Haas Voices: ‘Fighting for healthcare equity in my community’

Portrait: Adilene Dominguez, EWMBA 24
Adilene Dominguez, EWMBA 24, is determined to make healthcare more equitable.

Haas Voices is a first-person series that highlights the lived experiences of members of the Berkeley Haas community. In honor of Latinx Heritage Month, we spoke with Adilene Dominguez, EWMBA 24, who’s determined to create a new business model that will provide equitable health care to everyone, regardless of economic status. She shares her story below.

Growing up in Waukegan, Illinois, a suburb north of Chicago, I lived in a world with many blessings. My parents weren’t millionaires, they were migrant workers who worked 80 hours a week. But the opportunities afforded to us–access to public schools, tutors, health insurance, the ability to find work–were privileges that many Latinos in my community, including my extended family members, did not have.

I began to notice inequities, specifically in healthcare, when I was about five years old. I often accompanied friends and family whenever they needed to see the doctor. They spoke little English, so I translated on their behalf. I noticed that they’d have to stand in line for hours at the local clinic to get medical treatment, whereas if I needed medical care, my parents would take me to a hospital because I had health insurance. It just didn’t seem fair to me that our friends and family couldn’t get the same quality health care as I did.

family portrait featuring a mom, dad, 2 girls and 1 boy.
Dominguez’s family portrait. Dominguez, (center), began translating for friends and family when she was five years old.

Observing those disparities early on, coupled with a natural aptitude for science and math, led me to Beloit College where I joined the pre-med program. As a pre-med student, I interned with doctors and volunteered at hospitals, but quickly realized that I didn’t want to be a doctor. I thought that I’d have a greater impact if I could find a way to bring equitable health care to my community.

After college, I landed at Becton Dickinson (BD), a medical device company, working as a research and development (R&D) technician. I moved up the ranks from a technician to a scientist and eventually transitioned from R&D to global marketing and strategy. 

I also lead the Hispanic Organization for Leadership and Advancement (HOLA) at BD. Through my work with HOLA, I help raise awareness within my industry about health disparities that impact the Latino community. When the pandemic hit, access to testing was limited, especially in Latino communities in California, Arizona, and Texas. I, along with marketers across eight HOLA chapters, decided to advocate for the distribution of Veritor, a rapid antigen test that can detect the COVID-19 virus, to health clinics servicing Latino communities. Through our efforts, we helped the Family Health Center of San Diego, which provides care to more than 215,000 patients a year, 91% of whom are considered low-income and 29% are uninsured. 

It’s been gratifying to help my Latino community as it’s been disproportionately impacted by the COVID-19 pandemic. But I need to do more. The pandemic magnified health disparities that have long existed in Black and Brown communities. Whenever there’s a hurricane, earthquake, or any natural disaster, health care seems to be the primary resource that’s out of reach for these communities.

The pandemic magnified health disparities that have long existed in Black and Brown communities.

That’s why I’m at Haas. I want to acquire the skills needed to disrupt the healthcare system in the U.S. I want to design a profitable business model that will provide equitable health care for everyone, regardless of socioeconomic status.

What does disruption look like? It’s putting the patient first and profit last. Currently, the way healthcare works in the U.S. is that whoever or whichever entity has the most influence or paying power gets access to the best medical supplies. Typically government contracts are fulfilled first. Thereafter, private institutions and public institutions get priority, and community health centers are served last.

But what if we flipped the funnel? If we help community clinics first, which serve people like farmers and hourly-wage workers–the people who are growing our food and working at grocery stores and other service industries–we can prevent the spread of any disease.

For too long, our approach to providing health care has come from the top down, when we really need to flip the funnel and think about the process much differently. We can’t keep doing business as usual when there are hundreds of people filling up the emergency room because they don’t have access to COVID-19 testing or vaccines.

Creating a new business model for the healthcare system is a lofty goal. But someone has to do it, so why not me? 

Creating a new business model for the healthcare system is a lofty goal. But someone has to do it, so why not me? 

I know that I’m putting a lot of pressure on myself, but it’s my responsibility to help my community. That philosophy has been ingrained in me since I was a little girl. My family, who migrated from Tonatico, Mexico, made enormous sacrifices so that my siblings and I could have a better life. So I must move forward and be a role model for younger generations. If I don’t help my community, who will? 

Elle Wisnicki, MBA 22: Why goats should be part of mental healthcare

Haas Voices is a first-person series that highlights the lived experiences of members of the Berkeley Haas community

Elle Wisnicki, MBA 22, dreams of opening a wellness retreat center that offers animal-assisted therapy to children and adults—and she’s moving closer toward that goal at Haas. Wisnicki is a 2021 recipient of the John E. Martin Fellowship, (named for the father of Michael Martin, MBA 09) awarded to students who are working to improve mental healthcare quality and access. 

Elle Wisnicki photo with goats
Elle Wisnicki, MBA 22, dreams of opening a wellness retreat center that offers animal-assisted therapy.

I’m Black and Jewish and was raised by a single mom. I was an independent kid, always wanting to help others, so when I wasn’t caring for stray animals in the neighborhood, you could find me babysitting.

Growing up in Hollywood, Calif., where wealth exists parallel to a large population experiencing homelessness, I learned about mental health challenges at a young age. My mom and I got to know the stories of our neighbors who were homeless and faced post-traumatic stress disorder (PTSD), schizophrenia, depression, and more.

From childhood to high school, my career aspiration was to become an OB/GYN doctor or genetic counselor for families. However, after realizing that a lot of people can’t even get to the doctor for basic care, I shifted my goals away from providing care to helping people access care.

After realizing that a lot of people can’t even get to the doctor for basic care, I shifted my goals away from providing care to helping people access care.

After undergrad at Columbia University, I worked in consulting. At that job, I began connecting the dots among common mental health issues within different groups of people I’d met and worked with for over a decade, including homeless veterans, patients I worked with at Planned Parenthood, students I supported as an RA in my dorm, and even my financially well-off consulting coworkers who were burning out. No matter their walk of life , many shared a common thread: determining how to best address their mental health problems.

When I started putting it all together I began to see how I could thrive in this line of work and I wanted to start focusing on it right away. When I considered leaving consulting, I knew I had to align my career with my values so that my work would reflect my life’s greater purpose. After reaching out to diverse people in my network, I was inspired to become a mental health coach at Sibly, a text-based mental health and wellness app.

This was the first step toward starting my own mental health-related venture. However, I knew that creating a startup without the support of an MBA network would be challenging. So I initially came to Haas to focus on startup solutions for crisis response. What I quickly learned was that the many hours of research, customer discovery calls, and networking on a computer screen, on top of my MBA lectures, was leading to burnout.

In November 2020, I took the month off of my startup to spend some time restoring my own mental health. I volunteered for a ferret rescue and took llamas on walks up north in Yuba City, played with goats and did goat yoga in Half Moon Bay, and worked with kitten rescues. My soul lit up.

