Posted on

We’ll Be Wearing Masks for a While. Why Not Make Them Nice?

TOKYO — Rieko Kawanishi is the first to admit that the pearl-laden mask she designed is not the most effective defense against the coronavirus. “It’s full of holes,” she said with a laugh.

But her handmade face covering, which she recommends wearing over a regular mask, reflects a sudden burst of creative attention in the worlds of fashion and technology to a humble product that had been largely unchanged for decades.

“After the pandemic, there were so many more places where, for the first time, you absolutely had to wear a mask,” said Ms. Kawanishi, a jewelry designer in Tokyo. “I just thought, I want to make something elegant.”

As the virus continues its relentless spread, with rules on mask-wearing being tightened in many places around the world, consumers are starting to demand more of the coverings that will guard their public breaths for the foreseeable future.

In response, companies and designers have flooded the market with alternatives to the common throwaway surgical masks that spurred Ms. Kawanishi to action.

Image
Credit…Noriko Hayashi for The New York Times

Inventors have dreamed up masks with motorized air purifiers, Bluetooth speakers and even sanitizers that kill germs by heating the face covering (but hopefully not the face) to over 200 degrees. In South Korea, the electronics giant LG has created a mask powered with fans that make it easier to breathe.

In boutiques, patterned masks are showing up on mannequins, exquisitely paired with designer dresses. An Indian businessman said he spent $4,000 on a custom mask made of gold. And a French costume designer has filled Instagram with phantasmagoric designs featuring everything from pterodactyls to doll legs.

The coronavirus “has driven a rapid evolution in mask technology,” said Yukiko Iida, an expert on masks at the Environmental Control Center, a consulting company in Tokyo.

“When there’s demand, the market reacts quickly,” she said. “People are wearing them all day every day, so we’re seeing improvements in things like ease of wear and ease of communication,” she added, citing a mask with a clear front that allows people to see the wearer’s facial expressions.

Image

Credit…Noriko Hayashi for The New York Times

The urge to innovate has been great in Japan, where masks were widespread even before the pandemic, used to warm faces or protect against pollen, influenza or the unwelcome gaze of strangers.

While most people in the country are still wearing cheap white surgical masks, consumers have begun to move away from viewing face coverings as a one-and-done commodity, something picked up at a convenience store, worn a few times and tossed in the trash.

Taisuke Ono, the chief executive of a tech start-up, Donut Robotics, said he envisioned a world where people could be wearing masks on trips abroad for the next 10 years or more. If that happens, they will demand that their masks do more than just protect them from viruses, he said.

His company is building a mask that serves as a combination walkie-talkie, personal secretary and translator. It can record its users’ voice, projecting it to someone else’s smartphone — all the better for social distancing — or transmuting it from Japanese into a variety of languages.

Image

Credit…Noriko Hayashi for The New York Times

“The pandemic made this possible,” he said, noting that his prototype had generated media attention and enormous interest from investors on Makuake, a Japanese version of Kickstarter. Before, he said, “even if you made something like this, no one would invest in it, and you couldn’t sell it. Now, the global market has grown several times.”

Although the pandemic will end at some point, he added, “people will still be using masks because they’re afraid.”

While it’s unclear how well some of these more ambitious masks will fare with consumers, one innovation has been a clear hit: face coverings with high-tech fabrics that are said to provide superior comfort or protection.

As summer temperatures rise, masks made of materials intended to keep wearers cool are in demand. People who have been wearing reusable cloth masks — including those sent by the Japanese government to every household in the country — are finding them ill suited for the heat and humidity of summer in central Japan, much less Singapore or Hong Kong.

Image

Credit…Noriko Hayashi for The New York Times

Toyoshima, a Nagoya-based trading company, began collecting funds for a new mask made with military-grade nylon in mid-April. It raised over $1.2 million — more than 13,000 percent of its goal.

Customers told the company that they wanted a highly effective mask that was also fashionable, said Koki Yamagata, who leads the company’s crowdfunding initiatives.

“A lot of people said that they wanted more colors,” he said as he modeled a white version of the mask, which retails for around $50, on a Zoom call. The products have not generated much profit, he said, adding that the company began making them partly out of a sense of social responsibility.

Other Japanese companies have followed suit. Tadashi Yanai, the founder of Uniqlo, the giant clothing retailer, insisted that his company would not sell masks, but changed his mind after customers clamored for a product made from the brand’s high-performance, fast-drying fabric.

The masks sold out immediately, and the company has committed to making 500,000 packs a week, according to a spokesman, Aldo Liguori, who said that the company was now planning to sell them overseas, as well.

Image

Credit…Noriko Hayashi for The New York Times

For some clothing makers, producing masks has been a necessity, with retail sales slowing considerably as consumers stay home.

Many “factories haven’t had much to do for two or three months, so they’re saying ‘Why don’t we make cloth masks?’” said Kensuke Kojima, a product consultant for the fashion industry.

These Japanese producers have entered a market that had seen only incremental changes over the decades, like masks that came in different colors or offered no-smear coatings to protect makeup.

While medical practitioners have worn masks of one sort or another for hundreds if not thousands of years, the masks worn today were first developed in the late 19th century for use during surgeries.

They were first employed to fight epidemics in the early 20th century, when Wu Lien-teh, a doctor of Chinese descent, began promoting simple gauze masks as an effective method for battling an outbreak of pneumonic plague in a part of northeastern China then known as Manchuria.

Image

Credit…Noriko Hayashi for The New York Times

When the Spanish flu hit in 1918, the practice went global for the first time.

While masks soon fell out of favor in most countries, the Japanese government continued encouraging their use for fighting common illnesses like the flu, said Christos Lynteris, a medical anthropologist at the University of St. Andrews in Scotland.

The ubiquity of surgical masks in Japan, which are typically made of nonwoven synthetic materials, has risen and fallen over the years as the country confronted different health issues and crises.

In the 1990s, they became a popular defense against clouds of seasonal pollen created by fast-growing trees, like cypress, planted across the country to provide a source of cheap timber.

In 2011, after the nuclear meltdown at Fukushima, mask stocks ran low as consumers feared radioactive fallout. And in the following years, drastic increases in pollution from China drove more demand, particularly in the winter.

But, even in Japan, it took a pandemic to push mask sales into the stratosphere, with face coverings in such short supply early on that people were lining up at the crack of dawn to buy a box.

Months later, masks are abundant, and shops in Harajuku, the youth fashion mecca, are increasingly putting them on prominent display. On Takeshita Street, storefronts are lined with masks ranging from the playful (plush animal faces) to the punk-inspired (leather straps studded with spikes and safety pins).

Image

Credit…Noriko Hayashi for The New York Times

Although these masks may be fashionable, buyers should beware, said Kazunari Onishi, an expert on infectious diseases at the Graduate School of Public Health at St. Luke’s International University in Tokyo.

