Apple Watch, Fitbit, AI and Alexa: Yahoo Tech Founder David Pogue on Game-Changing Potential in Health Care

David Pogue

Moderator: Welcome to Conversations on Healthcare, with Mark Masselli and Margaret
Flinter. A show where we speak to the top thought leaders in health
innovation, health policy, care delivery and the great minds who are shaping
the healthcare of the futur e.

T his week Mark and Margaret speak with personal technology expert, David
Pogue, founder of Yahoo Tech and Science host on PBS’s NOVA, we will
discuss the potential of technology from fitness trackers to wearables and
smart watches with EKGs and fall det ectors to be game changers in
healthcare. Lori Robertson also checks in, the Managing Editor of
FactCheck.org looks at misstatements spoken health policy in the public
domain, separating the fake from the facts. And we end with a bright idea, its
improving health and wellbeing in everyday lives.

If you have comments, please email us at [email protected] or find
us on Facebook or Twitter, iTunes or wherever you listen to podcast. Y ou can
also hear us by asking Alexa or any smart speaker to play the program
Conversations on Healthcare. Now stay tuned for our interview with David
Pogue, founder of Yahoo Tech on Conversations on Healthcare.

Mark Masselli : We are speaking today with David Pogue, the founder of Yaho o Tech,
technology, news website run by Yahoo . He is also a columnist for Scientific
American and host of Science Shows on PBS NOVA as well as a long - time
correspondent for CBS’s Sunday Morning . P reviously he was the personal
tech writer for the New York T imes for 13 years and started writing for
Macworld back in 1988. He has won four Emmy Awards, two Webby Awards,
a Loeb Award for Journalism and an Honorary Doctorate in Music. David
graduated summa cum laude from Yale. David, welcome to Conversations on
He althcare.

David Pogue: Well, thank you so much.

Mark Masselli: 3 0 years ago, you started writing for Macworld and the distinction as one of
the most prolific writers and observers of technology, you are great piano
player a nd you have had this impressive r un with the New York Times, writing
the paper ’ s most popular columns Pogue’s Post and State of the Art a nd then
he launched the tech platform at Yahoo. T ell our listeners about the major
trends you are watching and we are particularly interested in the
tra nsformations that are going around in healthcare as well .

David Pogue: I think the one thing that affects both standard gadgetry that I look at and
healthcare is the rise of the cheap little sensor. So everybody says that the
innovation of the iPhone in 20 07 was you know, it doesn’t have keys, it’s on
the internet all of the time. And inside that tiny little phone, you have tilt
sensor, proximity sensor, light sensor, barometer, there is an altimeter,
gyroscope, compass, there is like 35 tiny little sensors and these data that it
collects can be intertwined and associated in all kinds of fascinating ways in
the world of consumer health electronics . N ow that I am reviewing a Garmin
Fitness Band right now that’s no wider than a rubber band. It not only tracks

David Pogue

your heart rate and your sleeps but also your stress levels, your blood
oxygen . T hat leads to the second huge trend which is big health data, the
ability to collects gigantic amounts of data from millions of people very
quickly, in ways that have never bee n done before couple of years ago. All of
these leads to a movement I have heard it called the Quantified Self. You
guys, have you ever had Eric Topol on your show.

Margaret Flinter: Oh yes, a good friend.

David Pogue: His book is so brilliant, it’s called The Patient Will See You Now and it’s about
how the power of the doctor/patient relationship is shipping. T he doctor is
now not the Ivory Tower of knowledge, it’s an amazing transformation that
we now have insight into our own health, in a way that we nev er had before.

Margaret Flinter: David, on that note you covered Apple’s recent annual product launch
event and healthcare definitely seem ed to be, I would say the most
prominently featured in the year ’ s announcements. We have had Apple COO,
Jeff Williams, former guest on the show a nd he unveiled an Apple watch that
not only offers E K G components but a fall detector and other health related
features . Maybe it tell u s whether you think they might be game changers
and I am going to tell you I am sure they are going to be game changers, but I
would love to have your opinion.

