An Open Standard for APIs Could Lead us to Better Health

There’s a parable about the elephant and the rider that’s been used by Chip and Dan Heath, and that originated with Jonathan Haidt, to describe how humans make decisions. A person’s mind can be thought of as consisting of a rider, representing the rational part of human thinking, and the elephant she’s riding, representing emotion. Both of these play a role in how a person decides things, and many of us believe the rider–the rational part–is in charge. The rider taps the elephant with her guide stick, and the elephant obediently moves in that general direction or does a specific task, like carrying lumber from place to place.

Except that’s not how a lot of decisions actually get made. Instead, the elephant sees a bunch of bananas, or a herd of other elephants, or a nice cool river to bathe in, and goes that way instead. And the rider…well, the rider can’t do much about it except, after the fact, rationalize how she always wanted to go in that direction to begin with. Yeah, it was time for a bath, sure

This framing has stuck in my mind for years and it’s a really helpful way of looking at many of the odd things that people do or say, ranging from climate change denial, to believing genetically modified organisms are inherently evil, to smoking despite everything we know about the harms that result, to even saying that Paul Blart, Mall Cop II is really, you know, not that bad–really. And it also speaks to one of the more vexing problems we have in human health. Why do people keep doing things they really probably shouldn’t, and know they shouldn’t, if they want to stay healthy?

I’ve touched before on how the power of digital tools can help make it easier for us to make good decisions. OPower is doing this for power consumption and conservation, and with the advent of tools like Apple’s Healthkit and the proliferation of activity trackers, the time is right to do this for health. Continue reading

Making Change

And now for something completely different! Short fiction in honor of the recent unveiling of the Apple iWatch and Healthkit.

“I wouldn’t eat that if I were you.”

Sylvia paused, bacon cheeseburger halfway to her mouth, and peered at the neon green band wrapped around her wrist. The wraparound touchscreen was currently showing a cat emoji. It had a frowny face, expression halfway between puzzlement and alarm.

“What did you say?”

“I’m just saying,” said her Best Buddy wristband, “that when we met a few weeks ago, you mentioned wanting to keep your weight in a specific range.” The emoji shrugged. “Little friendly reminder. You know?”

Sylvia carefully put the burger back down and resisted the urge to lick grease off her fingers. She fumbled for her napkin, her fingers leaving translucent streaks on the thin, white paper.

“I–well, yeah. But, I mean, you’ve never said anything like this before like when–” She broke off, remembering the milkshake, the onion rings, the King-size Choconut bar…

“Well it’s not the first thing you do, is it? When you meet someone and you’re just getting to know them?” The cat had morphed into a light pink, animated mouse, standing on its hind legs, bashfully kicking one leg. “But now, we’re friends!” Continue reading

Is Opower the model for getting us to wellness and health?

This is a post about nudges. And optimism.

There’s a story I read a long time ago by David Brin. It’s called “The Giving Plague,” and the protagonist is a virologist and epidemiologist who describes his life working on viruses and vectors. The Plague of the title is a virus that has evolved the ability to make infected people enjoy donating blood. Recipients keep giving blood, leading to an exponentially expanding network of people who find themselves giving blood regularly and even circumventing age and other restrictions to make sure they can give their pint every eight weeks.

The central twist of the story is that the protagonist’s mentor, who discovers this virus, realizes people who donate blood also perform other altruistic acts–that the act of giving blood changes their own self image. Makes them behave as better people. And so he suppresses the discovery, for the greater good of society. The protagonist, a rampant careerist, begins plotting murder to allow him to take credit. But before he can act, more diseases strike, the Giving Plague moves through the population, and the protagonist forgets about it in his efforts to cure newer diseases.

And if anyone thinks something like this is too outlandish, I encourage you to read this piece about Toxoplasma gondii and how it makes infected mice charge at cats, the better to be eaten so that T. gondii can spread. Yeah.

But what does this story have to do with the future of wellness and health?

