Posted on January 19, 2023 in Technology

Only Confidence


At this point, you’ve probably heard of Theranos, a company whose wondrous technology could have made blood testing less of an expensive nightmare for the average patient. Essentially, it would take a fraction of the amount of blood typically needed for a full panel, dilute it a bit, and then test that for all of the things it needed.

The dilution isn’t actually the suspicious part, at least not on its face. A lot of tests can handle dilution, so it made sense to professionals advising investors at the beginning. The suspicious part was that Theranos was only taking a few drops to run that full panel, and also running that panel in an absurdly quick time frame. At the ratio Theranos would have had to dilute, some of the tests would have become impossible because blood is more than just liquid, it’s also platelets, proteins, sugars, and cells. When you add saline to that, you’re not increasing any of those, just the liquid. This methodology increases bad results on a number of the tests using the traditional methods, but Theranos seemed to have decreased the margin of error somehow and promised it would get even better with time. Anybody buying the machine would have had to have some disclaimer that it has a higher failure rate than the original methods, but hey – it’s new. It can get better with time and money.

Obviously, all of this was later revealed to be a fraud. They never could get the error down enough for the machine to be a better alternative to standard methods, and reducing expectations to ‘it only tests some things’ or ‘it takes more blood than we promised, but less than the original tests would have’ didn’t come soon enough to prevent a lawsuit.

The issue here I think is not in trying to make the machine. It’s in trying to make the machine work miracles right out of the gate. It’s possible to make life easier for the patient without promising Star Trek level technology. A lot of the expense and difficulty that comes with running these tests is coming out of inefficiencies that are held in place by the hospital taking the blood and the insurance paying for it. If it were possible to streamline this and make it take fewer steps, it would naturally be cheaper and easier for the patient because there’d be less arguing between all parties at every step.

Look at the Instapot, for a much simpler example that isn’t tied to insurance profits: it was a simple pressure cooker with few features that could cook on the countertop instead of the stove. It reduces the risk of the customer hurting themselves because it pressurizes itself and monitors the temperature internally. That’s a cool thing! And at first it was all that it did. But then it also added a yogurt setting! And it can cook rice now, too! The newer models keep getting better and better, and it didn’t have to start off with the promise of being able to make whatever you want right off the bat to be worthwhile.

Perhaps the blood machine could have taken the same amount of blood as traditional tests do, but done all the tests within the machine. Perhaps it could have narrowed its scope to use less blood in the first place, and left the specialist tests to specialist labs. Maybe it could have even built its own pipelines to those places. Now we’ll probably never know. Investors have had their feelings hurt, and the next Theranos may have to crowdfund.

No Man’s Sky

Investors can really screw up a development path no matter what the product is. To go completely digital and talk about the same phenomenon elsewhere, there’s video games. Look across the gaming news headlines for games that came out waaay before they were ready: there seems to be more than ever. Everything from Pokemon to DOOM Eternal comes with bugs that must be patched out in updates after release.

               The problem happening here is that the game designer has good ideas, the development team is skilled, but the people funding the game want it now. They want it yesterday. They’re paying for these people to pursue a career that many people only dream of, and by golly do they expect those teams to be grateful to work 80-120 hours a week based on a completely arbitrary release date. Pokemon Scarlet and Violet is fun but buggy; Overwatch 2 has poorly optimized features that the original game did really well. They are not rare exceptions anymore. Triple-A games are being strangled by a need to get investors and their owning company a lot of money really fast.

Worse, sometimes it’s not even the investors – sometimes it’s the fans themselves. No Man’s Sky is a good game now. But during the press circuit run up to the game, the head developer and manager of the project was being pressured not only to increase the scope of the game, but also keep the same strict timeline they’d had when they initially announced launch. It’s not unusual for games like that to be delayed a bit or longer – it was putting a lot of pressure on the team, who ultimately ended up releasing a project a little bit worse than what they’d set out to make (with quite few bugs making it feel worse than it really was even at that point in time – it needed polishing) but way worse than everyone was expecting. No Man’s Sky was supposed to be a magnum opus of indie gaming – it only lived up to that years down the road after a lot of hard work and patches made by the original producers.

The Horizon: Prince of Persia

In a rare example of refunding money for an as of yet incomplete project, Ubisoft has announced that people who paid for the Prince of Persia pre-order will be getting a refund. The game isn’t ready, yet, and they don’t know when it really will be.

This is a fantastic step towards slowing the self-destructive cycle of shoving incomplete games out the door. It turns out the product doesn’t need to be exaggerated to get it to sell, and it doesn’t have to ship incomplete. Those are choices, usually choices not made by the people assembling the game, or the blood testing machine, or any number of products that have come out and promptly flopped.