Matthew Holt

In an exclusive interview with Matthew Holt, American Well President and CEO Roy Schoenberg, MD shrugs off the threat of emerging competitors, predicts that United Healthcare will own a telehealth company within the next 12 months, and reveals that his company has “turned the corner” in terms of generating revenue from telehealth services. Schoenberg also shares details of the company’s recently announced integration with Apple HealthKit and the growing use of scheduled telehealth visits to treat chronically ill patients.

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Lygeia RiccardiMaking Sense of Blue Button, Meaningful Use, and What’s Going on in Washington  …

At the recent Health 2.0 Conference in Santa Clara, co-chair Matt Holt expressed frustration about the difficulty of getting copies of his young daughter’s medical records. His experience catalyzed a heated discussion about individuals’ electronic access to their own health information. Many people are confused about or unaware of their legal rights, the policies that support those rights, and the potential implications of digital access to health data by individuals. The Health 2.0 conference crowd included 2000 entrepreneurs, consumer technology companies, patient advocates, and other potentially “disruptive” forces in healthcare, in addition to more traditional health system players.

Why is this topic so important? Until now, most people haven’t accessed their own health records, whether electronically or in paper, and I believe that making it easier to do so will help tip the scales toward more meaningful consumer/patient engagement in healthcare and in health. Access by individuals and their families to their own health records can empower them to coordinate care among multiple healthcare providers, find and address dangerous factual errors, and take advantage of a growing ecosystem of apps and tools for improving health-related behaviors, saving money on health services, and getting more convenient, personalized care.

A shorthand phrase for this kind of personal empowerment through access to digital health data is “Blue Button,” which is also the name of a public-private initiative in which hundreds of leading healthcare organizations across the US participate. The Blue Button Initiative is bolstered by the electronic access to health information requirements for patients in the “Meaningful Use” EHR Incentive Program, which is administered by CMS (the Centers for Medicare & Medicaid Services) with companion standards and certification requirements set by ONC (the Office of the National Coordinator for Health Information Technology). Continue reading “Getting Your Own Health Records Online: The Good and the Not So Good”

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Such a good question from my friend David Shaywitz, MD, PhD, (and co-author with me of the book Tech Tonics).  David has spoken and written about this this theme frequently, and most recently at the Health 2.0 conference held last week in Santa Clara, CA. He and I and 2000 of our closest friends were there to talk healthcare technology. Isn’t it ironic that it takes that level of human interaction to talk about the ways healthcare can disintermediate humans from healthcare?

What struck me so loudly at the conference was how easy it is for us all to forget how human the healthcare experience really is. I moderated and attended numerous sessions at the conference, each a twist on the theme of how technology can make healthcare delivery more accurate, more efficient, more effective than anything we have going today.

David participated in a session withMatthew HoltVinod Khosla and Dr. Jordan Shlain, who could not be farther part from each other on the topic of doctor vs. machine (David played the role of moderate guy in the middle), Mr. Khosla backed away or at least clarified his earlier statements about how 80% of doctors will be unnecessary in the coming new age of healthcare technology. His revision was that 80% of alldiagnosis will, in the future, be done by computers, not doctors, because computers are far better at seeing a holistic view of a patient and taking in all of the relevant data. He talked about how certain digital technologies can know everything about you, including when you are sleeping and when you are awake. It made me think that Santa Claus must be worried about being replaced by an app.

Continue reading “Wait, Maybe Technology Won’t Replace Doctors After All!”

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In more stunning proof that America’s 18th century style governing process just doesn’t work, a subset of a regional Federal court ruled against part of Obamacare. The Halbig ruling is certain to be overturned by the full DC court and then probably will stay that way after it makes it’s way through the Supremes–at least Jonathan Cohn thinks so.

But think about what the Halbig ruling is about. Its proponents say that when Congress (well, just the Senate actually as it was their version of the bill that passed) designed the ACA, they wanted states only to run exchanges and only people buying via states to get subsidies. But that they also wanted a Federal exchange for those states that couldn’t or (as it turned out) wouldn’t create their own. But apparently they meant that subsidies wouldn’t be available on the Federal exchange. That would just sail through Logic 101 at any high school. Well only if the teacher was asleep, as apparently most Senators were.

Now two judges interpret what was written down to imply that subsidies should only be available on state exchanges–even though logic, basic common sense and fairness would dictate that if we’re going to subsidize health insurance we should do it for everyone regardless of geography.

Don’t forget that in the House version of the bill there was only a Federal exchange. Continue reading “Halbig corpus interruptus”

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Yesterday phone and electronics giant Samsung rushed out its next step in health related hardware. Samsung was clearly trying to get this out the door and in the press before Apple’s forthcoming announcement of something health-related –or I assume that’s what their industrial espionage told them Apple was about to reveal (just kidding guys!). And some people (well, Techcrunch) were clearly unimpressed.