My soul lit up. I felt healed when an animal rested in my lap or greeted me.

I felt healed when an animal rested in my lap or greeted me, or when I moved my body around innocent beings, who only wanted to provide affection.

goats with Elle Wisnicki in barn
Goats are part of Elle Wisnicki’s animal-assisted therapy plan.

I realized others enjoy animals and nature in a healing way as do I and many people are looking for alternative wellness solutions. My potential customers told me they benefited from being closer to nature, but craved structure and couldn’t find affordable group wellness centers near them.

My vision is to offer that structure, by opening a retreat center with half day, full-day, and weekend wellness retreats. I’m also considering animal-assisted individual and group therapy, goat yoga, sustainable farming workshops, garden box subscriptions, children’s birthday parties, summer camps, a petting zoo, products, and transportation to access all of these services through bus rides between San Francisco and Oakland.

When I was applying for the Martin fellowship I connected with a Haas alum who had won a similar fellowship a few years before me. We recognized we both had similar goals. He recently began developing land he and his family own and considering what kind of venture they want to use it for. We’ve started discussions around the types of pilots we will put together to determine what is most appealing to our customers.

In addition to these plans, I continue to work in mental health tech.  This semester, through the Lean Launchpad entrepreneurship class, I worked for a wellness startup Shimmer, focused on employer wellness benefits and insurance. My summer internship is focused on health insurance and mental health access for children and youth in  foster care.

Throughout this journey, I’ve realized how grateful I am to be living and working at a time where as a society we’re finally prioritizing mental health. There has been tremendous growth in the wellness industry and I am thrilled about increasing access and with the movement toward mental health destigmatization.

Health Influencers

Haas alumni accelerate healthcare’s future

For 200 years, the stethoscope has been the workhorse of physical exams. But a stethoscope is only as good as the human ear listening to it. How could it be adapted for the digital age? wondered Jason Bellet, BS 14, and two Berkeley friends: Connor Landgraf, BS 13, MEng 14 (bioengineering), and Tyler Crouch, BS 14 (mechanical engineering).

In 2013, the trio co-founded Eko Devices and, with support from Berkeley’s SkyDeck Accelerator Program, developed a $349 stethoscope that can amplify heart and lung sounds 40 times better than its analog cousin. Connected software generates sound waveforms and electrocardiograms that allow some 80,000 clinicians to “see what they hear” and share recordings as needed. Last fall, the Oakland-based company, with 115 employees, closed on $65 million in Series C funding and partnered with AstraZeneca to develop new screening tools.

Jason Bellet, BS 14, Co-Founder, Eko Devices

“Heart disease is the No. 1 killer worldwide, and there are millions of people with undiagnosed cardiac problems that can now be detected with greater accuracy in 45 seconds during a routine checkup,” says Bellet (shown right). Early last year, the FDA cleared Eko’s algorithm for detecting heart murmurs and atrial fibrillation; a separate algorithm received an FDA emergency use authorization to help clinicians detect a weak heart pump in COVID-19 patients, an especially high-risk group.

Today, Eko is more than a device maker. It’s a software and data-science company aiming to develop artificial intelligence-powered screening tools that can detect a range of health conditions in 60 seconds during a routine checkup, says Bellet. His team is also building a virtual primary care platform.

Haas community healthcare innovations like Eko are booming. From startups to Fortune 500 companies, venture capital firms to nonprofits, alumni are leading monumental shifts in healthcare—often backed by huge sums of money. Some entrepreneurs, like Bellet, are focused on improving preventative care and disease diagnosis or helping to develop new drugs and treatments. Others are working to streamline features of healthcare that often hinder innovation: payment models, organizational structures, and regulations. In interviews, Haas alumni reveal a shared mission: to make medical care—a $3.8 trillion business in the U.S. in 2019, according to the Centers for Medicare & Medicaid Services—more affordable, accessible, and scalable.

Using ‘real-world’ data

In Ohio’s Montgomery County, death rates from opioid overdoses have been among the nation’s highest and are surging anew amid the pandemic. It’s also the test site for an ambitious effort by Alphabet-owned Verily Life Sciences to reinvent addiction treatment and recovery. Called OneFifteen—named for the country’s average daily opioid death rate of 115 people in 2017—it features state-of-the-art medical and residential facilities on a 4.5-acre campus in Dayton.

Rebecca Messing Haigler, MBA-MPH 09, Health Economics Lead, Verily
Rebecca Messing Haigler, MBA-MPH 09

Treating substance abuse, with its sky-high relapse rates, is difficult for many reasons, says Rebecca Messing Haigler, MBA/MPH 09, Verily’s health economics lead and recently announced chief development officer of portfolio company Onduo. Doctors lack high-quality information about how different patients respond to various treatments, and little or no coordination exists among clinicians, communities, and families. Payment models are also broken, she says. Patients don’t receive the comprehensive care they need in part because insurers typically pay for services up front—not based on outcomes.

OneFifteen’s model, which Messing Haigler helped design, relies on a comprehensive care continuum powered by a technology infrastructure that enables better data collection throughout the treatment and recovery process, from data sources including state and county programs, mobile apps, family surveys, employer updates, and the criminal justice system, among others.

“When patients fall off the radar, we can find out what happened from families or the community or if they showed up for work from employers,” says Messing Haigler. This could lead to improvements in treatment and at a faster rate.

Messing Haigler is describing a relatively new phenomenon in healthcare known as “real-world” data. The term essentially refers to the multitude of health-related information generated outside of a doctor’s office. Think voluntary user health surveys, fitness trackers—even insurance claims. Verily’s mission is to combine this data (with member consent and rigorous privacy policies) with machine learning to better prevent, detect, and manage diseases. For Messing Haigler, it also means developing new economic models, including payment structures based on successful patient outcomes.

When patients fall off the radar, we can find out what happened from families or the community or if they showed up for work from employers.

Real-world data is a byproduct of the booming digital health market. Seed fund Rock Health estimates that venture capitalists poured a record $14 billion last year into U.S. digital health companies, a 72% jump from the previous peak in 2018. McKinsey & Company valued the global digital health market at $350 billion in 2019—before the pandemic.

Terrell Baptiste, MBA 20, Senior Manager, Gilead SciencesTerrell Baptiste, MBA 20 (shown right), thinks about real-world data and its promise in another context: clinical drug trials. Last year, he joined Gilead Sciences as a senior manager to identify ways the pharmaceutical company can use information from nontraditional sources to speed the development and approval of new cancer drugs. A 2016 federal law mandated that the FDA incorporate data from outside traditional clinical trials into its approval process for pre-market pharmaceuticals. It’s early days for the FDA-developed framework for using real-world data, but the impact will be revolutionary: Trials can take eight years or more to conduct and are limited in scope because they depend on volunteers—who are often white, educated, and retired.

