Matthew Holt

Matthew Holt
Matthew Holt is the founder and publisher of The Health Care Blog and still writes regularly for the site. He is also the co-founder of the Health 2.0 Conference, as well as a Founding Principal of the associated consulting firm Health 2.0 Advisors.

Elation’s Kyna Fong on a new type of EMR company

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There’s so much happening in the Health 2.0 world of new technology in health that it’s hard to keep up. AI, VR, AR, Blockchain–and they’re just the buzzwords keeping the VCs happy. So this year I’ve decided to try to interview more interesting new companies to keep you in the know. We’ll see how long that resolution lasts but first up is Kyna Fong, CEO of ElationHealth. Yes, she left a Stanford tenure-track professorship to start an EMR company, and no, she doesn’t sound crazy! This is an in-depth interview including a decent length demo, and it hints at how companies like hers might solve the conundrum of EMRs being necessary but impossible to use.

Want to help Technologies for Healthy Communities?

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Health 2.0 is actively expanding Technology for Healthy Communities and looking for large healthcare organizations and foundations to help support technology adoption at a community level.

Technology for Healthy Communities is a dynamic pilot program designed to catalyze the adoption of technologies in communities. The program fosters the development of sustainable partnerships to address the social determinants of health in the under-served regions that need it the most. Over 200 innovators across the U.S. submitted applications to the program, and through curated matchmaking and access to funding, selected innovators were matched with three participating communities to conduct pilot projects.

Snapshot of the three pilots:

  • Spartanburg, SC: ACCESS Health Spartanburg, a non-profit agency primarily working with the uninsured population, is piloting with Healthify to provide community interventions for social determinants of health at the point of care. With support from Spartanburg Way to Wellville and the Mary Black Foundation, the pilot aims to address current pain points in community health care, such as the inefficiency of addressing social needs of patients and helping to make case management easier.
  • Jacksonville, FL: The City of Jacksonville and the Health Planning Council of NE Florida, with support from the Clinton Foundation is piloting with CTY to deploy its signature product, NuminaTM. With this technology, bicycle and pedestrian traffic data will be collected to assess current safety conditions and plan improvements in the built environment for residents to be more physically active.
  • Alameda County, CA: The Community Health Center Network is piloting with Welkin Health to implement a case management tool that engages members and eases current healthcare worker burden. Together, they will pilot this case management tool in four centers to help community health workers to effectively and efficiently coordinate care.

Due to the high demand from tech innovators and communities, Health 2.0 is expanding the program to new communities, tech startups and organizations who can benefit from technology adoption. By addressing the social determinants of health, the program has the potential to implement unique tech applications and address some of the most important systemic issues at the community level.

Health 2.0 is looking for partners such as foundations, large health systems and corporations who want to support pilots to test innovations in communities, interact with the fastest growing startups in the tech scene, and help create business opportunities for technology companies. Program sponsors will also have the opportunity to address local health needs by bringing exciting, new technologies to under-served regions across the U.S.

The program will focus on tools that support access to a healthy lifestyle, in categories such as:

  • Access to healthcare services
  • Food insecurity
  • Affordable housing
  • Behavioral/mental health

If you are interested in partnering with Health 2.0 to help deliver technology to communities, contact [email protected] to learn about opportunities to support the program.

Alexandra Camesas is a program manager at Catalyst @ Health 2.0

So what does Trump mean for new health tech?

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Matthew-Holt-colorI’m a pundit who like everyone else was surprised by Trump’s victory in the (profoundly undemocratic and hopefully-to-be-abolished-soon) electoral college, and everything I say here is prefaced by the fact that there was very little discussion of healthcare specifics by Trump. So there’s no certainty about what will happen–to state the obvious about his administration!

What we do know is that Trump said he’d repeal & replace the ACA and the House has voted to repeal it many times (but the Senate has only once & Obama has always vetoed that repeal). A full and formal repeal requires 60 votes in the Senate which it won’t get with the Democrats holding 48. Note that the Democrats needed 60 votes to to forestall a Republican filibuster in order to pass the ACA in 2010. That 60 vote total is a very rare state of events which existed for only only one year–from Jan 2009 until Scott Brown won Ted Kennedy’s old seat in Jan 2010 and one we likely won’t see again for many years.