The most compelling moment which I captured (poorly) in the video above was the demo of the new SIMBAND–albeit a concept rather than an available product. (In fact a couple of their partners told me that no-one outside the company has one). In the SIMBAND are a stack of new sensors which attempt to use the wrist to monitor not only heart rate, but blood pressure, temperature, EKG and do it all continuously. You can see a rather better video of the demo from Gizmodo, which I cued up to start at the right place.

They also announced a fully open platform (what at Health 2.0 we dub the Data Utility Layer) called Samsung Architecture Multimodal Interactions (SAMI) to accept and spit out all types of health related data.

This is all potentially very impressive. Samsung’s first two attempts at Smart Watches have fizzled, but they tend to keep coming back, and now are pretty much the best at Smart Phones. (You fan bois can keep your teeny iPhone screens!) But can they make the health related smartwatch work? I’ve three quick assessments/questions.

Continue reading “Samsung Throws Kitchen Sink onto the Wrist”

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Doximity, known as the LinkedIn for doctors and a frequent Health 2.0 participant, raised $54 million in a Series C funding round led by T. Rowe Price and Draper Fisher Jurveston with participation from Morgan Stanley Investment Management.

Doximity claims more than 40% of US physicians as active users, and in January of this year announced that their physician network has grown to more than 250,000 members.

Doctors can use Doximity to collaborate on cases, further their careers, and stay up to date on specialty-specific news, but that’s not where they make their revenue.

“There are a lot of things we can do to make medical networking more efficient,” Doximity CEO Jeff Tangney told Health 2.0 when asked how the funds would be used.

“If you think about it, how would your life be different if you weren’t able to use email in your job? How out of touch would you be? That’s what it’s like to be a US physician. We see a lot of opportunity to improve the connectivity of physicians as a new business area.”

Like LinkedIn, Doximity is a recruiting tool for people looking to hire doctors. Tangney didn’t reveal all the numbers, but he did say that Doximity was cash flow positive in January for the first time. He also said that Doximity has 55 employees, somewhere around 200 hospital clients, and that a subscription to the recruiting product costs $12,000 per seat per year to send 50 messages per month.

With some back of the envelope math, and a guess of a burn of about $10-12 million a year, it figures out to about four subscribed seats per hospital. With about 5,000 hospitals in the US and some other revenue streams to pursue, it looks like Doximity has room to grow at a bare minimum.

Continue reading “Doximity Raises Another $54M to Pursue LinkedIn’s Business Model Too”

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The Administration has snatched victory from the jaws of defeat and enrolled 7 million people (give or take a million who may not have paid their premiums) into health plans under the ACA, and more into Medicaid. The Affordable Care Act (ACA) isn’t as big a change as some of us would have liked, But in this moment of modest celebration let’s remember what some of the sensible old men said all along.

Sensible old men said reform couldn’t pass without bring in the Republicans. Sen. Baucus tried hard to do that, and it’s beyond clear that no Republican would have ever supported it–even a moderate like Snowe who was quitting. It passed anyway.

They said that we’d see massive rate shock. Instead plans tightened networks and rates were in general lower than they had been before.

They said that the web site debacle meant no-one would sign up and we’d go into an insurance death spiral. The web site launch was a cock up, but Medicaid expansion (where allowed) has more or less been OK, and the exchange web site(s) now more or less work(s)–outside Oregon & Maryland. By the way this backs my argument for having one Federal exchange, which you may remember was in the House bill before we ended up being forced to take the Senate version due to Ted Kennedy’s death.

One wise old man (Robert Laszewski) was still saying that the exchanges would be financial disaster for insurers the very week Wellpoint raised earnings expectations because they had more enrollees than expected.

Let’s also remember that because of the politics of the nation, the ACA is a ridiculous hodge-podge of a law requiring–you’ll recall:

a) an opt-in to what’s basically a social insurance program (hey, let’s opt-in to fire protection while we’re at it!)

b) arbitrary tax (and now subsidy) distinctions between those who get insurance via an employer and those who don’t, and

c) arbitrary access to insurance (well, Medicaid) for the poor depending on their income and which side of a randomly drawn line they live.

Continue reading “The ACA– As Much As We Could Have Hoped For, Despite Sensible Old Men”

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After years of speculation about a possible name change, Health 2.0 has become mHealth & Associates. My partner Co-Chairman and CEO Indu Subaiya and I didn’t take this move lightly. We were though concerned that the tired “2.0″ moniker is now thoroughly discredited by the emergence of the fully interoperable semantic Web, particularly as it’s been demonstrated in the healthcare sector in the US in recent years. In addition leading luminaries such as Chris Schroeder have finally realized the importance of the brand new smart phone devices that we’ve been ignoring for most of the last decade. And after some prompting, we were convinced by the intellectual rigor of the wider mHealth movement with its clear definition of mobile health, including the incorporation of highly portable technologies such as televisions bolted to the walls of hospital rooms.