With the combination of real-world data and digital health technologies, such as smartphones, clinical-trial volunteers could participate from home, allowing for more frequent monitoring of a possible treatment and thus faster discoveries. FDA regulators could also monitor a drug’s effects over a longer period of time.

For Baptiste, using real-world data in clinical trials has another crucial advantage. Marginalized paitients—often an afterthought in healthcare generally, and drug development specifically—can participate in studies and benefit from new ways of working that have arisen from the pandemic.

“Clinical trials measure effectiveness at a specific point in time and for a patient population who may not be the only ones actually benefiting from it,” says Baptiste, whose work includes volunteer research on behalf of sickle cell disease patients, the majority of whom are African American. “Real-world evidence attempts to fill the large gaps in knowledge about who could benefit from a new treatment. I’m hopeful this will help usher in more effective, realistic, and diverse ways to conduct clinical trial research.”

Closing gaps in care

Lauren Dugard Thomas, MBA-MPH 17, Senior Manager, Enterprise Innovation, Blue Shield of CaliforniaLauren Dugard Thomas, MBA/MPH 17 (shown left), works to address health inequities by improving the innovation process itself. At Blue Shield of California, where she’s a senior manager in enterprise innovation, she empowers all employees to generate entrepreneurial solutions, like with internal design challenges à la Shark Tank. She also ensures that underserved populations are factored into every business decision, big or small.

Dugard Thomas says that for companies committed to reducing inequities, “the first step is educating internal decision makers about disparities and making it clear that maintaining the status quo will only widen the gaps.”

Since the increase in national awareness of racial injustice last summer, she’s seen a spike in LinkedIn job listings for experts in social determinants of health. Even so, Dugard Thomas says real change goes beyond budgets and head counts.

“It’s about the mindset, expectations, and practices of leaders at all levels of the organization,” she says. “Do you want to include more Black and brown individuals in program design? Great. How are you incentivizing that from a leadership standpoint?”

Supercharging blood tests

Colorectal cancer is the second-leading cause of cancer deaths in the U.S., yet one-third of adults age 50 to 75 don’t get screened, according to the Centers for Disease Control (CDC). Newer tests using stool samples collected at home haven’t changed this.

Atul Sharan, MBA 91, Owner, CellMax Life
Atul Sharan, MBA 91

Atul Sharan, MBA 91, has a solution. His company, CellMax Life, has developed what he says is the first blood test for preventive screening for colon cancer—one that, according to a recent study conducted at Stanford’s Veterans Affairs Palo Alto Health Care System, successfully detects pre-cancerous polyps. It works by searching for extremely rare abnormal dysplastic epithelial cells and tiny traces of DNA that tumors shed. Other tests based on the company’s technology are already sold in Asia. CellMax plans to seek FDA approval before introducing the screening to the U.S. next year.

I’m hopeful [real-world evidence methods] will help usher in more effective, realistic, and diverse ways to conduct clinical trial research.

“The only real cure for cancer is early detection,” says Sharan, who started CellMax Life nearly a decade ago after his mother was diagnosed with late-stage, untreatable cancer and his wife with a malignant breast tumor shortly after being cleared by a negative mammogram. His company, which has raised more than $50 million, is part of a growing market for non-invasive “liquid biopsies” that use advanced genomic sequencing and machine learning to identify diseases and potentially tailor treatments to individuals. Bill Gates and Jeff Bezos, for example, poured over $100 million into liquid-biopsy company Grail, which sold last year for $8 billion.

Reinventing autism care

One in 54 children in the U.S. were diagnosed with autism in 2016, according to the CDC. Twenty years ago, it was just one in 150. No surprise, then, that waitlists for therapy can run up to six months.

Soaring demand for autism care isn’t the only problem, says Jia Jia Ye, MBA/MPH 11. Kids often need multiple forms of therapy—behavioral, speech, and physical—for up to 30 hours a week. Specialists often work independently, making it time-consuming and frustrating for parents to coordinate care and navigate labyrinthine insurance rules.

Jia Jia Ye, MBA-MPH 11, Co-Founder, Springtide Child Development
Jia Jia Ye, MBA-MPH 11. Photo: Chris Sorensen.

Ye’s groundbreaking solution is to combine expertise and payments at a single locale. A year ago, she co-founded Springtide Child Development with $18 million in Series A funding. Now with three clinics—two in Connecticut and one opening this summer in Massachusetts—the startup employs specialists from across disciplines, coordinates appointments, and handles insurance claims. Ye says consolidation enables an unprecedented degree of standardization in care.

Just as important: Ye and her team can quantify patient progress, which smaller operations can’t do for lack of money and data. “When you take an interdisciplinary approach to autism treatment, you see rapid improvement in kids’ progress,” says Ye. “And you can show it through consistent outcome metrics at all levels of care.”

Advancing women’s health

For Amy Fan, MBA/MPH 19, improving care is about making birth control more accessible and affordable for U.S. women—especially the 60% who are on Medicaid, uninsured, or underinsured—to get birth control. She co-founded Twentyeight Health in late 2018 to offer online reproductive services.

When you take an inter-disciplinary approach to autism treatment, you see rapid improvement in kids’ progress.

Her model is straightforward: Women complete an evaluation with a board-certified physician via a combination of asynchronous and live telemedicine—including phone and direct message—for a prescription for birth control pills, rings, patches, or shots. A monthly supply of pills starts at $18; for insured women, only co-pay fees (typically $0) apply. Twentyeight Health is the only online reproductive platform focused on underserved women, and it’s often the only player accepting Medicaid in the states where it’s active. It also partners with Bedsider’s Contraceptive Access Fund to provide a year of free birth control for uninsured women.

Amy Fan, MBA-MPH 19, Co-Founder, Twentyeight Health

Twentyeight Health’s expansion has been gradual as the company navigates state-by-state Medicaid rules, but today, the company operates in nine states, including New York, North Carolina, and Florida. Last fall, the startup landed $5.1 million in seed funding.

“So much of healthcare is focused on people with a high ability to pay,” says Fan (shown right). “For low-income patients, and for women of color especially, we put so many burdens on them without trying to understand how we can make it easier for them to access healthcare.”

Powering innovation

Fan attributes much of Twentyeight Health’s success to networks of healthcare insiders—within Haas and beyond—who have offered advice and opened doors.

Juan José Orellana, BS 95, Strategy ConsultantThey include Juan José Orellana, BS 95 (shown left), a Los Angeles-based strategy consultant who’s held senior roles within startups and the Fortune 200 company Molina Healthcare. He helped Fan explore the potential of expanding Twentyeight Health through partnerships with payers and providers.

“To innovate in healthcare, you need to be part of an ecosystem,” Orellana says. “You need to be able to tap into a value network that can facilitate collaboration, accelerate learning, and provide matchmaking for your organization’s needs and offerings.”

indu subaiya, MBA 06, President, Catalyst @ Health 2.0Indu Subaiya, MBA 06 (shown right), has made a career out of fostering ecosystems in healthcare. First as a co-founder of Health 2.0 and now as president of Catalyst @ Health 2.0, she’s organized conferences, open-innovation challenges, and pilot programs to introduce new ideas to deep-pocketed stakeholders. Too often, she says, healthcare entrepreneurs can’t get the traction to scale up. “My primary mission is to introduce groundbreaking technology to the world,” she says.

