Saturday, April 21, 2018
Blog

Health in 2 point 00, Episode 18

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Jessica DaMassa asks me all about health & technology, in just 2 minutes, featuring venture rounds for Kyruus, Parsley Health, Livongo buying RetroFit, the RWJF AI challenge from Catalyst @ Health 2.0 and a ridiculously long explanation of where the @boltyboy twitter name came from…–Matthew Holt

WTF Health | Kyruus co-founder, Julie Yoo

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WTF Health – ‘What’s the Future’ Health? is a new interview series about the future of health and how we love to hate WTF is wrong with it right now. Can’t get enough? Check out more interviews at www.wtf.health

They just raised another $10M and you should find out why….

I met up with Kyruus co-founder and chief product officer Julie Yoo at #HIMSS18 to hear about the #AI magic behind their ‘intelligent routing engine.’ Apparently, it does such an incredible job driving business into health systems by better matching patients to docs that some more funding is in order to help them expand!

So, where does Kyruus fit into the ‘big picture’ of health’s ‘big data’ movement? Julie’s beat on how AI implementation in healthcare is going gives you a pretty good idea.

Patient-Reported Outcome Measures: Progress Across the Pond

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This past October CMS Administrator Seema Verma announced the agency’s “Meaningful Measures” initiative.[1] Ms. Verma launched the initiative because, she admitted, the agency’s current quality measurement programming, widely criticized for years by MedPAC and others, ran the risk of outweighing the benefits. Under “Meaningful Measures,” CMS will, Ms. Verma stated, put “patients first” by aligning a smaller number of outcome-based quality measures meaningful to patients across Medicare’s programs. Since “the primary focus of a patient visit,” Ms. Verma said, “must be the patient,” the primary focus of the initiative will be “to focus health care quality efforts on what is really important to patients.”[2] As an indication of this commitment, immediately after Meaningful Measures was announced the National Quality Forum’s (NQF’s) Measures Application Partnership (MAP) began work reviewing a record number of CMS-recommended Patient-Reported Outcome Measures (PROMs).[3]

There appears to be an ever increasing interest in PROMS in the US. For example, last year The New England Journal of Medicine published three PROMs-related “Perspective” essays that moreover described initial success by a few early US PROMs adopters. One of these essays also noted that England and Scotland had “extensive experience” in the use of these measures.[4] Though possibly overstated, we believe providers in the US can benefit from, for example, our experience in the United Kingdom (UK) developing and implementing My Clinical Outcomes (MCO) (at: www.myclinicaloutcomes.com), a digital patient reported outcomes measurement and analytics platform that is now used in the treatment of several chronic conditions in a variety of clinical settings across the UK.

MCO was initially developed in collaboration with orthopedic surgeons working in the National Health Service (NHS). These surgeons were seeking a way to systematically follow-up with their patients after joint replacement surgery largely in order to better economize on their use of clinical resources or more appropriately or efficiently identify those patients in need of follow up face-to-face consultations. The web-based platform was developed to work flexibly around existing clinical work flows.

Announcing the RWJF AI & The Healthcare Consumer Challenge!

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When it comes to navigating healthcare and making decisions about your health, and the health of loved ones, there is no yellow brick road. Even the National Committee for Quality Assurance (NCQA), a leading national healthcare nonprofit, could only analyze 1,000 of over 1,400 private healthcare policy options with myriads more in the public arena. Navigating a health care plan, or not, is just the beginning of your healthcare journey.

Let’s say you find a health plan you like, and you get sick. You have to locate the right doctor that works for you, struggle through complicated referrals, tabulate the exact bottom line of these costs, find a pharmacy, perhaps grab a second opinion, and repeat this process every time you get sick.

WTF Health | Uber Health’s Head of Strategy, Lauren Steingold

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WTF Health – ‘What’s the Future’ Health? is a new interview series about the future of health and how we love to hate WTF is wrong with it right now. Can’t get enough? Check out more interviews at www.wtf.health

One of the new faces – and mega tech companies – to be at #HIMSS18, I caught up with Uber Health’s head of strategy Lauren Steingold just after the launch of their HIPAA compliant ride share service for patients.

Lauren talks about the year-long approach Uber took to get into #healthtech, what they’re looking to do next, and her first impressions of HIMSS.

