Interview with Bert Kaufman, Head of Policy and Regulation @ Zoox (Self Driving Cars)

Today, I’d like to introduce you to my friend Bert Kaufman, Head of Corporate and Regulatory Affairs at Zoox, one of the hottest self-driving car start-ups in the Valley.  I’ve previously written about why tech companies need policy teams more than ever, and Bert’s work is at the forefront of this.

When I first met Bert, we had already heard of each other, and immediately hit it off. In addition to being extremely kind and generous, Bert is a killer combination of a big-picture, systems thinker – from his days in Washington – and an embodiment of the generous, action-oriented, and creative start-up culture in the Valley, where he currently works.

In this interview, I ask him about his transition from Washington to Silicon Valley, issues surrounding self-driving, what he wishes Government folks knew, and how else he thinks technology should be harnessed for public good.

This is my third profile piece on folks who work at the intersection of tech and public good, following Xinwei Ngiam and Kenneth Tay. Enjoy!



  1. Tell us a little more about yourself. Why did you move to the Valley after almost 8 years in Washington?  

I spent most of my time growing up on the East Coast and down South, so from a cultural standpoint, I always thought Washington was a great mix of north and south—“The Northern most Southern city.” From a professional standpoint, I am a lawyer who loves policy issues, so I gravitated towards Washington after law school. But what I discovered about myself over the past decade is that I really love building organizations and organizing initiatives around good ideas. And there is no better place in the world to build these things than the capital of innovation and entrepreneurship. My move out to the Bay Area was prompted by my fiancée who was in graduate school at Stanford, and because my role as an appointee in the Obama Administration was winding down.

  1. What did you enjoy most about your job in Washington and how did it prepare you for your current role at an autonomous vehicle startup?

Before joining the Obama Administration in 2013, I spent five years growing an organization called Business Forward. We started Business Forward to help business leaders from across the country do a better job of advising Washington policymakers and, conversely, to make it more efficient and transparent for policymakers to listen to business leaders. Through that experience, I faced the challenges of building an organization from scratch and learned the importance of taking a long-term view. Our funding came from about 60 large companies—our members—and I traveled around the country, engaged with thousands of people, and learned about issues that businesses of all shapes, sizes and ages faced as the country emerged out of the 2008-09 financial crisis.

That experience prepared me for the chance to join Penny Pritzker’s team at the Commerce Department. Not only did I get to work for an incredibly brilliant, demanding, and hard-working leader in Secretary Pritzker, but I also had the opportunity to help build and manage an initiative we created called the Presidential Ambassadors for Global Entrepreneurship. This initiative worked across The White House, Commerce and State Departments, USAID, the Small Business Administration, NASA, and with some of America’s most successful entrepreneurs to mentor, motivate, and in some cases fund aspiring entrepreneurs from across the U.S. and around the world. I also worked on policy issues related to the digital economy on areas like data privacy and cybersecurity.

In my role now, as an in-house lawyer working on policy in a sea of engineers and computer scientists, it’s important to communicate clearly and to understand the policy implications of the technology that we’re developing. This is important both within my organization and externally. Transportation is a highly-regulated space, for many important reasons. As a society, we want people to move around freely, but we also want to ensure that they can do so safely. The advent of autonomous vehicles will lead to innovation in road safety. What we are doing is so new that we have the opportunity to create best practices that can set the bar for future policy.

Policy is really important to any technology business intersecting with regulated markets. Technology startups that fail to consider policy or regulatory implications do so at their own peril. Conversely, regulators need to understand that the regulations should be nimble, flexible, and fair and not cumbersome. These principles will allow technology to advance on a level playing field.

  1. What is one thing you’ve learned or experienced that you wish your colleagues in Washington had a chance to?

Meaningful innovation is hard and takes time, so it is important to take a long view. Government can and should catalyze and support innovation through funding basic and applied research and challenge grants. Government should set ambitious policy goals while at the same time leaving innovation to the private sector.