“You must choose a mask that meets the national standards,” he said, adding that “other types of masks are not intended to be used against infection.”

“If your priority is reliably preventing infection, these masks will not protect your life,” he said, adding that even if you wear a mask, “you must maintain a safe social distance.”

Posted on

Coronavirus Threatens the Luster of Superstar Cities

Cities are remarkably resilient. They have risen from the ashes after being carpet-bombed and hit with nuclear weapons. “If you think about pandemics in the past,” noted the Princeton economist Esteban Rossi-Hansberg, “they didn’t destroy cities.”

That’s because cities are valuable. The New York metropolitan area generates more economic output than Australia or Spain. The San Francisco region produced nearly one of five patents registered in the United States in 2015. Altogether, 10 cities, home to under a quarter of the country’s population, account for almost half of its patents and a third of its economic production.

So even as the Covid-19 death toll rises in the nation’s most dense urban cores, economists still mostly expect them to bounce back, once there is a vaccine, a treatment or a successful strategy to contain the virus’s spread. “I end up being optimistic,” said the Harvard economist Edward Glaeser. “Because the downside of a nonurban world is so terrible that we are going to spend whatever it takes to prevent that.”

And yet there is a lingering sense that this time might be different.

The pandemic threatens the assets that make America’s most successful cities so dynamic — not only their bars, museums and theaters, but also their dense networks of innovative businesses and highly skilled workers, jumping among employers, bumping into one another, sharing ideas, powering innovation and lifting productivity.

Image
Credit…Ruth Fremson/The New York Times

Compelled by the imperative of social distancing, the cutting-edge businesses that flocked to cities to exploit their bundles of talent have been experimenting with technologies that allow them to replicate their social interactions even if everybody is working from home.

As Mr. Rossi-Hansberg put it, “There’s a little bit of a realization that we can still do things,” even when we all stay home.

Covid-19 is not the deadliest disease to have ravaged cities through the ages. But it is showing us that they might not be as essential as they once were. “Cities are more in danger than in the 19th century even though this plague is less severe,” Mr. Glaeser said, “because we are rich enough to imagine a deurbanized world.”

Mark Zuckerberg, Facebook’s chief executive, has said he wants to reconfigure the company so half of its employees could work from home within the next decade. Twitter has said it will allow employees to work from home indefinitely. Jonathan Dingel and Brent Neiman of the University of Chicago estimate that almost 40 percent of the nation’s jobs can be done from home. If this model catches on, it could reconfigure the geography of America’s tech industries.

A survey by the market research firm Reach Advisors found that companies facing high real estate and labor costs were the most interested in pursuing remote work into the future. “The biggest shift away from density will likely be in markets such as the Bay Area and New York City,” said the company’s president, James Chung. By shifting to remote work, “they can dramatically widen their labor pool and evade the labor-wage trap that they are in.”

Paradoxically, America’s big cities are becoming more valuable, churning out an increasing share of the nation’s economic output.




Metro areas that have gained

innovation jobs

2

4

7

1

9

8

3

6

5

10

Change in jobs,

2005-2017

+75,000

+10,000

+1,000

Gained the most

In thousands

1

San Francisco

+77

6

Raleigh, N.C.

+12

7

Madison, Wis.

+12

2

Seattle

+56

3

Silicon Valley

+52

8

Denver

+10

9

Salt Lake City

+ 8

4

Boston

+26

10

Charleston, S.C.

+ 7

5

San Diego

+20

Metro areas that have gained

innovation jobs

2

4

7

1

9

8

3

6

5

10

Change in jobs,

2005-2017

Gained the most

In thousands

6

Raleigh, N.C.

+12

1

San Francisco

+77

+75,000

7

Madison, Wis.

+12

2

Seattle

+56

3

Silicon Valley

+52

8

Denver

+10

9

Salt Lake City

+ 8

4

Boston

+26

+10,000

5

San Diego

+20

10

Charleston, S.C.

+ 7

+1,000


Note: Data represent the change in jobs from 2005 to 2017 in industries where at least 45 percent of the work force has degrees in science, tech, engineering or math, and where investments in research and development amount to at least $20,000 per worker.

Source: Brookings Institution analysis of Emsi data

By Karl Russell

They have benefited from the rise of economic complexity and the explosive growth of technologies that reward the most highly educated workers. Complex industries like information technology, biotechnology and finance concentrate in large cities where they can find the most skilled employees.

These cutting-edge businesses don’t mind paying top dollar for the talent, not least because — research has found — highly skilled workers tend to be more productive and innovative when they are surrounded by others like them.

Despite the stratospheric rents, which have been pushing low-wage workers out, highly educated workers have continued to flock to the nation’s megalopolises in search of the high pay and urban amenities that have emerged to serve this affluent clientele.




INCOME PER PERSON

In thousands of 2019 dollars

San Francisco

Boston

New York

Seattle

$100

$108

80

$80

$78

$76

60

40

U.S. urban

average

20

0

1969

2018

1969

2018

1969

2018

1969

2018

EDUCATIONAL ATTAINMENT

Share of population holding a bachelor’s degree or higher

San Francisco

Boston

New York

Seattle

2010

43%

43%

36%

37%

2018

51%

49%

41%

44%

U.S. average

INCOME PER PERSON

In thousands of 2019 dollars

San Francisco

Boston

$100

$108

80

$80

60

40

U.S. urban

average

20

0

1969

2018

1969

2018

New York

Seattle

$100

80

$78

$76

60

40

20

0

1969

2018

1969

2018

EDUCATIONAL ATTAINMENT

Share of population holding a bachelor’s degree or higher

San Francisco

Boston

2010

43%

43%

2018

51%

49%

U.S. average

New York

Seattle

2010

36%

37%

2018

41%

44%

U.S. average


Sources: Bureau of Economic Analysis (income); Census Bureau (education)

By Guilbert Gates

From 1980 to 2018, the income per person in New York’s metropolitan area rose from 118 percent of the national average to 141 percent, according to government data. Boston’s rose from 109 to 144 percent, San Francisco’s from 137 to 183 percent, and Seattle’s from 120 to 137 percent.

But if big-city businesses find that work from home doesn’t hit their productivity too hard, they might reassess the need to pay top dollar to keep employees in, say, Seattle or the Bay Area. Workers cooped up in a two-bedroom in Long Island City, Queens, might prefer moving to the suburbs or even farther away, and save on rent.

Mr. Glaeser and colleagues from Harvard and the University of Illinois studied surveys tracking companies that allowed their employees to work from home at least part of the time since March. Over one-half of large businesses and over one-third of small ones didn’t detect any productivity loss. More than one in four reported a productivity increase.

Moreover, the researchers found that about four in 10 companies expect that 40 percent of their employees who switched to remote work during the pandemic will keep doing so after the crisis, at least in part. That’s 16 percent of the work force. Most of these workers are among the more highly educated and well paid.

