What Were the Year's Biggest Digital Health Stories? An Interview With CNBC's Christina Farr
Some Apps May Help Curb Insomnia, Others Just Put You To Sleep
This Digital Pill Wants To Make Following Your Prescription Easier
Digital Self-Harm: When Teens Cyberbully Themselves
New Diabetes Monitors Require Fewer Pricks, Less Guessing
From App Store To Drug Store, Digital Health Is Redefining Pharma
If Digital Health is the Future, the Future is Not Here. Yet.
What Are Digital Health's Biggest Successes and Disappointments? CNBC's Chrissy Farr Weighs In
Post-Theranos, Can Silicon Valley and Biomed Get Along?
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She covers wildfires, space and oceans (though she is prone to sea sickness).\r\n\r\nBefore joining KQED in 2015, Danielle was a staff reporter at KRCB in Sonoma County and a freelancer. She studied science communication at UC Santa Cruz and formerly worked at CERN in Geneva, Switzerland where she wrote about computing. She lives in Sonoma County and enjoys backpacking.","avatar":"https://secure.gravatar.com/avatar/ebaf11ee6cfb7bb40329a143d463829e?s=600&d=blank&r=g","twitter":"DanielleVenton","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"arts","roles":["contributor"]},{"site":"news","roles":["editor"]},{"site":"futureofyou","roles":["editor"]},{"site":"science","roles":["editor"]}],"headData":{"title":"Danielle Venton | KQED","description":"Science reporter","ogImgSrc":"https://secure.gravatar.com/avatar/ebaf11ee6cfb7bb40329a143d463829e?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/ebaf11ee6cfb7bb40329a143d463829e?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/dventon"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"home","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal Justice","link":"/criminaljustice"},{"name":"Silicon Valley","link":"/siliconvalley"},{"name":"Forum","link":"/forum"},{"name":"The California Report","link":"/californiareport"}]},{"key":"menu2","items":[{"name":"Arts & Culture","link":"/arts","type":"title"},{"name":"Critics’ Picks","link":"/thedolist"},{"name":"Cultural Commentary","link":"/artscommentary"},{"name":"Food & Drink","link":"/food"},{"name":"Bay Area Hip-Hop","link":"/bayareahiphop"},{"name":"Rebel Girls","link":"/rebelgirls"},{"name":"Arts Video","link":"/artsvideos"}]},{"key":"menu3","items":[{"name":"Podcasts","link":"/podcasts","type":"title"},{"name":"Bay Curious","link":"/podcasts/baycurious"},{"name":"Rightnowish","link":"/podcasts/rightnowish"},{"name":"The Bay","link":"/podcasts/thebay"},{"name":"On Our Watch","link":"/podcasts/onourwatch"},{"name":"Mindshift","link":"/podcasts/mindshift"},{"name":"Consider This","link":"/podcasts/considerthis"},{"name":"Political Breakdown","link":"/podcasts/politicalbreakdown"}]},{"key":"menu4","items":[{"name":"Live Radio","link":"/radio","type":"title"},{"name":"TV","link":"/tv","type":"title"},{"name":"Events","link":"/events","type":"title"},{"name":"For Educators","link":"/education","type":"title"},{"name":"Support KQED","link":"/support","type":"title"},{"name":"About","link":"/about","type":"title"},{"name":"Help Center","link":"https://kqed-helpcenter.kqed.org/s","type":"title"}]}]},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"futureofyou_445929":{"type":"posts","id":"futureofyou_445929","meta":{"index":"posts_1591205157","site":"futureofyou","id":"445929","score":null,"sort":[1545263282000]},"guestAuthors":[],"slug":"what-were-2018s-biggest-digital-health-stories-an-interview-with-cnbcs-christina-farr","title":"What Were the Year's Biggest Digital Health Stories? An Interview With CNBC's Christina Farr","publishDate":1545263282,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>We like to check in every once in awhile on the world of digital health, an area full of promise \u003ca href=\"https://www.kqed.org/futureofyou/438782/digital-medicine-may-have-just-hit-the-trough-of-disillusionment\" target=\"_blank\" rel=\"noopener\">but not, thus far, overbrimming with results\u003c/a>.\u003c/p>\n\u003cp>There are \u003ca href=\"https://www.kqed.org/futureofyou/437796/what-are-digital-healths-biggest-successes-and-disappointments-cnbcs-chrissy-farr-weighs-in\" target=\"_blank\" rel=\"noopener\">exceptions\u003c/a>, however, and as we did last year at this time, we're turning to San Francisco-based CNBC journalist\u003cstrong>\u003ca href=\"https://www.cnbc.com/christina-farr/\" target=\"_blank\" rel=\"noopener\"> Christina Farr, \u003c/a>\u003c/strong>who breaks a lot of health tech stories, to clue us in on her beat. This year we asked her what were the really big stories she covered in 2018.\u003c/p>\n\u003cp>\u003cstrong>Here are some highlights from our talk, in Christina's own words. The following has been edited for length and clarity.\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Big Digital Health: It's a Thing\u003c/strong>\u003c/p>\n\u003cp>It was a really big year in digital health, particularly where large tech companies are concerned: Apple, Amazon, Google, Microsoft, Samsung...\u003c/p>\n\u003caside class=\"pullquote alignright\">'As [big] tech companies attempt to become trillion-dollar or greater businesses, they need something more than just their core competencies. And you can't ignore health care; it's just too big.'\u003c/aside>\n\u003cp>John Doerr, the venture capitalist who is a big health investor, recounted at the Forbes Healthcare Summit how internet companies in the '90s aimed to disrupt the advertising space, which back then was based mostly on television advertising. Those companies thought they could do a better job because there was really no way at that time to measure and track the performance of ads in real time. So they took on this industry, which is now worth about $75 billion in the U.S.\u003c/p>\n\u003cp>By comparison the health care opportunity is $3.5 trillion in America alone. As these tech companies attempt to become trillion-dollar or greater businesses, they need something more than just their core competencies. And you can't ignore health care; it's just too big.\u003c/p>\n\u003cp>\u003cstrong>Here Comes Amazon ...\u003c/strong>\u003c/p>\n\u003cp>Amazon’s \u003ca href=\"https://www.cnbc.com/2018/06/28/amazon-to-acquire-online-pharmacy-pillpack.html\" target=\"_blank\" rel=\"noopener\">acquisition\u003c/a> of online pharmacy PillPack in June was a very big story. The announcement really marked them as a player, and the market response -- billions of dollars were knocked off some of these pharmacy stocks -- showed how much of a threat Amazon could be. It's also a very good deal for PillPack and probably showed the digital health community that those sorts of exits are possible.\u003c/p>\n\u003cfigure id=\"attachment_437838\" class=\"wp-caption alignright\" style=\"max-width: 589px\">\u003cimg class=\"size-full wp-image-437838\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/12/chrissyfarrphoto1.png\" alt=\"\" width=\"589\" height=\"428\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissyfarrphoto1.png 589w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissyfarrphoto1-160x116.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissyfarrphoto1-240x174.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissyfarrphoto1-375x272.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissyfarrphoto1-520x378.png 520w\" sizes=\"(max-width: 589px) 100vw, 589px\">\u003cfigcaption class=\"wp-caption-text\">CNBC's Chrissy Farr. \u003ccite>(CNBC)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Around the same time, Amazon also \u003ca href=\"https://www.cnbc.com/2018/12/14/amazon-explored-medical-diagnostics-was-in-talks-to-buy-confer-health.html\" target=\"_blank\" rel=\"noopener\">looked at Confer Health\u003c/a>, a company in the at-home medical diagnostic space. That's interesting, because it speaks to a strategy that goes deeper than just drug delivery.\u003c/p>\n\u003cp>Where Amazon could potentially go is this: Imagine you're experiencing symptoms for strep throat, and you \u003ca href=\"https://thenextweb.com/artificial-intelligence/2018/10/15/amazons-new-patent-will-allow-alexa-to-detect-your-illness/\" target=\"_blank\" rel=\"noopener\">talk to your Amazon Alexa device\u003c/a>, and there's an AI system, or a real physician, even, that speaks to you and recommends you get tested. A courier comes to your home with a portable device from which you run a sample and you get a result immediately. Or from there the same physician ships you a prescription. And that could all be done in a couple hours.\u003c/p>\n\u003cp>Or imagine an elderly person who potentially has the flu and might have to go to a physical clinic, and then from there bring a prescription to a Walgreens. That is an annoying user experience but also think about how many people they could infect with the flu on the way to the clinic and pharmacy. So I think there could be some basic things Amazon can do with diagnosing illness in the home. And if they can do that coupled with prescription drug delivery, that's a very \u003ca href=\"https://www.cnbc.com/2018/12/17/amazon-vision-future-health-care.html\" target=\"_blank\" rel=\"noopener\">different experience of health care\u003c/a> than we've seen.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>...and Apple\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>The whole Apple health care rollout was big, and I would probably pinpoint the electro-cardiogram\u003ca href=\"https://www.cnbc.com/video/2018/12/05/apple-watch-ecg-sensor-review.html\" target=\"_blank\" rel=\"noopener\"> being introduced on the Apple Watch\u003c/a> as the biggest story from what they've done this year. It got Apple into a more regulated medical device space; I don't know if they are now a medical device company, but they're certainly a consumer tech company that makes medical products.\u003c/p>\n\u003cp>It’s an important story because it sort of changed the game around proactive health monitoring. They were looking specifically for people who didn't even know they have a type of arrhythmia called atrial fibrillation.\u003c/p>\n\u003cp>That's controversial, as there are doctors who think this is bad news, because it's going to lead to a lot of anxious people thinking there's something wrong when there isn't. I've been hearing from physicians who already have patients with normal results reach out and ask, ‘Hey, does this look right?’ Doctors are already overloaded and don't want to be managing an influx of healthy people. So Apple's got to really make sure the false positive rate isn't too high, and they need to be transparent about what this ECG means.\u003c/p>\n\u003cp>But I think this is probably the beginning of what Apple's overall strategy is when it comes to bringing health monitoring to the watch.\u003c/p>\n\u003cp>\u003cstrong>... and, uh, Facebook? \u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">This year even Facebook was trying to get into digital health. At one point it hired some people in the medical community to \u003c/span>\u003ca href=\"https://www.cnbc.com/2018/04/05/facebook-building-8-explored-data-sharing-agreement-with-hospitals.html\">\u003cspan style=\"font-weight: 400\">approach top hospitals\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> about a patient data-sharing agreement. Facebook wanted to see if it could match up the health system's user data with its own data to see if patients might need special care\u003c/span>\u003cspan style=\"font-weight: 400\">. That seemed to be have fallen apart out of general fears of data privacy surrounding the company.\u003c/span>\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://player.cnbc.com/p/gZWlPC/cnbc_global?playertype=synd&byGuid=7000011603&size=530_298\" width=\"530\" height=\"298\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>\u003cstrong>'Real Money' for Digital Health Startup \u003c/strong>\u003c/p>\n\u003cp>Pharmaceutical giant \u003ca href=\"https://www.cnbc.com/2018/02/15/roche-buying-flatiron-health-backed-by-alphabet.html\" target=\"_blank\" rel=\"noopener\">Roche bought Flatiron Health\u003c/a> in February for just over $2 billion. I think that was a big deal because it was a pharmaceutical company spending real money on a digital health startup. I think it shows that there can be real successes in the space. It's also a thumbs-up for precision medicine; Flatiron was basically creating a medical record system that was popular with oncologists, and then using data to figure out better treatments for those patients.\u003c/p>\n\u003cp>\u003cstrong>Watson Stumbles, or: \u003ca href=\"https://www.youtube.com/watch?v=P18EdAKuC1U\" target=\"_blank\" rel=\"noopener\">Health Care Ain't 'Jeopardy'\u003c/a>\u003c/strong>\u003c/p>\n\u003cp>In talking with folks familiar with the IBM Watson strategy, I think where they may have gone wrong is in building this AI system that was \u003ca href=\"https://www.statnews.com/2017/09/05/watson-ibm-cancer/\" target=\"_blank\" rel=\"noopener\">trained using top U.S. oncologists\u003c/a>, and then they tried to sell it to other big cancer centers. So if you're an oncologist at one of these other places, why wouldn't you just say, \"Well, I'm as good as these physicians at Memorial Sloan Kettering?\"\u003c/p>\n\u003cp>So I think they tried to sell into the wrong market because they thought they could get these really big contracts, and what they probably should have done is figured out a much cheaper system that they could have sold to smaller health systems; you can see why some of these local offices and physicians who don't have the same resources as Sloan Kettering would find it beneficial to get information on what Sloan Kettering would do in any given situation.\u003c/p>\n\u003cp>\u003cstrong>It's the Outcomes, Stupid\u003c/strong>\u003c/p>\n\u003cp>For a long time you didn't really see digital health companies invest in outcomes, because I think they wanted to be viewed more as technology companies. But there were a few -- Livongo, Omada Health, Propeller Health -- that were always sort of forward-leaning and did do that investment from the outset, and I think those companies are the ones that are doing better now.\u003c/p>\n\u003cp>Propeller Health was \u003ca href=\"https://www.jsonline.com/story/money/business/health-care/2018/12/03/propeller-health-madison-acquired-225-million/2192097002/\" target=\"_blank\" rel=\"noopener\">sold\u003c/a> this year to ResMed, for instance. I think it was because it had that focus on outcomes.\u003c/p>\n\u003cp>That model is especially important for the influx of companies trying to sell into the employer space, because in order to tell the difference between them, there has been a lot of questioning around: \"Is this actually making my population healthier? Is it really going to save me money?\"\u003c/p>\n\u003cp>In general I think the companies that are coming up this year have kind of learned from the mistakes of some of their predecessors and are positioning themselves with a bit more humility, and in many cases doing the right thing. They don't describe themselves, when pitching potential customers, as startups. They take themselves more seriously now, and they want to be viewed as new health care companies and businesses.\u003c/p>\n\u003cp>It just speaks to a general sort of growing-up.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n","blocks":[],"excerpt":"The tech journalist discusses where the digital health industry is headed after a year in which Big Tech made some Big investments.","status":"publish","parent":0,"modified":1545332340,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":33,"wordCount":1389},"headData":{"title":"What Were the Year's Biggest Digital Health Stories? An Interview With CNBC's Christina Farr | KQED","description":"The tech journalist discusses where the digital health industry is headed after a year in which Big Tech made some Big investments.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"What Were the Year's Biggest Digital Health Stories? An Interview With CNBC's Christina Farr","datePublished":"2018-12-19T23:48:02.000Z","dateModified":"2018-12-20T18:59:00.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"445929 https://ww2.kqed.org/futureofyou/?p=445929","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/12/19/what-were-2018s-biggest-digital-health-stories-an-interview-with-cnbcs-christina-farr/","disqusTitle":"What Were the Year's Biggest Digital Health Stories? An Interview With CNBC's Christina Farr","source":"Digital Health","path":"/futureofyou/445929/what-were-2018s-biggest-digital-health-stories-an-interview-with-cnbcs-christina-farr","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>We like to check in every once in awhile on the world of digital health, an area full of promise \u003ca href=\"https://www.kqed.org/futureofyou/438782/digital-medicine-may-have-just-hit-the-trough-of-disillusionment\" target=\"_blank\" rel=\"noopener\">but not, thus far, overbrimming with results\u003c/a>.\u003c/p>\n\u003cp>There are \u003ca href=\"https://www.kqed.org/futureofyou/437796/what-are-digital-healths-biggest-successes-and-disappointments-cnbcs-chrissy-farr-weighs-in\" target=\"_blank\" rel=\"noopener\">exceptions\u003c/a>, however, and as we did last year at this time, we're turning to San Francisco-based CNBC journalist\u003cstrong>\u003ca href=\"https://www.cnbc.com/christina-farr/\" target=\"_blank\" rel=\"noopener\"> Christina Farr, \u003c/a>\u003c/strong>who breaks a lot of health tech stories, to clue us in on her beat. This year we asked her what were the really big stories she covered in 2018.\u003c/p>\n\u003cp>\u003cstrong>Here are some highlights from our talk, in Christina's own words. The following has been edited for length and clarity.\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Big Digital Health: It's a Thing\u003c/strong>\u003c/p>\n\u003cp>It was a really big year in digital health, particularly where large tech companies are concerned: Apple, Amazon, Google, Microsoft, Samsung...\u003c/p>\n\u003caside class=\"pullquote alignright\">'As [big] tech companies attempt to become trillion-dollar or greater businesses, they need something more than just their core competencies. And you can't ignore health care; it's just too big.'\u003c/aside>\n\u003cp>John Doerr, the venture capitalist who is a big health investor, recounted at the Forbes Healthcare Summit how internet companies in the '90s aimed to disrupt the advertising space, which back then was based mostly on television advertising. Those companies thought they could do a better job because there was really no way at that time to measure and track the performance of ads in real time. So they took on this industry, which is now worth about $75 billion in the U.S.\u003c/p>\n\u003cp>By comparison the health care opportunity is $3.5 trillion in America alone. As these tech companies attempt to become trillion-dollar or greater businesses, they need something more than just their core competencies. And you can't ignore health care; it's just too big.\u003c/p>\n\u003cp>\u003cstrong>Here Comes Amazon ...\u003c/strong>\u003c/p>\n\u003cp>Amazon’s \u003ca href=\"https://www.cnbc.com/2018/06/28/amazon-to-acquire-online-pharmacy-pillpack.html\" target=\"_blank\" rel=\"noopener\">acquisition\u003c/a> of online pharmacy PillPack in June was a very big story. The announcement really marked them as a player, and the market response -- billions of dollars were knocked off some of these pharmacy stocks -- showed how much of a threat Amazon could be. It's also a very good deal for PillPack and probably showed the digital health community that those sorts of exits are possible.\u003c/p>\n\u003cfigure id=\"attachment_437838\" class=\"wp-caption alignright\" style=\"max-width: 589px\">\u003cimg class=\"size-full wp-image-437838\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/12/chrissyfarrphoto1.png\" alt=\"\" width=\"589\" height=\"428\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissyfarrphoto1.png 589w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissyfarrphoto1-160x116.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissyfarrphoto1-240x174.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissyfarrphoto1-375x272.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissyfarrphoto1-520x378.png 520w\" sizes=\"(max-width: 589px) 100vw, 589px\">\u003cfigcaption class=\"wp-caption-text\">CNBC's Chrissy Farr. \u003ccite>(CNBC)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Around the same time, Amazon also \u003ca href=\"https://www.cnbc.com/2018/12/14/amazon-explored-medical-diagnostics-was-in-talks-to-buy-confer-health.html\" target=\"_blank\" rel=\"noopener\">looked at Confer Health\u003c/a>, a company in the at-home medical diagnostic space. That's interesting, because it speaks to a strategy that goes deeper than just drug delivery.\u003c/p>\n\u003cp>Where Amazon could potentially go is this: Imagine you're experiencing symptoms for strep throat, and you \u003ca href=\"https://thenextweb.com/artificial-intelligence/2018/10/15/amazons-new-patent-will-allow-alexa-to-detect-your-illness/\" target=\"_blank\" rel=\"noopener\">talk to your Amazon Alexa device\u003c/a>, and there's an AI system, or a real physician, even, that speaks to you and recommends you get tested. A courier comes to your home with a portable device from which you run a sample and you get a result immediately. Or from there the same physician ships you a prescription. And that could all be done in a couple hours.\u003c/p>\n\u003cp>Or imagine an elderly person who potentially has the flu and might have to go to a physical clinic, and then from there bring a prescription to a Walgreens. That is an annoying user experience but also think about how many people they could infect with the flu on the way to the clinic and pharmacy. So I think there could be some basic things Amazon can do with diagnosing illness in the home. And if they can do that coupled with prescription drug delivery, that's a very \u003ca href=\"https://www.cnbc.com/2018/12/17/amazon-vision-future-health-care.html\" target=\"_blank\" rel=\"noopener\">different experience of health care\u003c/a> than we've seen.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>...and Apple\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>The whole Apple health care rollout was big, and I would probably pinpoint the electro-cardiogram\u003ca href=\"https://www.cnbc.com/video/2018/12/05/apple-watch-ecg-sensor-review.html\" target=\"_blank\" rel=\"noopener\"> being introduced on the Apple Watch\u003c/a> as the biggest story from what they've done this year. It got Apple into a more regulated medical device space; I don't know if they are now a medical device company, but they're certainly a consumer tech company that makes medical products.\u003c/p>\n\u003cp>It’s an important story because it sort of changed the game around proactive health monitoring. They were looking specifically for people who didn't even know they have a type of arrhythmia called atrial fibrillation.\u003c/p>\n\u003cp>That's controversial, as there are doctors who think this is bad news, because it's going to lead to a lot of anxious people thinking there's something wrong when there isn't. I've been hearing from physicians who already have patients with normal results reach out and ask, ‘Hey, does this look right?’ Doctors are already overloaded and don't want to be managing an influx of healthy people. So Apple's got to really make sure the false positive rate isn't too high, and they need to be transparent about what this ECG means.\u003c/p>\n\u003cp>But I think this is probably the beginning of what Apple's overall strategy is when it comes to bringing health monitoring to the watch.\u003c/p>\n\u003cp>\u003cstrong>... and, uh, Facebook? \u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">This year even Facebook was trying to get into digital health. At one point it hired some people in the medical community to \u003c/span>\u003ca href=\"https://www.cnbc.com/2018/04/05/facebook-building-8-explored-data-sharing-agreement-with-hospitals.html\">\u003cspan style=\"font-weight: 400\">approach top hospitals\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> about a patient data-sharing agreement. Facebook wanted to see if it could match up the health system's user data with its own data to see if patients might need special care\u003c/span>\u003cspan style=\"font-weight: 400\">. That seemed to be have fallen apart out of general fears of data privacy surrounding the company.\u003c/span>\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://player.cnbc.com/p/gZWlPC/cnbc_global?playertype=synd&byGuid=7000011603&size=530_298\" width=\"530\" height=\"298\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>\u003cstrong>'Real Money' for Digital Health Startup \u003c/strong>\u003c/p>\n\u003cp>Pharmaceutical giant \u003ca href=\"https://www.cnbc.com/2018/02/15/roche-buying-flatiron-health-backed-by-alphabet.html\" target=\"_blank\" rel=\"noopener\">Roche bought Flatiron Health\u003c/a> in February for just over $2 billion. I think that was a big deal because it was a pharmaceutical company spending real money on a digital health startup. I think it shows that there can be real successes in the space. It's also a thumbs-up for precision medicine; Flatiron was basically creating a medical record system that was popular with oncologists, and then using data to figure out better treatments for those patients.