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The next healthcare revolution will have AI at its center

The global pandemic has heightened our understanding and sense of importance of our own health and the fragility of healthcare systems around the world. We’ve all come to realize how archaic many of our health processes are, and that, if we really want to, we can move at lightning speed. This is already leading to a massive acceleration in both the investment and application of artificial intelligence in the health and medical ecosystems.

Modern medicine in the 20th century benefited from unprec­edented scientific breakthroughs, resulting in improvements in every as­pect of healthcare. As a result, human life expectancy increased from 31 years in 1900 to 72 years in 2017. Today, I believe we are on the cusp of another healthcare revolution — one driven by artificial intelligence (AI). Advances in AI will usher in the era of modern medicine in truth.

Over the coming decades, we can expect medical diagnosis to evolve from an AI tool that provides analysis of options to an AI assistant that recommends treatments.

Digitization enables powerful AI

The healthcare sector is seeing massive digitization of everything from patient records and radiology data to wearable computing and multiomics. This will redefine healthcare as a data-driven industry, and when that happens, it will leverage the power of AI — its ability to continuously improve with more data.

When there is enough data, AI can do a much more accurate job of diagnosis and treatment than human doctors by absorbing and checking billions of cases and outcomes. AI can take into account everyone’s data to personalize treatment accordingly, or keep up with a massive number of new drugs, treatments and studies. Doing all of this well is beyond human capabilities.

AI-powered diagnosis

I anticipate diagnostic AI will surpass all but the best doctors in the next 20 years. Studies have shown that AI trained on sizable data can outperform physicians in several areas of medical diagnosis regarding brain tumors, eye disease, breast cancer, skin cancer and lung cancer. Further trials are needed, but as these technologies are deployed and more data is gathered, the AI stands to outclass doctors.

We will eventually see diagnostic AI for general practitioners, one disease at a time, to gradually cover all diagnoses. Over time, AI may become capable of acting as your general practitioner or family doctor.

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AI startup Sorcero secures $10M for language intelligence platform

Sorcero announced Thursday a $10 million Series A round of funding to continue scaling its medical and technical language intelligence platform.

The latest funding round comes as the company, headquartered in Washington, D.C. and Cambridge, Massachusetts, sees increased demand for its advanced analytics from life sciences and technical companies. Sorcero’s natural language processing platform makes it easier for subject-matter experts to find answers to their questions to aid in better decision making.

CityRock Venture Partners, the growth fund of H/L Ventures, and Harmonix Fund co-led the round and were joined by new investors Rackhouse, Mighty Capital and Leawood VC, as well as existing investors, Castor Ventures and WorldQuant Ventures. The new investment gives Sorcero a total of $15.7 million in funding since it was founded in 2018.

Prior to starting Sorcero, Dipanwita Das, co-founder and CEO, told TechCrunch she was working in public policy, a place where scientific content is useful, but often a source of confusion and burden. She thought there had to be a more effective way to make better decisions across the healthcare value chain. That’s when she met co-founders Walter Bender and Richard Graves and started the company.

“Everything is in service of subject-matter experts being faster, better and less prone to errors,” Das said. “Advances of deep learning with accuracy add a lot of transparency. We are used by science affairs and regulatory teams whose jobs it is to collect scientific data and effectively communicate it to a variety of stakeholders.”

The total addressable market for language intelligence is big — Das estimated it to be $42 billion just for the life sciences sector. Due to the demand, the co-founders have seen the company grow at 324% year over year since 2020, she added.

Raising a Series A enables the company to serve more customers across the life sciences sector. The company will invest in talent in both engineering and on the commercial side. It will also put some funds into Sorcero’s go-to-market strategy to go after other use cases.

In the next 12 to 18 months, a big focus for the company will be scaling into product market fit in the medical affairs and regulatory space and closing new partnerships.

Oliver Libby, partner at CityRock Venture Partners, said Sorcero’s platform “provides the rails for AI solutions for companies” that have traditionally found issues with AI technologies as they try to integrate data sets that are already in existence in order to run analysis effectively on top of that.

Rather than have to build custom technology and connectors, Sorcero is “revolutionizing it, reducing time and increasing accuracy,” and if AI is to have a future, it needs a universal translator that plugs into everything, he said.

