A blog covering the health/care ecosystem and people.

People are sick of being sick, the New York Times tells us. “Which virus is it?” the title of the article updating the winter 2022-23 sick-season asked. Entering 2023, U.S. health citizens face physical, financial, and mental health challenges of a syndemic, inflation, and stress – all of which will shape peoples’ demand side for health care and digital technology, and a supply side of providers challenged by tech-enabled organizations with design and data chops. Start with pandemic ennui The universal state of well-being among us mere humans is pandemic ennui: call it languishing (as opposed to flourishing), burnout, or

With valuations of digital health companies expected to decline in 2023, investors in the sector are Missourian in spirit in “Show Me” mode: here, it’s all about the clinical evidence and ROI, according to a survey from GSR Ventures.  conducted among over 50 major digital health venture capital investors.             Most of the 50+ responses to the survey expect that in 2023, valuations for digital health companies will decrease by over 20%: that’s a net of 83% including 60% expecting valuations to fall 20-40%, and 23% anticipating declines of over 40% of valuations in the next

Americans’ trust in technology as “plummeted” in the past decade, according to the 2022 Edelman Trust Barometer’s focused look on trust and technology. How might this play into U.S. health citizens’ trust in digital health technology?             To answer that, let’s start with the macro-view on trust in tech. Richard Edelman convened a virtual meeting launch for the Trust Barometer’s tech perspectives yesterday, looking broadly at the global study findings. For these trust-tech insights, Edelman surveyed 15,000 citizens between August 31 and September 12, 2022, residing in 12 countries: Australia, Brazil, Canada, China, France, Germany,

Only 4% of health care payments in the U.S. are pure fee-for-service (FFS) these days. “The end of pure FFS is near,” according to The State and Science of Value-Based Care, a report-out of survey research from Innovaccer and Morning Consult.             Innovaccer, a health cloud/data analytics company, worked with Morning Consult to do deep-dive interviews with 75 senior health care executives; research was conducted in November and December 2021, so these perspectives represent those of health system leaders at the start of 2022. The full report is worth your read; my focus in this Health

“Tom Lawry reminds us that the health care industry can shift from glacial to warp speed when it needs to. Given the right tools, we can evolve from health systems to systems of health, baked with Responsible Intelligence to do good while embedded with respect, inclusion, and transparency. Health citizens deserve Tom’s vision to emerge,” I wrote in a quote on the back of Tom’s new book, Hacking Health Care: How AI and the Intelligence Revolution Will Reboot an Ailing System.                 Tom knows whereof he speaks and writes and opines: he has

In another factor to add into the retail health landscape, Dollar General (DG) the 80-year old retailer known for selling low-priced fast-moving consumer goods in peoples’ neighborhoods appointed a healthcare advisory panel this week. DG has been exploring its health-and-wellness offerings and has enlisted four physicians to advise the company’s strategy. One of the advisors, Dr. Von Nguyen, is the Clinical Lead of Public and Population Health at Google….tying back to yesterday’s post on Tech Giants in Healthcare.         Just about one year ago, DG appointed the company’s first Chief Medical Officer, which I covered here in

Doctors heads and hearts are jammed with concerns beyond curing patients’ medical conditions: U.S. physicians are worried about big social issues, according to a Medscape survey report, Physicians’ Views on Today’s Divisive Social Issues 2022.               Topping physicians’ list of their top-five most important social issues, far above all others ranked healthcare access. Underneath that top-line statistic, it’s important to note that: 52% of doctors are “very concerned” about healthcare access, 28% are “concerned,” and 13% are “somewhat concerned.” Medscape underscores that in 2020, 31 million U.S. residents had no health insurance coverage, and

The COVID-19 pandemic revealed long-systemic health disparities in the U.S. and in other parts of the world. Income inequality, sickly environments in homes and communities (think unclean air and water), lack of public transportation and nutritious food deserts combine to limit peoples’ health and well-being., Beyond the traditional social determinants of health, such as these, we’ve called out another health risk that became crucial for life in the coronavirus pandemic era: digital connectivity, Indeed, WiFi and broadband represent the newest social determinant of health to add to a growing list of risk factors that challenge health citizens’ health. Kudos to