\u003c/p>\n\u003cp>\u003cstrong>Watson Stumbles, or: \u003ca href=\"https://www.youtube.com/watch?v=P18EdAKuC1U\" target=\"_blank\" rel=\"noopener\">Health Care Ain't 'Jeopardy'\u003c/a>\u003c/strong>\u003c/p>\n\u003cp>In talking with folks familiar with the IBM Watson strategy, I think where they may have gone wrong is in building this AI system that was \u003ca href=\"https://www.statnews.com/2017/09/05/watson-ibm-cancer/\" target=\"_blank\" rel=\"noopener\">trained using top U.S. oncologists\u003c/a>, and then they tried to sell it to other big cancer centers. So if you're an oncologist at one of these other places, why wouldn't you just say, \"Well, I'm as good as these physicians at Memorial Sloan Kettering?\"\u003c/p>\n\u003cp>So I think they tried to sell into the wrong market because they thought they could get these really big contracts, and what they probably should have done is figured out a much cheaper system that they could have sold to smaller health systems; you can see why some of these local offices and physicians who don't have the same resources as Sloan Kettering would find it beneficial to get information on what Sloan Kettering would do in any given situation.\u003c/p>\n\u003cp>\u003cstrong>It's the Outcomes, Stupid\u003c/strong>\u003c/p>\n\u003cp>For a long time you didn't really see digital health companies invest in outcomes, because I think they wanted to be viewed more as technology companies. But there were a few -- Livongo, Omada Health, Propeller Health -- that were always sort of forward-leaning and did do that investment from the outset, and I think those companies are the ones that are doing better now.\u003c/p>\n\u003cp>Propeller Health was \u003ca href=\"https://www.jsonline.com/story/money/business/health-care/2018/12/03/propeller-health-madison-acquired-225-million/2192097002/\" target=\"_blank\" rel=\"noopener\">sold\u003c/a> this year to ResMed, for instance. I think it was because it had that focus on outcomes.\u003c/p>\n\u003cp>That model is especially important for the influx of companies trying to sell into the employer space, because in order to tell the difference between them, there has been a lot of questioning around: \"Is this actually making my population healthier? Is it really going to save me money?\"\u003c/p>\n\u003cp>In general I think the companies that are coming up this year have kind of learned from the mistakes of some of their predecessors and are positioning themselves with a bit more humility, and in many cases doing the right thing. They don't describe themselves, when pitching potential customers, as startups. They take themselves more seriously now, and they want to be viewed as new health care companies and businesses.\u003c/p>\n\u003cp>It just speaks to a general sort of growing-up.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/445929/what-were-2018s-biggest-digital-health-stories-an-interview-with-cnbcs-christina-farr","authors":["80"],"categories":["futureofyou_1060","futureofyou_1062","futureofyou_1","futureofyou_73"],"tags":["futureofyou_26","futureofyou_80"],"featImg":"futureofyou_274615","label":"source_futureofyou_445929"},"futureofyou_444897":{"type":"posts","id":"futureofyou_444897","meta":{"index":"posts_1591205157","site":"futureofyou","id":"444897","score":null,"sort":[1539027168000]},"guestAuthors":[],"slug":"some-apps-may-help-curb-insomnia-others-just-put-you-to-sleep","title":"Some Apps May Help Curb Insomnia, Others Just Put You To Sleep","publishDate":1539027168,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>Paige Thesing has struggled with insomnia since high school. \"It takes me a really long time to fall asleep — about four hours,\" she says. For years, her mornings were groggy and involved a \"lot of coffee.\"[contextly_sidebar id=\"SWkBBNCnUWhPf7KOuvUyV7If0Ca3ug47\"]\u003c/p>\n\u003cp>After a year of trying sleep medication prescribed by her doctor, she turned to the internet for alternate solutions. About four months ago, she settled on a mobile phone meditation app called \u003ca href=\"https://www.inscape.life/\" target=\"_blank\" rel=\"noopener\">INSCAPE\u003c/a>.\u003c/p>\n\u003cp>\"It's about a 30-minute soundtrack, and it starts with a woman kind of telling you to relax and instructing your breathing,\" explains Thesing. \"Then it goes into sounds — relaxing noises. There's wind chimes, some atmospheric music playing...\"\u003c/p>\n\u003cp>She uses the app every night and falls asleep within 15 or 20 minutes. \"So, definitely a big improvement from four hours,\" she says.\u003c/p>\n\u003cp>Thesing is not alone. Chronic insomnia affects an estimated \u003ca href=\"https://www.ajmc.com/journals/supplement/2006/2006-05-vol12-n8suppl/may06-2307ps214-s220\" target=\"_blank\" rel=\"noopener\">10-15 percent of adults\u003c/a>, and another 25-35 percent struggle with sleep issues occasionally. And like Thesing, a growing number of insomniacs are turning to mobile phone apps to lull them to sleep.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>On \u003ca href=\"https://twitter.com/NPRHealth/status/1046884648167624711\" target=\"_blank\" rel=\"noopener\">Twitter\u003c/a> and Facebook, NPR asked its audience if they have used a mobile phone app to help manage insomnia. Nearly 100 people wrote back suggesting a range of apps, including podcasts created to put a listener to sleep.\u003c/p>\n\u003cp>\"These are usually relaxation strategies, white noise, meditation,\" \u003ca href=\"https://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=35378\" target=\"_blank\" rel=\"noopener\">Jason Ong\u003c/a>, an associate professor of neurology specializing in sleep at Northwestern University's Feinberg School of Medicine. He studies non-pharmacological treatments for various sleep disorders and treats patients at the university's Sleep Medicine clinic. \"It's not that there's something wrong with those apps. It's a reasonable first thing to try.\"[contextly_sidebar id=\"ljN7S8LuvqENw8QrvBPFbhASn6EIv1oE\"]\u003c/p>\n\u003cp>But, he adds, these kinds of apps aren't based on scientifically-proven solutions, and they don't really fix the problem of why someone is not sleeping.\u003c/p>\n\u003cp>Ong wanted to do something about that, so a few years ago, he consulted for a team that developed an app that uses a science-based approach to address insomnia called \u003ca href=\"https://www.sleepio.com/cbt-for-insomnia/\" target=\"_blank\" rel=\"noopener\">Sleepio\u003c/a>. (However, he doesn't have any ongoing financial interest in the product, he says.)\u003c/p>\n\u003cp>Sleepio and a few other apps like \u003ca href=\"http://www.myshuti.com/\" target=\"_blank\" rel=\"noopener\">SHUT-i\u003c/a> and a free one developed by the Veterans Administration use the most sustainable and \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/15451764\" target=\"_blank\" rel=\"noopener\">evidence-based\u003c/a> solution for insomnia. It's a kind of therapy called Cognitive Behavioral Therapy for Insomnia — \u003ca href=\"https://www.sleepfoundation.org/sleep-news/cognitive-behavioral-therapy-insomnia\" target=\"_blank\" rel=\"noopener\">CBT-I\u003c/a> for short, he says. It helps the patient understand the biology of sleep and gives them a bag of tools and tricks to change their own thought patterns and behaviors to treat their underlying sleep issues.\u003c/p>\n\u003cp>\"CBT for insomnia is a specific package ... [that] includes different techniques like spending less time in bed [and] what to do if you are in bed and can't sleep,\" says Ong. \"It's teaching you how to change your behavior to better work with your brain to give you confidence that you're going to be able to sleep on a regular basis.\"\u003c/p>\n\u003cp>It may be surprising to us, but our own thought patterns and sleep habits \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3621793/\" target=\"_blank\" rel=\"noopener\">affect our biology\u003c/a>, in this case how our brains regulate sleep. \"If you modify some of your behaviors, you can work better with how your brain regulates sleep and wake,\" he says.\u003c/p>\n\u003cp>The American College of Physicians \u003ca href=\"https://www.acponline.org/acp-newsroom/acp-recommends-cognitive-behavioral-therapy-as-initial-treatment-for-chronic-insomnia\" target=\"_blank\" rel=\"noopener\">first recommended\u003c/a> Cognitive Behavioral Therapy for Insomnia as the first-line treatment for insomnia in 2016. \"The evidence is quite strong to support the effectiveness of CBT-I treatment and there really aren't a lot of side effects,\" says Ong. And, because it changes behavior, \"in the long run CBT-I tends to perform quite well in maintaining the benefits.\"\u003c/p>\n\u003cp>In the past the only way for people to get Cognitive Behavioral Therapy for Insomnia was to see a therapist, now they can access the therapy on their mobile phones.\u003c/p>\n\u003cp>\"In Sleepio, it's like an avatar of a real therapist that's walking the patient through that process,\" explains Ong. Sleepio also allows users to keep a sleep diary so the app can use its algorithm to suggest a better bedtime schedule. It also reminds people to get up when they've spent too much time in bed trying to fall asleep, for example.[contextly_sidebar id=\"wEwpbDeWifEPnKULBpzGtSdpZ0ZUBzcu\"]\u003c/p>\n\u003cp>Like a real therapist, the apps that use Cognitive Behavior Therapy for Insomnia also provide practical tools to help the user worry less about their sleep and over time, be less anxious and more confident about their ability get a good night's rest. \"It's very similar to what we do face-to-face with patients,\" adds Ong.\u003c/p>\n\u003cp>\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427093/\" target=\"_blank\" rel=\"noopener\">Studies show\u003c/a> that CBT-I delivered digitally through mobile phone apps is effective in treating insomnia. And a \u003ca href=\"https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2704019\" target=\"_blank\" rel=\"noopener\">recent study\u003c/a> of Sleepio by Ong and the team that developed the product found that participants who used the product reported an improvement in insomnia symptoms and overall wellbeing.\u003c/p>\n\u003cp>\"It's an impressive study in size and scope,\" says \u003ca href=\"http://www.johntorousmd.com/\" target=\"_blank\" rel=\"noopener\">John Torous\u003c/a>, the director of digital psychiatry at Beth Israel Deaconess Medical Center. \"But like any study, we have to interpret it within reason.\"\u003c/p>\n\u003cp>The participants in the study were mostly white and female, he notes, and so it's hard to generalize the findings to the larger population. And, he adds that the study was designed and funded by Big Health, the company that created the app and is now marketing it.\u003c/p>\n\u003cp>Also, Sleepio is only available on a limited basis. You can get it through employers, health insurance and national health systems at the moment, says Mike Radocchia, the marketing and business development lead at Big Health. Although the company does give it to researchers and charities for free.\u003c/p>\n\u003cp>And while apps that use Cognitive Behavior Therapy for Insomnia cost less than in-person therapy, they can be pricey. A 26-week subscription of SHUTi \u003ca href=\"http://www.myshuti.com/shuti-pricing/\" target=\"_blank\" rel=\"noopener\">costs $149\u003c/a>.\u003c/p>\n\u003cp>That's why Torous often directs his patients with insomnia to a free app developed by the Veterans Administration called \u003ca href=\"https://mobile.va.gov/app/cbt-i-coach\" target=\"_blank\" rel=\"noopener\">CBT-I Coach\u003c/a>.\u003c/p>\n\u003cp>\"Anyone can access it. You don't have to be a veteran,\" Torous says.\u003c/p>\n\u003cp>\u003ca href=\"http://www.nextbreathcounseling.com/credentials/\" target=\"_blank\" rel=\"noopener\">Jake Hanks\u003c/a>, a mental health counselor based in Glenwood Springs, Colorado, agrees. \"CBT-I Coach would be my absolute favorite,\" he says. \"It includes a lot of the cognitive restructuring, the true things about sleep that we want patients to keep in mind.\" And so, he too, recommends the free app to his patients.\u003c/p>\n\u003cp>However, Torous notes that these apps don't work for everyone. The recent study by Ong and his colleagues hints at why.\u003c/p>\n\u003cp>\"Even in this clinical study, less than 50 percent [of people who were assigned to use the app in a randomized controlled trial] are able to make it through the entire course of CBT delivered through digital platforms,\" he notes. \"For some people it may be hard to make it through all the sessions of CBT.\"\u003c/p>\n\u003cp>This is true of most health and wellness apps, he says. Torous \u003ca href=\"https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2616170\" target=\"_blank\" rel=\"noopener\">has studied\u003c/a> this and found that of the 10,000 mental health apps out there, very few are actually being used. \"I don't think we really understand how people are using technology towards their health and recovery,\" he notes.[contextly_sidebar id=\"LqkvTN1dfENdC3n50jRUdIl6PSPHOHGb\"]\u003c/p>\n\u003cp>But in some ways, he says, people with insomnia may be ahead of scientists in figuring out what works well for them.\u003c/p>\n\u003cp>\"If you find something that works [for you], I think that's always a good first step,\" he says. \"Quick fixes or simple solutions may get you feeling better right away.\"\u003c/p>\n\u003cp>But, he notes, insomnia is a complex disorder with many underlying causes. Sometimes it can be caused by a medical condition that's easily treatable, like a thyroid problem, he adds.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>So, no matter what app you are considering, always talk to your doctor about your sleep issues, he advises. \"Until you know the diagnosis or what you're working with, you don't want to start treating something that's not what you think it is.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Some+Apps+May+Help+Curb+Insomnia%2C+Others+Just+Put+You+To+Sleep&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"People struggling with insomnia often turn to apps to help them fall asleep. But scientists say only some apps use proven methods that can help address the underlying causes of sleeplessness.","status":"publish","parent":0,"modified":1539016515,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":33,"wordCount":1348},"headData":{"title":"Some Apps May Help Curb Insomnia, Others Just Put You To Sleep | KQED","description":"People struggling with insomnia often turn to apps to help them fall asleep. But scientists say only some apps use proven methods that can help address the underlying causes of sleeplessness.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Some Apps May Help Curb Insomnia, Others Just Put You To Sleep","datePublished":"2018-10-08T19:32:48.000Z","dateModified":"2018-10-08T16:35:15.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"444897 https://ww2.kqed.org/futureofyou/?p=444897","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/10/08/some-apps-may-help-curb-insomnia-others-just-put-you-to-sleep/","disqusTitle":"Some Apps May Help Curb Insomnia, Others Just Put You To Sleep","source":"DIY Health","nprByline":"Rhitu Chatterjee, NPR","nprImageAgency":"Mary Mathis/NPR","nprStoryId":"654883409","nprApiLink":"http://api.npr.org/query?id=654883409&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/10/08/654883409/some-apps-may-help-curb-insomnia-others-just-put-you-to-sleep?ft=nprml&f=654883409","nprRetrievedStory":"1","nprPubDate":"Mon, 08 Oct 2018 09:02:00 -0400","nprStoryDate":"Mon, 08 Oct 2018 05:00:00 -0400","nprLastModifiedDate":"Mon, 08 Oct 2018 05:43:21 -0400","nprAudio":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/10/20181008_me_some_apps_may_help_curb_insomnia_others_just_put_you_to_sleep.mp3?orgId=1&topicId=1128&d=247&p=3&story=654883409&ft=nprml&f=654883409","nprAudioM3u":"http://api.npr.org/m3u/1655529006-c4b480.m3u?orgId=1&topicId=1128&d=247&p=3&story=654883409&ft=nprml&f=654883409","audioTrackLength":247,"path":"/futureofyou/444897/some-apps-may-help-curb-insomnia-others-just-put-you-to-sleep","audioUrl":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/10/20181008_me_some_apps_may_help_curb_insomnia_others_just_put_you_to_sleep.mp3?orgId=1&topicId=1128&d=247&p=3&story=654883409&ft=nprml&f=654883409","parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Paige Thesing has struggled with insomnia since high school. \"It takes me a really long time to fall asleep — about four hours,\" she says. For years, her mornings were groggy and involved a \"lot of coffee.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>After a year of trying sleep medication prescribed by her doctor, she turned to the internet for alternate solutions. About four months ago, she settled on a mobile phone meditation app called \u003ca href=\"https://www.inscape.life/\" target=\"_blank\" rel=\"noopener\">INSCAPE\u003c/a>.\u003c/p>\n\u003cp>\"It's about a 30-minute soundtrack, and it starts with a woman kind of telling you to relax and instructing your breathing,\" explains Thesing. \"Then it goes into sounds — relaxing noises. There's wind chimes, some atmospheric music playing...\"\u003c/p>\n\u003cp>She uses the app every night and falls asleep within 15 or 20 minutes. \"So, definitely a big improvement from four hours,\" she says.\u003c/p>\n\u003cp>Thesing is not alone. Chronic insomnia affects an estimated \u003ca href=\"https://www.ajmc.com/journals/supplement/2006/2006-05-vol12-n8suppl/may06-2307ps214-s220\" target=\"_blank\" rel=\"noopener\">10-15 percent of adults\u003c/a>, and another 25-35 percent struggle with sleep issues occasionally. And like Thesing, a growing number of insomniacs are turning to mobile phone apps to lull them to sleep.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>On \u003ca href=\"https://twitter.com/NPRHealth/status/1046884648167624711\" target=\"_blank\" rel=\"noopener\">Twitter\u003c/a> and Facebook, NPR asked its audience if they have used a mobile phone app to help manage insomnia. Nearly 100 people wrote back suggesting a range of apps, including podcasts created to put a listener to sleep.\u003c/p>\n\u003cp>\"These are usually relaxation strategies, white noise, meditation,\" \u003ca href=\"https://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=35378\" target=\"_blank\" rel=\"noopener\">Jason Ong\u003c/a>, an associate professor of neurology specializing in sleep at Northwestern University's Feinberg School of Medicine. He studies non-pharmacological treatments for various sleep disorders and treats patients at the university's Sleep Medicine clinic. \"It's not that there's something wrong with those apps. It's a reasonable first thing to try.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But, he adds, these kinds of apps aren't based on scientifically-proven solutions, and they don't really fix the problem of why someone is not sleeping.\u003c/p>\n\u003cp>Ong wanted to do something about that, so a few years ago, he consulted for a team that developed an app that uses a science-based approach to address insomnia called \u003ca href=\"https://www.sleepio.com/cbt-for-insomnia/\" target=\"_blank\" rel=\"noopener\">Sleepio\u003c/a>. (However, he doesn't have any ongoing financial interest in the product, he says.)\u003c/p>\n\u003cp>Sleepio and a few other apps like \u003ca href=\"http://www.myshuti.com/\" target=\"_blank\" rel=\"noopener\">SHUT-i\u003c/a> and a free one developed by the Veterans Administration use the most sustainable and \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/15451764\" target=\"_blank\" rel=\"noopener\">evidence-based\u003c/a> solution for insomnia. It's a kind of therapy called Cognitive Behavioral Therapy for Insomnia — \u003ca href=\"https://www.sleepfoundation.org/sleep-news/cognitive-behavioral-therapy-insomnia\" target=\"_blank\" rel=\"noopener\">CBT-I\u003c/a> for short, he says. It helps the patient understand the biology of sleep and gives them a bag of tools and tricks to change their own thought patterns and behaviors to treat their underlying sleep issues.\u003c/p>\n\u003cp>\"CBT for insomnia is a specific package ... [that] includes different techniques like spending less time in bed [and] what to do if you are in bed and can't sleep,\" says Ong. \"It's teaching you how to change your behavior to better work with your brain to give you confidence that you're going to be able to sleep on a regular basis.\"\u003c/p>\n\u003cp>It may be surprising to us, but our own thought patterns and sleep habits \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3621793/\" target=\"_blank\" rel=\"noopener\">affect our biology\u003c/a>, in this case how our brains regulate sleep. \"If you modify some of your behaviors, you can work better with how your brain regulates sleep and wake,\" he says.\u003c/p>\n\u003cp>The American College of Physicians \u003ca href=\"https://www.acponline.org/acp-newsroom/acp-recommends-cognitive-behavioral-therapy-as-initial-treatment-for-chronic-insomnia\" target=\"_blank\" rel=\"noopener\">first recommended\u003c/a> Cognitive Behavioral Therapy for Insomnia as the first-line treatment for insomnia in 2016. \"The evidence is quite strong to support the effectiveness of CBT-I treatment and there really aren't a lot of side effects,\" says Ong. And, because it changes behavior, \"in the long run CBT-I tends to perform quite well in maintaining the benefits.\"\u003c/p>\n\u003cp>In the past the only way for people to get Cognitive Behavioral Therapy for Insomnia was to see a therapist, now they can access the therapy on their mobile phones.\u003c/p>\n\u003cp>\"In Sleepio, it's like an avatar of a real therapist that's walking the patient through that process,\" explains Ong. Sleepio also allows users to keep a sleep diary so the app can use its algorithm to suggest a better bedtime schedule. It also reminds people to get up when they've spent too much time in bed trying to fall asleep, for example.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Like a real therapist, the apps that use Cognitive Behavior Therapy for Insomnia also provide practical tools to help the user worry less about their sleep and over time, be less anxious and more confident about their ability get a good night's rest. \"It's very similar to what we do face-to-face with patients,\" adds Ong.\u003c/p>\n\u003cp>\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427093/\" target=\"_blank\" rel=\"noopener\">Studies show\u003c/a> that CBT-I delivered digitally through mobile phone apps is effective in treating insomnia. And a \u003ca href=\"https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2704019\" target=\"_blank\" rel=\"noopener\">recent study\u003c/a> of Sleepio by Ong and the team that developed the product found that participants who used the product reported an improvement in insomnia symptoms and overall wellbeing.\u003c/p>\n\u003cp>\"It's an impressive study in size and scope,\" says \u003ca href=\"http://www.johntorousmd.com/\" target=\"_blank\" rel=\"noopener\">John Torous\u003c/a>, the director of digital psychiatry at Beth Israel Deaconess Medical Center. \"But like any study, we have to interpret it within reason.\"\u003c/p>\n\u003cp>The participants in the study were mostly white and female, he notes, and so it's hard to generalize the findings to the larger population. And, he adds that the study was designed and funded by Big Health, the company that created the app and is now marketing it.\u003c/p>\n\u003cp>Also, Sleepio is only available on a limited basis. You can get it through employers, health insurance and national health systems at the moment, says Mike Radocchia, the marketing and business development lead at Big Health. Although the company does give it to researchers and charities for free.\u003c/p>\n\u003cp>And while apps that use Cognitive Behavior Therapy for Insomnia cost less than in-person therapy, they can be pricey. A 26-week subscription of SHUTi \u003ca href=\"http://www.myshuti.com/shuti-pricing/\" target=\"_blank\" rel=\"noopener\">costs $149\u003c/a>.\u003c/p>\n\u003cp>That's why Torous often directs his patients with insomnia to a free app developed by the Veterans Administration called \u003ca href=\"https://mobile.va.gov/app/cbt-i-coach\" target=\"_blank\" rel=\"noopener\">CBT-I Coach\u003c/a>.\u003c/p>\n\u003cp>\"Anyone can access it. You don't have to be a veteran,\" Torous says.\u003c/p>\n\u003cp>\u003ca href=\"http://www.nextbreathcounseling.com/credentials/\" target=\"_blank\" rel=\"noopener\">Jake Hanks\u003c/a>, a mental health counselor based in Glenwood Springs, Colorado, agrees. \"CBT-I Coach would be my absolute favorite,\" he says. \"It includes a lot of the cognitive restructuring, the true things about sleep that we want patients to keep in mind.\" And so, he too, recommends the free app to his patients.\u003c/p>\n\u003cp>However, Torous notes that these apps don't work for everyone. The recent study by Ong and his colleagues hints at why.\u003c/p>\n\u003cp>\"Even in this clinical study, less than 50 percent [of people who were assigned to use the app in a randomized controlled trial] are able to make it through the entire course of CBT delivered through digital platforms,\" he notes. \"For some people it may be hard to make it through all the sessions of CBT.\"\u003c/p>\n\u003cp>This is true of most health and wellness apps, he says. Torous \u003ca href=\"https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2616170\" target=\"_blank\" rel=\"noopener\">has studied\u003c/a> this and found that of the 10,000 mental health apps out there, very few are actually being used. \"I don't think we really understand how people are using technology towards their health and recovery,\" he notes.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But in some ways, he says, people with insomnia may be ahead of scientists in figuring out what works well for them.\u003c/p>\n\u003cp>\"If you find something that works [for you], I think that's always a good first step,\" he says. \"Quick fixes or simple solutions may get you feeling better right away.