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Saturday, April 20, 2019

E-cigarette maker Juul eyes digital health tools for smokers looking to cut back

Although the company has faced backlash over the past six months for its popularity among young people, e-cigarette maker Juul is considering tapping into digital health, according to Business Insider.
Juul is looking to develop more behavior health research through an app or other smartphone-based tools, Business Insider reports. The company has posted two job listings on its website that suggest Juul is making a swift push into digital health.
One of the positions involves “developing the foundations for programs that more fully meet smokers’ personal goals … including mobile health-based interventions,” Business Insider reports. This suggests Juul may be looking to develop an app that would be used to help smokers who want to stay away from traditional cigarettes by using an e-cigarette.
Tools through the mobile app that may help smokers curb their traditional method of smoking include connecting with a network of like-minded peers or chat rooms and video resources.
Earlier this year, Juul published a study that provided evidence that some e-cigarette users are using the product to cut back on smoking. Business Insider reports that if Juul implements its digital health team with a behavioral research team the company may be able to help smokers.
Currently, Juul is still working to get its e-cigarette clearance from the FDA, a company spokesperson told Business Insider.

Scammers pay for DNA swabs, health insurance information to defraud CMS

Scam artists are targeting senior-living communities and low-income neighborhoods in what appears to be an elaborate ruse to commit identity theft and defraud Medicare, according to Bloomberg.
Authorities in Kentucky and Nebraska warned residents about the scam, in which groups visit vulnerable communities and offer payment in return for individuals’ DNA swabs and health insurance information. Officials told Bloomberg that some of these operations falsely claim to be associated with actual Medicaid insurers.
Though it is not yet clear how the scammers are using the information, officials worry it could be used to steal identities. The scammers may also attempt to defraud government health programs by billing Medicare for unnecessary medical services based on the DNA swabbing, since CMS announced in 2018 that Medicare covers certain genetic testing.

10 things to know about Ambulatory Surgery Center procedures

More procedures are migrating to the outpatient setting, including knee and hip arthroplasty procedures, according to data from MedPAC and Advisory Board.
MedPAC’s 2019 commission report to Congress outlined data on ASC characteristics, including which specialties experienced growth.
Key details to know:
1. Pain management ASCs grew most rapidly during the period covered by the report between 2015 and 2017. In 2017, there were 100 more pain management ASCs billing Medicare than in 2015.
2. Changing technology and clinical practices are contributing to the expansion of the types of procedures performed in ASCs. As this trend continues, more knee and hip arthroplasty procedures may be done in ASCs.
3. ASCs are more convenient for patients than hospital outpatient departments, according to MedPAC. Patients coinsurance is lower in ASCs than hospital outpatient departmetns for procedures covered on the ASC payment system.
4. Value-based care and the low-cost settings of ASCs make them appealing investments for private equity firms and hospital systems.
The percentage of surgeries completed in the inpatient setting has dropped since 2005, and analysts expect the decline will continue, according to an Advisory Board report.
The key statistics to know:
Inpatient surgery percentage by year
5. 2005: 42 percent
6. 2010: 40 percent
7. 2015: 37 percent
8. 2020 (projected): 36 percent
Distribution of outpatient surgeries
2005
9. ASC: 41 percent
10. HOPD: 59 percent

