State officials debuted Healthy Together in April as a tool for augmenting contact tracing, the painstaking work of identifying people who might’ve come into contact with coronavirus patients.
The mobile application — created via a no-bid contract worth up to $6.35 million — would track residents’ movements and, if they become ill, help public health workers figure out where they crossed paths with others.
The problem is, almost no one has used it that way.
“We’ve learned over the course of the past three months that location tracking isn’t popular,” state epidemiologist Dr. Angela Dunn said Thursday. “And as a result, it hasn’t really been helpful to our contact-tracing efforts.”
So, state leaders this week revealed they were turning off the app’s location-tracking function, eliminating one of the features that made Healthy Together a contact-tracing tool in the first place.
Dunn said the app will continue to serve as an important part of Utah’s coronavirus response — and will perhaps gain traction as the location tracker disappears and people aren’t as worried about officials following their movements. And the app’s creators are emphasizing its use as a daily wellness checker that prompts users to complete a symptom assessment, guides them to a local testing site if they report signs of COVID-19, and spreads critical public health information.
But Utah legislators are wondering if the state is getting taxpayers’ money’s worth from the contract with tech company Twenty, considering the delays in the app program’s full rollout and now the loss of one of its core components.
“We’ve got this app that we spent millions of dollars on that’s now essentially kind of a waste,” said Rep. Andrew Stoddard, a Sandy Democrat who’s been raising questions about the deal for weeks.
‘Slippery slope’
Contact-tracing efforts typically involve piecing together a person’s movements and notifying individuals who might’ve been exposed to the virus, and it can take days to finish a single case.
The app, state leaders said, would create a shortcut by logging a user’s whereabouts in real time, a ready-made record that the person could elect to share with health workers after testing positive for the coronavirus.
(Kristin Murphy, Deseret News/pool) In this April 22, 2020, file photo, Gov. Gary Herbert speaks during the daily COVID-19 media briefing at the Capitol in Salt Lake City. A poster displaying how the Healthy Together app will use location tracking for COVID-19 contact tracing is on display in the foreground.
But only about 200 app users have agreed to hand over their location data for contact tracing, a state health department spokesman said, adding that he’s not sure how many times local public health officials have relied on the information.
Salt Lake County’s health department hasn’t used it at all, according to Tair Kiphibane, the agency’s infectious disease bureau manager.
Delays to the app’s full deployment and public discomfort with relinquishing personal location data have limited its value in contact tracing, she said, so her department has continued to rely on traditional methods for following the disease’s spread.
“People don’t want a microchip placed in themselves and then to walk around and have someone track them wherever they go,” she said. “That’s kind of alarming.”
However, state officials say other aspects of Healthy Together have caught on. Users have completed about 630,000 symptom assessments, and about 18,000 people have been referred to testing, Twenty representatives said.
Twenty’s co-founder, Jared Allgood, said his company was willing to drop the GPS element from the app in hopes of quelling privacy concerns and encouraging more people to download it. Although the focus has been on Healthy Together’s contact-tracing function, that is only one piece of the app, he said.
“We partnered with the state with the expectation that we would spend a year helping the state shorten the time from an individual becoming symptomatic to knowing that they should be getting tested to getting access to testing resources to getting their test results delivered to them quickly and reliably,” he said.
That being said, Allgood argues that some have misunderstood the app’s privacy features. Users are able to delete their data at any time, and location data is automatically deleted in 30 days, as is data about symptoms. Anyone who tests positive has the choice of whether to share location information with contact tracers, he said.
State Rep. Robert Spendlove, who recently ran a bill on data privacy in the era of COVID-19, said he agrees with the decision to turn off GPS tracking in Healthy Together.
“It’s a really slippery slope to be collecting this information and going towards having overmonitoring of individual behaviors,” the Sandy Republican said.
His legislation would’ve made it a misdemeanor crime for state contractors to sell personally identifiable data gathered for the state’s battle with the coronavirus. The bill ended up stalling because some lawmakers wanted to take it even further and essentially halt COVID-19 data collection efforts until the Legislature had a chance to review them, he said.
