Continuing my interviews with various health tech players from HIMSS17, Julie Yoo MD may be one of the brightest people in health IT. She and her colleague Graham Gardner founded Kyruus to deal with one of the most complex problems in health care. The issue is the patient accessing the right doctor/provider, which is somewhat equivalent to getting everyone in the right plane to the right vacation (or in computer speak “load balancing“). While this sounds simple it’s a very complex issue with both a huge data problem (tracking which doctors are available and do what) and a rationalization issue (what patient needs what). Julie explains the problem and how Kyruus works with provider systems to fix it.
If you’re a hammer, you just want to smash nails; if you’re a programmer, you just want to build features. But features do not a successful product make. This is the central myopia that eventually blinds even the most brilliant engineer-entrepreneurs, unless they’re smart enough to surround themselves with people who can check their bias.
If you want an interesting example of this phenomenon, look no further than Adam Bosworth, the co-founder and chief technology officer at San Francisco-based health gamification startup Keas. There’s no question about this guy’s brilliance. At Citicorp in the late 1970s, he invented an analytical processing system that helped the bank predict changes in inflation and exchange rates. At Borland, he built the Quattro spreadsheet, and at Microsoft, he built the Access database. He was one of the first to propose standards for XML—the foundation of most Web services today. At Google, he helped to develop Google Docs before moving on to start Google Health.
But as everyone knows, Google Health was a failure—and so was Bosworth’s next effort, Keas, at least until the venture-backed startup went through a dramatic pivot in 2010. How Bosworth figured out that his old approach wasn’t working, and how Keas reinvented itself as a provider of health-focused games for large employers, is the tale I want to tell you today.
Wrapping up the CI Summit with a Health Affairs Chat
The Care Innovations Summit wrapped up with a fireside chat, and moderator Susan Dentzer observed that there hadn’t been much discussion about the Medicaid population throughout the day, even though the summit was co-hosted by the Centers for Medicare and Medicaid Services. Dentzer asked Deputy Administrator Director of CMS Cindy Mann how innovation could play into the care of the Medicaid population.
Mann mentioned three major ways: experimentation (with payment rules and service delivery), peer to peer learning and data. Though she mentioned data last, she emphasized it the most.
“We need to be much more intentional about getting the data that we need to see what’s working, what’s not working,” Mann said.
ONC and the National Cancer Institute (NCI) are challenging app developers to create new tools to help cancer survivors. The new Crowds Care for Cancer: Supporting Survivors Challenge is asking app developers to create new tools meant to help survivors manage their care after they have completed cancer treatment.
HHS has had a series of developer contests that have spawned the creation of tools and apps to help patients and doctors better manage care. Some past app challenges include:
- the Million Hearts Risk Check Challenge
- the Blue Button Mash Up Challenge, and
- the Ensuring Safe Transitions Challenge.
Cancer patients need more care coordination
The number of cancer survivors in the United States is currently estimated at 14 million people. With improvements in cancer screening, diagnosis, and treatment, as well as the aging of the United States, this number is expected to rise.
While celebrating advances in cancer care, there remains a need to help patients manage their health after they have completed their primary treatment. Cancer survivors experience a host of physical and psychosocial long-term and late effects of the disease, and it’s the treatment of this that requires coordinated follow-up care.
Despite significant progress in cancer treatment, the complex and often fragmented state of end-of-treatment care may lead to harmful breakdowns in patient-provider communication. This can result in unmet health care needs. Better communication, data exchange, and care coordination have been shown to help the patients.
At the Hawaii International Conference on Systems Sciences (HICSS) yesterday, Wednesday January 5, the Office of the National Coordinator for Health IT (ONC) and the National Cancer Institute (NCI) announced the winners of the “Using Public Data for Cancer Prevention and Control: From Innovation to Impact” Challenge. Congratulations to the winning teams, Ask Dory! and My Cancer Genome.
The public challenge launched in July 2011 in conjunction with the National Cancer Institute and under the auspices of the ONC’s Investing in Innovation (i2) program. The Challenge asked developers to create solutions that addressed various gaps in foci across the cancer control continuum. In addition to building applications that bridge these gaps, participants were instructed to design solutions in ways that promoted and made possible healthy decision-making, early detection and adherence to treatment plans.