10 Years As CEO: 3 Guiding Principles That Transformed Exact Sciences

Ten years ago, I took a phone call that changed my life.
In-between jobs, I wasn’t sure what was next. The company I led had been acquired, offering time to catch my breath. Looking ahead, I was committed to staying in Madison, Wisconsin, where my family had put down roots.
The phone call came from a recruiter working on behalf of Exact Sciences to find a new CEO who would be responsible for leading the company through a monumental transformation. What I knew about Exact Sciences made that first phone call brief: they had twice failed to develop colorectal cancer screening tests, were running very light on cash, and the pipeline did not provide a clear path forward.
The world has a serendipitous way of working. Around the same time, three friends were diagnosed with colorectal cancer, which led my conversations with the Exact Sciences Board of Directors to take on new meaning. While the company didn’t look like much on the surface, the feeling something was there wouldn’t leave me.
I took a leap, and in April 2009, joined Exact Sciences as the new CEO. A decade later, I’m immensely proud of everything the Exact Sciences team has accomplished. I’m often asked, “How’d you do it?” After reflecting on the past decade of transformation, here are three principles that guided Exact Sciences to where we are today:
1. Defy convention.
Part of the reason I decided to join Exact Sciences is that going against the grain is in my nature. I’m the guy at the table who will question the status quo and choose the road less traveled.
Exact Sciences wouldn’t be the company it is today if not for the team’s early ability to think differently and forge a path where others might see the end of the road. While wrestling with the decision to take this role, Maneesh Arora and I traveled to Mayo Clinic in Rochester, Minnesota to meet with gastroenterologist and researcher Dr. David Ahlquist. It’s there we came to understand, if we were going to do this, we needed to be a company that defies convention. Shifting the colorectal cancer paradigm would require outside of the box thinking. The opportunity and challenge were so complex that Graham Lidgard, our newly hired Chief Science Officer, moved from California to join us in our quest. There wasn’t a path to follow, and we needed to be willing to push, make mistakes, and try again.
The visit with Dave also made clear that Mayo Clinic needed to be an integral part of our future. When we launched our collaboration with Mayo Clinic, we believed that the opportunity to meaningfully improve both the detection and prevention of colorectal cancer was very real. Today, more than 2 million people have been screened using the technology that we developed together, showing what happens when you focus on a bigger mission instead of individual priorities.
We made our fair share of mistakes going against the grain, but we learned. It’s the learning that helped us grow and mature. Whether you’re at the peak of your career or just getting started, seek out opportunities to defy convention. You never know where they may lead.
2. Take risks if you want big change.
One theme that appears repeatedly in our history is the willingness to face a problem head-on with creative solutions. We never just stayed the course and hoped for the best. We greeted each challenge with big thinking and the requisite tenacity to see it through.
By 2011, we needed to validate the science for our potential screening test on a large scale. We embarked on a 10,000-patient study to satisfy the evidence requirement for the FDA and CMS and, ultimately, give patients and providers the confidence in a potential new screening method.
There was considerable risk in moving ahead with a study of this size. It would be the largest private trial for colorectal cancer and the future of the company rested on our ability to show similar results from our smaller, case-control research. As we started planning, consultants suggested it would take three years to meet our recruitment goals. We didn’t have three years. We set our goal at, an unheard of, 18 months.
We wanted to make a big change—playing a role in the eradication of colorectal cancer—and it required big risks. It paid off: we met our patient recruitment goals and the pivotal study ended up validating our test and leading to the first-ever parallel FDA/CMS review process and joint approval/coverage.
3. Focus on three priorities.
At Exact Sciences we have a mantra: if you have more than three priorities, you really have none. It’s been a guiding principle throughout my career and, especially, the last ten years at Exact Sciences.
In 2009, we set our first company priorities: develop a successful screening test, advance clinical trial planning, and create a performance culture. Every year our executive team outlines company priorities that are shared in January and tracked throughout the year. Even as we’ve grown to more than 2,000 team members, everyone focuses on these three annual priorities, aligning their individual goals and performance with the company’s priorities.
In the early days, a Post-it on my computer screen served as a reminder of those priorities. We have priority posters throughout our office spaces now. This focus, coupled with the team’s passion for our early detection mission, fuels our success every year.
Remind yourself WHY every day.
Reflecting on the last ten years, I frequently wonder what my friend, Jamie Truesdell, would say about Exact Sciences’ transformation. Jamie was diagnosed with Stage III colon cancer at age 49—right around the time I took that recruiter phone call in 2009. I keep a message from Jamie pinned to the bulletin board in my office. It says, in part, “To feel part of Exact Sciences’ evolution is something you will never understand how grateful and meaningful it was to me.”
In that same message, I was encouraged that Jamie was looking forward, sharing his goals for the upcoming year. A week later, while skiing with my family, I had to capture the surreal scene in front of me when I received the devastating call that Jamie passed away. The view was so peaceful and calm, just like Jamie’s outlook on life. He’s my motivation to keep looking forward and to defy convention; to meet every challenge with tenacity; and to stay laser-focused on our priorities. Because Jamie’s story is too familiar for millions of Americans, and earlier cancer detection has the possibility to make a difference. I can’t wait to see what the next ten years bring for Exact Sciences and our ability to change the course of disease detection.

