKszTI" data-rm-shortcode-id="5a2fd33c35687b126de47078bac6875d"> <div id="botr_DywYHLlW_FvQKszTI_div" class="jwplayer-media" data-jwplayer-video-src="https://content.jwplatform.com/players/DywYHLlW-FvQKszTI.js"> <img src="https://cdn.jwplayer.com/thumbs/DywYHLlW-1920.jpg" class="jwplayer-media-preview" /> </div> <script src="https://content.jwplatform.com/players/DywYHLlW-FvQKszTI.js"></script> </div> <p>Juno relies on several pieces of equipment. The most relevant in this case is the <a href="https://en.wikipedia.org/wiki/Microwave_Radiometer_(Juno)" target="_blank">microwave radiometer</a>. This device uses microwaves, like the ones you cook with, to measure the Jovian atmosphere's composition. When microwaves hit water or ammonia particles, they begin to heat up. By hitting the planet with microwaves and then looking for changes in the particles' observed temperature, the probe can determine what chemicals are present.</p><p>The findings of these studies demonstrate that Jupiter's atmosphere is more complicated than previously thought. Given how we already knew about the storms larger than <a href="https://en.wikipedia.org/wiki/Great_Red_Spot" target="_blank">Earth</a>, temperatures that swing between extremes in different layers of the atmosphere, and winds that blow at 100 meters per <a href="http://www.lpl.arizona.edu/~showman/publications/ingersolletal-2004.pdf" target="_blank">second</a>, that is saying something.</p>
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