But he expects lawmakers will revisit the measure in a special session next month and hopes strict legal safeguards around personal data will increase the public trust necessary for the success of any digital contact-tracing initiative.
Allgood said dropping the app’s geolocation function will eliminate the state’s ability to use Healthy Together to identify COVID-19 hot spots. However, the app will retain a Bluetooth component that will document close encounters between any two users, so it could still bolster contact-tracing efforts, he said.
It’s not clear if the state will view the app as a tracing tool going forward.
State health department spokesman Tom Hudachko said the Bluetooth function will be deactivated unless the user opts in and that state health officials haven’t yet decided whether they’ll use the information going forward.
‘Response to the crisis'
Allgood, Twenty’s co-founder, said his company did not pursue the deal to develop a contact-tracing app. In fact, he said, the state came to him.
Kristen Cox, head of the Governor’s Office of Management and Budget (GOMB), called up the company at the suggestion of Silicon Slopes, a nonprofit that boosts Utah’s tech sector, according to Allgood. She’d heard the company’s social media technology could be adapted for digital contact tracing and asked Twenty if it could build an app to support the state’s coronavirus response.
Utah’s top budgeting officials signed the contract with Twenty in late March, bypassing the normal purchasing processes designed to promote fairness and competition among businesses. At the time, Utah leaders were arguing that standard procurement rules would bog them down during the global rush for supplies and expertise, and the app deal was among roughly $84 million in no-bid contracts and supply orders doled out by the state in the early days of COVID-19.
Taymour Semnani, owner and co-founder of the tech company Ferry, said he offered a free contact-tracing application to the state about a week after the state had signed its contract with Twenty.
He argues that his app is more precise in identifying the close personal encounters that could transmit the virus and said he’s tried to persuade the state to incorporate his Bluetooth technology into Healthy Together. This week, he said his offer still stands, but Utah officials as yet haven’t taken him up on it.
GOMB has said it picked Twenty to create Healthy Together in part because of its Utah ties; while it’s based in New York City, the company has a Draper office, Allgood said.
More importantly, the tech developer had existing technology that could help Utah “get ahead of the COVID-19 virus through extensive contact tracing and could provide the product within 10 days,” the agency explained in a fact sheet shared with reporters in early May.
Despite that, Twenty failed to meet the deadlines laid out in its state contract, falling weeks behind in launching the portal where public health workers could view contact-tracing data shared by app users. A health department spokesman said the portal was finished in late May.
(Rick Bowmer | AP file photo) In this May 19, 2020, file photo, health investigator Mackenzie Bray adjusts her mask at the Salt Lake County Health Department, in Salt Lake City. Bray normally works to track contacts for people with sexually transmitted diseases, but she was reassigned during the coronavirus pandemic. She is now one of 130 people at this county health department assigned to track down COVID-19 cases in Utah's urban center around Salt Lake City. The investigators, many of them nurses, each juggle 30 to 40 cases that can include a total of several hundred people.
Allgood acknowledges that the app’s full deployment hit delays as state officials asked for new features and reordered their priorities amid a rapidly evolving public health emergency. That was to be expected, he argues.
“There’s language in the contract that acknowledges that this was made quickly in response to the crisis,” he said, “and that the scope of the contract could and would change over time.”
Stoddard, on the other hand, believes the holdups constitute a contractual breach and believes officials should’ve jumped at the chance to extricate themselves from the costly one-year deal. By now, that exit window has probably closed, he said.
“If we’re going to make contracts with these companies, when they fail, we need to cut them loose,” he said.
Now that the GPS function is disappearing from the app, Stoddard and Spendlove both say the state should negotiate a lower price for Healthy Together.
Under existing agreement, Utah officials have agreed to pay $2.75 million for the app and another $300,000 per month for a year of maintenance. Twenty has to date accepted more than $3.7 million from the state, an expense covered by federal CARES Act funds, according to GOMB.
Renegotiation talks are already under way between the tech firm and the state’s health department, which is assuming control of the contract from GOMB, according to Hudachko. The new contract terms haven’t been decided, he said.
