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What, Us Worry

By KIM BELLARD

2020 has been an awful year.  Hurricanes, wildfires, murder hornets, unjustified shootings, a divisive Presidential election, and, of course, a pandemic.  Most of us are spending unprecedented amounts of time sheltering in place, millions have lost their jobs, the economy is sputtering, and over a quarter million of us didn’t survive to Thanksgiving.  If you haven’t been depressed at some point, you haven’t been paying enough attention.

Within the last two weeks, though, there has finally been some cause for hope.  Whether you want to credit Operation Warp Speed or just science doing what it does, we are on the cusp of having vaccines to battle COVID-19.  First Pfizer/BioNTech, then Moderna, and most recently, AstraZenica, announced vaccines that appear to be highly effective. 

We’re having our Paul Revere moment, only this time with good news.  The vaccines are coming!  The vaccines are coming!

It strikes me, though, that our enthusiasm about these vaccines says a lot about why the U.S. has had such a hard time with the pandemic; indeed, it tells us a lot about why our healthcare system is in the state it is. We’re suckers for the quick fix, the medical intervention that will bring us health.

Unless you were alive when Woodrow Wilson was President, COVID-19 has been the worst public health crisis of our lifetime.  It took some time for us to fully realize how bad it was going to be, and, even then, most of us underestimated exactly how bad that would be.  We may still be underestimating how bad these next few months will be.

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THCB Book Club: Rosemarie Day – Marching Towards Coverage

Rosemarie Day has been a long time health care consultant and operator, most prominently as the COO of the Massachusetts Health Connector–the first real state exchange that was created as part of Romneycare (which with a few twists later became Obamacare!) Following the 2017 Women’s March, Rosemarie decided to write her own book, Marching Towards Coverage. It’s really four books in one. A personal patient & caregiver journal; a history of the slow march towards universal health care; a policy document; and a primer on how to become an activist. All in less than 200 pages! For the November THCB Book Club Jessica DaMassa and Matthew Holt talked with Rosemarie about what we can all do to really get to better health care for everyone.

#Healthin2Point 00, Episode 169 | They’re real and they’re SPACtacular!

Today on Health in 2 Point 00, It’s a whacky SPACy world, as a new SPAC rolls “UpHealth” and has me singing Bob Marley, meanwhile there’s $91m for remote clinical trial software player Medable, $76m more for Spring Health joining the throng of mental health companies, while K-Health gets $42m to introduce chat bot front ends to Korean pop music…or something like that. —Matthew Holt

The Art of Listening: Beyond the Chief Complaint

By HANS DUVEFELT

A doctor’s schedule as typical EMR templates see it only has “Visit Types”: New Patient, 15 minute, 30 minute. But as clinicians we like to know more than that.

One patient may have a brand new worrisome problem we must start evaluating from scratch, while another is just coming in for a quick recheck. Those are diametrically opposite tasks that require very different types of effort.

Some visits require that test results or consultant reports are available, or the whole visit would be a waste of time. How could you possibly plan your day or prioritize appointment requests without knowing more specifically why the patient needs to be seen?

So, as doctors, we usually want our daily schedules to have “Chief Complaints” in each appointment slot, like “3 month diabetes followup”, “knee pain” or “possible dementia”. That helps everybody in the office plan their day.

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Comcast, Independence BlueCross’s Quil: Fast-Forward Past Video Content to Home Sensors for Seniors

By JESSICA DaMASSA, WTF HEALTH

It’s not just eyeballs that Comcast NBCUniversal and Independence BlueCross’s joint venture, Quil, is after these days. Carina Edwards, Quil’s CEO, paints a compelling picture of the full-scale business model for “health-in-the-home” that her company is enacting. What started out with trusted healthcare content for surgery prep (able to be deployed across a household’s army of devices, including their TV for those 1.3M Comcast Xfinity cable subscribers) is now expanding with more tech and more services to meet the needs of seniors aging-in-place and the fifty million unpaid caregivers looking after them. Ambient, “context-aware” sensors. Voice integrations with smart speakers. And that’s nothing to say of the caregiver-focused programming that addresses everything from caregiver burnout to tackling tough conversations about a range of issues from paying for care to end-of-life wishes. Quil’s pilot of this new senior-focused offering will be rolled out with Comcast’s help this winter, with the full direct-to-consumer commercial launch expected in Q3 2021. As Carina says, “Comcast knows how to pilot technology.” And, Quil has shown its ability to impact healthcare quality measures thanks to studies around its initial surgery-prep offering. Will it be enough to take on others looking to help turn our living rooms into exam rooms? Tune-in around 17:20 to hear just how integrated Comcast and IBX are in the strategy at Quil.

Can the Government Mandate a Covid-19 Vaccine? Will It Have To?

By PHILLIP MEYLAN

With the emergence of two vaccines with high levels of effectiveness, there’s a strong prospect of having powerful new tools to combat Covid-19 in the months ahead. But the road between a vaccine and society returning to normal is far from certain. Millions of doses will need to be produced and intelligently distributed, and critically, people must be willing to take them. The last few months have seen already-low confidence in such a vaccine fall even further, with just two-thirds of Americans expressing a willingness to be vaccinated when one becomes available. Similar trends are playing out globally. 

Source: The Economist

Bringing the pandemic under control will likely require successfully vaccinating 60–70% of the population to halt community transmission. Vaccine skepticism puts rapidly reaching that goal in jeopardy. Can the government at the state or federal level mandate vaccination? What is motivating this growing skepticism in Covid vaccination and how might those sentiments shift over time? This week, Phillip looked at 28 articles from 24 sources to explore likely pathways toward vaccination, as well as related vaccine skepticism. 

