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The San Francisco-based non-profit wants to help the world's poorest individuals, who subsist on less than a few dollars per day. Its products include an \u003ca href=\"http://d-rev.org/projects/mobility/\">$80 prosthetic knee\u003c/a> and a \u003ca href=\"http://d-rev.org/2010/12/brilliance-is-licensed-to-phoenix-medical/\">phototherapy device\u003c/a> to treat infants with jaundice.\u003c/p>\n\u003cp>[Skip to the bottom of the article to watch a TED talk on the $80 ReMotion knee.]\u003c/p>\n\u003cp>What's unique about D-Rev is its approach to research. The company sends its small team of designers into the field -- whether it's a rural village in India or a remote hospital in Uganda -- to conduct interviews with patients, doctors and nurses.\u003c/p>\n\u003cp>During a recent conversation with a doctor based in rural India, D-Rev employees learned that many babies were dying of jaundice. The treatment devices were too expensive to maintain. The team brainstormed low-cost solutions and came up with \u003ca href=\"http://d-rev.org/projects/newborn-health/\">Brilliance\u003c/a>, a photo-therapy lamp that sells for $400, a fraction of the cost of its mainstream competitors.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cem>KQED\u003c/em> sat down with Krista Donaldson, the company's chief executive, to discuss the ongoing challenges of running a medical non-profit and the opportunities for the future. Donaldson shared that D-Rev is considering a move into the U.S. market to help those in need closer to home.\u003c/p>\n\u003cp>This interview has been condensed and edited for brevity.\u003c/p>\n\u003cp>\u003cstrong>In the past few years, D-Rev seems to have exploded in the media. When did the company get its start?\u003c/strong>\u003c/p>\n\u003cp>It was started in 2008 as a skunk-works of technology for the developing world. I was brought in because a lot of the products were in stages of prototyping and weren't reaching users. I cancelled most of the projects and focused our attention on people who are living on less than $4 a day. Our core mission is to close the gap in quality health care by focusing on delivery and design.\u003c/p>\n\u003cp>\u003cstrong>What was the first product that you released as CEO?\u003c/strong>\u003c/p>\n\u003cp>It was the Brilliance photo-therapy device. We got the idea after a doctor from India approached us at a conference. He said that the global health community, which is very Western-driven, is focused on the 'big ticket items' like preterm births and asphyxia [\u003cspan class=\"st\">a potentially-fatal condition caused by a lack of oxygen in the blood\u003c/span>.] But he told us that at his hospital, many babies were dying of jaundice. We estimate that 6 million babies with severe jaundice are not receiving adequate treatment.\u003c/p>\n\u003cp>My colleague got intrigued about developing a device that would shine an intense, blue light onto the baby's skin as a safe and effective therapy. We had heard that a hospital in Uganda was putting babies in the sun to get treated. This isn't safe, but the doctor did that because it was his only option.\u003c/p>\n\u003cp>[Watch the video below to learn more about D-Rev's solution.]\u003c/p>\n\u003cp>[youtube http://www.youtube.com/watch?v=eOgPT0faICs]\u003c/p>\n\u003cp>\u003cstrong>Many medical device companies will donate surplus equipment to developing nations. So why would health providers buy a product from D-Rev?\u003c/strong>\u003c/p>\n\u003cp>The medical device industry is far behind in terms of design. The approach they often take when thinking about low-income people is to donate the stuff that isn't being used in the West. There are all sorts of problems with that, whether it's different electronic frequencies, plugs and outlets, fluctuating temperature standards, or broader cultural issues.\u003c/p>\n\u003cp>\u003cstrong>How about low-income people in the U.S. who struggle to access cost-effective therapies? Are you planning to build devices for the domestic market?\u003c/strong>\u003c/p>\n\u003cp>Yes. We are in the early exploration phases of looking into low-income amputees in the United States. If we do something, it'll be a version of our prosthetic knee. The problem is that devices are so expensive here that many low-income people we've spoken to say they are ordering stuff from China on eBay. We'll have more information about our next steps later in the year.\u003c/p>\n\u003cp>\u003cstrong>What's your design process like for developing a new medical device?\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignright\">“ There were these teeny tiny babies that could fit in the palm of your hand. And they were under these photo-therapy devices that I could tell were ineffective in one glance.\"\u003cbr>\n\u003ccite>Krista Donaldson, CEO of D-Rev \u003c/cite>\u003c/aside>\n\u003cp>We start with a problem identified by a user, oftentimes a doctor at a rural clinic. One example might be a lack of high-quality, affordable prosthetic knees. We would ask questions to potential users like: 'Would you want a prosthetic that will help with your gait? Are you looking for a device that will help you to return to work?'\u003c/p>\n\u003cp>When we were doing the prototype of \u003ca href=\"http://d-rev.org/2014/10/learning-comet-rural-clinics-home-care-arent-ready-phototherapy/\">Comet\u003c/a>, an offshoot of our Brilliance phototherapy device, we drove around India and stopped at 20 different hospitals and clinics of all sizes to talk to the doctors. At this stage, we had four rough prototypes. Once you get more information, you can show the prototypes and get feedback. We also take into account cultural norms.\u003c/p>\n\u003cp>Once the product has been designed, we deal with things like regulation and intellectual property. Regulation is different in every country -- some have no requirements at all.\u003c/p>\n\u003cfigure id=\"attachment_2989\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-2989\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/05/Krista-Donaldson-talking-to-an-amputee-800x533.jpg\" alt=\"Donaldson interviewing an amputee \" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/05/Krista-Donaldson-talking-to-an-amputee-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/05/Krista-Donaldson-talking-to-an-amputee-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/05/Krista-Donaldson-talking-to-an-amputee-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/05/Krista-Donaldson-talking-to-an-amputee.jpg 1025w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Donaldson interviewing an amputee victim \u003ccite>(D-Rev)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Travel to rural parts of the world is expensive. Is it an ongoing challenge to raise funding?\u003c/strong>\u003c/p>\n\u003cp>We are raising money constantly. It is a challenge because we are more like a medical device startup than a typical philanthropic organization. We don't fit neatly into a bucket within the global health community, like\u003ca href=\"http://www.usaid.gov/\"> USAID [the government agency responsible for administering foreign aid.] \u003c/a>Their typical idea of global health innovation tends to be very labs-based.\u003c/p>\n\u003cp>But we have had a lot of success with foundations and individuals. Some companies help us out too, like \u003ca href=\"http://autodesk.com\">Autodesk\u003c/a>, which provides free software.\u003c/p>\n\u003cp>One big frustration I have is that big funders want to see data about improving mortality rates. They are less inclined to fund devices that prevent brain damage, rather than just save lives. We have to make sure that people can live healthy lives.\u003c/p>\n\u003cp>\u003cstrong>Aside from funding, what are some of the biggest hurdles that the company faces?\u003c/strong>\u003c/p>\n\u003cp>A lot of our users have low-trust in medical devices in general, in large part due to poor quality of some of the less expensive ones. Doctors often say to us: 'Why is your product so cheap? What's wrong with it?'\u003c/p>\n\u003cp>Another lesson learned is that in many low-income countries the government will purchase large batches of medical devices for state hospitals. They put out a tender with specifications that companies need to meet. I expected there to be less corruption in that process. But I'm hoping that things will improve over time with greater transparency.\u003c/p>\n\u003cp>\u003cstrong>What is the core demographic for D-Rev's devices?\u003c/strong>\u003c/p>\n\u003cp>We don't have any good data yet. But we are starting to do some preliminary research on gender. We have learned that boy babies are brought in for jaundice far more frequently than the girls -- it's about two to one. But boys and girl babies are equally likely to suffer from jaundice.\u003c/p>\n\u003cfigure id=\"attachment_2993\" class=\"wp-caption alignright\" style=\"max-width: 326px\">\u003cimg class=\" wp-image-2993\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/05/Bangladesh-Photo-450x600.jpg\" alt=\"A snap of some data compiled by a hospital in Bangladesh\" width=\"326\" height=\"435\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/05/Bangladesh-Photo-450x600.jpg 450w, https://ww2.kqed.org/app/uploads/sites/13/2015/05/Bangladesh-Photo-400x533.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/05/Bangladesh-Photo.jpg 843w\" sizes=\"(max-width: 326px) 100vw, 326px\">\u003cfigcaption class=\"wp-caption-text\">A snap of some data compiled by a hospital in Bangladesh \u003ccite>(D-Rev)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>We had heard that stat anecdotally for a long time, but it wasn't really apparent until we were in a hospital in Bangladesh last year and spotted a board filled with the data. It clearly showed more male babies.\u003c/p>\n\u003cp>We're spotting similar trends with our research into prosthetics. Female amputees will come into the clinic less frequently than men. We think it may be related to social stigma.\u003c/p>\n\u003cp>\u003cstrong>What have been a few of your high and low points at D-Rev?\u003c/strong>\u003c/p>\n\u003cp>My background is that I worked in Kenya for a number of years designing water pumps for farmers. I don't have as much experience in health.\u003c/p>\n\u003cp>The first time I was in a hospital in India, it was very upsetting. I was a new mother myself. There were these teeny tiny babies that could fit in the palm of your hand. And they were under these photo-therapy devices that I could tell were ineffective in one glance.\u003c/p>\n\u003cp>It was a low point, because I couldn't help but step back and think, 'these are lives that could be damaged permanently, but it's all so easily fixed.' My goal now is for everyone on our team to undertake at least one trip like this a year.\u003c/p>\n\u003cp>A high-point involves meetings with our users. I met a young woman called Poornima, who lost her leg in a car accident. She lost her brother in that accident. Poornima had wanted to be an engineer. Now, she wears one of our prosthetic knees and is filled with renewed energy.\u003c/p>\n\u003cp>\u003cstrong>In SIlicon Valley, almost every company is fighting to hire good designers and engineers. Do you find it difficult to find and retain talent?\u003c/strong>\u003c/p>\n\u003cp>I have this frustration that the nonprofit sector pays very talented people not very much money because they have chosen this field. We try to pay people market salaries, despite the push-back from donors. I think our employees are worth even more than what we're paying them.\u003c/p>\n\u003cp>Overall though, we've done well with recruiting. Where it gets challenging is with more senior staff; people with nonprofit experience and medical device experience.\u003c/p>\n\u003cp>\u003cstrong>Any parting words of wisdom for would-be health entrepreneurs who want to help low-income people?\u003c/strong>\u003c/p>\n\u003cp>Get out there and get experience. Talk to people; learn how to frame questions. Every time I go on vacation for instance, I stop into clinics and hospitals that use our products. Whenever I do field work, I always learn new things.