Will they stay in the city if they don’t need to go to the office more than a couple of times a week? Erik Hurst, an economist at the University of Chicago, argues that people will always seek the kind of social contact that cities provide. But what if their employers stop paying enough to support the urban lifestyle? Young families might flee to the suburbs sooner, especially if a more austere new urban economy can no longer support the ecosystem of restaurants and theaters that made city life attractive.

The overall economy might be less productive, having lost some of the benefits of social connection. But as long as the hit is not too severe, employers might be better off, paying lower wages and saving on office space. And workers might prefer a state of the world with somewhat lower wages and no commute.

Municipal governments in superstar cities might have a tough time doing their job as their tax base shrinks. The survival of brick-and-mortar retailers will be threatened as social distancing accelerates the shift to online shopping.

Smaller cities might benefit. If they don’t have to go into the office more than a couple of times a year, highly skilled workers in places like Seattle or Los Angeles might prefer Boulder or Vail.

“Everybody agrees on what are the key forces,” said Gilles Duranton, an economist at the Wharton School of the University of Pennsylvania. “The question is which will play out, and where are the tipping points?”

Image

Credit…Cayce Clifford for The New York Times

One of the big remaining questions is whether remote work will prove sustainable. The productivity increases captured in the surveys examined by Mr. Glaeser’s team might prove fleeting.

“In the more likely state of the world, we realize that we can carry on a project remotely for one or two days but ultimately we do need face-to-face interaction,” said Enrico Moretti, an expert in urban economics at the University of California, Berkeley. Remote education has proved inferior. In the long run, people may still need to live close to where they work.

And yet, technology continues to improve. “There are more incentives to invest in more technologies to stay at home,” Mr. Rossi-Hansberg said.

So what would the post-Covid city look like?

Mr. Rossi-Hansberg suggests that a reconfigured urban America could look a bit more like the 1980s, before technology set in motion the forces that produced the present-day superstars, leaving other places behind. “This would flatten the distribution of cities and reduce the occupational polarization of cities,” he said.

It would be a different world. But it might not be too terrible for urban living.

Consider life in a reconfigured New York City. Rents are lower, after the departure of many of its bankers and lawyers. There are fewer fancy restaurants, but probably still many cheaper ones. People with lower incomes, including the young, can again afford to live in town. City services may be reduced, but if a fifth or more of workers aren’t going to the office on any given day it will be easier to get around.

Mr. Duranton argues that the cities that will be devastated by Covid-19 are the ones that have been falling for a long time: the Rochesters and the Binghamtons, which lost their sustenance once the manufacturing industries that supported them through much of the 20th century folded or moved away.

But for a city like New York, he said, Covid-19 offers an opportunity for redemption. “New York was running into a dead end, turning into a paradise for the rich,” he said. “Culturally dead.” Moving back to a cheaper, messier, more diverse equilibrium may carry a silver lining.

Posted on

The dual PhD problem of today’s startups

One of the upsides of this job is that you get to see everything going on out there in the startup world. One of the downsides of this job is seeing just how many ideas out there aren’t all that original.

Every week in my inbox, there is another no-code startup. Another fintech play for payments and credit cards and personal finance. Another remote work or online events startup. Another cannabis startup, another cryptocurrency, another analytics tool for some other function in the workplace (janitor productivity as a service!)

It honestly feels at times like we are stuck: it’s the same rehashes of old software, but theoretically “better” (yes it is a note-taking app, but it runs on Kubernetes!). In fact, that feeling of repetitiveness and the glacial pace of true innovation isn’t just in my head or maybe yours: it’s also been identified by scientists and researchers and remains a key area of debate in the economics of innovation field.

Of course, there are a bunch of new horizons out there. Synthetic biology and personalized medicine. Satellites and spacetech. Cryptocurrencies and finance. Autonomous vehicles and urbantech. Open semiconductor platforms and the future of silicon. In fact, there are so many open vistas that it surprises me that every entrepreneur and investor isn’t running to claim these new territories ripe for creativity and ultimately, profit.

It’s a quandary at least until you begin to understand the entrance requirements for these frontier fields.

We’ve gone through the generation of startups you can do as a dropout from high school or college, hacking a social network out of PHP scripts or assembling a computer out of parts at a local homebrew club. We’ve also gone through the startups that required a PhD in electrical engineering, or biology, or any of the other science and engineering fields that are the wellspring for innovation.

Now, we are approaching a new barrier — ideas that require not just extreme depth in one field, but depth in two or sometimes even more fields simultaneously.

Take synethtic biology and the future of pharmaceuticals. There is a popular and now well-funded thesis on crossing machine learning and biology/medicine together to create the next generation of pharma and clinical treatment. The datasets are there, the patients are ready to buy, and the old ways of discovering new candidates to treat diseases look positively ancient against a more deliberate and automated approach afforded by modern algorithms.

Moving the needle even slightly here though requires enormous knowledge of two very hard and disparate fields. AI and bio are domains that get extremely complex extremely fast, and also where researchers and founders quickly reach the frontiers of knowledge. These aren’t “solved” fields by any stretch of the imagination, and it isn’t uncommon to quickly reach a “No one really knows” answer to a question.

It’s what you might call the dual PhD problem of today’s startups. To be clear, this isn’t about credentials — it’s not about the sheepskin at the end of the grad program. It’s about the knowledge represented by that diploma and how you need two whole rounds of it in order to synthesize the next generation of solutions.

Now, before you start yelling, let’s talk about teams. There is a reasonable argument that teams with the right specializations can come together and solve these problems. You don’t need a single founder with experience in bio and AI or cryptography and economics or computer vision and mobility hardware — you just need to bring the right talents together in the room to make innovation happen.

There is certainty truth in that, and indeed, that’s the impetus for many of the companies we are seeing today in these fields.

But that also feels like precisely the block today for pushing innovation even farther forward. Today’s startups have a biologist talking about wet labs on one side and an AI specialist waxing on about GPT-3 on the other, or a cryptography expert negotiating their point of view with a securities attorney. There is constant and serious translation required between these domains, translation that (I would argue mostly) prevents the fusion these fields need in order for new startups to be built.

Perhaps there is no greater and more obvious example of these domain requirements than the response to COVID-19. Epidemiology and public health are quite possibly the two most difficult fields out there in terms of the number of specializations required simultaneously to do them well. You need to know medicine and human physiology to understand the etiology of diseases, have the social science background to understand how humans interact individually and in groups, understand the economic and public policy implications of different prophylactics to comprehend the trade-offs involved, and finally, master the statistical training to read, understand, and build correct data models.

All this, and all at the same time. Is it any wonder that so little consensus emerges when so few people have all the requisite skills in their head?

The reason that teams run into resistance is that each specialist needs to understand the constraints that all the other specialties have, while also having enough nuance to understand what is really a barrier and what is perhaps a rule that can be broken. You can’t have a non-technical PM manage an AI product (“Can’t we just use TensorFlow for that?”) anymore than you can have these companies built by incompatible experts, always trying to explain to the other why an idea isn’t fathomable.

