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The Eatery experiment
I just downloaded “The Eatery” on my Iphone. Its a fun (can be addicitve) experiment and I believe way more effective then counting calories.
The Eatery is an experimental iPhone App that takes a different approach to improving your health by tracking what you eat.Unlike other health apps, The Eatery doesn’t watch how many calories you’re eating. Instead, it tracks your overall eating trends to figure out your eating habits and where you should make changes to improve your health.
The Eatery accomplishes this by asking users to snap a picture of the food they’re eating and swiping to indicate the serving size of what they’re eating. The Eatery then sends the picture to others using the app, where they will be able to rate the food you’re eating. By taking these photos for several days, patterns will begin to emerge. When are you eating your biggest servings? When do you eat the healthiest? Have you made improvements in your diet, or are you still eating junk?
The app lets you view your eating history through elegant photo montages — all the while it solicits the participation of you and you friends to rate each other’s dishes and keep your friends on task through commenting.
“Share your eating goals and food snaps with a network of friends and family. They’ll let you know when you’re on the right track and give you a nudge in the right direction if you get distracted,” co-founder Aza Raskin tellsMashable.
“As a founder, your job isn’t to make a great product. It’s to build a great team that makes great products. You are who you hire...To maintain your psychological health, you’ll need to learn how to shift the fufillment you get from making to the fufillment of enabling a team to make. You’ll be making vicariously, not making directly. You’ll have to come to terms and internalize it or else your lack of emotional fufillment will trickle down to your team.”—
Great piece on the shift from creator to founder.
As a researcher in the field of health behavior I was hesitant to use the Eatery app. I mean, what good could really come from taking pictures of your food? Once I got around to using the app I was pleasantly surprised to find myself drawn into the experience. Have I made some different choices because of it, sure. But what really gets me excited about the Eatery is the emphasis on simply user-focused design. I’ve said it before, as have others, the future success of health and health-related applications and tools lies at the intersection of data, design, and psychology. The eatery has the first two figured out and is actively figuring out the third. When they do, watch out. They might just make the world a healthier place.
Keep up the good work everyone over there at Massive Health. I hope to see good things from you in 2012.
Revolutions That Will Change Health Care
In our flailing attempts to fix our health care system, there are some rays of hope. Insurance providers are being forced to start thinking of patients as people, not as revenue streams.
Health care is broken. Insurance is hard to access, and expensive. What you pay often has little to do with the care quality you receive. Physicians are pressed for time, when you can see them. And the relationships between patient and doctor, and employer, and health insurer often seem to have broken down completely.
By 2000, 64% of Americans received health insurance through their employer. It wasn’t always this way. In 1943, the War Labor Board determined that health insurance benefits would be excluded from wage and price controls in key jobs like manufacturing. With much of the qualified labor off at war, and employers unable to raise wages, they resorted to offering non-wage perks (like health insurance) to attract and retain talent. The Kaiser Shipyards developed a system to care for their workforce. After the war, they opened their plan (today’s Kaiser Permanente) to other Northern California employers. By 1954, the tax exclusion was codified in law (PDF), solidifying the once-temporary link between employment status and health coverage.
Today, medical spending accounts for almost 18 cents of every dollar produced in our economy, the highest rate in the world. Americans pay 40% more than the country in second place on that list, and almost double what is spent in the U.K., but our outcomes are not substantially better. As more people confront the prospect of paying more for care out of pocket with reduced or non-existent benefit packages, it becomesincreasingly important to understand, and to receive, what we pay for.
Even if you have coverage, and you can afford the care, it’s likely that your doctor visit will only be about 20 minutes long. And while the shipbuilders at Kaiser probably developed a rapport with their doctor, the average college grad, staying in his or her first job less than 24 months, is unlikely to build a long-lasting relationship with one. Traditional relationships are breaking down between patients and their doctors.
But not all is lost. This very environment—fragmented, cost-pressured—is producing the innovative products and consumer-facing services which provide hope for the future.
THE MARKET IS FORCING INSURERS TO DESIGN PRODUCTS FOR CONSUMERS, NOT EMPLOYERS
The shift away from employer-sponsored health coverage is already beginning. If and when the health reform bill is fully implemented, millions of people are expected to have access to health coverage for the first time. And, if you believe the rhetoric, 20 million Americans will lose their employer-sponsored care at that time. The employer-sponsored market is shrinking, and a growing percentage of people will be buying insurance directly. The major insurers have already anticipated this shift: They are gearing up for a world where they market their products directly to consumers, through health insurance exchanges. On a recent trip to PIttsburgh, where the headquarters of regional insurer UPMC dominates the corporate skyline, I was surprised to see billboards aimed not at benefits managers, but at soccer moms. The advertisements, directed at consumers, touted new individual health plans. And the CEO of Aetna gave a keynote at SXSW to tout his company’s commitment to people and products focused on consumers, in an area he calls “strategic diversification.”
