Healthcare providers are
moving forward with their digital initiatives, pursuing intranet development, implementing e-prescribing software, and deploying
EHR systems and patient portals to enhance patient care, maximize staff
efficiency, and improve the bottom line.
However, while medical professionals
are largely enthusiastic about digital healthcare solutions, the disparity
between the rate of clinical support and patient utilization of some of this
software, patient portals in particular, is enormous. Even though patient
self-service solutions have become ubiquitous in medical facilities nation-wide,
over 62% of US hospitals report that their patient portal systems are used by less than a quarter of all patients.
Patients still don’t see
enough value in patient portals, voicing concerns over the steep learning curve,
lack of training, anxiety regarding data security and confidentiality, and
other issues. Addressing these challenges is critical to encouraging patient
buy-in and getting more patients involved in their health.
Since most medical
facilities in the country already have patient portals in place, the next step
to overcome barriers to their adoption is to expand these systems to deliver
features that will get more patients involved.
The Cure for healthcare isn’t Medicare for All, it’s establishing organizations with complete responsibility for the total care, costs, quality and outcomes for a person.
Discussions of Medicare for All substitute structure for substance. They engender a debate about the trappings of care delivery, administration, and cost, but don’t address the fundamental issue, which is how to provide genuinely better care for people of all ages and economic circumstances.
The premise of Medicare for All is that a single payer will provide better and more cost effective care. But what is really needed is single entity accountability. Whether there are one or many, whether they are public or private, is not as important as that one organization and its people become responsible for the total health and care of an individual and the costs associated with that care. With incentives for doing it well, and penalties for doing it poorly. And an ease of transition for people to move from an entity that doesn’t serve them well to one that does, to maintain the benefits of competition and varied approaches based on differing conditions.
Focusing on Medicare for All promulgate a systemic flaw baked into our health insurance and provider systems. High costs and lower quality can’t just be fixed by a single payer negotiating lower drug prices, nor would providing fewer services mean better care at lower costs. The core problem is exemplified by the invidious arbitrary split in public health insurance between Medicaid and Medicare, with each providing different services spread out among many providers, none of whom have sole responsibility for the complete health of the person.
BetterCare for All need not be a win-lose proposition, of Medicare for All or nothing. The feasibility near term of a one payer system is low, whereas the feasibility of building on existing systems and frameworks to create single system accountability is much higher.
What’s next for digital health’s premier IPO, Livongo? Executive Chairman Glen Tullman says “the best day of going public is the day you go public,” but there’s got to be more to it than that right?! We get inquisitive about acquisitions, keeping the market happy, and how his applied health signals company is blurring the lines between tech and healthcare. Is Livongo a tech company or a healthcare company? What does that AI-plus-AI really add up to?
Filmed at the HIMSS Health 2.0 Conference in Santa Clara, CA in September 2019.
It is well known by now that a physician’s demeanor influences the clinical response patients have to any prescribed treatment. We also know that even when nothing is prescribed, a physician’s careful listening, examination and reassurance about the normalcy of common symptoms and experiences can decrease patients’ suffering in the broadest sense of the word.
This has been the bread and butter of counselors for years. People will faithfully attend and pay for weeks, months and even years of therapy visits just to have an attentive and active listener and to feel like they have an ally.
We also have data that shows that adherence to treatment plans is dependent on how patients feel about their provider. One problem solved can build an ally for life
Primary care medicine is a relationship based business. I don’t know how often that basic fact is overlooked or denied. Whether you are trying to get another person to alter their lifestyle, take expensive medicines according to inconvenient schedules or even just trust and accept your diagnosis, you have to “earn” the right to do those things. Our titles and medical accoutrements give us a foot in the door, but they don’t usually get us all the way into peoples inner circles of trusted advisers.
In this age of corporate medicine, there is a belief that patients attach themselves to institutions and networks because of their trust in the organizations, and that therefore the connection with their individual providers is secondary.
Today on THCB Spotlight, Matthew catches up with Kuldeep Rajput, the founder and CEO of Biofourmis. Biofourmis uses biomarkers and sensors for health management, in pursuit of this dream of predicting disease before it happens so we can improve and health outcomes. The key question here is, how do you take a known pharmacotherapy and combine that with a digital solution so that it can synergistically act on patients to drive meaningful outcomes?
Biofourmis announced this week that they are acquiring Biovotion, as well as a commercialization deal with Novartis. Why did a device-agnostic platform decide to acquire a biosensor company? For the contract with Novartis for a major rollout of their heart failure platform across Asia—what are they trying to accomplish?
