⏭️Chris' Newsletter: No. 3
What's noteworthy and what's next in digital health & hardware.
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👩⚖️ Regulatory
Telling people how their DNA will affect their drug response doesn’t sit well with the FDA. This feels similar to when the FDA cracked down on Withings for telling consumers their Pulse Wave Velocity (a proxy for blood pressure). This comes as genome sequencing companies are looking for ways to add more value. Link ($)
FDA shuts down Opternative/Visbily’s online vision test. It seems there should be a place for a lower-cost, less accurate vision test, perhaps complimenting a higher accuracy one every X years. This feels like the result of lobbying . Link
💸 Healthcare Economics
For $50 shoppers can purchase a single doctor “visit” from the a Texas grocery chain’s pharmacy counter. The “visit” takes place via an app. The firms offering the service (MDBox) is likely using this as a way to collect initial data (banking that the familiarity of the chain will have high conversion) rather than as the beginning for a long term strategy. Link
⌚ Wearables and Apps
Fitbit announces Fitbit premium for $10/mo or $80/year. A lot of news this month about fitbit and services… good to see them making moves. In exchange for your money fitbit will apparently offer you more health/sleep info than you get with the free versions and access to several programs with names like “Intro to Healthy Habits”, “Get More Zzz’s”, etc. There is not much of an indication that people are willing to pay subscriptions for that sort of thing, but perhaps Fitbit can unlock something here. Link
Movement measurement firm Figur8 raises $7.5M in seed. The value proposition is to use the unprecedented precision of the motion information to better inform treatment. Closing the gap between that data and an actionable insight for the doctor will be a challenge. Link
Apple Watch 5 is expected to be announced soon. From a health perspective the series 4 had an interesting change to the PPG sensor and of course the EKG, both of which were marginal improvements. Sleep is widely expected to be added (finally) with some speculation about blood oxygenation (SpO2) which has diagnostic value for several disease states, notably sleep apnea (as fitbit is very aware). Link
🧪Labwork
Baze, a firm that uses at-home blood tests to sell a personalized vitamins raises $6M. The tests is $99 and then the supplements are $15/mo. Feels like putting on a patina of science to justify high margin business. Would be more valuable if there was a significant risk of overdosing on multivitamins. Link
🛠️Hardware
Apple Watch will be subject to a 15% tariff starting at midnight Sunday. It’s tough to imagine a transparent price hike. I suspect Apple will eat it. Of course this also applies more broadly to other devices. There’s been a lot of talk from firms small and large alike in looking to other locations (Singapore, Malaysia, Vietnam, Korea) for manufacturing of their products. Link
A great breakdown of International Commercial Terms (incoterms). Speaking of international trade. Link
Laser welded ceramics. Ceramics are wonderful. They don’t cause allergic reactions, don’t disrupt bluetooth signals, don’t scratch, and don’t look cheap. They are however super difficult ($$) to manufacture and join to other parts. I welcome any advancement that lets me use ceramics more often. Link
👩🔬 Trials & Studies
The All of Us research program is launching an awareness campaign to familarize providers with precision medicine. This is one of the biggest hurdles for adoption of a lot of cool tech. The knowledge just doesn’t exist within provider institutions to process new types of data. Any awareness and education campaign is a good one. Link
🔒Privacy and security
~30M people have got their DNA sequenced from consumer companies and it’s unclear from where future growth will come. The group of people who were super geeked about their ancestry has been tapped. Some combination of more tangible benefits, lower cost, and better assurances on privacy is needed. Link
The combination of privacy regulations is confusing. HIPAA was created in 1996 and so, naturally, doesn’t map well to the modern world, so various states (notably California) have come up with other regualations on how health data is to be treated. On one hand this is a big friction that favors large incumbent firms, on the other hand treatment health data deserves at least as much scrutiny as was given to the General Data Protection Regulation (GDPR). It’s unclear how this get’s resolved. Link
Methods for de-identification of personal health information. Lots of methods. A good resource though. Link
😖 Mental Health and Addiction
A global look at the uneven toll of suicide. It’s falling in many places, but it’s rising in the U.S. Link
Democratic presidential candidates on their mental health positions. Link
📃 Other Things
The largest study to date on the genetic basis of sexuality has revealed five spots on the human genome that are linked to same-sex sexual behaviour… but none of the markers are reliable enough to predict someone’s sexuality. Link
Optimists live longer. Cool. Link
📖 Books I’m reading
Surveillance Capitalism by Shoshana Zuboff
History of Europe by Norman Davies
Best,
Chris
P.S. We should be better friends. Send me a note, I’ll buy you tea/coffee :)