\"\u003c/p>\n\u003cp>But, he notes, insomnia is a complex disorder with many underlying causes. Sometimes it can be caused by a medical condition that's easily treatable, like a thyroid problem, he adds.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>So, no matter what app you are considering, always talk to your doctor about your sleep issues, he advises. \"Until you know the diagnosis or what you're working with, you don't want to start treating something that's not what you think it is.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Some+Apps+May+Help+Curb+Insomnia%2C+Others+Just+Put+You+To+Sleep&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/444897/some-apps-may-help-curb-insomnia-others-just-put-you-to-sleep","authors":["byline_futureofyou_444897"],"categories":["futureofyou_1060","futureofyou_1062","futureofyou_1","futureofyou_73","futureofyou_1061"],"tags":["futureofyou_542","futureofyou_26","futureofyou_1593","futureofyou_787"],"collections":["futureofyou_1093","futureofyou_1097","futureofyou_1096"],"featImg":"futureofyou_444898","label":"source_futureofyou_444897"},"futureofyou_442141":{"type":"posts","id":"futureofyou_442141","meta":{"index":"posts_1591205157","site":"futureofyou","id":"442141","score":null,"sort":[1527615830000]},"guestAuthors":[],"slug":"this-digital-pill-wants-to-make-following-your-prescription-easier","title":"This Digital Pill Wants To Make Following Your Prescription Easier","publishDate":1527615830,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>Doctors \u003ca href=\"http://annals.org/aim/fullarticle/1357338/interventions-improve-adherence-self-administered-medications-chronic-diseases-united-states\" target=\"_blank\" rel=\"noopener\">estimate\u003c/a> about half of all medications for chronic conditions are not taken as prescribed, resulting in $100 billion to $289 billion in preventable health care costs and more than 100,000 deaths every year in the U.S. \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/22510235\" target=\"_blank\" rel=\"noopener\">A majority of adults\u003c/a> say they struggle with remembering to take their prescriptions.[contextly_sidebar id=\"2CHr3EdFO0IpmlPpjqlB7AVQ3gwHnKDA\"]\u003c/p>\n\u003cp>Now, as with many other seemingly intractable challenges, technology has been enlisted to help. A new clinical study is underway at 16 health centers around the country to see if a pill with an ingestible sensor can improve medication adherence rates for \u003ca href=\"https://www.cdc.gov/hepatitis/hcv/cfaq.htm\" target=\"_blank\" rel=\"noopener\">Hepatitis C\u003c/a> drugs.\u003c/p>\n\u003cp>\u003ca href=\"https://www.proteus.com/\" target=\"_blank\" rel=\"noopener\">Proteus Digital Health\u003c/a>, the inventor of this so-called digital pill, is part of an emerging field of medicine and one of a handful of companies designing these high-tech pills.\u003c/p>\n\u003cp>While medication adherence is an issue for everyone, it can be especially difficult for patients with mental health and substance abuse conditions to rigorously follow their prescriptions.\u003c/p>\n\u003cp>And the latter is a significant factor in the spread of Hepatitis C. Intravenous drug use, particularly opioids, has fueled a \u003ca href=\"https://www.cdc.gov/nchhstp/newsroom/2017/Hepatitis-Surveillance-Press-Release.html\">spike in\u003c/a> Hepatitis C infections in recent years.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>On Wednesday’s PBS NewsHour, I explore how a new wave of Hepatitis C drugs, known as direct-acting antivirals, can cure the disease 95 percent of time when used as prescribed. But insurance providers have limited their payouts and the access for direct-acting antivirals, due to the drugs’ expensive price tag.\u003c/p>\n\u003cp>[youtube https://www.youtube.com/watch?v=3DN2gI87R3Q?feature=oembed]\u003c/p>\n\u003cp>David Wyles, head of infectious diseases at \u003ca href=\"https://www.denverhealth.org/\" target=\"_blank\" rel=\"noopener\">Denver Health\u003c/a> where the digital pill is being trialed, said the information gathered from the study may help \u003ca href=\"https://www.chlpi.org/chlpi-nvhr-launch-interactive-report-card-project-grading-52-medicaid-programs-discriminatory-hepatitis-c-treatment-restrictions/\" target=\"_blank\" rel=\"noopener\">convince insurers to expand access \u003c/a>to the new but more expensive Hepatitis C drugs. \u003ca href=\"https://www.denverhealth.org/\" target=\"_blank\" rel=\"noopener\">Denver Health\u003c/a> has 18 voluntary patients enrolled in the trial and is one of the largest study sites. The Colorado Department of Health estimates about \u003ca href=\"https://drive.google.com/file/d/0B0tmPQ67k3NVQjJXSFRGajdWUEE/view\" target=\"_blank\" rel=\"noopener\">70,000\u003c/a> people in the state carry Hepatitis C, and Denver Health cares for many of them.\u003c/p>\n\u003cp>“Insurance payers have imposed restrictions, not necessarily based on medical or scientific facts,” Wyles said. “This is a population that some will look at and say, ‘They won’t take their medications, why would we want to treat them?’ Potentially this study is something to refute that if we can show adherence rates are good.”[contextly_sidebar id=\"64LqO8WUg7X2FUJe9uqsRXqMVyuUE8BQ\"]\u003c/p>\n\u003cp>Proteus’ digital pill consists of the prescription medication with a tiny, FDA-approved ingestible sensor, packed inside a gel capsule. Once swallowed, minerals in the sensor react when they hit the acids in the stomach and create a tiny electronic signal. A band-aid-like patch, worn on the skin of the torso, captures this signal and relays it to an app on a smartphone or tablet.\u003c/p>\n\u003cp>Patients share the data with their doctors but also control who else has access. Their doctors can then monitor when and how many pills have been taken.\u003c/p>\n\u003cp>“If the patient misses a dose or a couple of doses, you can set up an alert in the program to send you an email. You can contact them and hopefully intervene right away,” David Wyles said. “Without the technology, you may not know anything until your next visit, which could be a month later, and then it’s too late to do anything.”\u003c/p>\n\u003cp>Yet the new technology raises questions about patient privacy. \u003ca href=\"https://psychnews.psychiatryonline.org/doi/full/10.1176/appi.pn.2017.pp12a2\" target=\"_blank\" rel=\"noopener\">Some doctors in the mental health community\u003c/a> expressed concerns last year about patient trust and misuse of data when the \u003ca href=\"https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm584933.htm\" target=\"_blank\" rel=\"noopener\">FDA approved\u003c/a> Proteus Digital Health’s sensors to be embedded in the antipsychotic drug \u003ca href=\"https://www.proteus.com/press-releases/otsuka-and-proteus-announce-the-first-us-fda-approval-of-a-digital-medicine-system-abilify-mycite/\" target=\"_blank\" rel=\"noopener\">Abilify.[contextly_sidebar id=\"BuXdE0rwLJ9KNHT80EszuM4r2ocN7n84\"]\u003c/a>\u003c/p>\n\u003cp>“In an era in which even the National Security Agency gets hacked, there are obvious concerns about patient privacy with a technology that communicates personal medical information,” Paul Appelbaum, director of the division of Law, Ethics, and Psychiatry at Columbia University, \u003ca href=\"https://psychnews.psychiatryonline.org/doi/full/10.1176/appi.pn.2017.pp12a2\" target=\"_blank\" rel=\"noopener\">told Psychiatric News\u003c/a>. “The potential for this technology to be misused by judges and probation officers who may require offenders to use pills with sensors, and then respond punitively to the most trivial failure to adhere to the treatment regimen, is real.”\u003c/p>\n\u003cp>Dr. George Savage, chief medical officer for Proteus Digital Health, said his company is adamant about patients controlling their own data: “The patient owns their own data and decides who to share it with beyond their medical team. We don’t sell data and never will.”\u003c/p>\n\u003cp>Nine health systems across the U.S. have used the technology so far for conditions like diabetes, heart failure, and hypertension. Proteus Digital Health is also testing the digital pills with oncology and HIV drugs, and on patients using opioids for pain relief. Dr. Savage said adherence rates with the digital pills have been shown to be high.\u003c/p>\n\u003cp>‘When we provide feedback to the patient, adherence is about 87 percent,” Savage said. “When we add in someone following up with a patient, like a doctor, adherence is 96 percent. Near perfection.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Editor’s note: This post has been updated to clarify that the signal is only sent once when the pill reaches the stomach acid and that the related patch is worn on the torso.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"A new clinical study is underway at 16 health centers around the country to see if a pill with an ingestible sensor can improve medication adherence rates for hepatitis C drugs. ","status":"publish","parent":0,"modified":1527615917,"stats":{"hasAudio":false,"hasVideo":true,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":20,"wordCount":900},"headData":{"title":"This Digital Pill Wants To Make Following Your Prescription Easier | KQED","description":"A new clinical study is underway at 16 health centers around the country to see if a pill with an ingestible sensor can improve medication adherence rates for hepatitis C drugs. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"This Digital Pill Wants To Make Following Your Prescription Easier","datePublished":"2018-05-29T17:43:50.000Z","dateModified":"2018-05-29T17:45:17.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"442141 https://ww2.kqed.org/futureofyou/?p=442141","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/05/29/this-digital-pill-wants-to-make-following-your-prescription-easier/","disqusTitle":"This Digital Pill Wants To Make Following Your Prescription Easier","source":"Health","nprByline":"Cat Wise, PBS Health NewsHour","path":"/futureofyou/442141/this-digital-pill-wants-to-make-following-your-prescription-easier","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Doctors \u003ca href=\"http://annals.org/aim/fullarticle/1357338/interventions-improve-adherence-self-administered-medications-chronic-diseases-united-states\" target=\"_blank\" rel=\"noopener\">estimate\u003c/a> about half of all medications for chronic conditions are not taken as prescribed, resulting in $100 billion to $289 billion in preventable health care costs and more than 100,000 deaths every year in the U.S. \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/22510235\" target=\"_blank\" rel=\"noopener\">A majority of adults\u003c/a> say they struggle with remembering to take their prescriptions.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Now, as with many other seemingly intractable challenges, technology has been enlisted to help. A new clinical study is underway at 16 health centers around the country to see if a pill with an ingestible sensor can improve medication adherence rates for \u003ca href=\"https://www.cdc.gov/hepatitis/hcv/cfaq.htm\" target=\"_blank\" rel=\"noopener\">Hepatitis C\u003c/a> drugs.\u003c/p>\n\u003cp>\u003ca href=\"https://www.proteus.com/\" target=\"_blank\" rel=\"noopener\">Proteus Digital Health\u003c/a>, the inventor of this so-called digital pill, is part of an emerging field of medicine and one of a handful of companies designing these high-tech pills.\u003c/p>\n\u003cp>While medication adherence is an issue for everyone, it can be especially difficult for patients with mental health and substance abuse conditions to rigorously follow their prescriptions.\u003c/p>\n\u003cp>And the latter is a significant factor in the spread of Hepatitis C. Intravenous drug use, particularly opioids, has fueled a \u003ca href=\"https://www.cdc.gov/nchhstp/newsroom/2017/Hepatitis-Surveillance-Press-Release.html\">spike in\u003c/a> Hepatitis C infections in recent years.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>On Wednesday’s PBS NewsHour, I explore how a new wave of Hepatitis C drugs, known as direct-acting antivirals, can cure the disease 95 percent of time when used as prescribed. But insurance providers have limited their payouts and the access for direct-acting antivirals, due to the drugs’ expensive price tag.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/3DN2gI87R3Q?feature=oembed'\n title='//www.youtube.com/embed/3DN2gI87R3Q?feature=oembed'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003c/p>\n\u003cp>David Wyles, head of infectious diseases at \u003ca href=\"https://www.denverhealth.org/\" target=\"_blank\" rel=\"noopener\">Denver Health\u003c/a> where the digital pill is being trialed, said the information gathered from the study may help \u003ca href=\"https://www.chlpi.org/chlpi-nvhr-launch-interactive-report-card-project-grading-52-medicaid-programs-discriminatory-hepatitis-c-treatment-restrictions/\" target=\"_blank\" rel=\"noopener\">convince insurers to expand access \u003c/a>to the new but more expensive Hepatitis C drugs. \u003ca href=\"https://www.denverhealth.org/\" target=\"_blank\" rel=\"noopener\">Denver Health\u003c/a> has 18 voluntary patients enrolled in the trial and is one of the largest study sites. The Colorado Department of Health estimates about \u003ca href=\"https://drive.google.com/file/d/0B0tmPQ67k3NVQjJXSFRGajdWUEE/view\" target=\"_blank\" rel=\"noopener\">70,000\u003c/a> people in the state carry Hepatitis C, and Denver Health cares for many of them.\u003c/p>\n\u003cp>“Insurance payers have imposed restrictions, not necessarily based on medical or scientific facts,” Wyles said. “This is a population that some will look at and say, ‘They won’t take their medications, why would we want to treat them?’ Potentially this study is something to refute that if we can show adherence rates are good.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Proteus’ digital pill consists of the prescription medication with a tiny, FDA-approved ingestible sensor, packed inside a gel capsule. Once swallowed, minerals in the sensor react when they hit the acids in the stomach and create a tiny electronic signal. A band-aid-like patch, worn on the skin of the torso, captures this signal and relays it to an app on a smartphone or tablet.\u003c/p>\n\u003cp>Patients share the data with their doctors but also control who else has access. Their doctors can then monitor when and how many pills have been taken.\u003c/p>\n\u003cp>“If the patient misses a dose or a couple of doses, you can set up an alert in the program to send you an email. You can contact them and hopefully intervene right away,” David Wyles said. “Without the technology, you may not know anything until your next visit, which could be a month later, and then it’s too late to do anything.”\u003c/p>\n\u003cp>Yet the new technology raises questions about patient privacy. \u003ca href=\"https://psychnews.psychiatryonline.org/doi/full/10.1176/appi.pn.2017.pp12a2\" target=\"_blank\" rel=\"noopener\">Some doctors in the mental health community\u003c/a> expressed concerns last year about patient trust and misuse of data when the \u003ca href=\"https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm584933.htm\" target=\"_blank\" rel=\"noopener\">FDA approved\u003c/a> Proteus Digital Health’s sensors to be embedded in the antipsychotic drug \u003ca href=\"https://www.proteus.com/press-releases/otsuka-and-proteus-announce-the-first-us-fda-approval-of-a-digital-medicine-system-abilify-mycite/\" target=\"_blank\" rel=\"noopener\">Abilify.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/a>\u003c/p>\n\u003cp>“In an era in which even the National Security Agency gets hacked, there are obvious concerns about patient privacy with a technology that communicates personal medical information,” Paul Appelbaum, director of the division of Law, Ethics, and Psychiatry at Columbia University, \u003ca href=\"https://psychnews.psychiatryonline.org/doi/full/10.1176/appi.pn.2017.pp12a2\" target=\"_blank\" rel=\"noopener\">told Psychiatric News\u003c/a>. “The potential for this technology to be misused by judges and probation officers who may require offenders to use pills with sensors, and then respond punitively to the most trivial failure to adhere to the treatment regimen, is real.”\u003c/p>\n\u003cp>Dr. George Savage, chief medical officer for Proteus Digital Health, said his company is adamant about patients controlling their own data: “The patient owns their own data and decides who to share it with beyond their medical team. We don’t sell data and never will.”\u003c/p>\n\u003cp>Nine health systems across the U.S. have used the technology so far for conditions like diabetes, heart failure, and hypertension. Proteus Digital Health is also testing the digital pills with oncology and HIV drugs, and on patients using opioids for pain relief. Dr. Savage said adherence rates with the digital pills have been shown to be high.\u003c/p>\n\u003cp>‘When we provide feedback to the patient, adherence is about 87 percent,” Savage said. “When we add in someone following up with a patient, like a doctor, adherence is 96 percent. Near perfection.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Editor’s note: This post has been updated to clarify that the signal is only sent once when the pill reaches the stomach acid and that the related patch is worn on the torso.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/442141/this-digital-pill-wants-to-make-following-your-prescription-easier","authors":["byline_futureofyou_442141"],"categories":["futureofyou_1060","futureofyou_1","futureofyou_73"],"tags":["futureofyou_26","futureofyou_736","futureofyou_1056","futureofyou_35"],"collections":["futureofyou_1093","futureofyou_1097"],"featImg":"futureofyou_442144","label":"source_futureofyou_442141"},"futureofyou_440941":{"type":"posts","id":"futureofyou_440941","meta":{"index":"posts_1591205157","site":"futureofyou","id":"440941","score":null,"sort":[1524510027000]},"guestAuthors":[],"slug":"digital-self-harm-when-teens-cyberbully-themselves","title":"Digital Self-Harm: When Teens Cyberbully Themselves","publishDate":1524510027,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>During the stressful teen years, most adolescents experience emotional highs and lows, but for more than \u003ca href=\"https://www.nami.org/learn-more/mental-health-by-the-numbers\" target=\"_blank\" rel=\"noopener\">20 percent\u003c/a> of teenagers, their worries and sad feelings turn into something more serious, like anxiety or depression. \u003ca href=\"https://www.bmj.com/content/349/bmj.g5954\" target=\"_blank\" rel=\"noopener\">Studies\u003c/a> show that 13 percent to 18 percent of distressed teens physically injure themselves via cutting, burning or other forms of self-harm as a way to cope with their pain.[contextly_sidebar id=\"DrtrOIrhwdXvJWg13P3oHysKbwZZeMlt\"]\u003c/p>\n\u003cp>Recent research and clinical psychologists now suggest that some adolescents are engaging in a newer form of self-aggression — \u003ca href=\"http://www.jahonline.org/article/S1054-139X(17)30313-0/fulltext\" target=\"_blank\" rel=\"noopener\">digital self-harm\u003c/a>. They're anonymously posting mean and derogatory comments about themselves on social media.\u003c/p>\n\u003cp>Child psychologist \u003ca href=\"http://denverchildtherapy.com/about-us/sheryl-ziegler/\" target=\"_blank\" rel=\"noopener\">Sheryl Gonzalez-Ziegler\u003c/a> of Denver says it's a growing problem among teens whom she counsels. One recent client, an adolescent girl, told Gonzalez-Ziegler that she anonymously cyberbullied herself because, as a gay teen, she felt vulnerable and exposed.\u003c/p>\n\u003cp>\"She set up ghost accounts on Instagram and posted mean comments about herself, saying things like, 'I think you're creepy and gay' and 'Don't sit next to me again,' \" Ziegler says.\u003c/p>\n\u003cp>\"She said these things because she feared being mocked by her peers,\" the psychologist explains. \"She thought their teasing wouldn't be so bad if she beat them to the punch.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>According to a survey \u003ca href=\"http://www.jahonline.org/article/S1054-139X(17)30313-0/fulltext\" target=\"_blank\" rel=\"noopener\">published\u003c/a> late last year in the \u003cem>Journal of Adolescent Health\u003c/em>, teens are bullying themselves online as a way to manage feelings of sadness and self-hatred and to gain attention from their friends. For the study, 5,593 middle and high school students from across the U.S., ages 12 to 17, completed a series of questionnaires that asked about their experiences with digital self-harm and cyberbullying.\u003c/p>\n\u003cp>[contextly_sidebar id=\"HCX9vH8V4cXCVb46T0BO94RkguEqSp86\"]\"We were alarmed to learn that 6 percent of the youth who participated in our study engaged in some form of digital self-harm,\" says \u003ca href=\"http://hinduja.org/\" target=\"_blank\" rel=\"noopener\">Sameer Hinduja\u003c/a>, co-author of the study and a professor of criminology at Florida Atlantic University. He is also the co-director of the \u003ca href=\"https://cyberbullying.org/\" target=\"_blank\" rel=\"noopener\">Cyberbullying Research Center\u003c/a>.\u003c/p>\n\u003cp>Hinduja and a colleague found that more than half the teens who cyberbullied themselves had done so more than once. When asked why they had participated in this behavior, the teens said things like, \"I already felt bad about myself, and I wanted to make myself feel worse\" and \"I wanted to see if someone was really my friend.\"\u003c/p>\n\u003cp>Psychologists have seen inklings of this type of self-aggression before. In a smaller, \u003ca href=\"https://webhost.bridgew.edu/marc/DIGITAL%20SELF%20HARM%20report.pdf\" target=\"_blank\" rel=\"noopener\">2012\u003c/a> study of 617 high school freshmen, researchers found that 9 percent of the teens had bullied themselves online. Teens who participated in that study reported harming themselves as a way to encourage others to worry about them, to prove how \"tough\" they were or to get an adult's attention.\u003c/p>\n\u003cp>[contextly_sidebar id=\"4WLViXQpKTG5m375AY6olZ1s9VjHu8hm\"]\"Because teens' online and offline worlds overlap, digital self-harm is a concern for some youth, making online self-harm an emerging area of research,\" says, \u003ca href=\"https://cehs.unl.edu/edpsych/faculty/susan-swearer/\" target=\"_blank\" rel=\"noopener\">Susan Swearer\u003c/a>, a professor of psychology at the University of Nebraska, Lincoln who also studies bullying.\u003c/p>\n\u003cp>A \u003ca href=\"https://jamanetwork.com/journals/jama/article-abstract/2664031\" target=\"_blank\" rel=\"noopener\">statistical analysis\u003c/a> by the Centers for Disease Control and Prevention of more than a decade's worth of emergency room visits in the U.S. suggests that since 2009, the number of girls ages 10 to 14 years who are physically harming themselves has been rising steadily.\u003c/p>\n\u003cp>According to \u003ca href=\"http://www.apa.org/monitor/2015/07-08/who-self-injures.aspx\" target=\"_blank\" rel=\"noopener\">the American Psychological Association\u003c/a>, teens who physically injure themselves often struggle with depression, post-traumatic stress disorder or difficulties with emotional regulation. Not all adolescents who cyberbully themselves have a psychiatric illness, Ziegler notes, but that doesn't mean their behavior should be taken lightly.\u003c/p>\n\u003cp>\"Similar to teens who self-harm by cutting, kids who cyberbully themselves often suffer silently, feeling like they don't have a friend or adult to confide in,\" says Ziegler.\u003c/p>\n\u003cp>If these teens don't receive mental health treatment, she says, their feelings of loneliness and sadness can cause them to become depressed and, in rare cases, suicidal.\u003c/p>\n\u003cp>Because the advent of social media has changed the way many teens form and experience relationships, normal adolescent feelings of insecurity, anxiety and loneliness can become magnified as they scroll through their peers' social media reels. Hinduja says some teens cope with that distress by turning their angst on themselves online.\u003c/p>\n\u003cp>While some parents are quick to limit a teen's social media use in response, that doesn't adequately address the problem, Hinduja says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"One of the best thing parents can do is to promote open, nonjudgmental lines of communication with their kids,\" he says. \"Validating a teen's experience can encourage them to confide in adults about their distressing experiences — offline or online.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=When+Teens+Cyberbully+Themselves&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"The latest form of self-harming behavior is a way of managing feelings of sadness or self-loathing.","status":"publish","parent":0,"modified":1524505085,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":19,"wordCount":788},"headData":{"title":"Digital Self-Harm: When Teens Cyberbully Themselves | KQED","description":"The latest form of self-harming behavior is a way of managing feelings of sadness or self-loathing.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Digital Self-Harm: When Teens Cyberbully Themselves","datePublished":"2018-04-23T19:00:27.000Z","dateModified":"2018-04-23T17:38:05.