But this doesn’t does not mean things will continue as usual for two reasons. Congress can change the budget with the Republican 52 seat Senate majority, and the Administration can change regulations and stop enforcing them. So we have to assume that the new Administration and its allies(?) on the Hill will roll back the expansion of Medicaid which was responsible for most of the reduction in the uninsured (even if it didn’t happen in every state). They’ll also reduce or eliminate the subsidies which enable about 10m people to buy insurance using the exchanges. Both of those were in the repeal bill Obama vetoed, although in the bill the process was delayed for 2 years.

This of course may not happen or may be replaced by something equivalent because many of the people who voted for Trump (the rural, white, lower-income voters) fall into the category of those helped by the law, and in a few of his remarks he’s also said that he’ll be taking care of them. Even this week Senator Wicker (R-Mississippi) said that they weren’t going to take away 20 million people’s insurance. In Kentucky which went from a Democratic to Republican governor 2 years ago, the new administration ended their local exchange (from 2017), but in fact not much consequential happened as people were sent to the Federal exchange. If there are changes to the exchanges and the individual mandate or they’re both abolished, there’ll be lots of commotion but it won’t be completely system changing.

My day job at Health 2.0 involves running a conference and innovation program based on a community of companies using SMAC technologies to change health care services and delivery–either by starting new types of health care services or selling those technologies to the current incumbents. So I’m acutely interested in what happens next, albeit somewhat biased about my preferences!

Overall I think that (unlike many other areas of American life) health care technology won’t be that greatly affected. 

No, I Didn’t Expect That Either.
What’s Next?

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As a Democrat, I can only hope this is a Dewey defeats Truman moment, but at 2.00am ET on Nov 9, President Trump with a Republican House and a open Supreme Court seat seems to be our new reality. For the health care establishment, this is a bombshell. It’s been easy for Congressional Republicans to vote to repeal the ACA when they knew Obama would veto it. But what happens next when Trump is happy to sign the “repeal”?

It’s hard to figure out what’s there in terms of putting together to “replace” either in the Congressional Republicans or in what passes for policy in what passes for the Trump camp. As Margalit Gur-Aire said on THCB recently other than one speech with some stale talking points about block grants for Medicaid and selling insurance across state lines, Trump seems to have no ideas about health care. (To be fair he doesn’t seem to have any ideas about anything, or he claims they’re a secret).

Then we have the issue of his relationship with Congress. Now he’s President he may declare a truce, but then again he might decide to tweet into oblivion Paul Ryan and the many others who wouldn’t support him. And he might of course self-immolate as he tries to manage his business, his relationship with Russia and his soon to be launched TV network–while actually having to be President.

But if he’s going to end Obamacare, Trump is going to have to worry about two things. First, he has said that he wants to repeal it but is going to make sure everyone can buy health insurance, even if they have preconditions. When the middle aged white working class who voted for Trump discover that their Medicaid and their health insurance goes away, and that insurers wont sell them insurance if they’re not a good risk, they might be unhappy.

Second, the other people who are going to be unhappy are the health care industry stakeholders. Health care is a series of complex legislative and market interactions. As a consequence of the ACA, most health insurers, providers and even pharma or device companies have made huge changes to their business strategy. Those business strategies and investment are now six years old. Like Wall Street and corporate America, Trump is going to make the health care establishment deeply uncomfortable. The question is, once big pharma, insurers and providers lean on the Administration, will anything actually change, or will we see the route towards value-based care continue?

Not only that, but the sea-change that is just starting in the shift from FFS to value-based payments from Medicare & CMS is underway because the country can’t afford continued health care cost growth. That remains the same. Eventually that reality will impinge even on a Trump administration.

So what happens next? Well it’s amateur hour and we’ve all failed to predict it thus far, so it’ll be tough to do it now. But health care will be a sideshow.

Oh, and time to repeal the frigging electoral college.