For example, between 2004 and 2007, DARPA (the Defense Advanced Research Projects Agency) set out some “Moonshot-like” challenges and put forth a modest amount of prize money for autonomous vehicle-related technology. Today, the payoffs are huge. The teams that competed in those challenges are the fathers and mothers of all the autonomous driving R&D now taking place across the entire automotive industry. In other words, a series of small government challenges have generated an enormous amount of private sector investment and job creation. Two lessons here: the first is that a little can go a very long way; the second is that government set a goal, got out of the way, and let academia and the private sector drive the evolution of the space.

  1. Self Driving Car technology is one of the hottest areas in the Valley. What are a few things the international community should know about Self Driving Cars?

Three points here:

  • First, autonomous technology will usher in a paradigm shift as large as when we transitioned from the age of the horse and carriage to the age of the automobile. Getting around will allow for increased productivity, and for people who live in areas with poor access to public transit, it could make it easier to access jobs and opportunities. We will also think about real estate differently. For example, much of real estate today is built for and around the automobile. Think parking lots and parking garages. In a world of shared autonomous vehicles, demand for parking decreases.
  • Second, the first rollouts will happen in cities in a ridesharing model, not in vehicles sold to end customers. Cities can benefit from shared electric, autonomous transportation because it will ease congestion and decrease pollution. As more people move into cities, the idea of individual car ownership becomes less tenable. In this model, liability shifts away form individuals towards fleet managers and manufacturers.
  • Finally, and most importantly, safety is paramount. In the U.S., more than 35,000 people are killed every year in automobile collisions. Most of those fatalities are caused by human choice or error. Autonomous vehicle systems will be designed to interact safely on the roads with other road users like human drivers, pedestrians, and cyclists.
  1. Moving away from Self Driving Cars, what is one problem in society today – perhaps one you encountered at the Department of Commerce – that you think we can solve more aggressively using technology?

I think that technology, correctly harnessed and understood, has the potential to improve the lives of many. Technology underpins most of our economy today, and it’s only going to compound over time, so we need to use technology to do a better job of training and educating people for the jobs of the future. Governments can identify important priorities and strategies and incentivize education and training so that people are prepared and trained for an evolving economy.

Finally, as I said earlier, if the private sector’s job is to drive innovation, government should work to ensure that there is an adequate social safety net in place for all people as the economy changes.

Thanks, Bert, for sharing your insights!


Bert and Zoe.jpg
Bert, Zoe (his super-woman fiancee) and Talia!

5 Learnings From My First 6 Months in The Valley

This week, I hit my sixth month in the Valley. In October last year, we packed up our lives into suitcases, took our 5-month old on a 20 hour plane ride, and landed at Stanford University, where we both started new gigs: my husband, a PhD in statistics at Stanford, and I, setting up the Smart Nation and Govtech office in the U.S., working on partnerships, strategy & research, engagement & communications of Singapore’s tech agenda.

It’s been exciting but exhausting to be a start-up parent, start-up at work, and start-up socially, leaving all the comforts of knowing and being known back in Singapore. This is a more personal post, but I wanted to share five things I’ve learned about starting life in the Valley, since people often ask. I don’t think I’ve got it right all the time, but I thought I’d pen down some thoughts my six-month checkpoint, and see how it evolves over time.

Regardless of the reason that brings you to the Valley, I hope you find this useful.

  1. Be Generous

When I arrived in the Valley, I hardly knew anyone, save for a few college friends (most of them stayed on the East Coast). I was nervous about building up a network for my job. Again and again, I was surprised by the generosity of people I met. I told them about my objectives, and they generously made introductions and shared their insights.

Generosity is the ethos of the Valley. How is this different from other places I’ve lived in? I won’t deny that the natural human instinct is to ask “if I help this person, what’s in it for me?”. Some people are risk averse when it comes to this question, not helping unless they are sure they will get something out of it. In the Valley, people are more willing to take a risk that they will gain nothing in the short-term from that specific interaction, but that their generosity will come around one day.