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>[ted id=1895]\u003c/p>\n\n","blocks":[],"excerpt":"D-Rev CEO Krista Donaldson on selling medical devices to hospitals and clinics in the world's poorest communities. ","status":"publish","parent":0,"modified":1477282577,"stats":{"hasAudio":false,"hasVideo":true,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":46,"wordCount":1658},"headData":{"title":"D-Rev CEO: We Build Medical Devices for People who Live on Less than $4 a Day | KQED","description":"D-Rev CEO Krista Donaldson on selling medical devices to hospitals and clinics in the world's poorest communities. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"D-Rev CEO: We Build Medical Devices for People who Live on Less than $4 a Day","datePublished":"2015-05-14T16:00:03.000Z","dateModified":"2016-10-24T04:16:17.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"2981 http://ww2.kqed.org/futureofyou/?p=2981","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/05/14/d-rev-ceo-we-build-medical-devices-for-people-who-live-on-less-than-4-a-day/","disqusTitle":"D-Rev CEO: We Build Medical Devices for People who Live on Less than $4 a Day","path":"/futureofyou/2981/d-rev-ceo-we-build-medical-devices-for-people-who-live-on-less-than-4-a-day","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Most medical equipment companies don't regularly top \"\u003ca href=\"http://www.fastcompany.com/most-innovative-companies/2013/d-rev\">most innovative\u003c/a>\" lists.\u003c/p>\n\u003cp>But \u003ca href=\"http://d-rev.org/\">D-Rev\u003c/a> isn't your typical medical device maker. The San Francisco-based non-profit wants to help the world's poorest individuals, who subsist on less than a few dollars per day. Its products include an \u003ca href=\"http://d-rev.org/projects/mobility/\">$80 prosthetic knee\u003c/a> and a \u003ca href=\"http://d-rev.org/2010/12/brilliance-is-licensed-to-phoenix-medical/\">phototherapy device\u003c/a> to treat infants with jaundice.\u003c/p>\n\u003cp>[Skip to the bottom of the article to watch a TED talk on the $80 ReMotion knee.]\u003c/p>\n\u003cp>What's unique about D-Rev is its approach to research. The company sends its small team of designers into the field -- whether it's a rural village in India or a remote hospital in Uganda -- to conduct interviews with patients, doctors and nurses.\u003c/p>\n\u003cp>During a recent conversation with a doctor based in rural India, D-Rev employees learned that many babies were dying of jaundice. The treatment devices were too expensive to maintain. The team brainstormed low-cost solutions and came up with \u003ca href=\"http://d-rev.org/projects/newborn-health/\">Brilliance\u003c/a>, a photo-therapy lamp that sells for $400, a fraction of the cost of its mainstream competitors.\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>\u003cem>KQED\u003c/em> sat down with Krista Donaldson, the company's chief executive, to discuss the ongoing challenges of running a medical non-profit and the opportunities for the future. Donaldson shared that D-Rev is considering a move into the U.S. market to help those in need closer to home.\u003c/p>\n\u003cp>This interview has been condensed and edited for brevity.\u003c/p>\n\u003cp>\u003cstrong>In the past few years, D-Rev seems to have exploded in the media. When did the company get its start?\u003c/strong>\u003c/p>\n\u003cp>It was started in 2008 as a skunk-works of technology for the developing world. I was brought in because a lot of the products were in stages of prototyping and weren't reaching users. I cancelled most of the projects and focused our attention on people who are living on less than $4 a day. Our core mission is to close the gap in quality health care by focusing on delivery and design.\u003c/p>\n\u003cp>\u003cstrong>What was the first product that you released as CEO?\u003c/strong>\u003c/p>\n\u003cp>It was the Brilliance photo-therapy device. We got the idea after a doctor from India approached us at a conference. He said that the global health community, which is very Western-driven, is focused on the 'big ticket items' like preterm births and asphyxia [\u003cspan class=\"st\">a potentially-fatal condition caused by a lack of oxygen in the blood\u003c/span>.] But he told us that at his hospital, many babies were dying of jaundice. We estimate that 6 million babies with severe jaundice are not receiving adequate treatment.\u003c/p>\n\u003cp>My colleague got intrigued about developing a device that would shine an intense, blue light onto the baby's skin as a safe and effective therapy. We had heard that a hospital in Uganda was putting babies in the sun to get treated. This isn't safe, but the doctor did that because it was his only option.\u003c/p>\n\u003cp>[Watch the video below to learn more about D-Rev's solution.]\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/eOgPT0faICs'\n title='//www.youtube.com/embed/eOgPT0faICs'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Many medical device companies will donate surplus equipment to developing nations. So why would health providers buy a product from D-Rev?\u003c/strong>\u003c/p>\n\u003cp>The medical device industry is far behind in terms of design. The approach they often take when thinking about low-income people is to donate the stuff that isn't being used in the West. There are all sorts of problems with that, whether it's different electronic frequencies, plugs and outlets, fluctuating temperature standards, or broader cultural issues.\u003c/p>\n\u003cp>\u003cstrong>How about low-income people in the U.S. who struggle to access cost-effective therapies? Are you planning to build devices for the domestic market?\u003c/strong>\u003c/p>\n\u003cp>Yes. We are in the early exploration phases of looking into low-income amputees in the United States. If we do something, it'll be a version of our prosthetic knee. The problem is that devices are so expensive here that many low-income people we've spoken to say they are ordering stuff from China on eBay. We'll have more information about our next steps later in the year.\u003c/p>\n\u003cp>\u003cstrong>What's your design process like for developing a new medical device?\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignright\">“ There were these teeny tiny babies that could fit in the palm of your hand. And they were under these photo-therapy devices that I could tell were ineffective in one glance.\"\u003cbr>\n\u003ccite>Krista Donaldson, CEO of D-Rev \u003c/cite>\u003c/aside>\n\u003cp>We start with a problem identified by a user, oftentimes a doctor at a rural clinic. One example might be a lack of high-quality, affordable prosthetic knees. We would ask questions to potential users like: 'Would you want a prosthetic that will help with your gait? Are you looking for a device that will help you to return to work?'\u003c/p>\n\u003cp>When we were doing the prototype of \u003ca href=\"http://d-rev.org/2014/10/learning-comet-rural-clinics-home-care-arent-ready-phototherapy/\">Comet\u003c/a>, an offshoot of our Brilliance phototherapy device, we drove around India and stopped at 20 different hospitals and clinics of all sizes to talk to the doctors. At this stage, we had four rough prototypes. Once you get more information, you can show the prototypes and get feedback. We also take into account cultural norms.\u003c/p>\n\u003cp>Once the product has been designed, we deal with things like regulation and intellectual property. Regulation is different in every country -- some have no requirements at all.\u003c/p>\n\u003cfigure id=\"attachment_2989\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-2989\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/05/Krista-Donaldson-talking-to-an-amputee-800x533.jpg\" alt=\"Donaldson interviewing an amputee \" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/05/Krista-Donaldson-talking-to-an-amputee-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/05/Krista-Donaldson-talking-to-an-amputee-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/05/Krista-Donaldson-talking-to-an-amputee-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/05/Krista-Donaldson-talking-to-an-amputee.jpg 1025w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Donaldson interviewing an amputee victim \u003ccite>(D-Rev)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Travel to rural parts of the world is expensive. Is it an ongoing challenge to raise funding?\u003c/strong>\u003c/p>\n\u003cp>We are raising money constantly. It is a challenge because we are more like a medical device startup than a typical philanthropic organization. We don't fit neatly into a bucket within the global health community, like\u003ca href=\"http://www.usaid.gov/\"> USAID [the government agency responsible for administering foreign aid.] \u003c/a>Their typical idea of global health innovation tends to be very labs-based.\u003c/p>\n\u003cp>But we have had a lot of success with foundations and individuals. Some companies help us out too, like \u003ca href=\"http://autodesk.com\">Autodesk\u003c/a>, which provides free software.\u003c/p>\n\u003cp>One big frustration I have is that big funders want to see data about improving mortality rates. They are less inclined to fund devices that prevent brain damage, rather than just save lives. We have to make sure that people can live healthy lives.\u003c/p>\n\u003cp>\u003cstrong>Aside from funding, what are some of the biggest hurdles that the company faces?\u003c/strong>\u003c/p>\n\u003cp>A lot of our users have low-trust in medical devices in general, in large part due to poor quality of some of the less expensive ones. Doctors often say to us: 'Why is your product so cheap? What's wrong with it?'\u003c/p>\n\u003cp>Another lesson learned is that in many low-income countries the government will purchase large batches of medical devices for state hospitals. They put out a tender with specifications that companies need to meet. I expected there to be less corruption in that process. But I'm hoping that things will improve over time with greater transparency.\u003c/p>\n\u003cp>\u003cstrong>What is the core demographic for D-Rev's devices?\u003c/strong>\u003c/p>\n\u003cp>We don't have any good data yet. But we are starting to do some preliminary research on gender. We have learned that boy babies are brought in for jaundice far more frequently than the girls -- it's about two to one. But boys and girl babies are equally likely to suffer from jaundice.\u003c/p>\n\u003cfigure id=\"attachment_2993\" class=\"wp-caption alignright\" style=\"max-width: 326px\">\u003cimg class=\" wp-image-2993\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/05/Bangladesh-Photo-450x600.jpg\" alt=\"A snap of some data compiled by a hospital in Bangladesh\" width=\"326\" height=\"435\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/05/Bangladesh-Photo-450x600.jpg 450w, https://ww2.kqed.org/app/uploads/sites/13/2015/05/Bangladesh-Photo-400x533.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/05/Bangladesh-Photo.jpg 843w\" sizes=\"(max-width: 326px) 100vw, 326px\">\u003cfigcaption class=\"wp-caption-text\">A snap of some data compiled by a hospital in Bangladesh \u003ccite>(D-Rev)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>We had heard that stat anecdotally for a long time, but it wasn't really apparent until we were in a hospital in Bangladesh last year and spotted a board filled with the data. It clearly showed more male babies.\u003c/p>\n\u003cp>We're spotting similar trends with our research into prosthetics. Female amputees will come into the clinic less frequently than men. We think it may be related to social stigma.\u003c/p>\n\u003cp>\u003cstrong>What have been a few of your high and low points at D-Rev?\u003c/strong>\u003c/p>\n\u003cp>My background is that I worked in Kenya for a number of years designing water pumps for farmers. I don't have as much experience in health.\u003c/p>\n\u003cp>The first time I was in a hospital in India, it was very upsetting. I was a new mother myself. There were these teeny tiny babies that could fit in the palm of your hand. And they were under these photo-therapy devices that I could tell were ineffective in one glance.\u003c/p>\n\u003cp>It was a low point, because I couldn't help but step back and think, 'these are lives that could be damaged permanently, but it's all so easily fixed.' My goal now is for everyone on our team to undertake at least one trip like this a year.\u003c/p>\n\u003cp>A high-point involves meetings with our users. I met a young woman called Poornima, who lost her leg in a car accident. She lost her brother in that accident. Poornima had wanted to be an engineer. Now, she wears one of our prosthetic knees and is filled with renewed energy.