Robert Chang, Assistant Professor of Ophthalmology at Stanford University Medical Center and SCPKU Faculty Fellow, gave a public talk at the center earlier this month focused on mobile healthcare innovation and the growing adoption of smartphones as medical devices.

Life expectancy worldwide made huge gains in the last century alone which has created an increasingly heavier burden on our health systems.  The world has seen a rise in age-related chronic illnesses, unique challenges for less developed nations, an increased need for specialized health care workers, and alarming health care cost increases.  These challenges have created opportunities which have spurred innovation in mobile healthcare solutions and the use of smartphones as medical devices to improve the delivery and cost of healthcare.

Chang highlighted Apple’s plans to penetrate the mobile healthcare market including rumors that the company will be releasing a new “iWatch” in October.  At its Worldwide Developer Conference in early June, the company also announced a new iOS 8-based health app and HealthKit framework for tracking personal health and fitness data.  Chang believes these represent important steps in digital health, signaling strong interest in major high-tech players to develop digital healthcare “hubs” and solutions for effective disease monitoring and management.

The current trend within the healthcare technology space is the general population’s use of smartphone sensors to self-track health and fitness data including heart rate, sleeping patterns, activity level and calorie consumption.  Over time, Chang sees the industry moving towards more wearable devices that are more fashionable, invisible and intuitive. 

Within the field of ophthalmology, eye disease diagnoses have typically been done with expensive, bulky equipment.  This limits the ability to deliver effective and efficient eye care in remote patient situations and/or where eye specialists aren’t readily available.  Ophthalmology is well-suited for telehealth and the use of mobile devices to facilitate remote triage. As mobile medical devices, smartphones are ideal given their broad market adoption and processing power and the ubiquity of the Internet.  Currently,  however, cost-effective adapters are needed to accompany a smartphone solution as the smartphone alone is insufficient to capture enough detail inside the eye for effective diagnoses.  As an ophthalmologist with a special interest in healthcare startups, Chang is working with a Stanford-based team to develop the EyeGo, a custom iPhone attachment and adapter coupled with a HIPAA-secure app to facilitate taking pictures of both the front and back of the eye to support remote triage and more efficient physician to physician communication.  While his initial platform is iPhone-based due to the phone’s ubiquity in the Silicon Valley, he eventually plans to port his solution to an open systems platform.

Chang closed his talk by re-emphasizing his point about wearable mobile healthcare becoming more invisible and intuitive.  “The lines are blurring between man and machine,” he said. He cited the “Turing Test,” an experiment developed by famed mathematician Alan Turing to create an artificial intelligence (AI) design standard for the tech industry.  “Can you design an AI where the AI can talk to a person but you can’t tell the difference between the computer and the human?” he challenged.  In order to pass the test, one must fool at least 33% of the judgment panel into thinking the AI is the real person.  Chang believes that mobile health technology can be successfully integrated into the medical field and that we will get to the point where people are completely comfortable interacting with the technology   “This is the next level in the wearable healthcare revolution  -- it will be like you’re talking to your doctor and you won’t be able to tell the difference,” he said.

Chang is a clinician-scientist with an active surgical practice and an interest in early stage medical device development and healthcare IT startups. He has received numerous grants and fellowships In recognition of his focus on patient care, physician innovation, biodesign, and design thinking.  Chang’s clinical research revolves around understanding the association between myopia and glaucoma.  

Fourteen Stanford researchers addressing global poverty through a range of academic disciplines are receiving a total of $4.6 million in awards from the university-wide Global Development and Poverty (GDP) initiative.

Their projects, which are the first to be funded by the GDP, deal with challenges of health, violence, economics, governance and education in the developing world.

“GDP seeks to transform scholarly activity and dialogue at Stanford around the topic of global poverty, so that the university may have a greater impact on poverty alleviation in developing economies,” said GDP faculty co-chair Jesper B. Sørensen. “By focusing on placing a small number of big bets, GDP encourages researchers to think big, and to move beyond the conventional way of doing things. We are thrilled by the inaugural set of awardees, as they demonstrate the creative, inter-disciplinary approaches that will make Stanford a leader in this area.”

The GDP initiative is part of the Stanford Institute for Innovation in Developing Economies (SEED) and is administered in partnership with Stanford's Freeman Spogli Institute for International Studies (FSI). The GDP is co-chaired by Sørensen, the faculty director for SEED and the Robert A. and Elizabeth R. Jeffe Professor of Organizational Behavior at the Graduate School of Business; and Mariano-Florentino Cuéllar, senior fellow and director of FSI and the Stanley Morrison Professor at Stanford Law School.

SEED, which seeks to alleviate poverty by stimulating the creation of economic opportunities through innovation, entrepreneurship and the growth of businesses, was established in 2011 through a generous gift from Robert King, MBA '60, and his wife, Dorothy.