“One of the hallmarks in the response to COVID was how quickly the scientific community had to do revolutionary things,” Libby added. “The time to vaccine was almost a miracle of modern science. One of the first things they did was track medical resources and turn them into a hook for pharmaceutical companies. There couldn’t have been a better use case for Sorcero than COVID.”

 

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Tonal adds live classes to its strength training workouts

Wall-mounted fitness startup Tonal this morning announced that it’s bringing live courses to it portfolio of strength training workouts. The company did a soft launch of the live offering back in December of last year, though at the time, it wasn’t live, so much as prerecorded — “live, on tape,” to steal a line from The Larry Sanders Show.

“[Y]our coach works out with you — just like in a live class,” the company wrote. Our Live (Beta) workouts combine the energizing feeling of working out alongside a coach with Tonal’s ability to count your reps and wait for you to complete each set […] It’s all on-demand, so you can work out whenever it fits into your schedule.”

The new offering brings the company’s content selection more in-line with leaders in the home fitness space like Peloton. Certainly live isn’t for everyone, but many users do appreciate the motivation that comes with a fixed schedule, as well as the sense of community one derives from working out with others.

The new offering provides real-time feedback from coaches, coupled with a “social zone” for interacting with fellow Tonal users. The portfolio is also getting four new coaches for live workouts. After a day, live workouts will be archived in Tonal’s on-demand offerings.

“As our community has grown over the past few years, we’ve been encouraged by the organic social engagement, the craving for more interaction with our coaches, and the excitement that comes from reaching new milestones,” founder and CEO Aly Orady said in a release. “Tonal Live will allow us to connect these elements through a studio experience while retaining the foundation of what differentiates our workouts: personalization, guidance, and feedback.”

Founded in 2015, the San Francisco-based company is among those connected fitness brands that saw a major boost as the pandemic forced many to rethink their workout routines. Tonal has raised $450 million to date, including a $250 million Series E that raised its valuation to $1.6 billion, back in March.

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What we expect from next week’s Apple event

We’ve been scouring the latest rumors and leaks and playing all of The Mamas and The Papas songs forward and backward to get the best possible picture of what we’re in store for with next Tuesday’s “California Streaming’” event.

The invites, which went out a week in advance, don’t appear to give the game away here. There was some extremely cool AR trickery, accessible through Safari on mobile, which could point to some fancy camera upgrades, though augmented reality has become a bit of a staple on these invites.

The California Streaming title, meanwhile, seems likely to be more of a nod to the all-virtual nature of the event, rather than anything to do with, say, Apple TV (of course, we’ve been one-more-thinged in the past). And as for that lovely shot of the Sierras — that could well be a nod to macOS, though the company has moved onto Monterey. It seems just as likely to be a reference to the aforementioned title.

The biggest, simplest and most important answer to the question of what to expect is a new iPhone. Last year’s models saw a notable delay due to COVID-19-related supply chain bottlenecking. Supply chain problems have persisted, of course, but by all accounts, the company appears to be back on track with its pre-pandemic release cycle.

The iPhone 12’s biggest upgrade was, of course, the long-awaited addition of 5G. That, coupled with the delay, led Apple to some pretty massive sales quarters amid a broader stalling of the overall mobile market. While other manufacturers have skipped the number out of superstitious concerns, Apple seems firmly on board with iPhone 13 (even as renders of its successor, the iPhone 14 have reportedly already leaked).

Image Credits: Getty Images / Qi Heng/VCG

Recent reports suggest that the iPhone 13 will arrive in four different configurations — much like its predecessor. So: the iPhone 13, 13 Mini, 13 Pro and 13 Pro Max. The screen sizes should remain the same: 5.4, 6.1 (x2) and 6.7 inches. A separate report, meanwhile, suggests that we’ll see additional colors, with the full lineup being black, white, blue, purple, pink (rather than green) and Product (Red). But, keep in mind that offering different color availabilities in different markets isn’t entirely out of the question.

Unsurprisingly, camera upgrades appear to be the biggest news here. Word from analyst Ming-Chi Kuo is that last year’s Pro Max model specs will graduate to the rest of the line (including, potentially, lidar). A ProRes video mode is said to be following the addition of ProRAW to further advance the handset’s bonafides as a semi-pro video shooting rig. Cinematic Video, meanwhile, is said to bring a Portrait-mode-style effect to video. Kuo has also suggested that the devices will be getting a feature based on the Qualcomm X60 that allows for emergency satellite calls — reportedly only available in select markets.