The four top trends to watch for this week at CES 2022 are transportation, space tech, sustainable technology, and digital health, based on Steve Koenig’s annual read-out that kicks off this largest annual conference featuring innovations in consumer electronics. Last night, Steve discussed these trends for media attendees, of which I am one (gratefully) participating in #CES2022 virtually from the hygienic comfort and safety of my home health hub (more on that later in this post). All four of these mega-themes impact health and well-being in some way. “Space Tech?” you  might wonder. Yes. My friend Dorit Donoviel can be

A coalition of health care providers, health plans, technology innovators, NGOs, and medical societies has come together as the Public Health Tech Initiative (PHTI), endorsed by the Consumer Technology Association (CTA) with the goal of advancing the use of trustworthy digital health to proactively meet the challenge of future public health emergencies….like pandemics. At the same time, CTA has published a paper on Advancing Health Equity Through Technology which complements and reinforces the PHTI announcement and objective. The paper that details the PHTI program, Using Heath Technology to Response to Public Health Emergencies, identifies the two focus areas: Digital health

A new look into Americans’ views on health privacy from Morning Consult provides a current snapshot on citizens’ concerned embrace of technology — worried pragmatism, let’s call it. This ambivalence will flavor how health citizens will adopt and adapt to the growing digitization of health care, and challenge the healthcare ecosystem’s assumption that patients and caregivers will universally, uniformly engage with medical tools and apps and technologies. More Boomers are concerned with health data app privacy than Gen Z consumers, as the chart illustrates. 46% of U.S. adults said that health monitoring apps were not an invasion of privacy; 32%

As connected devices proliferate within health care enterprises and across the health care ecosystem, cybersecurity risks abound. During the first year of the COVID-19 pandemic, the health care sector was profoundly affected by cyber-attacks on connected devices, we learn in the report, Rise of the Machines 2021: State of Connected Devices – IT, IoT, IoMT and OT from Ordr. For this annual report, Ordr analyzed security risks across over 500 deployments in healthcare, life sciences, retail, and manufacturing sectors for the 12 months June 2020 through June 2021. In health care, outdated operating systems present some of the greatest risks:

The rise of digital health investment and growing role of technology in health care services only accelerated during the COVID-19 pandemic. At the same time, people took on their own versions of digital transformation at home, for work, for school, for cooking, shopping, and indeed, for health care. But with digital health adoption gains has come some ambivalence and mixed signals, Accenture has discovered in its 2021 Health and life Sciences Experiences Survey released this week during the HIMSS Annual Conference. As the report concludes, “people’s sentiments and behaviors” with respect to technology in health care “provide no clear answer.”

The pandemic ushered in millions of peoples’ first digital health experiences, many of which will persist according to the 23rd Annual U.S. Consumer Technology Ownership & Market Potential Study, published by the Consumer Technology Association. CTA conducted an online survey among 2,409 U.S. adult 18 and over in April 2021 to gather data for this annual report. To ensure a fair sample, CTA drew three datasets for the general population along with an Hispanic oversample and an oversample for people 65 years of age and older. The study looked at 83 consumer technology products and sub-categories, including many directly related

In April 2020, the U.S. Centers for Disease Control issued a report featuring evidence that in the month of March 2020, the coronavirus pandemic was not an equal-opportunity killer. Within just a couple of months of COVID-19 emerging in America, it became clear that health disparities were evident in outcomes due to complications from the coronavirus. An update from that early look at differences in COVID-19 diagnoses and mortality rates was published in Health Disparities by Race and Ethnicity During the COVID-19 Pandemic: Current Evidence and Policy Approaches, In this report, the Assistant Secretary for Planning and Evaluation, part of

Investments in the digital health sector have fast-grown in the past decade, reaching $14bn in 2020 based on Rock Health’s latest read on the market. The COVID-19 pandemic accelerated the field across many industry segments. With such turbocharged growth on the supply side, Beazley, experts in specialty insurance, explores the risks of digital health and wellness in a new report, Digital health, telehealth and wellness: Attitudes to risk and insurance. With great potential for both innovation and reward comes great risks: Beazley points to the facts that, over two-thirds of digital health companies lack insurance coverage for medical malpractice for