We aren’t used to this sort of cognitive challenge. Software is so democratized today, we forget just how blisteringly difficult almost all other facets of human endeavor are to even start. A middle schooler can build and deploy a web service scalable to millions of people with some lines of code (learned from easily and widely accessible resources on the internet) and some basic cloud infrastructure tools that are designed to onboard new users expeditiously.

Try that with rocketry. Or with pharma. Or with autonomous vehicles. Or any of the interesting new frontiers with green fields that are just sitting there waiting for the taking.

So to propel the progress of the world further, we need to fuse more fields together and compress the requisite knowledge faster and earlier for more people. We can’t wait until 25 years of school is complete and people graduate haggard at 40 before they can take a shot at some of these fascinating intersections. We need to build slipstreams to these lacuna where innovation hasn’t yet reached.

Otherwise, we are going to see the same pattern in the future that we see today: the thirtieth app for X with no barrier to entry whatsoever. That’s not where progress comes.

Read More

Posted on

Free Market Politics Part 2: Can We Fix America’s Political System?

July 02, 2020

The two-party system has been an entrenched feature of the U.S. electoral system since its inception. Is change even possible?

In the second episode of this special two-part discussion, business leader Katherine Gehl and Harvard Business School professor Michael Porter discuss innovative reforms, like ranked-choice voting, that promote competition and accountability.

Later in the show, we talk with attorney and author Jeff Clements, of American Promise, about his efforts to reform campaign finance laws.

Want to explore more of the world of FOMO Sapiens? Follow Patrick McGinnis: FacebookLinkedInInstagramTwitter. Download the free FOMO Sapiens Handbook and more at www.patrickmcginnis.com.

HBR Presents is a network of podcasts curated by HBR editors, bringing you the best business ideas from the leading minds in management. The views and opinions expressed are solely those of the authors and do not necessarily reflect the official policy or position of Harvard Business Review or its affiliates.

Read More

Posted on

How to Make Remote Monitoring Tech Part of Everyday Health Care

Executive Summary

Remote patient monitoring is a subset of telehealth that involves the collection, transmission, evaluation, and communication of patient health data from electronic devices. These devices include wearable sensors, implanted equipment, and handheld instruments. During the pandemic, such monitoring programs have proven valuable. But special measures and conditions made that possible. By encouraging regulators to make permanent the temporary measures introduced during the pandemic and by following six guidelines to integrate these programs into health care, providers realize their tremendous promise.

Yagi Studio/Getty Images

By making the collection of valuable patient data feasible outside of the clinic, remote monitoring can facilitate care for conditions ranging from chronic diseases to recovery from acute episodes of care. For years, it has been touted as one of the most promising opportunities for health care in the digital age. But the pandemic has underscored its value. Indeed, policy changes introduced during the pandemic due to the riskiness of in-person patient visits have created conditions ripe for its adoption. We urge regulators to extend these changes beyond the pandemic and for health care leaders to take advantage of this window of opportunity to develop, test, and improve remote-patient-monitoring programs.

What is remote patient monitoring? While “telehealth” broadly refers to all health care activities that are conducted through telecommunications technology, remote patient monitoring is a subset that involves the collection, transmission, evaluation, and communication of patient health data from electronic devices. These devices include wearable sensors, implanted equipment, and handheld instruments.

We define remote patient monitoring as the set of activities that meet four key criteria: (1) data on patients is collected remotely (e.g., in a home setting without oversight from a health care provider); (2) the data collected is transmitted to a health care provider in a different location; (3) the data is evaluated and care providers are notified, as needed; and (4) care providers communicate relevant data-driven insights and interventions to patients.

Remote Monitoring During the Pandemic

By making it possible to virtually perform medical activities that have traditionally been conducted in person, remote monitoring technologies have played a significant role in patient care during the Covid-19 pandemic. For example, providers such as Mount Sinai Health System in New York City, University Hospitals in Cleveland, Ohio, St. Luke’s University Health Network in Bethlehem, Pennsylvania, and Providence St. Joseph Health in Renton, Washington, started programs during the Covid-19 pandemic in order to monitor vital sign and symptom data and assess the status of coronavirus patients. Other hospitals, such as Mayo Clinic in Rochester, Minnesota, are working to set up remote patient monitoring programs for non-Covid-19 patients (e.g., as those with congestive heart failure).

New policies have recognized the importance of remote patient monitoring in this context. The U.S. Centers for Medicare and Medicaid Services expanded Medicare coverage for remote patient monitoring to include patients with acute conditions and new patients as well as existing patients. Moreover, the U.S. Food and Drug Administration issued a new policy allowing certain devices (FDA-approved non-invasive devices used to monitor vital signs) to be used in remote settings. Nonetheless, these changes remain temporary: They have only been authorized for the duration of the Covid-19 public health emergency. We hope that additional policies will be enacted to ensure that these programs can serve a variety of patients and conditions beyond the context of Covid-19.

Guidelines for Development and Implementation

These guidelines are drawn from our own experience managing remote-patient-monitoring programs, including one created specifically to care for Covid-19 patients, and research on the drivers of clinical success of established programs.

The technology must be easy for both patients and clinicians to adopt and continue using. It is essential to provide both patients and clinicians with intuitive equipment and user interfaces as well as resources for trouble-shooting when needed. Clinicians should be able to easily explain the equipment to patients, and it should be easy for patients to set up and use. The patient data generated by remote monitoring should also be simple to monitor and analyze.

This need is illustrated by a trial that studied remote monitoring of patients with congestive heart failure. In this trial, study physicians could not collect data for 12 out of 66 enrolled patients because these patients were unable to properly operate the mobile-phone-based monitoring device to begin data transmission.

The tools should be incorporated into clinician workflows. Given the high burden of administrative work that clinicians already face, it is imperative to introduce remote tools that blend seamlessly into their work processes. In some cases, this may require redesigning processes in order to ensure that remote monitoring is appropriately integrated into an organization’s practices.

For example, the administrators of a diabetes management program established at Massachusetts General Hospital found that they needed to modify the existing workflow for managing patients with diabetes in order to readily identify which patients required laboratory testing. Subsequently, the program built an application that remotely monitored diabetic patients and helped coordinate responsibilities for following up with patients about laboratory testing. This redesigned workflow improved efficiency by making it easier for nurse managers to remind patients about laboratory testing.

Sources of sustainable funding must be identified and tapped. This is especially critical at a time when hospitals are struggling financially due to the huge amount of revenue they have lost from pandemic-related cancellations and delays in performing surgeries and imaging.