Always pay forward generosity. As I go about my day, I keep in mind the people I’ve met and the professional and personal interests they’ve shared. I keep a look out not just for my own interests, but theirs as well. Nothing makes me happier than to help people to connect: to see minds meet, interests aligned, new opportunities explored. I’ve been lucky to facilitate many of these in the past six months, both within the Valley, and across the U.S. and Asia. I’ve experienced “what goes around comes around” first-hand.

2. Be Clear and Concrete About What You Bring 

While generosity is pervasive, I urge people not to take this for granted. Silicon Valley is a prime destination for “innovation tourism”. I have had many people approach me to link them up for “learning trips”. In general, people in the Silicon Valley are game to meet new people and share what they know. But people are also very busy. When I make an introduction, I like to be sure that the person on both ends will benefit – whether it is a new insight, a new partnership or investment opportunity, or access to new networks.

Hence, my second learning is to be very concrete about what you bring to the table when you reach out to someone. It need not be a fanciful effort. Share about the idea you are exploring professionally, or personally. Share about your (our your organisation’s) experience, and how it might align with the person’s interests. If you have details about collaborations that the conversation could result in, share that as well. Be upfront about the opportunities and uncertainties.

3. Find your Voice

The third thing I learned was the importance of finding your voice. People in the Valley are often genuinely interested in you as a person – beyond your professional capacity. What was your journey? Why do you do what you do? I boil it down to a natural curiosity; a bent towards learning from others’ experiences.

I’m not one to naturally write, or get in front of an audience. But I started writing ( and speaking at conferences, inspired by the many conversations I had with people who asked me deeper questions, after we had finished talking about work. Some pointed out that my eyes lit up when I talked about how technology could be used for public good, and how my experiences working on education, poverty and housing issues shaped my views. When I communicate on public platforms, none of it feels forced because these are issues that resonate with me.

 Finding your voice has a snowball effect for building relationships. As I wrote and spoke, people with common interests contacted me from around world – all over the U.S., Australia, China, Singapore, the UK, Rwanda, Korea, Germany. My blog has had over 10,000 readers over a few months, which surprised me because I the content is not exactly “light”. People who both agreed and disagreed with my views reached out to debate. One of my favourite things: having start-up founders share their passion for working on social issues (such as elderly caregiving, pre-school, workforce development), and, based on my experience in these areas – being able to give good advice on the challenges and opportunities.

By finding my voice, I’ve also been able to play the role of a bridge, facilitating conversations and link-ups between governments, civil society and tech founders on issues at the intersection of tech and public good. It drives contacts towards my work as well.

4. Find Time to Think and Invest Deeply 

My husband recently commented that being back in school for his PhD has been far more mentally tiring than working. Here’s what we concluded: when we work, we exercise many different capabilities, some of which require less intellectual effort. Especially when starting up, there are a million things to do, people to meet, process kinks to iron out. It’s easy to be swept away by the operations.

To make space for deep thinking, I’ve identified several areas where I have no ready answers, but which I think would be super impactful for Singapore if we get right. Every week, I set aside a few hours to work on these issues. I’ve developed hypotheses, and have a small circle of people I meet regularly to exchange ideas with. One such area is the policy, technology and data needed to tackle job displacement at scale.

Setting aside time for these things takes a little faith because you aren’t entirely sure how it will contribute to the bottom-line, or what is expected of you. But I’ve applied this principle in every job since I started my career, and I can assure you it does. In my first job, I felt strongly about equalising opportunities in pre-school education, and worked on a small side project reviewing all academic literature on the outcomes of preschool education. Because it was the right time, it became one of the key impetus for major preschool reforms, which I had the chance to work on subsequently. 

5. Keep Your Perspective 

Finally, find ways to keep a broader perspective of the world. One of my best friends from college left the Valley shortly before I arrived. He expressed relief to be moving out of a place that was so “uniformed” – all about tech, largely upwardly-mobile and highly-educated. Another recently told me she plans to move permanently to Rwanda, because you can’t avoid the realities of human suffering the same way you can in a developed country – even more so the Silicon Valley.

