Apple's VP of health says the company works 'like an orchestra'

AppleInsider

Apple executive Dr. Sumbul Desai claims that the tech giant's success in health comes from how its design and engineering teams all work together for the Apple Watch, and other fitness projects.

Dr. Sumbul Ahmad Desai speaking during WWDC 2021

Apple's vice president, health, Dr. Sumbul Ahmad Desai, has confirmed that Apple runs entire clinics as part of its health research. Dr. Desai, speaking on the "Second Life" podcast, also revealed how it was partly Apple's integration of teams that persuaded her to join the company from Stanford Medical.

"I wasn't looking to leave," she says on Who What Wear's "Second Life" podcast. "It was a really hard decision to make, I mean, I really, really love Stanford."

"But what I was thinking was, you know, healthcare needs to change and where is it going to change from?" she continued. "Is it going to happen from within or is it going to happen with companies that are known for innovation that will help bring kind of healthcare along?"

"And I was really lucky, I mean it's kind of serendipity just kind of got to know somebody who asked me to start consulting on a project here [at Apple]," she said. "So I consulted first and then got to know the team here, and had a conversation probably over the span of a year on whether I should join or not."

Before her medical career, Dr. Desai worked in business and business strategy for Disney and ABC. She says now that this work, alongside her role as Associate Chief Medical Officer at Stanford, unexpectedly prepared her for Apple.

"Oh, absolutely I would have never thought that my role today could merge my past experiences so well, but it does," she continues. "[Studying] communications and working at ABC [helps with] how do you simplify the message and get to the core."

Dr. Desai says that within Apple she is responsible for the clinics and their research, as well as for health overall, but also that Apple blurs the lines between different teams.

"Design and engineering is really tied at the hip," she says. "Apple is very, very cross-functional, so you have every team come together."

Both in her medical career and now at Apple, Dr. Desai says that this combination of skills and people appeals to her, which gets the greatest results.

"What's amazing about my work today is [that it is] multidisciplinary," she continued. "When it comes together, it's like an orchestra in a symphony."

Dr. Desai joined Apple in 2017 and is now a regular presenter on the company's keynote presentations.

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patchythepirate

Apple is doing a lot of fantastic stuff here, and some particularly amazing stuff using the Apple watch sensors. It looks like Apple understands where they can make the biggest (ie most broad) difference here, which is in the Health UI, so to speak, as exemplified by cardiology app they developed, where all they are saving lives merely by making information and treatment more understandable and easier to follow for the patient (who can't understand the doctor) and the doctor (who can't understand the patient.. or can't get reliable information from the pt for various reasons; eg I can ask a pt the same question 10 times and literally get 10 different answers on something as simple as "how is your sleep?")*. Most of medicine seems to be focused on coming out with the next study, which invariably occurs in silos, and not reflective of the pragmatic issues that are faced in the real world application of these studies. Improving the Health UI for patients and doctors is perfectly within apple's wheelhouse, and could make a much larger difference in people's health than most of the studies coming out today.

*

Patient: I don't sleep at all!

Me: Like, you're not getting any sleep?

Pt: No, it's terrible!

Me: That does sound terrible. So what time do you get to bed, and what time do you wake up?

Pt: I go to bed around midnight, and wake up sometime in the afternoon usually.

Me: I thought you didn't sleep at all?

Pt: I dont, well, I guess I do, but I wake up a lot.

Me: How much do you wake up?

Pt: Yesterday I woke up at 1am and stayed up all night.

Me: So you only slept one hour last night?

Pt: Yeah, I guess so.

Me: Ok, well how much sleep do you get on average?

Pt: I dont know, like one hour I guess.

Me: But I thought you usually sleep from noon to afternoon, that's over 12 hours.

Pt: Oh yeah, like 12 hours I guess.

...

^this is why doctors drink

GeorgeBMac

patchythepirate said:

Apple is doing a lot of fantastic stuff here, and some particularly amazing stuff using the Apple watch sensors. It looks like Apple understands where they can make the biggest (ie most broad) difference here, which is in the Health UI, so to speak, as exemplified by cardiology app they developed, where all they are saving lives merely by making information and treatment more understandable and easier to follow for the patient (who can't understand the doctor) and the doctor (who can't understand the patient.. or can't get reliable information from the pt for various reasons; eg I can ask a pt the same question 10 times and literally get 10 different answers on something as simple as "how is your sleep?")*. Most of medicine seems to be focused on coming out with the next study, which invariably occurs in silos, and not reflective of the pragmatic issues that are faced in the real world application of these studies. Improving the Health UI for patients and doctors is perfectly within apple's wheelhouse, and could make a much larger difference in people's health than most of the studies coming out today.

