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Big Tech Is Going After Health Care

nytimes.com

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Re: Big Tech Is Going After Health Care

#91

Post by aviv »

joshgel wrote: post #81
aviv wrote: post #79

Earlier quoted context omitted.

Why do we need technology to help improve lives when so many diseases (type 2 diabetes, Crohn's, IBS, high blood pressure, arthritis, and dozens of others) can already be reversed and prevented by simply changing a person's diet and lifestyle habits? It's really quite insane that people would rather take pills for the rest of their lives to treat symptoms of a disease than actually getting rid of it altogether by giv…

Before you become "so dismissive" of traditional physicians, you try getting someone to radically alter their lifestyle for the promise of potential benefit in 10-20 years. Even if you can point to a few people that have done it, I can point you to plenty of data that says it's really hard and most people can't. Even technology may not help: https://jamanetwork.com/journals/jama/fullarticle/2553448 . Edit: Also rever…

You haven't seen it because your traditional world of medicine does not include that group of people.

I have. About a dozen of them. In fact, each Crohn's patient that I've seen undergo a fast 2 weeks or longer has not had any flare ups since. And completely stopped taking all medications and undergoing their usual treatments.

(they do watch their diet after, mostly fruits and veggies).

Lifestyle change alone will not cure it. It must be preceded by a proper water fast.

Reversed IS a strong word, and very appropriate here.

Re: Big Tech Is Going After Health Care

#92

Post by ubernostrum »

blhack wrote: post #7

Good. I spent a few years working in a medical IoT startup, and the current state of the "mainstream" medical monitoring technology is not inspiring. During a brainstorming meeting, I asked one of our cofounders, a physician, to tell me about some of the problems he had seen in health. Don't try and solve it, just lets talk about problems. He said that by far one of the most common causes for re-hospitalization is co…

I'll throw in a slightly contrary opinion.

I work for a health-insurance startup. And many of the people we cover are on extremely low fixed incomes. It's not unusual for them to be in situations where they have to choose which bill to pay this month and thus which utility will get shut off next month for non-payment. Their premiums are heavily subsidized and they only have insurance at all because of government programs, sometimes only because they're eligible for multiple programs which combine to help them out (and which are also constantly on the chopping block). So any kind of cellular phone, let alone a multi-hundred-dollar smartphone with service contract, is simply an unaffordable luxury for them.

And that's why I worry about these kinds of efforts. More affluent people can benefit from smartphone-centric approaches, but a huge percentage of the US slips through the cracks when you do that.

So solving America's health-care problem is not going to happen by focusing on people who have smartphones. That will just heighten the divide; the people who are already in a position to get good care will continue to get it, and the people who aren't will continue to get worse. If you want to avoid the grim-meathook-future problem, smartphone-centric (and, really, most tech-centric) approaches are unlikely to work.

Re: Big Tech Is Going After Health Care

#93

Post by joshgel »

aviv wrote: post #86
opportune wrote: post #80

Earlier quoted context omitted.

Well as a physician, you can't really force your patient to exercise and eat better. The best you can do is prescribe a medication to treat the symptoms, tell your patient to exercise and eat better, and send them off. Do you have an alternative to prescribing medication for type 2 diabetes and Crohn's? Do you think doctors should simply withhold care since it's their patients' faults that they have those conditions?

Sure, most physicians nowadays will mention to the patient that diet and exercise are beneficial, but at the same time will outright dismiss the critical role that diet specifically plays in curing the disease. Yes, the alternative is a 10 to 30 day water fast for both of those. I know several people that successfully cured both. Especially Crohn's, the amount of misinformation given by physicians is stunning and bor…

Prove it. In a randomized, placebo-controlled, double-blinded trial.

There are plenty of quality and health savings organizations that would fund such a trial if there were any hint of benefit. But there isn't.

I'm glad to hear that pseudo-science still gets shut down in social circumstances.

Re: Big Tech Is Going After Health Care

#94

Post by grzm »

aviv wrote: post #86
opportune wrote: post #80

Earlier quoted context omitted.

Well as a physician, you can't really force your patient to exercise and eat better. The best you can do is prescribe a medication to treat the symptoms, tell your patient to exercise and eat better, and send them off. Do you have an alternative to prescribing medication for type 2 diabetes and Crohn's? Do you think doctors should simply withhold care since it's their patients' faults that they have those conditions?

Sure, most physicians nowadays will mention to the patient that diet and exercise are beneficial, but at the same time will outright dismiss the critical role that diet specifically plays in curing the disease. Yes, the alternative is a 10 to 30 day water fast for both of those. I know several people that successfully cured both. Especially Crohn's, the amount of misinformation given by physicians is stunning and bor…

I think there's a lot to be said for sleep, diet, and exercise for combating many what are often termed lifestyle illnesses. That said, I think there's a lot of use for tech (which is really just applied science) in monitoring, diagnosing, and researching illnesses and treatments, as well. And not all maladies can be treated by sleep, diet, and exercise alone.

I can easily imagine anecdotal evidence like that you mention while dismissing the rest of the medical establishment (with loaded phrases like Big Pharma) is likely to get you dismissed as well. Perhaps that's not how you intend to come across, so perhaps you might look at tempering your arguments to make them more palatable to those you believe are brainwashed.

