Broad spectrum antibiotics and the case for precision medicine - VIDEO

For this post, I created a video giving information about broad spectrum antibiotics and how precision medicine could change the way healthcare is delivered.  I used images I gathered from the web and the free version of Animoto to create this video.  I must admit that I enjoyed this exercise. It was fun exercising the creative part of my brain.

Theranos has fallen, but precision medicine will rise. Are we ready?

The Promise

Theranos, a medical device company, was founded in 2003 by 19-year-old Elizabeth Holmes.  It created a device called Edison, that Theranos claimed could perform hundreds of tests with a tiny amount of blood taken from a finger prick (Ledford, 2019).  Theranos and Holmes promised to jumpstart a new era of preventative medicine by detecting health issues before it is too late.  The process was simple, fast, and very affordable, with blood tests costing approximately 90% less than traditional blood testing methods (Weinstein et al., 2016).  

 

The Downfall

 

Unfortunately for Theranos, the promise far outweighted the delivery.  Theranos was only able to test for a small fraction of test advertised and was relying on devices made by other companies to test their blood samples (McCarthy, 2016).  Theranos’ laboratory certificate was revoked for concerns of jeopardy of patient healthy and safety, and the owners and operators of the lab were suspended from running a lab for at least two years.

 

Elizabeth Holmes settled with the SEC in 2018 for a $500,000 fine, over 19 million shares of company stock, and agreed to not hold any type of leadership position for 10 years.   Both Holmes and Ramesh “Sunny” Balwani, the president of Thanos, are chared with wire fraud based on their deceptive practices promoting their company and technology.  That litigation is still ongoing.

 

How could Thanos have been saved?

 

Theranos hit a chord in the biotechnology market because there is a strong desire for preventative medicine, as well as medicines that are tailored to the patient.  Unfortunately, Holmes resorted to deceptive practices to raise funds and relied on her charisma and refined public image to bolster the company in the absence of peer-reviewed published test data.  Holmes had the charisma to make any company profitable, but she should have started with what she could deliver.  She wanted too much too fast, and it caused the downfall of her reputation, career, and company.

 

The Sociotechnical Plan and Precision Medicine

 

Precision medicine is not ready for the market but gives the promise that medicine can eventually be tailored to a person based on their unique genomic makeup, increasing the odds that it will meet the expected outcomes, and minimize unnecessary side effects.  This technology is becoming more possible because human genome sequencing is becoming more probable, and electronic copies of this information can be used with algorithms to identify patients with specific risk factors.

 

Precision medicine introduces privacy concerns.  If a genome is sequenced for purposes of precision medicine, and it becomes used in healthcare data warehouses, what happens if a person wants to remove their information from those databases?  How can a person know that their genomic data was completely anonymized before entry in a data warehouse?  If a person is identified as having risk factors, could those genetic test results negatively affect employment or insurance coverage (Stiles & Appelbaum, 2019)?

 

Genomic data is not like personal credit information.  Credit card and banking numbers can be changed, but our genomic data is the same over time.  The potential mismanagement of this data can have serious effects for participants and needs to be a serious consideration as we move forward with precision medicine.

 

References

 

Ledford, H. (2019). Blood money: Theranos on screen. Nature, 568(7753), 455-456. https://doi.org/http://dx.doi.org/10.1038/d41586-019-01066-0

McCarthy, M. (2016). US officials ban Theranos CEO from running laboratories for two years. BMJ : British Medical Journal (Online), 354. https://doi.org/http://dx.doi.org/10.1136/bmj.i3824

Stiles, D., & Appelbaum, P. S. (2019). Cases in Precision Medicine: Concerns About Privacy and Discrimination After Genomic Sequencing. Annals of internal medicine, 170(10), 717-721. https://doi.org/10.7326/M18-2666

Weinstein, A., Sipala, A., Turkington, L., & Stromberg, M. (2016). Theranos - A Case Study on Customer Value and Technology. Journal of Marketing Perspectives, 1, 6-22. 

 

Unexpected inventions by serendipity, error, or exaptation

Serendipity is the occurrence and development of events by chance in a happy or beneficial way.  An invention that follows the term serendipity is potato chips.  George “Speck” Crum was frustrated with complaints about his thick cut French fried potatoes, so he cut them as thinly as he could, fried them, and covered them with a lot of salt (Breyer, 2017).  He did not anticipate that his patrons, and the rest of the world would enjoy his new snack creation.  

An error is simply defined as a mistake.  An example of an invention that was found in error was the color mauve.  Mauve was created in error by a teenage chemistry student, William Perkins, who mixed tree bark and coal tar to create the color (Accidental scientific discoveries and breakthroughs, 2020).  Personally, I felt that the rage that followed mauve in the 80’s was another error.  Does anyone else remember the rage around the color combination mauve and country blue?  I do, and unfortunately, my mom was a strong follower of this 80’s color craze. 

Mauve bedroom, from http://vintagegoodness.blogspot.com/2011/07/vintage-80s-home-decorating-trends.html

Exaptation is a shift in the function of a trait during evolution.  One example is the company GroundProbe, who created a short-range radar technology that has a high level of precision.  The company invented this technology for locating pipes and power cables underground.  However, when it went to market, it was not received well.  Under re-examination, the company found that their technology had other uses, such as monitoring the stability of rock walls in mines (Kastelle, 2015).