Admittedly, while mHealth Intelligence and the mHealth Challenge roll off the tongue, we were a little stuck by what to call our main Fall conference–our organization’s best known event. But while mHealth Summit, mHealth Conference and most other variants are already use, we think that clear market visibility will surround out new name. So instead of the 8th Annual Health 2.0 Fall Conference, this September we’ll welcome you to the First mHealth Confabulation.

Finally we wanted to acknowledge the role of  our wider movement, our team and our 75 chapters across the globe, so we have added the “*& Associates” moniker to the name. In recognition of their contributions all mHealth colleagues will now be known as Mobile Health Associates or in its shortened version, as an “mHealth Ass.” Indu has suggested that I adopt the title of “Biggest mHealth Ass.”

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Matthew Holt sat down with CareCloud President and CEO Albert Santalo to discuss the latest news from the Miami-based cloud practice management and EHR services provider. CareCloud got started in 2009 and since then has raised $55 million in angel and private venture funding and grown to 270 employees.

Currently, about 5,000 doctors use CareCloud for their practice management services with about a quarter of those doctors also using the CareCloud EHR. Santalo expects that number to grow to about 12,000 by the end of the year, explaining in three points why he thinks the market is primed for CareCloud’s cloud-based, integrated practice management and EHR system.

While Santalo’s grin says more than his answer when asked about a potential IPO, he shares some interesting thoughts on practice consolidation, meaningful use requirements, and the cloud in in-patient settings in this interview recorded at HIMSS last month.

 

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Today venerable health content creator Healthwise merged with the Informed Medical Decisions Foundation which was previously funded by (and had an exclusive relationship up until last month with) Health Dialog. I asked Healthwise CEO–and old friend of Health 2.0–Don Kemper what was happening and what it meant. I also snuck in a smidgen of snark about a conference we worked on together five years ago.–Matthew Holt

Matthew: Don, you’re merging Healthwise with the Informed Medical Decisions Foundation. So I know the two organizations are both non-profits but as a poorly informed outsider I always thought of you as rival content creators, with Healthwise selling your content and services to insurers and providers and Informed Medical Decisions being funded by Health Dialog which then got to use and sell the content and decision support aids it created to its customers. Am I wrong?

Don: You aren’t completely wrong—but then not overly well informed either. We have always thought of ourselves as sister organizations rather than rivals. We have collaborated well in advocacy efforts to promote the role of the patient. Health Dialog has had a near exclusive relationship with the Foundation until recently. Health Dialog has been a long-term client of Healthwise, too—just not an exclusive one. When the restructured Health Dialog-Foundation relationship dropped the exclusivity requirement it allowed us to proceed with the merger discussions.

Matthew: Now that change occurred for Informed Medical Decisions and you two can merge, what do they have that Healthwise hasn’t got, and vice versa?

Don: The Foundation has three things that will add greatly to the Healthwise mission:

1. Medical Evidence—Their assessment of medical evidence in key areas goes deeper than we have been able to go. Whereas we have often waited for treatment guidelines to change before reflecting the changes in our content, their medical editors are often involved in making the guideline changes. Getting that information into the patient’s hands six months earlier could make a life or death difference.

2. Value Demonstration—The Foundation has developed research relationships with many health services researchers around the country. By setting up and evaluating demonstration sites for shared decision making (SDM) they have proven how SDM improves decision quality and reduces the use of expensive but preference-sensitive treatments.

3. Practice Change Management—The Foundation has gained a great deal of experience in helping clinicians build SDM into their workflow. Those learnings will help as we integrate patient engagement into the mainstream of care.

What they get from us is “reach.” People now turn to our information, tools and solutions over 340 times a minute. (180 million times a year). Fifteen percent of US physicians can now prescribe Healthwise patient instructions through their EMRs.

Healthwise has invested heavily in the technology needed to integrate into EMRs and has excelled at building broad-based solutions that fit within a health plan’s or health system’s workflow. It would have been hard for the Foundation to have matched that without us.

Matthew: So how will this actually work. How many people do you have, how many do they? Who gets to keep their jobs? Is this a real merger or a takeover?

Don: This is a merger made in heaven. No one will be out of work. Continue reading “Healthwise Adds Informed Medical Decisions: Don Kemper Interview”

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The Power of Small Why Doctors Shouldn't Be Healers Big Data in Healthcare. Good or Evil? Depends on the Dollars. California's Proposition 46 Narrow Networking
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