\u003c/p>\n\u003cp>\u003cstrong>In SIlicon Valley, almost every company is fighting to hire good designers and engineers. Do you find it difficult to find and retain talent?\u003c/strong>\u003c/p>\n\u003cp>I have this frustration that the nonprofit sector pays very talented people not very much money because they have chosen this field. We try to pay people market salaries, despite the push-back from donors. I think our employees are worth even more than what we're paying them.\u003c/p>\n\u003cp>Overall though, we've done well with recruiting. Where it gets challenging is with more senior staff; people with nonprofit experience and medical device experience.\u003c/p>\n\u003cp>\u003cstrong>Any parting words of wisdom for would-be health entrepreneurs who want to help low-income people?\u003c/strong>\u003c/p>\n\u003cp>Get out there and get experience. Talk to people; learn how to frame questions. Every time I go on vacation for instance, I stop into clinics and hospitals that use our products. Whenever I do field work, I always learn new things.\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>[ted id=1895]\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/2981/d-rev-ceo-we-build-medical-devices-for-people-who-live-on-less-than-4-a-day","authors":["3252"],"series":["futureofyou_135","futureofyou_219"],"categories":["futureofyou_1062"],"tags":["futureofyou_316","futureofyou_320","futureofyou_322","futureofyou_80","futureofyou_317","futureofyou_321","futureofyou_319","futureofyou_323","futureofyou_318"],"featImg":"futureofyou_2987","label":"futureofyou_219"},"futureofyou_1722":{"type":"posts","id":"futureofyou_1722","meta":{"index":"posts_1591205157","site":"futureofyou","id":"1722","score":null,"sort":[1429131211000]},"guestAuthors":[],"slug":"meet-the-man-leading-californias-3m-precision-medicine-initiative","title":"Meet the Man Leading California's $3M 'Precision Medicine' Initiative","publishDate":1429131211,"format":"standard","headTitle":"Q&A | Future of You | KQED Future of You | KQED Science","labelTerm":{"term":54,"site":"futureofyou"},"content":"\u003cp>\"Precision medicine\" may seem like a vague and futuristic term. But for President Obama and other policymakers, it represents the future of cancer treatment and care.\u003c/p>\n\u003cp>For decades, doctors would prescribe treatments that work for some or most people -- a \"one sized fits all\" approach. But precision medicine proposes that care providers treat patients on an individual basis.\u003c/p>\n\u003cp>This week, the state of California stepped up its efforts to deliver more targeted health care by setting aside $3 million for precision medicine.\u003c/p>\n\u003cp>The program relies on support from patients, caregivers and researchers, including doctors and nurses. Many health experts are already on board, as precision medicine could dramatically improve how we treat serious diseases, like cancer and diabetes.\u003c/p>\n\u003cfigure id=\"attachment_1760\" class=\"wp-caption alignright\" style=\"max-width: 370px\">\u003cimg class=\"size-full wp-image-1760\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/Precision-Medicine-Timeline2.jpg\" alt=\"A timeline of precision medicine milestones\" width=\"370\" height=\"1190\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/Precision-Medicine-Timeline2.jpg 370w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Precision-Medicine-Timeline2-187x600.jpg 187w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Precision-Medicine-Timeline2-367x1180.jpg 367w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Precision-Medicine-Timeline2-320x1029.jpg 320w\" sizes=\"(max-width: 370px) 100vw, 370px\">\u003cfigcaption class=\"wp-caption-text\">A timeline of precision medicine milestones \u003ccite>(UCSF)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Atul Butte, a physician and computational health buff, has stepped up to lead California's $3 million initiative. \u003cem>KQED's Future of You\u003c/em> discussed with Butte the goals for the program,called the \"California Initiative To Advance Precision Medicine,\" a few of the challenges, and the real benefits for people. This interview has been edited and condensed for brevity.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Do patients understand this \"Precision Medicine\" idea? How will you communicate this initiative to the general public?\u003c/strong>\u003c/p>\n\u003cp>Honestly, I don't think most people do. We are still trying to define the phrase, and figure out how best to describe it to the public. President Obama mentioned it earlier this year in a speech, and positioned it as a way for the country to try to solve cancer. I use phrases like \"imagine a Google Maps for health\" or \"a new molecular approach to thinking about disease\" -- and I tell people that now we're in a position to really do something.\u003c/p>\n\u003cp>\u003cstrong>The analogy of \"Google Maps for health\" is catchy. Did you come up with it? And what does it mean?\u003c/strong>\u003c/p>\n\u003cp>I actually borrowed the term from a \u003ca href=\"http://www.ucsf.edu/sites/default/files/legacy_files/documents/new-taxonomy.pdf\">\u003cspan class=\"s2\">2011 report from the Institute of Medicine\u003c/span>\u003c/a>. Susan Desmond-Hellman and \u003ca href=\"http://yamamotolab.ucsf.edu/\">\u003cspan class=\"s2\">Keith Yamamoto\u003c/span>\u003c/a> and others from UCSF were part of a committee to decide what the future of medical research would be. The committee collected health data in all sorts of layers, including a layer for cost of care, for genomics, or for medications. But we are not connecting the dots between these layers. The analogy the committee used is with Google Maps, which pulls together in its visualization traffic data, restaurant ratings, building data and more. You need that kind of data integration for Life Sciences and medicine also.\u003c/p>\n\u003cp>\u003cb>KQED \u003c/b>\u003ca href=\"http://ww2.kqed.org/futureofyou/2015/03/20/ucsf-white-house-search-for-better-treatments-for-disease/\">\u003cspan class=\"s2\">\u003cb>recently visited your new digs at the UCSF Mission Bay\u003c/b>\u003c/span>\u003c/a>\u003cb> to meet with U.S. Department of Health and Human Services Secretary Sylvia Burwell and discuss the government's plans for Precision Medicine. What new details have emerged since then?\u003c/b>\u003c/p>\n\u003caside class=\"pullquote alignright\">“We're not looking at tiny bits of human DNA anymore, but the whole genome.\"\u003c/aside>\n\u003cp>Well, our plans date back to well before your visit in March. Governor Brown mentioned 'Precision Medicine' in the 2014 State of the Union Address. A pot of money -- $3 million -- was put into the state budget. We've been thinking since then about how to leverage that money.\u003c/p>\n\u003cp>We now know that we're planning to use it in two ways. We will start by collecting data that is necessary for us to provide Precision Medicine. We will determine questions like: Who has the assets? Is it groups of patients or genomics companies?\u003c/p>\n\u003cp>The bulk of the money, however, will go to two research pilots. These pilots will be run at multiple sites across the UC Health System.\u003c/p>\n\u003cp>\u003cstrong>How will you pick the two pilots? Will you setup a committee to evaluate all the proposals? And which diseases are you focusing on first?\u003c/strong>\u003c/p>\n\u003cp>We envision that all ten of the UC campuses will put in proposals. We may also get entries from Stanford and other California medical schools, as well as private biotech companies. We'll put together a committee in the next few weeks to decide on the two that will receive funding.\u003c/p>\n\u003cp>We're hoping that different campuses will work together and exchange relevant data. For instance, if two of the UC schools are exceptionally great at taking care of patients with breast cancer, they could pool data to develop specific drug therapies.\u003c/p>\n\u003cp>Cancer is an obvious target for Precision Medicine, and a lot of people are talking about that. We could also help kids with rare diseases.\u003c/p>\n\u003cp>\u003cstrong>How will you deal with some of the challenges of sharing data across different medical institutions? As recent articles \u003ca href=\"http://ww2.kqed.org/futureofyou/broken-medical-records\">(including a two-part series from KQED) \u003c/a>have demonstrated, much of this data isn't stored in a format that computers can ingest. And as you gather this sensitive data, how will you protect it?\u003c/strong>\u003c/p>\n\u003cp>A lot of this data is structured, which makes it easier for a computer to sort. But some of it, like imaging studies and text-based medical reports, are very difficult to process. There are some tools we can use, but we envision that many more tools will be developed in the next few years, whether it's from academia or private companies.\u003c/p>\n\u003cp>Another thing to highlight is that we want to make sure patients are involved in the process. We will make sure the data is anonymized and de-identified. We don't need to know who these patients are. We'll also be adding ethics and privacy advocates on the committee.\u003c/p>\n\u003cp>\u003cstrong>$3 million is a drop in the bucket when it comes to health care. Are you disappointed that there aren't more funds for the initiative?\u003c/strong>\u003c/p>\n\u003cp>Frankly, I am thrilled there is any money at all. Money for science from state budgets is hard to come by! But there may be more money in the future, potentially from private investors.\u003c/p>\n\u003cp>\u003cstrong>Speaking of patients, how will people benefit from this initiative in real and tangible ways? The initiative seems quite vague in its scope.\u003c/strong>\u003c/p>\n\u003cp>Let's be clear: This is a modest sum of money that will be spent on short-term trials. Some patients might enroll in these studies, particularly as existing studies expand to more UC centers. Those who participate at the early stages can learn about genetics. But the experience will not change for the average Californian.\u003c/p>\n\u003cp>\u003cstrong>How did you get involved in this field of \"computational health sciences\"? Will there be a hot market for jobs like this, which combine computer science and medicine skill-sets?\u003c/strong>\u003c/p>\n\u003cp>I started my career as a computer scientist, and used to work as a contractor for big companies like Apple. I later attended medical school and trained as a pediatrician. My advisors convinced me to go to \u003ca href=\"http://web.mit.edu/\">The Massachusetts Institute of Technology (MIT) to earn a PhD. \u003c/a>After graduating, I set up a lab to figure out how to better use medical data.\u003c/p>\n\u003cp>I just moved over to UCSF from Stanford at the beginning of April to build out the Institute for Computational Health Science. We'll be recruiting heavily.\u003c/p>\n\u003cp>The field of bioinformatics has been important for some time, but the significance is new. We're not looking at tiny bits of human DNA anymore, but the whole genome. The scope is much bigger. Bioinformatics is absolutely the career of the future.\u003c/p>\n\u003cp>\u003cstrong>What brought you to UCSF after over a decade at Stanford?\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"Bioinformatics is absolutely the career of the future.\"\u003c/aside>\n\u003cp>I loved Stanford, but UCSF offered two things I couldn't get there. It's a major medical center with large patient populations and resources that are required to build out a whole program in computational health. We're going to build a new building -- you need a large set of resources for that. Also, I have this physician link across all the UC health campuses. That's 13 million patients! We can really learn a lot from them, while we work to improve the consistency of care across the UC system.\u003c/p>\n\u003cp>\u003cstrong>Do you have any plans for new research that would reduce inefficiencies and help keep health care costs under control? And how about pricing, which can wildly differ between California hospitals?\u003c/strong>\u003c/p>\n\u003cp>Yes, there are a lot of inefficiencies in our health care system. I think data might shed light on where we can improve. I am hopeful we can reduce health care costs. How can we remove the piece that isn't needed?