Today is Health in 2 Point 00’s 100th Episode and we are reporting from Frontiers Health in Berlin! Jess and I talk about Google & Ascension’s deal to move all of their information and data onto Google Cloud, however, they are currently facing backlash over data privacy issues and are being investigated by HHS’ Office for Civil Rights. Apple released some new research on EKGs, carrying out a clinical trial on 400,000 people, I didn’t think their results were that interesting, but their ability to reach that many people for a clinical trial was impressive and may open up new doors in research for recruiting participants using Apple products. At Frontiers Health, Noom, a nutrition startup focusing on managing chronic care conditions, announced that they are looking to do $235M in revenue by this year, which is big news considering Livongo (which IPOed this year) did $165M in revenue. We also take a moment of silence for Bernard J Tyson, CEO of Kaiser Permanente, who was an active leader for equity in health care and a leading black executive for the community. Rest in Peace – Matthew Holt
Forced absence from gun violence has created a literal and metaphorical void in schools across our country that may impact students and staff for decades to come. The students are referred to as “Parkland kids,” “Sandy Hook students,” or “Columbine survivors.” These labels are sadly reflective of a new reality for American schools, as students, teachers, and staff no longer feel safe. America’s students feel vulnerable as the facade of schools as a safe place is no longer true. The Center for American Progress recent report revealed that 57% of teenagers now fear a school shooting.
Often, perpetrators of gun violence leave a trail of “red flags” for years, as they are troubled youths. This was the case in the Parkland shooting. Tragically, multiple agencies failed to respond to the signs the troubled young man was leaving, including specifically writing online that he aspired and planned to be a school shooter.
In the aftermath of the Parkland, Florida tragedy, parents and school districts turned to security experts demanding a plan of action. Sadly, the information provided was substandard and lacked evidence to support the strategies as efficacious. Lives weigh in the balance and there is no more tolerance for guessing.
Research is needed to guide the creation of evidence-based frameworks for school communities to address prevention as well as protection. Threat assessment teams are a strategy to assess for potential threats, but more importantly is that an intrinsic safety network is woven into the fabric of the educational system. Exposing the root cause of the contagion of violence impacting our youth is key.
“YOUR LIKELIHOOD OF SECURING RESIDENCY TRAINING DEPENDS ON MANY FACTORS – INCLUDING THE NUMBER OF RESIDENCY PROGRAMS YOU APPLY TO.”
So begins the introduction to Apply Smart: Data to Consider When Applying to Residency – a informational campaign from the Association of American Medical Colleges (AAMC) designed to help medical students “anchor [their] initial thinking about the optimal number of applications.”
In the era of Application Fever – where the mean number of applications submitted by graduating U.S. medical students is now up to 60 – some data-driven guidance on how many applications to submit would be welcome, right?
And yet, the more I review the AAMC’s Apply Smart campaign, the more I think that it provides little useful data – and the information it does provide is likely to encourage students to submit even more applications.
This topic will be covered in two parts. In the first, I’ll explore the Apply Smart analyses and air my grievances against their logic and data presentation. In the second, I’ll suggest what the AAMC should do to provide more useful information to students.
Introduction to Apply Smart
The AAMC unveiled Apply Smart for Residency several years ago. The website includes lots of information for students, but the piece de resistance are the analyses and graphics that relate the number of applications submitted to the likelihood of successfully entering a residency program.
Today on THCB Spotlight, Matthew catches up with Dr. Pascal Zuta, the Co-Founder and CEO of Gyant at HLTH. Gyant is a digital “front door” for hospitals which helps patients find the right care. In their vision, health care software should not smell like a hospital—they’ve worked to infuse their system with fun and empathy, with the goal of building a system that can follow someone all the way along their patient journey in an empathetic way in which AI and humans work together seamlessly.
Google’s semi-secret deal with Ascension is testing the limits of HIPAA as society grapples with the future impact of machine learning and artificial intelligence.
Glenn Cohen points out that HIPAA may not be keeping up with our methods of consent by patients and society on the ways personal data is used. Is prior consent, particularly consent from vulnerable patients seeking care, a good way to regulate secret commercial deals with their caregivers? The answer to a question is strongly influenced by how you ask the questions.
Here’s a short review of this current and related scandals. It also links to a recent deal between Mayo and Google, also semi-secret. A scholarly investigative journalism report of the Google AI scandal with London NHS Foundation Trust in 2016 might be summarized as: the core issue is not consent; it is a conflict of interest at the very foundation of the information governance process. The foxes are guarding the patient data henhouse. When the secrecy of a deal is broken, a scandal ensues.
The parts of the Google-Ascension deal that are secret are likely designed to misdirect attention away from the intellectual property value of the business relationship.