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"440941 https://ww2.kqed.org/futureofyou/?p=440941","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/04/23/digital-self-harm-when-teens-cyberbully-themselves/","disqusTitle":"Digital Self-Harm: When Teens Cyberbully Themselves","source":"Health","nprImageCredit":"Jasmin Merdan","nprByline":"Juli Fraga\u003cbr />NPR Shots","nprImageAgency":"Getty Images","nprStoryId":"604073315","nprApiLink":"http://api.npr.org/query?id=604073315&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/04/21/604073315/when-teens-cyberbully-themselves?ft=nprml&f=604073315","nprRetrievedStory":"1","nprPubDate":"Sat, 21 Apr 2018 13:03:00 -0400","nprStoryDate":"Sat, 21 Apr 2018 07:00:24 -0400","nprLastModifiedDate":"Sat, 21 Apr 2018 13:03:48 -0400","path":"/futureofyou/440941/digital-self-harm-when-teens-cyberbully-themselves","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>During the stressful teen years, most adolescents experience emotional highs and lows, but for more than \u003ca href=\"https://www.nami.org/learn-more/mental-health-by-the-numbers\" target=\"_blank\" rel=\"noopener\">20 percent\u003c/a> of teenagers, their worries and sad feelings turn into something more serious, like anxiety or depression. \u003ca href=\"https://www.bmj.com/content/349/bmj.g5954\" target=\"_blank\" rel=\"noopener\">Studies\u003c/a> show that 13 percent to 18 percent of distressed teens physically injure themselves via cutting, burning or other forms of self-harm as a way to cope with their pain.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Recent research and clinical psychologists now suggest that some adolescents are engaging in a newer form of self-aggression — \u003ca href=\"http://www.jahonline.org/article/S1054-139X(17)30313-0/fulltext\" target=\"_blank\" rel=\"noopener\">digital self-harm\u003c/a>. They're anonymously posting mean and derogatory comments about themselves on social media.\u003c/p>\n\u003cp>Child psychologist \u003ca href=\"http://denverchildtherapy.com/about-us/sheryl-ziegler/\" target=\"_blank\" rel=\"noopener\">Sheryl Gonzalez-Ziegler\u003c/a> of Denver says it's a growing problem among teens whom she counsels. One recent client, an adolescent girl, told Gonzalez-Ziegler that she anonymously cyberbullied herself because, as a gay teen, she felt vulnerable and exposed.\u003c/p>\n\u003cp>\"She set up ghost accounts on Instagram and posted mean comments about herself, saying things like, 'I think you're creepy and gay' and 'Don't sit next to me again,' \" Ziegler says.\u003c/p>\n\u003cp>\"She said these things because she feared being mocked by her peers,\" the psychologist explains. \"She thought their teasing wouldn't be so bad if she beat them to the punch.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>According to a survey \u003ca href=\"http://www.jahonline.org/article/S1054-139X(17)30313-0/fulltext\" target=\"_blank\" rel=\"noopener\">published\u003c/a> late last year in the \u003cem>Journal of Adolescent Health\u003c/em>, teens are bullying themselves online as a way to manage feelings of sadness and self-hatred and to gain attention from their friends. For the study, 5,593 middle and high school students from across the U.S., ages 12 to 17, completed a series of questionnaires that asked about their experiences with digital self-harm and cyberbullying.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\"We were alarmed to learn that 6 percent of the youth who participated in our study engaged in some form of digital self-harm,\" says \u003ca href=\"http://hinduja.org/\" target=\"_blank\" rel=\"noopener\">Sameer Hinduja\u003c/a>, co-author of the study and a professor of criminology at Florida Atlantic University. He is also the co-director of the \u003ca href=\"https://cyberbullying.org/\" target=\"_blank\" rel=\"noopener\">Cyberbullying Research Center\u003c/a>.\u003c/p>\n\u003cp>Hinduja and a colleague found that more than half the teens who cyberbullied themselves had done so more than once. When asked why they had participated in this behavior, the teens said things like, \"I already felt bad about myself, and I wanted to make myself feel worse\" and \"I wanted to see if someone was really my friend.\"\u003c/p>\n\u003cp>Psychologists have seen inklings of this type of self-aggression before. In a smaller, \u003ca href=\"https://webhost.bridgew.edu/marc/DIGITAL%20SELF%20HARM%20report.pdf\" target=\"_blank\" rel=\"noopener\">2012\u003c/a> study of 617 high school freshmen, researchers found that 9 percent of the teens had bullied themselves online. Teens who participated in that study reported harming themselves as a way to encourage others to worry about them, to prove how \"tough\" they were or to get an adult's attention.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\"Because teens' online and offline worlds overlap, digital self-harm is a concern for some youth, making online self-harm an emerging area of research,\" says, \u003ca href=\"https://cehs.unl.edu/edpsych/faculty/susan-swearer/\" target=\"_blank\" rel=\"noopener\">Susan Swearer\u003c/a>, a professor of psychology at the University of Nebraska, Lincoln who also studies bullying.\u003c/p>\n\u003cp>A \u003ca href=\"https://jamanetwork.com/journals/jama/article-abstract/2664031\" target=\"_blank\" rel=\"noopener\">statistical analysis\u003c/a> by the Centers for Disease Control and Prevention of more than a decade's worth of emergency room visits in the U.S. suggests that since 2009, the number of girls ages 10 to 14 years who are physically harming themselves has been rising steadily.\u003c/p>\n\u003cp>According to \u003ca href=\"http://www.apa.org/monitor/2015/07-08/who-self-injures.aspx\" target=\"_blank\" rel=\"noopener\">the American Psychological Association\u003c/a>, teens who physically injure themselves often struggle with depression, post-traumatic stress disorder or difficulties with emotional regulation. Not all adolescents who cyberbully themselves have a psychiatric illness, Ziegler notes, but that doesn't mean their behavior should be taken lightly.\u003c/p>\n\u003cp>\"Similar to teens who self-harm by cutting, kids who cyberbully themselves often suffer silently, feeling like they don't have a friend or adult to confide in,\" says Ziegler.\u003c/p>\n\u003cp>If these teens don't receive mental health treatment, she says, their feelings of loneliness and sadness can cause them to become depressed and, in rare cases, suicidal.\u003c/p>\n\u003cp>Because the advent of social media has changed the way many teens form and experience relationships, normal adolescent feelings of insecurity, anxiety and loneliness can become magnified as they scroll through their peers' social media reels. Hinduja says some teens cope with that distress by turning their angst on themselves online.\u003c/p>\n\u003cp>While some parents are quick to limit a teen's social media use in response, that doesn't adequately address the problem, Hinduja says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"One of the best thing parents can do is to promote open, nonjudgmental lines of communication with their kids,\" he says. \"Validating a teen's experience can encourage them to confide in adults about their distressing experiences — offline or online.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=When+Teens+Cyberbully+Themselves&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/440941/digital-self-harm-when-teens-cyberbully-themselves","authors":["byline_futureofyou_440941"],"categories":["futureofyou_1","futureofyou_73"],"tags":["futureofyou_26","futureofyou_204","futureofyou_35","futureofyou_872"],"featImg":"futureofyou_440942","label":"source_futureofyou_440941"},"futureofyou_440094":{"type":"posts","id":"futureofyou_440094","meta":{"index":"posts_1591205157","site":"futureofyou","id":"440094","score":null,"sort":[1521469806000]},"guestAuthors":[],"slug":"new-diabetes-monitors-require-fewer-pricks-less-guessing","title":"New Diabetes Monitors Require Fewer Pricks, Less Guessing","publishDate":1521469806,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003ch3>\u003cem>Continuous glucose monitors have been around for over a decade, but reductions in cost and improvements in quality have enticed more patients and doctors to try them out.\u003c/em>\u003c/h3>\n\u003cp>For Melissa Lee, the worst part of diabetes isn’t pricking her finger to check her glucose level or changing her diet to keep her blood sugar in check. Rather, it’s the constant worry and mental calculations.\u003c/p>\n\u003caside class=\"pullquote alignright\">'In a perfect world, everybody with diabetes would benefit from some form of this technology.'\u003ccite>Kathleen Dungan, Ohio State University\u003c/cite>\u003c/aside>\n\u003cp>“You have to think about what did I eat last, how much insulin did I take for that, where is my blood sugar now, which direction is it trending, and then based on that, what am I going to eat?” she says. “You’re making these educated guesses about how much of a really volatile hormone [insulin] to take, and that is mentally exhausting.”\u003c/p>\n\u003cp>Lee, 38, who was diagnosed with Type 1 diabetes when she was 10, recounts ruined dates, missed flights and abandoned excursions, all because she was worried about her glucose level or forgot to bring a replacement for her insulin pump.\u003c/p>\n\u003cp>“You can go from being okay to being really not okay in a moment’s notice,” says Lee, who lives in Milpitas, California and works as the director of community relations at Bigfoot Biomedical.\u003c/p>\n\u003cp>To relieve some of the burden for the estimated 9.3 million people who use insulin to regulate diabetes, medical device makers have introduced new ways to monitor glucose and administer insulin.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Better Glucose Management\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_440097\" class=\"wp-caption aligncenter\" style=\"max-width: 539px\">\u003cimg class=\"wp-image-440097 size-full\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi.jpg\" alt=\"FreeStyle Libre\" width=\"539\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi.jpg 539w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi-520x347.jpg 520w\" sizes=\"(max-width: 539px) 100vw, 539px\">\u003cfigcaption class=\"wp-caption-text\">Melissa Lee displays the components of the FreeStyle Libre, her blood glucose monitor. \u003ccite>(Lauren Hanussak/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Continuous glucose monitors, or CGMs, have been around for over a decade, but poor quality and high costs have been barriers to use, says Irl Hirsch, who holds the Diabetes Treatment and Teaching Chair at the University of Washington School of Medicine. But improvements on both fronts lead him to believe that CGMs will soon become the standard of care. At his own clinic, 60 percent of patients use one.\u003c/p>\n\u003cp>“The financial impact and the insurance coverage is not the barrier that it used to be,” Hirsch says. What’s more, “The quality and the accuracy of these things have just gotten better.”\u003c/p>\n\u003cp>CGMs measure glucose levels not in blood but in the interstitial fluid, which surrounds the cells just underneath the skin. A sensor sticks onto the body, typically on the upper arm or abdomen, with a small, flexible needle that penetrates the skin. The sensor takes a reading every 5 to 15 minutes and transmits that information to a separate receiver or a smartphone app, which patients can check at any time. The reading shows their current glucose level and a trend graph for the last eight hours. If the number is high and rising, the patient can bring their glucose down using insulin; if it’s low and dropping, they need to eat some sugar, fast.\u003c/p>\n\u003cp>“It's very exciting technology. I think it's really revolutionizing diabetes care,” says Kathleen Dungan, an associate professor of medicine at Ohio State University who runs the school’s endocrine clinical trials unit. “In a perfect world, everybody with diabetes would benefit from some form of this technology.”\u003c/p>\n\u003cp>\u003cstrong>Too Little Insulin\u003c/strong>\u003c/p>\n\u003cp>Every time you eat, your pancreas pumps out insulin to help your cells extract glucose from the blood and use it for fuel. In Type I diabetes, the pancreas stops producing insulin, while in Type II the cells can’t utilize the hormone properly. In either case, too little insulin causes excessive blood glucose levels. Chronic high blood sugar, or hyperglycemia, can lead to heart disease, kidney disease, stroke, nerve damage, blindness and loss of limbs.\u003c/p>\n\u003cfigure id=\"attachment_440099\" class=\"wp-caption aligncenter\" style=\"max-width: 539px\">\u003cimg class=\"size-full wp-image-440099\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi.jpg\" alt=\"Melissa Lee, who was diagnosed with type one diabetes at 10 years old, models the FreeStyle Libre in Hayward, Calif.\" width=\"539\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi.jpg 539w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi-520x347.jpg 520w\" sizes=\"(max-width: 539px) 100vw, 539px\">\u003cfigcaption class=\"wp-caption-text\">Melissa Lee, who was diagnosed with Type 1 diabetes at 10 years old, models the FreeStyle Libre, \u003ccite>(Lauren Hanussak/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In contrast, too much insulin results in low blood sugar, or hypoglycemia, which can cause weakness, dizzy spells, seizures, shaking, fainting and even death.\u003c/p>\n\u003cp>Patients typically use blood glucose meters that measure sugar levels in a drop of blood to determine if they need to take more insulin or not. However, having to prick your finger and draw blood to check your glucose level can be a major hurdle for maintaining normal blood sugar. Some patients may have aversions to needles, while others may have difficulty creating a sterile environment in which to take a reading.\u003c/p>\n\u003cp>\u003cstrong>Popular CGMs\u003c/strong>\u003c/p>\n\u003cp>CGMs aim to ease that pain and inconvenience. Dexcom and Abbott are two of the largest producers of CGMs, with Abbott’s FreeStyle Libre the newest device approved by the FDA, in September 2017.\u003c/p>\n\u003cp>The Libre sensors last for 10 days and cost $59 each. Sensors for Dexcom’s G4 or G5 system are $350 for a pack of four and have to be replaced every seven days. Patients also have to purchase a receiver, about $60 for the Libre versus $465 for the Dexcom G5. Finally, Dexcom requires a separate transmitter to send the glucose information to the receiver, another $595. Both companies’ devices are covered by major insurance providers and Medicare, so the actual cost to patients varies.\u003c/p>\n\u003cfigure id=\"attachment_440100\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-440100\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/IMG_0829-1020x680.jpg\" alt=\"Ken Reutell of Petaluma, Calif. displays his MiniMed 670G\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-520x347.jpg 520w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">Ken Reutell of Petaluma, Calif. displays his MiniMed 670G. \u003ccite>(Danielle Venton/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The Libre is the only monitor that doesn’t have to be calibrated daily with a traditional blood glucose reading, meaning patients never have to prick their fingers.\u003c/p>\n\u003cp>Studies show that patients who use a CGM have \u003ca href=\"http://care.diabetesjournals.org/content/40/Supplement_1/S48\" target=\"_blank\" rel=\"noopener\">better control over their diabetes\u003c/a> than patients who use traditional blood glucose tests. Doctors recommend patients check their glucose between \u003ca href=\"https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/blood-sugar/art-20046628\" target=\"_blank\" rel=\"noopener\">4 and 10 times per day\u003c/a>, but in reality, only \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/14999899\" target=\"_blank\" rel=\"noopener\">one-third of patients\u003c/a> test themselves as often as they should. Abbott says patients using its device easily exceed this standard, checking on average 16 times a day.\u003c/p>\n\u003cp>Lee, who uses the FreeStyle Libre, says being able to easily check her blood glucose helps her know how it's affected by her diet. “You suddenly have this insight into how actions you took actually affected some kind of diabetes outcome,” she says.\u003c/p>\n\u003cp>Another Type 1 diabetes patient, Lisa Trahan, 33, yses the Dexcom G4 and says it’s “terrific.” Trahan, a clinical psychologist based in San Marcos, Texas, says the frequent readings provide her with more peace of mind, especially before exercising or eating. However, she still doesn’t trust the device enough to forego pricking her finger to double check the numbers.\u003c/p>\n\u003cfigure id=\"attachment_440101\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-440101\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/IMG_0816-800x533.jpg\" alt=\"A man's hand holds a small gaget.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Ken Reutell's MiniMed 670G means he spends less time pricking himself to monitor his blood glucose levels. \u003ccite>(Danielle Venton/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“I can trust the CGM reading of my Dexcom G4 to be within 20 percent in either direction of my actual blood sugar reading,” she explains. But, she says, that range can make a big difference when tinkering with blood sugar or insulin. “I use the alert as a suggestion to check my blood sugar and go from there.”\u003c/p>\n\u003cp>\u003cstrong>Smarter Insulin Pumps\u003c/strong>\u003c/p>\n\u003cp>Besides checking blood sugar, the other part of managing diabetes is taking insulin, either with an injection or an insulin pump.\u003c/p>\n\u003cp>Traditional insulin pumps are preset to deliver different doses at certain times of the day. However, it can be difficult to match the correct dose to fluctuations in glucose levels that occur naturally throughout the day or because of diet or exercise. A patient or doctor can adjust the levels manually, but it requires complex calculations and typically isn’t done every day.\u003c/p>\n\u003cp>Medtronic’s MiniMed 670G, the first integrated CGM-insulin pump system approved by the FDA in 2016, aims to solve that problem. The 670G can vary the amount of insulin it delivers as often as every five minutes, in response to input from an integrated glucose monitor.\u003c/p>\n\u003cp>The only calculation patients have to make is to manually deliver a boost of insulin every time they eat that is proportionate to the number of carbohydrates in the meal. They also need to prick their fingers three times a day to calibrate the system.\u003c/p>\n\u003cp>Despite the excitement over the 670G, the price can be prohibitive, running between $6,000 and $9,000. Medtronic says some of the cost is covered by insurance.\u003c/p>\n\u003cp>\u003cstrong>A Debate Over Alarms\u003c/strong>\u003c/p>\n\u003cp>Because low glucose levels can be so dangerous, most monitors have built-in alarms that go off when a patient’s glucose has dropped too low. However, Abbott’s FreeStyle Libre does not. Hirsch, the diabetes expert from the University of Washington, says because of this he recommends Dexcom’s CGM, even though the Libre is less expensive and easier to use.\u003c/p>\n\u003cp>The MiniMed 670G also has an alarm, and to patient Ken Reutell, 67, from Petaluma, California, this is a great feature. In the past he’s had to call 911 and has even passed out because his blood sugar had dropped so low. He's used the 670G for six months and says the alarm alerts him well before he gets to that point. Other users, however, have \u003ca href=\"https://www.reddit.com/r/diabetes_t1/comments/7sjpsi/just_placed_on_order_for_the_medtronic_790/dt5oh0l/\" target=\"_blank\" rel=\"noopener\">complained\u003c/a> that the 670G’s alarm is loud and goes off too frequently.\u003c/p>\n\u003cp>And while the device can alert a patient to a dangerously low glucose level, it can’t do anything about it because it doesn’t administer glucose.\u003c/p>\n\u003cp>“(W)hen you get too low, your liver starts pumping out more glucose. That’s something that insulin pumps don’t do yet,” Reutell laments.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Something for the next generation of devices, perhaps.\u003c/p>\n\n","blocks":[],"excerpt":"Continuous glucose monitors have been around for over a decade, but reductions in cost and improvements in quality have enticed more patients and doctors to try them out.","status":"publish","parent":0,"modified":1521487176,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":36,"wordCount":1621},"headData":{"title":"New Diabetes Monitors Require Fewer Pricks, Less Guessing | KQED","description":"Continuous glucose monitors have been around for over a decade, but reductions in cost and improvements in quality have enticed more patients and doctors to try them out.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"New Diabetes Monitors Require Fewer Pricks, Less Guessing","datePublished":"2018-03-19T14:30:06.000Z","dateModified":"2018-03-19T19:19:36.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"440094 https://ww2.kqed.org/futureofyou/?p=440094","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/03/19/new-diabetes-monitors-require-fewer-pricks-less-guessing/","disqusTitle":"New Diabetes Monitors Require Fewer Pricks, Less Guessing","sourceUrl":"DIY Health","nprByline":"Dana Smith","path":"/futureofyou/440094/new-diabetes-monitors-require-fewer-pricks-less-guessing","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003ch3>\u003cem>Continuous glucose monitors have been around for over a decade, but reductions in cost and improvements in quality have enticed more patients and doctors to try them out.\u003c/em>\u003c/h3>\n\u003cp>For Melissa Lee, the worst part of diabetes isn’t pricking her finger to check her glucose level or changing her diet to keep her blood sugar in check. Rather, it’s the constant worry and mental calculations.\u003c/p>\n\u003caside class=\"pullquote alignright\">'In a perfect world, everybody with diabetes would benefit from some form of this technology.'\u003ccite>Kathleen Dungan, Ohio State University\u003c/cite>\u003c/aside>\n\u003cp>“You have to think about what did I eat last, how much insulin did I take for that, where is my blood sugar now, which direction is it trending, and then based on that, what am I going to eat?” she says. “You’re making these educated guesses about how much of a really volatile hormone [insulin] to take, and that is mentally exhausting.”\u003c/p>\n\u003cp>Lee, 38, who was diagnosed with Type 1 diabetes when she was 10, recounts ruined dates, missed flights and abandoned excursions, all because she was worried about her glucose level or forgot to bring a replacement for her insulin pump.\u003c/p>\n\u003cp>“You can go from being okay to being really not okay in a moment’s notice,” says Lee, who lives in Milpitas, California and works as the director of community relations at Bigfoot Biomedical.\u003c/p>\n\u003cp>To relieve some of the burden for the estimated 9.3 million people who use insulin to regulate diabetes, medical device makers have introduced new ways to monitor glucose and administer insulin.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Better Glucose Management\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_440097\" class=\"wp-caption aligncenter\" style=\"max-width: 539px\">\u003cimg class=\"wp-image-440097 size-full\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi.jpg\" alt=\"FreeStyle Libre\" width=\"539\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi.jpg 539w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29282_LIBRE_020718_002-sfi-520x347.jpg 520w\" sizes=\"(max-width: 539px) 100vw, 539px\">\u003cfigcaption class=\"wp-caption-text\">Melissa Lee displays the components of the FreeStyle Libre, her blood glucose monitor. \u003ccite>(Lauren Hanussak/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Continuous glucose monitors, or CGMs, have been around for over a decade, but poor quality and high costs have been barriers to use, says Irl Hirsch, who holds the Diabetes Treatment and Teaching Chair at the University of Washington School of Medicine. But improvements on both fronts lead him to believe that CGMs will soon become the standard of care. At his own clinic, 60 percent of patients use one.\u003c/p>\n\u003cp>“The financial impact and the insurance coverage is not the barrier that it used to be,” Hirsch says. What’s more, “The quality and the accuracy of these things have just gotten better.”\u003c/p>\n\u003cp>CGMs measure glucose levels not in blood but in the interstitial fluid, which surrounds the cells just underneath the skin. A sensor sticks onto the body, typically on the upper arm or abdomen, with a small, flexible needle that penetrates the skin. The sensor takes a reading every 5 to 15 minutes and transmits that information to a separate receiver or a smartphone app, which patients can check at any time. The reading shows their current glucose level and a trend graph for the last eight hours. If the number is high and rising, the patient can bring their glucose down using insulin; if it’s low and dropping, they need to eat some sugar, fast.\u003c/p>\n\u003cp>“It's very exciting technology. I think it's really revolutionizing diabetes care,” says Kathleen Dungan, an associate professor of medicine at Ohio State University who runs the school’s endocrine clinical trials unit. “In a perfect world, everybody with diabetes would benefit from some form of this technology.”\u003c/p>\n\u003cp>\u003cstrong>Too Little Insulin\u003c/strong>\u003c/p>\n\u003cp>Every time you eat, your pancreas pumps out insulin to help your cells extract glucose from the blood and use it for fuel. In Type I diabetes, the pancreas stops producing insulin, while in Type II the cells can’t utilize the hormone properly. In either case, too little insulin causes excessive blood glucose levels. Chronic high blood sugar, or hyperglycemia, can lead to heart disease, kidney disease, stroke, nerve damage, blindness and loss of limbs.