David Pogue: I mean say for example Atrial Fibrillation, AFib is the world’s most common
heart rhythm problems, it leads to a lot of strokes and heart attacks and
kidney disease and I am re ading even dementia . T he problem with Atrial
Fibrillation is the way you test for it, is at a doctor’s appointments, but AFib is
intermittent so you might go have the test and the doctor won’t see it. T he
fact that now there is a device that ’s on your wris t, all of the time and can
detect Atrial Fibrillation when it happens, I mean it could save thousands and
thousands of lives. T here are sensors on the back of a watch now they have
hooked that up electronically to the crown, the little knob on the side tha t
you turn. So when you put your finger on the crown and open this EKG app, it
will actually generate you know a classic EKG graph that you can submit to
your doctor , t hat’s amazing .

T he one that I guarantee will save lives, is the fall detection. W hen you fall it’s
a very particular motion that your arms do, the watch has an accelerometer
in it which is a 3 - axis motion sensor s o of course it can tell what kind of
motion your body is doing. N ow if you fall it says, wow it looks like you have
had a sudden fa ll, are you okay. I f you say, yes I am okay, then life goes on,
but if you don’t respond within a minute it starts sending out text to people
you have designated as your loved ones. I f there is still no response after
couple of more minutes, it calls 911 f or you and send s your location
automatically. W e know that for older people who fall when they break
something, they are , a lot of times it’s the end . T his is the ultimate I have
fallen, and I can’t get up device and it’s on your wrist all the time.

Mark M asselli: I think that’s a really good point . A ctually Margaret we had a great, bright

David Pogue

idea a while ago, that somebody had developed a inflatable belt that also
picked up the sensors, when you fell it would inflate the belts around your
waist . W e obviously admire Apple, Jeff Williams was there suggesting the
watch would be the intelligent Guardian of the Galaxy or I guess something
rest , b ut what do you think consumers uptake will be, just the regular folks
out across the country?

David Pogue: H ere is the pr oblem in particular with the Apple Watch. First of all it’s not a
huge seller in the first place, I mean, yes you see it on the east coast and the
west coast , but it’s nowhere near the popularity of let’s say an iPhone or a
MacBook Air. The second problem is that the people who need this health
monitoring most are precisely the older people who don’t want to deal with a
tiny electronic gadget that’s very complicated on your wrist that’s hard to see
without glasses. Y ou have to take this thing off to charge it nightly, there are
grandmother, grandfather in the world who is going to take off her watch
every night to charge it and let alone the fact that when its charging, all night
it’s not guarding your health. T here is a big disconnect I think between the
co mplexity and size.

My dad is 90 and we did get him going with a Fit b it and he, wow, does he
love that thing. S ome of the Fit b its, they also have some of th ese more
sophisticated sensors, they haven't turned on the feature yet , th e stuff like
the Atrial Fib rillation detection that’s coming. This Garmin that I am looking
at right now, it has a feature where i f it sees your heart rate spiking for more
than 10 minutes when you are not exercising, it alerts you and that’s super
smart because if you are just sitt ing st ill and your heart starts going that’s
probably something. T hese are much simpler devices with much longer
battery life s o even if Apple Watch is leading the way, I have no doubt it will
trickle down into simpler gadgets.

Margaret Flinter: David, I r ea d a note someone recently, we may have now a 150 billion
hours of data from all of these tens of millions of wrist mounted devices that
have been collecting heart data among other things for years now. And that
there are researchers who are beginning to do a deep - dive into that data,
maybe talk with our listeners a little bit about what they are finding.