 

References

Accidental scientific discoveries and breakthroughs. InterFocus Lab Furniture. (2020, November 23). Retrieved November 7, 2021, from https://www.mynewlab.com/blog/accidental-scientific-discoveries-and-breakthroughs/. 

Breyer, M. (2017, June 5). 10 accidental inventions that changed the world. Treehugger. Retrieved November 7, 2021, from https://www.treehugger.com/accidental-inventions-that-changed-the-world-4864131. 

Kastelle, T. (2015, January 23). Innovation through exaptation. Tim Kastelle. Retrieved November 7, 2021, from https://timkastelle.org/blog/2010/05/innovation-through-exaptation/. 

Nokia's Limited Vision: How Poor Planning Killed the Mobile Giant

As a teenager in the late 1990’s and a no-so-responsible college student in the early 2000’s, I have fond memories of my Nokia phones.  They were indestructible, and I was fiercely loyal to them.  I dropped them, drowned them, and abused them, but they kept turning on.  They didn’t require cases, and they got great coverage.  However, the advent of smartphones with software operating systems put Nokia on the defensive, and for fear of alienating their current customer base, they did not embrace the adoption of data as the future of communication (“Most popular examples of top companies that failed business strategy”, 2020).   

Nokia Phone, Pooh01, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=2399492

 

Rise to Stardom

In the late 1990’s through early 2000’s, Nokia had it all.  They had the best-selling mobile phone brand, net operating profits around $4 billion, and the Nokia 1100 became the best-selling phone of all time in 2003.  They dominated the cellular phone industry and peaked at a 49.4% of the mobile phone market in 2007 (Barr, 2020).  Everyone seemed to have a Nokia phone, and they gained an almost unheard of popularity.  Even Neo in the blockbuster Matrix films gets a Nokia phone, also dubbed the "banana phone," which only helped bolster Nokia's prominence.

Photo credit: Warner Bros. Pictures, retrieved from https://arstechnica.com/gadgets/2018/02/nokias-latest-nostalgia-bait-feature-phone-is-the-8110-banana-phone/

Costly Mistakes

 

However, Nokia made a series of costly mistakes that cost them their position and ultimately, forced them to sell to Microsoft.  They underestimated the impact of the iPhone.  They failed to see how important software would become on mobile phones, and how data would emerge as a leading technology in mobile devices.  

Nokia’s management adopted thought processes that could be considered arrogant.  They leaned on their position of being the industry leader for the past decade, and overestimated their brand strength (Barr, 2020).  Nokia also pushed an organizational structure that prevented middle management from telling upper management about their poor inter-departmental communication, lack of technological progress, and a sub-par operating system (Symbian) that would hinder their ability to be viable against competitors.  

 

Fall From Grace

Nokia failed to try new and innovative ideas, and stayed locked into their play it safe strategy.  They became risk-averse, and over-complicated their structure, stifling decision-making.  Also, Nokia did not focus as much on the United States as a major market as Apple and Google did with their Apple iPhone and Google Android phones.  

Another factor cementing Nokia's demise was the appointment of Stephen Elop in 2010.  He announced that they would change their operating system to Windows, at a time when the Android and iOS operating systems were clearly more dominant (Onikoyi, 2019).  What followed was one of the fastest collapses in the tech industry, and they were bought by Microsoft in 2013.   

How Could Have Scenario Planning Helped?

Scenario planning allows a company to set a proactive stance in the face of ongoing, unpredictable change.  It is a process that allows for people to imagine multiple possible futures, develop courses of action, and create informed decisions on how to act should that event occur.

Nokia had no way to know what was coming, but scenario planning could have helped them imagine situations and create solutions that would have helped them adapt to the competition, technical challenges, and market pressures they would inevitably face.  However, they chose to rely on their past forecasts and historical data, which provided them no help with an unpredictable future.

Scenario planning increases flexibility.  Nokia was notably risk-averse, but a scenario planning strategy could have allowed them to become flexible in the face of change.  It changes reactive situations into proactive solutions, and creates time for organizations to capitalize on opportunities.  

Nokia could have used scenario planning to think about their markets and asked questions like, what happens if we lose market share in the United States, what happens if we lose 10% market share, and what happens if our technology cannot keep up with our competition?  Because they did not as these questions and others like these, they were unprepared for what would inevitably come their way.

Photo Credit: Matt Ranen, retrieved from https://www.mattranen.com/how-it-works

References

 

Barr, B. (2020, June 18). Nokia: What went wrong? Medium. Retrieved November 3, 2021, from https://medium.com/thoughts-economics-politics-sustainability/nokia-what-went-wrong-c342c237a069. 

Most popular examples of top companies that failed business strategy. CBNation. (2020, June 14). Retrieved November 3, 2021, from https://rescue.ceoblognation.com/2020/06/14/most-popular-examples-of-top-companies-that-failed-business-strategy/. 

Onikoyi, O. (2019, October 2). How Nokia lost its pace in the smartphone race. Medium. Retrieved November 3, 2021, from https://olaonikoyi.medium.com/how-nokia-lost-its-pace-in-the-smartphone-race-a22c0ff1d846.