\u003c/p>\n\u003cp>Pricing depends on a complicated system of players, including payers. If I can even partially solve the cost problem, I'll see that as a success. Pricing is a different story.\u003c/p>\n\u003cp>\u003cstrong>How will the private sector get involved with this initiative? And are you looking at involving digital health tools from Silicon Valley's startups?\u003c/strong>\u003c/p>\n\u003cp>Yes, we expect that private industry will want to get involved. I have been getting tons of emails already from companies.\u003c/p>\n\u003cp>We envision that these pilots will draw on resources from the tech world, like Apple's ResearchKit, which offers an interesting way to recruit patients. We would also encourage research teams to use new tools and partner with companies like Apple or Samsung to get more outcomes data on their patients. What are patients like at home? How healthy are their habits? We need more real-world data.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>I am definitely optimistic about the role of technology in health care. Computers and digitization really has helped. We just need to make sure people aren't being left behind as we move into this digital age, and that everyone makes these transition away from paper-based systems in a safe and effective way.\u003c/p>\n\n","blocks":[],"excerpt":"The state of California just launched a $3 million \"Precision Medicine\" initiative. The project's leader, Dr. Atul Butte, opens up to KQED about some of the key challenges, including efforts to safeguard patient privacy. ","status":"publish","parent":0,"modified":1429133385,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":39,"wordCount":1637},"headData":{"title":"Meet the Man Leading California's $3M 'Precision Medicine' Initiative | KQED","description":"The state of California just launched a $3 million "Precision Medicine" initiative. The project's leader, Dr. Atul Butte, opens up to KQED about some of the key challenges, including efforts to safeguard patient privacy. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Meet the Man Leading California's $3M 'Precision Medicine' Initiative","datePublished":"2015-04-15T20:53:31.000Z","dateModified":"2015-04-15T21:29:45.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"1722 http://ww2.kqed.org/futureofyou/?p=1722","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/04/15/meet-the-man-leading-californias-3m-precision-medicine-initiative/","disqusTitle":"Meet the Man Leading California's $3M 'Precision Medicine' Initiative","path":"/futureofyou/1722/meet-the-man-leading-californias-3m-precision-medicine-initiative","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\"Precision medicine\" may seem like a vague and futuristic term. But for President Obama and other policymakers, it represents the future of cancer treatment and care.\u003c/p>\n\u003cp>For decades, doctors would prescribe treatments that work for some or most people -- a \"one sized fits all\" approach. But precision medicine proposes that care providers treat patients on an individual basis.\u003c/p>\n\u003cp>This week, the state of California stepped up its efforts to deliver more targeted health care by setting aside $3 million for precision medicine.\u003c/p>\n\u003cp>The program relies on support from patients, caregivers and researchers, including doctors and nurses. Many health experts are already on board, as precision medicine could dramatically improve how we treat serious diseases, like cancer and diabetes.\u003c/p>\n\u003cfigure id=\"attachment_1760\" class=\"wp-caption alignright\" style=\"max-width: 370px\">\u003cimg class=\"size-full wp-image-1760\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/Precision-Medicine-Timeline2.jpg\" alt=\"A timeline of precision medicine milestones\" width=\"370\" height=\"1190\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/Precision-Medicine-Timeline2.jpg 370w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Precision-Medicine-Timeline2-187x600.jpg 187w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Precision-Medicine-Timeline2-367x1180.jpg 367w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Precision-Medicine-Timeline2-320x1029.jpg 320w\" sizes=\"(max-width: 370px) 100vw, 370px\">\u003cfigcaption class=\"wp-caption-text\">A timeline of precision medicine milestones \u003ccite>(UCSF)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Atul Butte, a physician and computational health buff, has stepped up to lead California's $3 million initiative. \u003cem>KQED's Future of You\u003c/em> discussed with Butte the goals for the program,called the \"California Initiative To Advance Precision Medicine,\" a few of the challenges, and the real benefits for people. This interview has been edited and condensed for brevity.\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>Do patients understand this \"Precision Medicine\" idea? How will you communicate this initiative to the general public?\u003c/strong>\u003c/p>\n\u003cp>Honestly, I don't think most people do. We are still trying to define the phrase, and figure out how best to describe it to the public. President Obama mentioned it earlier this year in a speech, and positioned it as a way for the country to try to solve cancer. I use phrases like \"imagine a Google Maps for health\" or \"a new molecular approach to thinking about disease\" -- and I tell people that now we're in a position to really do something.\u003c/p>\n\u003cp>\u003cstrong>The analogy of \"Google Maps for health\" is catchy. Did you come up with it? And what does it mean?\u003c/strong>\u003c/p>\n\u003cp>I actually borrowed the term from a \u003ca href=\"http://www.ucsf.edu/sites/default/files/legacy_files/documents/new-taxonomy.pdf\">\u003cspan class=\"s2\">2011 report from the Institute of Medicine\u003c/span>\u003c/a>. Susan Desmond-Hellman and \u003ca href=\"http://yamamotolab.ucsf.edu/\">\u003cspan class=\"s2\">Keith Yamamoto\u003c/span>\u003c/a> and others from UCSF were part of a committee to decide what the future of medical research would be. The committee collected health data in all sorts of layers, including a layer for cost of care, for genomics, or for medications. But we are not connecting the dots between these layers. The analogy the committee used is with Google Maps, which pulls together in its visualization traffic data, restaurant ratings, building data and more. You need that kind of data integration for Life Sciences and medicine also.\u003c/p>\n\u003cp>\u003cb>KQED \u003c/b>\u003ca href=\"http://ww2.kqed.org/futureofyou/2015/03/20/ucsf-white-house-search-for-better-treatments-for-disease/\">\u003cspan class=\"s2\">\u003cb>recently visited your new digs at the UCSF Mission Bay\u003c/b>\u003c/span>\u003c/a>\u003cb> to meet with U.S. Department of Health and Human Services Secretary Sylvia Burwell and discuss the government's plans for Precision Medicine. What new details have emerged since then?\u003c/b>\u003c/p>\n\u003caside class=\"pullquote alignright\">“We're not looking at tiny bits of human DNA anymore, but the whole genome.\"\u003c/aside>\n\u003cp>Well, our plans date back to well before your visit in March. Governor Brown mentioned 'Precision Medicine' in the 2014 State of the Union Address. A pot of money -- $3 million -- was put into the state budget. We've been thinking since then about how to leverage that money.\u003c/p>\n\u003cp>We now know that we're planning to use it in two ways. We will start by collecting data that is necessary for us to provide Precision Medicine. We will determine questions like: Who has the assets? Is it groups of patients or genomics companies?\u003c/p>\n\u003cp>The bulk of the money, however, will go to two research pilots. These pilots will be run at multiple sites across the UC Health System.\u003c/p>\n\u003cp>\u003cstrong>How will you pick the two pilots? Will you setup a committee to evaluate all the proposals? And which diseases are you focusing on first?\u003c/strong>\u003c/p>\n\u003cp>We envision that all ten of the UC campuses will put in proposals. We may also get entries from Stanford and other California medical schools, as well as private biotech companies. We'll put together a committee in the next few weeks to decide on the two that will receive funding.\u003c/p>\n\u003cp>We're hoping that different campuses will work together and exchange relevant data. For instance, if two of the UC schools are exceptionally great at taking care of patients with breast cancer, they could pool data to develop specific drug therapies.\u003c/p>\n\u003cp>Cancer is an obvious target for Precision Medicine, and a lot of people are talking about that. We could also help kids with rare diseases.\u003c/p>\n\u003cp>\u003cstrong>How will you deal with some of the challenges of sharing data across different medical institutions? As recent articles \u003ca href=\"http://ww2.kqed.org/futureofyou/broken-medical-records\">(including a two-part series from KQED) \u003c/a>have demonstrated, much of this data isn't stored in a format that computers can ingest. And as you gather this sensitive data, how will you protect it?\u003c/strong>\u003c/p>\n\u003cp>A lot of this data is structured, which makes it easier for a computer to sort. But some of it, like imaging studies and text-based medical reports, are very difficult to process. There are some tools we can use, but we envision that many more tools will be developed in the next few years, whether it's from academia or private companies.\u003c/p>\n\u003cp>Another thing to highlight is that we want to make sure patients are involved in the process. We will make sure the data is anonymized and de-identified. We don't need to know who these patients are. We'll also be adding ethics and privacy advocates on the committee.\u003c/p>\n\u003cp>\u003cstrong>$3 million is a drop in the bucket when it comes to health care. Are you disappointed that there aren't more funds for the initiative?\u003c/strong>\u003c/p>\n\u003cp>Frankly, I am thrilled there is any money at all. Money for science from state budgets is hard to come by! But there may be more money in the future, potentially from private investors.\u003c/p>\n\u003cp>\u003cstrong>Speaking of patients, how will people benefit from this initiative in real and tangible ways? The initiative seems quite vague in its scope.\u003c/strong>\u003c/p>\n\u003cp>Let's be clear: This is a modest sum of money that will be spent on short-term trials. Some patients might enroll in these studies, particularly as existing studies expand to more UC centers. Those who participate at the early stages can learn about genetics. But the experience will not change for the average Californian.\u003c/p>\n\u003cp>\u003cstrong>How did you get involved in this field of \"computational health sciences\"? Will there be a hot market for jobs like this, which combine computer science and medicine skill-sets?\u003c/strong>\u003c/p>\n\u003cp>I started my career as a computer scientist, and used to work as a contractor for big companies like Apple. I later attended medical school and trained as a pediatrician. My advisors convinced me to go to \u003ca href=\"http://web.mit.edu/\">The Massachusetts Institute of Technology (MIT) to earn a PhD. \u003c/a>After graduating, I set up a lab to figure out how to better use medical data.\u003c/p>\n\u003cp>I just moved over to UCSF from Stanford at the beginning of April to build out the Institute for Computational Health Science. We'll be recruiting heavily.\u003c/p>\n\u003cp>The field of bioinformatics has been important for some time, but the significance is new. We're not looking at tiny bits of human DNA anymore, but the whole genome. The scope is much bigger. Bioinformatics is absolutely the career of the future.\u003c/p>\n\u003cp>\u003cstrong>What brought you to UCSF after over a decade at Stanford?\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"Bioinformatics is absolutely the career of the future.\"\u003c/aside>\n\u003cp>I loved Stanford, but UCSF offered two things I couldn't get there. It's a major medical center with large patient populations and resources that are required to build out a whole program in computational health. We're going to build a new building -- you need a large set of resources for that. Also, I have this physician link across all the UC health campuses. That's 13 million patients! We can really learn a lot from them, while we work to improve the consistency of care across the UC system.