*

Patient: I don't sleep at all!

Me: Like, you're not getting any sleep?

Pt: No, it's terrible!

Me: That does sound terrible. So what time do you get to bed, and what time do you wake up?

Pt: I go to bed around midnight, and wake up sometime in the afternoon usually.

Me: I thought you didn't sleep at all?

Pt: I dont, well, I guess I do, but I wake up a lot.

Me: How much do you wake up?

Pt: Yesterday I woke up at 1am and stayed up all night.

Me: So you only slept one hour last night?

Pt: Yeah, I guess so.

Me: Ok, well how much sleep do you get on average?

Pt: I dont know, like one hour I guess.

Me: But I thought you usually sleep from noon to afternoon, that's over 12 hours.

Pt: Oh yeah, like 12 hours I guess.

...

^this is why doctors drink

There is more than one type of insomnia -- this patient suffers not from an inability to fall asleep, but to stay asleep -- which apparently is leading to naroclepsy -- daytime sleepiness.

But I agree that medicine is overly focused on studies:   physicians are conditioned and trained to only use "evidence based" medicine -- and, without a valid study, there is no evidence.   Unfortunately, the main determinant of the outcome of any study is who funded & conducted that study -- which is why we have patients eating statins instead of broccoli.

GeorgeBMac

Tech -- such as that backed by Apple is and will continue to revolutionize both FinTech and Healthcare.

In the case of healthcare, we don't have a healthcare system.  We have DiseaseManagement system -- and a for-profit one at that!

It's a system Americans spend $17Trillion a year on and 80% of that goes to treat so called "age related" chronic diseases -- 80% of which could be eliminated with lifelong healthy lifestyles -- which is exactly what the Apple helps to encourage.

patchythepirate

GeorgeBMac said:

patchythepirate said:

Apple is doing a lot of fantastic stuff here, and some particularly amazing stuff using the Apple watch sensors. It looks like Apple understands where they can make the biggest (ie most broad) difference here, which is in the Health UI, so to speak, as exemplified by cardiology app they developed, where all they are saving lives merely by making information and treatment more understandable and easier to follow for the patient (who can't understand the doctor) and the doctor (who can't understand the patient.. or can't get reliable information from the pt for various reasons; eg I can ask a pt the same question 10 times and literally get 10 different answers on something as simple as "how is your sleep?")*. Most of medicine seems to be focused on coming out with the next study, which invariably occurs in silos, and not reflective of the pragmatic issues that are faced in the real world application of these studies. Improving the Health UI for patients and doctors is perfectly within apple's wheelhouse, and could make a much larger difference in people's health than most of the studies coming out today.

*

Patient: I don't sleep at all!

Me: Like, you're not getting any sleep?

Pt: No, it's terrible!

Me: That does sound terrible. So what time do you get to bed, and what time do you wake up?

Pt: I go to bed around midnight, and wake up sometime in the afternoon usually.

Me: I thought you didn't sleep at all?

Pt: I dont, well, I guess I do, but I wake up a lot.

Me: How much do you wake up?

Pt: Yesterday I woke up at 1am and stayed up all night.

Me: So you only slept one hour last night?

Pt: Yeah, I guess so.

Me: Ok, well how much sleep do you get on average?

Pt: I dont know, like one hour I guess.

Me: But I thought you usually sleep from noon to afternoon, that's over 12 hours.

Pt: Oh yeah, like 12 hours I guess.

...

^this is why doctors drink

There is more than one type of insomnia -- this patient suffers not from an inability to fall asleep, but to stay asleep -- which apparently is leading to naroclepsy -- daytime sleepiness.

But I agree that medicine is overly focused on studies:   physicians are conditioned and trained to only use "evidence based" medicine -- and, without a valid study, there is no evidence.   Unfortunately, the main determinant of the outcome of any study is who funded & conducted that study -- which is why we have patients eating statins instead of broccoli.

@GeorgeBMac Well, the point of my little dialogue example (which is not uncommon) was that I'm back at square one, having no idea what the sleep issue is despite a 5-10 min discussion with a patient about it. Could be primary insomnia, poor sleep hygiene, bipolar disorder, PTSD, substance abuse, medication side effects, hyperthyroid, sleep apnea, etc. If Apple can get reliable info to doctors, and help patients understand and follow through with treatment recommendations, that would result in probably %25 improvement in health care right outcomes by itself.

We're definitely agreed on the on the issue of institutional bias in medicine. It's strange how public health 'experts' continue to push for 'evidence based' standardization, while somehow not accounting for the (very predictable) bias in most studies, and the lack of a holistic perspective that comes from focusing only on highly-studied factors.