Especially with the 2016 Presidential Election behind us, we all realise we live in a bubble. Even after moments of self-reflection, it’s tough to keep a broader perspective: My news and social media feeds, meetings and calls are overwhelmingly tech-related.

In the next quarter, our family wants to get more involved in community service (though admittedly, with a one-year old, it’s harder to get out!). In the mean time, one of the things I do is to make sure I read a book in a completely different field every few weeks. My two favourites this year: “Hillbilly Elegy” – a compelling narrative on the social issues facing middle America – and  “My Promised Land: The Triumph and Tragedy of Israel”, which helped me reflect on geopolitics, race, and foreign policy.

Back at You 

As I write this, I’ve realised that these need not apply just to starting life in the Valley. They could be applied to starting out in any new place, or even to building a new network in your existing home. Many of you have experiences that far exceed mine. Would love to hear your thoughts!

Also, I am back in Singapore for the month of May and would be happy to catch any of you there.

Having a child helps keep better track of time. In the six months we’ve been here, our baby has grown into a toddler who walks everywhere, and has a mind of her own. It reminds us of the need to stop, reflect and savour each moment we have. 

These 6 technologies are redefining the ‘smart city’ (David Gilford)

I loved this article by David Gilford on how we should think about Smart City technology. He captures simply what matters, and why – from the technology perspective. Enjoy!


The phrase “smart city” conjures up images of gleaming new infrastructure, from intelligent street lights to NASA-style command centers. In reality, however, technology’s biggest impact on urban life is much less flashy.

Rather than betting on VR headsets or other currently popular interfaces, communities that invest in six underlying capabilities are best positioned for the longer term:

1. Recognition

  • Allowing personalized recognition between people and systems

In the popular imagination, small towns are where “everybody knows your name,” sharing goods and spaces without a second thought. The urban bike rack may seem like the polar opposite, yet programs like Citi Bike entrust strangers to pick up objects worth hundreds of dollars and drop them off across town. Such systems recognize individuals and extend privileges accordingly, using technology from biometrics to token-based authentication to enable the sharing economy. If sharing one’s home is an expression of faith in fellow citizens, Airbnb is an early example of how technology expands circles of trust, bringing aspects of small communities to even the largest cities.

2. Location

  • Providing context-aware, location-based information for efficient and engaged movement

Mobile phones with ubiquitous GPS have nearly rendered the feeling of being lost obsolete, yet the built environment is only beginning to understand where people want to go. While autonomous vehicles dominate headlines, simply understanding people’s locations and desires offers both a big economic and social payoff. Ridesharing services like Via blur the distinction between private and public transportation, effectively creating “on-demand buses.” Similarly, by analyzing millions of data points from Amsterdam to Singapore, the MIT Senseable City Lab estimates that intelligently matching riders could reduce the total number of taxi trips by as much as 40 percent.

3. Sensing

  • Observing, understanding and anticipating the world around us, from the movement of people to the quality of our environment

Sensors are hidden but ubiquitous components of the urban landscape. Beyond piecemeal installations, communities are recognizing the benefits of a holistic approach. The Array of Things project is deploying environmental sensors across Chicago, aiming to be a “fitness tracker” that captures and analyzes data impacting quality of life, including air quality, climate and noise pollution. New York City’s recently announced Neighborhood Innovation Labs take this a step further, partnering with communities, government, technologists and educators to solve locally-identified challenges, starting in Brownsville, Brooklyn.

4. Transactions

  • Creating secure, convenient methods to pay for goods and services

Blockchain, best known as the technology behind bitcoin, is finding unexpected applications in the built environment. The Brooklyn Microgrid shows how solar power can be shared across a neighborhood, improving sustainability and resilience to disruptions. By facilitating decentralized, low-cost and secure transactions, blockchain empowers citizens to participate in what had previously been the exclusive purview of large utilities. Such peer-to-peer approaches offer the potential to transform other urban markets, from ridesharing to real estate.