David Pogue: T his is a while, the Fit b it has indeed now collected a 150 billion hours’ worth
of human heart data and because Fit b it knows your age, your weight and
where you live, your activity level, how much sleep you get, it knows all this
about you. T he press release said, “W e have now collected the 150 billion
hours of heart data .” I contacted the PR people and I said, “S o wow, I bet you
guys could c ome up with some amazing insights on the relationship between
heart rate and our health. ” And they are like, “O h yeah, I guess we could .” S o
it’s hasn’t even occur red to them . T hey offered to give me an exclusive deep -
dive into this stuff and it was just a n amazing ride, they put their top two data
scientist on this and came up with th ese really cool correlations, some of
which are brand news, news no one had ever heard before. T his is data
collected from people who own Fitbit, these are people who have the money

David Pogue

to own a Fitbit and who care about their health enough to buy a Fitbit. T his is
all resting heart rate data, they explain ed to me that your resting heart rate is
sort of like a thermometer of your overall fitness because it incorporate so
many thing s like your body mass index and how much exercise, your age and
your gender and all of that. T his is really cool observations that came out of
this, one of them is that, women have higher resting heart rates than men
across every demographic. And their dat a scientist says, they don’t know
exactly why but they think it’s because women tend to be smaller and
therefore they have a smaller hearts and therefore it needs to work harder,
to make the blood circulating, we don’t know, this is all new news, so no one
has looked into why yet .

Another thing they found and I thought that was really cool, is that your
resting heart rate steadily goes up as you approach middle - age and then after
about 50 it steadily goes down the rest of your life. T hat’s something we
real ly didn’t know about, we are not sure exactly why, but one theory is, you
know you have kids, you get busy, worse food, you are stressed out all the
time . B ut then the question is, why does our heart rate drop after middle - age
and they had a great theory f or this, 30% of us in United States are on Beta
Blockers, we are all in blood pressure and heart attack midst , it’s an artificial
e ffect.

Mark Masselli: We are speaking today with what David Pogue, the founder of Yahoo Tech
Technology News website run by Y ahoo. He is also host of Science Shows on
PBS NOVA as well as a long - time correspondent for CBS Sunday Morning, you
know another thing I am just really excited about is, the whole issue about
voice - activated devices you have got the Amazon Alexa, you have got
Microsoft Google in it. I am wondering what your thought is, as you connect
those sensors you were talking about the Big Data, can we start thinking
about the home a s a place where healthcare can be delivered. It seems like
Alexa or voice - activated ass istance might be the vehicle to do that . W e hear
that the Amazon folks have a whole team dedicated to finding ways to use
this in healthcare, but what your sense about this, is it overblown or is it still
too early to see the promise land?

David Pogue: No I would say it’s underblown there is this entire i ndustry that the tech
industry has been following, the Internet of Things, I can’t stand that term,
it’s like I would put on my jeans of blue , like nobody talks like that . I t just
means putting internet con nections into everyday appliances so that you can
control them with your phones right, turn on the lights, open the garage door
with your phones and they just kept coming out with more and more stuff in
this category, but nobody was buying it. T he problem was that you had to
open up an app on your phone every time you wanted to turn off the g osh
darn lights. I t was just not effective, it wasn’t efficient, it was slow and clunky
and complicate . T hat’s the real shock of this Alexa business, is that it has
sav ed the entire remote control gadget industry from itself , b ecause now you
just say, turn on the lights in the living room and that’s it, play Beethoven in
the bedroom, well I guess Barry White. It is revolutionary and think of people

David Pogue

who have trouble with motor control, who have trouble with mobility in the
house, I mean there are thousand ways that being able to voice control your
environment saved everything .

I n fact the news I heard about Amazon, just this week, is that they have 8
new appliances coming out, there is a microwave, dishwasher, they are
actually building Alexa into the devices themselves. And already they have
got something like 15,000 companies building Alexa into their devices at their
Consumer Electronic Show, they were demonstrating an A lexa - enabled house
where you could say is the dryer done yet? So it is getting better really fast
and it is spreading really fast, to every other kind of machine there is.

Margaret Flinter: E very time we have one of these conversations, I think of all the
parents who named their child Alexa, in the last decades you are really
seriously thinking about changing that name. L et me ask you, sort of think
about the science side of things a nd not what we wear but who we are and
the whole advance in genomics and pe ople in addition to knowing their
fitness and who they are, genetically and in combination with their habits and
ancestry and so forth. I wonder what your thoughts are there in terms of the
degree to which that is also going to inspire people to change the ir health
habits.