In the last 15 years, Subaiya’s conference platform has debuted hundreds of startups, including Teladoc, a big provider of telehealth services, and Livongo Health, which helps patients manage diseases digitally. Last year, Teladoc bought Livongo for $18.5 billion. She and her team have also coordinated more than 90 contests, with $9 million in total prize money.

One competition, worth $100,000, drew scientists from 18 countries in a race to build a better COVID outbreak prediction model using government data and millions of Facebook user surveys tracking virus symptoms. The CDC has incorporated the winning model, developed by a Georgia Tech team, into its pandemic forecasting—and found it to be among the top five most accurate prediction tools. “That’s a phenomenal example of open innovation,” says Subaiya.

Innovation, accessibility, scaling up—just as in medicine, different balms can help to heal our healthcare system. And the Berkeley Haas community is shaping countless paths to greater wellness for everyone.

Haas Healthcare Conference to explore COVID-19 response, racial equity

Innovative COVID-19 testing methods, digital options for mental health treatment, and racial equity challenges in healthcare are among the topics to be explored during the 2021 Haas Healthcare Association Conference.

With a theme of “Finding New Breath: Emerging Stronger Through Health Crises,” the 14th Annual Haas Healthcare Association Conference will be held online from Feb. 22-24. The conference, typically held at UCSF Mission Bay on a Friday, will span three half-days.

Corrine Marquardt, MBA/MPH 21
Corrine Marquardt, MBA/MPH 21, co-chair of the 2021 Haas Healthcare Association Conference

This year’s theme is a nod to the many challenges that have impacted breathing over the past year—from the COVID-19 pandemic to rampant wildfires, said conference co-chair Corrine Marquardt, MBA/MPH 21. “2020 was so hard, with many challenges focused around mental and physical health, so we wanted this year to be about resilience and coming through stronger than we were pre-crises,” she said. “We also wanted to address how tech and innovation can help get us through our health challenges.”

Each day will focus on a different theme, including health and environmental equity, (day one) COVID-19 & pandemic response, (day two) and health technology & innovation (day three). A career networking night is planned on Monday, Feb. 22, from 4-5 pm.

“We have a lot of ground to cover over three days and we’ve brought together some of the brightest minds in this space to reflect on everything from racial injustice in healthcare to vaccine development and distribution challenges,” said conference co-chair Ben Delikat, MBA/MPH 21.

Berkeley Haas Dean Ann Harrison and Michael Lu, Dean of UC Berkeley’s School of Public Health, will welcome attendees to the conference, which includes many guests from across the UC Berkeley campus.

We wanted this year to be about resilience and coming through stronger than we were pre-crises. —Corrine Marquardt.

Ben Delikat
Ben Delikat, co-chair of the Haas Healthcare Association Conference

Monday’s line-up includes Dr. Alice Chen, Chief Medical Officer for Covered California, as well as two panels on health equity, one focused on health equity implications of COVID-19 and the other focused on addressing social determinants of health through payers and providers.

Tuesday session highlights include a climate-change focused conversation with Kristine Belesova, deputy director of the Centre on Climate Change and Planetary Health at the London School of Hygiene, along with a COVID-19-focused conversation with Niranjan Bose, managing director of Health & Life Sciences Strategy at Gates Ventures.

Dr. Guy Nicolette, assistant vice chancellor, University Health Services (UHS) of UC Berkeley will join Dr. Anna Harte, UHS Medical Director of UC Berkeley, for a panel discussion with Othman Laraki CEO of genetic test company Color Genomics about public/private partnerships in addressing COVID-19.

On Wednesday, Alice Raia of KP Digital and Kim MacPherson, executive director of Health Management at Haas, will discuss recent digital transformation trends in health systems. The day also includes a conversation on how technology has enabled global health endeavors through COVID-19, as well as a panel on how technology solutions are being used to address mental health. Mariya Filipova, co-founder of the XPRIZE Pandemic Alliance and Anthem’s former vice president of innovation, will close the conference in conversation with Marquardt.

Business leaders from organizations including Google, Jazz Ventures, Headspace, Accenture, Vida Health, and UCSF will participate.

The conference is open to the public. Tickets are available here.

Berkeley Haas team wins Mental Healthcare Tech Challenge 

Portraits of MBA students. Two women, two men.
A team of Berkeley Haas MBA students place first at the John E. Martin Healthcare Tech Challenge. From left to right, top to bottom: Zhuoran (Zia) Li, Zixuan Chen, Eugene Kim, and Chen Su, all EWMBA 23.

An AI-powered app aimed to help construction workers experiencing anxiety, depression, and suicidal thoughts netted a first place win at the first inaugural John E. Martin Healthcare Tech Challenge. The competition was held online Nov. 16-20.

The winning team, Team CLiKS, included Eugene Kim, Zhuoran Li, Zixuan Chen, and Chen Su, all EWMBA 23. The team competed against 11 other teams from top U.S. business schools, including Wharton, Harvard, Columbia, MIT Sloan, and Kellogg for $10,000 in prize money.

Another Haas team placed second, earning $4,000 in prize money for pitching a chatbot that could collect health data, such as sleep patterns and appetite, and recommend tele-health therapy and wellness ambassadors stationed at construction worksites. 

Portraits of two women and two men
A second Berkeley Haas team placed second at the John E. Martin Healthcare Challenge. From left to right, top to bottom: Vishalli Loomba, MD/MS 23; Doug Pollack, MBA/MPH 20; Ben Delikat, and Sophie Schonfeld, both MBA/MPH 21.

Team members included Sophie Schonfeld, Ben Delikat, both MBA/MPH 21; Doug Pollack, MBA/MPH 20; and Vishalli Loomba, MD/MS 23. 

The competition was organized by the Berkeley Haas Healthcare Association and the Berkeley Haas Tech Club, and sponsored by Google. 

For the competition, students were asked to come up with an innovative solution to address mental health issues in the construction industry, which reports some of the highest rates of depression and suicide.

Team CLiKS pitched a mental health app that addressed three critical factors: prevention, assessment, and intervention. Through this app, construction workers would have access to music, podcasts, mental health specialists, peer volunteers, and a community-based forum to seek emotional support. The app would also collect daily mental health data from users through notifications, wellness checks, and diary entries.

The team credited its success to interviewing and surveying more than 90 construction workers, powerful storytelling, and a personal commitment to helping construction workers with mental health issues–an issue that hits close to home for Chen, Kim, and Li. 

Chen, a civil engineer who’s worked in the construction industry, said one of her co-workers committed suicide. “The amount of work, the physical stress, and the financial instability that comes with the job pushes people to the edge.”

