Among the many fronts that have opened in the war against COVID-19 and the effort to reopen the economy and society was the news two weeks ago that Google and Apple are working together on developing content tracing apps that could be used by public health authorities. Among my colleagues in the tech community, as well as friends and family, this potentially promising development was greeted with a mix of optimism and trepidation. On the one hand, few people questioned that these two companies, with their collective resources and brainpower, could play a vital role in helping to develop some form of ‘coronavirus early warning system’. At the same time, it also raises questions about consumer privacy, and the potentially undesirable and nefarious ways the data, and the window into our lives it would peer into, could be used.
This is a really important conversation, because if this initial effort on the COVID-19 front is successful, it could provide a valuable springboard into a much larger opportunity for Big Tech in healthcare. Putting aside Covid for a moment, few would argue that from a systems, IT, and data perspective, our health care system is a bloated, inefficient mess. We spend 2x per capita what other OECD countries do, with relatively little to show for it. You show up at your doctor’s office and are asked to fill out a 1950s-era mimeographed form with skewed letters at the top. Poll question: If you wanted to access your medical records right now, could you? And the well-meaning $50+ billion Obama-era electronic health records (EHR) initiative is so cumbersome it has driven large numbers of doctors away from the profession.
Few would question that tech could play an important role in improving these systems and reducing their cost. COVID-19, and the threat of recurrence and future pandemics in our globally connected society, adds a sense of urgency and focus to the issue. The smartphone — with its combined set of connectivity capabilities (cellular, Wi-Fi, Bluetooth, and GPS), suite of (current and future potential) sensors, apps, and the data about what we do, who we communicate with, and where we go — is the ideal home base for Covid-related tracing and some broader set of opportunities in health care.
The problem is that Big Tech is starting from a relatively low point on the ‘ol consumer trust-o-meter. It’s not any one company, or any one particularly egregious action. It’s the collective body of trust and privacy violations, ranging from Cambridge Analytica to consumer data breaches to fake advertisements to the optics of Facebook launching a dating app in the middle of Congressional investigations. It’s the fact that nobody from Theranos has yet been brought to justice, and the near-criminal lack of oversight that enabled the disaster at WeWork and allows Adam Neumann to walk away with billions and sit on a beach in Israel. The beyond-what’s-reasonable profits, incessant need for growth, and short-termism driven by the needs of the stock market, juxtaposed against the widening equality gap now placed into particularly sharp relief are all ingredients added to this soup.
That said, this is a generational opportunity. Big Tech could be the systems and software companion to the ground-breaking and in-record-speed work being done on the life sciences front to fight Covid and fast-track our return to some semblance of normalcy. We should note the collective brainpower at Apple, Google, and others, and the deep capabilities of their senior leadership. In another time, these are the people that would have been working in government, NASA, universities, or other publicly-funded institutions. But those sectors have been hollowed out by declining budgets and a de-prioritization of their work. Much R&D has shifted from the public sector to the private sector.
Priority One will be accomplishing the immediate mission at hand: developing some form of contact tracing capability, with the proper safeguards and data protections. The stakes are high – even if the development of the app is successful, one high-profile wrong move on the data/privacy front would set the longer-term, bigger opportunities back a ways. But the level of private/public sector collaboration that will be needed to pull this off could be the template for a much bigger play in health care. Think of what Apple+Google+Facebook+Microsoft+Amazon+Sales Force+IBM+Qualcomm+Palantir+etc, etc. could do, with the proper allocation of resources, prioritization, and, yes, potential for profit. This could be THE project of the 2020s, in a way that mobile and cloud were the projects of the 2010s.
One final note: There’s been much discussion about U.S. leadership, and its waning role on the global stage. But the list of private sector companies in both Silicon Valley and in life sciences, plus the collective venture capital and private equity assets that might need to be amassed to beat this thing, and help deal with the world that results at the other end, provide the type of opportunity that could help reverse this course.