Episode 7 of “The THCB Gang” was live-streamed on Thursday, April 30th at 1pm PT- 4pm ET! You can see it below. If you’d rather listen, the “audio only” version is preserved as a weekly podcast available on our iTunes & Spotify channels.
Joining me were regulars futurist Ian Morrison (@seccurve), patient advocate Grace Cordovano (@GraceCordovano), quality expert Michael Millenson (@MLMillenson), with guests Raj Aggarwal (@docaggarwal) head of innovation at Jefferson Health System, and our very own health tech “IT girl” Jessica DaMassa (@jessdamassa) from WTF Health. We had a great conversation about the present and future of care delivery and finance. — Matthew Holt
“It has always been science versus fundamentalism, not science versus religion.”
Abhijit Naskar, Biopsy of Religions: Neuroanalysis Towards Universal Tolerance
On February 3, 2020, the luxury cruise ship Diamond Princess docked on Japanese shores and was promptly quarantined with 3711 people on board, because a passenger who had disembarked at Hong Kong two days earlier had tested positive for SARS-Cov-2, or also known as COVID-19. Passengers & crew members were either repatriated or hospitalized in Japan over the next 4 weeks. In total,, more than 700 of them were found to be infected with the virus. This was a unique opportunity – a Petri dish in a ship, if you may – for epidemiologists and virologists to study the disease and the virus.
At the beginning of this global pandemic, health care professionals and policymakers used data from the Diamond Princess experience and inferences thereof, such as infectivity & death rates, as a supplement to the observations from Wuhan. They used the data to derive models on how the pandemic will play out in the rest of the world. Later, after widespread devastation in Iran, Europe, & the United States, and after relative containment in Taiwan, South Korea & Singapore, experts have access to larger datasets & a variety of scenarios to help develop disease virulence predictions and control models.
So far, authorities in the Indian subcontinent appear to copy strategies of other countries to combat the spread of the pandemic. The curves of exponential ascendency of COVID-19’s spread across countries appear identical in nature, except in a few where health care response is more regimented. Yet, there is speculation about the virus’s survival in India’s climatic conditions: Indians may have a better “innate resistance” and the impact of compulsory the BCG vaccination in most Indians may have some effect on the expression of the disease in the country. Therefore, it may be worthwhile for India to study the actual transmission, clinical expression, and outcomes of the disease in her own population and design responses to the pandemic based on those studies.
That is to say, we must find our own Diamond Princess before we find our Wuhan.
“The mental health system was completely broken before COVID. The supply-demand imbalance was wildly upside down. Now, that’s just all exacerbated.”
On-demand mental health startup Ginger has watched usage of their app climb 130% over the last 4-week period. The conversations people are having with clinicians are growing more intense (there’s an internal metric for that) and amid all of this the late-stage startup has re-run its ‘Workforce Attitudes’ survey to find out what’s really going on with the mental health of the employee populations it serves.
CEO Russell Glass dives into some of the findings of that report, which are pretty revealing in terms of understanding how we as a population are dealing with our stress around COVID-19 when we’re seeking professional help with it. Nearly 70% of respondents confessed this was the most stressful period of their career — five times more stressful than the financial crash of 2008 — and there are some surprising differences with how this is all unfolding across gender lines, especially with working from home.
With inbound interest from employers up 4X over the past month, we get Russ’s input on whether or not the demand for telehealth will sustain once the crisis is over and if the temporary regulatory and reimbursement changes will become permanent. Says Russ: “This is like a great experiment of the efficacy of telehealth versus non-telehealth.”
Today on Health in 2 Point 00, we have a digital audience! Eugene Borukhovich and Jim Joyce join us as guests on Episode 121. Well actually we were invited on their show A Shot Of Digital Health, and we decided to launch a takeover! Jess asks me about a lot of movement in the telehealth space with Medici raising $24 million in a Series B, Tomorrow Health launching with a $7.5M seed round for in-home care, Decoded Health launching an AI telehealth app and IDC Telemed buying Ilum. Also HIMSS launches a new Digital Health Indicator to help hospitals judge their digital health readiness — and don’t get Jess started on their new definition of digital health. In fact everyone piled in on that!—Matthew Holt
As more people die every day from COVID-19 (we
were edging towards 20,000 casualties in the U.S. at the time this article was
written), the answers to what a cure could look like are waiting to be
discovered in EMRs and patients’ homes. We have the technology and business
models to turn this data into insights, but we are stalling… What seems to be the problem?
First this. It’s time to end the illusion that
patients do not pay for healthcare. Whether it is out of pocket, paycheck, or
taxes, U.S. citizens pay for 100% of the healthcare spend. It is indeed their healthcare. It follows logically
from this that patients should be allowed and empowered to lower the cost and
increase the quality of the care they receive. Receiving access to their own
medical records is one important way to accomplish this.
In 2017, when I asked the World Economic Forum
if there is a study on the cost of lack of interoperability in healthcare they
said – “That’s a good idea.”