Kim, an Army veteran, said several soldiers he served with had committed suicide and Li, a music rehabilitation therapist, treats patients with severe mental health illnesses. 

Su said the cause was important to him and he wanted to leverage his AI and computer engineering skills to help.

The team also credited its success to their construction industry mentor Matt Schulte; Rebecca Portnoy, a professional faculty member who teaches an organizational culture course called Leading People; and James Sallee, an associate economics professor at UC Berkeley. 

“As a first-year Evening and Weekend MBA student without previous business knowledge, I was thankful to have taken a class with Prof. Sallee to guide my thinking and to tackle this mental health challenge from a health and business perspective,” Li said.

New Program Fast-Tracks Innovation

Joint degree prepares students to shake up healthcare

Series of six charts and diagrams tethered to a pill.Before Berkeley Haas’ dual-degree Biology+Business program even launched, junior Michelle Podlipsky attended a biotech seminar hosted by program planners and knew she’d found her calling.

“Biotech firms are trying to bring life-saving therapeutics to market, but they don’t necessarily know how to do that from the business side,” she says. “I want to help them commercialize new therapies—and clear the various regulatory hurdles necessary to do that.”

This fall, a generous donation from Berkeley alumnus Mark Robinson, BA 88 (history and political science), and his wife, Stephanie—part of a total gift of $10 million to support bio-entrepreneurship at Berkeley—has given the program a new name: the Robinson Life Sciences Business and Entrepreneurship Program.

Podlipsky, BA/BS 22, is part of the first cohort and will have the opportunity to engage in two summer internships (one each in business and science) and to take a capstone course senior year for which she’ll help a newly formed company evolve its nascent business.

The Robinsons’ gift will be used not only to encourage students to create much-needed biomedical technologies but also to create scholarships aimed at drawing more Black and Latinx students to the program. It will also establish a Biotechnology Entrepreneurship Center where early career scientists can fast-track technologies serving human health.

“One of our big goals is to create a loop of both entrepreneurship and giving back,” Mark Robinson says. “We want to create leaders who will go out into industry and make a difference by developing new medical devices, new therapies, new medicines that will change the course of human health.”

For junior Gary Liu, the joint degree program has helped him envision a career that will allow him to use the knowledge he gains to maximum positive effect.

“I came into college as premed,” he says. “But when I heard about this program, it struck me as a great combination of skills that would allow me to have even more impact than I would have as a physician.”

New strategy would allow for cheap, daily COVID-19 testing for big groups

eople line up behind a health care worker at a mobile coronavirus testing site on July 22 at the Charles Drew University of Medicine and Science in Los Angeles.
People line up behind a health care worker at a mobile coronavirus testing site on July 22 at the Charles Drew University of Medicine and Science in Los Angeles. (AP Photo/Marcio Jose Sanchez, File)

UC Berkeley researchers have developed a strategy to massively increase the scale and frequency of COVID-19 testing while drastically lowering costs. The key is to pool samples using machine learning algorithms to look for transmission patterns and predict risk.

Associate professors Jonathan Kolstad and Ned Augenblick of Berkeley Haas and Ziad Obermeyer of the School of Public Health laid out their strategy for reducing the cost of screening from $100-$200 per test to just $3-$5 per person per day in an MIT Technology Review article. It’s based on a National Bureau of Economic Research working paper they published this month, along with economics PhD student Ao Wang.

“In the absence of a vaccine, it’s impossible to control COVID-19 without knowing who is infected, and the way to do that is through frequent, mass testing,” Kolstad said. “Testing once a month is almost totally useless to stop the spread by asymptomatic people, who are transmitting nearly half of new infections.”

Testing capacity has been unable to handle the surge in new infections, with some results delayed by two weeks or more. To help reduce the strain, the U.S. Food and Drug Administration this month approved the use of pooled testing, in which multiple peoples’ samples are combined into one. If no virus is detected, the entire group is cleared with one test; if the virus is detected in the pool, however, each sample is tested individually to determine who is infected. 

The method was first developed in the 1940s to test for syphilis, and the U.S. military uses the technique at its bases.

“Pooling would give us the capacity to go from half a million tests per day to potentially 5 million individuals tested per day,” Dr. Deborah Birx, a White House coronavirus task force official, told the American Society for Microbiology last month.

Pooled testing is far more efficient when the prevalence of the virus is lower, since fewer re-tests are required. But rapid changes in infection rates across geographic areas and disparate risks between groups of people—for example, health-care workers versus people working remotely—makes pooling a challenge to implement. That’s where the power of machine learning comes in, Obermeyer, Augenblick, and Kolstad write. 

“Using publicly available data from employers and schools, epidemiological data on local infection and testing rates, and more sophisticated data on travel patterns, social contacts, or sewage, if available, modelers can predict anyone’s risk of having covid-19 on a day-by-day basis. This allows highly flexible approaches to pooling that drive huge efficiency gains,” they write.

In fact, the researchers determined that with efficient pooling of sample, more frequent testing actually drives down the number of tests needed—dramatically reducing the cost. It also reduces the spread of the virus. “According to our analysis, testing daily costs only twice as much as testing monthly. And daily testing can actively suppress the virus, whereas monthly testing really only allows us to see how badly things have gone.”

The technique would work particularly well on college campuses, nursing homes, or warehouses and factories—locations where a specific population of people interact frequently, Kolstad said. Even if the prevalence of the virus is initially high, those who are infected can quickly be identified through an initial screening, followed by pooled testing to quickly identify any new outbreaks. 

The researchers acknowledge that there are logistical challenges to putting high-frequency pooled testing into practice, but that they can be solved—particularly as less-invasive tests, such as the saliva test now undergoing a trial at UC Berkeley, come online.

“Pooled testing that harnesses the power of machine learning makes paying the associated costs not only viable but, when weighed against the alternative of prolonged closures, a tremendous deal,” they write.


Read the article in MIT Technology Review.

Expert Panel: How can we safely reopen the economy?

Returning society to some version of normal will require customized plans that may vary by locale, depending on the intensity of COVID-19 infections. Even so, the economy can’t be safely reopened without strong data, unified decision-making frameworks, and some policies that span the country.

That was the consensus of experts from the Haas School of Business and the School of Public Health who took part in a virtual discussion on reopening the economy Friday as part of the Berkeley Conversations COVID-19 series.

“One size does need to fit all for at least large swaths of the population,” said Assoc Prof. Jonathan Kolstad, a health economist with joint appointments at Berkeley Haas and the Department of Economics. “Everyone’s behavior affects everyone else. (Reopening) in the absence of any sort of coordination is an incredibly costly strategy.”

One size does need to fit all for at least large swaths of the population. —Assoc. Prof. Jonathan Kolstad

According to Maya Petersen, associate professor and co-chair of the Graduate Group in Biostatistics at the School of Public Health, fragmentation hurts the ability of any small population anywhere to respond effectively to their epidemics.