Continue reading

Big data and baseball efficiency: the traveling salesman had nothing on a baseball scout

All opinions are my own and do not necessarily reflect those of Novo Nordisk

The MLB draft is coming up and with any luck I’ll get this posted by Thursday and take advantage of web traffic. I can hope! Anyway, Tuesday in Fangraphs I read a fascinating portrayal of the draft process, laying out the nuts and bolts of how organizations scout for the draft. The piece, written by Tony Blengino (whose essays are rapidly becoming one of my favorite parts of this overall terrific baseball site), describes all the behind the scenes work that happens to prepare a major league organization for the Rule 4 draft. Blengino described the dedication scouts show in following up on all kinds of prospects at the college and high school levels, what they do, how much they need to travel, and especially how much ground they often need to cover to try and lay eyes on every kid in their area.

One neat insight for me was Blengino’s one-word description of most scouts as entrepreneurs. You could think of them almost as founders of a startup, with the kids they scout as the product the scouts are trying to sell to upper layers of management in the organization. As such, everything they can do to get a better handle on a kid’s potential can feed into the pitch to the scouting director.

I respect and envy scouts’ drive to keep looking for the next big thing, the next Jason Heyward or Mike Trout. As Blengino puts it, scouts play “one of the most vital, underrated, and underpaid roles in the game.” While one might make the argument that in MLB, unlike the NFL or NBA, draft picks typically are years away from making a contribution and therefore how important can draft picks be?, numerous studies have shown that the draft presents an incredible opportunity for teams in building and sustaining success. In fact, given that so much of an organization’s success hinges on figuring out which raw kids will be able to translate tools and potential into talent, one could (and others have)  made the argument that scouting is a huge potential market inefficiency for teams to exploit. Although I’ll have a caveat later. But in any case, for a minor league system every team wants to optimize their incoming quality because, like we say in genomic data analysis, “garbage in, garbage out.”

As I was reading this piece, I started thinking about ways to try and create more efficiencies. And I started thinking about Big Data.  Continue reading

The innovators dilemma in biopharma part 3. What would disruption look like?

All opinions are my own and do not necessarily reflect those of Novo Nordisk.

h/t to @Frank_S_David, @scientre, and the LinkedIn Group Big Ideas in Pharma Innovation and R&D Productivity for links and ideas

Part 1 is here.

Part 2 is here.

In the previous parts to this series I’ve covered both why the biopharma industry is ripe for disruption, and what the markets might be that could support a nascent, potentially disruptive technology until it matures enough to allow it to supplant the current dominant industry players.  In this final part I’d like to ask what disruption would look like and provide some examples of directions and companies that exemplify what are, to my mind, these sorts of disruptive technologies and approaches. With, I might add, the complete and utter knowledge that I’m wrong about who and what specifically will be disruptive! But in any case, before we can identify disruption, it’s worthwhile to ask what are the key elements of biopharma drug development that serve as real bottlenecks to affecting  human health, since these are the elements most likely to provide an avenue for disruption. Continue reading

Getting patients back to normal

All opinions my own and do not necessarily reflect those of Novo Nordisk.

Inspired in part by this column from David Shaywitz

Here is a story I had the privilege to hear from Fred Modell, one of the founders of the Jeffrey Modell Foundation (check them out; they’re a great group):  Fred was at their annual picnic, where they host kids with immune system defects.  Fred walked by two early teenage girls, and as he passed by he heard one of them asking the other, “You really kissed a boy?”  Which seems like a common enough thing for two teenage girls to be talking about.

Only in this case it wasn’t.  If your immune system doesn’t function like most everyone else’s, then kissing a boy is not just part of growing up.  It can be dangerous to your health. It’s something  about which you have to think hard, and try your best to understand the implications, and you need to be careful, cautious and measured.  Everything your first kiss really shouldn’t be.

For these girls, though, because of groups like the Modell Foundation and the treatments they’ve helped pioneer and support, these girls could experience the spontaneity of an event that so many kids take for granted.  And they could feel normal, like their friends in school. Continue reading