Expanding omni-channel, data-driven, cost-effective health care in the community, tailoring that care, and attending to mental health paint the picture of health through the lens of CVS Health. The company published the Health Trends Report 2021 today, calling out ten forces shaping health care this year. Those themes are, The Year of the Pharmacist The Next Step Forward in Cardiac Care Cancer Needs a Better Roadmap The EHR Hits Its Stride The Mental Health Shadow of COVID-19 Tailor Care to the Older Patient More Agents that Predict Disease Paying for the New Medical Miracle Virtual Care Goes Mainstream, and Diabetes

Artificial intelligence (AI) has begun to play a role in health care for predictive analytics, personalization, and public health. On 26th January, I’ll moderate a tweetchat at 1 pm Eastern time, brainstorming the current and future state of and opportunities for AI in health care. I’ll be co-chatting with Microsoft’s AI leader, Tom Lawry (@TCLawry on Twitter). In advance of that discussion, I wanted to feature remarks shared by Brad Smith, Microsoft President, that I recently heard at CES 2021, the annual (this year, virtual) meeting convening the largest community of consumer electronics stakeholders globally Smith wove a crucial, impactful

Citizens around the world unite around the concept that Trust is Dead. This is no truer than in the U.S., where trust in every type of organization and expert has plummeted in the wake of the COVID-19 pandemic, political and social strife, and an economic downturn. Welcome to the sobering 2021 Edelman Trust Barometer, released this week as the world’s technology innovators and analysts are convening at CES 2021, and the annual JP Morgan Healthcare meetup virtually convened. As the World Economic Forum succinctly put the situation, “2020 was the year of two equally destructive viruses: the pandemic and the

In the U.S., the latest read on supply-and-demand for COVID-19 vaccines illustrates a gap between what had been promised for the first phase of vaccine rollout versus the reality of supply chain challenges, cold storage, and 50-state and local fragmentation at the last mile for U.S. health citizens. An op-ed published in yesterday’s Washington Post by Dr. Robert Wachter of UCSF and Dr. Ashish Jha of Brown University found these two wise physicians feeling “punched in the face” with the state of coronavirus vaccination in America. As a result, they soberly, pragmatically recommended administering just the first jab of vaccine

The coronavirus pandemic has been a shock to people across all aspects of everyday living, for older and younger people, for work and school, for entertainment and travel — all impacting our hearts, minds, and wallets. “As the bedrock of daily life was shaken, uncertainty predictably emerged as the prevailing emotion of our time but this universal problem was eliciting a highly differentiated reaction in different people,” Kern Schireson, CEO of Known, observed. His company has conducted a large quantitative and qualitative research program culminating in a first report, The Human Condition 2020: A Shock To The System. Known’s team of

In the pandemic, I’ve been weaving together data to better understand how people as consumers are being re-shaped in daily life across their Maslow Hierarchies of Needs. One of those basic needs has been digital connectivity. People of color have faced many disparities in the wake of the pandemic: the virus itself, exacting greater rates of mortality and morbidity being the most obvious, dramatic inequity. Another has been digital inequity. Black people have had a more difficult time paying for phone and Internet connections during the COVID-19 crisis, we learned in a Morning Consult poll fielded in June 2020. In

The coronavirus pandemic has revealed the importance of connectivity, WiFi, broadband, as a social determinant of health and living. Connecting from our homes — now our health hubs, workplaces, schools, entertainment centers, and gyms — is necessary like air and water for survival across daily life flows. Digital connectivity can ameliorate social isolation and anxiety, bolster mental health, and access needed medical care via telehealth channels. As a result of the pandemic, staying connected is more important than ever for older people, Best Buy Health learned in a survey of U.S. adults. Insights from this study have informed the launch

The pandemic has become a sort of forcing function on all aspects of daily living, include health care. Deloitte’s latest wave of health care consumer market research updates the COVID-19 impacts on the U.S. health care landscape and asks the question in the study report’s title: “Are consumers already living the future of health?” For the general survey of U.S. Health Consumers, Deloitte polled 4,522 U.S. adults 18 and older online in February and March 2020. Deloitte conducted an additional 1,510 interviews with consumers in April to gauge peoples’ perspectives on the pandemic, health and well-being. In the Great Lockdown

The pace of digital health investments quickened in the first half of 2020, based on Rock Health’s look at health-tech financing in mid-year. Digital health companies garnered $5.4 billion in the first half of the year, record-setting according to Rock Health. Underneath this number were very big deals, shown by the size of the blue bubbles in the first graphic from the report. Note that in H1 2020, the average deal size exceeded $25 mm. Among the largest deals valued at over $100 mm were ClassPass (raising $285 mm), in the business of virtual fitness classes;  Alto Pharmacy, a digital

