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Healthcare Might Look Good in Plaid

By KIM BELLARD

I don’t really follow FinTech — I can’t even keep up with HealthTech! — but it caught my eye when Visa announced that it was acquiring FinTech company Plaid for $5.3b; a 2018 funding round valued the company at $2.65b.  A 100% increase in valuation within a year suggests that something important is going on, or at least that people think something is.  

I suspect there may be some lessons for healthcare in there somewhere.  

For those of you who are equally as unfamiliar with FinTech’s terrain, Plaid has been described as the “plumbing” that supports many other FinTech companies.  Launched in 2013, one in four people with a U.S. bank account are now believed to use Plaid to connect with 2,600 FinTech developers connected to more than 11,000 financial institutions.  Its customers include Acorns, Betterment, Chime, Coinbase, Gemini, Robinhood, Transferwise, and Venmo.  Plaid claims it connects with 200 million consumer accounts. 

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THCB Spotlights: Scott Shreeve, CEO of Crossover & Jay Parkinson, CEO of Sherpaa

Today on THCB Spotlights, Matthew chats with a couple of the OGs from the original days of Health 2.0—Scott Shreeve, founder and CEO of Crossover Health, and Jay Parkinson, founder and CEO of Sherpaa, who were the first ones doing something different in terms of doctors figuring out this digital health stuff. The two of them ask the question, what would happen if you married the physical world with the online world and created a new care model that exceeds at both? While Scott was putting in onsite primary care clinics to employers like Apple and Facebook, he realized Crossover wasn’t reaching 70% of the people they were contracted with because many employees were geographically remote. Meanwhile, Jay was doing something similar with virtual primary care—which differs from traditional telehealth in that his model enables a true relationship between patient and provider—and the rest is history.

Digital Health Experts Needed for Landmark International Forum

SPONSORED POST

By CATALYST @ HEALTH 2.0

The IDIH Project (International Digital Health Cooperation for Preventive, Integrated, Independent and Inclusive Living) is setting up an expert-driven “Digital Health Transformation Forum” to promote and increase international collaboration, advance digital health, and support active and healthy ageing through innovation. IDIH is funded under the European Union Horizon 2020 Research and Innovation Programme and brings together prominent organizations from EU and five Strategic Partner Countries: Canada, China, Japan, South Korea and the USA. 

IDIH is seeking individuals whose expertise is in alignment with the following focus areas: 

1. Preventive careFocus: Early diagnosis and detection

2. Integrated care –  Focus: Using new technologies to redesign, coordinate and integrate health and social services and place citizens, patients and seniors at the centre of health systems

3. Independent and connected livingFocus: Tele-monitoring via smart home and living technologies

4. Inclusive living Focus: Helping the elderly feel more connected socially/ healthy living

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Why Do We Have Residency Training?

By BRYAN CARMODY, MD

Surely every resident has had the experience of trying to explain to a patient or family what, exactly, a resident is. “Yes, I’m a real doctor… I just can’t do real doctor things by myself.”

In many ways, it’s a strange system we have. How come you can call yourself a doctor after medical school, but you can’t actually work as a physician until after residency? How – and why – did this system get started?

These are fundamental questions – and as we answer them, it will become apparent why some problems in the medical school-to-residency transition have been so difficult to fix.

In the beginning…

Go back to the 18th or 19th century, and medical training in the United States looked very different. Medical school graduates were not required to complete a residency – and in fact, most didn’t. The average doctor just picked up his diploma one day, and started his practice the next.

But that’s because the average doctor was a generalist. He made house calls and took care of patients in the community. In the parlance of the day, the average doctor was undistinguished. A physician who wanted to distinguish himself as being elite typically obtained some postdoctoral education abroad in Paris, Edinburgh, Vienna, or Germany.

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A New Era for One Digital Health’s First Unicorns? | Maeve O’Meara, CEO, Castlight Health

BY JESSICA DAMASSA, WTF HEALTH

Is Castlight Health suffering a case of ‘first-mover’ curse? One of digital health’s first unicorns, Castlight Health, IPO’d back in 2014 with a valuation of over $3 billion dollars (reportedly, 107 times revenue) at a share price of $40. Today, the stock trades around $1.20, and the company has endured years of frustration from shareholders who’ve complained about customer churn and questioned the company’s business model. A recent change in leadership at the top of the organization has ushered in new CEO Maeve O’Meara, a long-time employee of the trailblazing company, who’s now responsible for blazing a new path toward forward herself. Refreshingly candid about the road ahead, Maeve explains how some new high-touch (but cost-effective) offerings are opening up new markets for the biz and hints at potential partnerships emerging with Big Tech. A must-watch for any digital health startup, investor, or industry analyst who wants longitudinal perspective on health tech’s market resilience and the importance of timing. Maeve, who was a health investor herself before joining Castlight, sums up the challenge of trailblazing tech in healthcare like this: “In healthcare, you always want to be one step ahead and not two steps ahead — you can get burned easily by being two steps ahead.”

Filmed at HLTH 2019 in Las Vegas, October 2019.