\u003c/p>\n\u003cfigure id=\"attachment_440099\" class=\"wp-caption aligncenter\" style=\"max-width: 539px\">\u003cimg class=\"size-full wp-image-440099\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi.jpg\" alt=\"Melissa Lee, who was diagnosed with type one diabetes at 10 years old, models the FreeStyle Libre in Hayward, Calif.\" width=\"539\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi.jpg 539w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29281_LIBRE_020718_001-sfi-520x347.jpg 520w\" sizes=\"(max-width: 539px) 100vw, 539px\">\u003cfigcaption class=\"wp-caption-text\">Melissa Lee, who was diagnosed with Type 1 diabetes at 10 years old, models the FreeStyle Libre, \u003ccite>(Lauren Hanussak/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In contrast, too much insulin results in low blood sugar, or hypoglycemia, which can cause weakness, dizzy spells, seizures, shaking, fainting and even death.\u003c/p>\n\u003cp>Patients typically use blood glucose meters that measure sugar levels in a drop of blood to determine if they need to take more insulin or not. However, having to prick your finger and draw blood to check your glucose level can be a major hurdle for maintaining normal blood sugar. Some patients may have aversions to needles, while others may have difficulty creating a sterile environment in which to take a reading.\u003c/p>\n\u003cp>\u003cstrong>Popular CGMs\u003c/strong>\u003c/p>\n\u003cp>CGMs aim to ease that pain and inconvenience. Dexcom and Abbott are two of the largest producers of CGMs, with Abbott’s FreeStyle Libre the newest device approved by the FDA, in September 2017.\u003c/p>\n\u003cp>The Libre sensors last for 10 days and cost $59 each. Sensors for Dexcom’s G4 or G5 system are $350 for a pack of four and have to be replaced every seven days. Patients also have to purchase a receiver, about $60 for the Libre versus $465 for the Dexcom G5. Finally, Dexcom requires a separate transmitter to send the glucose information to the receiver, another $595. Both companies’ devices are covered by major insurance providers and Medicare, so the actual cost to patients varies.\u003c/p>\n\u003cfigure id=\"attachment_440100\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-440100\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/IMG_0829-1020x680.jpg\" alt=\"Ken Reutell of Petaluma, Calif. displays his MiniMed 670G\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0829-520x347.jpg 520w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">Ken Reutell of Petaluma, Calif. displays his MiniMed 670G. \u003ccite>(Danielle Venton/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The Libre is the only monitor that doesn’t have to be calibrated daily with a traditional blood glucose reading, meaning patients never have to prick their fingers.\u003c/p>\n\u003cp>Studies show that patients who use a CGM have \u003ca href=\"http://care.diabetesjournals.org/content/40/Supplement_1/S48\" target=\"_blank\" rel=\"noopener\">better control over their diabetes\u003c/a> than patients who use traditional blood glucose tests. Doctors recommend patients check their glucose between \u003ca href=\"https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/blood-sugar/art-20046628\" target=\"_blank\" rel=\"noopener\">4 and 10 times per day\u003c/a>, but in reality, only \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/14999899\" target=\"_blank\" rel=\"noopener\">one-third of patients\u003c/a> test themselves as often as they should. Abbott says patients using its device easily exceed this standard, checking on average 16 times a day.\u003c/p>\n\u003cp>Lee, who uses the FreeStyle Libre, says being able to easily check her blood glucose helps her know how it's affected by her diet. “You suddenly have this insight into how actions you took actually affected some kind of diabetes outcome,” she says.\u003c/p>\n\u003cp>Another Type 1 diabetes patient, Lisa Trahan, 33, yses the Dexcom G4 and says it’s “terrific.” Trahan, a clinical psychologist based in San Marcos, Texas, says the frequent readings provide her with more peace of mind, especially before exercising or eating. However, she still doesn’t trust the device enough to forego pricking her finger to double check the numbers.\u003c/p>\n\u003cfigure id=\"attachment_440101\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-440101\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/IMG_0816-800x533.jpg\" alt=\"A man's hand holds a small gaget.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/IMG_0816-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Ken Reutell's MiniMed 670G means he spends less time pricking himself to monitor his blood glucose levels. \u003ccite>(Danielle Venton/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“I can trust the CGM reading of my Dexcom G4 to be within 20 percent in either direction of my actual blood sugar reading,” she explains. But, she says, that range can make a big difference when tinkering with blood sugar or insulin. “I use the alert as a suggestion to check my blood sugar and go from there.”\u003c/p>\n\u003cp>\u003cstrong>Smarter Insulin Pumps\u003c/strong>\u003c/p>\n\u003cp>Besides checking blood sugar, the other part of managing diabetes is taking insulin, either with an injection or an insulin pump.\u003c/p>\n\u003cp>Traditional insulin pumps are preset to deliver different doses at certain times of the day. However, it can be difficult to match the correct dose to fluctuations in glucose levels that occur naturally throughout the day or because of diet or exercise. A patient or doctor can adjust the levels manually, but it requires complex calculations and typically isn’t done every day.\u003c/p>\n\u003cp>Medtronic’s MiniMed 670G, the first integrated CGM-insulin pump system approved by the FDA in 2016, aims to solve that problem. The 670G can vary the amount of insulin it delivers as often as every five minutes, in response to input from an integrated glucose monitor.\u003c/p>\n\u003cp>The only calculation patients have to make is to manually deliver a boost of insulin every time they eat that is proportionate to the number of carbohydrates in the meal. They also need to prick their fingers three times a day to calibrate the system.\u003c/p>\n\u003cp>Despite the excitement over the 670G, the price can be prohibitive, running between $6,000 and $9,000. Medtronic says some of the cost is covered by insurance.\u003c/p>\n\u003cp>\u003cstrong>A Debate Over Alarms\u003c/strong>\u003c/p>\n\u003cp>Because low glucose levels can be so dangerous, most monitors have built-in alarms that go off when a patient’s glucose has dropped too low. However, Abbott’s FreeStyle Libre does not. Hirsch, the diabetes expert from the University of Washington, says because of this he recommends Dexcom’s CGM, even though the Libre is less expensive and easier to use.\u003c/p>\n\u003cp>The MiniMed 670G also has an alarm, and to patient Ken Reutell, 67, from Petaluma, California, this is a great feature. In the past he’s had to call 911 and has even passed out because his blood sugar had dropped so low. He's used the 670G for six months and says the alarm alerts him well before he gets to that point. Other users, however, have \u003ca href=\"https://www.reddit.com/r/diabetes_t1/comments/7sjpsi/just_placed_on_order_for_the_medtronic_790/dt5oh0l/\" target=\"_blank\" rel=\"noopener\">complained\u003c/a> that the 670G’s alarm is loud and goes off too frequently.\u003c/p>\n\u003cp>And while the device can alert a patient to a dangerously low glucose level, it can’t do anything about it because it doesn’t administer glucose.\u003c/p>\n\u003cp>“(W)hen you get too low, your liver starts pumping out more glucose. That’s something that insulin pumps don’t do yet,” Reutell laments.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Something for the next generation of devices, perhaps.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/440094/new-diabetes-monitors-require-fewer-pricks-less-guessing","authors":["byline_futureofyou_440094"],"categories":["futureofyou_1060","futureofyou_1062","futureofyou_1","futureofyou_73"],"tags":["futureofyou_309","futureofyou_26","futureofyou_128","futureofyou_80"],"featImg":"futureofyou_440096","label":"futureofyou"},"futureofyou_440112":{"type":"posts","id":"futureofyou_440112","meta":{"index":"posts_1591205157","site":"futureofyou","id":"440112","score":null,"sort":[1521040226000]},"guestAuthors":[],"slug":"from-app-store-to-drug-store-digital-health-is-redefining-pharma","title":"From App Store To Drug Store, Digital Health Is Redefining Pharma","publishDate":1521040226,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>The pitches always sounded promising: A new software app could track glucose levels for people with diabetes or soothe the brains of insomniacs. Most pharma executives would politely smile and nod, but then park their money somewhere else.\u003c/p>\n\u003cp>Not anymore.\u003c/p>\n\u003cp>Backed by a growing body of evidence, software is itself becoming a prescription for diseases ranging from depression to heart disease, and drug companies are starting to take notice. In the past couple years, many have quickly ramped up their investments in digital startups, infusing software-based therapies into pipelines once dominated by traditional medicines.[contextly_sidebar id=\"vRMOcUiT66pyiT86wyEK8HoXGjDpcJLk\"]\u003c/p>\n\u003cp>These products, known broadly as digital therapeutics, deliver treatment to patients through video games, smartphone apps, and sensors buried in pills or attached to medication dispensers. They are designed to stimulate changes in behavior — and in some cases brain function — to help patients control a variety of illnesses and chronic conditions.\u003c/p>\n\u003cp>In 2017, global investment in these companies jumped to $11.5 billion, a fivefold increase from 2012, according to StartUp Health, a research firm that tracks the digital health market. The uptick in investment mirrors an increasing focus by many digital companies in achieving scientific backing for their inventions.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>And just as importantly as the money flowing in is the rising stature of digital health products. Specifically, in two key ways they’re starting to be treated as drugs: They’re seeking Food and Drug Administration approval, and they’re being covered by insurers. Increasingly, then, across the industry, digital health is moving from the app store to the drug store.\u003c/p>\n\u003cp>\u003cstrong>A Drug In App’s Clothes\u003c/strong>\u003cbr>\n“We’re a team of drug developers that just happens to be developing digital products,” said Dr. Corey McCann, president of Pear Therapeutics, a maker of apps for substance use disorder, post-traumatic stress, and other diseases. “What we’ve done as a company is to demonstrate that software can produce drug-like efficacy.”\u003c/p>\n\u003cp>In 2017, Pear’s reSET program, designed to treat substance use disorder, became the first digital product to receive FDA approval for the treatment of a specific disease. And last month the company inked a partnership with Novartis to develop prescription software to treat schizophrenia and mental health problems associated with multiple sclerosis.\u003c/p>\n\u003cp>The Novartis deal is one of many that highlights increasing investment in these therapies by prominent drug makers. Among the biggest spenders on digital health are GlaxoSmithKline, Roche, Johnson & Johnson, and Merck, whose $500 million global health innovation fund has invested in 24 companies since 2009.[contextly_sidebar id=\"GamWIkUUy1zvAmx2sFp4vTWRVfsXPCLs\"]\u003c/p>\n\u003cp>Analysts who follow the field say digital products are getting more direct attention from pharma CEOs who now see their development as a business imperative, as opposed to a supplemental service with marginal importance to their companies.\u003c/p>\n\u003cp>“The CEOs are coming to us and saying, ‘I have a strategic problem, which is that my R&D pipeline isn’t as productive as I need it to be and there are adjacent businesses my current [employees] just aren’t focused on,’” said Scott Bechtler-Levin, a director with BCG Digital Ventures, a consulting firm.\u003c/p>\n\u003cp>That is causing many companies to buy stakes in these companies or form partnerships to develop and commercialize their products — either as standalone treatments, or as a complement to existing medicines.\u003c/p>\n\u003cp>\u003cstrong>Honing The Pitch To Insurers\u003c/strong>\u003cbr>\nThe rising investment in digital therapeutics does not guarantee their success. As a whole, the industry is still in its early stages of development, and so is the scientific evidence needed to show these products are safe and effective.\u003c/p>\n\u003cp>But some early entrants are winning over medical societies and insurers, putting themselves on more equal footing with traditional pharmaceutical products.\u003c/p>\n\u003cp>Omada Health, a maker of software to treat \u003ca href=\"https://www.statnews.com/2017/11/16/prediabetes-insurance-counseling-diabetes/\" target=\"_blank\" rel=\"noopener\">pre-diabetes\u003c/a>, obesity, and heart disease, now has contracts with more than 175 employers as well as dozens of insurance plans. Its program costs between $550 and $650 for the first year, with the price tied to the achievement of patient outcomes.[contextly_sidebar id=\"0QmrfLARboHh7FZkmCdqJRZJFkLkOMNT\"]\u003c/p>\n\u003cp>“Our big goal is to get to the point where in 70 percent of the country, if you’re in clinical need for a program like ours, it’s written by default into your insurance design,” said Omada’s co-founder and chief executive, Sean Duffy.\u003c/p>\n\u003cp>Founded in 2011, Omada describes itself as a digital behavior change company. Its pre-diabetes program is essentially a set of clinical prevention strategies wrapped in a digital package. The software tracks patients’ weight, food intake, and activity, as well as glucose and lipid levels, among other measures. It also pairs them with a health coach to help provide education and feedback on progress.\u003c/p>\n\u003cp>The company’s website features nine published studies that report either positive results for patients or a clinical validation of Omada’s programs. Many of the studies are small and observational, owing to the company’s short history and limited reach compared to other providers. But it has helped leverage key victories in the industry: Last year, the American Medical Association decided to issue its first ever billing code to cover digital health services like those provided by Omada.\u003c/p>\n\u003cp>The AMA’s designation is crucial, because it helps digital companies gain coverage for their services from private insurers. “It allows us to be categorized as a proper medical benefit,” Duffy said. “That’s always been the long game of Omada.”[contextly_sidebar id=\"qlS21f91d5rV5InQtLOUoNHm1y7ElbJX\"]\u003c/p>\n\u003cp>Medicare has not yet extended coverage for digital pre-diabetes treatment, but it is \u003ca href=\"https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-Fact-Sheet-items/2017-11-02.html\" target=\"_blank\" rel=\"noopener\">inching closer\u003c/a>. It has begun covering the prevention services Omada offers, just not in a digital format. Duffy argues doing so would greatly expand access to care, particularly for people who must travel long distances to see their doctors. “If you’re a Medicare beneficiary, you’re probably willing to drive three hours one time to get a knee replacement,” he said. “But it’s unlikely you’re going to do that for 16 straight weeks of a [diabetes prevention] program.”\u003c/p>\n\u003cp>\u003cstrong>A Scientific Formula For Business Success\u003cbr>\n\u003c/strong>The extent and type of regulatory validation sought by digital health companies varies widely. Some have sought to shield themselves from review, while others have achieved positive results by taking the exact opposite approach.\u003c/p>\n\u003cp>McCann, Pear’s chief executive, said running scientific trials — and ultimately gaining FDA approval — is a crucial part of the company’s business plan. Pear’s current product pipeline includes digital treatments for cancer, Parkinson’s disease, depression and schizophrenia, among others.\u003c/p>\n\u003cp>“If you want to say that something treats schizophrenia … then that’s something that absolutely requires regulatory oversight,” McCann said. “And in these very fragile patient populations, one absolutely needs to demonstrate safety data.”\u003c/p>\n\u003cfigure id=\"attachment_72940\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-72940\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/11/ihealth-800x450.jpg\" alt=\"\" width=\"800\" height=\"450\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/11/ihealth-800x450.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/11/ihealth-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/11/ihealth-960x540.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/11/ihealth.jpg 1024w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A blood pressure monitor from iHealth. \u003ccite>(Juhan Sonin/Flickr)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>That approach has positioned Pear as a direct competitor to traditional pharmaceutical companies, as well as an attractive partner. Its deal with Novartis is designed to further develop its schizophrenia treatment and bring it into clinical use.\u003c/p>\n\u003cp>The product, known as THRIVE, currently consists of a smartphone app that uses branching logic — similar to what one might find in a choose-your-own-adventure game — to help patients identify and counteract delusions and other symptoms. Novartis may contribute by developing complementary drug therapies for schizophrenia patients as well as those with mental health problems arising from multiple sclerosis.\u003c/p>\n\u003cp>Dr. Jay Bradner, president of the Novartis Institutes for BioMedical Research, said Pear’s success in gaining FDA approval for reSET is seen as a model for others in the industry to follow.\u003c/p>\n\u003cp>“It was a heavy lift, but the path that they have carved through the forest is very appealing,” he said. “The proof of concept offered by reSET is indeed encouraging to suggest that other forms of cognitive behavioral therapy might likewise be delivered through digital devices.”[contextly_sidebar id=\"NJID6CERRgAHMSQb34OqsGPaMEPkrsBk\"]\u003c/p>\n\u003cp>The partnership with Pear is part of a broader digital transformation at Novartis. The company has hired a new chief digital officer and is investing in software to allow clinical trials to be carried out in patients’ homes, a move to speed up research and development and reach a more diverse group of patients.\u003c/p>\n\u003cp>“It’s a full reconsideration of the research, development, and commercialization model,” Bradner said, adding that such change is long overdue in an industry famous for its half-hearted embrace of technology.\u003c/p>\n\u003cp>“My mother in her retirement home is running AI when she logs onto the Amazon Prime website, without her even knowing,” he said. “Yet in science and medicine, as sophisticated as these fields have become, there is no pervasive impact of artificial intelligence and deep neural networks, as yet realized.”\u003c/p>\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://www.statnews.com/\" target=\"_blank\" rel=\"noopener\">STAT\u003c/a>, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.intern\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cstrong> \u003c/strong>\u003c/p>\n\n","blocks":[],"excerpt":"Backed by a growing body of evidence, software is itself becoming a prescription for diseases.","status":"publish","parent":0,"modified":1521074525,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":33,"wordCount":1534},"headData":{"title":"From App Store To Drug Store, Digital Health Is Redefining Pharma | KQED","description":"Backed by a growing body of evidence, software is itself becoming a prescription for diseases.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"From App Store To Drug Store, Digital Health Is Redefining Pharma","datePublished":"2018-03-14T15:10:26.000Z","dateModified":"2018-03-15T00:42:05.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"440112 https://ww2.kqed.org/futureofyou/?p=440112","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/03/14/from-app-store-to-drug-store-digital-health-is-redefining-pharma/","disqusTitle":"From App Store To Drug Store, Digital Health Is Redefining Pharma","source":"DYI Health","nprByline":"Casey Ross\u003cbr />STAT","path":"/futureofyou/440112/from-app-store-to-drug-store-digital-health-is-redefining-pharma","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The pitches always sounded promising: A new software app could track glucose levels for people with diabetes or soothe the brains of insomniacs. Most pharma executives would politely smile and nod, but then park their money somewhere else.\u003c/p>\n\u003cp>Not anymore.\u003c/p>\n\u003cp>Backed by a growing body of evidence, software is itself becoming a prescription for diseases ranging from depression to heart disease, and drug companies are starting to take notice. In the past couple years, many have quickly ramped up their investments in digital startups, infusing software-based therapies into pipelines once dominated by traditional medicines.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>These products, known broadly as digital therapeutics, deliver treatment to patients through video games, smartphone apps, and sensors buried in pills or attached to medication dispensers. They are designed to stimulate changes in behavior — and in some cases brain function — to help patients control a variety of illnesses and chronic conditions.\u003c/p>\n\u003cp>In 2017, global investment in these companies jumped to $11.5 billion, a fivefold increase from 2012, according to StartUp Health, a research firm that tracks the digital health market. The uptick in investment mirrors an increasing focus by many digital companies in achieving scientific backing for their inventions.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>And just as importantly as the money flowing in is the rising stature of digital health products. Specifically, in two key ways they’re starting to be treated as drugs: They’re seeking Food and Drug Administration approval, and they’re being covered by insurers. Increasingly, then, across the industry, digital health is moving from the app store to the drug store.\u003c/p>\n\u003cp>\u003cstrong>A Drug In App’s Clothes\u003c/strong>\u003cbr>\n“We’re a team of drug developers that just happens to be developing digital products,” said Dr. Corey McCann, president of Pear Therapeutics, a maker of apps for substance use disorder, post-traumatic stress, and other diseases. “What we’ve done as a company is to demonstrate that software can produce drug-like efficacy.”\u003c/p>\n\u003cp>In 2017, Pear’s reSET program, designed to treat substance use disorder, became the first digital product to receive FDA approval for the treatment of a specific disease. And last month the company inked a partnership with Novartis to develop prescription software to treat schizophrenia and mental health problems associated with multiple sclerosis.\u003c/p>\n\u003cp>The Novartis deal is one of many that highlights increasing investment in these therapies by prominent drug makers. Among the biggest spenders on digital health are GlaxoSmithKline, Roche, Johnson & Johnson, and Merck, whose $500 million global health innovation fund has invested in 24 companies since 2009.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Analysts who follow the field say digital products are getting more direct attention from pharma CEOs who now see their development as a business imperative, as opposed to a supplemental service with marginal importance to their companies.\u003c/p>\n\u003cp>“The CEOs are coming to us and saying, ‘I have a strategic problem, which is that my R&D pipeline isn’t as productive as I need it to be and there are adjacent businesses my current [employees] just aren’t focused on,’” said Scott Bechtler-Levin, a director with BCG Digital Ventures, a consulting firm.\u003c/p>\n\u003cp>That is causing many companies to buy stakes in these companies or form partnerships to develop and commercialize their products — either as standalone treatments, or as a complement to existing medicines.\u003c/p>\n\u003cp>\u003cstrong>Honing The Pitch To Insurers\u003c/strong>\u003cbr>\nThe rising investment in digital therapeutics does not guarantee their success. As a whole, the industry is still in its early stages of development, and so is the scientific evidence needed to show these products are safe and effective.\u003c/p>\n\u003cp>But some early entrants are winning over medical societies and insurers, putting themselves on more equal footing with traditional pharmaceutical products.\u003c/p>\n\u003cp>Omada Health, a maker of software to treat \u003ca href=\"https://www.statnews.com/2017/11/16/prediabetes-insurance-counseling-diabetes/\" target=\"_blank\" rel=\"noopener\">pre-diabetes\u003c/a>, obesity, and heart disease, now has contracts with more than 175 employers as well as dozens of insurance plans. Its program costs between $550 and $650 for the first year, with the price tied to the achievement of patient outcomes.