“Ideally what happens is you have a unified decision-making framework, you have unified communication, you have clear policies that span the country,’ Petersen said. “And within those, you have the ability to use your data locally to meaningfully fine-tune your epidemic response.”

If there was one steady drumbeat throughout Friday’s conversation it was data, data, data—which panelists agreed are a prerequisite for reopening, and which must be used to guide testing and identify outbreaks. Other key themes were putting proper systems into place, as well as restoring trust.

To do that, leaders need to be realistic, consistent, and deliberate, said Jennifer Chatman, professor of management and Associate Dean of Learning Strategies at Berkeley Haas. “The mental calculus of leadership is even more vital now because you need to anticipate how people are going to react to what you say and what you do,” Chatman said.

The mental calculus of leadership is even more vital now because you need to anticipate how people are going to react to what you say and what you do.” —Prof. Jennifer Chatman

“Leaders should be realistic with their people—the future is going to be complicated, and it’s going to be challenging. At the same time, they also need to be reassuring, so people can continue to have some semblance of calm and be productive. Leaders need to ask people to comply with rules, but at the same time they need to call on people to use their ingenuity to address problems that we haven’t confronted before,” she said. “If there is any time that a deliberate leader was needed, now is the time.”

Prof. David Levine, a labor economist at Berkeley Haas, said the positive news is that all the tools of good management apply.

“For generations, we’ve been figuring out how to improve product quality, how to make food safer, or how to avoid environmental disasters. And the answer is good management,” he said. “There are lots of management tools around training, incentives, monitoring, and continuous improvement that we know how to use for lots of old threats. Coronavirus is a new threat, but the tools to fight it are the same tools.”

“There are lots of management tools around training, incentives, monitoring, and continuous improvement that we know how to use for lots of old threats. Coronavirus is a new threat but the tools to fight it are the same tools.” —Prof. David Levine

One key thing organizations must do is make it easy for employees to be safe. For example, it’s not enough to just tell people to wash hands: Managers must give people breaks to wash their hands. All states should require every workplace to complete an assessment to look for risks, as California does. Employees should have the authority to stop production if they see a health problem—right now, in most states, they don’t.
“Managers need to make clear that this is how you become a hero, and not a former employee,” Levine said.

However, if one large company has the wherewithal to implement safe solutions for their employees, but those employees live with people working at other firms that don’t, “it verges on futile for that large firm to do all those testing and safety strategies,” Kolstad commented. “At every point, coordination is critical from a health, economic and messaging perspective. If you’re a big employer across a lot of states, keeping your workforce healthy and safe is good for reopening, and good for your employees.”

A woman wearing a protective mask walks past a closed children's clothing store in Chicago, Wednesday, April 15, 2020. (AP Photo/Charles Rex Arbogast)
A woman wearing a protective mask walks past a closed children’s clothing store in Chicago, Wednesday, April 15, 2020. (AP Photo/Charles Rex Arbogast)

People need to remember, however, that our goal as a society is not to get to zero transmissions: Unless we have a vaccine, the goal is to minimize the spread of the virus, Petersen said. The way to do that is to continue using public health techniques such as social distancing and hygiene, while employing integrated data streams to guide testing, identify outbreaks as early as possible, and quickly isolate any new cases.

“We all navigate risks in our lives every day. Thinking in terms of good public health principles, what you need to do is communicate risks clearly to people, have the data available to be able to quantify risks accurately, and you need to have people’s trust so when you say this is the best estimate of your current risk and this is what you need to do to mitigate it, people believe it,” she said.

We all navigate risks in our lives every day. Thinking in terms of good public health principles, what you need to do is communicate risks clearly to people, have the data available to be able to quantify risks accurately, and you need to have people’s trust so when you say this is the best estimate of your current risk and this is what you need to do to mitigate it, people believe it. —Assoc. Prof. Maya Petersen

That’s why organizations must tread carefully, Chatman said. “Crises like this one are opportunities for organizations to display their commitment. Employees are watching closely, and they’re going to remember what you did. If you are known as the employer who, when the going got tough, you got going, there will be long-term cultural consequences.”

This May 1 panel was sponsored by the Haas School of Business as part of Berkeley Conversations: COVID-19. This series of live, online events feature faculty experts from across the UC Berkeley campus who are sharing what they know, and what they are learning, about the pandemic. Panelists were Prof. Jennifer Chatman, Prof. David Levine, and Assoc. Prof. Jonathan Kolstad  from Berkeley Haas and Assoc. Prof. Maya Petersen from the School of Public Health. The moderator was Assistant Vice Chancellor for Public Affairs Dan Mogulof.

 

 

 

Open-source smartphone database offers a new tool for tracking coronavirus exposure

Researchers from Berkeley Haas and four other universities have released a trove of smartphone tracking data in an open-source database—a powerful tool for studying how people are changing their movement patterns and potential exposure levels during the coronavirus pandemic.

Asst. Prof. Victor Couture
Victor Couture

The Covid-19 Exposure Indices, created by Berkeley Haas Asst. Prof. Victor Couture and researchers from Yale, Princeton, the University of Chicago, and the University of Pennsylvania in collaboration with location data company PlaceIQ, is aimed at academic investigators studying the spread of the pandemic. The data sets allow researchers to visualize how people can potentially be exposed to those infected with the virus, based on cell-phone movements to and from businesses and other locations where a great deal of the exposure happens.

Couture hopes that researchers may start to find correlations between the disease and certain venues and travel patterns. Looking forward, the data also could be useful in anticipating the movement patterns that predict where future outbreaks could reemerge once restrictions are lifted. “The end goal is to identify how changes in exposure rates within different types of venues and for different demographic groups impact the number of cases,” says Couture.

Couture and his collaborators are the first academics to release open-source smartphone location data. They are part of a much bigger movement of researchers, companies, and institutions making data easily and freely available to study the pandemic. For instance, Apple, Google, Foursquare, and other big companies have also released movement data. Couture hopes that by being transparent about their data source, methodology, and potential biases, they can make available data that is suitable for peer-reviewed research.

“We’re in the midst of an unprecedented sharing of data from the academic and technical communities,” Couture says. “We hope everyone can use this data to influence better policies during the coronavirus pandemic.“

We’re in the midst of an unprecedented sharing of data from the academic and technical communities. We hope everyone can use this data to influence better policies during the coronavirus pandemic.

The smartphones in our pockets are all equipped with GPS, and depending on privacy settings, many popular applications record our geolocation. Data providers buy and aggregate location information from different applications, and build databases that record the movement and visits to various venues for millions of devices.

Couture and his colleagues have so far released two indices derived from this smartphone movement data: the location exposure index (LEX), showing our movements between states and counties, such as people flying or driving across the country; and the device exposure index (DEX), showing how many people (as measured by their devices) we are coming into close proximity with outside the home. For instance, if you drive to Walmart and 100 other phones are at that same location, and then you drive to a drugstore with 50 people with phones inside before returning home, your DEX exposure level would be 150 people. More detailed data that includes types of venues (grocery stores, drugstores, big-box stores, parks) will be released soon.

