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Silicon Valley's product strategy won't work with health care, says Apple veteran

Robin Goldstein, a former Apple executive who served most recently as Senior Manager of Health Special Projects, assails the tech industry's approach to health tech.

In an opinion piece published to CNBC's website Thursday Robin Goldstein, who served in a wide variety of roles in her 22-year career at Apple, argues tech companies need to take a different approach to product failure when it comes to health-related devices. In particular, the "fast fail" strategy is not an option.

"This is the mindset Silicon Valley has brought to every space it enters: A bad product or poor user experience doesn't have any ramifications beyond that particular product or experience, and they can always wipe the slate clean and start again," Goldstein writes. "In the world of digital health this is a big problem."

There are three reasons for this, according to the author. The functionality of digital health products is often a matter of life and death, the health products "require buy-in from both the user and their health care provider," and that the old adage, "You don't get a second chance to make a first impression," applies especially to the health sector.

She mentions Theranos, the controversial blood testing startup that collapsed last year in scandal and indictments, leading to the company's official dissolution earlier this week. Theranos sought to emulate Apple, while its founder Elizabeth Holmes saw herself as a new Steve Jobs, but the company not only failed to come up with a working product, but was allegedly committing fraud.

"Every new microfluidics testing venture is now subject to both increased scrutiny and has to to overcome a general suspicion regarding the technology, its effectiveness, and actual benefits," Goldstein writes. "In other words, everyone who follows Theranos has the burden of proving they're not Theranos before even getting to the question of whether their product will pass the risk/benefit analysis discussed above."

Goldstein's piece, aside from the sharing of her credentials, does not mention Apple directly, nor does it refer specifically to any of Apple's initiatives. Apple has launched some ambitious health-related products in the last year, including a huge health records digitization effort, while numerous news stories have had Apple Watches literally saving users' lives.

"The size of the healthcare market and relative ease with which products can be developed, as well as the current appeal of applying algorithms and machine learning to the imprecision of the human body, requires that extra care be taken," Goldstein writes. "High tech cannot view digital health as simply the next great market opportunity.

Goldstein, according to her LinkedIn page, left Apple after 22 years in November 2017. Her final title was Senior Manager for Health Special Projects, and she had previously served principal counsel, and senior engineering manager and NewtonOS product marketing manager.

Some emails that surfaced in 2016 had Goldstein, then an attorney for Apple's health division, expressing interest in cardiac monitoring hardware, and Parkinson's support.



27 Comments

thrang 17 Years · 1037 comments

Apple seems insanely careful to NOT do what she says is endemic in the tech industry. It doesn't mean they don't swing and miss on occasion, but I suspect Apple is treading VERY deliberately with Health initiatives...

rob53 13 Years · 3312 comments

I take exception to her comparison to Theranos. They had one product she gambled on and when she discovered it wasn’t working she acted like it was. That is fraud, something Apple had never done (to the same extent). She should know that because Apple hasn’t released much of any medical related product, especially under her control. If they did she’d be compared to Elizabeth Holmes, which nobody is claiming. 

tundraboy 18 Years · 1914 comments

The fast fail strategy not only does not work in health care, it also doesn't work in self-driving cars.  Sadly, a few lives had to be sacrificed before Silicon Valley finally learned that lesson.

sflocal 16 Years · 6138 comments

rob53 said:
I take exception to her comparison to Theranos. They had one product she gambled on and when she discovered it wasn’t working she acted like it was. That is fraud, something Apple had never done (to the same extent). She should know that because Apple hasn’t released much of any medical related product, especially under her control. If they did she’d be compared to Elizabeth Holmes, which nobody is claiming. 

The caution in the industry caused by the implosion of Theranos and the outing of Elizabeth Holmes as a fraud was I think a necessity.  People were claiming the next big thing and essentially throwing a smoke-screen at the faces of investors.  I'm actually glad that now everyone has to basically prove that they're not producing some kind of vaporware and pretend it's real.


I just started reading "Bad Blood", a book about Elizabeth Holmes and Theranos.  I'm only in a few chapters, and even then I'm stunned at the fraud she was already doing at the beginning.  She did a demo which didn't work, but on the monitor were pre-recorded results from an entirely different test.  She lied about it and when confronted about it by her then first CFO (Henry Mosley), she fired him on the spot for not being a "team player".  Disgusting.  She has serious issues.

rob53 13 Years · 3312 comments

sflocal said:
rob53 said:
I take exception to her comparison to Theranos. They had one product she gambled on and when she discovered it wasn’t working she acted like it was. That is fraud, something Apple had never done (to the same extent). She should know that because Apple hasn’t released much of any medical related product, especially under her control. If they did she’d be compared to Elizabeth Holmes, which nobody is claiming. 
The caution in the industry caused by the implosion of Theranos and the outing of Elizabeth Holmes as a fraud was I think a necessity.  People were claiming the next big thing and essentially throwing a smoke-screen at the faces of investors.  I'm actually glad that now everyone has to basically prove that they're not producing some kind of vaporware and pretend it's real.
I just started reading "Bad Blood", a book about Elizabeth Holmes and Theranos.  I'm only in a few chapters, and even then I'm stunned at the fraud she was already doing at the beginning.  She did a demo which didn't work, but on the monitor were pre-recorded results from an entirely different test.  She lied about it and when confronted about it by her then first CFO (Henry Mosley), she fired him on the spot for not being a "team player".  Disgusting.  She has serious issues.

I chuckled when I saw your comment about vaporware. That's how it's been since the beginning of computers and it's still prevalent with all the early announcements of products that never quite seem to come to market. The medical field is no exception with all their new drugs, both FDA-approved and not, being broadcast every day on TV. We haven't changed and I doubt any market will.