China draws up tighter rules on human gene and embryo trials

China’s top legislature will consider tougher rules on research involving human genes and embryos, the first such move since a Chinese scientist sparked controversy last year by announcing he had made the world’s first “gene-edited” babies.
He Jiankui, associate professor at Southern University of Science and Technology in Shenzhen, attracted condemnation from the global scientific community when he said he had used a technology known as CRISPR-Cas9 to alter the embryonic genes of twin girls born in November.
Chinese authorities launched an investigation into He’s work and said they had halted the kind of research he was undertaking.

Under the draft laws sent to China’s legislature for review on Saturday, medical and human trials would face closer scrutiny and stricter requirements, such as ensuring human subjects are properly briefed, state media outlet Xinhua reported.
The rules would also require all future trials to be approved by administrative authorities as well as ethical committees, it said.
The report did not specify a timeline for the approval of the regulations, or make specific mention of He’s research.

In videos posted online and at the November 2018 conference where He made his controversial presentation, He said he believed his gene editing would help protect the girls from infection with HIV, the virus that causes AIDS.
Chinese authorities and institutions, as well as hundreds of international scientists, condemned him and said any application of gene editing on human embryos for reproductive purposes was against the law and medical ethics of China.

100 percent renewable energy isn’t very green: researchers

In order to keep global temperature rise below 1.5 degrees Celsius, we’ll need to rely on renewable energy, electric vehicles (EV) and battery storage. But creating that infrastructure will dramatically increase our need for metals like cobalt and lithium. A report released this week cautions that a spike in demand for those and other metals could drain the planet’s reserves and lead to dire social and environmental consequences.
The situation is especially urgent for the EV and battery industries, according to the researchers from the Institute for Sustainable Futures. Those industries are the main drivers of demand for cobalt, with each EV requiring between five to 10 kilograms of the metal for its lithium-ion batteries. As much as 60 percent of cobalt comes from the Democratic Republic of Congo, which has already been charged with using child laborin its mines.
The researchers looked at a total of 14 metals, including those used in solar panels and wind turbines. They estimate that converting to 100 percent renewable energy could increase demand for lithium and nickel by as much as 280 percent and 136 percent, respectively. As Grist reports, the rush to meet that demand would likely increase mining in countries with lax environmental and safety regulations.
According to the report, recycling is our best bet to reduce primary demand. Companies like Apple and Amazon are already working to develop closed-loop recycling systems, but that will only get us so far. As Payal Sampat of Earthworks, which published the study, told Grist, “We’re not going to tech fix our way out of this. It’s going to require more meaningful policy changes that fundamentally reduce the overall demand.”

Sidewalk Labs’ street signs alert people to data collection in use

Sidewalk Labs
As Sidewalk Labs builds its “smart city” in Toronto, there have been growing concerns that the sensor and camera-laden neighborhood may invade the privacy of citizens. To deal with some of those issues, the subsidiary of Alphabet announced today that it is working on creating icons that would help people better understand the technology they run into while navigating cities. The images would be displayed on hexagon-shaped signs that would highlight what type of data is being collected in an area and how it is being used.
The idea behind Sidewalk Labs’ icons is pretty simple. The company wants to create an image-based language that can quickly convey information to people the same way that street and traffic signs do. Icons on the signs would show if cameras or other devices are capturing video, images, audio or other information. Additionally, Sidewalk Labs plans to color-code the signs to highlight how the information is used. Yellow signs mean data being collected is identifiable while blue means it is de-identified before being used. Other colors could be introduced to convey any additional details.
The signs would also include a QR code that would display additional information about the data collection process in a given area. Citizens could scan the code and be presented with a detailed explanation of who is collecting data, the exact information they are sucking up from passersby and what they intend to use it for. It would also show how long the data is retained by the collector and how it is stored.
For Now, Sidewalk Labs’ signs are just a concept. The first draft has been made publicly available on GitHub, and the company is planning to make tweaks over time. The signage in its current format will get a test run at the Sidewalk Labs offices in Toronto, and digital marketing company Soofa has agreed to demo the icons in a number of cities where it operates.