\u003c/p>\n\u003cp>\u003cstrong>Do you have any plans for new research that would reduce inefficiencies and help keep health care costs under control? And how about pricing, which can wildly differ between California hospitals?\u003c/strong>\u003c/p>\n\u003cp>Yes, there are a lot of inefficiencies in our health care system. I think data might shed light on where we can improve. I am hopeful we can reduce health care costs. How can we remove the piece that isn't needed?\u003c/p>\n\u003cp>Pricing depends on a complicated system of players, including payers. If I can even partially solve the cost problem, I'll see that as a success. Pricing is a different story.\u003c/p>\n\u003cp>\u003cstrong>How will the private sector get involved with this initiative? And are you looking at involving digital health tools from Silicon Valley's startups?\u003c/strong>\u003c/p>\n\u003cp>Yes, we expect that private industry will want to get involved. I have been getting tons of emails already from companies.\u003c/p>\n\u003cp>We envision that these pilots will draw on resources from the tech world, like Apple's ResearchKit, which offers an interesting way to recruit patients. We would also encourage research teams to use new tools and partner with companies like Apple or Samsung to get more outcomes data on their patients. What are patients like at home? How healthy are their habits? We need more real-world 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>I am definitely optimistic about the role of technology in health care. Computers and digitization really has helped. We just need to make sure people aren't being left behind as we move into this digital age, and that everyone makes these transition away from paper-based systems in a safe and effective way.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/1722/meet-the-man-leading-californias-3m-precision-medicine-initiative","authors":["3252"],"programs":["futureofyou_54"],"series":["futureofyou_135"],"categories":["futureofyou_1","futureofyou_73"],"tags":["futureofyou_15","futureofyou_194","futureofyou_29","futureofyou_200","futureofyou_103","futureofyou_141","futureofyou_190","futureofyou_34","futureofyou_138","futureofyou_197","futureofyou_196","futureofyou_171","futureofyou_80","futureofyou_112","futureofyou_170","futureofyou_198","futureofyou_113"],"featImg":"futureofyou_1750","label":"futureofyou_54"},"futureofyou_1394":{"type":"posts","id":"futureofyou_1394","meta":{"index":"posts_1591205157","site":"futureofyou","id":"1394","score":null,"sort":[1428681366000]},"guestAuthors":[],"slug":"23andme-ceo-we-are-now-the-poster-child-for-patient-empowerment","title":"23andMe CEO: We Are Now the 'Poster Child' for Patient Empowerment","publishDate":1428681366,"format":"standard","headTitle":"Q&A | KQED Future of You | KQED Science","labelTerm":{"term":135,"site":"futureofyou"},"content":"\u003cp>\u003cstrong>Update, 12:00 p.m. Oct 21: \u003c/strong>\u003ca href=\"http://ww2.kqed.org/futureofyou/2015/10/21/its-back-23andme-relaunches-its-consumer-gene-test/\">23andMe relaunched\u003c/a> its gene test with dozens of health reports, making it the first direct to consumer DNA test to gain approval from FDA.\u003c/p>\n\u003cp>\u003cstrong>Original story:\u003c/strong>\u003c/p>\n\u003cp>Many media pundits wrote off a genetic-testing start-up called \u003ca href=\"http://23andme.com\">23andMe\u003c/a> in November of 2013, when federal regulators ordered an immediate halt to sales of its flagship product.\u003c/p>\n\u003cp>In exchange for a swab of spit, Google-funded 23andMe provided people with direct access to over 200 health reports, detailing their risk of getting or carrying the gene mutation for a disease such as breast cancer or Parkinson's disease. But regulators\u003ca href=\"http://www.fda.gov/iceci/enforcementactions/warningletters/2013/ucm376296.htm\"> feared that people would misinterpret this health data\u003c/a>, which had not been clinically validated, or take action based on a \"false positive\" result.\u003c/p>\n\u003cp>Obstacles aside, the company has continued to \u003ca href=\"http://www.foxbusiness.com/markets/2015/03/12/dna-testing-firm-23andme-hires-biotechnology-executive-in-bid-to-develop-its/\">grow its team with some high-profile\u003c/a> hires, ink partnerships with big\u003ca href=\"https://www.genomeweb.com/genetic-research/23andme-pfizer-partner-genetic-research-target-lupus\"> pharmaceutical companies like Pfizer\u003c/a> and expand its customer base to more than 850,000 people. All this, while it continues to work with the U.S. Food and Drug Administration (FDA) to bring its DNA test back to market.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The secret to the company's success? Its unstoppable chief executive, Anne Wojcicki, who has stayed true to the company's core mission: To improve access to the human genome.\u003c/p>\n\u003cp>I spoke with Wojcicki shortly after a meeting with her ever-expanding staff, and a week before a rare vacation to a remote corner of the world with her sister, Susan Wojcicki, another Silicon Valley power player who works as the CEO of \u003ca href=\"http://youtube.com\">YouTube\u003c/a>. Our interview has been condensed and edited for brevity.\u003c/p>\n\u003cp>\u003cstrong>23andMe has certainly had its critics over the years, as it's ambitious in scope. What prompted you to start the company in the first place?\u003c/strong>\u003c/p>\n\u003cp>As a young analyst on Wall Street, I invested in health care companies. I loved it, but I felt conflicted. I would go to parties filled with people in health care, and it was all about making money and having fun. I was also volunteering at hospitals in my spare time. I noticed this disconnect between the world that was making money on health care and those who are using it.\u003c/p>\n\u003cp>I still cringe at the U.S. health care system that is focused on optimizing revenues, versus improving access to care. I wanted to democratize access and I also knew that very little money was spent on prevention. 23andMe is focused on showing people their health risks. If I can do that, I think I'm doing a great service.\u003c/p>\n\u003cp>\u003cstrong>What are some of the most eye-opening discoveries you've made by using your own service?\u003c/strong>\u003c/p>\n\u003cp>I remember the first time my family took the test, because we found out that Sergey [Brin, cofounder of Google and Wojcicki's husband] was a carrier for the LRRK2 gene, making him a carrier for Parkinson's Disease. That was monumental. We also found out that I have a higher risk for breast cancer and I'm a carrier of an inherited disease called \u003ca href=\"http://ghr.nlm.nih.gov/condition/bloom-syndrome\">Bloom's Syndrome\u003c/a>. I am now more proactive about my diet.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"I still cringe at the U.S. health care system that is focused on optimizing revenues, versus improving access to care.\"\u003cbr>\n\u003ccite>Anne Wojcicki, 23andMe CEO\u003c/cite>\u003c/aside>\n\u003cp>Another cool thing is the first time you see that your children are actually our children. Obviously I know they're mine as I saw them being born. But when you can see it in a digital form, it's pretty awesome. It's one of those moments where you feel like you're part of this legacy.\u003c/p>\n\u003cp>[Editors' Note: Wojcicki is still legally married to Google cofounder Sergey Brin, but the pair are separated. Google invested \u003cspan class=\"st\">$3.9 million in 23andMe in 2007.\u003c/span>]\u003c/p>\n\u003cp>\u003cstrong>Were you surprised by the FDA's warning letter? Or did you expect to overcome some major hurdles with this company?\u003c/strong>\u003c/p>\n\u003cp>When I worked on Wall Street, we knew that stocks would go up and go down. Likewise, we have always anticipated that there would be ups and downs with an ambitious company like this, which is focused on helping people understand, access and benefit from the human genome. The FDA letter was obviously a big bump in the road for us, but our board and our investors understood from the beginning that it wasn't going to be easy.\u003c/p>\n\u003cp>\u003cstrong>You recently experienced a small victory, with the FDA approving your test for a rare genetic disease called Bloom Syndrome. How did you feel when you heard the news?\u003c/strong>\u003c/p>\n\u003cp>It was one of the first times in the company that we had a standing ovation. We felt a ton of pride. On a personal level, this has been a big lesson. There is a level of steps and patience that is required. I'm trying not to inhale the health revolution all at once.\u003c/p>\n\u003cp>I also felt fortunate to have Kathy Hibbs [\u003ca href=\"https://www.linkedin.com/pub/kathy-hibbs/40/679/a0a\">23andMe's chief legal and regulatory officer\u003c/a>] on board. We understood even back in 2010 that we would be regulated as a medical device. But there was a lot of miscommunication on our behalf. With Kathy, we have someone who has paved the way towards getting the product to market.\u003c/p>\n\u003cp>\u003cstrong>What's next in the pipeline for approval after Bloom Syndrome?\u003c/strong>\u003c/p>\n\u003cp>I'm playing the role of the obedient CEO and deferring to Kathy [Hibbs] on this. With the Bloom Syndrome approval, the FDA \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm435003.htm\">down-classified \u003cspan class=\"st\">autosomal recessive disorder\u003c/span>s.\u003c/a> We're pretty excited about that. \u003ca href=\"http://www.nigms.nih.gov/Research/SpecificAreas/PGRN/Background/Pages/pgrn_faq.aspx\">We are also looking at pharmacogenetics [how individuals respond to drugs]\u003c/a>; the BRCA gene test for breast cancer and disease risks, including Alzheimer's Disease.\u003c/p>\n\u003cp>\u003cstrong>A recent Washington Post article \u003ca href=\"http://www.washingtonpost.com/national/health-science/23andme-co-founder-anne-wojcickis-washington-charm-offensive/2014/06/27/b465b086-f240-11e3-9ebc-2ee6f81ed217_story.html\">described you as being on the \"charm offensive\" in D.C.\u003c/a>, as you have been seen liaising with folks from the White House and other federal agencies. Why the shift in focus?\u003c/strong>\u003c/p>\n\u003cp>One of the benefits of the warning letter from the FDA is that it brought me to D.C. often for conversations with policymakers. We weren't in D.C. enough before.\u003c/p>\n\u003cp>23andMe is now seen in D.C. as a poster child for this \"consumer empowerment\" movement, as we've spoken out publicly on this topic. I've said many times that consumers with no background in medicine can understand complicated ideas. We're seeing this idea circulate on the Hill that it's the right time for the consumer to transition from subject to participant.\u003c/p>\n\u003cp>\u003cstrong>We've heard your name in association with the President's \"Precision Medicine\" initiative. How involved have you been?\u003c/strong>\u003c/p>\n\u003cp>We are not that involved, but I have been super impressed with the initiative so far. They called out the fact that there should be far more consumer engagement in health care. For example, why hasn't there been a single federally funded study where consumers get their genetic information? All this money is going into research, but participants aren't getting their data back.\u003c/p>\n\u003cp>I saw Eric Green [director of the \u003ca href=\"http://www.genome.gov/\">National Human Genome Research Institute\u003c/a>] last night. There is definitely a vision in the government to get a larger number of people engaged and leverage a lot of data. They have to put together a plan for the initiative soon. I feel lucky I'm not part of it. It's going to be a lot of work over the next three months.\u003c/p>\n\u003cp>\u003cstrong>You've been partnering up with big pharmaceutical vendors and other stakeholders. How can we be sure that you won't detract from the core mission, and end up like the money-guzzling entities you encountered on Wall Street? \u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"There's men, there's women and then there's assholes. I recommend trying to work with the men and the women.