Re: Big Tech Is Going After Health Care

#95

Post by dawhizkid »

aviv wrote: post #74
dawhizkid wrote: post #64

I am a big believer that we have already discovered a safe, free, plentiful lever against some of the most high profile diseases (cancer, Alzheimer’s, some mental illnesses) out there in fasting/calorie restriction/keto. I highly doubt it will ever become mainstream for the simple reason that no healthcare or big tech co can make money from telling people to eat in a way that induces ketosis. Science of Fasting doc:…

Insane how we both get downvoted isn't it? Oh well. Another decade or two before people wake up. Agree with you, so much of our economy and social structure is built on the fact that people get sick - and either stay sick or get medicated for the foreseeable future. Sad. All we can do is mention it, even though we get shut down quickly be it online or IRL. Mandatory anecdote: I cured severe arthritis in the knee 6 ye…

Step one is getting to consensus on sugar = toxic, then refined carbs = bad, then getting people to stop believing we were evolved to eat consistently throughout the day everyday

It’s amazing that “you are what you eat” has become so controversial

Re: Big Tech Is Going After Health Care

#96

Post by joshgel »

blhack wrote: post #57
joshgel wrote: post #53

Earlier quoted context omitted.

Interesting you bring up heart failure readmissions. Not saying they aren't a problem, but here is a fascinating study in JAMA that argues that places with lower readmissions have higher (worse) mortality. https://jamanetwork.com/journals/jamacardiology/article-abst... Not sure we (I'm a physician) understand even what the problems we need technology to solve are. But yes, we need technology to help (find and) solve…

Are there other examples of things you wish existed? Again, forget about if they could exist, just stuff you wish you had?

Loads. A functional EHR (UX). An easy way to keep track of what medications a patient is one and has been on (?blockchain). Better quality and cost measures (big data).

Re: Big Tech Is Going After Health Care

#97

Post by aviv »

joshgel wrote: post #93
aviv wrote: post #86

Earlier quoted context omitted.

Sure, most physicians nowadays will mention to the patient that diet and exercise are beneficial, but at the same time will outright dismiss the critical role that diet specifically plays in curing the disease. Yes, the alternative is a 10 to 30 day water fast for both of those. I know several people that successfully cured both. Especially Crohn's, the amount of misinformation given by physicians is stunning and bor…

Prove it. In a randomized, placebo-controlled, double-blinded trial. There are plenty of quality and health savings organizations that would fund such a trial if there were any hint of benefit. But there isn't. I'm glad to hear that pseudo-science still gets shut down in social circumstances.

It is slowly trickling in.

http://www.telegraph.co.uk/science/2016/03/12/fasting-for-th...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4684131/

I personally know multiple people that did listen to me and others who told them about the healing powers of a water fast, and cured their illnesses by doing it. There's really no downside. You are not "starving" yourself. That is such an insane myth.

I myself did too - got rid of a bad arthritis in the knee that I've suffered from for years - just 20 days into a fast (this was 6 years ago, no inflammation of any kind since).

Re: Big Tech Is Going After Health Care

#99

Post by opportune »

mxwll wrote: post #41

There are some major hurdles for these SV companies to overcome if they want any level of success in this arena. EPIC and Cerner together hold over 50% market share of EHR systems in American hospitals. Their interoperability and patient facing applications are a joke. EPIC actively makes it difficult for third parties to build on top of their system. Sure, these SV companies have figured out how to build great tech…

Apple and Samsung entering the healthcare space to compete with Epic (their name isn't all-caps) and Cerner, in reality, is going to be closer to this: https://xkcd.com/927/

Most of the employees at Epic and Cerner in the healthcare space are actually operations. Like, at least 60% of their workers are operations. Not only that, but they're not traditional IT workers who go out and get certs, they're really closer to devops professionals who are able to provide both IT support and have an intimate understanding of what they're working with. Last time I checked, Apple and Samsung don't really even have this tier of customer facing support. It's going to take organizational shifts for them to break into this sector, and it's not so sure a thing.

That said, I completely agree with your observation that hospitals need to become tech companies. My parents are medical professionals and I have also worked at a medical software company in the past, so I think I'm pretty well grounded when it comes to saying this: hospitals hate developers, and developers hate hospitals. From the perspective of the hospital worker, developers make overly confusing systems and as soon as the worker gets used to it, they completely change everything and make it even more complicated than before. From the perspective of developers, most hospital professionals are luddites who oppose all change and progress as a matter of principle. If the two roles were more closely integrated, these severe communication issues would be mitigated. Medicine needs to be redesigned form the ground up with these two fields learning each others' skills and understanding how and why the other field does what it does.

Re: Big Tech Is Going After Health Care

#100

Post by rayiner »

blhack wrote: post #7

Good. I spent a few years working in a medical IoT startup, and the current state of the "mainstream" medical monitoring technology is not inspiring. During a brainstorming meeting, I asked one of our cofounders, a physician, to tell me about some of the problems he had seen in health. Don't try and solve it, just lets talk about problems. He said that by far one of the most common causes for re-hospitalization is co…

> Can you imagine my frustration at hearing this? It's this massive problem with an obvious (CHEAP!! SO FUCKING CHEAP!!) solution.

I suspect the nurse is there to perform the “getting the patient on the scale” function, not the “reading out the weight and tracking it” function.

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