What advice does the tech company have for healthcare? HINT: uber’s ‘on-demand’ ethos extends to the way providers can sign up for their service. It’s a self-service sign-up (no cumbersome contract negotiations with procurement, whaaaat?) with next day implementation. The bar is set, Health Tech.

Twitter-Based Medicine: How Social Media is Changing the Public’s View of Medicine

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Doctors can be two-faced. This isn’t necessarily a negative attribute. Doctors have distinct personas for our patients and our colleagues. With patients, doctors strive for a compassionate but authoritative role. However, with each other, doctors often reveal a different demeanor: thoughtful and collaborative, but also opinionated and even sometimes petty. These conflicts are often the result of our struggle with evidence-based medicine. The modern practice of evidence-based medicine is more than the scientific studies we read in journals. Medicine doesn’t just change in rational, data-driven increments. Evidence-based medicine is a dialectic, a conversation. Doctors are being continually challenged to reconcile personal experience, professional judgment, and scientific data. Conflict can naturally result.

This struggle has been ongoing since the rise of evidence-based medicine decades ago. There are factions in medicine who are skeptical of clinical trials as the answer to all of medicine’s important questions, while other factions are wary of authority and consensus-driven medicine. These battles have traditionally been confined to the doctor’s lounge, both literal and in the figurative “safe spaces” of academic journals and conferences. But now the doctor’s lounge is going public. Social media is enabling doctors to rapidly communicate with each other. The heated public arguments that often result are in turn raising new questions about the effect of public discourse on the medical profession and the patients we serve.

Why go to Health Datapalooza? Ask Bruce Greenstein, CTO of HHS

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Health Datapalooza is coming up quick at the end of April, so I sat down with Bruce Greenstein, CTO of HHS about why all of THCB’s health tech friends should attend. Plus, we get into what’s happening with the open data movement and how Bruce’s past-life at Microsoft is going to shape how he and HHS work with those consumer tech companies that are pushing harder and harder into healthcare.

Curb Your Enthusiasm

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Lawton Burns and Mark Pauly, economists at the Wharton School, just published an article that should be required reading for all policy makers and health services researchers. The article,  entitled “Transformation of the health care industry: Curb your enthusiasm,” appears in the latest edition of the Milbank Quarterly.

Burns and Pauly undertook an enormous task and executed it well. They first sought to explain the assumptions underlying Managed Care (MC) 2.0 – the proposals promoted by the managed care movement in the wake of the HMO backlash of the late 1990s. Then they evaluated the probability that the MC 2.0 proposals will work as advertised. To do that, they looked at the relevant research and then at the social conditions that are impeding the implementation of those proposals. That’s a lot to bite off.

This is an unusually valuable article because of its scope, organization, and documentation. I will summarize it first, then discuss it in more detail. I’ll close with a discussion of my one serious criticism of this excellent paper: The authors, having made it clear they think the current “value-based” approach to cost containment is doomed, profess to see no solutions to rising health care costs.

Testing a mantra

Burns and Pauly are among the small minority of health services researchers who seem to be curious about the powerful norms that influence their profession but which are rarely acknowledged and never studied. They do not come right out and say, “Our profession resembles a religion more than a scientific discipline,” but you get the feeling they might agree with that statement if you could talk to them over coffee. They communicate their interest in the undiscussed norms both in the way they treat health policy jargon (they view it with some skepticism) and in their willingness to declare that fundamental assumptions underlying MC 2.0 were never tested.

Health in 2 point 00, Episode 17

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Today Jessica DaMassa asks me about the microbiome, the Dev4Health conference & whether there are more female CEOs than there used to be. All in 2 minutes, plus a bit more with me defending myself from Bruce Greenstein’s wisecracks–Matthew Holt

Vineti raises $33m, Amy DuRoss interview

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Any DuRoss is one of the more charming and remarkable characters in the health tech world. She lead the campaign for Proposition 71 in 2004 which funded and established the California Institute for Regenerative Medicine. Later on she was a key player at early genetics company Navigenics, and more recently after time at GE Ventures she founded Vineti, which today raised $33.4m in Series B funding. Vineti is a new kind of pharma supply chain company helping deliver gene therapy, but what does that mean? I asked Amy and she told me!