With the health plans preparing to sell their coverage directly to individuals, they’re starting to think like consumer marketers. Instead of focusing just on what happens when a member has an extraordinary diagnosis (and extraordinary cost), insurers are beginning to ask about what happens between billable moments, and between incidents of clinical care. When customer acquisition costs are high—as with a mobile carrier, or any subscription business—the key business success metric becomes customer retention rate. Unlike the mobile carriers, health insurers bear financial risk, so they’re even more motivated to keep around their healthy members, the ones who don’t anticipate using high-cost services and who are more likely to shop around based on features. The new plans clearly have incentive to optimize not just for cost, but for member experience.
CONSUMERS ARE FINDING WAYS TO ACCESS HEALTH CARE PROVIDERS OUTSIDE OF TRADITIONAL CHANNELS
With health reform bringing a new influx of people into the insurance system, pundits are projecting a shortage of as many as 150,000 physicians. Care seekers will be forced to rely more on alternative sources of care and guidance. Already, pharmacists can be reimbursed $2 a minute for counseling about diabetes. And any person can visitSharecare and HealthTap to get a medical question answered by a qualified professional. You no longer need to make an appointment for the summer-camp physical or a flu shot; over 11 million people visited CVS-located MinuteClinic since it opened in 2000.
COST SENSITIVITY SUGGESTS CONSUMERS WILL OPT FOR “RIGHT FIT” RATHER THAN “BEST” SOLUTIONS
Consumers do not always choose the most expensive product in a cost-value tradeoff. Consider cars, electronics, or even vacations. But historically, this didn’t hold true for health care. People shopped almost blindly for surgeries, deliveries, and medical imaging, with no information on cost or quality. As more more people bear more of the cost, and want to make decisions around quality, health care management companies like Castlight and CakeHealth, are poised to succeed by helping provide the right information, to the right people, at the right time.
TECHNOLOGY ALLOWS US, MORE THAN EVER, TO TAKE HEALTH INTO OUR OWN HANDS
American habits have changed, and we’ve become more of a do-it-yourself culture. The average bank customer conducts less than 15% of his business with a live person in an actual branch, preferring instead to bank via ATM or computer. And in the hospitality industry, where the very name implies placing a premium on human interaction and the personalized touch, hotel chains now promote checking in at a kiosk without ever having to talk to a human.
We are seeing this transformation in the health care space. Over 80% of people have sought health information online (PDF), with over one-third of smartphone users tracking diet or exercise. Even Weight Watchers, built upon the strength of in-person meetings, is betting the future on DIY online and mobile experiences. In his critically acclaimed book, The Creative Destruction of Medicine, cardiologist Eric Topol details these transformations happening across the field. We are taking health into our own hands, supplementing fragmented physician interactions with data-driven personalized applications that really know us.
There will always be a need for deeply involved physician relationships. Especially with complex diagnoses and significant treatment plans. But the future seems bleak. Health care is broken. Coverage and care are harder to access, more expensive than ever, and lacking in quality and value.
But from where I sit, there’s hope. Market forces are pushing health insurers to develop products that consumers really want. And since retaining low-cost members is so important financially, the insurers are incentivized to look beyond traditional disease models and to design services for people to get healthy and stay healthy. New technologies and changing regulations allows consumers to access clinical resources where and when they want, outside of established channels. Shifting social norms mean that we’re often more accepting, even demanding of, a self-service model in health care. The companies poised to win in this space are the ones which build products not just for patients, but for people.
-Andrew J. Rosenthal runs the business side of Massive Health
Thinking the Long Game
So here’s something that I think people need to think about. Right now, everyone is rightly worried about the baby boomer generation. They’re driving up healthcare costs, driving the demand for healthcare, and are the main voters that influence how the government responds to healthcare.
But has anyone thought about what will happen to us after the baby boomer generation? Assuming our systems and economy can weather the storm by maintaining the current status quo, how will the healthcare system look like after they’re gone?
Well for one thing, primary care will be a dead cause. We’re a generation that sleeps with smart phones and can google anything in a few minutes to figure things out. Medical homes will still exist to a certain capacity but specialists will have to step in to really get any semblance of regular medical contact. Using technology, we’ll have to ensure that medicine can keep up with the lifestyles of our current generation after we graduate and enter the workforce for a few decades.
At this point, if you were a really risky but brave entrepreneur, you’d try and focus on our generation right now and get them to form some sort of mental connection with the type of new tech-enhanced medicine that will resonate with their lifestyles and choices. Use health IT data from cool companies like Massive Health to monitor an entire generation’s health choices. I think if I decided against academic medicine, this is a field I’d want to go in.