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RWJF Emergency Response Challenge Results!

by MATTHEW HOLT

Yesterday Catalyst @ Health 2.0 hosted the finals of the RWJF Emergency Response Challenges, one for tools for the General Public and the other for the Health System. It was a great session, sadly virtual and not at a conference with cocktails afterwards. But the promise of the tools that have been built as part of these challenges is immense in the battle against this COVID-19 pandemic and the ones yet to come.

The finalists for the General Public challenge were

  • Binformed Covidata– A clinically-driven comprehensive desktop + mobile infectious disease, epidemic + pandemic management tool targeting suppression and containment of diseases such as COVID-19. The presenter was veteran health IT expert Rick Peters.
  • CovidSMS– A text message-based platform providing city-specific information and resources to help low-income communities endure COVID-19. In contrast to Rick, CovidSMS’ team were undergraduates at Johns Hopkins led by Serena Wang
  • Fresh EBT by Propel– A technology tool for SNAP families to address food insecurity & economic vulnerability in times of crisis – highlighted by Michael Lewis on his Against the Rules podcast about coaching earlier this year. Stacey Taylor, head of partnerships for Propel presented their solutions for those in desperate need.

The finalists for the Health System challenge were

  • PathCheck A non profit just spun out of MIT. It has a raft of volunteers and well known advisors like John Brownstein and John Halamka among many others, and is already working with several states and countries. Pathcheck provides privacy first, free, open source solutions for public health to supplement manual contact tracing, visualize hot spots, and interface with citizen-facing privacy first apps. MIT Professor Ramesh Raskar was the presenter.
  • Qventus A patient flow automation solution that applies AI / ML and behavioral science to help health systems create effective capacity, and reduce frontline burnout. Qventus is a great data analytics startup story. It’s raised over $45m and has lots of health system clients, and they have built a suite of new tools to help them with pandemic preparedness. Anthony Moorman, who won the best facial hair of the day award, showed the demo.
  • Tiatros IncA mental health and social support platform that combines clinical expertise, peer communities and scalable technology to advance mental wellbeing and to sustain meaningful behavioral change. They’ve done a lot of work with soldiers with PTSD and as you’ll see entered this challenge to get their tools to another group of extremely stressed professionals–frontline health care workers. CEO Kimberlie Cerrone and COO Seth Norman jointly presented.

Videos of the whole session and the demos will be up soon.

And the winners were…

A tie in General Public challenge between CovidSMS & BInformed, who split the $25,000 first prize (and the $10,000 second prize!)

Qventus in the Health System challenge who take home $25,000

But there were no losers. A great culmination of a lot of work to get tech solutions to help us deal with the pandemic.

Matthew Holt is Publisher of THCB and also Co-Chairman at Catalyst @ Health 2.0

THCB Gang Episode 33, Thursday 11/19

Episode 33 of “The THCB Gang” was live-streamed here Thursday, November 19th. You can watch it below.

Matthew Holt (@boltyboy) was joined by some of our regulars: CEO of Day Health Strategies Rosemarie Day (@Rosemarie_Day1), data privacy expert Deven McGraw (@healthprivacy), patient safety expert Michael Millenson (@MLMillenson) and health futurist Ian Morrison (@seccurve). While the chaos of the post election legal shenanigans goes on, we chatted what the Biden team might and can do, and look at the pre- and post-vaccine COVID-19 future of health care.

If you’d rather listen to the episode, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels.

Women Leaders Increasingly Visible In The Fight Against Covid-19

By MIKE MAGEE, MD

As we struggle to control a second wave of Covid-19, we are reminded once again of the nurses and doctors who place themselves at risk willingly and consistently.  They are struggling uphill with a deeply segmented health care system that chronically rewards the have’s over the have-not’s, and a President clearly intent on creating as much havoc as is humanly possible on the way out the door.

Filling the leadership void this week, we witnessed the unusual appearance on network television of two national leaders from the professions of Nursing and Medicine, Dr. Susan Bailey (President, AMA) and Debbie Hatmaker (Chief Nursing Officer, ANA) appearing in tandem. 

The united front presented by these two women leaders was reassuring. They didn’t pull punches, but spoke truth to power, describing the nation’s condition as “very grim” and “quite stark.”

In many ways, their joint appearance was a reflection of a changing reality in communities large and small across America. A Medscape survey released this week found that women’s roles in health care are growing in leaps and bounds. For example, in Family Medicine, close to 40% of the physicians are now women, and they work approximately the same number of hours per week as their male counterparts.

These women doctors are increasingly working in team settings. The majority of Family Physicians (71%) now work within a team that includes either a Nurse Practitioner (NP) or Physician’s Assistant (PA).

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#Healthin2Point 00, Episode 168 | Is Amazon taking over the world of healthcare?

Goodbye health insurance, hello Amazon Prime membership! Today on Health in 2 Point 00, we talk about all the Amazon news now that they’re moving into pharmacy via Amazon Prime. Jess and I also discuss AliveCor raising $65 million for its personal EKG technology and Talkspace acquiring Lasting, a relationship counseling app. Levels raises $12 million in a seed round, adding more fun things you can do with your CGM, and another SPAC takes a company public—Barry Sternlicht’s SPAC is acquiring Cano Health at a $4.4 billion valuation. —Matthew Holt

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