An application of the data is shown below. This animated time-lapse map from January 23 to April 2 shows how people’s movements dropped much more quickly in some areas than in others, such as in the South and Southeast of the United States. This is represented by color changes from yellow to green to dark purple as the average device exposure within a county went down.

Device Exposure Index gif

The data can’t tell researchers how well people are practicing social distancing at any given location, and therefore their specific risk of catching the coronavirus. But it can start to reveal how successful various policies—such as states of emergencies and shelter-in-place orders—have been. “When you prescribe rules of movement, when you tighten them, and when you relax them—you can correlate that with what people are actually doing and which groups and areas are reducing their exposure,” says Couture.

“It often looks like people start to reduce their exposure when a state of emergency is declared, but when the actual shelter in place order comes in, it has less impact on movement,” says Couture. An example is the analysis charted below for New Haven-Milford, Connecticut, which showed that the announcement of the state of emergency itself appeared to be a powerful mechanism that convinced people to reduce their movements, and hence their exposure, to the virus.

The exposure indices Couture and colleagues have compiled also include demographic information that can show which groups are at greater risk for exposure, such as minorities and low-income people. Exposure levels vary over time: The top chart in the set below shows that people living in New Haven, Connecticut neighborhoods with median incomes in the top 10% initially had higher exposure rates than those in the bottom 10%.  After a state of emergency was declared, exposure levels in high-income neighborhoods declined much faster than in low-income neighborhoods. This may be because lower income people are more likely to work on the front lines in essential business, and have less ability to reduce their exposure than those who can afford to shelter at home.

The bottom panel shows the ratio of the device exposure index (DEX) for people living in neighborhoods with median income levels in the bottom 10% relative to those in the top 10%. A value higher than 1 signals that exposure is higher in low-income than in high-income neighborhoods

Tracking device expose by income

These patterns could prove helpful in showing which locations and demographics have the potential for greater exposure under different types of orders when policies have been gradually lifted.

As another example, the graphic below shows that metropolitan areas with more jobs that can be done from home had larger reductions in potential exposure to the coronavirus. Again, this correlation suggests that who works from home depends on who can afford to do so while remaining gainfully employed.

 

 

Eventually, the explosion of location data has the potential to tease out even deeper stories explaining not just the hidden patterns behind our unique location in the world, but also the unexpected things that larger groups and types of places share in common. “One of the things we want to encourage is careful work to identify the causations behind these correlations,” says Couture.

The Covid-19 Exposure Indices were created by Jonathan Dingel of the University of Chicago’s Booth School of Business, Kevin Williams of the Yale School of Management, Jessie Handbury of the Unviersity of Pennsyania’s Wharton School of Business, Allison Green of Princeton University, and Victor Couture at Berkeley Haas.

Terrell Baptiste, EWMBA 20, on investing in better healthcare for marginalized communities

Listening to people’s stories about their problems as a young legislative aide in Texas ignited Terrell Baptiste’s interest in healthcare policy as a way to improve lives on a larger scale.

Terrell Baptiste
Terrell Baptiste, EWMBA 20

That led Baptiste, EWMBA 20, on a career journey from Washington D.C., where he worked as a senior legislative associate in healthcare policy, and then in communications at the FDA, to Bay Area pharmaceutical company BioMarin, which specializes in rare diseases.

Now focused on investing in healthcare companies, he also volunteers at the MLK Jr. Outpatient Center in Los Angeles, which treats adults with sickle cell disease, a red blood cell disorder that disproportionately impacts the African American community. 

We spoke with Baptiste about his healthcare journey, his commitment to improving healthcare in marginalized communities, and his most useful Berkeley courses.

Where did you grow up?
I grew up in Houston and went to high school in Sugarland, a wonderfully diverse community. I don’t identify as a Texan but I have a soft spot for Texas as it brings me positive memories and connects me back to my childhood.

How did you end up in the Texas legislature?
As an undergraduate student at the University of Texas in San Antonio, I became enamored with politics. One of my professors introduced me to a Texas state representative for whom I ultimately interned. Six months later I found myself running his re-election campaign and working 20 hours a day in the process. I’m still tired from that job!

Terrell Baptiste in the Texas Legislature
Terrell Baptiste (left) worked as a senior legislative associate in healthcare policy.

Is that when you became interested in healthcare?
Yes, that’s where I found health policy. It was formative to me. I enjoyed the idea that I could listen to stories, help people, and make things happen from a legislative perspective. It lit a fire in me to figure out how I could make an even bigger impact for good.

So why did you end up choosing to get an MBA?
At the FDA, we would interact with pharmaceutical companies at a distance while we were evaluating their products. We would hear about the state of the companies, but I didn’t have the background to understand what certain things meant. I didn’t understand how the companies were being financially supported. I came to business school to understand more about that. My overarching goal with my career has been and is to improve the lives of marginalized patients and so I see my Berkeley MBA as a tool to further that objective.

Your plan is to shift over to biotech hedge fund investing? Why?
I never imagined I’d go from working with the FDA to actually evaluating these companies from an investment perspective at a biotech hedge fund. It’s nice to be able to take my understanding of the way the government thinks about treatments for people as well as the operating experience from BioMarin—where I worked as a regulatory policy analyst, pipeline commercialization associate, and global market access senior analyst—and apply that to investing roles. It’s not a traditional path. I am able to conceptualize what people are doing and see it from different angles.

Which MBA courses have you found most useful to your job?
The entire core program at Haas gives you a fluency in business. You share a common language with people around the world, and a conceptual framework. Turnarounds: Effective Leadership in Crisis with Peter Goodson helped me conceptualize as an investor what options CEOs have and what companies are going through. I took M&A at Berkeley Law with Steven Davidoff Solomon. I wanted a deeper understanding of M&A and I wanted to understand what the process was. This course wasn’t about value creation, but about the legal mechanics behind deal making. I wanted to educate myself on that as an investor or future operator.

What led you to volunteer at the sickle cell center?
At the Sickle Cell Clinic at MLK Jr. Outpatient Center, I’m a lead author of a research study on the impact of innovative adult sickle cell care. My experiences in Washington D.C. and at the FDA have allowed me to see firsthand how a marginalized community can receive uneven care, especially for a disease with limited treatment options.

 

Terrell Baptiste in France
Terrell Baptiste studied in France last spring.

Working with marginalized populations makes sense to me because you need to have core values connected to the work you do. One main reason I went to France to study for a semester last spring is that I wanted to go to a country that believes that philanthropic and social values are connected to work. I wanted to see that live in action. Here, I’d like to continue to have a hybridized world where I work with real patients and I do projects to support them, and where I can also work as a healthcare investor.

