1/ With the announcement of @AkiliLabs going public to accelerate their pipeline for ADHD, here are some thoughts on the intersection of gaming with health and why I believe video games (and perhaps the metaverse) might be a big part of the future for healthcare. $AKLI 🧵
2/ One of the most exciting projects I worked on at @Apple with my HSI team was a health game powered by the Apple Watch called LumiHealth with the @sporeMOH in Singapore. Your behaviors in the real world mirror the mechanics of the game, earning your character (and you) rewards
3/ Apple recently reported some of the Year 1 results of LumiHealth last fall with some impressive milestones:
- 200k users participating in 7m challenges
- 39% increase in exercise minutes overall
- 88% increase in exercise minutes for sedentary groups
4/ There have been a number of activity-based wearable “games” that have launched, including a number from insurers around the world that have paired the “Earn Your Watch” mechanic with the Apple Watch Activity Rings.
5/ The engagement rates for these programs are often unbelievably high — higher than popular social media apps on a variety of well-known metrics like MAU, DAU/MAU, power curves.
This is the opposite of most episodic healthcare utility apps that payors and providers offer.
6/ Going back to LumiHealth, the most exciting thing the 1-year data suggests is the sustained increase in physical activity of a very large cohort, in particular the most sedentary users.
Just 10 min of daily walking can prevent thousands of deaths!
7/ For a sedentary population, a little nudge from a game might be a literal game-changing intervention for longer-term health; other countries might take notice of what Singapore is trying to do.
A drug that provided the exercise benefits of LumiHealth would be a blockbuster.
8/ Separate from full-blown games, the integration of game mechanics into health apps is bound to grow — goals, streaks, badges and rewards, competition. The Activity Rings are one of the most popular features of the Apple Watch because of a simple engaging game mechanic.
9/ It is outdated to think that games are only for the young. Games are the most popular category of the App Store by far, enjoyed by people of all ages.
11/ What Akili and digital CBT apps have demonstrated is the connection between games and mental health & neurocognitive function. Whether these benefits are “proven” through clinical trials, it seems games allow people to connect socially, stay mentally sharp, and reduce stress
12/ As for the future, the still-popular Pokemon Go foreshadows how health gaming might work in the metaverse, in particular when AR becomes more mainstream.
13/ Beyond “brain” games and programs, health is about what you do in the “real world”, not inside a digital universe. If AR can be designed to keep you engaged with the world around you, the opportunities to weave health into everyday life could be endless.
14/ I especially like @ZombiesRunGame, which “motivates” you to run away from zombies in an imaginary epidemic while you walk or run.
15/ To weave all of this together with web3 (how could I resist?), the marriage of coins with health games could be a way for people to “power up” their metaverse avatars through healthy behaviors. @Sweatcoin is a prototype of what this could become.
1/ Japan has fared better throughout COVID than most western countries (146 deaths/million vs. 2,590 deaths/million in the US) despite:
- Very low public trust in gov’t
- Less trust in science
- No mandates
2/ This trope around Confucius societies “winning the COVID-19 war” with “authoritarian mentalities” doesn’t neatly apply to Japan where only 4% of people surveyed in 2020 say they trust the government “a lot”, compared to 9% in the US and 12% in the UK.
1/ The pandemic has felt endless, so the beginnings seem like a distant memory. Does anyone remember the worst-case model of 1.5-2.2m deaths that the White House used to “shock and awe” in March ’20?
To date, there have been 864k deaths in the US.
A look back below🧵
2/ Before this press conference, Trump compared COVID to the flu with only “22 deaths”, “life & the economy go on.”
Sound familiar?
If only the current death rate — with all of the advantage of our vaccines and therapeutics — were as low as the flu today.
3/ The current 7-day average of COVID deaths is 2k+/day with yesterday's number of 3,866 deaths being one of the worst days ever during the pandemic.
At this rate, this is a 20-50x difference from what the average flu season is like!
My ten “surprises” in healthcare for 2022 — events that the average person would only assign a one out of three chance of taking place but which I believe have a better than 50% likelihood of happening. Styled after Byron Wien’s annual predictions. 🧵
#1: There is at least one new variant that emerges in 2022 that drives another omicron-sized surge of cases and hospitalizations, putting renewed stress on the healthcare system.
#2: Employers capitulate in mandating in-person return-to-work (with a few notable exceptions) for 2022. A widely distributed workforce enhances the value proposition of national, scaled healthcare players and virtual solutions.
1/ Even with the Supreme Court invalidating the Biden vaccine mandate, large companies are likely to take matters into their own hands with “sticks” (versus “carrots”). Even with a “mild” variant, economic consequences are significant enough to impact corporate behavior 🧵
2/ With hospitalizations surging (with fewer deaths) among the unvaccinated, the bill will come due at some point — to the tune of $20,000+ per hospitalization.
3/ Beyond hospitalization costs, the higher case rates of unvaccinated people have implications for productivity loss due to absence along with short-term disability costs. Chart below shows the trend for NYC.
1/ With the omicron wave putting untold pressure on staffing across a wide variety of industries, it is not inconceivable for these staffing shortages to become more “endemic” with behaviors that have likely changed forever. 🧵
2/ An estimated 5 million people are isolating at home due to omicron, which could “deal a significant hit to the economy over the next month or two.”
3/ In historical flu seasons, the current omicron-driven work absentee rate would be ~2x the average peak of workplace absence due to all illnesses in the US (largely flu).