On Episode 120 of Health in 2 Point 00, Jess asks me about health data sharing company Particle Health raising $12 million in an A round, AliveCor and OMRON partnering in a remote monitoring play for combined EKG and blood pressure monitoring, and Compass Pathways scoring $80 million in a B round for psilocybin therapy for treatment-resistant depression. Also, Optum is reportedly acquiring AbleTo for $470 million which provides behavioral telehealth — looks like they’re slowly putting all the pieces together to become a big virtual Kaiser. —Matthew Holt
It’s amazing that the word “medication” is not mentioned in a recent Morbidity and Mortality Weekly Report from the US Centers for Disease Control and Prevention (CDC). The research states that a staggering 90% of people hospitalized for COVID-19 have underlying conditions, including hypertension, diabetes mellitus and cardiovascular disease, all of which require drug treatments for patients to remain healthy.
Yet nowhere in the report is there mention of how
patients can potentially prevent COVID-19 related health decline through better
medication use for their underlying disease.
Are the COVID-19 hospitalization rates truly caused by the underlying
disease and insufficient use of preventive measures like social distancing? Or
are these underlying conditions unmanaged due to medication optimization issues
placing these patients at higher risk for hospitalizations?
Medication optimization is how the healthcare system
supports the patient from the initial prescription to follow up and ongoing
review. It aims to improve the safety, effectiveness, and affordable use of
prescribed drugs.
The invisible threat enabling the spread of COVID-19
that no one seems to be talking about is that barriers to medication use are
accelerating infections for these high-risk populations. Buried within the “People Who Need Extra Precautions”
section of its website, the CDC states people with high-risk for severe illness
from COVID-19 are “people of all ages with underlying medical conditions,
particularly if not well controlled”. Clearly, optimizing medications is one of
the most important aspects to controlling chronic illness. Optimization
supports patients through medication therapy that aims to improve safety,
effectiveness, and affordable use of prescribed drugs.
When it comes to money back guarantees in health care, it’s
often less about the money and more about the guarantee.
That’s the biggest takeaway shared by two organizations—Geisinger
Health System and Group Health Cooperative of South Central Wisconsin (GHCSCW)—that
separately rolled out closely-watched campaigns to refund patients their
out-of-pocket costs for health care experiences that fell short of expectations.
Both programs started as a way to inject a basic level of
consumerism into a process long bereft of one. In fact, as consumer frustration
over medical costs rise, a money back guarantee has the potential to win back a
dissatisfied public.
But like many experiments in health care, the effort
produced some unexpected results as well. Instead of a rush on refunds,
executives from both systems said their money-back pledge served even better as
a continuous-improvement tool, with patients providing almost instantaneous
feedback to staff who felt newly empowered to address problems.
As healthcare systems around the world grapple with the coronavirus, ‘virtual-first healthcare’ is fast becoming the global response of private and public healthcare systems alike. In Australia, the federal government recently committed to investing $500M to built out its country’s ‘virtual-first’ healthcare infrastructure, so we caught up with Louise Schaper, CEO of the Australasian Institute of Digital Health (AIDH), to find out what that means for telehealth, remote monitoring, and digital health companies looking to capitalize on the market opportunity in Australia.
With a population of 25 million people (roughly the number of people in Florida) and a set of newly-minted reimbursement codes that makes telehealth available to all of them via the government-funded public healthcare system, the appetite for investing in new health tech solutions has grown ravenous.
Says Louise, “Anyone who has solutions that are already market-tested and approved, I’d actually expand your networks globally now. There’s not a section of the globe that hasn’t been impacted by [covid19] and we’re all needing to work out how to deliver healthcare differently.”
As in other parts of the world, the government codes reimbursing telehealth and other virtual-first services are temporary (Australia’s are set to expire September 30, 2020), but organizations like the AIDH, the Australian Medical Association, and others are advocating for their permanence and are optimistic.
The prevailing sentiment is that, like in the US, the benefits of virtual care to healthcare consumers and clinicians are going to be difficult for the government to ignore. Add to that the potential of linking virtual care to the Aussie government’s AUD$2 billion dollar build of its MyHealthRecord system — a centralized, cloud-based EMR that holds the healthcare data of 90% of all Australians — and the prospect grows even more appealing.
Join us as we talk through the basics of the Australian healthcare system and get an insider’s look at the demand for digital health, remote monitoring, and telehealth Down Under.
There are so many
stories about the coronavirus pandemic — some inspiring, some tragic, and
all-too-many frustrating. In the world’s supposedly most advanced
economy, we’ve struggled to produce enough ventilators, tests, even swabs, for
heaven’s sake.
I can’t stop thinking
about infrastructure, especially unemployment systems.
We’d never purposely shut down our economy; no nation had. Each state is trying to figure out the best course between limiting exposure to COVID-19 and keeping food on people’s tables. Those workers deemed “essential” still show up for work, others may be able to work from home, but many have suddenly become unemployed.
The U.S. is seeing
unemployment levels not seen since the Great Depression, and occuring in a matter
of a couple months, not several years. As of this writing, there
are over 22 million unemployed; no one believes that is a complete count (not
everyone qualifies for unemployment), and few believe that will be the peak.
Many unemployment
systems could not manage the flood of applications.
Recent Comments