Reimbursement for remote-patient-monitoring programs is challenging to navigate given that individual activities eligible for reimbursement — such as device set-up, patient education, interpretation of data, and follow-up patient conversations — are reimbursed separately. Nonetheless, reimbursement for such programs has improved with the advent of risk-based models of reimbursement such as Medicare Advantage plans and accountable care organizations, which offer providers increased flexibility in allocating capital to remote monitoring programs.

Many remote-patient-monitoring programs may have to rely on other sources of funding besides reimbursement, especially to fulfill upfront capital needs. In some instances, these sources of funding may be from the provider system’s operating budget. Internal innovation grants also may support programs. For instance, a diabetes remote monitoring program at Su Clinica Familiar, a federally qualified health center, was funded through a grant by the University of Texas System. Regardless of the nature of funding, we believe it is essential to identify a committed source of capital before establishing a remote-patient-monitoring program.

Dedicate sufficient non-physician staff to operate the program. A key reason this is necessary is that busy physicians will have difficulty carving out additional time to administer a program and sift through data. For example, Ochsner Medical Center in New Orleans developed a digital hypertension program staffed by pharmacists, who monitored 6,000 high-risk patients’ blood pressure readings remotely and followed up with patients via text and email. This program resulted in a significant increase in the proportion of patients who met their blood pressure goals.

As demonstrated by this example, it’s critical that staff in these roles are matched with the nature of the work. For instance, the complex tasks involved in hypertension-medication management might require a pharmacist or nurse as opposed to a patient navigator without clinical expertise.

Focus on digital health equity. Patients may appear to be better candidates for remote monitoring if they are younger, technologically savvy, or are fluent English-speakers. However, access to technology may be limited by poverty, and numerous other socio-demographic factors may influence engagement and participation in remote monitoring programs. At a time when the Covid-19 pandemic has disproportionately affected minority populations, care providers should go the extra mile to ensure that underserved patients not only have access to programs, but are also provided education and support needed to make them successful .

Start with an initial pilot and expand after demonstrated successes. Even in a pandemic setting in which time is of the essence, it is essential to demonstrate that remote patient monitoring initiatives improve clinical outcomes. Not all programs have demonstrated success, so the use of pilots can help avoid expensive mistakes. One successful program that scaled gradually is the Hospital of the University of Pennsylvania’s remote postpartum hypertension monitoring program. This program expanded from a small pilot to a larger clinical trial to the entire academic medical center based on evidence that it decreased admissions and costs associated with postpartum hypertension.

Covid-19 has created an opportunity to accelerate the adoption of remote patient monitoring as our health care system struggles to care for patients outside of the physical walls of a clinic or hospital. We encourage leaders to act decisively in establishing new programs by following best-in-class examples and guidelines. We believe that leaders who do so will spur a paradigm shift in how patient care is delivered that lasts far beyond the current crisis.

Read More

Posted on

Turn Your Covid-19 Solution into a Viable Business

Executive Summary

Many entrepreneurs have seized this moment as an opportunity to launch a social enterprise — businesses that have a dual mission of social impact and financial growth. But how can these entrepreneurs ensure that their short-term innovations can last as viable, long-term businesses? The author, a founder of a mission-driven company and a professor of social enterprise and global health at Emory University, offers four steps forward.

Scott Olsen/Getty Images

We’ve made our coronavirus coverage free for all readers. To get all of HBR’s content delivered to your inbox, sign up for the Daily Alert newsletter.

As the challenges associated with the coronavirus pandemic mount, there is no shortage of innovative entrepreneurs who have stepped up to help. During March and April 2020 alone, virtual Covid-19-innovation competitions (aka hackathons) drew in tens of thousands of participants from 175 countries.

Further Reading

From the Atlanta high school student who started an organization delivering free meals to front line hospital workers, to a group of Colombian engineers building low-cost ventilators from scratch, innovators worldwide are creating novel solutions to the problems caused by the pandemic. And many are looking to turn their Covid-19 inspired innovations into sustainable businesses that will continue on past the immediate crisis.

As an entrepreneur who co-founded, built, and sold a mission-driven company, and a professor of social enterprise and global health at Emory University, I’d suggest that today’s Covid-19-inspired innovators take four key steps if they want to turn that project into a viable business for the long term.

1. Determine whether your innovation is addressing a long-term problem.

The best innovations are created in response to specific, urgent, and sizeable problems. In some ways, the Covid-19 crisis has made our most urgent problems and their potential solutions more obvious. For example: Health care providers needed masks; production facilities were idle; workers were furloughed and needed jobs. A social enterprise could address all three of these urgent problems simultaneously: Train workers to make masks in underused production facilities for health care providers.

But will this cluster of problems still need your solution three to five years from now?

Some coronavirus-inspired entrepreneurs are building on existing trends that have been amplified and accelerated by the pandemic, such as the explosive growth in telehealth, remote patient monitoring and the use of AI in health care. One MIT Covid-19 Challenge winner, for example, built a model to track the national distribution of critical medical supplies for hospitals in highest need. The efficient distribution of healthcare supplies is obviously an urgent problem today, but even beyond the current crisis, will be of value to healthcare systems that need to reduce waste and lower costs. On the other hand, some Covid-19 inspired organizations have been established in response to problems that are urgent and important today but are unlikely to be as critical once circumstances change. Free meal delivery services that were started to help health care workers may fall into this second category.

In order to determine whether your new product or service is addressing a long-term or short-term problem, I recommend that entrepreneurs start by looking to the past. Construct a market-opportunity analysis using data from 2019 and earlier. Was the problem you are addressing now a problem then? And, if so, how big was it? Next, list what specifically changed with the emergence of Covid-19 that created or amplified this problem and the need for your innovation.

For example, the need to care for patients from a distance, a problem solved by telehealth and remote-patient monitoring, certainly existed prior 2020. What changed with Covid-19 were the widespread stay-at-home orders, more widely available video and home-based technologies and, in the case of telehealth, changes in regulations and reimbursement, which, together, have led to a tremendous demand for these services.

2. Identify your long-term market.

The next step is projecting whether there will be a large, passionate market for your product or service in a post-Covid future. Research conducted by CB Insights prior to the pandemic found that a lack of market demand was the most common reason for failed startups’ demise, with 42% of companies citing it as a contributing cause.

I came close to becoming a member of the “failed-startup-founder club” myself 20 years ago when I relinquished tenure at a top university to co-found an early digital health company. Our mission was to build an online health resource for Latin America. Soon after we incorporated, however, we realized that there were only a couple million Spanish-speaking consumers online at the time — a market too small to build a viable business around. On top of that, we made another mistake common to rookie entrepreneurs: We were too focused on the technology, and not enough on the customer.

User-centered design has taught us that a key to building a lasting business is having a deep understanding of who your customers are and how your product or service fits into their world.

As a Covid-19 inspired entrepreneur, ask yourself two questions: Are you delivering an innovation that your customers are passionate about? And will there be a large enough number of these passionate customers to grow a business once coronavirus is under control?