Millions of dollars and developers’ time have been invested in conceiving and making digital health tools. Yet with that bullish supply side of digital health,  there was a marked decline in peoples’ use of them in the past two years, found by Accenture in their latest health consumer survey, Digital is Transforming Health, So Why is Consumer Adoption Stalling? Use of mobile apps to track personal health activity fell from nearly 1 in 2 consumers to 1 in 3. Use of wearable tech nearly halved, from 33% to 18%, between 2018 and 2020. Some, but not necessarily a majority, of

Most Americans associate more optimistic words with human genetics research than they do darker implications: “curious,” “hopeful,” “amazed.” and indeed “optimistic” ranked the top four impressions in peoples’ minds, based on a survey form the American Society of Human Genetics (ASHG). Below these perceptions are a few concerning concepts such as “cautious,” “concerned,” “hesitant, and “skeptical,” the poll found. Based on the relatively positive views on genetics research, most Americans support increasing Federal funding for that research: 74% said it was somewhat or very important to do so, compared with 15% saying it was not important. People value genetics research

There’s less talk about Bitcoin and cryptocurrency at #CES2020. The most important currency under discussion is Trust. We have begun a consumer electronics migration from the past decade of the Internet of Things to this next decade of the Intelligence of Things. The different “I’s” signal the transition from devices that have connected to the Internet and generated data from our everyday lives, to the next ten years of gathering that data, mashing it up for meaning, and feeding back intelligence to users in the form of advising, coaching, nudging — with potentially powerful feedback loops for health, wellness and

In CTA’s 2020 Consumer Tech Forecast launched yesterday at Media Day 1 at CES, Steve Koenig VP of Research, said that, “digital health is an ecosystem of ecosystems.” Health, medical and wellness trends featured large in the forecast, which brought together key trends for 5G, robotics, voice tech, AR/VR/XR, and the next iteration of IoT — which Steve said will still be called “IoT,” but in this phase will morph into the “Intelligence of Things.” That speaks to Steve’s phrase, “ecosystem of ecosystems,” because that’s not just “digital” health — that’s now the true nature of health/care, and what is

The new year will see a “looming tsunami” of high prices in healthcare, regulation trumping health reform, more business deals reshaping the health/care industry landscape, and patients growing do-it-yourself care muscles, according to Top health industry issues of 2020: Will digital start to show an ROI from the PwC Health Research Institute. I’ve looked forward to reviewing this annual report for the past few years, and always learn something new from PwC’s team of researchers who reach out to experts spanning the industry. In this 14th year of the publication, PwC polled executives from payers, providers, and pharma/life science organizations. Internally,

As technology continues to re-shape consumers’ experiences and expectations with health/care, retail, travel and work, peoples’ concerns about data privacy are also growing as observed by a 2020 consumer trends forecast from GlobalWebIndex, Connecting the dots. First, some overall context to the study. GlobalWebIndex “connects the dots” of consumers trends in 2020 including the topics shown in the first graphic including commerce and retail, gaming, travel, human touch, nostalgia, privacy and digital health — the first of these trends discussed in the report. Note that the data discussed in this post include responses from consumers residing in both the U.S.

Patients searching online for health information and health care provider reviews is mainstream in 2019.  Digital health tracking is now adopted by 4 in 10 U.S. consumers. Rock Health’s Digital Health Consumer Adoption Report for 2019 was developed in collaboration with the Stanford Medicine Center for Digital Health. Rock Health’s research has tracked peoples’ use of telemedicine, wearable technology, digital health tracking, and online health information since 2015, and the results this round show relative flattening of adoption across these various tools. Rock Health’s top-line findings were that: Patient-generated health data creates opportunity, and potential challenges Online health information is

“Bold thinking is great. Bold doing is better,” Dr. Eric Topol introduced his talk yesterday at Medecision’s Liberation 2019 conference. I have the opportunity, for which I’m so grateful, of not only attending this meeting but playing a role as a speaker, a sometimes stage “emcee,” and a keynote speaker. And as an attendee, I learn so much from other speakers, fellow attendees, and Medecision staff all sharing perspectives during breakouts and networking breaks. In mode of attendee (and self-confessed collegial-groupie of Dr. Topol’s), I took in his remarks taking notes as fast as I could thanks to Mom teaching

