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YouTube reins in eating disorder content, Q&A with Evidation’s Christine Lemke, & Uber’s free-ride pilot for pregnant D.C. patients

April 18, 2023
Reporter, STAT Health Tech Writer

Good morning, health tech readers! Today I've got a look at new projects from YouTube and Uber Health, new early-stage health tech funding, and some thoughts from the head of Evidation on using tech to build trust among underrepresented populations. Comments and news tips go to mohana.ravindranath@statnews.com.

big tech

YouTube limiting harmful eating disorder content

Google's video site is taking several steps to restrict eating disorder-related content, the company announced Tuesday — including removing videos that might lead viewers to imitate disordered eating behavior, and adding age restrictions to some educational or recovery-related content that details behavior like purging or calorie counting. It also will start suggesting crisis resources to viewers watching or searching for eating disorder content. Garth Graham, YouTube's director of health care and public health partnerships, told me the company was working on the effort long before controversy swirled around telehealth platforms prescribing medication for weight loss, and that YouTube's efforts are unrelated.  

"We know YouTube in particular is a major source of health information broadly," said Graham, who added that the platform has been consulting outside expert organizations like the National Eating Disorder Association on updating its policies globally. YouTube is also pushing videos created by qualified clinicians to the top of search results, he said. 

"Public health is changing," Graham added. "We have to really, really be thoughtful about our approach to content moderation."

YouTube has historically banned content promoting eating disorders, but it's now also prohibiting other content that experts say could lead viewers  to imitate harmful behaviors, he explained. The company relies on human content moderators scattered across the globe as well as technology that scours the audio and visuals from videos to flag prohibited content. Viewers can flag problematic content as well. 

The video platform is trying to strike a delicate balance between hosting valuable educational resources and inadvertently triggering harmful behavior, Graham said. "How do you get information to people but also realize that displaying the behavior can also be triggering?"


startups

Define Ventures raises $460 million for startups 

Define Ventures has raised the money to fuel early-stage health tech companies, Mario Aguilar reports. Managing partner Lynne Chou O'Keefe last raised a fund in January 2021; the difference between then and now is "a tale of two cities," she told Mario. 

"Many of these founders raised a lot of money that allowed them time to pursue many different strategies," she told STAT. "And sometimes that's not a great thing. We have to be much more focused now."

Chou O'Keefe, previously of Kleiner Perkins, has a history of strong bets — including on the chronic disease management company Livongo which merged with Teladoc in 2020. That deal, which valued Livongo at $18.5 billion, helped jump start the digital health funding boom that has since contracted amid economic uncertainty. Read more here.


Notes from the bay

Q&A with Evidation co-founder and CEO

Last month, I caught up with Christine Lemke at a San Francisco coffee shop. As I write about clinicians and companies using technology to build trust among underserved populations, I've been looking for common tech principles that other entrepreneurs or practitioners might use to reach their own populations. Evidation, whose clients are mostly biopharma companies seeking to recruit specific populations into clinical trials, has a consumer app that pays users in points or cash for tracking their own health, making behavioral changes, and also sharing their data with the company. Evidation also recently helped develop a publicly available benchmark registry for health data — known as American Life in Realtime — that it says represents diverse populations and lowers risk of systemic bias against already marginalized groups. This conversation has been edited for length and clarity.

How does Evidation use tech to build trust?

We're convenient. You don't have to be near an academic medical center, it's a low barrier. The basic ingredients that anybody needs is both distribution, so that anyone can sign up, and then just being easy and convenient to use. We had to really be intentional about the types of partners we have…[and] trying to understand which community organizations were plugged in. 

How do you choose community partners?

In the past it's just through our own personal relationships and networks, with people we know in the community and organizations like BlackDoctor.org.

There are standout organizations like Project TECH that are very excited about digital health and are looking for partnerships in this area. I would recommend almost any digital health company, not just us to partner with them. 

From a compensation perspective, we try to make it easy. We cover the costs. We know it's a special effort to reach underrepresented organizations. and so we know there's a cost attached to that. 

What populations are hardest to break into?

People without smartphones. We had to acknowledge the limitations to what we do and that's probably a population that is going to be harder for us to reach just by nature of our offering. It's hard to create a value proposition for consumers when they don't have a smartphone on our system.


medicaid

Inside Uber's maternal health pilot in D.C.

Ridesharing giant Uber has been searching for a viable way into traditional health care for years, experimenting with prescription delivery and non-emergency medical transport. More recently, it's been focused on low-income pregnant mothers — a formidable market, with roughly half of births happening among Medicaid patients. 

Between 2021 and 2022, the company ran a pilot giving free rides to hundreds of patients at  the Community of Hope and Mary's Center clinics in Washington, D.C. Many of them live far from public transit or lack cars, putting them at risk of missing crucial prenatal visits. Uber said the free rides — either organized by the health systems or paid for using a voucher on the consumer app — made patients slightly more likely to attend visits. 

Armed with positive findings from the pilot, Uber's goal is to demonstrate to payers that covering patients' rides to preventive visits could save them money that might have been spent on costly emergency procedures later. While Medicaid plans typically do cover non-emergency medical transport, it often requires calling into a third-party dispatch system, which clinic staff told STAT is less convenient than using the Uber app. Read more on the pilot, including a perspective from one of the clinics' ride coordinators, here.



Artificial intelligence

Microsoft, Epic weave AI into health records

Microsoft and Epic are planning to integrate Azure's OpenAI technology into Epic's health record software, the two companies announced Monday. With the new tech, health systems can auto-draft messages, show patients interactive data, and flag opportunities for lowering costs, according to a press release. The auto-draft feature is already in use at a handful of health systems including UC San Diego Health, UW Health in Madison, Wisc., and Stanford Health Care.


Telehealth

Calibrate trims workforce by 18 %

Telehealth company Calibrate, which prescribes obesity drugs and offers weight loss coaching, let go of almost a fifth of its workforce last week, my colleague Elaine Chen reports. The company plans to ramp up partnerships with employers who can offer its services to their workforce, according to a statement.  "Calibrate is accelerating our transformation into an Enterprise-first business, shifting internal resources and restructuring our team," the company said. Still, "we will continue to grow our direct-to-consumer business responsibly." Read more from Elaine.


Devices

In device news...Philips and the FDA beef

The FDA posted an update on Friday calling out Philips for overstating the number of replacement CPAP devices it has sent consumers impacted by the company's botched recall, my colleague Lizzy Lawrence writes. Philips recalled the breathing machines, which treat sleep apnea, for shedding foam with potentially carcinogenic chemicals that patients inhaled as they slept. The company originally said it had shipped 2.46 million devices to U.S. consumers on its website, but some of that number includes devices shipped to internal Philips facilities — and not consumers.

In response, Philips changed its website to read that 2.8 million devices have been "produced to meet the U.S. registration demand." The company told STAT that 2.2 million devices have been shipped to patients.


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Thanks for reading! More on Thursday - Mohana

Mohana Ravindranath is a Bay Area correspondent covering health tech at STAT and has made it her mission to separate out hype from reality in health care.


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