This is not a fun day for athenahealth, and frankly with HIMSS coming up, not a fun time to have such a day. None of this has anything to do with their products or their client services, but late last night the company announced that it’s going to be restating its earnings. You can see a longer discussion on The Street.com but essentially it appears that athenahealth has been amortizing its installation costs over one year whereas they ought to have been doing it over more years. The net result is that they’ll have to restate some earnings and are going to miss the next earnings reporting deadline. The stock is off roughly 12% today.
What’s been happening is that the new CFO (Timothy Adams) has come in and cleaned house, and not liked what some of the old CFO (Carl Byers who moved to Chile!) had been doing. Long term this clean up is probably good news. The company is still operationally profitable (we assume!), and its business of running the back office and increasingly front offices of doctors using a combination of technology and forklifts/sweat remains a great way of both routinizing their businesses and aggregating data for overall process improvement.
So better to get any financial “irregularities” cleared out now and be more conservative. But while other than the shareholders (and the coming lawsuits) it probably doesn’t matter much, this may per chance slow down Jonathan Bush a touch next week. Or maybe not. We’ll see….
Let’s face it, as a startup in the health care space, it’s not easy to land a first pilot to demonstrate the value your new technology, much less get paid for one. Strict federal regulations, billion dollar EMR implementations, and the fear of privacy leaks have made our nation’s providers very risk averse and extremely cautious about working with early stage health tech companies. Implementing new technologies in hospitals, where there are strict IT guidelines relating to ensuring patient data privacy and heavy bureaucracy, is difficult. Large hospital systems and other health care service organizations simply do not have the bandwidth or resources to guide companies through these challenges and therefore are reluctant to partner with early stage companies.
What results is a problem we are all too familiar with – failure of new technologies to diffuse into the market. Startups face the classic chicken and egg problem. As a startup, you need some traction, or proof of evidence that your technology brings some value to your customer. But in order to show that you bring value, a startup needs to test out the technology in the health care setting. Houston, we have a problem!
The New York City Economic Development Corporation (NYCEDC), a non-profit that aims to catalyze economic growth in New York City’s five boroughs, recognized this problem early on and decided to tackle the issue head-on. After many health care stakeholder working groups and other research, NYCEDC launched PILOT Health Tech NYC in collaboration with Health 2.0, Blueprint Health, and Startup Health. PILOT Health Tech NYC matches early-stage health care technology companies (‘innovators’) with key NYC health care service organizations or individuals (‘hosts’), including hospitals, physician clinics, payors, pharma companies, and nursing associations. NYCEDC will fund approximately 10 innovative NYC-based pilot projects with up to $100,000 each. That funding is equity free and acts like a milestone based grant that can be split between the ‘host’ and the ‘innovator’ as they see fit.
And the best part – the program will help facilitate connections between ‘innovators’ and ‘hosts’ via matchmaking events to promote formation of partnerships. For most startups, that eliminates months (if not years) of cold-calling and precious business development resources.
Matthew Holt spoke to Martha Wofford, head of Aetna’s CarePass platform, at the 2012 mHealth Summit in Washington, D.C. last week. Aetna CEO Mark Bertolini had just delivered a keynote and announced that his company will release the CarePass mobile app in March 2013. CarePass is a web portal where patients can connect data from their different personal applications. Here Holt speaks to Wofford about the development of Aetna’s technology offerings. He also asks her how much of an impact she thinks this tech can have on wasteful spending in the U.S. health care system.
At the recent Health 2.0 Conference, an unusual session highlighted the health importance of such “unmentionables” as job stress, marital worries and sexual dysfunction. However, despite the moderator’s inexplicable pride in a panelist’s mention of “vagina” – a topic certainly not lacking for Internet attention, albeit under more colloquial synonyms – the truly unmentionable subject was not sex, but the link between social class and health.
Unlike sex, talking openly about age and class distinctions makes most Americans squirm uncomfortably. Still, a number of speakers showed they understood that one of Health 2.0’s biggest challenges is proving itself useful to the population most in need of its help.
To start with, that means the elderly. Age brings an increased susceptibility to disease: half of Medicare beneficiaries are receiving care for one of six chronic conditions. Similarly, income is one of the most powerful predictors of health status. Those in the bottom 80 percent of adult income earners have an adjusted life expectancy almost 6 years shorter than those in the top 20 percent.
From that population perspective, two presentations stood out. The first was the partnership between Geisinger Health System and dLife. The second, for very different reasons, was the unveiling of Sharecare.