Based on the influx of research studies and position papers on social determinants of health flowing into my email box and Google Alerts, I can say we’re past the inflection point where SDoH is embraced by hospitals, professional societies, health plans and even a couple of pioneering pharma companies. PwC published a well-researched global-reaching report this week appropriately titled, Action required: The urgency of addressing social determinants of health. The “wheel of determinants” illustrates potential partners for collaborating in communities to address SDoH factors. The collaborators include governments, health care providers, payors, life science and pharma, tech and telecomms, policy

“Every company is a tech company,” Christopher Mimms asserted in the Wall Street Journal in December 2018. Connectivity, artificial intelligence, and automation are now competencies every company must master, Mimms explains. This ethos underpins Humana’s decision to join CTA, the Consumer Technology Association which hosts CES every January in Las Vegas. If you read this blog, you know one of the fastest-growing “aisles” at the annual conference is digital health. Humana joined up with CTA’s Health and Fitness Technology Division this month. Last year, Humana hired Heather Cox in the new post of Chief Digital Health and Analytics Officer, reporting directly

There are about 55 million patient records held by the United Kingdom’s National Health Service (NHS). Their monetary value to private sector companies would be £5 billion and nearly that much in patient benefits. Add in value for patient outcomes, and the total approaches £10 billion. In today’s UK:US currency exchange rate, 10 billion British pound sterling is worth roughly $12 billion. Realising the Value of Healthcare Data from EY explores how patient data can, in the words of the report, “unlock significant operational savings, enhanced patient outcomes, and wider economic benefits” for the NHS and patients through using artificial

A “one layered delivery network through which patients can move seamlessly as they age and their needs evolve” will be the new health care platform to meet patients’ demands by 2030, according to a forecast from KPMG’s Healthcare and Life Sciences Institute. In Healthcare 2030: The consumer at the center, the KPMG team explores the demographic shifts and market drivers that will challenge the health care industry in the current U.S. delivery and financing system. The lens on that 2030 future is a consumer-centric delivery model that KPMG believes will be a solution to dealing with a demographic divide between

The health care section of Mary Meeker’s 334-page annual report, Internet Trends 2019, comprises 24 of those pages (270 through 293). These two dozen exhibits detail growing adoption of digital tech in health care, the growth of genomics and EHR adoption, examples of these tools from “A” (Apple) to “Z” (Zocdoc), and on the last page of that chapter, medical spending in the U.S., the highest in raw and per capita numbers versus the rest of the world. But the most important implications for American health care aren’t found in those pages: they’re in other parts of the report addressing

People want to make health with their health care providers, and they want more than care from them: most patients are looking for support with healthy eating, exercise, emotional support, sleep, stress management, social relationships, and financial health. And in case physicians, nurses and pharmacists aren’t sufficiently business with that punch-list for health, two in three U.S. patients would also like to receive help in finding a higher purpose. This is the health consumer’s mass call-out for holistic health, Welltok discovered in a survey conducted among over 1,600 U.S. adults in March 2019. The results are detailed in the assertively 

The supply side of digital health tools and tech is growing at a hockey-stick pace. There are mobile apps and remote health monitors, digital therapeutics and wearable tech from head-to-toe. Today in America, electronic health records (EHRs) are implemented in most physician offices and virtually all hospitals. Chapter 5 of my book, HealthConsuming: From Health Consumer to Health Citizen, details the promise of digital health: wearable, shareable and virtual. Today, we can also call on Alexa to remind us to take medications, play nostalgic music when we are lonely, check our physical activity status with Fitbit, and query WebMD about

We are all Homo informaticus these days, multi-channel, multi-platform beings using digital platforms. “Computing is not about computers anymore. It is about living,” Nicholas Negroponte wrote in Being Digital. He said that in 1995. In that quarter-century since Negroponte made that prescient observation, we come to better understand that being a Digital Society has its upsides and downfalls, alike. We need a “new needs model” for the digital age, asserts a new report, Human Needs in a Digital World, the 2019 Digital Society Index report from the Dentsu Aegis network. Taking Maslow’s Hierarchy of Needs as a basic construct, the Index