David Pogue: I feel like we have very much been in the era of data collection, like all these
devices are just scarfing down terabytes of data a day. We are not really
figuring out exactly what to do with all of th e data and how it is sup posed to
work. They are out of business now , but there is another fitness band, the
Upband and they ha d this really great idea, they were going to integrate all of
this data that the band knows about you, your activity, your sleep, your age
and weight and gender and all that stuff a nd it was going to start offering
observations that you would have no other way to know like we notice that
when you work out in the morning, you tend to have more deep sleep that
night. T he Fitbit does a little bit of that, it w ill say, today you got the most
exercise you have all week, but no one is really doing the correlating and t he
parsing of this stuff, really hasn’t begun yet . Yes, we are all talking about the
future of super personalized medicine. I feel like we are just at the dawn of
this stuff , but because the data is the first step, the parsing can now beg i n.

Mark Masselli: S peaking of the future, we are seeing a lot of new disruptors coming into the
market place, Amazon, Berkshire Hathaway, JPMorgan Chase have pull ed
together a partnership , you have got Google’s parent company Alphabet
launching projects, promoting tech - enabled interventions, you have got this
whole group of folks coming really from the Silicon Valley side into trying to
disrupt healthcare. But healthc are, you are better off yelling down the street
to the hospital about your health record than having it sent. Do you think
really the healthcare industry is ready for all this great talent ? W hat do you
see on the horizon about healthcare innovation and int egration of this
technology in th ese new future applications?

David Pogue: We haven't really talked yet about data and privacy and these guys are the

David Pogue

villains right now, the Google’s and Apple’s and Microsoft, collecting data
willy nilly and so we should b e wearing. I personally, I am like take my data,
tell me cool stuff, I have a feeling that the younger generation tends to be,
“H h you are going to give me free stuff, in exchange of my data, great. ”

Mark Masselli: I will put it on Facebook for you.

David Pogue: Exactly, that warning said, I do think they stand a great chance of improving
healthcare systems, th ese big Silicon Valley companies, for couple of reasons.
One is because they are commercial for - profit entities and they have this
gigantic incentive to come up with useful things t hat touch a lot of people
because they are money making outfits . I mean the government don’t quite
have the brainpower that is attracted to for - profit startups and they don’t
have the same motivation to do it.

I mean I am do ing a story right now for Yahoo Finance about SpaceX, this
private version of NASA, it’s a commercial company and they are not able to
get rockets and satellites into space at one - third the cost of the government.
Right now, SpaceX is the largest launcher of rockets in the world and t hey got
their so fast because they are private enterprise, they have the money to
attract the talents, and they don’t have the red tape, they have a fire li t
under them. I n that regard I do believe that having so many smart min ds on
the problems with such a great incentive to get it right, is very promising for
the future.

Margaret Flinter: We have been speaking today with David Pogue, the founder of
Yahoo Tech and the host of Science Shows on PBS’s NOVA as well as a long
term c orrespond ed for CBS’s Sunday Morning. You can learn more about his
work by going to his website www.davidpogue.com or follow him on Twitter
@Pogue and that’s spelled P - O - G - U - E . David thank you so much for joining u s
on Conversations on Healthcare T oday ; and you r very optimistic look at our
future.

David Pogue: M y pleasure, thank you so much for the chat.

[Music]

Mark Masselli: At Conversations on Healthcare, we want our audience to be truly in the
know, when it come s to the facts about healthcare reform and policy, Lori
Robertson is an award - winning journalist and Managing Editor of
FactCheck.org, a non - partisan, nonprofit consumer advocate for voters that
aim to reduce the level of deception in U.S. politics. Lori, what have you got
for us this week?

