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(CNN) – For years, Apple and Google have dreamed of breaking into the huge personal health market. Apple CEO Tim Cook said he wants health technology to be considered Apple’s “greatest contribution” to humanity, and asked for approval from the Food and Drug Administration (FDA). ) so that the latest Apple watches can monitor heart rate. Google has invested hundreds of millions in research on aging, cancer and neuroscience. Both have acquired new healthcare companies and poached healthcare executives.
But perhaps no effort can give companies a foothold in the $ 1 trillion healthcare industry as their joint plan, announced earlier this month, to track the spread of the coronavirus.
The task is daunting: By incorporating disease monitoring capabilities into virtually every smartphone on the planet, the tech giants hope to create a worldwide covid-19 warning system. Soon, potentially millions of people could have their first interactions with Apple and Google in a health-related context.
Convincing large audiences to think of Apple and Google as natural actors in the healthcare space is likely to open even more doors for companies in the highly regulated and highly complex bureaucratic healthcare sector.
There are many ways that the initiative could fail. It may not attract enough users to be effective. Governments can reject technology. And within years, the project could be remembered within the health care industry as another example of the growing ambitions of Big tech that exceed their ability to generate results.
A high-profile failure to win the trust of users, public health agencies, and industry partners could “haunt Apple and Google again” in future health initiatives, said Joy Pritts, an expert on health privacy. and former chief privacy and security adviser at the Department of Health and Human Services. But if they can make it, according to her and other experts, she could finally establish Apple and Google’s credentials with the public as leading and trusted players in the healthcare field, paving the way for even greater opportunities.
Neither Apple nor Google responded to requests for comment.
In Silicon Valley, a story of great health ideas and stumbles
Bold gambling – and the occasional dead ends – are nothing new in Silicon Valley’s healthcare efforts. From immortality searches and supposedly revolutionary blood samples to affordable genetic testing, “altering” health has been a perennial dream for an industry that prides itself on applying cutting-edge engineering and an innovator mindset to the most thorny of problems.
The same radical aspirations to change the world were put forth when Apple and Google, pledging to save lives, declared that they would join the fight this month against the coronavirus.
“All of us at Apple and Google believe there has never been a more important time to work together to solve one of the world’s most pressing problems,” the companies said. Through close cooperation and collaboration with developers, governments, and public health providers, we hope to harness the power of technology to help countries around the world curb the spread of covid-19 and accelerate the return of life. everyday ”.
The move made headlines, especially as it saw two lifelong rivals team up. But Google’s ambitions in this area have long been clear. In 2008, Google introduced a new project, Google Health, to host users’ medical data. By allowing participants to share their health information with CVS, Quest Diagnostics, Walgreens, and others, the goal was to create an easy way for patients to manage their healthcare online.
Since then, several units of Google’s parent company have embarked on even bigger projects. Calico was formed in 2013, dedicated to nothing less than lengthening human life. Verily has toyed with smart contact lenses that monitor glucose and AI algorithms trained to detect heart disease. (More recently, Verily built a website to direct thousands of Californians to coronavirus testing sites.)
However, reflecting Silicon Valley’s fail-safe ethics, many of these experiments have remained that. The glucose-tracking contact lens effort was archived in 2018. Google Health closed in 2012 after executives admitted that it “didn’t take the path we hoped for,” though it was later resurrected as a partnership with one of the The nation’s largest health care providers in a move that drew some federal scrutiny.
Apple’s health record is somewhat more limited, but its goals are equally high. In 2014, it launched HealthKit and the Health iOS app, which serve as the connective tissue linking health apps, doctor’s offices, and health data created and stored on iPhones. Since then, Apple has partnered with hundreds of medical providers, including the Department of Veterans Affairs, to make patient health records visible from the health app itself. And it has increasingly positioned Apple Watch as a health assistant, going so far as to secure authorization from the Food and Drug Administration for the electrocardiogram function of Apple Watch. The device can even call for help if users experience a fall.