Michelle Longmire, CEO Medable

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I never ceased to be amazed by how smart young clinicians solve problems that they see. Michelle Longmire was in residency at Stanford working with colleagues building point solutions when she realized that what they needed was an easy platform on which to develop medical grade apps. Her company Medable was the result. Then she realized that the other big market was clinical researchers, who now have access to Apple’s ResearchKit, but need an easy way to build a study without using developers. I interviewed her recently and she built a study for me using Medable’s new Axon product.

Interview with Rasu Shrestha, CIO at UPMC

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More about Health 2.0 Rasu Shrestha, CIO at the University of Pittsburg Medical Center, will be joining me on stage this afternoon in our Provider Symposium (on his birthday) and again on Tuesday, September 27th for our Information Blocking, APIs & App Stores: The State of Play in Data Access session. Below is the interview I had with him a couple of weeks ago about how a huge medical center like UPMC deals with the innovation side of the house. Not too late to sign up and come to Health 2.0 and come hear what else Rasu has to say!

Accessing & Using APIs from Major EMR Vendors–Some Data at Last!

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Today I’m happy to release some really unique data about a pressing problem–the ability of small tech vendors to access health data contained in the systems of the major EMR vendors. There’ll be much more discussion of this topic at the Health 2.0 Provider Symposium on Sunday, and much more in the Health 2.0 Fall Annual Conference as a whole.

Information blocking, Siloed data. No real inter-operability. Standards that aren’t standards. In the last few years, the clamor about the problems accessing personal health data has grown as the use of electronic medical records (EMRs) increased post the Federally-funded HITECH program. But at Health 2.0 where we focus on newer health tech startups using SMAC (Social/Sensor; Mobile OS; Cloud; Analytics) technologies, the common complaint we’ve heard has been that the legacy–usually client-server based–EMR vendors won’t let the newer vendors integrate with them.

With support from California Health Care Foundation, earlier this year (2016) Health 2.0 surveyed over 100 small health tech companies to ask their experiences integrating with specific EMR vendors.

The key message: The complaint is true: it’s hard for smaller health tech companies to integrate their solutions with big EMR vendors. Most EMR vendors don’t make it easy. But it’s a false picture to say that it’s all the EMR vendors’ fault, and it’s also true that there is great variety not only between the major EMR vendors but also in the experience of different smaller tech companies dealing with the same EMR vendor. All the data is in the embedded slide set below, with much more commentary below the fold.

Jess Jacobs, POTS & her bio

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10yrGlobaRetroBIG

As part of Health 2.0’s 10 Year Global Retrospective Awards (yes, winners to be celebrated at Health 2.0’s 10th Annual Fall Conference September 25-8), I wrote a bunch of bios. One patient and friend of mine Jess Jacobs has (as many of you know) recently died. Fellow POTS patient Greg Norman didn’t much care for the brief bio I wrote about Jess. So below the fold please read his tweet storm about it! And of course please comment.

Interview with Aptus Health at HIMSS

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One in a series of interviews that should have been posted months ago, but Matthew Holt is just getting to now.

Previously known as Physicians Interactive, Aptus Health rebranded itself after acquiring several companies including MedHelp, Quantia & Univadis, and now focuses on both physicians and consumers globally and domestically. At HIMSS back in February, Matthew met with Teri Condon, VP of Strategy and Development at Aptus Health, previously with IMS Health and PharMetrics, and Michael Bodenstab, Vice President of Healthcare Solutions at MedHelp, to talk about where the company stands today and what their platform offers.

Priya Kumar is an Intern at Health 2.0, and a student at George Washington University

Matthew Holt Interviews Health Catalyst CEO, Dan Burton

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One in a series of interviews that should have been posted months ago, but Matthew Holt is just getting to now.

Health Catalyst has emerged to be a dominant player in data warehousing and analytics to support quality (and business) enhancement for huge providers like Kaiser, Partners and Allina, and many more. They’ve also raised over $220m from a stack of noted VCs. Back in February Matthew Holt caught up with CEO, Dan Burton at HIMSS to see what the latest plans for the company were.

Priya Kumar is an Intern at Health 2.0, and a student at George Washington University