\"\u003cbr>\n\u003ccite>Anne Wojcicki, 23andMe CEO\u003c/cite>\u003c/aside>\n\u003cp>Pharma isn't all bad. It's a necessary component of the health care system. They are the ones who make the therapies. But I do want us to do things differently in making sure the consumer is part of the solution, and we also want to continue to do work on prevention. I'm also keeping an eye on different health care models in other parts of the world, which I feel morally better about.\u003c/p>\n\u003cp>\u003cstrong>\u003ca href=\"http://www.forbes.com/sites/matthewherper/2015/03/12/23andme-enters-the-drug-business-just-as-apple-changes-it/\">23andMe is getting into drug invention,\u003c/a> which seems very ambitious given the high costs of bringing a new pharmaceutical to market. How will you find the resources?\u003c/strong>\u003c/p>\n\u003cp>We're going to do it differently. I find it outright crazy that so few firms are researching who this drug will work for. We want to do the right thing even if it means cutting down our market size.\u003c/p>\n\u003cp>There are so many inefficiencies in drug development and we'll take a different approach in clinical trial recruitment. We have almost a million people and growing, and we'll recruit directly from our database. As for the money, it will be solvable if we get to that point. We'll raise the funds if we have good target ideas.\u003c/p>\n\u003cp>\u003cstrong>What's next for the future? How about sequencing the whole genome, given the \u003ca href=\"http://www.nature.com/news/technology-the-1-000-genome-1.14901\">recent claims that it can be done for $1000\u003c/a>?\u003c/strong>\u003c/p>\n\u003cp>We are definitely thinking about sequencing. It's high on our list of priorities and topics. We've always said we'll move into it when it finally gets to an even more consumer-friendly price point.\u003c/p>\n\u003cp>\u003cstrong>Finally, KQED's Future of You \u003ca href=\"http://ww2.kqed.org/futureofyou/2015/03/23/what-digital-health-lacks-female-ceos/\">published some findings\u003c/a> on the lack of gender diversity in health care. Any advice for would-be female founders?\u003c/strong>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>There's men, there's women and then there's assholes. I recommend trying to work with the men and the women! On a more serious note though, there should be more women in the industry. Gender diversity leads to more innovation for the entire sector.\u003c/p>\n\n","blocks":[],"excerpt":"23andMe's secret weapon? Its mission-driven, straight-talking CEO Anne Wojcicki. She opens up with KQED about DNA, diversity and more.","status":"publish","parent":0,"modified":1477283137,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":38,"wordCount":1639},"headData":{"title":"23andMe CEO: We Are Now the 'Poster Child' for Patient Empowerment | KQED","description":"23andMe's secret weapon? Its mission-driven, straight-talking CEO Anne Wojcicki. She opens up with KQED about DNA, diversity and more.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"23andMe CEO: We Are Now the 'Poster Child' for Patient Empowerment","datePublished":"2015-04-10T15:56:06.000Z","dateModified":"2016-10-24T04:25:37.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"1394 http://ww2.kqed.org/futureofyou/?p=1394","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/04/10/23andme-ceo-we-are-now-the-poster-child-for-patient-empowerment/","disqusTitle":"23andMe CEO: We Are Now the 'Poster Child' for Patient Empowerment","path":"/futureofyou/1394/23andme-ceo-we-are-now-the-poster-child-for-patient-empowerment","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Update, 12:00 p.m. Oct 21: \u003c/strong>\u003ca href=\"http://ww2.kqed.org/futureofyou/2015/10/21/its-back-23andme-relaunches-its-consumer-gene-test/\">23andMe relaunched\u003c/a> its gene test with dozens of health reports, making it the first direct to consumer DNA test to gain approval from FDA.\u003c/p>\n\u003cp>\u003cstrong>Original story:\u003c/strong>\u003c/p>\n\u003cp>Many media pundits wrote off a genetic-testing start-up called \u003ca href=\"http://23andme.com\">23andMe\u003c/a> in November of 2013, when federal regulators ordered an immediate halt to sales of its flagship product.\u003c/p>\n\u003cp>In exchange for a swab of spit, Google-funded 23andMe provided people with direct access to over 200 health reports, detailing their risk of getting or carrying the gene mutation for a disease such as breast cancer or Parkinson's disease. But regulators\u003ca href=\"http://www.fda.gov/iceci/enforcementactions/warningletters/2013/ucm376296.htm\"> feared that people would misinterpret this health data\u003c/a>, which had not been clinically validated, or take action based on a \"false positive\" result.\u003c/p>\n\u003cp>Obstacles aside, the company has continued to \u003ca href=\"http://www.foxbusiness.com/markets/2015/03/12/dna-testing-firm-23andme-hires-biotechnology-executive-in-bid-to-develop-its/\">grow its team with some high-profile\u003c/a> hires, ink partnerships with big\u003ca href=\"https://www.genomeweb.com/genetic-research/23andme-pfizer-partner-genetic-research-target-lupus\"> pharmaceutical companies like Pfizer\u003c/a> and expand its customer base to more than 850,000 people. All this, while it continues to work with the U.S. Food and Drug Administration (FDA) to bring its DNA test back to market.\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 secret to the company's success? Its unstoppable chief executive, Anne Wojcicki, who has stayed true to the company's core mission: To improve access to the human genome.\u003c/p>\n\u003cp>I spoke with Wojcicki shortly after a meeting with her ever-expanding staff, and a week before a rare vacation to a remote corner of the world with her sister, Susan Wojcicki, another Silicon Valley power player who works as the CEO of \u003ca href=\"http://youtube.com\">YouTube\u003c/a>. Our interview has been condensed and edited for brevity.\u003c/p>\n\u003cp>\u003cstrong>23andMe has certainly had its critics over the years, as it's ambitious in scope. What prompted you to start the company in the first place?\u003c/strong>\u003c/p>\n\u003cp>As a young analyst on Wall Street, I invested in health care companies. I loved it, but I felt conflicted. I would go to parties filled with people in health care, and it was all about making money and having fun. I was also volunteering at hospitals in my spare time. I noticed this disconnect between the world that was making money on health care and those who are using it.\u003c/p>\n\u003cp>I still cringe at the U.S. health care system that is focused on optimizing revenues, versus improving access to care. I wanted to democratize access and I also knew that very little money was spent on prevention. 23andMe is focused on showing people their health risks. If I can do that, I think I'm doing a great service.\u003c/p>\n\u003cp>\u003cstrong>What are some of the most eye-opening discoveries you've made by using your own service?\u003c/strong>\u003c/p>\n\u003cp>I remember the first time my family took the test, because we found out that Sergey [Brin, cofounder of Google and Wojcicki's husband] was a carrier for the LRRK2 gene, making him a carrier for Parkinson's Disease. That was monumental. We also found out that I have a higher risk for breast cancer and I'm a carrier of an inherited disease called \u003ca href=\"http://ghr.nlm.nih.gov/condition/bloom-syndrome\">Bloom's Syndrome\u003c/a>. I am now more proactive about my diet.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"I still cringe at the U.S. health care system that is focused on optimizing revenues, versus improving access to care.\"\u003cbr>\n\u003ccite>Anne Wojcicki, 23andMe CEO\u003c/cite>\u003c/aside>\n\u003cp>Another cool thing is the first time you see that your children are actually our children. Obviously I know they're mine as I saw them being born. But when you can see it in a digital form, it's pretty awesome. It's one of those moments where you feel like you're part of this legacy.\u003c/p>\n\u003cp>[Editors' Note: Wojcicki is still legally married to Google cofounder Sergey Brin, but the pair are separated. Google invested \u003cspan class=\"st\">$3.9 million in 23andMe in 2007.\u003c/span>]\u003c/p>\n\u003cp>\u003cstrong>Were you surprised by the FDA's warning letter? Or did you expect to overcome some major hurdles with this company?\u003c/strong>\u003c/p>\n\u003cp>When I worked on Wall Street, we knew that stocks would go up and go down. Likewise, we have always anticipated that there would be ups and downs with an ambitious company like this, which is focused on helping people understand, access and benefit from the human genome. The FDA letter was obviously a big bump in the road for us, but our board and our investors understood from the beginning that it wasn't going to be easy.\u003c/p>\n\u003cp>\u003cstrong>You recently experienced a small victory, with the FDA approving your test for a rare genetic disease called Bloom Syndrome. How did you feel when you heard the news?\u003c/strong>\u003c/p>\n\u003cp>It was one of the first times in the company that we had a standing ovation. We felt a ton of pride. On a personal level, this has been a big lesson. There is a level of steps and patience that is required. I'm trying not to inhale the health revolution all at once.\u003c/p>\n\u003cp>I also felt fortunate to have Kathy Hibbs [\u003ca href=\"https://www.linkedin.com/pub/kathy-hibbs/40/679/a0a\">23andMe's chief legal and regulatory officer\u003c/a>] on board. We understood even back in 2010 that we would be regulated as a medical device. But there was a lot of miscommunication on our behalf. With Kathy, we have someone who has paved the way towards getting the product to market.\u003c/p>\n\u003cp>\u003cstrong>What's next in the pipeline for approval after Bloom Syndrome?\u003c/strong>\u003c/p>\n\u003cp>I'm playing the role of the obedient CEO and deferring to Kathy [Hibbs] on this. With the Bloom Syndrome approval, the FDA \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm435003.htm\">down-classified \u003cspan class=\"st\">autosomal recessive disorder\u003c/span>s.\u003c/a> We're pretty excited about that. \u003ca href=\"http://www.nigms.nih.gov/Research/SpecificAreas/PGRN/Background/Pages/pgrn_faq.aspx\">We are also looking at pharmacogenetics [how individuals respond to drugs]\u003c/a>; the BRCA gene test for breast cancer and disease risks, including Alzheimer's Disease.\u003c/p>\n\u003cp>\u003cstrong>A recent Washington Post article \u003ca href=\"http://www.washingtonpost.com/national/health-science/23andme-co-founder-anne-wojcickis-washington-charm-offensive/2014/06/27/b465b086-f240-11e3-9ebc-2ee6f81ed217_story.html\">described you as being on the \"charm offensive\" in D.C.\u003c/a>, as you have been seen liaising with folks from the White House and other federal agencies. Why the shift in focus?\u003c/strong>\u003c/p>\n\u003cp>One of the benefits of the warning letter from the FDA is that it brought me to D.C. often for conversations with policymakers. We weren't in D.C. enough before.\u003c/p>\n\u003cp>23andMe is now seen in D.C. as a poster child for this \"consumer empowerment\" movement, as we've spoken out publicly on this topic. I've said many times that consumers with no background in medicine can understand complicated ideas. We're seeing this idea circulate on the Hill that it's the right time for the consumer to transition from subject to participant.\u003c/p>\n\u003cp>\u003cstrong>We've heard your name in association with the President's \"Precision Medicine\" initiative. How involved have you been?\u003c/strong>\u003c/p>\n\u003cp>We are not that involved, but I have been super impressed with the initiative so far. They called out the fact that there should be far more consumer engagement in health care. For example, why hasn't there been a single federally funded study where consumers get their genetic information? All this money is going into research, but participants aren't getting their data back.\u003c/p>\n\u003cp>I saw Eric Green [director of the \u003ca href=\"http://www.genome.gov/\">National Human Genome Research Institute\u003c/a>] last night. There is definitely a vision in the government to get a larger number of people engaged and leverage a lot of data. They have to put together a plan for the initiative soon. I feel lucky I'm not part of it. It's going to be a lot of work over the next three months.