3. Proactively pivot, if you need to.

If you determine that your current target market may not be large enough in a post-Covid future, you may need to pivot, like we did.

For the first five years of our company, we kept the lights on by selling translation and marketing services to U.S. hospital systems that served Hispanic patients, buying ourselves time until the market of Spanish-speakers passionate about health information eventually grew to half a billion people.

If it’s your turn for a strategic pivot, do whatever you can to pivot early, proactively, and thoughtfully. There are ample stories in the media these days of startups that are pivoting — but are doing so reactively in a frantic scramble for survival.

4. Map your business model.

Many of today’s Covid-19 inspired innovations are being given away for free, or are supported by donations, as is appropriate during an emergency. The leaders of these startups should be aware that contributions to non-profit organizations that are not Covid-19 centric are way down. Maintaining a donation-exclusive organization over the long-run in the face of today’s economic circumstances will likely be difficult.

Covid-19 inspired innovators should consider revenue models native to the field of social entrepreneurship. Social enterprises have a dual mission of social impact and financial growth and have developed an array of business models to achieve these parallel goals. For example, a Covid-19 inspired innovator in the U.K. is using the “buy one, give one” sales model to distribute the newly invented “hygienehook.”

Today’s entrepreneurs who are working on mapping their business model should also look to the past, when other economic disruptions similarly forced many companies to rethink their businesses. During the “great recession” of 2008, for example, Mark Johnson, Clayton Christensen, and Henning Kagermann presented a framework for reinventing your business model that is as relevant today as it was then. I suggest today’s entrepreneurs use this framework to define their company’s customer value proposition (CVP), profit formula, and the key resources and processes needed to deliver the offering as they navigate a future that is likely to demand novel solutions for some time to come.

The Covid-19 pandemic has clearly confirmed the maxim that crisis breeds innovation and opportunity. We have been reminded that WWII yielded the first programmable digital computers as well as unexpected discoveries like super glue.
It is unclear at this time which of the tens of thousands of Covid-19 inspired entrepreneurs are creating products and services that will succeed in the long-term, but by going through these steps, more of today’s innovations will be the ones that people are using years and decades from now.

If our free content helps you to contend with these challenges, please consider subscribing to HBR. A subscription purchase is the best way to support the creation of these resources.

Read More

Posted on

How One Boston Hospital Built a Covid-19 Forecasting System

Executive Summary

Faced with the Covid-19 pandemic, the healthcare delivery infrastructure in much of the United States has faced the equivalent of an impending hurricane but without a national weather service to warn us where and when it will hit, and how hard. To build a forecasting model that works at the local level, the Beth Israel Deaconess Medical Center relied on an embedded research group, the Center for Healthcare Delivery Science, that reports to the CMO and is dedicated to applying rigorous research methods to study healthcare delivery questions

Andriy Onufriyenko/Getty Images

We’ve made our coronavirus coverage free for all readers. To get all of HBR’s content delivered to your inbox, sign up for the Daily Alert newsletter.

The Covid-19 pandemic created an unprecedented strain on healthcare systems across the globe. Beyond the clinical, financial, and emotional impact of this crisis, the logistical implications have been daunting, with crippled supply chains, diminished capacity for elective procedures and outpatient care, and a vulnerable labor force. Among the most challenging aspects of the pandemic has been predicting its spread. The healthcare delivery infrastructure in much of the United States has faced the equivalent of an impending hurricane but without a national weather service to warn us where and when it will hit, and how hard.

To build a forecasting model that works at the local level – within a hospital’s service area, for example — the Beth Israel Deaconess Medical Center (BIDMC), relied on an embedded research group, the Center for Healthcare Delivery Science, that reports to the CMO and is dedicated to applying rigorous research methods to study healthcare delivery questions. We used a series of methods derived from epidemiology, machine learning, and causal inference, to take a locally focused approach to predicting the timing and magnitude of Covid-19 clinical demands for our hospital. This forecasting serves as an example of a new opportunity in healthcare operations that is particularly useful in times of extreme uncertainty.

Insight Center

In early February, as the U.S. was grappling with the rapid spread of SARS-COV-2, the virus that causes Covid-19, the healthcare community in Boston began to brace for the months ahead. Later that month, participants in a biotechnology conference and other residents returning from overseas travel were diagnosed with the new disease.

It was the start of a public health emergency. To understand how to respond, our hospital needed a Covid-warning system, just as coastal towns need hurricane warning systems. Our hospital is an academic medical center with over 670 licensed beds, of which 77 are intensive care beds. We knew it was hurricane season, but when would the storm arrive, and how hard would it hit? We were uncertain about what lay ahead.

Hurricane season — but where is the storm?

Lesson 1: National forecasting models broke down when predicting hospital capacity for Covid-19 patients because no local variables were included.

Our institution turned first to national models. The most widely used national model applied curve-fitting methods (which draw a best-fit curve on a series of data points) on earlier Covid-19 data from other countries to predict future developments in the United States. National models did not consider local hospital decision-making or local-level socioeconomic factors which dramatically impact key variables like population density, pre-existing health status, and reliance on public transportation. For example, social media data showed many student-dense neighborhoods in Boston emptying after colleges canceled in-person classes at the beginning of March, which meant fewer people were in Boston to contract the virus. Another critical variable in hospital capacity forecasting, the rate of hospitalization for people with Covid-19, varied as the weeks went on, even though national models held this variable constant. For example, early on our hospital was choosing to admit rather than send home many SARS-COV-2 positive patients, even with mild infections, because the clinical trajectory of the disease was so uncertain. Thus we needed a dynamic hyper-local model.

Building our storm alert system

Lesson 2: Local infection modeling required a range of different research methods, and the trust and commitment of operational leaders who recognized the value of the work.

The hospital turned to our research center to achieve these goals. The center, which is embedded in the hospital and reports to the Chief Medical Officer (Dr. Weiss), brought applied machine learning and epidemiological approaches to construct a hyper-local alert system.

Further Reading

To demonstrate the feasibility of forecasting local hospital-capacity needs for managing Covid-19 patients, we built a preliminary SIR model (a traditional epidemiological framework that models the number of Susceptible, Infected and Recovered people in a population), which was integrated into our institution’s incident command structure, an ad hoc team created with members of the hospital and disaster management leadership to respond to the pandemic. However, the accuracy of SIR models depends on the accuracy of estimates of disease characteristics such as incubation time, infectious period, and transmissibility, variables that are still not well understood. Therefore, we turned to machine learning approaches, harnessing real-time data from our electronic medical record to determine these variables directly from real patients. We also gathered Covid-patient census data from multiple hospitals simultaneously, using a common machine-learning technique called multi-task learning to capitalize on limited data. These methods allowed us to estimate when the demand for hospital capacity to treat Covid-19 patients would peak and plateau — predicting the timing to within five days of the true peak and more accurately modeling the slope of the peak and decline than national models did.