Focus rooms, collaboration lounges, and nature views: New book explains how office design fads fall short

Modern office scene with standing desk
Credit: Alvarez for Getty Images

Sit-stand desks, “collaboration lounges” sprinkled among cubicles, “focus rooms” for privacy, and windows with views of nature are all among today’s cool office trends.

But here’s the rub. As amazing as modern offices appear to be, they may not be helping employees do their jobs. They may even be distracting them from getting work done.

Senior Lecturer Cristina Banks
Senior Lecturer Cristina Banks

That’s the premise of a provocative new book co-authored by Berkeley-Haas Senior Lecturer Cristina Banks. In Built to Thrive: How to Build the Best Workplaces for Health, Well-Being, & Productivity, Banks and her collaborators combine research insights and workplace experiences to argue that too much attention is paid to physical space at the expense of the psychological and social needs of today’s employees.

Case in point: sit-stand desks. While they’re meant to get workers up on their feet for health reasons, studies show the novelty quickly wears off and employees mostly sit. “Collaboration” lounges rarely get used because they’re too close to cubicles. “Focus” rooms are rarely soundproof, meaning conversations intended to be private aren’t. And what about those outside views of trees and grass? The only beneficiaries are people who work on the office periphery.

Though well-intentioned, piecemeal features like these don’t go nearly far enough to promote employee health and well-being. “They miss a fundamental understanding of what leads to employee productivity and that is a multi-pronged approach,” says Banks, who teaches management and also serves as director of the UC Berkeley Interdisciplinary Center for Healthy Workplaces (ICHW), which published the book. Berkeley Haas also sponsors the Center.

“Built to Thrive” relies on empirical research findings and professional advice to make the case for why a holistic understanding of the physical, emotional and social needs of employees is crucial in today’s workplace. The book’s 10 authors, each of whom contribute a chapter, are experts from a number of fields including environmental psychology, real estate, architecture, public health, and design strategy.

The authors argue that to inspire motivation and a sense of well-being businesses should pay attention to autonomy, social connection, bodily security, and work with purpose. Physical spaces, they argue, either enhance or detract from those goals.

For example, environmental psychologist Sally Augustin writes about the important roles that mood and emotion play in the workplace. Extroverts, for example, are happy to sit on a sofa with coworkers and collaborate, while introverts prefer to sit behind a desk or table. Cognitive thinking improves under blue lighting, while warmer hues encourage more socialization. Even scents serve a purpose: the smell of lemon improves performance, while cinnamon inspires creativity.

In separate chapters, Gervais Tompkin, a principal with the global design firm Gensler, describes the power of experience in the workplace, including the use of sound and projections of nature on screens or augmented reality glasses. Kevin Kelly, a senior architect with the General Services Administration, explains why employees’ subjective opinions of their workspace matter more than objective reality. And Google executive Anthony Ravitz details how the company relies on employee surveys and other data sources to measure office quality.

The book ends with a general framework to guide businesses on their existing and future office design projects. The approach emphasizes user needs while also recognizing that all departments need to be integrated into the process. It also points out that creating an optimal workspace doesn’t have to be costly and can actually be fun.

“There’s this myth that designing wellness into the workplace is more expensive than not doing it,” says Banks. “This book shows why that’s not the case, and why office design needs to be among the top three concerns for any business leader.”

How opioid use spreads in families, worsening crisis

A bottle of opioids

Berkeley Haas researchers have identified another driver of the opioid epidemic in the United States: family ties.

In a new study published in American Sociological Review, Asst. Prof. Mathijs de Vaan and Prof. Toby Stuart show that the likelihood of someone using opioids increases significantly once a family member living in the same household has a prescription. They also find that the chances of a relative obtaining a prescription for opioids within a year after a relative they live with gets one rises by 19 percent to over 100 percent, depending on family circumstances. Individuals from low-income households, for example, are the most likely to secure their own prescription after a family member does.

The study is one of the few analyses of the opioid crisis that finds a causal link between a specific action—in this case, the introduction of painkillers into a home—and their growing use. In all, de Vaan and Stuart analyzed hundreds of millions of medical claims and almost 14 million opioid prescriptions written between 2010 and 2015 and contained in a database operated by the state of Massachusetts. They were able to track family members’ health care through shared medical insurance policy numbers.

“Our research finds huge effects on the likelihood that family members who are influenced by other family members will start using opioids,” says de Vaan, a sociologist who studies social networks.

“Social contagion”

De Vaan and Stuart, who holds the Leo Helzel Chair in Entrepreneurship and Innovation at Haas, suggest two reasons for this contagion: when a family member takes painkillers, other relatives in the home observe firsthand its effects. Patients also typically receive more pills than they need, which means relatives may be tempted to experiment with leftovers sitting in the medicine cabinet.

Family members’ exposure to painkillers then increases the likelihood that they will visit a doctor within a year and obtain their own prescription. Other research has shown that Americans are more willing to ask for—and receive—specific treatments than consumers in other countries.

Because of this, de Vaan and Stuart offer a new insight into the role of physicians in the opioid epidemic. While it’s long been believed that physicians who work in the same community or are connected in other ways rely on each other for advice and adopt similar forms of treatment, the authors show that the explosion in opioid prescription rates may be coming from patients, too.

“The actions of one doctor toward one patient affect the requests that that patient then makes of other doctors he or she visits,” says de Vaan. “We find that physicians are not only influencing each other directly when it comes to opioid prescriptions. They’re influencing each other by steering patient demand.”

A causal link

Sociologists have long studied the role that social networks have on people’s health. Smoking and alcohol use are two prominent examples of habits families often share.

The problem with research into social contagion is that most of it identifies correlations, but can’t establish cause and effect. It’s possible that other factors—like genetics or the tendency for people to marry others like them—come into play, too.

De Vaan and Stuart, however, were able to establish a causal link between opioid prescriptions and an increase in the drug’s use within families. They did this by narrowing their research to emergency room visits only, where patients are randomly assigned to doctors who prescribe opioids at vastly different rates—so the likelihood that one patient received a painkiller prescription over another was random. The experiment also eliminated the possibility that family members who later got a prescription got one from the same doctor or that family members were visiting the same provider, such as a primary care physician.

 Finding prevention methods that work

De Vaan and Stuart suggest several steps to address the spread of opioid use within families. To prevent so-called “doc shopping,” states that track prescription drug use and make that information available to doctors could also include data on family members’ access to medications. To avoid violating the privacy of relatives, de Vaan says the program could simply issue a “risk” score that would signal to doctors that their patient has been indirectly exposed to painkillers at home.

Policymakers could also expand upon existing efforts to collect leftover prescription drugs—namely through National Prescription Drug Take Back Day—by paying people to return their excess supply. The upfront costs would likely be offset by the money saved in addiction treatment and other costs, de Vaan says. Doctors should also be trained on how to push back when patients ask for painkillers.

“We’ve identified a specific driver of opioid consumption, so all of these steps make a lot of sense,” de Vaan says.

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