Through complementary areas of focus, GDP funding and other SEED research initiatives will stimulate research, novel interdisciplinary collaborations and solutions to problems of global poverty and development. GDP research aims to pursue answers to crucial questions that are essential to an understanding of how to reduce global poverty and promote economic development. That includes governance and the rule of law, education, health, and food security – all of which are essential for entrepreneurship to thrive. By contrast, other SEED research focuses on innovation, entrepreneurship, and the growth of businesses in developing economies.

Since 2012, SEED’s Entrepreneurship and Innovation in Developing Economies Award program also has doled out 22 awards and seven PhD fellowships to help support and scale businesses in developing economies. Among the $1 million in funded projects were studies of how to improve the livelihoods of small-holder cacao farmers throughout the tropics; how to identify startups with high job- and wealth-creating potential in Chile; how political accountability affects the ability to attract investment in Sierra Leone; and how managerial practices affect trade entrepreneurship in China.

First GDP Awards

The first 14 GDP award recipients are professors of economics, political science, law, medicine, pediatrics, education and biology, and senior fellows from FSI, the Woods Institute, and the Stanford Institute for Economic Policy Research (SIEPR).

“Each of these projects cuts across disciplines, reflects innovative thinking, and has the potential to generate crucial knowledge about how to improve the lives of the poor around the world,” Cuéllar said. “These projects, along with a variety of workshops engaging the university and external stakeholders, will help us strengthen Stanford’s long-term capacity to address issues of global poverty through research, education and outreach.”

Among the award recipients is Pascaline Dupas, an associate professor of economics and senior fellow at SIEPR. Dupas, along with faculty from the Center for Health Policy and Center on Democracy, Development and the Rule of Law, will launch the Stanford Economic Development Research Initiative using GDP funds.  This initiative will focus on collecting high-quality institutional and individual-level data on economic activity in a number of developing countries over the long term, and making these data available to scholars around the world.

Beatriz Magaloni, an associate professor of political science and senior fellow at FSI, is receiving an award to lead a team focused on criminal violence and its effects on the poor in developing economies, and the practical solutions for increasing security in those regions.

Douglas K. Owens, a professor of medicine and FSI senior fellow, was awarded an award to help him lead a team that will develop models to estimate how alternative resource allocations for health interventions among the poor will influence health and economic outcomes.

Stephen Haber, a professor of political science and history and a senior fellow at the Hoover Institution, received an award to bring together Stanford researchers interested in examining the long-term institutional constraints on economic development. Their goal will be to provide policymakers with a framework for determining the conditions under which particular innovations are likely to have positive payoffs, and the conditions under which resources will likely be wasted.

Other projects will address the educational impacts of solar lighting systems in poor communities; identifying interventions to improve the profits and safety among poor, smallholder pig farmers in Bangladesh and China; the role of law and institutions in economic development and poverty reduction; and how to rethink worldwide refugee problems. Awards are also being provided to researchers focused on microfinance, online education and teacher training.

The project proposals were reviewed by an interdisciplinary faculty advisory council chaired by Cuéllar and Sørensen. 

“We were very encouraged by the impressive number of project proposals from a wide range of areas and are looking forward to introducing several new capacity and community-building activities in the fall,” Sørensen said.. “This wide range of research initiatives will form a vibrant nucleus for Stanford’s growing community of scholars of global development and poverty.”

Karl Eikenberry  Photo Credit: Rod Searcey

President Barack Obama has announced he will send several hundred troops to help secure the U.S. Embassy in Baghdad as militants aligned with the Islamic State in Iraq and Syria - known as ISIS - take neighborhoods in Baquba, only 44 miles from the Iraqi capital.

Former Ambassador to Afghanistan Karl Eikenberry, the William J. Perry Fellow in International Security, is interviewed by the Australian Broadcast Corporation. He says the advances by Islamic militants in Iraq in the last week "have been absolutely stunning." The retired U.S. Army Lt. Gen., however, thinks the ISIS advancement will end quickly. "The bigger worry that we have though is ISIS crossing over to the Iraqi and the Syrian frontier and the possibility of them establishing a sanctuary for international terrorists," Eikenberry says.

You can watch Eikenberry's interview here. and ready an interview in The Australian here.

Martha Crenshaw  Photo Credit: Rod Searcey

Martha Crenshaw, a senior fellow at CISAC and its parent organization, the Freeman Spogli Institute for International Studies, is one of the world's leading experts on terrorism. She joined a panel on the public radio program KQED Forum to discuss the political situation and what the militants envision for an Islamic state.

"The ISIS is a group that is even more radical than al-Qaida itself," Crenshaw says. 
"Syria provided a launching board for them, which allowed them to become sort of a caliphate linking Syria and Iraq."

