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The AMA’s Digital Health Investment Fund | Andrew Elkind & Stas Sokolin, Health2047

By JESSICA DAMASSA, WTF HEALTH

The American Medical Association (AMA) announced Health 2047, its accelerator and investment fund in 2018. A year later, Andrew Elkind and Stas Sokolin, both Principals at the fund, stop by to get us up-to-speed on the progress the AMA has made so far with its $45 million accelerator fund and $30 million investment fund. What kinds of health tech startups are piquing the attention of this physician-led fund? Get the details behind the Health 2047 investment thesis here!

THCB Spotlights: Omri Shor, CEO & Co-founder of Medisafe

Today on THCB Spotlights, Matthew chats with Omri Shor, the CEO and Co-founder of Medisafe. Way back in 2014, Medisafe took home the gold at Health 2.0, winning first place at Traction. Since then, their consumer medication management tool has evolved quite a bit. While the app is available for patients with over 6 million users today, they also have folks across the health care continuum partnering with Medisafe to manage the medication journey for their patients. Matthew picks Omri’s brain on how things will continue to evolve, what he’s learned to help people in health care think about the problem of medication management, and how Medisafe fits in with the numerous medication management and chronic disease management tools out there.

Explain yourself, machine. Producing simple text descriptions for AI interpretability

By LUKE OAKDEN-RAYNER, MD

One big theme in AI research has been the idea of interpretability. How should AI systems explain their decisions to engender trust in their human users? Can we trust a decision if we don’t understand the factors that informed it?

I’ll have a lot more to say on the latter question some other time, which is philosophical rather than technical in nature, but today I wanted to share some of our research into the first question. Can our models explain their decisions in a way that can convince humans to trust them?


Decisions, decisions

I am a radiologist, which makes me something of an expert in the field of human image analysis. We are often asked to explain our assessment of an image, to our colleagues or other doctors or patients. In general, there are two things we express.

  1. What part of the image we are looking at.
  2. What specific features we are seeing in the image.

This is partially what a radiology report is. We describe a feature, give a location, and then synthesise a conclusion. For example:

There is an irregular mass with microcalcification in the upper outer quadrant of the breast. Findings are consistent with malignancy.

You don’t need to understand the words I used here, but the point is that the features (irregular mass, microcalcification) are consistent with the diagnosis (breast cancer, malignancy). A doctor reading this report already sees internal consistency, and that reassures them that the report isn’t wrong. An common example of a wrong report could be:

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This Digital Health Tool is Proven to Improve Cognitive Fitness | Jean Castonguay, NeuroTracker

By JESSICA DAMASSA, WTF HEALTH

Neuroscience startup, NeuroTracker, has a virtual training tool with a proven ability to help improve “cognitive fitness.” Jean Castonguay, co-founder, board member and Head of Global Strategic Partnerships at NeuroTracker, explains the science and clinical validation behind their tech and drops some big name users in the process — Manchester United, German and French soccer teams, US special forces, as well as some of the world’s leading sports concussion rehabilitation clinics. What sets the startup apart from other companies in the mental performance space? How have they shored up their science in the face of Lumosity’s Federal Trade Commission suit against false claims about brain health outcomes? It shook up the industry, and NeuroTracker actually feels it strengthened their business and their value proposition.

Filmed at Bayer G4A Signing Day in Berlin, Germany, October 2019.

Lower Health Insurance Premiums Sound Like Great News – But It’s Only Part Of the Story

By A. MARK FENDRICK, MD

It’s great news to read headlines that the average health-insurance premium will drop by 4% next year in the 38 states using federal Obamacare exchanges. As millions of Americans entered open enrollment this year to choose their health insurance plans, it is important to remember that premiums are only one of the ways that we pay for our medical coverage. 

In many plans lower premiums (paid by everyone) often mean a higher deductible — or paying more out-of-pocket before insurance coverage kicks in. This burden is paid only by those who use medical care services.

Deductibles are rising, and so is the number of Americans enrolled in so-called high-deductible health plans (HDHPs). Thus, more people with health insurance are being asked to pay full price for all their care, regardless of its clinical value. Although it may be better for many people with significant medical needs (and less disposable income) to avoid plans with high deductibles, more and more people who receive health insurance through their employer no longer have a choice except to choose a plan with hefty costs in addition to premiums.

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Health in 2 Point 00, Episode 102 | Proteus, Health 2.0 Asia/Japan, and…a Jewel Heist?

Today on Health in 2 Point 00, Jess is in Las Vegas while I’m all the way in Tokyo for Health 2.0 Japan. In Episode 102, Proteus Digital (finally) announces that they’re running out of money. Does this put the whole category of digital therapeutics at risk? In other news, Seema Verma’s jewelry was stolen and she wants taxpayers to pay her back! How is she going to survive this? And find out what’s going on in Tokyo at Health 2.0 Japan—a whopping 50 startups pitched in a contest yesterday and we’re really seeing the coming of age for this market. —Matthew Holt

RSNA 2019 AI Round-Up

Shah Islam
Hugh Harvey

By HUGH HARVEY, MBBS and SHAH ISLAM, MBBS

AI in medical imaging entered the consciousness of radiologists just a few years ago, notably peaking in 2016 when Geoffrey Hinton declared radiologists’ time was up, swiftly followed by the first AI startups booking exhibiting booths at RSNA. Three years on, the sheer number and scale of AI-focussed offerings has gathered significant pace, so much so that this year a decision was made by the RSNA organising committee to move the ever-growing AI showcase to a new space located in the lower level of the North Hall. In some ways it made sense to offer a larger, dedicated show hall to this expanding field, and in others, not so much. With so many startups, wiggle room for booths was always going to be an issue, however integration of AI into the workflow was supposed to be a key theme this year, made distinctly futile by this purposeful and needless segregation.