Had leadership relied on national models, they would have expected a sharper peak and decline, and a peak two weeks earlier than the actual peak. Our modeling affected key decisions, including the need to bolster personal protective equipment (PPE) supplies; to gauge the necessity of even urgent procedures, and postpone them if necessary in order assure we had the capacity to absorb the peak; and to establish staffing schedules that continued farther into the future than those originally planned.

Predicting the next hurricane

Lesson 3: Effective modeling in confusing times may require rapidly developing new methods for predicting the next storm.  

Hospitals now face a difficult challenge. We need to open our doors to the patients without Covid-19 who didn’t seek care or whose care was deferred. But how do we make sure to have enough protective equipment for safely bringing back outpatient procedures? And when can nurses who had been redeployed to our ICUs return to the floors and interventional areas such as the endoscopy suite and cardiac catheterization lab? Complicating these questions is whether we will see another rise in infections with changes in state-wide policies, reopening of schools and businesses, or a coming influenza season.

In this new phase, we now need to develop methods for understanding how people will move within a community (going to school and visiting stores, for instance) and how much they will interact with one another and, therefore, affect the risk of infection over time. To this end, we constructed a risk index for local businesses by comparing pre-pandemic traffic to traffic as they reopen, and whether they are indoors or partly or entirely outdoors. Businesses where visitors are densely packed in indoor spaces, especially for longer periods, have a higher risk index — meaning they are more likely to be the site of infection spread. Using our risk index, we created and validated a model for identifying such potential “super-spreader” businesses in our service area. This analysis is part of another body of research that will undergo peer review and publication and, therefore, its results are provisional. Meanwhile, we can use our work with businesses to further inform our forecasting model by examining traffic in business locations we have identified as high-risk and assessing whether incorporating these data improves the ability of our model to predict the demand on hospital capacity.

Integrating rigorous research methods into hospital operations

Lesson 4: Given the profound future uncertainty in healthcare, small investments in trusted internal research groups that can answer operational questions with new methods can yield substantial returns.

Our institution made a prescient investment in creating an embedded and trusted research group made up of clinicians, economists, and epidemiologists studying healthcare operations. The team has brought specialized machine learning methods and expertise in extracting conclusions from messy data to quickly and accurately solve emerging real-world problems — capabilities that traditional business analytics groups are less likely to have. Other organizations can similarly unite the rigor and flexibility of methodological experts with the need to rapidly answer operational questions in dynamic and even chaotic environments.

The authors would like to thank Manu Tandon, Venkat Jegadeesan, Lawrence Markson, Tenzin Dechen, Karla Pollick and Joseph Wright for their valuable contributions to this work. 

If our free content helps you to contend with these challenges, please consider subscribing to HBR. A subscription purchase is the best way to support the creation of these resources.

Read More

Posted on

‘Taking Action Earlier’ Could Have Delayed U.S. Outbreak, Says CDC’s No. 2 Official

TOPLINE

The U.S. government and its top health agency missed several opportunities to slow the spread of the coronavirus, the No. 2 official at the Centers for Disease Control and Prevention told the Associated Press Friday—a more critical evaluation than what has come from the White House.

KEY FACTS

Limited testing and delayed travel alerts for areas like Europe led to a sharp rise in coronavirus cases across the country starting in late February, Dr. Anne Schuchat, the principal deputy director of the CDC, said Friday.

In a report published by the CDC, she analyzed the U.S. response to the outbreak, concluding that action was not taken quickly enough and several opportunities were missed to curb the spread of the pandemic.

“We clearly didn’t recognize the full importations that were happening,” Schuchat told the AP, adding, “I think the timing of our travel alerts should have been earlier.”

While the Trump administration imposed travel restrictions on anyone who had traveled to China starting in early February, it didn’t block travel from Europe until March 11.

Nearly 2 million travelers arrived in the U.S. from Italy and other European countries that were having outbreaks during February, Schuchat notes in her article.

Delaying travel bans allowed for the virus to spread throughout the U.S. and “contributed to the initiation and acceleration of domestic COVID-19 cases in March,” her report found.

Crucial quote

“I think in retrospect, taking action earlier could have delayed further amplification [of the U.S. outbreak], or delayed the speed of it,” Schuchat said in an interview. “The extensive travel from Europe, once Europe was having outbreaks, really accelerated our importations and the rapid spread.”

Tangent

“This report seems to challenge the idea that the China travel ban in late January was instrumental in changing the trajectory of this pandemic in the United States,” Jason Schwartz, an assistant professor of health policy at the Yale School of Public Health, told the AP. He noted that while the article is carefully worded, it marks a departure from that White House narrative.

Big number: Over 1.1. Million

That’s how many Americans have contracted coronavirus so far, with over 65,000 deaths. The United States is the hardest-hit nation from the pandemic, with about a third of the world’s reported cases and more than a quarter of the deaths.

Further reading

Public Health Response to the Initiation and Spread of Pandemic COVID-19 in the United States, February 24–April 21, 2020 (CDC)

Most World Leaders See Approval Ratings Surge Amid Coronavirus. Not Trump. (Forbes)

Report: CDC Director Warns A Second Coronavirus Wave Would Be ‘Even More Difficult’ (Forbes)

Reopening States Before June Would Save Millions Of Jobs But Result In Hundreds Of Thousands More Coronavirus Deaths: Report (Forbes)

Full coverage and live updates on the Coronavirus

Read More

Posted on

European Founders “seizing The Day” Amidst Crisis

A surprising number of both founders and VCs are taking the (possibly apocryphal) advice of Winston Churchill to “never let a good crisis go to waste.” In their recent weekly VC and entrepreneur sentiment surveys, Chausson Finance has produced some timely insights into how investors and founders are behaving and a weekly sentiment gauge.

A full two thirds of European founders are seeing the crisis as an opportunity, with a whopping peak of 85% of founders surveyed in the UK saying the adoption of digital tools is a driver for their business. A surprising 44% are also still growth focused, with the rest pulling back into cash preservation mode. A healthy 42% of the companies say they may take advantage of state support when it comes to subsequent funding but a majority still think they can rely upon VC backers to fill the coffers

While founders are optimistic about opportunity and financing potential they still face headwinds as investors slow their pace of investments. The survey shows while investors are generally optimistic their capacity for deals is slowed by the inability to travel and meet founders in person.

A striking percentage of European VCs, 70%, think the recovery will follow a ‘U’ shaped curve but still has yet to bottom out. This means only half of funds really are operating at their usual capacity, as many still do have fires to fight among existing portfolio companies and are otherwise slowing their new investment pace assuming a market bottom is still yet to come. Further, given that at least one-third of investors say they are not comfortable making investments remotely, the other two-thirds are likely to limit their investments mainly to founders they’ve previously known or previously worked with in earlier investments.