Maybe its time for me to learn code and move to NYC or San Francisco and start getting to know people who have the technical skills to help me with this.
Columbia/Cornell and Stanford/UCSF, please let me in!!!
7 Months In, Here’s The Big Data Download From Massive Health’s ‘Eatery’ App
Massive Health, the San Francisco startup that aims to tackle major health care problems with tools such as mobile apps and big data technology, launched its first iPhone app “Eatery” back in November 2011. For users, the Eatery app is almost deceptively simple: You use it take a photo of what you’re eating, grade it on a scale of “fit to fat,” and give your rating to others’ meals as well. But for Massive Health, it’s been a veritable firehose of data about the whats, whens, and hows of nutrition from all over the world. Eatery has amassed more than 7.68 million food ratings from over 50 countries during its first five months alone. And for the first time the company is publicly pulling back the curtain on what it’s learned so far. http://dlvr.it/1SMhGh
“It's not your fault if you can't understand an interface.”—So speaks Aza Raskin in Making Personal Health Hip, a short piece in Fortune by Jessi Hempel. Raskin, progeny of interface guru and Apple stalwart, the late Jef Raskin, is the brains behind Massive Health, a startup looking to bring principles of Web 2.0 and simple, intuitive design to healthcare. As Hempel writes, “Raskin’s vision is a more holistic version of services such as the Nike+ iPod sport kit, which records a user’s runs and provides feedback on how to maximize a workout.”
Jawbone Acquires Mobile Health Startup Massive Health For Tens Of Millions
Hosain Rahman’s Jawbone may have first made a name for itself because of its line of high-performance Bluetooth headsets, but these days it has taken on a healthier image thanks to its more recent forays into activity tracking with the UP wristband. As it turns out, Jawbone is far from done tinkering with the UP experience. According to a new report from GigaOM, Jawbone has acquired San Francisco startup Massive Health and Portland-based design firm Visere to help out. http://dlvr.it/2vFmnc @suryaray
The Eatery & Why Calorie Counting Is The Worst Weight Loss Strategy Ever
Oh calorie counting.
The first and worst refuge for would be weight losers. On the surface, it seems so simple. 3,500 calories burned equals a pound. Figure out your basal metabolic rate (the amount you burn during a day just existing), add in a workout, reduce calories in so that the numbers work out with a steady, predictable loss.
Except, in real life, it almost never works like this. First, people often have adaptable metabolisms that figure out how to reset how much the body burns as diets change. Second, we’re at the beginning of an era where we are just discovering how much variation their is in how our individual bodies process different types of food. 1,500 calories for me may mean something fundamentally different than 1,500 calories for you.
And third, counting calories is both exceedingly hard and often a recipe for psychological disaster. Nothing like building an entire emotional edifice around knowing everything in when you’re doing well and exactly how badly you cheated on a hard diet to lead a person towards binge eating disorder.
These are not just passive observations for me. I lost 150 pounds in college, gained a chunk of it back after college when I started drinking, and have recently lost another 80 to get back down to where I was in school. In the process, I’ve experimented with just about every approach, and done things that no doctor on the planet would recommend just to figure out what works. I’ve experienced both the thrill of achieving and also the absolute agony of heading in the wrong direction again. I’ve come to believe that approaches based, ultimately, on blacks-and-whites are not only doomed to fail, but wreak havoc on most peoples’ psyches.
The bad news first: there are no shortcuts. It’s the specifics of calories that are the problem - the fact that calories may not mean what they’re supposed to mean for you - not the principal, which is that more burned than consumed equals weight loss. Ultimately, the only way to ensure you’re losing weight is to figure out your set point balance between a regular sustainable diet and a sustainable work out schedule.
The good news: the behavior change required for weight loss and maintenance is, once over the initial catalytic hump, much more pleasant than extreme diets and intense regimens of calorie counting would have you believe. It’s mostly about a regular awareness about the decisions that you’re making, and the comfort of knowing the actual implications when you’re making them.
I’ve been watching for the past few years to see if anyone would build an app in the personal health space that took this sort of approach. There are many apps for tracking your food and workouts - but all of them are about the scrupulous detailed data collection, rather than the big patterns.
Today, Massive Health is launching The Eatery, an app that is designed to help you figure out the big patterns in your eating. With The Eatery, you snap a photo of your meal and it helps you figure out where it fits on the scale of fat to fit - no calories involved. The calculus includes both the parts of the meal as well as the portion sizes. The app shows you the trends in your habits for the week and how you’re looking week to week.
I’m super intrigued to see how it works. It’s success will depend on both people’s adherence and the accuracy of the info, but the approach is more inline with what experience tells me will work than anything I’ve seen. If I could invest in them, I would.