\u003c/p>\n\u003cp>\u003cstrong>You've been partnering up with big pharmaceutical vendors and other stakeholders. How can we be sure that you won't detract from the core mission, and end up like the money-guzzling entities you encountered on Wall Street? \u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"There's men, there's women and then there's assholes. I recommend trying to work with the men and the women.\"\u003cbr>\n\u003ccite>Anne Wojcicki, 23andMe CEO\u003c/cite>\u003c/aside>\n\u003cp>Pharma isn't all bad. It's a necessary component of the health care system. They are the ones who make the therapies. But I do want us to do things differently in making sure the consumer is part of the solution, and we also want to continue to do work on prevention. I'm also keeping an eye on different health care models in other parts of the world, which I feel morally better about.\u003c/p>\n\u003cp>\u003cstrong>\u003ca href=\"http://www.forbes.com/sites/matthewherper/2015/03/12/23andme-enters-the-drug-business-just-as-apple-changes-it/\">23andMe is getting into drug invention,\u003c/a> which seems very ambitious given the high costs of bringing a new pharmaceutical to market. How will you find the resources?\u003c/strong>\u003c/p>\n\u003cp>We're going to do it differently. I find it outright crazy that so few firms are researching who this drug will work for. We want to do the right thing even if it means cutting down our market size.\u003c/p>\n\u003cp>There are so many inefficiencies in drug development and we'll take a different approach in clinical trial recruitment. We have almost a million people and growing, and we'll recruit directly from our database. As for the money, it will be solvable if we get to that point. We'll raise the funds if we have good target ideas.\u003c/p>\n\u003cp>\u003cstrong>What's next for the future? How about sequencing the whole genome, given the \u003ca href=\"http://www.nature.com/news/technology-the-1-000-genome-1.14901\">recent claims that it can be done for $1000\u003c/a>?\u003c/strong>\u003c/p>\n\u003cp>We are definitely thinking about sequencing. It's high on our list of priorities and topics. We've always said we'll move into it when it finally gets to an even more consumer-friendly price point.\u003c/p>\n\u003cp>\u003cstrong>Finally, KQED's Future of You \u003ca href=\"http://ww2.kqed.org/futureofyou/2015/03/23/what-digital-health-lacks-female-ceos/\">published some findings\u003c/a> on the lack of gender diversity in health care. Any advice for would-be female founders?\u003c/strong>\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>There's men, there's women and then there's assholes. I recommend trying to work with the men and the women! On a more serious note though, there should be more women in the industry. Gender diversity leads to more innovation for the entire sector.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/1394/23andme-ceo-we-are-now-the-poster-child-for-patient-empowerment","authors":["3252"],"series":["futureofyou_135"],"categories":["futureofyou_1060","futureofyou_1064"],"tags":["futureofyou_15","futureofyou_36","futureofyou_17","futureofyou_138","futureofyou_120","futureofyou_61","futureofyou_171","futureofyou_80","futureofyou_170"],"featImg":"futureofyou_1396","label":"futureofyou_135"},"futureofyou_769":{"type":"posts","id":"futureofyou_769","meta":{"index":"posts_1591205157","site":"futureofyou","id":"769","score":null,"sort":[1427702755000]},"guestAuthors":[],"slug":"fighting-ebola-in-west-africa-qa-with-steven-vanroekel","title":"Fighting Ebola in West Africa: Q&A with Steven VanRoekel","publishDate":1427702755,"format":"standard","headTitle":"Q&A | Future of You | KQED Future of You | KQED Science","labelTerm":{"term":54,"site":"futureofyou"},"content":"\u003cp>Steven VanRoekel has dedicated his career to developing and communicating complex technologies, whether at Microsoft or the federal government. But this past Fall, he faced his biggest challenge yet: To use the simplest technology available to help combat the Ebola epidemic in West Africa.\u003c/p>\n\u003cp>In September of 2014, VanRoekel left his post as Chief Information Officer (CIO) at the White House to join USAID, the government agency responsible for administering aid to civilians overseas. VanRoekel was charged with coordinating the U.S. government's response to the Ebola outbreak. He worked at USAID until mid-March, when he \u003ca href=\"http://www.washingtonpost.com/business/capitalbusiness/steven-vanroekel-steps-down-from-usaid/2015/03/19/69c3e666-ce5d-11e4-a2a7-9517a3a70506_story.html\">announced that he would be leaving \u003c/a>to spend more time with family.\u003c/p>\n\u003cp>When he first took on the job, the Ebola crisis seemed to have no end in sight. Today, rates of new infections are starting to wind down. New Ebola cases continue to be reported in Guinea and Sierra Leone, but the situation has vastly improved in Liberia, where no confirmed cases have been reported in over a month. In about a year, \u003ca href=\"http://www.cdc.gov/vhf/ebola/\">the disease has claimed over 10,000 lives in West Africa\u003c/a>, making it the largest Ebola epidemic in history.\u003c/p>\n\u003cp>I sat down with VanRoekel at the tech conference SXSW in Austin, Texas earlier this month and asked him about his experience using simple technologies to fight Ebola in West Africa.\u003c/p>\n\u003ch2>Can you recall what it was like to fly into the midst of an Ebola outbreak when you first visited West Africa?\u003c/h2>\n\u003cfigure id=\"attachment_1012\" class=\"wp-caption alignleft\" style=\"max-width: 337px\">\u003cimg class=\" wp-image-1012\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/03/CAAcusnVEAA_6jQ.jpg\" alt=\"Steven VanRoekel speaking at SXSW in Austin, Tx. \" width=\"337\" height=\"337\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/03/CAAcusnVEAA_6jQ.jpg 600w, https://ww2.kqed.org/app/uploads/sites/13/2015/03/CAAcusnVEAA_6jQ-400x400.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/03/CAAcusnVEAA_6jQ-320x320.jpg 320w, https://ww2.kqed.org/app/uploads/sites/13/2015/03/CAAcusnVEAA_6jQ-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/13/2015/03/CAAcusnVEAA_6jQ-64x64.jpg 64w, https://ww2.kqed.org/app/uploads/sites/13/2015/03/CAAcusnVEAA_6jQ-96x96.jpg 96w, https://ww2.kqed.org/app/uploads/sites/13/2015/03/CAAcusnVEAA_6jQ-128x128.jpg 128w, https://ww2.kqed.org/app/uploads/sites/13/2015/03/CAAcusnVEAA_6jQ-75x75.jpg 75w\" sizes=\"(max-width: 337px) 100vw, 337px\">\u003cfigcaption class=\"wp-caption-text\">Steven VanRoekel speaking at SXSW in Austin, Tx. \u003ccite>(Jessica Bolaños Vanegas / Goodspero)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>My first visit to West Africa during the midst of the crisis was a trip to neighboring Ghana to attend a two-day planning session with the United Nations. Ghana had not seen a case of Ebola at that time, but you could feel the fear in the air. My next trip, a few weeks later, was to Monrovia, Liberia. There were active cases in the city, Ebola Treatment Units on the way to the city from the airport, and the precautions were even more intense. You had to wash your hands in bleach water before entering any establishment, including restaurants, hotels and meeting places, have your temperature taken, and there was no physical contact of any kind. It is pretty weird when you meet someone to not shake their hand, but that was the norm in Liberia.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In Liberia we were all in it together, so there was really no stigma to this behavior. The stigma really came flying back to the States. The airline employees all wore rubber gloves and you could tell they were afraid to be working around you. The customs people in the United States were terrific, as were the public health officials, but you had this real fear for three weeks that you may have somehow contracted Ebola. We now know that it is much harder to transmit than we all thought in the early Fall.\u003c/p>\n\u003ch2>Were new consumer technologies, like virtual conferencing services for doctors or health tracking wearables, relevant in this crisis?\u003c/h2>\n\u003caside class=\"pullquote alignright\">“You had to wash your hands in bleach water before entering any establishment\"\u003cbr>\n\u003ccite>Steven VanRoekel, former White House and USAID executive\u003c/cite>\u003c/aside>\n\u003cp>You're lucky if you get a 2G connection in some parts of West Africa. We did set up call centers, so we could provide communication tools at scale. We also did work with communication technology providers in the region, like Facebook's nonprofit Internet.org and [Microsoft cofounder] Paul Allen. We also talked to Google, which is doing work around '\u003ca href=\"http://www.google.com/loon/\">launchable' communications services like Project Loon. \u003c/a>\u003c/p>\n\u003cp>As for wearables, they can also be very applicable, but more so in the care setting -- both for monitoring patients as well as monitoring health workers. This did not play a big role in the epidemic, but we made advances in this space, \u003ca href=\"http://mashable.com/2015/03/14/smart-band-aid-ebola/\">like this smart band\u003c/a>, that will be applicable to future crisis.\u003c/p>\n\u003ch2>In Africa, mobile phone usage has been exploding. How did your team take advantage of the new opportunities for SMS communications?\u003c/h2>\n\u003cp>The growth of mobile in remote parts of the world, including West Africa, has been profound in the last decade. You can certainly find at least a few people who have a phone in very remote areas. These phones are typically simple voice and text phones, not smart devices, and there is a booming business model around pay-as-you-go services. People visit these little wooden kiosks in their village and buy a “scratch card” that gives them a code for minutes on their phones. Where mobile comes into play in this environment is the use of minimally-viable solutions, namely using voice and SMS to both communicate out, like messaging to people what symptoms to look for or how to get help, as well as to provide services where people can report cases. There is a wonderful emerging suite of tools that exist to do this data collection. One of the coolest is the \u003ca href=\"http://www.mhero.org/mHero\">MHERO\u003c/a> suite created by UNICEF.\u003c/p>\n\u003ch2>Speaking of communications challenges, how were you able to pull together patient records and track the spread of the disease?\u003c/h2>\n\u003cp>That's what a big part of our work was about. When I started, we had a lot of confusion in the field because case loads were going up so rapidly. What we did -- and by 'we', I mean the global response teams -- was to kick off an effort to get data harmonized and make it operational. During my first trip to Liberia, we worked with the health ministry to create a structure where people in the field could manually collect data.\u003c/p>\n\u003ch2>How would that work in practice?\u003c/h2>\n\u003caside class=\"pullquote alignleft\">\"In Liberia we were all in it together. The stigma really came flying back to the States.\"\u003cbr>\n\u003ccite>Steven VanRoekel, former White House, USAID executive\u003c/cite>\u003c/aside>\n\u003cp>We trained 10,000 people to collect data in paper formats, until it got to the \u003ca href=\"http://liberiamohsw.org/\">Ministry of Health in Liberia\u003c/a>. Our health workers would answer questions like, 'Are they probable or confirmed?' What are the symptoms?' Who have they been in contact with?' We then looked at the trends to find correlations like whether more men were getting it than women, or whether there was any correlation with the sex trade. Every day at around 4.30pm, we held a situation meeting where this data would be presented and argued about. We asked, 'What was the story behind the numbers?' We learned that about 70 percent of those who got infected were touching dead bodies. You're most infectious when you die. But there are cultural practices about hugging a loved one after they had passed. We had to get the word out.\u003c/p>\n\u003ch2>Where does this effort go from here?\u003c/h2>\n\u003cp>We need this data to continue to flow. We hope this is a model for the U.S. and other countries where some health data is trapped. Our vision is that by having open medical data systems that work across the vast variability of the operating environment, including a low- or no-connectivity dirt floor clinic with illiterate staff. You could create a world where you would not only have early warnings of issues arising in remote areas, but you could address those quickly and stop disease before it becomes a crisis. USAID is working on convening the community to make this a reality in West Africa and hopefully a platform for bio-surveillance around the world.