“The Fourth Industrial Age,” Dr. Abraham Verghese writes, “has great potential to help, but also to harm, to exaggerate the profound gap that already exists between those who have much and those who have less each passing year.” Dr. Verghese asserts this in his forward to Deep Medicine, Dr. Eric Topol’s latest work which explores the promise of artificial intelligence (AI), Big Data, and robotics — three legs of the Fourth Industrial Age stool. [If you don’t know the work of Dr. Verghese, and since you’re reading the Health Populi blog, you must get to know Dr. V now. Your

When you think “genomics,” your mind probably pictures a human DNA strand. Well, my mind did, prior to meeting with Dr. Joseph Frassica and Dr. Felix Baader at HIMSS19 to discuss Philips’ approach to the tragic problem of healthcare-acquired infections that kill patients. Ever since that conversation, my mind’s eye is filled with images of MRSA cells like those shown here. At HIMSS19, Philips launched a solution that couples clinical informatics with genomic sequencing of bacteria to quickly identify and treat patients that are affected with tough-to-treat infections that, so often, result in death. Healthcare-acquired infections (HAIs) are a worldwide

“The promise of AI is undeniable…could AI help clinicians deliver better and more humanistic care?” This question is asked and answered in a JAMA viewpoint published January 1/8 2019 titled, Humanizing Artificial Intelligence. This theme motivated a conversation held over a dinner convened by Philips hosted by Frans Van Houten this week at HIMSS19. To provide context Geoff Colvin, Fortune‘s Senior Editor, first talked about taking friction out of industries, as Lyft and Uber have done in the transport sector. “Taking friction out of industries challenges and changes business models,” Geoff noted. With Uber’s IPO valuation approaching $100 billion, I’d say that’s

Self-care is the new health care as patients, now consumers at greater financial risk for medical spending, are learning. At #CES2019, I’m on the lookout for digital technologies that can help people adopt and sustain healthy behaviors that can help consumers save money on medical care and enhance quality of life-years. This week’s heart-and-food tech announcements at #CES2019 coincide with an FDA recall on a popular drug prescribed to treat hypertension (high blood pressure). Using food and tech as medicine can help people avoid going on medications like statins and others for heart health. An important example of this self-care

Today is Boxing Day and St. Stephens Day for people who celebrate Christmas, so I share this post as a holiday gift with well-wishes for you and those you love. The tea leaves have been brewing here at THINK-Health as we prepared our 2019 forecast at the convergence of consumers, health, and technology. Here’s our trend-weaving of 4 C’s for 2019: costs, consumerism, cyber and care, everywhere… Health care costs will continue to be a mainstream pocketbook issue for patients and caregivers, with consequences for payors, suppliers and ultimately, policymakers. Legislators inside the DC Beltway will be challenged by the

The future of healthcare is not about being sick, Prof. Dr. Koen Kas believes. Having spent many years in life sciences in both research and as an entrepreneur, Koen now knows that getting and staying healthy isn’t about just developing medicines and med-tech: optimally, health requires a tincture of delight, Koen advises in his breakthrough, innovative book, Your Guide to Delight. Healthcare must go beyond traditional user-centered design, Koen’s experience has shown, and aspire toward design-to-delight. The concept of “delight” in healthcare, such as we experience in hospitality, grocery stores, and entertainment, is elusive. I’ve observed this, too, in my

Information is power in the hands of people. When it’s open in the sunshine, it empowers people — whether doctors, patients, researchers, Presidents, teachers, students, Everyday People. Welcome to the era of Open Source Healthcare, not only the “about time” for patients to own their health, but for the launch of a new publication that will support and continue to evolve the concept. It’s really a movement that’s already in process.     Let’s go back to some definitions and healthcare basics to understand just why Open Source Healthcare is already a thing. When information access is uneven, it’s considered

In our Amazon-Primed world, the future of retail is not ten years from now; it’s “tomorrow.” So GMDC, the association of retailers and brands who supply them, has formed a program called Retail Tomorrow to turbocharge the supply side with consumers who are already demanding convenience, immediate (or “soon”) gratification, and health where she/he “is.” That’s personalization, and that’s where retail health can and is making a difference in Everyday Peoples’ lives. In our DIY culture, we’re pumping our own petrol, making our own airline and hospitality reservations (from Expedia to Airbnb), trading stocks online, and cooking at home enabled by