“If you look away into the future, you look back and ask the question, ‘What was Apple’s biggest contribution to humanity?’ It will be about health,” Apple CEO Tim Cook said on CNBC last year. .
Apple and Google contact tracking plan has mixed reception
However, compared to previous Apple and Google healthcare ventures, no project can affect as many of its users as directly, or as immediately, as the contact tracking feature that companies have called “notification of exposition”. But it can also create friction with certain governments, which have a great influence on whether the companies’ technology will be used in their countries.
Under the companies’ pandemic plan, public health officials will be able to create special covid-19 apps that use Bluetooth wireless signals, not location data, to track when two or more devices come in contact with each other. Through a new function in iOS and Android, the applications will be able to work together even if they are created by different agencies. Only the organizations that Apple and Google have recognized will be able to take advantage of the technology, the companies said, and those who develop the applications must comply with the strict guidelines established by the platforms.
Most of the data collection and computation associated with the project will be done on people’s own phones, rather than on a centralized server controlled by the authorities or companies.
The limitations have affected some governments in the wrong way. France has asked Apple and Google to ease privacy barriers that prevent officials from collecting user data, despite a history of resistance to privacy. Britain and Australia have also moved to reject the tech companies’ approach, out of similar concerns. The Australian app asks users to provide their names, phone numbers, postal codes, and approximate age.
In local cases, some US states they advance without the companies. North and South Dakota residents have already started using an official contact tracking app, just like Utah. Those apps, unlike the system envisioned by Apple and Google, collect certain location information. Location data will help make contact tracking more effective, officials behind the apps told Reuters, and they expect Apple and Google to reconsider their stance on GPS data.
Privacy researchers say the use of GPS data could reveal more about a person than the use of Bluetooth data just because the Bluetooth approach tracks only when devices have been in close proximity and regardless of their location in the world physical. For example, the system could register two people who share a park bench as if they had been in close contact without knowing that a visit to the park was ever involved.
So far, Apple and Google have pushed stricter privacy standards in their solution. In a recent press conference, the companies said they would duplicate themselves with additional encryption and data obfuscation layers. The bolt-on strategy appears to be working: Germany this week gave in and said it would drop its support for an alternative European proposal that did not fit the tech companies’ approach.
Now Apple and Google just need the rest of the world to join. Experts say that at least 50% to 60% of people would need to opt for maximum effectiveness; Anything less could result in missing links in understanding the transmission chain, undermining efforts by public health officials to trace the virus.
Even after users agree to participate, they will need to abide by the public health advice provided through the system, including choosing to report their own positive results. All this is far from being guaranteed.
Partners with very different business models, for now
Although the two companies are working together on this initiative, their underlying business models could not be more different. While the privacy-first approach to the exposure notification system may carry greater risks for Google, whose core business model revolves around extracting personal information for advertising, experts say Google’s long-term vision is more. sophisticated.
Both companies have already promised not to monetize covid-19 exposure notification technology. And because the solution specifically minimizes the amount of personal data users will generate, the system does not lend itself to ads.
That makes the pandemic monitoring system less of a viable business in itself than a way for Google to show public health agencies what they might be as future Google customers, said Lucia Savage, director of privacy and regulation of the virtual care company Omada Health.
Google’s approach so far suggests it is more interested in organizing and interpreting information as a paid service for medical organizations, not in free advertising-backed products, according to Savage.
“That could be the next phase,” he said, “bringing this scientific data and search processes and algorithms that are ubiquitous in Silicon Valley into the realm of public health.”
For Apple, Savage says the exposure notification project fits perfectly into the company’s existing strategy with HealthKit: creating platforms and tools that help patients manage their own healthcare, digitally.
If there had not been a pandemic, Apple and Google would probably have figured out, in their own time, how to enter the health sector in a major way. But in responding to the current global crisis, companies now have an opportunity to have a highly visible impact on the health of entire populations, and claim that this is an area to which they really belong.
