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lekanwang

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lekanwang
·2 yıl önce·discuss
As an investor in healthcare AI companies, I actually completely agree that there's a lot of bad implementations of AI in healthcare settings, and what practitioners call "alarm fatigue" as well as the feeling of loss of agency is a huge thing. I see a lot of healthcare orgs right now roll out some "AI" "solution" in isolation that raises one metric of interest, but fails to measure a bunch of other systemic measures.

Two thoughts: 1: I think the industry could take cues from aerospace and the human factors research that's drastically improved safety there -- autopilot and autoland systems in commercial airliners are treated as one part of a holistic system with the pilot and first officer and flight attendants in keeping the plane running smoothly. Too few healthcare AI systems are evaluated holistically.

2: Similarly, if you're going to roll out a system, either there's staff buy-in, or the equilibrium level of some kind of quality/outcomes/compliance measure should increase that justifies staff angst and loss of agency. Not all AI systems are bad. One "AI" company we invested in, Navina, is actually loved by physicians using them, but the team also spent a LOT of time doing UX research and feedback with actual users and the support team is always super responsive.
lekanwang
·2 yıl önce·discuss
Pediatric allergy and atopic diseases in general is a mess an only slowly getting better. There's strong correlation between early eczema and food allergies, and now mild but convincing evidence it could even be causal. That eczema (and atopic disease in general) is strongly linked with microbiome and exposure to beneficial bacteria, especially in the first few days and weeks of life. This is also associated with malnutrition, diabetes, obesity, colic, and other symptoms we generally only treat symptomatically and in a silo. Yet for structural reasons, most pediatricians will at best tell you that early probiotics is a placebo. Top pediatricians in the know though will enthusiastically support targeted probiotics. Hell, the whole country of Bangledesh has a successful probiotic program -- https://www.science.org/doi/10.1126/scitranslmed.abk1107. It's amazing how much of common pediatric wisdom in the 80s/90s (clean newborn after birth, eat mushy prepared foods, enriched formula feeding, clean environments, avoid allergens, etc) are now seen as really harmful.
lekanwang
·2 yıl önce·discuss
Freestyle rap should be the modern equivalent. Can judge on things like lyricism, flow/delivery, concept/cohesiveness, etc.
lekanwang
·2 yıl önce·discuss
As a healthcare tech investor, I do see a lot of startups selling potentially dangerous AI systems into the healthcare system. That said, there are also a good number of companies that are implementing systems thoughtfully to address a number of issues that are very real in healthcare like staff burnout, continuing education, adherence to standard of care, managing complex value-based payment contracts and coordination of care, etc. The trouble I see is that clinician/hospital buyers of these systems can't always tell the difference. A basic initial filter that can be used is simply (a) does the team have an experienced medical professional with power on its executive team, and (b) does the team credibly know how to measure clinical quality impact of what they're building and do they have a plan to honestly measure it.
lekanwang
·3 yıl önce·discuss
Metagenomic sequencing: The field exploded after technologies and techniques were developed for using next-gen sequencing to characterize entire populations/communities of living things, first with 16S rRNA sequences, then with full genomes. The cost to do this has also gone down many, many, many orders of magnitude in the last decade or two (just search "sequencing cost graph" on google).
lekanwang
·3 yıl önce·discuss
Yep, you're right. Only meant to associate them in terms of why they're valued land, but yes, they're in separate riparian zones. Central valley is Sacramento/San Joaquin river delta.
lekanwang
·3 yıl önce·discuss
The unfortunate thing is that large stretches of California desert (and much of the Central Valley to the north) used to be lake bottoms and have incredibly rich and fertile soils. Between that and a long growing season that's nearly cloudless, you get ideal growing conditions -- rich soil, lots of sun, low moisture (i.e. low disease load), and H2A labor -- provided you can control the irrigation. Ah the problems caused by mispriced externalities...
lekanwang
·3 yıl önce·discuss
I like the Singaporean model of benchmarking high-ranking government salaries to a percent of the pay of top earners in the country (https://www.dollarsandsense.sg/heres-much-singapores-preside..., https://www.psd.gov.sg/docs/default-source/default-document-...), and pairing that with very active anticorruption enforcement.

MPs get paid over $1M USD under this model, but it incentives are much more aligned under this model.
lekanwang
·4 yıl önce·discuss
Broadening out, this reminds me of one of the most eye-opening classes I've ever taken (and it was back in high-school!) -- Comparative Government/Politics: https://apcentral.collegeboard.org/media/pdf/ap-comparative-...

Was one of the few "see-the-matrix" moments I've had in my life.