Of course, the phone will also be getting Apple’s latest chip, the A15, said to be coupled with 120 Hz ProMotion display. Apple could also be bringing an always-on feature to the screen, hopefully with minimal impact on battery life. Looks-wise we anticipate it will be more or less the same as its predecessor, albeit with a somewhat smaller camera notch up front — though not to the point of the fake Ted Lasso iPhone. The camera bump around back, meanwhile, is said to be getting larger, perhaps offering an improved telephoto lens.

Oh, and apparently they’ll be more expensive than the iPhone 12 — clearly not one of the new features Apple is going to be actively promoting.

Image Credits: Apple

The Apple Watch 7 seems destined to be the other big news of the event. Apple’s massively popular wearable is reportedly set to get more massive, with a larger display, resulting in a slightly larger case size, from 40 mm and 44 mm to 41 mm and 45 mm. The overall size won’t be too large a change, however, as the company is said to be reducing its bezels this go-round.

Perhaps the most exciting rumor around the Watch is the addition of significant battery life. That’s long felt like a blind spot for the product, compared to competing smartwatches — particularly after Apple significantly improved sleep tracking. Most aren’t anticipating major new health features for the Watch this outing, which is a bit of a surprise here, given that health and fitness have been a major cornerstone for Apple.

Image Credits: TechCrunch

AirPods 3 seem like a reasonably good bet. The latest version of the company’s entry-level earbuds (and their case) are said to be getting a more Pro-style redesign, along with a new chip that’s designed to improve battery life. Active noise cancelation and replaceable tips are apparently not going to make an appearance to maintain the distinction between the two models.

With the company’s rangewide upgrade to its own silicon chugging along, don’t be surprised if we see a number of new Macs. Rumors suggest a new MacBook Pro, Mac Mini and a larger, 27-inch version of its ARM-powered iMac.

The event kicks off Tuesday, September 14 at 10 a.m. PDT/1 p.m. EDT. We’ll be here, bringing you the news as it arrives.
Read more about Apple's Fall 2021 Event on TechCrunch

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Seqera Labs grabs $5.5M to help sequence COVID-19 variants and other complex data problems

Bringing order and understanding to unstructured information located across disparate silos has been one of the more significant breakthroughs of the big data era, and today a European startup that has built a platform to help with this challenge specifically in the area of life sciences — and has, notably, been used by labs to sequence and so far identify two major COVID-19 variants — is announcing some funding to continue building out its tools to a wider set of use cases, and to expand into North America.

Seqera Labs, a Barcelona-based data orchestration and workflow platform tailored to help scientists and engineers order and gain insights from cloud-based genomic data troves, as well as to tackle other life science applications that involve harnessing complex data from multiple locations, has raised $5.5 million in seed funding.

Talis Capital and Speedinvest co-led this round, with participation also from previous backer BoxOne Ventures and a grant from the Chan Zuckerberg Initiative, Mark Zuckerberg and Dr. Priscilla Chan’s effort to back open source software projects for science applications.

Seqera — a portmanteau of “sequence” and “era”, the age of sequencing data, basically — had previously raised less than $1 million, and quietly, it is already generating revenues, with five of the world’s biggest pharmaceutical companies part of its customer base, alongside biotech and other life sciences customers.

Seqera was spun out of the Centre for Genomic Regulation, a biomedical research center based out of Barcelona, where it was built as the commercial application of Nextflow, open source workflow and data orchestration software originally created by the founders of Seqera, Evan Floden and Paolo Di Tommaso, at the CGR.

Floden, Seqera’s CEO, told TechCrunch that he and Di Tommaso were motivated to create Seqera in 2018 after seeing Nextflow gain a lot of traction in the life science community, and subsequently getting a lot of repeat requests for further customization and features. Both Nextflow and Seqera have seen a lot of usage: the Nextflow runtime has been downloaded more than 2 million times, the company said, while Seqera’s commercial cloud offering has now processed more than 5 billion tasks.

The COVID-19 pandemic is a classic example of the acute challenge that Seqera (and by association Nextflow) aims to address in the scientific community. With COVID-19 outbreaks happening globally, each time a test for COVID-19 is processed in a lab, live genetic samples of the virus get collected. Taken together, these millions of tests represent a goldmine of information about the coronavirus and how it is mutating, and when and where it is doing so. For a new virus about which so little is understood and that is still persisting, that’s invaluable data.