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“Our big goal is to get to the point where in 70 percent of the country, if you’re in clinical need for a program like ours, it’s written by default into your insurance design,” said Omada’s co-founder and chief executive, Sean Duffy.\u003c/p>\n\u003cp>Founded in 2011, Omada describes itself as a digital behavior change company. Its pre-diabetes program is essentially a set of clinical prevention strategies wrapped in a digital package. The software tracks patients’ weight, food intake, and activity, as well as glucose and lipid levels, among other measures. It also pairs them with a health coach to help provide education and feedback on progress.\u003c/p>\n\u003cp>The company’s website features nine published studies that report either positive results for patients or a clinical validation of Omada’s programs. Many of the studies are small and observational, owing to the company’s short history and limited reach compared to other providers. But it has helped leverage key victories in the industry: Last year, the American Medical Association decided to issue its first ever billing code to cover digital health services like those provided by Omada.\u003c/p>\n\u003cp>The AMA’s designation is crucial, because it helps digital companies gain coverage for their services from private insurers. “It allows us to be categorized as a proper medical benefit,” Duffy said. “That’s always been the long game of Omada.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Medicare has not yet extended coverage for digital pre-diabetes treatment, but it is \u003ca href=\"https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-Fact-Sheet-items/2017-11-02.html\" target=\"_blank\" rel=\"noopener\">inching closer\u003c/a>. It has begun covering the prevention services Omada offers, just not in a digital format. Duffy argues doing so would greatly expand access to care, particularly for people who must travel long distances to see their doctors. “If you’re a Medicare beneficiary, you’re probably willing to drive three hours one time to get a knee replacement,” he said. “But it’s unlikely you’re going to do that for 16 straight weeks of a [diabetes prevention] program.”\u003c/p>\n\u003cp>\u003cstrong>A Scientific Formula For Business Success\u003cbr>\n\u003c/strong>The extent and type of regulatory validation sought by digital health companies varies widely. Some have sought to shield themselves from review, while others have achieved positive results by taking the exact opposite approach.\u003c/p>\n\u003cp>McCann, Pear’s chief executive, said running scientific trials — and ultimately gaining FDA approval — is a crucial part of the company’s business plan. Pear’s current product pipeline includes digital treatments for cancer, Parkinson’s disease, depression and schizophrenia, among others.\u003c/p>\n\u003cp>“If you want to say that something treats schizophrenia … then that’s something that absolutely requires regulatory oversight,” McCann said. “And in these very fragile patient populations, one absolutely needs to demonstrate safety data.”\u003c/p>\n\u003cfigure id=\"attachment_72940\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-72940\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/11/ihealth-800x450.jpg\" alt=\"\" width=\"800\" height=\"450\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/11/ihealth-800x450.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/11/ihealth-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/11/ihealth-960x540.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/11/ihealth.jpg 1024w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A blood pressure monitor from iHealth. \u003ccite>(Juhan Sonin/Flickr)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>That approach has positioned Pear as a direct competitor to traditional pharmaceutical companies, as well as an attractive partner. Its deal with Novartis is designed to further develop its schizophrenia treatment and bring it into clinical use.\u003c/p>\n\u003cp>The product, known as THRIVE, currently consists of a smartphone app that uses branching logic — similar to what one might find in a choose-your-own-adventure game — to help patients identify and counteract delusions and other symptoms. Novartis may contribute by developing complementary drug therapies for schizophrenia patients as well as those with mental health problems arising from multiple sclerosis.\u003c/p>\n\u003cp>Dr. Jay Bradner, president of the Novartis Institutes for BioMedical Research, said Pear’s success in gaining FDA approval for reSET is seen as a model for others in the industry to follow.\u003c/p>\n\u003cp>“It was a heavy lift, but the path that they have carved through the forest is very appealing,” he said. “The proof of concept offered by reSET is indeed encouraging to suggest that other forms of cognitive behavioral therapy might likewise be delivered through digital devices.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The partnership with Pear is part of a broader digital transformation at Novartis. The company has hired a new chief digital officer and is investing in software to allow clinical trials to be carried out in patients’ homes, a move to speed up research and development and reach a more diverse group of patients.\u003c/p>\n\u003cp>“It’s a full reconsideration of the research, development, and commercialization model,” Bradner said, adding that such change is long overdue in an industry famous for its half-hearted embrace of technology.\u003c/p>\n\u003cp>“My mother in her retirement home is running AI when she logs onto the Amazon Prime website, without her even knowing,” he said. “Yet in science and medicine, as sophisticated as these fields have become, there is no pervasive impact of artificial intelligence and deep neural networks, as yet realized.”\u003c/p>\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://www.statnews.com/\" target=\"_blank\" rel=\"noopener\">STAT\u003c/a>, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.intern\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong> \u003c/strong>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/440112/from-app-store-to-drug-store-digital-health-is-redefining-pharma","authors":["byline_futureofyou_440112"],"categories":["futureofyou_1060","futureofyou_1"],"tags":["futureofyou_26","futureofyou_191","futureofyou_952","futureofyou_442","futureofyou_774","futureofyou_35"],"collections":["futureofyou_1093"],"featImg":"futureofyou_440113","label":"source_futureofyou_440112"},"futureofyou_438782":{"type":"posts","id":"futureofyou_438782","meta":{"index":"posts_1591205157","site":"futureofyou","id":"438782","score":null,"sort":[1517252159000]},"guestAuthors":[],"slug":"digital-medicine-may-have-just-hit-the-trough-of-disillusionment","title":"If Digital Health is the Future, the Future is Not Here. Yet.","publishDate":1517252159,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>In 1995, in order to educate its clients on what technology to adopt, the IT consulting firm Gartner \u003ca href=\"https://www.gartner.com/technology/research/methodologies/hype-cycle.jsp\" target=\"_blank\" rel=\"noopener\">released a graph\u003c/a> illustrating the “hype cycle.”\u003c/p>\n\u003cp>The model posits that when a new technology is developed, it creates a frenzy of anticipation, leading to a Peak of Inflated Expectations. \u003ca href=\"https://theconversation.com/fitbits-decline-is-a-reflection-of-the-end-of-the-over-hyped-promise-of-wearables-73823\" target=\"_blank\" rel=\"noopener\">Failing\u003c/a> to live up to its pie-in-the-sky promise, the technology then becomes the butt of \u003ca href=\"https://www.youtube.com/watch?v=9507aK_nBHo&ab_channel=cgmcreative\">jokes and derision\u003c/a> — a Trough of Disillusionment.\u003c/p>\n\u003cfigure id=\"attachment_438726\" class=\"wp-caption aligncenter\" style=\"max-width: 506px\">\u003cimg class=\"wp-image-438726 \" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/01/gartner-for-marketers-hype-cycle.png\" alt=\"A graph showing the rise, fall, and subsequent rise of new forms of technology\" width=\"506\" height=\"259\">\u003cfigcaption class=\"wp-caption-text\">The Hype Cycle.\u003c/figcaption>\u003c/figure>\n\u003cp>But as it improves, it reaccumulates credibility -- the Slope of Enlightenment. The technology then matures into the mainstream, where the rollercoaster lifecycle finally smooths out along the Plateau of Productivity.\u003c/p>\n\u003cp>And this, says Dr. Robert Wachter, author of \"\u003ca href=\"https://ww2.kqed.org/futureofyou/tag/the-digital-doctor/\">The Digital Doctor\u003c/a>\" and chair of the Department of Medicine at UCSF, “turns out to be a perfect map for digital medicine.”\u003c/p>\n\u003cp>\u003cstrong>Does This Stuff Work? \u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignright\">'We’re trying to emphasize this is not the end of wearables. [But] we don’t want to overpromise what these can achieve.'\u003ccite>Dr. Brennan Spiegel, Cedars-Sinai Health Services Research\u003c/cite>\u003c/aside>\n\u003cp>A \u003ca href=\"https://www.nature.com/articles/s41746-017-0002-4\" target=\"_blank\" rel=\"noopener\">meta-analysis\u003c/a> published this month in the journal \u003cem>Digital Medicine\u003c/em> would seem to buttress Wachter’s view. The study, conducted mostly by researchers at Cedars-Sinai Medical Center in Los Angeles, takes a broad look at the effectiveness of wearable sensors. The study looked at 16 randomized controlled trials, published from 2000 to 2016, which researchers assessed to be high quality. To be included in the study, devices had to be non-invasive, wearable, and capable of automatically transmitting data to a web portal or mobile app for review by patients or health providers. Among the devices tested were internet-connected weight scales, blood pressure monitors and activity trackers with text-message reminders.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The primary question researchers wanted to answer: Do these wearable biosensors make patients healthier?\u003c/p>\n\u003cp>Not very much, was the conclusion. The analysis found no significant difference in health outcomes like weight or blood pressure between patients who used the devices and those who didn't.\u003c/p>\n\u003cp>The researchers say they were not surprised, and they hope the work will pave the way for better development and use of remote health monitoring.\u003c/p>\n\u003cp>“We’re trying to emphasize this is not the end of wearables,” says co-author Dr. Brennan Spiegel, director of Cedars-Sinai Health Services Research in Los Angeles. “[But] we don’t want to overpromise what these can achieve.”\u003c/p>\n\u003cp>The authors did note some positive effect in certain cases. For instance, \u003ca href=\"http://www.mdpi.com/1424-8220/14/4/6229/htm\">a study\u003c/a> looking at Parkinson’s patients found a positive effect when physical therapy included devices that gave feedback about gaits; and in some trials patients did lose weight.\u003c/p>\n\u003cfigure id=\"attachment_438738\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003cimg class=\"wp-image-438738 size-large\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/01/6905654506_5ac041bada_k-1020x752.jpg\" alt=\"Three joggers near a body of water.\" width=\"640\" height=\"472\">\u003cfigcaption class=\"wp-caption-text\">Wearing an activity tracker does not necessarily lead to more activity.\u003c/figcaption>\u003c/figure>\n\u003cp>“The most successful studies tend to be coupled with some behavioral intervention,” Spiegel says. This added component sometimes took the form of a health coach or cognitive behavioral therapy, in addition to use of the device.\u003c/p>\n\u003cp>That means the greatest hurdles to efficacy in the digital health revolution may not be technical, but human.\u003c/p>\n\u003cp>“What we conclude in the study is that digital health is not a computer science or an engineering science; it’s a social and behavioral science.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'Medicine is probably the last field to be touched by technology.'\u003ccite>Dr. Bob Wachter, author of 'The Digital Doctor'\u003c/cite>\u003c/aside>\n\u003cp>Other recently published research, a \u003ca href=\"http://mhealth.jmir.org/2018/1/e23/\" target=\"_blank\" rel=\"noopener\">systematic review\u003c/a> of systematic reviews, focused on mobile health interventions, most frequently involving text messaging. The analysis, published in the\u003cem> Journal of Medical Internet Research mHealth and uHealth\u003c/em>, looked at 371 studies published between 2009 and 2016, comprised of nearly 80,000 patients. The studied interventions included apps to manage chronic disease, increase treatment adherence and modify behavior. The analysis found evidence that mobile health apps helped with a variety of conditions, including symptom improvement in chronic pulmonary disease and heart failure; glycemic control in diabetes patients; and blood pressure in those with hypertension. There was also evidence that text reminders improved adherence to tuberculosis and HIV therapies.\u003c/p>\n\u003cp>[contextly_sidebar id=\"cJJOGi35mjmKyVRrfPXWGXPW5fc4Gdks\"]However, the quality of the evidence for many studies was rated as generally low. Among the more rigorous studies were those that found good evidence for improvement in asthma symptoms, appointment attendance and smoking cessation rates.\u003c/p>\n\u003cp>\u003cstrong>Medicine Needs to do Better. Will Technology Help?\u003c/strong>\u003c/p>\n\u003cp>Wachter ticked off the ways medicine is \"coming up short in what we want from it.\"\u003c/p>\n\u003cp>\"Safety is not very good,\" he says. \"We harm and kill a lot of people because of medical mistakes. People are not very satisfied ... . Access is often quite bad. And the costs are bankrupting local governments, national governments, and businesses and individuals.”\u003c/p>\n\u003caside class=\"pullquote alignright\">'[Investors] wanted a quick win, but now they realize there aren’t a lot of quick wins in health care.'\u003ccite>Melissa Buckley, California Health Care Foundation\u003c/cite>\u003c/aside>\n\u003cp>And yet, “Medicine is probably the last field to be touched by technology,\" he says. \"Think about how manufacturing, retail, financial services, travel, journalism, pretty much every field has been overtaken by technology.”\u003c/p>\n\u003cp>These manifold inefficiencies present a natural target for technologists, Wachter says.\u003c/p>\n\u003cp>“You have the technology trigger, a massive uptick in expectation. Then, of course, studies like [the one in \u003cem>Digital Medicine\u003c/em>] come out and it leads to a rapid downslope, that Trough of Disillusionment.\"\u003c/p>\n\u003cp>Still, Wachter, as well as many other experts, believe remote sensors, mobile health and tech-enhanced medical services will play an important role in the future of medicine, because there are so many people who need help monitoring chronic disease and guidance on diet and exercise. It’s just too time-consuming and costly to always get these directly from medical professionals, Wachter says.\u003c/p>\n\u003cp>“Right now many people take a half-day off work to go to a 15- minute visit to see the doctor. That’s crazy. How can that be the model over time?”\u003c/p>\n\u003cp>Wachter predicts digital health devices will eventually become as indispensable as smartphones and personal assistants.\u003c/p>\n\u003cp>“That has not happened yet in remote patient monitoring. My suspicion is that over time it probably will, but we have to learn a lot.”\u003c/p>\n\u003cp>Melissa Buckley is director of the Health Innovation Fund for the California Health Care Foundation, which is dedicated to improving health care for low-income state residents. The fund invests in technology and service companies it hopes will help in that mission.\u003c/p>\n\u003cp>Buckley says she’s seen companies only in the last two years try to shorten the hype cycle, which they're doing by becoming more realistic and intentional in the design and deployment of technology. She points out that some of the studies cited in the \u003cem>Digital Health \u003c/em>analysis date back to 2000, when devices were relatively primitive.\u003c/p>\n\u003cp>During the initial phase of excitement over using technology to solve health problems, she says, many investors put money into simple concepts. “They wanted a quick win, but now they realize there aren’t a lot of quick wins in health care.”\u003c/p>\n\u003cp>The field is learning, she believes, to be more attuned to what patients really need.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“But just because [some tool] is digital, we shouldn’t think it will be magically effective.”\u003c/p>\n\n","blocks":[],"excerpt":"Studies of wearable biosensors for patients found they made patients healthier very occasionally, with most interventions showing no benefit over conventional treatment.\r\n","status":"publish","parent":0,"modified":1517528450,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":33,"wordCount":1223},"headData":{"title":"If Digital Health is the Future, the Future is Not Here. Yet. | KQED","description":"Studies of wearable biosensors for patients found they made patients healthier very occasionally, with most interventions showing no benefit over conventional treatment.\r\n","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"If Digital Health is the Future, the Future is Not Here. Yet.","datePublished":"2018-01-29T18:55:59.000Z","dateModified":"2018-02-01T23:40:50.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"438782 https://ww2.kqed.org/futureofyou/?p=438782","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/01/29/digital-medicine-may-have-just-hit-the-trough-of-disillusionment/","disqusTitle":"If Digital Health is the Future, the Future is Not Here. Yet.","source":"KQED Future of You","path":"/futureofyou/438782/digital-medicine-may-have-just-hit-the-trough-of-disillusionment","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>In 1995, in order to educate its clients on what technology to adopt, the IT consulting firm Gartner \u003ca href=\"https://www.gartner.com/technology/research/methodologies/hype-cycle.jsp\" target=\"_blank\" rel=\"noopener\">released a graph\u003c/a> illustrating the “hype cycle.”\u003c/p>\n\u003cp>The model posits that when a new technology is developed, it creates a frenzy of anticipation, leading to a Peak of Inflated Expectations. \u003ca href=\"https://theconversation.com/fitbits-decline-is-a-reflection-of-the-end-of-the-over-hyped-promise-of-wearables-73823\" target=\"_blank\" rel=\"noopener\">Failing\u003c/a> to live up to its pie-in-the-sky promise, the technology then becomes the butt of \u003ca href=\"https://www.youtube.com/watch?v=9507aK_nBHo&ab_channel=cgmcreative\">jokes and derision\u003c/a> — a Trough of Disillusionment.\u003c/p>\n\u003cfigure id=\"attachment_438726\" class=\"wp-caption aligncenter\" style=\"max-width: 506px\">\u003cimg class=\"wp-image-438726 \" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/01/gartner-for-marketers-hype-cycle.png\" alt=\"A graph showing the rise, fall, and subsequent rise of new forms of technology\" width=\"506\" height=\"259\">\u003cfigcaption class=\"wp-caption-text\">The Hype Cycle.\u003c/figcaption>\u003c/figure>\n\u003cp>But as it improves, it reaccumulates credibility -- the Slope of Enlightenment. The technology then matures into the mainstream, where the rollercoaster lifecycle finally smooths out along the Plateau of Productivity.\u003c/p>\n\u003cp>And this, says Dr. Robert Wachter, author of \"\u003ca href=\"https://ww2.kqed.org/futureofyou/tag/the-digital-doctor/\">The Digital Doctor\u003c/a>\" and chair of the Department of Medicine at UCSF, “turns out to be a perfect map for digital medicine.”\u003c/p>\n\u003cp>\u003cstrong>Does This Stuff Work? \u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignright\">'We’re trying to emphasize this is not the end of wearables. [But] we don’t want to overpromise what these can achieve.'\u003ccite>Dr. Brennan Spiegel, Cedars-Sinai Health Services Research\u003c/cite>\u003c/aside>\n\u003cp>A \u003ca href=\"https://www.nature.com/articles/s41746-017-0002-4\" target=\"_blank\" rel=\"noopener\">meta-analysis\u003c/a> published this month in the journal \u003cem>Digital Medicine\u003c/em> would seem to buttress Wachter’s view. The study, conducted mostly by researchers at Cedars-Sinai Medical Center in Los Angeles, takes a broad look at the effectiveness of wearable sensors. The study looked at 16 randomized controlled trials, published from 2000 to 2016, which researchers assessed to be high quality. To be included in the study, devices had to be non-invasive, wearable, and capable of automatically transmitting data to a web portal or mobile app for review by patients or health providers. Among the devices tested were internet-connected weight scales, blood pressure monitors and activity trackers with text-message reminders.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The primary question researchers wanted to answer: Do these wearable biosensors make patients healthier?\u003c/p>\n\u003cp>Not very much, was the conclusion. The analysis found no significant difference in health outcomes like weight or blood pressure between patients who used the devices and those who didn't.\u003c/p>\n\u003cp>The researchers say they were not surprised, and they hope the work will pave the way for better development and use of remote health monitoring.\u003c/p>\n\u003cp>“We’re trying to emphasize this is not the end of wearables,” says co-author Dr. Brennan Spiegel, director of Cedars-Sinai Health Services Research in Los Angeles. “[But] we don’t want to overpromise what these can achieve.”\u003c/p>\n\u003cp>The authors did note some positive effect in certain cases. For instance, \u003ca href=\"http://www.mdpi.com/1424-8220/14/4/6229/htm\">a study\u003c/a> looking at Parkinson’s patients found a positive effect when physical therapy included devices that gave feedback about gaits; and in some trials patients did lose weight.\u003c/p>\n\u003cfigure id=\"attachment_438738\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003cimg class=\"wp-image-438738 size-large\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/01/6905654506_5ac041bada_k-1020x752.jpg\" alt=\"Three joggers near a body of water.\" width=\"640\" height=\"472\">\u003cfigcaption class=\"wp-caption-text\">Wearing an activity tracker does not necessarily lead to more activity.\u003c/figcaption>\u003c/figure>\n\u003cp>“The most successful studies tend to be coupled with some behavioral intervention,” Spiegel says. This added component sometimes took the form of a health coach or cognitive behavioral therapy, in addition to use of the device.\u003c/p>\n\u003cp>That means the greatest hurdles to efficacy in the digital health revolution may not be technical, but human.\u003c/p>\n\u003cp>“What we conclude in the study is that digital health is not a computer science or an engineering science; it’s a social and behavioral science.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'Medicine is probably the last field to be touched by technology.'\u003ccite>Dr. Bob Wachter, author of 'The Digital Doctor'\u003c/cite>\u003c/aside>\n\u003cp>Other recently published research, a \u003ca href=\"http://mhealth.jmir.org/2018/1/e23/\" target=\"_blank\" rel=\"noopener\">systematic review\u003c/a> of systematic reviews, focused on mobile health interventions, most frequently involving text messaging. The analysis, published in the\u003cem> Journal of Medical Internet Research mHealth and uHealth\u003c/em>, looked at 371 studies published between 2009 and 2016, comprised of nearly 80,000 patients. The studied interventions included apps to manage chronic disease, increase treatment adherence and modify behavior. The analysis found evidence that mobile health apps helped with a variety of conditions, including symptom improvement in chronic pulmonary disease and heart failure; glycemic control in diabetes patients; and blood pressure in those with hypertension. There was also evidence that text reminders improved adherence to tuberculosis and HIV therapies.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>However, the quality of the evidence for many studies was rated as generally low. Among the more rigorous studies were those that found good evidence for improvement in asthma symptoms, appointment attendance and smoking cessation rates.\u003c/p>\n\u003cp>\u003cstrong>Medicine Needs to do Better. Will Technology Help?\u003c/strong>\u003c/p>\n\u003cp>Wachter ticked off the ways medicine is \"coming up short in what we want from it.\"\u003c/p>\n\u003cp>\"Safety is not very good,\" he says. \"We harm and kill a lot of people because of medical mistakes. People are not very satisfied ... . Access is often quite bad. And the costs are bankrupting local governments, national governments, and businesses and individuals.”\u003c/p>\n\u003caside class=\"pullquote alignright\">'[Investors] wanted a quick win, but now they realize there aren’t a lot of quick wins in health care.'\u003ccite>Melissa Buckley, California Health Care Foundation\u003c/cite>\u003c/aside>\n\u003cp>And yet, “Medicine is probably the last field to be touched by technology,\" he says. \"Think about how manufacturing, retail, financial services, travel, journalism, pretty much every field has been overtaken by technology.”\u003c/p>\n\u003cp>These manifold inefficiencies present a natural target for technologists, Wachter says.\u003c/p>\n\u003cp>“You have the technology trigger, a massive uptick in expectation. Then, of course, studies like [the one in \u003cem>Digital Medicine\u003c/em>] come out and it leads to a rapid downslope, that Trough of Disillusionment.