Considering the size and scope of Alphabet, it should be little surprise that the company and its subsidiaries (Google, Google Cloud and Verily, to name a few) have become deeply ingrained in the healthcare ecosystem over the last several years.
The tech giant maintained the momentum in 2020 with efforts focused on artificial intelligence, data flow and digital clinical research – and also sought to tackle the curveball of COVID-19 through community testing centers, contact tracing APIs, population-level behavior analyses and more.
Not to be lost in the mix is that pending acquisition of health wearable-maker Fitbit (which has been grappling with regulators throughout the better part of the year), or the launch of a new health insurance venture targeting self-funded employers.
For a recap of Alphabet's major health tech moves throughout 2020, let's review MobiHealthNews' stories on the company and its subsidiaries, starting from the beginning.
January 2: DeepMind and other collaborating researchers publish a study in Nature that found the company's AI identified breast cancer from mammograms more accurately than doctors. After training the system on de-identified images from more than 90,000 women, the tool performed its screening with a reduced number of false positives and false negatives in cancer.
January 8: Per Twitter, word broke that Dr. Vindell Washington would be joining Verily as chief clinical officer. Washington had previously served as head at the Office of the National Coordinator for Health IT for about half a year, but more recently held a chief medical officer position at BCBS of Louisiana.
January 16: Verily's staffing push continues with the hiring of Deepak Ahuja as CFO. His background includes time as an executive at Tesla and as an advisor to the Capricorn Investment Group.
January 22: Verily receives an FDA 510(k) clearance for an augmented version of its prescription Study Watch wearable that includes arrhythmia monitoring. The tool is indicated for use in professional healthcare facilities among patients aged 22 years and older who have been diagnosed with or are likely to develop atrial fibrillation, and not intended for consumer purchase.
January 30: Google Cloud partners with Massachusetts General Hospital and clinical trial platform ProofPilot to create a new research platform designed for academic medical centers and universities.
March 4: Senators Elizabeth Warren (D-Mass.), Richard Blumenthal (D-Conn.) and Dr. Bill Cassidy (R-La.) again press Ascension CEO Joseph Impicciche on Project Nightingale, a highly scrutinized "secret" collaboration between the system and Google revealed in fall 2019. They laid out a number of outstanding questions surrounding patient consent for data use and privacy concerns, which the senators said was unaddressed in their earlier inquiries.
March 16: Verily launched the first iteration of its COVID-19 testing ecosystem for certain California residents. Conducted through Project Baseline (Verily's ongoing population health effort), the project's initial rollout polled users on their symptom severity and directed them to a limited number of testing sites. The initiative was heavily promoted by President Donald Trump prior to launch, and quickly halted new registrations due to high demand.
April 6: Google launches its COVID-19 Community Mobility Reports a web tool that aggregates anonymized location tracking data from mobile devices to generate insights on large-scale behavior trends. The tool builds regular reports that highlight movement trends on the country, state, county or regional levels for those devising public health policies during the pandemic.
April 10: Google and Apple give the first word on their mobile contact tracing API collaboration – later named Exposure Notifications – and release a slew of draft documents describing specifications, cryptography and API frameworks. The tools would enable anonymous, Bluetooth-based contact tracing functionalities at a system level, and be interoperable across mobile operating systems, they said.
April 21: The Google Cloud Healthcare API, a platform standardizing data exchange between Google Cloud-based digital tools, launches. Along with privacy and security features, the API offers pre-built connectors for streaming data processing in Dataflow, scalable analytics with BigQuery and machine learning with AI Platform.
May 20: The first iteration of the Google-Apple contact tracing API goes live for public health agency adoption. It's adopted by a handful of countries in the weeks to come, with the U.K.'s back-and-forth on the tools making it a notable standout.
June 24: Verily launches the Healthy at Work program, which combines COVID-19 symptom checking and testing services with data analytics dashboards for employers transitioning to in-person operations.
June 26: Alphabet is listed as one of the main institutional investors participated in insurtech company Oscar Health's $225 million Series C raise.
July 21: Word breaks that the Android implementation of Exposure Notifications collects GPS data that Google could use to determine users' locations, thanks to a requirement for device location settings to be turned on whenever using Bluetooth. Google stresses that apps built using the tools still do not have access to location data without user permission.
July 31: Exposure Notifications receives a major update that provides more information on exposure risk, cross-country interoperability and developer debug tools. Of particular note, the update came with word that the Google version of the system would be updated with the Android 11 release that would more clearly divorce Bluetooth and location tracking settings.
August 4: The European Commission announces that its probe into the Google-Fitbit acquisition would expand into a full-scale antitrust investigation. Google had offered to silo any Fitbit-collected data so that it could not be used for advertising during the months prior. However, that pledge wasn't enough for the regulator, which said it was also concerned about competitive advantages in Europe's smart device and digital health markets.
August 6: Virginia becomes the first state to roll out an Exposure Notifications-based contact tracing system.