So the problem is not if the data exists for better insights (it does); it is that it’s nearly impossible to use more legacy tools to view that data as a holistic body. It’s in too many places, and there is just too much of it, and it’s growing every day (and changing every day), which means that traditional approaches of porting data to a centralized location to run analytics on it just wouldn’t be efficient, and would cost a fortune to execute.

That is where Segera comes in. The company’s technology treats each source of data across different clouds as a salient pipeline which can be merged and analyzed as a single body, without that data ever leaving the boundaries of the infrastructure where it already exists. Customised to focus on genomic troves, scientists can then query that information for more insights. Seqera was central to the discovery of both the Alpha and Delta variants of the virus, and work is still ongoing as COVID-19 continues to hammer the globe.

Seqera is being used in other kinds of medical applications, such as in the realm of so-called “precision medicine.” This is emerging as a very big opportunity in complex fields like oncology: cancer mutates and behaves differently depending on many factors, including genetic differences of the patients themselves, which means that treatments are less effective if they are “one size fits all.”

Increasingly, we are seeing approaches that leverage machine learning and big data analytics to better understand individual cancers and how they develop for different populations, to subsequently create more personalized treatments, and Seqera comes into play as a way to sequence that kind of data.

This also highlights something else notable about the Seqera platform: it is used directly by the people who are analyzing the data — that is, the researchers and scientists themselves, without data specialists necessarily needing to get involved. This was a practical priority for the company, Floden told me, but nonetheless, it’s an interesting detail of how the platform is inadvertently part of that bigger trend of “no-code/low-code” software, designed to make highly technical processes usable by non-technical people.

It’s both the existing opportunity and how Seqera might be applied in the future across other kinds of data that lives in the cloud that makes it an interesting company, and it seems an interesting investment, too.

“Advancements in machine learning, and the proliferation of volumes and types of data, are leading to increasingly more applications of computer science in life sciences and biology,” said Kirill Tasilov, principal at Talis Capital, in a statement. “While this is incredibly exciting from a humanity perspective, it’s also skyrocketing the cost of experiments to sometimes millions of dollars per project as they become computer-heavy and complex to run. Nextflow is already a ubiquitous solution in this space and Seqera is driving those capabilities at an enterprise level – and in doing so, is bringing the entire life sciences industry into the modern age. We’re thrilled to be a part of Seqera’s journey.”

“With the explosion of biological data from cheap, commercial DNA sequencing, there is a pressing need to analyse increasingly growing and complex quantities of data,” added Arnaud Bakker, principal at Speedinvest. “Seqera’s open and cloud-first framework provides an advanced tooling kit allowing organisations to scale complex deployments of data analysis and enable data-driven life sciences solutions.”

Although medicine and life sciences are perhaps Seqera’s most obvious and timely applications today, the framework originally designed for genetics and biology can be applied to any a number of other areas: AI training, image analysis and astronomy are three early use cases, Floden said. Astronomy is perhaps very apt, since it seems that the sky is the limit.

“We think we are in the century of biology,” Floden said. “It’s the center of activity and it’s becoming data-centric, and we are here to build services around that.”

Seqera is not disclosing its valuation with this round.

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Singapore-based caregiving startup Homage raises $30M Series C

Homage, the caregiving-focused startup, has raised a $30 million Series C led by Sheares Healthcare Group, which is wholly-owned by investment firm Temasek. Other participants included new investors DG Daiwa Ventures and Sagana Capital, and returning backers East Ventures (Growth), HealthXCapital, SeedPlus, Trihill Capital and Alternate Ventures.

The new funding will be used to develop Homage’s technology, continue integrating with aged and disability care payer and provider infrastructure and speed-up its regional expansion through partnerships with hospitals and care providers. Homage currently operates in Singapore, Malaysia and Australia.

The Singapore-based company’s services include home visits from caregivers, nurses, therapists and doctors; telemedicine; and services for chronic illnesses. One of the reasons Homage’s platform is able to scale up is its matching engine, which helps clients, like older adults and people living with chronic conditions, find providers who are best suited to their needs (the final matches are made by Homage’s team).

The startup says the round was oversubscribed and one of the largest fundings raised by an on-demand care platform in Southeast Asia and Oceania so far. It brings Homage’s total raised to more than $45 million.