\"\u003c/p>\n\u003cp>Still, Wachter, as well as many other experts, believe remote sensors, mobile health and tech-enhanced medical services will play an important role in the future of medicine, because there are so many people who need help monitoring chronic disease and guidance on diet and exercise. It’s just too time-consuming and costly to always get these directly from medical professionals, Wachter says.\u003c/p>\n\u003cp>“Right now many people take a half-day off work to go to a 15- minute visit to see the doctor. That’s crazy. How can that be the model over time?”\u003c/p>\n\u003cp>Wachter predicts digital health devices will eventually become as indispensable as smartphones and personal assistants.\u003c/p>\n\u003cp>“That has not happened yet in remote patient monitoring. My suspicion is that over time it probably will, but we have to learn a lot.”\u003c/p>\n\u003cp>Melissa Buckley is director of the Health Innovation Fund for the California Health Care Foundation, which is dedicated to improving health care for low-income state residents. The fund invests in technology and service companies it hopes will help in that mission.\u003c/p>\n\u003cp>Buckley says she’s seen companies only in the last two years try to shorten the hype cycle, which they're doing by becoming more realistic and intentional in the design and deployment of technology. She points out that some of the studies cited in the \u003cem>Digital Health \u003c/em>analysis date back to 2000, when devices were relatively primitive.\u003c/p>\n\u003cp>During the initial phase of excitement over using technology to solve health problems, she says, many investors put money into simple concepts. “They wanted a quick win, but now they realize there aren’t a lot of quick wins in health care.”\u003c/p>\n\u003cp>The field is learning, she believes, to be more attuned to what patients really need.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“But just because [some tool] is digital, we shouldn’t think it will be magically effective.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/438782/digital-medicine-may-have-just-hit-the-trough-of-disillusionment","authors":["11088"],"categories":["futureofyou_1060","futureofyou_452","futureofyou_1062","futureofyou_73"],"tags":["futureofyou_717","futureofyou_26","futureofyou_1275","futureofyou_80","futureofyou_145","futureofyou_25"],"featImg":"futureofyou_274615","label":"source_futureofyou_438782"},"futureofyou_437796":{"type":"posts","id":"futureofyou_437796","meta":{"index":"posts_1591205157","site":"futureofyou","id":"437796","score":null,"sort":[1513718610000]},"guestAuthors":[],"slug":"what-are-digital-healths-biggest-successes-and-disappointments-cnbcs-chrissy-farr-weighs-in","title":"What Are Digital Health's Biggest Successes and Disappointments? CNBC's Chrissy Farr Weighs In","publishDate":1513718610,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>Christina Farr was the first host of KQED Future of You, but today she’s better known as a technology and health \u003ca href=\"https://www.cnbc.com/christina-farr/\" target=\"_blank\" rel=\"noopener\">reporter\u003c/a> for CNBC, where she continues to break \u003ca href=\"https://www.cnbc.com/2017/07/26/amazon-1492-secret-health-tech-project.html\" target=\"_blank\" rel=\"noopener\">stories\u003c/a>. She’s been covering digital health for years, and she's one of the more influential media voices on this beat -- in 2016, venture fund Rock Health named her \u003ca href=\"https://rockhealth.com/where-are-the-2016-top-50-in-digital-health-now/\" target=\"_blank\" rel=\"noopener\">digital health reporter of the year\u003c/a>.\u003c/p>\n\u003cp>As Chrissy's successor at this site, I thought it would be cool to get back to our roots and pick her brain on where digital health is going and where it's been. I interviewed her at CNBC’s San Francisco office, located in skyscraping Salesforce Tower. Here’s our chat, edited for length and clarity.\u003c/p>\n\u003cp>\u003cstrong>First off, how should we define digital health?\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignright\">On wearables: 'I'm really still quite bullish. It’s not just millennials and the \"worried well\" that are using these devices; a lot of seniors love them.'\u003c/aside>\n\u003cp>People have attempted to come up with a good working definition, and sometimes it ends up sounding very vague, like \"the intersection of health and technology.\"\u003c/p>\n\u003cp>I think the term will forever be associated with \u003ca href=\"https://ww2.kqed.org/futureofyou/tag/wearables/\" target=\"_blank\" rel=\"noopener\">wearables\u003c/a> and \u003ca href=\"https://ww2.kqed.org/futureofyou/tag/telemedicine/\" target=\"_blank\" rel=\"noopener\">telemedicine\u003c/a>, and now AI and a couple of other trends. I don't really see a problem with that, because it's still connected with innovation in a lot of people's minds.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>What have been some of the successes in the digital health space?\u003c/strong>\u003c/p>\n\u003cp>I see a lot of potential in digital therapeutics. Companies like Propeller Health and \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/06/23/expanding-digital-health-beyond-the-rich/\" target=\"_blank\" rel=\"noopener\">Omada Health\u003c/a> are studying the effect of apps that attempt to change behavior for purposes of disease prevention and management. Propeller Health, for example, is thinking about \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/06/13/inhalers-plus-smartphones-meant-fewer-trips-to-er-hospital/\" target=\"_blank\" rel=\"noopener\">connected inhalers\u003c/a> and how to combine them with data like the weather to figure out when a person with asthma should take medicine.\u003c/p>\n\u003caside class=\"pullquote alignright\">Disappointments? Telehealth and artificial intelligence.\u003c/aside>\n\u003cp>Virta Health is going after Type 2 diabetes reversal with a\u003ca href=\"https://www.medscape.com/viewarticle/890090\" target=\"_blank\" rel=\"noopener\"> digital system\u003c/a> that encourages a massive behavior change around diet, which it thinks could actually replace medicines.\u003c/p>\n\u003cp>AliveCor is a super-interesting company. They have a \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/03/17/mobile-ekg-on-a-watchband-is-useful-for-some-say-docs/\" target=\"_blank\" rel=\"noopener\">mobile EKG\u003c/a> that a lot of doctors really like. I think it's something that a lot of seniors will use when they find out they're at risk for \u003ca href=\"http://www.heart.org/HEARTORG/Conditions/Arrhythmia/AboutArrhythmia/What-is-Atrial-Fibrillation-AFib-or-AF_UCM_423748_Article.jsp#.VusMvOIrKUk\" target=\"_blank\" rel=\"noopener\">atrial fibrillation\u003c/a>, because it means they can check on their heart from home and not have to go to the doctor every few months.\u003c/p>\n\u003cp>\u003cstrong>You mentioned wearables, like Fitbit and Apple Watch. How's that business going? \u003c/strong>\u003c/p>\n\u003cp>I‘m really still quite bullish on wearables, and I think they have become mainstream. It's not just millennials and the \"\u003ca href=\"http://www.telegraph.co.uk/lifestyle/wellbeing/diet/10977877/Are-you-one-of-the-rising-numbers-of-the-worried-well.html\" target=\"_blank\" rel=\"noopener\">worried well\u003c/a>\" that are using these devices; a lot of seniors love them. You're also starting to see insurance companies think about partnering with companies like Apple, and the reason they're doing that isn't necessarily to get their already healthy populations to exercise more; it's about getting to those really sick and costly people that have multiple chronic conditions.\u003c/p>\n\u003cp>\u003cstrong>Do you think investors in the digital health space are more circumspect after the \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/10/13/the-rise-and-fall-of-theranos-a-cartoon-history/\" target=\"_blank\" rel=\"noopener\">Theranos debacle\u003c/a>?\u003c/strong>\u003c/p>\n\u003cp>Some are. Others don't necessarily want companies to invest the time into building a base of evidence before they start selling the product; these investors are looking for their money back in three to five years, like they would get with a consumer internet company.\u003c/p>\n\u003caside class=\"pullquote alignright\">'In a lot of ways, Theranos is just the worst example.'\u003c/aside>\n\u003cp>It's hard to find another company like Theranos, which put patients \u003ca href=\"http://tucson.com/news/local/theranos-to-pay-m-to-arizonans-over-blood-tests-that/article_dacc3bd1-54e0-58dd-92b3-18dec8eb8854.html\" target=\"_blank\" rel=\"noopener\">in danger\u003c/a>. But in a lot of ways, Theranos is just the worst example. More companies are still failing to provide proper evidence. Often they say, \"We're wellness. We're not making claims around disease, so we don't need to bother.\"\u003c/p>\n\u003cp>\u003cstrong>What's the biggest disappointment of the digital health era to date?\u003c/strong>\u003c/p>\n\u003cp>This is going to be controversial, but I don't think telemedicine has panned out to the extent people expected it would by this time. People thought it was going to revolutionize all health care. But I'm not seeing every physician say this is something they want to incorporate into their medical practice, because there's a perception they're not going to get paid as much.\u003c/p>\n\u003cp>Also pretty overhyped in terms of what we're actually seeing out there: AI and big data. \u003ca href=\"https://ww2.kqed.org/futureofyou/2015/08/20/this-robo-eye-doctor-may-help-patients-with-diabetes-keep-sight/\" target=\"_blank\" rel=\"noopener\">Diabetic retinopathy\u003c/a>, for example, is an area where you see a lot of people investing in AI research. Could we take a pile of medical images that have been labeled as showing diabetic retinopathy or not, and then you train AI to do that job in triage?\u003c/p>\n\u003cp>There's been some great results, but that does not mean we're on the cusp of a robo eye doctor, because an actual eye doctor would\u003ca href=\"https://ww2.kqed.org/futureofyou/2016/11/07/will-computers-ever-be-able-to-make-diagnoses-as-well-as-physicians/\" target=\"_blank\" rel=\"noopener\"> need to know\u003c/a> every single medical condition out there that could be affecting this person. I think we’ve been too quick to look at one disease and one use case and say, well, this is evidence that doctors will be replaced.\u003c/p>\n\u003cp>\u003cb>Do you think the Food and Drug Administration and other regulators can keep up with all this? And does the industry \u003cem>want\u003c/em> them to keep up?\u003c/b>\u003c/p>\n\u003cfigure id=\"attachment_437841\" class=\"wp-caption alignright\" style=\"max-width: 640px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/12/chrissymum.jpg\">\u003cimg class=\"wp-image-437841 size-large\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/12/chrissymum-1020x591.jpg\" alt=\"\" width=\"640\" height=\"371\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissymum-1020x591.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissymum-160x93.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissymum-800x463.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissymum-768x445.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissymum-1180x683.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissymum-960x556.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissymum-240x139.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissymum-375x217.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissymum-520x301.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissymum.jpg 1613w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Chrissy Farr discussing Fitbit vs. Apple Watch with her mom, for a CNBC segment. (CNBC)\u003c/figcaption>\u003c/figure>\n\u003cp>I think at the birth of this digital health movement, people thought of the FDA as the big bad wolf. The prevailing narrative was that it's obstructing innovation. Now there seems to be more nuance around that; people recognize that the FDA does have an important role to play. Many of the digital therapeutics companies, for instance, see the FDA as a potential stamp of approval that sets them ahead of a mass of apps that are making false claims and essentially peddling snake oil.\u003c/p>\n\u003cp>So there needs to be a watchdog, but that's not the FDA's role. They're not out there policing companies and investing time into looking through the app store and thinking, \"This dermatology app doesn't look quite right.\"\u003c/p>\n\u003cp>As a result, you get this huge quality variation, and I do sometimes fear that doctors will start prescribing or patients will start using apps that are of lower quality. I think someone needs to step into that role in 2018 so we have a better way of figuring out which apps work and which don't.\u003c/p>\n\u003cp>\u003cstrong>Last question: Occasionally you hear the complaint about digital health that these are primarily tools for young, rich people. Do you think that's valid?\u003c/strong>\u003c/p>\n\u003cp>The true problems of health care, which are particularly an issue for underrepresented groups and minorities, are around how it's paid for. We need massive payment reforms. There's also a lack of investment around social determinants, things like social services and affordable housing, which improve outcomes. \u003cspan style=\"font-weight: 400\">All of these problems are not going to be solved with an AI Band-Aid or by handing someone a Fitbit.\u003c/span>\u003c/p>\n\u003cp>That said, I don't think it's fair to label this entire group of companies as purely helping the rich, wealthy, paranoid types who are just \u003ca href=\"https://www.youtube.com/watch?v=hBA0AH-LSbo\" target=\"_blank\" rel=\"noopener\">dying to live forever\u003c/a>.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>A lot of these companies are going after Medicaid populations, and that absolutely makes sense; that's more than 12 million people in California alone. Even Apple, which hasn't traditionally been a health care player, is working with Aetna on a study with Stanford about whether or not they can use the Apple Watch to detect \u003ca href=\"http://www.heart.org/HEARTORG/Conditions/Arrhythmia/AboutArrhythmia/What-is-Atrial-Fibrillation-AFib-or-AF_UCM_423748_Article.jsp#.VusMvOIrKUk\" rel=\"noopener\">afib\u003c/a>. That's not something a young or healthy person would necessarily worry about at all. It's something that over-65, more vulnerable populations with a history of stroke are more at risk for. So you can see even Apple saying this is a tool that we expected would be mostly about consumer delight, but we've found that it can help save lives.\u003c/p>\n\n","blocks":[],"excerpt":"The technology reporter has been sorting through buzzwords and bona fides for years while on the digital health beat.","status":"publish","parent":0,"modified":1513800516,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":28,"wordCount":1332},"headData":{"title":"What Are Digital Health's Biggest Successes and Disappointments? CNBC's Chrissy Farr Weighs In | KQED","description":"The technology reporter has been sorting through buzzwords and bona fides for years while on the digital health beat.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"What Are Digital Health's Biggest Successes and Disappointments? CNBC's Chrissy Farr Weighs In","datePublished":"2017-12-19T21:23:30.000Z","dateModified":"2017-12-20T20:08:36.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"437796 https://ww2.kqed.org/futureofyou/?p=437796","disqusUrl":"https://ww2.kqed.org/futureofyou/2017/12/19/what-are-digital-healths-biggest-successes-and-disappointments-cnbcs-chrissy-farr-weighs-in/","disqusTitle":"What Are Digital Health's Biggest Successes and Disappointments? CNBC's Chrissy Farr Weighs In","source":"KQED Future of You","nprByline":"Jon Brooks\u003cbr />Future of You","path":"/futureofyou/437796/what-are-digital-healths-biggest-successes-and-disappointments-cnbcs-chrissy-farr-weighs-in","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Christina Farr was the first host of KQED Future of You, but today she’s better known as a technology and health \u003ca href=\"https://www.cnbc.com/christina-farr/\" target=\"_blank\" rel=\"noopener\">reporter\u003c/a> for CNBC, where she continues to break \u003ca href=\"https://www.cnbc.com/2017/07/26/amazon-1492-secret-health-tech-project.html\" target=\"_blank\" rel=\"noopener\">stories\u003c/a>. She’s been covering digital health for years, and she's one of the more influential media voices on this beat -- in 2016, venture fund Rock Health named her \u003ca href=\"https://rockhealth.com/where-are-the-2016-top-50-in-digital-health-now/\" target=\"_blank\" rel=\"noopener\">digital health reporter of the year\u003c/a>.\u003c/p>\n\u003cp>As Chrissy's successor at this site, I thought it would be cool to get back to our roots and pick her brain on where digital health is going and where it's been. I interviewed her at CNBC’s San Francisco office, located in skyscraping Salesforce Tower. Here’s our chat, edited for length and clarity.\u003c/p>\n\u003cp>\u003cstrong>First off, how should we define digital health?\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignright\">On wearables: 'I'm really still quite bullish. It’s not just millennials and the \"worried well\" that are using these devices; a lot of seniors love them.'\u003c/aside>\n\u003cp>People have attempted to come up with a good working definition, and sometimes it ends up sounding very vague, like \"the intersection of health and technology.\"\u003c/p>\n\u003cp>I think the term will forever be associated with \u003ca href=\"https://ww2.kqed.org/futureofyou/tag/wearables/\" target=\"_blank\" rel=\"noopener\">wearables\u003c/a> and \u003ca href=\"https://ww2.kqed.org/futureofyou/tag/telemedicine/\" target=\"_blank\" rel=\"noopener\">telemedicine\u003c/a>, and now AI and a couple of other trends. I don't really see a problem with that, because it's still connected with innovation in a lot of people's minds.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>What have been some of the successes in the digital health space?\u003c/strong>\u003c/p>\n\u003cp>I see a lot of potential in digital therapeutics. Companies like Propeller Health and \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/06/23/expanding-digital-health-beyond-the-rich/\" target=\"_blank\" rel=\"noopener\">Omada Health\u003c/a> are studying the effect of apps that attempt to change behavior for purposes of disease prevention and management. Propeller Health, for example, is thinking about \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/06/13/inhalers-plus-smartphones-meant-fewer-trips-to-er-hospital/\" target=\"_blank\" rel=\"noopener\">connected inhalers\u003c/a> and how to combine them with data like the weather to figure out when a person with asthma should take medicine.\u003c/p>\n\u003caside class=\"pullquote alignright\">Disappointments? Telehealth and artificial intelligence.\u003c/aside>\n\u003cp>Virta Health is going after Type 2 diabetes reversal with a\u003ca href=\"https://www.medscape.com/viewarticle/890090\" target=\"_blank\" rel=\"noopener\"> digital system\u003c/a> that encourages a massive behavior change around diet, which it thinks could actually replace medicines.\u003c/p>\n\u003cp>AliveCor is a super-interesting company. They have a \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/03/17/mobile-ekg-on-a-watchband-is-useful-for-some-say-docs/\" target=\"_blank\" rel=\"noopener\">mobile EKG\u003c/a> that a lot of doctors really like. I think it's something that a lot of seniors will use when they find out they're at risk for \u003ca href=\"http://www.heart.org/HEARTORG/Conditions/Arrhythmia/AboutArrhythmia/What-is-Atrial-Fibrillation-AFib-or-AF_UCM_423748_Article.jsp#.VusMvOIrKUk\" target=\"_blank\" rel=\"noopener\">atrial fibrillation\u003c/a>, because it means they can check on their heart from home and not have to go to the doctor every few months.\u003c/p>\n\u003cp>\u003cstrong>You mentioned wearables, like Fitbit and Apple Watch. How's that business going? \u003c/strong>\u003c/p>\n\u003cp>I‘m really still quite bullish on wearables, and I think they have become mainstream. It's not just millennials and the \"\u003ca href=\"http://www.telegraph.co.uk/lifestyle/wellbeing/diet/10977877/Are-you-one-of-the-rising-numbers-of-the-worried-well.html\" target=\"_blank\" rel=\"noopener\">worried well\u003c/a>\" that are using these devices; a lot of seniors love them. You're also starting to see insurance companies think about partnering with companies like Apple, and the reason they're doing that isn't necessarily to get their already healthy populations to exercise more; it's about getting to those really sick and costly people that have multiple chronic conditions.\u003c/p>\n\u003cp>\u003cstrong>Do you think investors in the digital health space are more circumspect after the \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/10/13/the-rise-and-fall-of-theranos-a-cartoon-history/\" target=\"_blank\" rel=\"noopener\">Theranos debacle\u003c/a>?\u003c/strong>\u003c/p>\n\u003cp>Some are. Others don't necessarily want companies to invest the time into building a base of evidence before they start selling the product; these investors are looking for their money back in three to five years, like they would get with a consumer internet company.\u003c/p>\n\u003caside class=\"pullquote alignright\">'In a lot of ways, Theranos is just the worst example.'\u003c/aside>\n\u003cp>It's hard to find another company like Theranos, which put patients \u003ca href=\"http://tucson.com/news/local/theranos-to-pay-m-to-arizonans-over-blood-tests-that/article_dacc3bd1-54e0-58dd-92b3-18dec8eb8854.html\" target=\"_blank\" rel=\"noopener\">in danger\u003c/a>. But in a lot of ways, Theranos is just the worst example. More companies are still failing to provide proper evidence. Often they say, \"We're wellness. We're not making claims around disease, so we don't need to bother.\"\u003c/p>\n\u003cp>\u003cstrong>What's the biggest disappointment of the digital health era to date?\u003c/strong>\u003c/p>\n\u003cp>This is going to be controversial, but I don't think telemedicine has panned out to the extent people expected it would by this time. People thought it was going to revolutionize all health care. But I'm not seeing every physician say this is something they want to incorporate into their medical practice, because there's a perception they're not going to get paid as much.\u003c/p>\n\u003cp>Also pretty overhyped in terms of what we're actually seeing out there: AI and big data. \u003ca href=\"https://ww2.kqed.org/futureofyou/2015/08/20/this-robo-eye-doctor-may-help-patients-with-diabetes-keep-sight/\" target=\"_blank\" rel=\"noopener\">Diabetic retinopathy\u003c/a>, for example, is an area where you see a lot of people investing in AI research. Could we take a pile of medical images that have been labeled as showing diabetic retinopathy or not, and then you train AI to do that job in triage?\u003c/p>\n\u003cp>There's been some great results, but that does not mean we're on the cusp of a robo eye doctor, because an actual eye doctor would\u003ca href=\"https://ww2.kqed.org/futureofyou/2016/11/07/will-computers-ever-be-able-to-make-diagnoses-as-well-as-physicians/\" target=\"_blank\" rel=\"noopener\"> need to know\u003c/a> every single medical condition out there that could be affecting this person. I think we’ve been too quick to look at one disease and one use case and say, well, this is evidence that doctors will be replaced.\u003c/p>\n\u003cp>\u003cb>Do you think the Food and Drug Administration and other regulators can keep up with all this? And does the industry \u003cem>want\u003c/em> them to keep up?\u003c/b>\u003c/p>\n\u003cfigure id=\"attachment_437841\" class=\"wp-caption alignright\" style=\"max-width: 640px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/12/chrissymum.jpg\">\u003cimg class=\"wp-image-437841 size-large\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/12/chrissymum-1020x591.jpg\" alt=\"\" width=\"640\" height=\"371\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissymum-1020x591.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissymum-160x93.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissymum-800x463.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissymum-768x445.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissymum-1180x683.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissymum-960x556.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissymum-240x139.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissymum-375x217.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissymum-520x301.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/chrissymum.jpg 1613w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Chrissy Farr discussing Fitbit vs. Apple Watch with her mom, for a CNBC segment. (CNBC)\u003c/figcaption>\u003c/figure>\n\u003cp>I think at the birth of this digital health movement, people thought of the FDA as the big bad wolf. The prevailing narrative was that it's obstructing innovation. Now there seems to be more nuance around that; people recognize that the FDA does have an important role to play. Many of the digital therapeutics companies, for instance, see the FDA as a potential stamp of approval that sets them ahead of a mass of apps that are making false claims and essentially peddling snake oil.\u003c/p>\n\u003cp>So there needs to be a watchdog, but that's not the FDA's role. They're not out there policing companies and investing time into looking through the app store and thinking, \"This dermatology app doesn't look quite right.