Text: Clément Bürge
Photo: karen Ichters

The battle between the giants has begun

The forays of Google, Apple and Facebook into medicine are stirring both enthusiasm and apprehension. Here’s why.

In July 2013, Dr Eric Schadt, a professor of genomics at the Icahn School of Medicine at Mount Sinai, was looking for participants to conduct a new study on asthma. The re-searcher and his team sent 300 letters to potential candidates, and fifty subjects ended up enrolling. “It took one year to recruit them,” the specialist says. This tedious process soon sparked a small revolution in the research world.

In March 2015, Apple came out with a new tool, ResearchKit, which could radically change medical studies. This programme can be used by researchers to develop smartphone apps that help them find participants for their studies. And one of the scientists who collaborated with Apple is none other than… Eric Schadt. A few weeks later when he launched a new call for participants using this framework, his team found 3,500 participants in less than three days. “Without Apple’s toolkit, that would have taken us years,” he says.

How does it work? ResearchKit is an open source software framework that allows researchers to create apps used to gather data especially useful for healthcare. Eric Schadt developed the Asthma Health app to facilitate self-monitoring and encourage patients to stick to their treatment plans. Patients report any acute asthma attacks, while the programme tracks and sends researchers a broad range of other data. “We can ask the app to send us information about factors that could trigger attacks at a given time, including indoor air humidity or a region’s pollution,” says Eric Schadt.

“On average, people spend ten minutes a year with a doctor, which is nothing compared to the amount of data smartphones and other connected objects can collect about our health.”

Four other health data apps have been developed. Massachusetts General Hospital has created GlucoSuccess to track blood sugar levels, Stanford University’s medical department has designed MyHeartCounts to monitor cardiovascular health, Sage Bionetworks and the University of Rochester have developed mPower to allow patients with Parkinson’s disease to measure their symptoms, while the Dana-Farber Cancer Institute, University of Pennsylvania, Sage Bionetworks and University of California Los Angeles have teamed up to produce Share The Journey, which studies why breast cancer patients experience symptoms differently.

Enter Google and Facebook

The launch of these apps means that Silicon Valley’s tech giants have now penetrated the research world. Eric Schadt believes that these firms will “fundamentally transform medicine and improve patients’ lives while reducing healthcare costs.” Their biggest impact will be in data collection. “With the new sensor-equipped wearables and social media, patients will pool larger amounts of information about their state of health,” says Schadt. “Doctors and researchers will be able to better understand what’s happening with their patients.”

Dr Schadt sees it as if there was a doctor constantly at the patient’s bedside, whether or not the person is sick. “On average, people spend ten minutes a year with a doctor, which is nothing compared to the amount of data smartphones and other connected objects can collect about our health.”

Over the past few years, Microsoft has developed hospital management software, IBM has created Watson, a supercomputer that helps physicians diagnose diseases, and Facebook is home to a number of patient support groups.

But one tech behemoth is shooting higher than mere
data gathering, and that is Google. “The firm hopes to revolutionise healthcare,” says Thomas Gauthier, a specialist in healthcare and new technologies at the HEG Geneva management school. “Google has the drive and financial means to change a lot of things.”

In March 2015, Google announced its collaboration with Johnson & Johnson to develop robots that could perform surgical procedures with infinite precision. The California-based group will also build a system used to visualise blood vessels and other hard-to-see anatomical structures in real time on a screen.

But its real gamechanger is Calico, a special research unit focused on developing treatments for age-related illnesses. Its clearly stated objective? Immortality. The man behind Calico is none other than Arthur D. Levinson, a star player in the convergence between medicine and technology.
The biochemist has served as Apple’s Chairman of the board and as Genentech’s Chief Executive Officer. In 2015, Google announced that it would invest $1.5 billion in the project.

Future challenges

Success in these projects is not guaranteed. Google’s first medical project launched in 2008 was a flop. Google Health was developed to centralise health records online. Due to lack of use, the service was discontinued in 2013. “The company didn’t get involved enough in the project,” says Thomas Gauthier. “Today, things are different. Google has since introduced a vast official programme focused on health and proved its commitment by setting up concrete, independent ventures such as Calico,” he says. “They are unlikely to make the same mistake.”

Success in these projects is not guaranteed. Google’s first medical project launched in 2008 was a flop.

One of the main threats that could compromise its ambitions is government regulation. During a panel in 2014, Google co-founder Larry Page stated that he was “excited” about health and longevity. But health is “so heavily regulated.” He fears that the United States enforces too many rules and kills any potential that new technologies may have to offer before they get started. When developing a new product, he believes that the administrative process to obtain approval from the authorities is too complicated.

And the medical community does not necessarily welcome these newcomers with open arms. Some are concerned that investing private money into medical research can distort research priorities. Preston Estep, director of gerontology for Harvard Medical School’s Personal Genome Project, accused the tech giants of funding “pseudoscience,” pointing specifically to Calico.

To avoid these obstacles, several companies have begun collaborating directly with the medical community, such
as Apple with Eric Schadt. Calico has forged a partnership with the pharmaceutical group AbbVie to benefit from “its
profound medical expertise”. And Google has teamed up with Novartis to develop smart contact lenses that
measure patients’ glucose levels. “Novartis is one of
the largest contact lens producers,” says Novartis Chief Executive Officer Joe Jimenez. “But we don’t know anything about microprocessors or sensors.” This collaboration will enable companies to harness the strengths on each side of the project and earn the trust of health professionals. ⁄

Swisscom and Swiss Post move into health services

In Switzerland, it is Swiss Post and Swisscom that are moving into the world of medicine. The postal services group has formed a team of 30 people to create a management system for electronic patient records. Its extensive experience in handling confidential data and data transmission has prompted the Swiss giant to get involved in providing medical information. Lausanne University Hospital (CHUV) will experiment with the system developed by Swiss Post as part of a project set up by the eHealth unit in the Canton of Vaud. Pierre-François Regamey, director of information systems at the CHUV, feels that this new system will be extremely useful. “Hospitals still use a lot of paper,” he says. “Electronic records will help health professionals easily find a patient’s medical history, and we will avoid running the same tests over and over again.”

Meanwhile, Swisscom has launched a new Health division with 300 people. It offers various services such as electronic health records, management software for doctor’s offices and the Evita programme, which patients can use to create a personal health record using data gathered from their smartphone. “It’s a very promising area,” says Stefano Santinelli, CEO of Swisscom Health. “Hospitals could save up to 90% in administrative costs if they digitised procedures.”




In millions of dollars, the sum invested by Google in 2014 to buy health and biology start-ups.


The number of health apps available for download worldwide.