5. Connectivity

  • Linking people to services, resources, amenities and each other

In a world where internet-connected devices outnumber humans, connectivity is essential to competitiveness. Through LinkNYC, my company, Intersection, is replacing old payphone infrastructure and bringing free gigabit wireless to New York City, where nearly 20 percent of residents lack broadband at home. Though the kiosks themselves are becoming a fixture of the streetscape, LinkNYC’s biggest impact may be invisible, with each unit supporting hundreds of simultaneous users. Since launching last year, over 1.3 million individuals have registered to use the WiFi, with over 5 million sessions occurring each week. As access to high-speed broadband is democratized, more citizens will be able to fully participate in their community’s growth.

6. Integration

  • Enabling different systems, information sources and data types to work together

As the examples above demonstrate, no technology operates in isolation. Just as smartphone apps connect with each other, physical systems need interoperability. Unlike consumer applications, however, systems in the built environment are harder to interconnect, from elevators to energy systems. Cities and real estate developers that overcome traditional biases towards closed and proprietary systems can provide a platform for others to build upon and improve.


To improve people’s lives, technology needs to serve people, not vice versa. Questions of accessibility and equity must remain at the forefront as communities envision responsive neighborhoods. While no one can predict what technologies will dominate next year’s headlines, places that embrace these foundational capabilities will be ready for whatever comes next. Beyond simply being “smart” today, such communities enable all of us to collaborate in building better environments tomorrow.

David GilfordDavid Gilford leads Intersection’s Connected Communities practice, helping municipalities, real estate developers and public-private partnerships create connected, responsive communities. Prior to joining Intersection, Gilford held multiple leadership positions with the City of New York, most recently as Vice President for Urban Innovation & Sustainability at the New York City Economic Development Corporation.

When a Nudge Becomes a Shove: Uber’s Guilt is All Of Ours

Uber recently made headlines with this feature by the New York Times, on how it uses behavioural insights to get drivers to work longer hours, and go to areas where there is high passenger demand. As Uber drivers are not employees, Uber has very little formal influence over their behavior – they can’t mandate how much drivers drive, or what area they cover. Behavioural nudges are a relatively costless way of getting drivers to do what Uber wants, instead of using monetary incentives. But is Uber particularly guilty?


A Brief Overview of Behavioural Nudges

The use of behavioural nudges to shape customer, constituent and employee behavior is certainly not unique. Examples abound, including:

  • Businesses and customers. Positive reinforcement is the bedrock of modern advertising. Jeff Bezos from Amazon famously said “through our Selling Coach program, we generate a steady stream of automated machine-learned ‘nudges’ (more than 70 million in a typical week).” Games like candy crush turn us into addicts by providing mini rewards in our brains, releasing the neurochemical dopamine and tapping into the same neuro-circuitry involved in addiction.
  • Governments and constituents. The UK Government has its own Behavioral Insights team, which has helped sign up an extra 100,000 organ donors a year and doubled the number of army applicants by simply changing default options and how emails were written.
  • Employers and employees. One of the reason Google will fix your car, take care of your health and food needs all in one place is because they know it will get you to stay longer and work harder.

Now that you’ve seen some examples, what exactly are “behavioral nudges”? Definitions vary, but I’ll boil it down to two things:

  • Applying an insight about a person’s decision-making calculus (that the person might not even know about himself!) to get him to make the decision you want.
  • The person is likely unaware that this tool is being used (unlike a law or a policy, which he actively shapes his behavior to comply with).

For example, the principle of “loss aversion” suggests that humans are more likely to respond to a potential loss, than a potential gain. When you want drivers to drive for two more hours, tell them they’d lose out on $200 if they didn’t. Don’t tell them they’ll gain $200. We are also a lot more vulnerable to peer pressure than we think. The UK Government managed to nudge forward the payment of £30m a year in income tax by introducing new reminder letters that informed recipients that most of their neighbours had already paid. Never underestimate the power of inertia – which is why companies adopt “opt-out” rather than “opt-in” clauses.

An in-depth article on leading thinkers in the field of behavioural science (Kahneman, Tversky, Thaler, Lewis), can be found here.

The use of behavioural nudges is not new, but data has made it an increasingly powerful tool.