As part of Series C, Sheares Healthcare Group chief corporate development officer Khoo Ee Ping will join Homage’s board of directors.

Homage now has a regional network of more than 6,000 pre-screened and trained care professionals. It claims that its business outside of Singapore has grown more than 600% year-over-year in 2021, and it has more than tripled revenue over the past year.

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Startups should look to state-of-the-art tech to tackle diseases affecting women

Startups devoted to reproductive and women’s health are on the rise. However, most of them deal with women’s fertility: birth control, ovulation and the inability to conceive. The broader field of women’s health remains neglected.

Historically, most of our understanding of ailments comes from the perspective of men and is overwhelmingly based on studies using male patients. Until the early 1990s, women of childbearing age were kept out of drug trial studies, and the resulting bias has been an ongoing issue in healthcare. Other issues include underrepresentation of women in health studies, trivialization of women’s physical complaints (which is relevant to the misdiagnosis of endometriosis, among other conditions), and gender bias in the funding of research, especially in research grants.

For example, several studies have shown that when we look at National Institutes of Health funding, a disproportionate share of its resources goes to diseases that primarily affect men — at the expense of those that primarily affect women. In 2019, studies of NIH funding based on disease burden (as estimated by the number of years lost due to an illness) showed that male-favored diseases were funded at twice the rate of female-favored diseases.

Let’s take endometriosis as an example. Endometriosis is a disease where endometrial-like tissue (‘‘lesions’’) can be found outside the uterus. Endometriosis is a condition that only occurs in individuals with uteruses and has been less funded and less studied than many other conditions. It can cause chronic pain, fatigue, painful intercourse and infertility. Although the disease may affect one out of 10 women, diagnosis is still very slow, and the disease is confirmed only by surgery.

There is no non-invasive test available. In many cases, a woman is diagnosed only due to her infertility, and the diagnosis can take up to 10 years. Even after diagnosis, the understanding of disease biology and progression is poor, as well as the understanding of the relationships to other lesion diseases, such as adenomyosis. Current treatments include surgical removal of lesions and drugs that suppress ovarian hormone (mainly estrogen) production.

However, there are changes in the works. The NIH created the women’s health research category in 1994 for annual budgeting purposes and, in 2019, it was updated to include research that is relevant to women only. In acknowledging the widespread male bias in both human and animal studies, the NIH mandated in 2016 that grant applicants would be required to recruit male and female participants in their protocols. These changes are slow, and if we look at endometriosis, it received just $7 million in NIH funding in the fiscal year 2018, putting it near the very bottom of NIH’s 285 disease/research areas.

It is interesting to note that critical changes are coming from other sources, and not so much from the funding agencies or the pharmaceutical industry. The push is coming from patients and physicians themselves that meet the diseases regularly. We see pharmaceutical companies (such as Eli Lilly and AbbVie) in the women’s healthcare space following the lead of their patients and slowly expanding their R&D base and doubling efforts to expand beyond reproductive health into other key women’s health areas.

New technological innovations targeting endometriosis are being funded via private sources. In 2020, women’s health finally emerged as one of the most promising areas of investment. These include (not an exhaustive list by any means) diagnostics companies such as NextGen Jane, which raised a $9 million Series A in April 2021 for its “smart tampon,” and DotLab, a non-invasive endometriosis testing startup, which raised $10 million from investors last July. Other notable advances include the research-study app Phendo that tracks endometriosis, and Gynica, a company focused on cannabis-based treatments for gynecological issues.

The complexity of endometriosis is such that any single biotech startup may find it challenging to go it alone. One approach to tackle this is through collaborations. Two companies, Polaris Quantum Biotech and Auransa, have teamed up to tackle the endometriosis challenge and other women’s specific diseases.

Using data, algorithms and quantum computing, this collaboration between two female-led AI companies integrates the understanding of disease biology with chemistry. Moreover, they are not stopping at in silico; rather, this collaboration aims to bring therapeutics to patients.

New partnerships can majorly impact how fast a field like women’s health can advance. Without such concerted efforts, women-centric diseases such as endometriosis, triple-negative breast cancer and ovarian cancer, to name a few, may remain neglected and result in much-needed therapeutics not moving into clinics promptly.

Using state-of-the-art technologies on complex women’s diseases will allow the field to advance much faster and can put drug candidates into clinics in a few short years, especially with the help of patient advocacy groups, research organizations, physicians and out-of-the-box funding approaches such as crowdfunding from the patients themselves.

