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In a recent exposé, The New York Times revealed the appalling conditions that surround end-of-life care in New York City and the perverse incentives that perpetuate the system. The piece—tragic, enraging, and, one hopes, change-inducing—exemplifies the real, meaningful value that the best journalism creates for a society.
The story moved me, and because the doings of the tech industry are my daily bread, it made me think: why isn’t this the kind of problem Silicon Valley is trying to hack?
Startup entrepreneurs love to talk about how they can remove “pain points,” though that’s usually in reference to something like getting your dinner delivered faster. But The Times piece showed people in real, terrible pain. Sure, there are political reasons why Medicare provides far better coverage for cut-rate nursing home stays than genuine quality home care—it’s one of those intractable public policy issues that doesn’t offer a clear path to an easy startup exit—but if Silicon Valley is going to live up to its self-image as a center of innovation, these are the kinds of problems it needs to devote more of its energy to targeting.
Perhaps another reason for the reluctance to take on serious healthcare issues is the absence of any real role models. The biggest companies in the Valley haven’t done much to change how healthcare works, and not always for lack of trying. Most conspicuously, Google has made various attempts to apply its technology and resources to the world of healthcare, from its discontinued Google Health personal health record service to its backing of genome analysis startup 23andMe, none of which have had a huge impact. More recently, Google has taken the more traditional approach of giving lots of money to fund biomedical research.
Facebook has taken less initiative with healthcare, even though it’s the big tech company that seems most naturally compatible with health issues. From posting their latest workouts to complaining about their sniffles, people talk about their health on Facebook. What’s more, all that information is tied to a broader demographic context—age, location, social connections, background—that creates the potential for all kinds of previously unobtainable insights.
Now, the social networking giant seems be recognizing that these possibilities exist. According to Reuters, the company is exploring forays into ailment-specific support communities and preventative care apps. One apparent impetus for the effort is Facebook’s organ-donor status option, which one study found correlated to a dramatic rise in online organ donor registrations.
The most serious hindrance to Facebook doing more with healthcare is the ever-hazardous terrain surrounding privacy. Beyond Facebook’s clumsiness in the past around specific privacy issues, the entire premise of the company hinges on aggregating users’ personal information to sell to advertisers. People reveal a lot about themselves on Facebook, but will they really want the most intimate details of their physical lives packaged and sold? For Facebook, health information presents ethical and regulatory challenges that may not always seem worth the trouble in the context of a quarterly earnings report.
Last week, Facebook sort-of apologized to users for experimenting on them (us) without their (our) knowledge. But nowhere did Facebook say the experiments would stop. One reason they won’t is that we users haven’t stopped using Facebook, even though we’re appalled—appalled!—at the violation of trust.
But if users aren’t going to use their leverage to get Facebook to stop exploiting our trust, maybe we can at least get Facebook to exploit us for better ends. The study that got everyone so mad focused on the concept of “emotional contagion”—could Facebook friends’ feelings impact our own? For instance, what if Facebook used its massive trove of data on the human species to track actual contagion?
Part of the reason a Dallas hospital sent home a man showing Ebola-like symptoms who had recently traveled to west Africa was that a nurse’s note of his travels didn’t show up on the electronic health report viewed by a hosptial doctor. I’m just spitballing here, but what if the patient’s Facebook profile was included as part of his medical record, and the doctor could see a recent status update from Liberia?
As for Ebola outbreak itself, the outbreak itself reportedly wasn’t detected early thanks to sophisticated big-data algorithms. Rather, the information surfaced through traditional media, government, and public health channels. Imagine an algorithm with the power of Google Flu Trends, which attempts to predict infectious outbreaks based on searches, applied to personally reported health information.
However much users complain about big tech companies tracking us and probing our private lives for profit, the services those companies provide in exchange are apparently too valuable to cause those user bases to shrink. But if users won’t use their power to force practices they don’t like to change, perhaps we at the very least can act as constituents to demand companies like Facebook do more, to take advantage of their unique power to effect genuine innovation, not just better photo filters. If Facebook going to watch you, mess with your News Feed, turn you into a micro-target for marketers, at least it could use some of the data we all give away to do some real good.
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