\"\u003c/p>\n\u003cp>As a result, you get this huge quality variation, and I do sometimes fear that doctors will start prescribing or patients will start using apps that are of lower quality. I think someone needs to step into that role in 2018 so we have a better way of figuring out which apps work and which don't.\u003c/p>\n\u003cp>\u003cstrong>Last question: Occasionally you hear the complaint about digital health that these are primarily tools for young, rich people. Do you think that's valid?\u003c/strong>\u003c/p>\n\u003cp>The true problems of health care, which are particularly an issue for underrepresented groups and minorities, are around how it's paid for. We need massive payment reforms. There's also a lack of investment around social determinants, things like social services and affordable housing, which improve outcomes. \u003cspan style=\"font-weight: 400\">All of these problems are not going to be solved with an AI Band-Aid or by handing someone a Fitbit.\u003c/span>\u003c/p>\n\u003cp>That said, I don't think it's fair to label this entire group of companies as purely helping the rich, wealthy, paranoid types who are just \u003ca href=\"https://www.youtube.com/watch?v=hBA0AH-LSbo\" target=\"_blank\" rel=\"noopener\">dying to live forever\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>A lot of these companies are going after Medicaid populations, and that absolutely makes sense; that's more than 12 million people in California alone. Even Apple, which hasn't traditionally been a health care player, is working with Aetna on a study with Stanford about whether or not they can use the Apple Watch to detect \u003ca href=\"http://www.heart.org/HEARTORG/Conditions/Arrhythmia/AboutArrhythmia/What-is-Atrial-Fibrillation-AFib-or-AF_UCM_423748_Article.jsp#.VusMvOIrKUk\" rel=\"noopener\">afib\u003c/a>. That's not something a young or healthy person would necessarily worry about at all. It's something that over-65, more vulnerable populations with a history of stroke are more at risk for. So you can see even Apple saying this is a tool that we expected would be mostly about consumer delight, but we've found that it can help save lives.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/437796/what-are-digital-healths-biggest-successes-and-disappointments-cnbcs-chrissy-farr-weighs-in","authors":["byline_futureofyou_437796"],"categories":["futureofyou_1060","futureofyou_452","futureofyou_1062","futureofyou_1","futureofyou_73"],"tags":["futureofyou_1428","futureofyou_1427","futureofyou_26","futureofyou_1275","futureofyou_80","futureofyou_25"],"featImg":"futureofyou_437838","label":"source_futureofyou_437796"},"futureofyou_371437":{"type":"posts","id":"futureofyou_371437","meta":{"index":"posts_1591205157","site":"futureofyou","id":"371437","score":null,"sort":[1493017845000]},"guestAuthors":[],"slug":"post-theranos-can-silicon-valley-and-biomed-get-along","title":"Post-Theranos, Can Silicon Valley and Biomed Get Along?","publishDate":1493017845,"format":"standard","headTitle":"Startup Culture | KQED Future of You | KQED Science","labelTerm":{"term":110,"site":"futureofyou"},"content":"\u003cp>Oil and water. Plaid and polka dots. Fish and peanut butter. We all know these things don't go together.\u003c/p>\n\u003cp>It's worth asking how well the \"get in hard, cash out fast\" tech ethos \u003cem>du jour\u003c/em> fits in with the plodding, regulation-heavy culture of health care. It's a valid question in the wake of the \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/07/14/the-rise-and-fall-of-theranos-a-cartoon-history/\">Theranos flameout,\u003c/a> in which a Silicon Valley entrepreneur with no medical background, lots of hype and very little scientific scrutiny raised copious venture backing to revolutionize blood testing, only to see the technology fail in market.\u003c/p>\n\u003cp>Tech culture rewards disruptors. And those who can pivot on a dime.\u003c/p>\n\u003cp>But the process of getting a new drug or medical device to market is long and convoluted, a necessary drag. There's the academic papers subject to peer review, the many stages of clinical testing and government approval. Yes, it all takes years, but\u003ca href=\"http://www.slate.com/articles/health_and_science/science/2017/04/science_is_not_a_free_market_endeavor.html\"> it makes the science transparent\u003c/a>.\u003c/p>\n\u003cp>By contrast, Theranos CEO Elizabeth Holmes was secretive about how the company's technology worked, and the venture firms that pumped millions into Theranos either didn't have the details, or weren't scientifically literate enough to ask the questions that might have raised red flags.\u003c/p>\n\u003caside class=\"pullquote alignright\">'I think Silicon Valley is used to this kind of thing: take an idea that isn’t fully formed and get it out into the world without validation, and maybe it fails later on.'\u003ccite>Dr. Norman Paradis, Darmouth College\u003c/cite>\u003c/aside>\n\u003cp>Stanford professor Dr. John Ioannidis \u003ca href=\"https://www.washingtonpost.com/news/to-your-health/wp/2015/07/03/the-insanely-influential-stanford-professor-behind-biotech-firms-push-to-get-fda-approval-it-probably-doesnt-need/?utm_term=.386a29abd2f8\">saw the red flags early on\u003c/a> --some that even non-scientists could have discovered.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"So the first thing that I did as a researcher, as a scientist, is check the scientific literature,\" he recently\u003ca href=\"http://www.npr.org/sections/alltechconsidered/2016/05/02/475972922/biotechs-theranos-offers-a-cautionary-tale-for-silicon-valley\"> told NPR.\u003c/a> \"How much do we know about what they [Theranos] do? And I couldn't find even a single paper.\"\u003c/p>\n\u003cp>Dr. Norman Paradis is a professor of medicine at Dartmouth College who works as a consultant for diagnostic startups. He has given presentations to venture firms, and he says the fact that Theranos got hundreds of millions of dollars and went to market without proving itself makes it \"a Silicon Valley event, and not a biomedical event.\"\u003c/p>\n\u003cp>\"I think Silicon Valley is used to this kind of thing: take an idea that isn’t fully formed and get it out into the world without validation, and maybe it fails later on.\" Whereas in the biomedical field you almost always need to have data early on.\u003c/p>\n\u003cp>So what happened? The wrong people were asking the questions, says Paradis. \"If you look at the list of who invested in Theranos, none of the venture capitalists who regularly do biomedical diagnostics were investors,\" he says. The firms with relevant medical expertise steered clear. \"Normally you show up to present an idea to these firms, they really know what you're talking about,\" he added.\u003c/p>\n\u003cp>At a conference it hosted in January, The Economist asked a panel of venture capitalists about the broader perception of a culture clash between scientists and Silicon Valley entrepreneurs ... and the Theranos example, specifically. The panelists represented three firms that invest in life science and healthcare ventures: Lisa Suennen from\u003ca href=\"https://www.geventures.com/\"> GE Ventures\u003c/a>, David Sabow from\u003ca href=\"https://www.svb.com/\"> Silicon Valley Bank\u003c/a>, and Emily Melton from \u003ca href=\"https://dfj.com/\">DFJ Venture Capital\u003c/a>.\u003c/p>\n\u003cp>Here's the full video:\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe width=\"560\" height=\"315\" src=\"https://www.youtube.com/embed/6GAZcb9jyT0\" frameborder=\"0\" scrolling=\"yes\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>The panelists agreed that some of the accepted rules that govern much of today's startup development and commercialization seem to run counter to those of science-based startups in medicine and biotech. And that there is a tension between the two sides.\u003c/p>\n\u003cp>\"It's a solution sell versus a product sell,\" said Melton from DFJ. \"Investors think of things as products, whereas people on the health care side think of solutions.\"[contextly_sidebar id=\"MhTn4bRZadvdRBhNxWpIi87Ako9TIWSD\"]\u003c/p>\n\u003cp>Suennen from GE Ventures agreed. \"On the tech side, people are practically allergic to providing services,\" she said. But in the case of health care, \"You can’t take the people out of caring for people.\"\u003c/p>\n\u003cp>And, said Suennen, the timelines involved are vastly different.\u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>\"In the health care world, the time horizon for investments to mature and exit is pretty long compared to other marketplaces – usually 7 to 10 years,\" Suennen added.\u003c/p>\n\u003cp>Melton noted that won't deter some venture firms from investing in health care. \"We’re willing to be more patient if we feel like there’s a great opportunity at the end,\" she said, adding that, \"We do need to have a clear path to commercialization.\"\u003c/p>\n\u003cp>Of course a startup can't come to market without jumping through the hoops -- specifically, the FDA approval process. That's why these panelists said regulation is a -- gasp! -- \u003cem>good\u003c/em> thing. \"You need regulation in health care, for the most part, to make the market grow,\" Suennen said.\u003c/p>\n\u003cp>Everyone on the panel agreed that the next big thing in digital health or biomedicine will not emerge until tech innovators and medical experts work together: venture companies need the new ideas from the tech side combined with the health care knowledge. And that's starting to happen.\u003c/p>\n\u003cp>Since most biomedical startups are still in early funding stages, it will take a few years to see a new model of collaboration emerge and produce significant breakthroughs in biomed.\u003c/p>\n\u003cp>\"You need that life sciences perspective to understand how has it been done, what works, what doesn’t -- in order to totally revolutionize it,\" said Sabow, from Silicon Valley Bank. \"People who are trying to do it without that multidimensional perspective are going to spend a lot of money, get a lot of buzz, but not necessarily have the revolutionary impact they’re hoping for.\"\u003c/p>\n\u003cp>There was some awkwardness when Melton was asked about Theranos. Her firm, DFJ, pumped $500,000 in seed money into the venture early on. Interestingly, she all but said that her firm did not have access to data from Theranos when they cut the check.\u003c/p>\n\u003cp>\"I think transparency is critical. You can’t mess around with people’s lives and you can’t put products out there without being very transparent about what you’re doing. Data is very critical, and letting people have access to the data.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>The Theranos debacle has a \"tragic\" element that goes beyond hundreds of lost jobs and lost investment, says Paradis. For \u003ca href=\"https://www.forbes.com/sites/petercohan/2016/04/15/can-theranos-raise-new-capital/#6b421282406b\">$750 million\u003c/a>, you could have funded at least seven good startups, he says. \"It's almost impossible to get a complete new diagnostic test developed, because funders are so conservative [when it comes to medical products],\" he says. \"That’s even less likely to happen now.\"\u003c/p>\n\n","blocks":[],"excerpt":"Tech innovation can find common ground with scientific products in the health sector under certain conditions, VCs say.","status":"publish","parent":0,"modified":1493057767,"stats":{"hasAudio":false,"hasVideo":true,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":28,"wordCount":1108},"headData":{"title":"Post-Theranos, Can Silicon Valley and Biomed Get Along? | KQED","description":"Tech innovation can find common ground with scientific products in the health sector under certain conditions, VCs say.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Post-Theranos, Can Silicon Valley and Biomed Get Along?","datePublished":"2017-04-24T07:10:45.000Z","dateModified":"2017-04-24T18:16:07.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"371437 https://ww2.kqed.org/futureofyou/?p=371437","disqusUrl":"https://ww2.kqed.org/futureofyou/2017/04/24/post-theranos-can-silicon-valley-and-biomed-get-along/","disqusTitle":"Post-Theranos, Can Silicon Valley and Biomed Get Along?","customPermalink":"2017/04/13/post-theranos-can-silicon-valley-and-biomed-get-along/","path":"/futureofyou/371437/post-theranos-can-silicon-valley-and-biomed-get-along","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Oil and water. Plaid and polka dots. Fish and peanut butter. We all know these things don't go together.\u003c/p>\n\u003cp>It's worth asking how well the \"get in hard, cash out fast\" tech ethos \u003cem>du jour\u003c/em> fits in with the plodding, regulation-heavy culture of health care. It's a valid question in the wake of the \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/07/14/the-rise-and-fall-of-theranos-a-cartoon-history/\">Theranos flameout,\u003c/a> in which a Silicon Valley entrepreneur with no medical background, lots of hype and very little scientific scrutiny raised copious venture backing to revolutionize blood testing, only to see the technology fail in market.\u003c/p>\n\u003cp>Tech culture rewards disruptors. And those who can pivot on a dime.\u003c/p>\n\u003cp>But the process of getting a new drug or medical device to market is long and convoluted, a necessary drag. There's the academic papers subject to peer review, the many stages of clinical testing and government approval. Yes, it all takes years, but\u003ca href=\"http://www.slate.com/articles/health_and_science/science/2017/04/science_is_not_a_free_market_endeavor.html\"> it makes the science transparent\u003c/a>.\u003c/p>\n\u003cp>By contrast, Theranos CEO Elizabeth Holmes was secretive about how the company's technology worked, and the venture firms that pumped millions into Theranos either didn't have the details, or weren't scientifically literate enough to ask the questions that might have raised red flags.\u003c/p>\n\u003caside class=\"pullquote alignright\">'I think Silicon Valley is used to this kind of thing: take an idea that isn’t fully formed and get it out into the world without validation, and maybe it fails later on.'\u003ccite>Dr. Norman Paradis, Darmouth College\u003c/cite>\u003c/aside>\n\u003cp>Stanford professor Dr. John Ioannidis \u003ca href=\"https://www.washingtonpost.com/news/to-your-health/wp/2015/07/03/the-insanely-influential-stanford-professor-behind-biotech-firms-push-to-get-fda-approval-it-probably-doesnt-need/?utm_term=.386a29abd2f8\">saw the red flags early on\u003c/a> --some that even non-scientists could have discovered.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"So the first thing that I did as a researcher, as a scientist, is check the scientific literature,\" he recently\u003ca href=\"http://www.npr.org/sections/alltechconsidered/2016/05/02/475972922/biotechs-theranos-offers-a-cautionary-tale-for-silicon-valley\"> told NPR.\u003c/a> \"How much do we know about what they [Theranos] do? And I couldn't find even a single paper.\"\u003c/p>\n\u003cp>Dr. Norman Paradis is a professor of medicine at Dartmouth College who works as a consultant for diagnostic startups. He has given presentations to venture firms, and he says the fact that Theranos got hundreds of millions of dollars and went to market without proving itself makes it \"a Silicon Valley event, and not a biomedical event.\"\u003c/p>\n\u003cp>\"I think Silicon Valley is used to this kind of thing: take an idea that isn’t fully formed and get it out into the world without validation, and maybe it fails later on.\" Whereas in the biomedical field you almost always need to have data early on.\u003c/p>\n\u003cp>So what happened? The wrong people were asking the questions, says Paradis. \"If you look at the list of who invested in Theranos, none of the venture capitalists who regularly do biomedical diagnostics were investors,\" he says. The firms with relevant medical expertise steered clear. \"Normally you show up to present an idea to these firms, they really know what you're talking about,\" he added.\u003c/p>\n\u003cp>At a conference it hosted in January, The Economist asked a panel of venture capitalists about the broader perception of a culture clash between scientists and Silicon Valley entrepreneurs ... and the Theranos example, specifically. The panelists represented three firms that invest in life science and healthcare ventures: Lisa Suennen from\u003ca href=\"https://www.geventures.com/\"> GE Ventures\u003c/a>, David Sabow from\u003ca href=\"https://www.svb.com/\"> Silicon Valley Bank\u003c/a>, and Emily Melton from \u003ca href=\"https://dfj.com/\">DFJ Venture Capital\u003c/a>.\u003c/p>\n\u003cp>Here's the full video:\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe width=\"560\" height=\"315\" src=\"https://www.youtube.com/embed/6GAZcb9jyT0\" frameborder=\"0\" scrolling=\"yes\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>The panelists agreed that some of the accepted rules that govern much of today's startup development and commercialization seem to run counter to those of science-based startups in medicine and biotech. And that there is a tension between the two sides.\u003c/p>\n\u003cp>\"It's a solution sell versus a product sell,\" said Melton from DFJ. \"Investors think of things as products, whereas people on the health care side think of solutions.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Suennen from GE Ventures agreed. \"On the tech side, people are practically allergic to providing services,\" she said. But in the case of health care, \"You can’t take the people out of caring for people.\"\u003c/p>\n\u003cp>And, said Suennen, the timelines involved are vastly different.\u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>\"In the health care world, the time horizon for investments to mature and exit is pretty long compared to other marketplaces – usually 7 to 10 years,\" Suennen added.\u003c/p>\n\u003cp>Melton noted that won't deter some venture firms from investing in health care. \"We’re willing to be more patient if we feel like there’s a great opportunity at the end,\" she said, adding that, \"We do need to have a clear path to commercialization.\"\u003c/p>\n\u003cp>Of course a startup can't come to market without jumping through the hoops -- specifically, the FDA approval process. That's why these panelists said regulation is a -- gasp! -- \u003cem>good\u003c/em> thing. \"You need regulation in health care, for the most part, to make the market grow,\" Suennen said.\u003c/p>\n\u003cp>Everyone on the panel agreed that the next big thing in digital health or biomedicine will not emerge until tech innovators and medical experts work together: venture companies need the new ideas from the tech side combined with the health care knowledge. And that's starting to happen.\u003c/p>\n\u003cp>Since most biomedical startups are still in early funding stages, it will take a few years to see a new model of collaboration emerge and produce significant breakthroughs in biomed.\u003c/p>\n\u003cp>\"You need that life sciences perspective to understand how has it been done, what works, what doesn’t -- in order to totally revolutionize it,\" said Sabow, from Silicon Valley Bank. \"People who are trying to do it without that multidimensional perspective are going to spend a lot of money, get a lot of buzz, but not necessarily have the revolutionary impact they’re hoping for.\"\u003c/p>\n\u003cp>There was some awkwardness when Melton was asked about Theranos. Her firm, DFJ, pumped $500,000 in seed money into the venture early on. Interestingly, she all but said that her firm did not have access to data from Theranos when they cut the check.\u003c/p>\n\u003cp>\"I think transparency is critical. You can’t mess around with people’s lives and you can’t put products out there without being very transparent about what you’re doing. Data is very critical, and letting people have access to the data.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The Theranos debacle has a \"tragic\" element that goes beyond hundreds of lost jobs and lost investment, says Paradis. For \u003ca href=\"https://www.forbes.com/sites/petercohan/2016/04/15/can-theranos-raise-new-capital/#6b421282406b\">$750 million\u003c/a>, you could have funded at least seven good startups, he says. \"It's almost impossible to get a complete new diagnostic test developed, because funders are so conservative [when it comes to medical products],\" he says. \"That’s even less likely to happen now.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/371437/post-theranos-can-silicon-valley-and-biomed-get-along","authors":["8664"],"series":["futureofyou_110"],"categories":["futureofyou_1"],"tags":["futureofyou_1246","futureofyou_26","futureofyou_814","futureofyou_617","futureofyou_340"],"collections":["futureofyou_1097"],"featImg":"futureofyou_215272","label":"futureofyou_110"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. 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But is this once sleepy suburb ready for them?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/American-Suburb-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/news/series/american-suburb-podcast","meta":{"site":"news","source":"kqed","order":"13"},"link":"/news/series/american-suburb-podcast/","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=1287748328","tuneIn":"https://tunein.com/radio/American-Suburb-p1086805/","rss":"https://ww2.kqed.org/news/series/american-suburb-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMzMDExODgxNjA5"}},"baycurious":{"id":"baycurious","title":"Bay Curious","tagline":"Exploring the Bay Area, one question at a time","info":"KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. 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Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.","airtime":"MON-FRI 3am-9am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.npr.org/programs/morning-edition/","meta":{"site":"news","source":"npr"},"link":"/radio/program/morning-edition"},"onourwatch":{"id":"onourwatch","title":"On Our Watch","tagline":"Police secrets, unsealed","info":"For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg","imageAlt":"On Our Watch from NPR and KQED","officialWebsiteLink":"/podcasts/onourwatch","meta":{"site":"news","source":"kqed","order":"1"},"link":"/podcasts/onourwatch","subscribe":{"apple":"https://podcasts.apple.com/podcast/id1567098962","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw","npr":"https://rpb3r.app.goo.gl/onourwatch","spotify":"https://open.spotify.com/show/0OLWoyizopu6tY1XiuX70x","tuneIn":"https://tunein.com/radio/On-Our-Watch-p1436229/","stitcher":"https://www.stitcher.com/show/on-our-watch","rss":"https://feeds.npr.org/510360/podcast.xml"}},"on-the-media":{"id":"on-the-media","title":"On The Media","info":"Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us","airtime":"SUN 2pm-3pm, MON 12am-1am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png","officialWebsiteLink":"https://www.wnycstudios.org/shows/otm","meta":{"site":"news","source":"wnyc"},"link":"/radio/program/on-the-media","subscribe":{"apple":"https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2","tuneIn":"https://tunein.com/radio/On-the-Media-p69/","rss":"http://feeds.wnyc.org/onthemedia"}},"our-body-politic":{"id":"our-body-politic","title":"Our Body Politic","info":"Presented by KQED, KCRW and KPCC, and created and hosted by award-winning journalist Farai Chideya, Our Body Politic is unapologetically centered on reporting on not just how women of color experience the major political events of today, but how they’re impacting those very issues.","airtime":"SAT 6pm-7pm, SUN 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Our-Body-Politic-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://our-body-politic.simplecast.com/","meta":{"site":"news","source":"kcrw"},"link":"/radio/program/our-body-politic","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/our-body-politic/id1533069868","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5zaW1wbGVjYXN0LmNvbS9feGFQaHMxcw","spotify":"https://open.spotify.com/show/4ApAiLT1kV153TttWAmqmc","rss":"https://feeds.simplecast.com/_xaPhs1s","tuneIn":"https://tunein.com/podcasts/News--Politics-Podcasts/Our-Body-Politic-p1369211/"}},"pbs-newshour":{"id":"pbs-newshour","title":"PBS NewsHour","info":"Analysis, background reports and updates from the PBS NewsHour putting today's news in context.","airtime":"MON-FRI 3pm-4pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.pbs.org/newshour/","meta":{"site":"news","source":"pbs"},"link":"/radio/program/pbs-newshour","subscribe":{"apple":"https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2","tuneIn":"https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/","rss":"https://www.pbs.org/newshour/feeds/rss/podcasts/show"}},"perspectives":{"id":"perspectives","title":"Perspectives","tagline":"KQED's series of of daily listener commentaries since 1991","info":"KQED's series of of daily listener commentaries since 1991.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Perspectives-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/perspectives/","meta":{"site":"radio","source":"kqed","order":"15"},"link":"/perspectives","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/id73801135","npr":"https://www.npr.org/podcasts/432309616/perspectives","rss":"https://ww2.kqed.org/perspectives/category/perspectives/feed/","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvcGVyc3BlY3RpdmVzL2NhdGVnb3J5L3BlcnNwZWN0aXZlcy9mZWVkLw"}},"planet-money":{"id":"planet-money","title":"Planet Money","info":"The economy explained. 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