It’s easy

We’re at The Society of Behavioral Medicine meeting in Philly (my homeland) today talking about social media. I just mentioned microblogging and it’s ease. See how easy?

Why are we so unwilling to sleep?

Very cool device, but doesn’t this say everything our horrible sleep behaviors?

Reminds me of a great spot that 60 Minutes did with noted sleep researcher, Eve Van Cauter, a few years ago:

…I find it amazing to see how many people are asleep within five minutes of boarding an airplane at 11 o’clock in the morning. You know, sit down and boom. It shouldn’t happen. A normal adult shouldn’t be falling asleep at 11 o’clock in the morning, minutes after sitting in a small, uncomfortable airplane seat. It just shows that, you know, people are exhausted.

Here comes Healthbook

Big news recently as the first images of Apple’s long expected Healthbook app have hit the net. Now, if you’re a student of Apple leaks, you’ll know that new Apple products tend to bring out the Photoshop in a lot of people. That said, releases from 9-to-5 Mac have been consistently accurate, which is why this one is getting more attention.

There’s a lot to discuss here, but let’s focus today on the most obvious issues: there is A LOT here. Blood pressure, physical activity, diet? All expected. But, pulse ox? I don’t know whether this warrants a “Whoa! or a “Whoa…”

Quick — which one’s the good cholesterol: HDL or LDL? That’s my point.

We’re still missing a lot of information. We don’t yet know precisely how iOS will be gathering all of these metrics (although this does raise the intriguing possibility that the new Touch ID can do more than we initially imagined). We don’t yet know how these data will be secured or how third-party developers will be allowed to access them.

But this we do know: Healthbook will not be enough.

We’ve gotten a lot better at collecting data. We have all manner of sensors and devices wrapped around nearly every appendage. It’s become easier and cheaper for even novice users to track important health information.

But behavioral science is clear on this point: tracking is necessary but not sufficient. People need feedback to improve their health. It doesn’t need to come from a trained counselor or coach, an evidence-based algorithm fits the bill. But you need both: tracking and feedback.

Apple will be giving us the tools to do the tracking. Who’s bringing the rest?

Time to play with the pros?

Provocative piece from my colleague, Kate Wolin on expertise in the digital health space.

There are a lot of apps that have been created by some smart teams. Many of them have brilliant programmers. But most of them have never run a behavior change program.

I can read every Berkshire Hathaway Annual Report, but that doesn’t make me the Oracle of Omaha and I can’t imagine someone suggesting to you that taking investment advice from me is a sound financial decision. So why are we putting our health data and the opportunities it provides for information, knowledge and wisdom in the hands of amateurs?

Idea Matters

Great new-to-me quote from The Jobs about research ideas.

You know, one of the things that really hurt Apple was after I left John Sculley got a very serious disease. It’s the disease of thinking that a really great idea is 90% of the work. And if you just tell all these other people “here’s this great idea,” then of course they can go off and make it happen.

And the problem with that is that there’s just a tremendous amount of craftsmanship in between a great idea and a great product. And as you evolve that great idea, it changes and grows. It never comes out like it starts because you learn a lot more as you get into the subtleties of it. And you also find there are tremendous tradeoffs that you have to make. There are just certain things you can’t make electrons do. There are certain things you can’t make plastic do. Or glass do. Or factories do. Or robots do.

Designing a product is keeping five thousand things in your brain and fitting them all together in new and different ways to get what you want. And every day you discover something new that is a new problem or a new opportunity to fit these things together a little differently.

And it’s that process that is the magic.

Ideas are virtually meaningless necessary, but not sufficient. Execution matters.

h/t @cdixon

We’re hiring a software developer

We’re launching a new digital health science center and are hiring the first member of our programming team. The job ad is below. Please share far and wide and contact us with any questions.

Senior Analyst Programmer @ Duke Digital Health

The mission of the Global Digital Health Science Center at Duke is to foster the design, evaluation, and dissemination of digital health innovations for low-income populations, worldwide.

The Center is looking for a creative Analyst Programmer, Sr. (that’s software engineer in Duke-speak) who will design and manage digital health technologies for Center projects. We’re looking for a creative all-around programmer with strong Ruby skills and comfort with both back-and front-end development.

Here’s who we’re looking for:

  • You’ve written a lot of Ruby and Rails code. You’re experienced developing public-facing web applications in Ruby on Rails and SQL.

  • You’re comfortable with front-end development using HTML/CSS/Javascript, especially jQuery. You love frameworks like Twitter Bootstrap, or Foundation.

  • You’re a SQL expert. You should understand normalization, joins, query optimization, views, stored procedures and triggers and when and how to use them.

  • You have experience with RESTful API design. You have used a range of popular APIs (extra points for Twilio, Twitter, and Facebook).
  • You’re extremely attentive to detail. You accept bugs as a fact of life, but are committed to their destruction. You write tests because you know it#s the right thing to do.
  • You can read code. You have experience working with unfamiliar code bases and can pick up where they left off.
  • You’re totally into application security. You don’t just read about security, you can do it, and talk about it. Pen testing is your friend. You can ensure that external and internal regulations governing data management are met.
  • You can stage a project and execute without managerial oversight.
  • You’re comfortable being a mentor to junior staff members.

EEO STATEMENT Duke University and Duke University Health System are Equal Opportunity Employers including People with Disabilities Protected Under Section 503 of the Rehabilitation Act and Protected Veterans

Minimum Qualifications

Work requires Bachelor’s degree in mathematics or computer science or a computer-related field or equivalent coursework or technical training.

Work requires four years of progressive programming experience which includes experience as a member of a development team implementing a major system and experience in a supervisory capacity.


Competitive Qualifications:

  • You have at least 4 years of work experience.
  • You have previous startup, small company, or design firm experience.
  • You’ve worked in a team.

Identity revealed

Okay, maybe this wasn’t as big as revealing the identity of the Bitcoin developer, but Politico just doxed the guy who created the new Nutrition Facts Label. Rather than going with a public health type, FDA [somewhat surprisingly] engaged Kevin Grady, a director at leading design firm IDEO.

Perhaps that’s why Grady…was not afraid to take a slightly unconventional approach and venture outside design norms, in part by blowing up the font size for calorie counts on nutrition labels from 8- to an eye-popping 24-point font, making the number even larger than the “Nutrition Facts” text.

They’re right. Calories have gained weight, just like the rest of us. In this case, that’s a good thing.

That said, I’m a bit surprised that FDA retained so much of the old label format. The copious use of percentages would drive a health communication scientist crazy. FDA seems not to accept the data showing that low numeracy is a major U.S. health challenge. Indeed, most Americans have numeracy levels at or below the basic level of proficiency. If I need to teach you how to read a label — and that’s exactly what we do in today’s weight management programs — it probably doesn’t work.

It would have been nice to see a more revolutionary change in the new label. Just look at the infographic that FDA uses to explain the changes.

FDA explanation of new label

That said, the new label is an important step in the right direction. And it must be nice being the Jony Ive of public health.