Founders, especially those without existing venture financing or previous relationships, will see some of their optimism dampened when it comes time for them to seek that financing. First time founders especially will struggle to build these relationships when they can only do Zoom meetings for the indefinite future. The consensus amongst surveyed investors was that it would be 14-19 months until business was “back to usual” so founders should heavily consider that timing in their own fundraising plans. Even when isolation restrictions are lifted many VCs will still choose to limit their time in the office and prefer virtual meetings, so it could be a substantial wait before these founder relationships can be fully developed enough to drive investment decisions.

Read More

Posted on

Coronavirus Pushes Aviation Industry in New Directions

This article is part of our continuing Fast Forward series, which examines technological, economic, social and cultural shifts that happen as businesses evolve.

The coronavirus outbreak has upended commercial aviation, with consequences that are not fully realized. The airline trade group, International Air Transport Association, anticipates that the world’s air carriers will see this year’s revenues drop by more than half, and a number of industry watchers predict that it will be years before air travel returns to 2019 levels.

The crisis has created both hurdles and opportunities for entrepreneurs offering new products or services.

“Timing is often out of our control, but our ability to be nimble and keep pivoting, that is essential,” said Marie Forleo, the owner of an online business training program and the author of the book “Everything Is Figureoutable.”

Sometimes even that is not enough, as Heather Howley, the owner of Independent Helicopters, is learning. Her charter air service was thriving for nearly a dozen years, providing aerial inspection and mapping services in New Windsor, N.Y., a rapidly developing area about 60 miles north of New York City. But when drones started making inroads into that business several years ago, Ms. Howley looked elsewhere to keep her company aloft.

“We fill in in situations where a drone can’t go,” said Ms. Howley, the business’s chief pilot. “We do football games, baseball games.” At the same time, she increased her focus on flight training and offered the ground portion of it online. But with large events canceled and flight schools deemed nonessential, the coronavirus pandemic threatens Ms. Howley’s business in spite of her flexibility.

At the end of March, Ms. Howley was worried about how she would survive if the economy shut down for more than a month and projected that even after business resumes, it would be slow.

“We may see another drop in students even after we get back to work,” she said. “We’re still supporting the utility company, but they’re not paying us at the moment since none of their staff is in the office to cut the checks. It’s a vicious cycle.”

The opposite has happened to Arthur Kreitenberg, a physician and inventor, and his son Elliot. In 2013, the duo bet that airlines would be eager to buy a product that disinfects planes. After the Ebola virus outbreak in 2014, Virgin America (now part of Alaska Airlines) gave the Kreitenbergs access to its airliners so they could create the GermFalcon, a device that kills germs in airplane cabins using ultraviolet light.

“Airlines play a direct role in the way disease is spread around the world,” the younger Mr. Kreitenberg said, a claim supported by a 2015 U.S. National Security Strategy that cited the growth in intercontinental air travel as a factor in the global spread of dangerous pathogens.

But the Kreitenbergs misjudged the market; no airlines were interested. Instead, they turned their attention to disinfecting hospitals.

“People dismissed us as Chicken Little, but in the last couple of months there’s been a change of heart” in the aviation industry, the younger Mr. Kreitenberg said.

An entrepreneur can turn a crisis to an advantage by “focusing first what you can give and not what you can get,” Ms. Forleo said. In early March, Mr. Kreitenberg offered the free use of GermFalcon and a similar device for airports to help the air travel industry with the pandemic. Mr. Kreitenberg said he was in touch with nearly every U.S. airline. Seattle’s secondary airport at Paine Field is now a customer and an investor. Alaska Airlines evaluated the device but opted to use a different kind of disinfection technique, a spokeswoman said in late April.

Aviation, with its emphasis on safety, can be a challenging environment for new ideas.

“Regulations have taken risk-taking away, and not even swashbuckling risk, but even a way of looking at the future as something you can construct,” said Saras Sarasvathy, a professor at the University of Virginia Darden School of Business. As a result, many beneficial innovations may never be realized, Professor Sarasvathy said.

Luke Miles, co-founder and creative director of the London-based industrial design firm New Territory, came up with a novel idea for how to make airplane seats more comfortable. But he recognized that having to get government approval for an entirely new seat design would be an expensive and time-consuming problem, so he found a workaround. Last fall, he unveiled Interspace, a set of panels embedded in the upholstery of seat backs that already meet government regulations. During flight, a traveler can unfold the panels, lean into them and sleep.

“Sometimes, it is not about grand moves and everything has to change,” Mr. Miles said. “Here’s where we could enter carefully in a considered way and have more success.”

Mr. Miles, whose company has done design work for Airbus, Aeromexico and Virgin Atlantic, said his experience and connections with airlines contributed to the final product. This collaboration with potential customers is critical.

In his book “Upstream: The Quest to Solve Problems Before They Happen,” the author Dan Heath calls this “surrounding a problem.”

“When you have a complex problem, there is usually no one person or entity who has all the answers,” he said in an interview. “You have a situation where people only see a facet of the problem, and it’s only by assembling the different facets you can come to appreciate the whole and solve for the whole.”

But the Kreitenbergs had no experience in aviation and few contacts, only Elliot Kreitenberg’s evangelism for his father’s invention.

“All we could do was say, ‘We’re using this technology that works in hospitals, and we built it so it fits on an airplane,’” he said.

Stan Malicki, a Polish businessman, faced a similar problem generating buzz for his invention, a system that moves airplanes on an electric track, instead of using engine thrust. The company, Aircraft Towing Systems, claimed U.S. carriers could save millions of gallons of fuel each year while reducing their carbon emissions. But on its own, the company couldn’t get traction until the State of Oklahoma got involved.

“Thrust is a terrible way to move airplanes. It’s great in the air, but terrible on the ground,” said Vince Howie, who saw the idea’s value and could do something about it as director of aerospace and defense with the Oklahoma Department of Commerce.

Mr. Howie persuaded Mr. Malicki to move from Europe to Oklahoma, joining the state’s substantial aviation network, which includes two of the world’s largest aircraft maintenance stations, Tinker Air Force Base and American Airlines. A.T.S. contracted with Oklahoma State University to help develop the prototype, and Mr. Howie became the chief executive at the end of last year.

“It is a collaboration of 10 people with different ideas, and of course everybody we talk to, I always want to hear the negatives,” Mr. Howie said. “I want to hear the negatives so we can put a mitigation or design changes as needed.”

Because good ideas do not thrive on their own, Professor Sarasvathy said, entrepreneurs should remain open to the ideas of their potential customers and investors.

Ideas are the products the Florida-based aviation consultant Tricia Fantinato was selling to airports and aerospace companies until the coronavirus brought an abrupt halt to funding for many projects.

“This is going to be the new normal, so we have to be prepared,” she said she planned to tell them, adding that she was there to advise them during the crisis.

“Aviation is an industry that is crippled right now,” Ms. Forleo said. “But any industry, no matter how complex, is made of humans. In helping folks — that’s where all creative possibilities lie.”

Read More