Lori Robertson: President Donald Trump on several occasions has taken credit for
making Medicare “stronger.” In fact Medicare’s finances have worsened
since he took office. The latest Medicare trustees reports says the M edicare
Part A Trust Funds which covers payments to hospitals will run out of money
by 2026, 3 years earlier than projected just last year. That’s partly because
the tax cut laws that Trump signed last year will reduce Medicare revenues

David Pogue

and increase expens ive. Medicare remains on an unsustainable path, the
annual cost for all four parts of Medicare including physician payments and
prescription drugs, is expected to more than double from $710 billion in 2017
to $1.44 trillion in 2027 a nd general revenues fro m the federal government
will increase as a share of Medicare financing from 41% in 2017 to 49% in
2032.

Trump said that Medicare would be $700 billion stronger over the next 10
years because of growth, b ut the Congressional Budget Office in April
estimate d that economic growth could increase all payroll tax revenues
including social security by $92 billion over the next 10 years. That’s far short
of Trump’s $700 billion figure, which he said was just for Medicare. The
Medicare Part A Trust Funds spent more on hospital payments than it
received in income from 2008 through 2015, the trustees said , “D eficit
spending will return this year and accelerate in the coming decade ” why the
trustees say, “P art of the reason is the tax cut law. It repealed the individua l
mandate in the Affordable Care Act which required people to have insurance
or pay a penalty, the repeal is expected to increase the number of uninsured
Americans and that in turn will increase Medicare disproportionate share
payments made to hospitals th at serve large populations of low income
people without insurance. ”

Also the tax law reduced federal income tax rates and some trust fund
revenues come from income taxes on social security benefit. With lower tax
rates there is less income from the taxes f or Medicare. The Bipartisan Budget
Act of 2018 also eliminated the Independent Payment Advisory Board
created by the Affordable Care Act to reduce Medicare cost. The board had
not yet been formed but was supposed to reduce the growth of spending in
the fut ure. And that’s my factcheck for this week, I am Lori Robertson,
Managing Editor of FactCheck.org.

Margaret Flinter: FactCheck.org is committed to factual accuracy from the country’s
major political players and is a project of the Annenberg Public Policy C enter
at the University of Pennsylvania. If you have a fact that you would like
checked, email us at www.chcradio.com , we will have FactCheck.org’s Lori
Robertson, check it out for you, here on Conversations on Healt hcare.

Mark Masselli: Each week C onversations highlights a bright idea about how to make
wellness a part of our communities and everyday lives. Fitness trackers have
become all the rage especially among upwardly mobile fitness conscious
people seeking to m onitor their own health, but another trend has emerged
in the age of wearable devices . A fter a few months about a third of users
simple stop using them , t he reality capture the imagination of Tufts
University School of Medicine, Dr. Lisa Gualtieri.

Lisa Gu altieri: And I saw what if you could take all of th ese abandon trackers and give them
to the people who could benefit most from them.

Mark Masselli: She thought what if we could get disinterested owners to donate their used

David Pogue

fitness trackers to be repurpose d and donated to underserved populations.
So in 2015 she launched Recycle Health an online social media campaign to
raise awareness for her program which seeks, donated wearable devices to
provide th ese expensive devices for free to those in need.

Lisa Gua ltieri: A lot of the work that we have been doing has been with older adults, racial
and ethnic minorities and for a lot of people th e cost is precipitate so I think
that’s a barrier -- .

Mark Masselli: She partner ed with the organizations working with low - income adults,
seniors and Fall Prevention Programs and veterans as well.

Lisa Gualtieri: What we do is talk to people about how access, how sedentary they are and
coming up with a reasonable goals they might start off with 3000 steps as
their goals, but t hey know how to make that higher when they are ready to.

Mark Masselli: Recycle Health, a simple repurposing of personalize d wearables, providing
these tools for free to vulnerable populations empowering them to improve
their own health, now that’s a brigh t idea.

[Music]

Mark Masselli: You have been listening to Conversations on Healthcare.

Margaret Flinter: And I am Margaret Flinter.

Mark Masselli: Peace and health.

Moderator: Conversations on Healthcare is recorded at WESU at Wesleyan University,
streamin g live at www. chcradio.com , iTunes or whatever you listen to
podcast. If you have comments please email us at [email protected]
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