We believe that going after the women’s health market is a win-win for the patients as well as from the business perspective, as the global market for endometriosis drugs alone is expected to reach $2.2 billion in the next six years.

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Whoop raises another $200M for its athlete-focused fitness wearable

Founded in 2012, Whoop is far from a household name in the world of fitness trackers. But over the years, the company has attracted its share of converts. It hasn’t had any issue attracting venture capital over the years, either. Last time we checked in on the Boston-based company was in late-2019, when it raised $55 million. Now it’s back with a massive $200 million raise.

The Series F round brings Whoop’s total funding to nearly $405 million — a pretty massive investment for a company of its size. The round, led by SoftBank’s Vision Fund 2, puts the valuation at a jaw-dropping $3.6 billion valuation.

Additional investors include IVP, Cavu Venture Partners, Thursday Ventures, GP Bullhound, Accomplice, NextView Ventures and Animal Capital. They join a long list of former backers, including the National Football League Players Association, Jack Dorsey and a number of professional athletes.

The company’s targeting of athletes marks a strong contrast with leading consumer wearables like the Apple Watch and Fitbit. In fact, the company has a specific offering for sports teams, as well as solutions for businesses, healthcare and government/defense.

Whoop’s name made the rounds recently when Fitbit announced a “Daily Readiness Score” for the Charge 5, which many likened to the company’s more advanced analytics.

The company cites “rapid growth” in its membership offering over the past year as a motivation behind seeking additional funding. That was likely driven, in part, by the decision in 2019 to make the $500 wearable free, while focusing on a subscription service that starts at $18 a month for an 18-month membership (the shorter the membership, the more the monthly fee).

Whoop is eying international expansion beyond the U.S. and using the massive influx of cash on R&D for its hardware, software and analytics solutions. Money will also go toward expanding headcount, which is currently in excess of 500 (with nearly half of those employees having joined in the past year).

“We are thrilled to deepen our partnership with SoftBank as we grow internationally,” founder and CEO Will Ahmed said in a release. “While we have experienced amazing growth in the past year, the potential of our technology and the vast market for health monitoring remains largely untapped.”

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Is the best way to solve climate change to “do nothing?”

When it comes to climate change, it might seem that a book entitled “How to Do Nothing” would not only be irrelevant, but also downright obscene and even dangerous. Not to mention that after more than a year of pandemic living, many people are understandably fatigued at the prospect of continuing to keep their lives empty of social activities.

Yet, messing with our notions of action and contemplation is precisely the plan that Jenny Odell has laid out in her lapidary work, a meditation that is, ironically, a call to action.

Odell is a Bay Area star, who has been an artist in residence at a variety of institutions from the Internet Archive to Recology, San Francisco’s trash pickup and processing company. Her artistic work centers on attention, of focusing on the details that envelop us in this world and what we can learn from them. It’s an activity that leads her to birdwatching and long walks in Oakland’s public parks such as the Morcom Rose Garden.

Her book, it might be helpful to note, is subtitled “Resisting the Attention Economy” and Odell has made it her mission to help wean a generation, and well, a population off the spasmodic negativity that emanates from our social media platforms. In fact, she has a more ambitious goal: to wean people off the notion that productivity is the only value to life — that action is the only useful metric by which to measure ourselves. She wants to direct our attention to more important things.

“I fully understand where a life of sustained attention leads. In short, it leads to awareness,” she writes in the introduction. The key word here is sustained — and that’s also the connection with sustainability and the climate more broadly.

We don’t lack for information, data or opinions. In fact, we are overwhelmed with the dross of human thought. Some studies have shown that modern knowledge workers read more words per day than ever before in history — but they’re reading social media posts, emails, Slack messages and other ephemera that are each nibbling and collectively devouring our attention. What’s left is, for many of us, not much of any thought at all. The world is more frenetic and chaotic than ever before, but in the process, we have traded a deeper understanding of ourselves and our place in this world for an incessant deluge of media. Odell wants us to take that imbalance and level it.

For her, that means practicing a more sustained form of attention. That’s a skill most of us have little practice with (a deficit we may not even be aware of, ironically), and indeed, sustaining attention might even mean regularly refusing to engage with the world around us. That’s a good thing in her analysis. “At their loftiest, such refusals can signify the individual capacity for self-directed action against the abiding flow; at the very least, they interrupt the monotony of the everyday.”