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9 Things Every Healthcare Startup Should Know About Business Development

By ANDY MYCHKOVSKY

In this post, I write down all my strategy and business development knowledge in healthcare and organize it into the top 9 commandments for selling as a healthcare startup. I think everyone from the founder to the most junior person on the team should know these pillars because all startups must grow. I should also note these tenets are most applicable for selling into large enterprise healthcare incumbents (e.g., payers, providers, medical device, drug companies). Although I appreciate the direct-to-consumer game, these slices are less applicable for that domain. If your startup needs help developing or implementing your business development strategy, shoot me an email and we can discuss a potential partnership. Enjoy!

1. Understand Everything About the Product and Market

You must also understand the competitive landscape, who else is in the marketplace and how they appear differentiated? What has been their preferred go-to-market approach and is your startup capable of replicating a similar strategy with your current team members? Also, do you understand the federal and state policy that most affects your vertical, whether that be pharmaceutical or medical device (e.g., FDA), health plans (e.g., state insurance commissioners), or providers (e.g., CMS)? For example, if your company is focused on “value-based care” and shifting payment structures of physicians to downside risk, do you intimately understand The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and the requisite CMS Demonstration Models from the Innovation Center (e.g., MSSP, BPCI-A, etc.)? Make sure you do or at least hire someone to explain what is important now and in the future.

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Uber as a Healthcare Company: The ‘Rideshare in Healthcare’ State-of-Play | Dan Trigub, Uber Health

BY JESSICA DAMASSA, WTF HEALTH

Looks like Uber has found its place as a healthcare company. On the heels of announcing a major partnership with Cerner to integrate its platform directly into the Cerner EMR system (and its reach of 220 million patients), Head of Uber Health, Dan Trigub, stops by to talk all things ‘rideshare in healthcare.’ From the regulatory environment shaping non-emergency medical transportation to reimbursement, Dan provides a sophisticated, in-depth description of the market opportunity the ride-hailing business sees in healthcare. How is Uber Health fairing within Uber’s larger business model, which is notoriously known to still be waiting to turn a profit? With more than 1,000 clients and 400% year-over-year growth in the health vertical it sounds like things are picking up.

Filmed at HLTH 2019 in Las Vegas, October 2019.

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“I Want Complete Labs Ordered Before My Physical”

By HANS DUVEFELT, MD

Many patients make this or similar requests, especially in January it seems.

This phenomenon has its roots in two things. The first is the common misconception that random blood test abnormalities are more likely early warning signs of disease than statistical or biochemical aberrances and false alarms. The other is the perverse policy of many insurance companies to cover physicals and screening tests with zero copay but to apply deductibles and copays for people who need tests or services because they are sick.

It is crazy to financially penalize a person with chest pain for going to the emergency room and having it end up being acid reflux and not a heart attack while at the same time providing free blood counts, chemistry profiles and lipid tests every year for people without health problems or previous laboratory abnormalities.

A lot of people don’t know or remember that what we call normal is the range that 95% of healthy people fall within, and that goes for thyroid or blood sugar values, white blood cell counts, height and weight – anything you can measure. If a number falls outside the “normal” range you need to see if other parameters hint at the same possible diagnosis, because 5% of perfectly healthy people will have an abnormal result for any given test we order. So on a 20 item blood panel, you can pretty much expect to have one abnormal result even if you are perfectly healthy.

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Hospital Innovation in Madrid: Harder than in U.S.? | Julio Mayol, CMO, Hospital Clinico San Carlos

BY JESSICA DAMASSA, WTF HEALTH

Is healthcare innovation more challenging in a public healthcare system? We sat down with the Chief Medical Officer & Director of Innovation for the Hospital Clinico San Carlos, Dr. Julio Mayol, to find out! A large, academic research hospital in Madrid, Hospital Clinico San Carlos is an 800-bed facility that has served Madrid since 1717. The hospital counts the entire population of the city (all 6.5M of them) as their patient base and, as such, takes a different approach to integrating new health technology and innovations. Dr. Mayol unpacks the way he leads population health initiatives in his institution, talking through his approach for engaging physicians, external partners, and patients alike to improve the quality of care. Is it different than the way it works in the U.S.? Tune in to find out!

Filmed at Barcelona Health Hub Summit in Barcelona, Spain, October 2019.

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Healthcare Needs Some IHOPs

By KIM BELLARD

The New York Times had an article that surprised me: Current Job: Award Winning Chef.  Education: IHOP.   The article, by food writer Priya Krishnaprofiled how many high-end chefs credit their training in — gasp! — chain restaurants, such as IHOP, as being invaluable for their success. 

I immediately thought of Atul Gawande’s 2012 article in The New YorkerWhat Big Medicine Can Learn From the Cheesecake Factory.

Ms. Krishna mentions several well-known chefs “who prize the lessons they learned — many as teenagers — in the scaled-up, streamlined world of chain restaurants.”  In addition to IHOP, chefs mentioned experiences at chains such as Applebee’s, California Pizza Kitchen, Chipotle, Hillstone, Houston’s, Howard Johnson’s, Olive Garden, Panda Express, Pappas, Red Lobster, Waffle House, and Wendy’s.  

Some of the lessons learned are instructive.  “It was pretty much that the customer is always right,” one chef mentioned.  Another said she learned “how to be quick, have a good memory, and know the timing of everything.”  A third spoke to the focus that was drilled into all employees: “Hot food hot. Cold food cold. Money to the bank. Clean restrooms,” 

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