The potential for behavioural nudges is increasing with the proliferation of data about individuals. The more you understand how people make decisions – to work longer hours, to buy your product, to pay their taxes, to brush their teeth, to play a game, the more effectively you can nudge them towards your desired behaviour. Facebook knows more about me than I do. Uber knows more about their drivers than drivers themselves.

As a result, these companies can push buttons I didn’t even know existed. They have the potential to hack my operating system and change my behaviour.

Hence the ethical question of when a “nudge” becomes outright manipulation is more pertinent than ever.

Here are several ways to think about whether a “nudge” is being used ethically. <By the way, some people argue that it’s never OK to curb someone’s “moral freedom” through nudges, but I find that too idealistic – nudges have been used for time immemorial. It has to be a matter of degree.>

First, what is the inherent goodness of the outcome for the target population?

On the positive extreme, behaviours such as showing up at a doctors’ appointment, attending school or paying bills on time can be seen as actions that are positive for the individual. On the negative extreme, you could have outcomes such as an alcoholic purchasing more alcohol, or a suicidal person being nudged off the ledge.

There is huge scope for debate in between the extremes. Uber could argue that getting drivers to work longer hours during peak period is good for their earnings. Facebook would argue that repeatedly pushing advertisements that users are more likely to click helps them find what they need and like faster.

But here are two sub-questions to consider, in Uber’s case:

  • What is the distribution of benefits accruing to Uber vs the driver if the driver changes his behaviour? In this case, there seems to be a direct trade-off between Uber and drivers’ interests. As more drivers come onto the platform as a result of the nudges, drivers don’t benefit from surge pricing. On the other hand, Uber gets the benefit of more rides and hence more earnings.
  • Is there an intention to deceive? The author suggests that some of Uber’s methods nudged drivers towards geographical areas on the pretext of a surge, but when drivers got there, they found there was none. Even if this was not the intention, the asymmetry of information is unfair to drivers. More transparency is needed, perhaps by providing drivers a live feed of surge rates in various areas, including when surge is dropping.

Second, how easy is it to “opt-out”?

The ‘opt-out’ technique is one of the most commonly used “nudges”: always set your preferred option as the default, and count on human inertia (or ignorance) to keep people there. If you are a Netflix user, you’ve experienced this: once your episode ends, the next one comes on automatically in ten seconds. It is a nudge to keep you watching, but you can turn off this feature permanently. Google and Facebook will send you personalized ads, but you can opt-out and get those replaced by randomised advertisements instead.

If you are an Uber driver, you can also temporarily turn off the forward-dispatch feature, which dispatches a new ride to you before the current one ends (keeping you constantly driving, just as Netflix keeps you constantly watching). However, there is no permanent way to turn it off. It will keep popping back on when you take a new ride: you have to be constantly proactive about stopping it if you don’t want to overwork. Does the lack of a permanent opt-out feature make Uber more guilty? Perhaps. But I would like to find out more about the design considerations of both Uber and Lyft before giving a definitive view (hit me up if you have further insight!).

Generally, how proactively institutions educate their users/employees about the opt-out function matters, as does how easy it is to opt-out.

A More Important Question

So is Uber particularly guilty? On the surface it seems to. But want to hear my real answer? I have no idea, simply because much of the nudging that institutions do today is invisible, making it impossible to compare. We – as users, employees, constituents – do not even know that it is happening, and there is no legal obligation to tell us.

Hence, rather than ask whether Uber is guiltier than other institutions which deploy “nudges”, I believe the more important question should be: is self-regulation by these institutions sufficient? If not, does anyone have the moral high-ground to arbitrate? Should there be a system where institutions report their use of “nudges” and hold each other accountable? Would love to hear your thoughts.

Source: New York Times

Tech for Health – Too Little Too Late (Alam Kasenally)

This week, I feel lucky to have a veteran in healthcare technology and data science from the Silicon Valley, Alam Kasenally, give us an overview on how technology has already transformed healthcare, and the gaping hole which has yet to be filled: patient experience.