Controlling our attention, directing it, and filtering out the noise of contemporary life results not in further atomization and narcissism, but rather a more collective sense of being. “When the pattern of your attention has changed, you render your reality differently. You begin to move and act in a different kind of world,” she writes. Suddenly, the trees and flowers that were once backdrops to our walks to brunch become complex and elegant life in their own right. We deepen our camaraderie with our friends and colleagues in ways that we never could with an emoji in Slack. We build up the potential to work together to solve problems.

Climate Change Books Summer 2021

Our sustained attention also allows us to notice the details of what is changing around us, the subtle variations of our environment that come from a warming planet. “Things like the American obsession with individualism, customized filter bubbles, and personal branding—anything that insists on atomized, competing individuals striving in parallel, never touching—does the same violence to human society as a dam does to a watershed.” We can’t fix what we don’t see, and with our fragmented attention, we really don’t see much.

The irony of course is that while technology products dissolve attention — building them takes an extraordinary amount of it. While some startup founders strike it rich on a whim and others are injected with product ideas from friends or VCs, the vast majority learned to sustain their attention on a market or customer for sometimes extraordinarily long periods of time in order to notice the gaps in a market. A founder recently told me that he had been working with customers in his market for more than a decade before he eventually understood a need that wasn’t being fulfilled with existing solutions.

What’s missing in the tech and startup community today is connecting that user empathy and focus on product-market fit to the attention we need in all the other aspects of our lives today. Odell analyzes it a bit more negatively than I would: we actually have these skills and in fact, use them quite specifically. We just don’t use them broadly enough to bring our minds to look at our friendships, communities and planet in a deeper light.

Doing nothing allows us to see what matters and what doesn’t. When it comes to solving big problems, particularly some of the most intractable like climate change, it’s precisely doing nothing that allows us to see the right path to doing something.


How to Do Nothing: Resisting the Attention Economy by Jenny Odell
Melville House, 2019, 256 pages

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Back to the suture: The future of healthcare is in the home

The pandemic has highlighted some of the brightest spots — and greatest areas of need — in America’s healthcare system. On one hand, we’ve witnessed the vibrancy of America’s innovation engine, with notable contributions by U.S.-based scientists and companies for vaccines and treatments.

On the other hand, the pandemic has highlighted both the distribution challenges and cost inefficiencies of the healthcare system, which now accounts for nearly a fifth of our GDP — far more than any other country — yet lags many other developed nations in clinical outcomes.

Many of these challenges stem from a lack of alignment between payment and incentive models, as well as an overreliance on hospitals as centers for care delivery. A third of healthcare costs are incurred at hospitals, though at-home models can be more effective and affordable. Furthermore, most providers rely on fee for service instead of preventive care arrangements.

These factors combine to make care in this country reactive, transactional and inefficient. We can improve both outcomes and costs by moving care from the hospital back to the place it started — at home.

Right now in-home care accounts for only 3% of the healthcare market. We predict that it will grow to 10% or more within the next decade.

In-home care is nothing new. In the 1930s, over 40% of physician-patient encounters took place in the home, but by the 1980s, that figure dropped to under 1%, driven by changes in health economics and technologies that led to today’s hospital-dominant model of care.

That 50-year shift consolidated costs, centralized access to specialized diagnostics and treatments, and created centers of excellence. It also created a transition from proactive to reactive care, eliminating the longitudinal relationship between patient and provider. In today’s system, patients are often diagnosed by and receive treatment from individual doctors who do not consult one another. These highly siloed treatments often take place only after the patient needs emergency care. This creates higher costs — and worse outcomes.

That’s where in-home care can help. Right now in-home care accounts for only 3% of the healthcare market. We predict that it will grow to 10% or more within the next decade. This growth will improve the patient experience, achieve better clinical outcomes and reduce healthcare costs.

To make these improvements, in-home healthcare strategies will need to leverage next-generation technology and value-based care strategies. Fortunately, the window of opportunity for change is open right now.

Five factors driving the opportunity for change

Over the last few years, five significant innovations have created new incentives to drive dramatic changes in the way care is delivered.

  1. Technologies like remote patient monitoring (RPM) and telemedicine have matured to a point that can be deployed at scale. These technologies enable providers to remotely manage patients in a proactive, long-term relationship from the comfort of their homes and at a reduced cost.

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