\u003c/p>\n\u003cp>\u003cem>This interview has been condensed and edited for brevity.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>It is the first in an occasional Q&A series for KQED's Future of You, where we interview influential people working at the intersection of healthcare and technology.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"As the chief innovation officer at USAID, Steven VanRoekel coordinated the U.S. government's response to the Ebola outbreak in West Africa. ","status":"publish","parent":0,"modified":1427745976,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":16,"wordCount":1300},"headData":{"title":"Fighting Ebola in West Africa: Q&A with Steven VanRoekel | KQED","description":"As the chief innovation officer at USAID, Steven VanRoekel coordinated the U.S. government's response to the Ebola outbreak in West Africa. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Fighting Ebola in West Africa: Q&A with Steven VanRoekel","datePublished":"2015-03-30T08:05:55.000Z","dateModified":"2015-03-30T20:06:16.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"769 http://ww2.kqed.org/futureofyou/?p=769","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/03/30/fighting-ebola-in-west-africa-qa-with-steven-vanroekel/","disqusTitle":"Fighting Ebola in West Africa: Q&A with Steven VanRoekel","path":"/futureofyou/769/fighting-ebola-in-west-africa-qa-with-steven-vanroekel","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Steven VanRoekel has dedicated his career to developing and communicating complex technologies, whether at Microsoft or the federal government. But this past Fall, he faced his biggest challenge yet: To use the simplest technology available to help combat the Ebola epidemic in West Africa.\u003c/p>\n\u003cp>In September of 2014, VanRoekel left his post as Chief Information Officer (CIO) at the White House to join USAID, the government agency responsible for administering aid to civilians overseas. VanRoekel was charged with coordinating the U.S. government's response to the Ebola outbreak. He worked at USAID until mid-March, when he \u003ca href=\"http://www.washingtonpost.com/business/capitalbusiness/steven-vanroekel-steps-down-from-usaid/2015/03/19/69c3e666-ce5d-11e4-a2a7-9517a3a70506_story.html\">announced that he would be leaving \u003c/a>to spend more time with family.\u003c/p>\n\u003cp>When he first took on the job, the Ebola crisis seemed to have no end in sight. Today, rates of new infections are starting to wind down. New Ebola cases continue to be reported in Guinea and Sierra Leone, but the situation has vastly improved in Liberia, where no confirmed cases have been reported in over a month. In about a year, \u003ca href=\"http://www.cdc.gov/vhf/ebola/\">the disease has claimed over 10,000 lives in West Africa\u003c/a>, making it the largest Ebola epidemic in history.\u003c/p>\n\u003cp>I sat down with VanRoekel at the tech conference SXSW in Austin, Texas earlier this month and asked him about his experience using simple technologies to fight Ebola in West Africa.\u003c/p>\n\u003ch2>Can you recall what it was like to fly into the midst of an Ebola outbreak when you first visited West Africa?\u003c/h2>\n\u003cfigure id=\"attachment_1012\" class=\"wp-caption alignleft\" style=\"max-width: 337px\">\u003cimg class=\" wp-image-1012\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/03/CAAcusnVEAA_6jQ.jpg\" alt=\"Steven VanRoekel speaking at SXSW in Austin, Tx. \" width=\"337\" height=\"337\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/03/CAAcusnVEAA_6jQ.jpg 600w, https://ww2.kqed.org/app/uploads/sites/13/2015/03/CAAcusnVEAA_6jQ-400x400.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/03/CAAcusnVEAA_6jQ-320x320.jpg 320w, https://ww2.kqed.org/app/uploads/sites/13/2015/03/CAAcusnVEAA_6jQ-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/13/2015/03/CAAcusnVEAA_6jQ-64x64.jpg 64w, https://ww2.kqed.org/app/uploads/sites/13/2015/03/CAAcusnVEAA_6jQ-96x96.jpg 96w, https://ww2.kqed.org/app/uploads/sites/13/2015/03/CAAcusnVEAA_6jQ-128x128.jpg 128w, https://ww2.kqed.org/app/uploads/sites/13/2015/03/CAAcusnVEAA_6jQ-75x75.jpg 75w\" sizes=\"(max-width: 337px) 100vw, 337px\">\u003cfigcaption class=\"wp-caption-text\">Steven VanRoekel speaking at SXSW in Austin, Tx. \u003ccite>(Jessica Bolaños Vanegas / Goodspero)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>My first visit to West Africa during the midst of the crisis was a trip to neighboring Ghana to attend a two-day planning session with the United Nations. Ghana had not seen a case of Ebola at that time, but you could feel the fear in the air. My next trip, a few weeks later, was to Monrovia, Liberia. There were active cases in the city, Ebola Treatment Units on the way to the city from the airport, and the precautions were even more intense. You had to wash your hands in bleach water before entering any establishment, including restaurants, hotels and meeting places, have your temperature taken, and there was no physical contact of any kind. It is pretty weird when you meet someone to not shake their hand, but that was the norm in Liberia.\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>In Liberia we were all in it together, so there was really no stigma to this behavior. The stigma really came flying back to the States. The airline employees all wore rubber gloves and you could tell they were afraid to be working around you. The customs people in the United States were terrific, as were the public health officials, but you had this real fear for three weeks that you may have somehow contracted Ebola. We now know that it is much harder to transmit than we all thought in the early Fall.\u003c/p>\n\u003ch2>Were new consumer technologies, like virtual conferencing services for doctors or health tracking wearables, relevant in this crisis?\u003c/h2>\n\u003caside class=\"pullquote alignright\">“You had to wash your hands in bleach water before entering any establishment\"\u003cbr>\n\u003ccite>Steven VanRoekel, former White House and USAID executive\u003c/cite>\u003c/aside>\n\u003cp>You're lucky if you get a 2G connection in some parts of West Africa. We did set up call centers, so we could provide communication tools at scale. We also did work with communication technology providers in the region, like Facebook's nonprofit Internet.org and [Microsoft cofounder] Paul Allen. We also talked to Google, which is doing work around '\u003ca href=\"http://www.google.com/loon/\">launchable' communications services like Project Loon. \u003c/a>\u003c/p>\n\u003cp>As for wearables, they can also be very applicable, but more so in the care setting -- both for monitoring patients as well as monitoring health workers. This did not play a big role in the epidemic, but we made advances in this space, \u003ca href=\"http://mashable.com/2015/03/14/smart-band-aid-ebola/\">like this smart band\u003c/a>, that will be applicable to future crisis.\u003c/p>\n\u003ch2>In Africa, mobile phone usage has been exploding. How did your team take advantage of the new opportunities for SMS communications?\u003c/h2>\n\u003cp>The growth of mobile in remote parts of the world, including West Africa, has been profound in the last decade. You can certainly find at least a few people who have a phone in very remote areas. These phones are typically simple voice and text phones, not smart devices, and there is a booming business model around pay-as-you-go services. People visit these little wooden kiosks in their village and buy a “scratch card” that gives them a code for minutes on their phones. Where mobile comes into play in this environment is the use of minimally-viable solutions, namely using voice and SMS to both communicate out, like messaging to people what symptoms to look for or how to get help, as well as to provide services where people can report cases. There is a wonderful emerging suite of tools that exist to do this data collection. One of the coolest is the \u003ca href=\"http://www.mhero.org/mHero\">MHERO\u003c/a> suite created by UNICEF.\u003c/p>\n\u003ch2>Speaking of communications challenges, how were you able to pull together patient records and track the spread of the disease?\u003c/h2>\n\u003cp>That's what a big part of our work was about. When I started, we had a lot of confusion in the field because case loads were going up so rapidly. What we did -- and by 'we', I mean the global response teams -- was to kick off an effort to get data harmonized and make it operational. During my first trip to Liberia, we worked with the health ministry to create a structure where people in the field could manually collect data.\u003c/p>\n\u003ch2>How would that work in practice?\u003c/h2>\n\u003caside class=\"pullquote alignleft\">\"In Liberia we were all in it together. The stigma really came flying back to the States.\"\u003cbr>\n\u003ccite>Steven VanRoekel, former White House, USAID executive\u003c/cite>\u003c/aside>\n\u003cp>We trained 10,000 people to collect data in paper formats, until it got to the \u003ca href=\"http://liberiamohsw.org/\">Ministry of Health in Liberia\u003c/a>. Our health workers would answer questions like, 'Are they probable or confirmed?' What are the symptoms?' Who have they been in contact with?' We then looked at the trends to find correlations like whether more men were getting it than women, or whether there was any correlation with the sex trade. Every day at around 4.30pm, we held a situation meeting where this data would be presented and argued about. We asked, 'What was the story behind the numbers?' We learned that about 70 percent of those who got infected were touching dead bodies. You're most infectious when you die. But there are cultural practices about hugging a loved one after they had passed. We had to get the word out.\u003c/p>\n\u003ch2>Where does this effort go from here?\u003c/h2>\n\u003cp>We need this data to continue to flow. We hope this is a model for the U.S. and other countries where some health data is trapped. Our vision is that by having open medical data systems that work across the vast variability of the operating environment, including a low- or no-connectivity dirt floor clinic with illiterate staff. You could create a world where you would not only have early warnings of issues arising in remote areas, but you could address those quickly and stop disease before it becomes a crisis. USAID is working on convening the community to make this a reality in West Africa and hopefully a platform for bio-surveillance around the world.\u003c/p>\n\u003cp>\u003cem>This interview has been condensed and edited for brevity.\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>\u003cem>It is the first in an occasional Q&A series for KQED's Future of You, where we interview influential people working at the intersection of healthcare and technology.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/769/fighting-ebola-in-west-africa-qa-with-steven-vanroekel","authors":["3252"],"programs":["futureofyou_54"],"series":["futureofyou_135"],"categories":["futureofyou_1","futureofyou_73"],"tags":["futureofyou_142","futureofyou_141","futureofyou_122","futureofyou_143","futureofyou_138","futureofyou_61","futureofyou_80","futureofyou_140","futureofyou_25"],"featImg":"futureofyou_1013","label":"futureofyou_54"}},"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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You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED MindShift: How We Will Learn","officialWebsiteLink":"/mindshift/","meta":{"site":"news","source":"kqed","order":"2"},"link":"/podcasts/mindshift","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5","npr":"https://www.npr.org/podcasts/464615685/mind-shift-podcast","stitcher":"https://www.stitcher.com/podcast/kqed/stories-teachers-share","spotify":"https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"}},"morning-edition":{"id":"morning-edition","title":"Morning Edition","info":"\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. 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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. 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