August 25: Verily jumps into the health insurance game with the launch of a new venture called the Coefficient Insurance Company. A tech-enabled payer targeted at self-funded employers, the offering combines Verily’s hardware, software, and data science and distribution model of Swiss Re Corporate Solutions (which is backing the endeavor).
August 25: Google Cloud pours $100 million into telehealth giant Amwell as part of a deal designating the two companies as each other's preferred cloud and telehealth providers.
September 1: Another big update comes to Exposure Notifications designed to lessen the burden on public health authorities with pre-built apps.
September 4: A judge dismisses the class action data privacy lawsuit against Google and the University of Chicago Medical Center.
September 8: Google Cloud signs a deal to supply the Department of Defense's medical facilities with a prototype AI pathology system. Specifically, the project aims to improve cancer diagnosis accuracy by providing centers with augmented reality microscopes that overlay the AI system.
September 10: Google doles out more than $8.5 million to academic and health organization researchers who are using AI and data analytics to combat COVID-19.
September 24: Google announces an update for Google Maps that will display the prevalence of COVID-19 cases in certain regions as a color-coded overlay.
September 24: Google Chief Health Officer Dr. Karen DeSalvo gives a keynote talk comparing her experience in New Orleans with Hurricane Katrina to the ongoing COVID-19 emergency.
September 30: Google is listed along a number of technology, healthcare and digital health companies signing on to a Consumer Technology Association-led coalition focused on COVID-19 health disparities. Called the Health Equity and Access Leadership Coalition, the group said it would soon release a white paper outlining policy and operational recommendations to help best deploy novel health technologies.
October 27: Reports spread in the media that San Francisco and Alameda counties "severed ties" with Verily's Project Baseline COVID-19 testing program. The life sciences tech company contested these reports, which described community testing sites that were closed for months and never very well received by underserved residents.
November 3: Alphabet's moon shot subsidiary, X, unveils research from its Amber mental health tech project. The effort is looking to develop biomarkers for depression, thereby building an assessment that can be deployed in clinics or counseling centers.
November 11: Google Cloud pulls back the curtain yesterday on two AI tools designed to help healthcare and life science organizations scan and analyze large volumes of unstructured text – the Healthcare Natural Language API and AutoML Entity Extraction for Healthcare.
The first of these two offerings looks to automatically extract common trends or other insights from medical records notes or other digital text that would normally require time-intensive manual review. The second seeks to lower the barrier to AI text data analysis for healthcare workers.
November 30: Google Cloud launches its Healthcare Interoperability Readiness Program, a consultancy offering designed to help healthcare organizations as they gear up for Cures Act compliance in 2022. The focus is on APIs and implementation standards such as HL7's FHIR, which are the key mechanisms for enabling more seamless health data exchange in ONC's rules.
December 1: The DeepMind team cracks a decades-old protein-folding challenge with an AI deep learning system they say could eventually be used to identify new disease treatments. The AlphaFold tool was named the winner of the competition that tasked participants with blindly predicting proteins' structures from amino acid sequences. DeepMind said that it's currently preparing a paper describing its system for publication in a peer-reviewed journal, and notes there's still room to improve the tool.
December 1: Amnesty International warns against the pending Google-Fitbit merger, stressing that human rights to privacy are at risk if the deal goes through without appropriate restrictions.
December 2: Google Health and HHS' Agency for Healthcare Research and Quality describe an in-pilot online tool that helps patients build a visit plan for their upcoming healthcare visits. The tool is built on a list of recommended questions and other resources developed by AHRQ, according to the post. It allows users to ask questions about their upcoming encounter or select from a list of questions such as "What is this test for?"
December 9: The Google Health team launches an Android app that streamlines study recruitment for consumers and shows them how survey and sensor data are being employed for health research. Intended as a long-term platform for study enrollment and engagement, Google Health Studies platform went live with a respiratory infection-focused study being conducted alongside Boston Children's Hospital and Harvard Medical School.
December: Google said says it's implementing new strategies to circumvent COVID-19 vaccine misinformation on its platforms. These include search features providing direct information on available vaccines, pledging money to a fact-checking initiative, removing misleading content on the platforms it owns and more.
December 17: The European Commission signs off on Google's Fitbit purchase, albeit with a handful of requirements for the soon-to-merge companies. These include mandates on Fitbit sensor data use for ads, data storage and third-party access to APIs that are set to last at least 10 years.
December 18: Verily announces a $700 million investment round funded by existing investors, including Alphabet. The subsidiary said that the money would help expand its commercial businesses, in particular Project Baseline.
December 23: The Australian Competition and Consumer Commission rejects an undertaking proposed by Google to address competition concerns over its planned acquisition of Fitbit. Google had attempted to ease the ACCC’s concerns by offering a court enforceable undertaking that it would behave in certain ways with competitors, not use health data for advertising and, in certain circumstances, allow competing businesses access to health and fitness data. However, the ACCC was not satisfied with the undertaking and said it “continues to have concerns” over the deal.
Taking Stock of Progress and Looking Ahead
This December, we look back at a challenging year – and forward to what we hope is a better, stronger, more connected and resilient healthcare ecosystem.