Alam recently moved to Mauritius with his wife, Min Xuan (one of Singapore’s brightest entrepreneurs), where they manage a hospital. They’re also busy inspiring youth toward entrepreneurship, and building an innovation hub in Mauritius. Prior to his relocation, Alam worked in Cancer Commons in the Bay Area, which provides patients and their physicians with the knowledge needed to select the best available therapies and trials, and to continuously update that knowledge based on each patient’s response. He also worked in Oracle, Yahoo and Crowdcast prior.

Alam and Min are two people who will inspire you with their commitment to using tech and innovation for public good, how deeply their invest in others, and their entrepreneurial experience. For our entrepreneur readers: If you are a founder trying to gain quick access to real users and customers to pilot quickly, their hospital in Mauritius provides an immediate incubator for medical technologies, while they also have trusted partners especially in the agriculture and tourism verticals that can move quickly. Let me know if you’d like to be in touch!


What’s the opportunity for Tech in Health?

Early Sunday morning, and that ridiculously healthy neighbor of mine is already lunging and squatting on my, I mean our lawn, ready for her half-marathon practice. My overwhelming instinct is to grab my fitbit and try and compete, but really, I should be (from an economist’s point of view) happy that I have an additional neighbor in my community that is healthy. For a start, the workforce is larger by one (and perhaps more than one: serious illnesses affect entire families of people who care for the patient). I enjoy a larger share of tax dollars deployed to Leslie Knope rather than, uh Gregory House. Finally, my neighbor is probably not lunging with a dripping nose. My neighborhood is safer.

So, now we’ve established that Health is a Public Good (as well as being “in the Public Good”), is there therefore a role for technology in Health? Well, there already is, and let’s take a tour of the landscape.

Technology, and I’ll focus on tech as the Valley knows it, minus traditional medical technology (prosthetics, diagnostic and treatment infrastructure, etc) has made a serious impact in the last 10 years. Smart entrepreneurs everywhere have caught on that tech can:

  1. Lower overall costs through automation and efficiency (Epic, the Goliath of the industry, now faces an impressive challenge led by lean startups)
  2. Lower overall costs through the finding of patterns in hospital big data
  3. Avoid adverse selection and moral hazard through finding of patterns in insurance data and monitoring patient behavior (though I have to yet to see these cost-savings trickle down to patients)
  4. Provide a variety of “quantified self” (steps, sleep, calorie, breath) in an effort to influence behavior change and lower their healthcare system’s cost
  5. Lower overall costs through remote monitoring of patients (FBS, SPO2, EKG) and we’re even seeing these devices cross into the consumer space.

So is there any scope for the use of technology left?

There’s scope for a combination of technology, process, regulation and people. Healthcare is not only an expensive good, but a remarkably complex one. Sleep, Dieting, Breathing are just fine (though they have attracted the most VC dollars, as they are the easiest to do). The patient experience, on the other hand, is broken, in a million pieces. The complexity of choosing the institution and doctor that will lead to the best (and most consistent) outcome is daunting. The complexity of referrals is mind-boggling and reimbursement is ludicrous. The simple knowledge of viable treatment options and associated outcomes is not available to patients, their families and even doctors.

Is this the limit of the use of technology for Health? No, it’s only the beginning. It’s time for a true Uber of Healthcare to emerge.

“Huber” re-invents the patient experience just like Uber successfully re-invented the taxi experience. This company (and maybe government) will successfully join different partners and datasets, to create an experience that is to the patient’s (and her family’s) satisfaction, safety and in her interests. Datasets that only get smarter, as Healthcare outcomes, treatment models and patient preference filter back into the system. From my experience, certain countries remain crippled in regulation that thwart such efforts, often with the reasonable but ironic pretext of patient privacy. But others (Singapore comes to mind) have an honest broker, trustworthy IT custodian of the data and could write regulation and create necessary conditions that could well be in the patient’s interest.

Soon, participants will begin to realize that it isn’t just Health that’s the Public Good. But Data. Now, excuse me while I grab my fitbit.