By moving the location, the show hall for AI startups was made more difficult to find, with many vendors verbalising how their natural booth footfall was not as substantial as last year when AI was upstairs next to the big-boy OEM players. One witty critic quipped that the only way to find it was to ‘follow the smell of burning VC money, down to the basement’. Indeed, at a conference where the average step count for the week can easily hit 30 miles or over, adding in an extra few minutes walk may well have put some of the less fleet-of-foot off. Several startup CEOs told us that the clientele arriving at their booths were the dedicated few, firming up existing deals, rather than new potential customers seeking a glimpse of a utopian future. At a time when startups are desperate for traction, this could have a disastrous knock-on effect on this as-yet nascent industry.

It wasn’t just the added distance that caused concern, however. By placing the entire startup ecosystem in an underground bunker there was an overwhelming feeling that the RSNA conference had somehow buried the AI startups alive in an open grave. There were certainly a couple of tombstones on the show floor — wide open gaps where larger booths should have been, scaled back by companies double-checking their diminishing VC-funded runway. Zombie copycat booths from South Korea and China had also appeared, and to top it off, the very first booth you came across was none other than Deep Radiology, a company so ineptly marketed and indescribably mysterious, that entering the show hall felt like you’d entered some sort of twilight zone for AI, rather than the sparky, buzzing and upbeat showcase it was last year. It should now be clear to everyone who attended that Gartner’s hype curve has well and truly been swung, and we are swiftly heading into deep disillusionment.

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Will Health Data from Wearables EVER Be Useful to Physicians? | Yenvy Truong, HealthSnap

By JESSICA DAMASSA, WTF HEALTH

Whether it be from an Apple Watch or a Withings scale, the amount of health data available to provide a glimpse into a patient’s everyday life has grown exponentially in recent years. Unfortunately, the utility of all those data points for healthcare providers has not…at least, not yet! Enter HealthSnap, who’s CEO & Co-founder, Yenvy Truong, aims to make sense of all that health data collected from wearables, sensors, and other medical devices with a “Lifestyle Profile” that provides care providers with a clear-and-concise summary of the data that matters most to understanding the day-to-day health lives of their patients. The early stage startup is gaining traction, with 12 health system partners and over 500 physicians using their tech in clinic today. Learn more about their business model, the Series A round they’re raising, and their scale-up plans in this quick chat with HealthSnap.

Filmed at the HIMSS Health 2.0 Conference in Santa Clara, CA in September 2019.

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The Liability of Outside Provider Orders and What Could be Done About It

By HANS DUVEFELT, MD

As a family doctor I receive a lot of reports from emergency room visits, consultations and hospitalizations. Many such reports include a dozen or more blood tests, several x-rays and several prescriptions.

Ideally I would read all these reports in some detail and be more than casually familiar with what happens to my patients.

But how possible is it really to do a good job with that task?

How much time would I need to spend on this to do it well?

Is there any time at all set aside in the typical primary care provider’s schedule for this task?

I think the answers to these questions are obvious and discouraging, if not at least a little bit frightening.

10 years ago I wrote a post titled “If You Find It, You Own It” and that phrase constantly echoes in my mind. You would hope that an emergency room doctor who sees an incidental abnormal finding during a physical exam or in a lab or imaging report would either deal with it or reach out to someone else, like the primary care provider, to pass the baton – making sure the patient doesn’t get lost to followup.

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Rebuilding Trust in our Doctors: An Option for our Broken System

By AMITA NATHWANI, MA

This week’s impeachment hearings show what a crisis of trust we live in today.  69% of Americans believe the government withholds information from the public, according to recent findings by Pew Research Center.  Just 41 % of Americans trust news organizations.  We even distrust our own health care providers: Only 34% of Americans say they deeply trust their doctor.

One important way doctors can regrow that trust is to become educated about the types of medicine their patients want, including alternative therapies. 

People are seeking new ways to care for their health. For instance, the percentage of U.S. adults doing yoga and mediating—while still a minority– rose dramatically between 2012 and 2017, according to the CDC’s National Center for Health Statistics.  Likewise, the number of Americans taking dietary supplements including vitamins, minerals and natural therapies like turmeric, increased ten percentage points, to 75% in the past decade, according to the Council for Responsible Nutrition.  As Americans increasingly seek out non-pharmaceutical ways to address wellness, they need doctors who can talk to them about such alternatives. 

Unfortunately, this is rare.  As a provider of an holistic approach to health called Ayurvedic Medicine, I often see people who tell me their physician dismissed them when they asked about treatments they’d read about on the internet.  In many cases, clients tell me their doctor has actually chastised them for entertaining an alternative approach to their existing illness.  This leaves them disempowered. They wanted to make choices to improve their own health, but found they were not acknowledged, supported or even understood by the doctor.  

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