Crenshaw estimates there are between 5,000 to 6,000 members of the ISIS fighting in Iraq and that new recruits are coming in all the time. "But the source of their strength is not merely in numbers," she says. They have gained strength through discipline and communicating what an Islamic state would look like.

Listen to KQED panel discussion here.

Arash Aramesh, a national security analyst at Stanford Law School, discusses the crisis through the prism of Iran on Al Jazeera English.

The United States and Russia should keep working together to stop the spread of nuclear weapons even while disagreeing on issues like Ukraine, Stanford scholars say.

In a recent article in the Bulletin of the Atomic Scientists, Professor Siegfried Hecker and researcher Peter Davis advocate continued U.S.-Russia collaboration on nuclear weapon safety and security.

"The Ukraine crisis has exacerbated what had already become a strained nuclear relationship," Hecker said in an interview. "As one of our Russian colleagues told us, nuclear issues are global and accidents or mishaps in one region can affect the entire world."

Hecker is a professor in the Department of Management Science and Engineering and a senior fellow at CISAC and the Freeman Spogli Institute for International Studies. Over the past 20-plus years, he has worked with Russian scientists to help stop nuclear proliferation. He and Davis returned from a trip this spring to Russia, where they met with nuclear scientists.

"We agreed that we have made a lot of progress working together over the past 20-plus years, but that we are not done," they wrote in the journal essay.

Hecker and Davis described Moscow as a reluctant partner in talks on nuclear proliferation. As for the United States, it actually backed away from cooperation first. A House of Representatives committee recently approved legislation that would put nuclear security cooperation with Russia on hold. And though the White House has opposed this, the Energy Department has issued its own restrictions on scientific interchanges as part of the U.S. sanctions regime against Russia.

But, Hecker said, "Cooperation is needed to deal with some of the lingering nuclear safety and security issues in Russia and the rest of the world, with the threats of nuclear smuggling and nuclear terrorism, and to limit the spread of nuclear weapons."

Washington does not have to choose between the two. It still can pressure Moscow on Ukraine while cooperating on nuclear issues, Hecker and Davis wrote.

They called for further nuclear arms reductions between the two countries, rather than a resumption of the nuclear arms race that took place in the mid-20th century.

Changing relationship

Hecker and Davis acknowledged that the U.S.-Russian relationship overall is changing.

"We realize … that the nature of nuclear cooperation must change to reflect Russia's economic recovery and its political evolution over the past two decades," they wrote.

For example, due to the strained relationship, nuclear proliferation programs must change from U.S.-directed activities to more jointly sponsored collaborations that serve both countries' interests.

As they noted, one huge problem is that Russia still has no inventory or record of all the nuclear materials the Soviet Union produced – or where those materials might be today.

"Moreover, it has shown no interest in trying to discover just how much material is unaccounted for. Our Russian colleagues voice concern that progress on nuclear security in their country will not be sustained once American cooperation is terminated," Hecker and Davis said.

Iran is a flashpoint

America needs Russia to help in its effort to stop Iran from building a nuclear weapon, Hecker and Davis wrote. Russia is a close ally of Iran: "Much progress has been made toward a negotiated settlement of Iran's nuclear program since President Hassan Rouhani was elected in June, 2013. However, little would have been possible without U.S.-Russia cooperation."

In a June 2 interview in the Tehran Times, Hecker said that the only way forward for Iran's nuclear program is transparency and international cooperation. He suggested that the country follow the South Korean model of peaceful nuclear power.

"In my opinion, South Korea will not move in a direction of developing a nuclear weapon option because it simply has too much to lose commercially. That is the place I would like to see Tehran. In other words, it decides that a nuclear program that benefits its people does not include a nuclear weapons option," he told the interviewer.

Hecker said that it is not in Russia's interest to have nuclear weapons in Iran so close to its border.

"Washington, in turn, needs Moscow, especially if it is to develop more effective measures to prevent proliferation as Russia and other nuclear vendors support nuclear power expansion around the globe," Hecker said.

In February, the Iranian government republished an article by Hecker and Abbas Milani, the director of Iranian Studies at Stanford University. The story ran in Farsi on at least one official website, possibly indicating a genuine internal debate in Tehran on the nuclear subject. Hecker and Milani described such a "peaceful path" in another essay on Iranian nuclear power.

Hecker is working with Russian colleagues to write a book about how Russian and American nuclear scientists joined forces at the end of the Cold War to stymie nuclear risks in Russia.

Media Contact

Siegfried Hecker, Freeman Spogli Institute: (650) 725-6468, shecker@stanford.edu

Clifton B. Parker, Stanford News Service: (650) 725-0224, cbparker@stanford.edu