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Digital Health Experts Needed for Landmark International Forum

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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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The Applied Health Signals Category of Health Tech | Jennifer Schneider, Livongo

BY JESSICA DAMASSA, WTF HEALTH

Before Livongo set digital health records for its IPO, it started 2019 by launching a brand-new category of healthcare company: the Applied Health Signals company. How is this category different than what we already think of when we think about digital health and healthcare? How is it distinct from health tech’s other emerging classification, digital therapeutics? Jennifer Schneider, Livongo’s President, explains why the company started the new category, which is intended for those who are working at the intersection of data science, clinical impact, and behavioral outcomes. Could your company be an Applied Health Signals Company? Listen in to hear Jenny talk about how Livongo’s “AIAI engine” drove the decision to start the new classification. If your tech works like hers…maybe you are!

Filmed at HLTH 2019 in Las Vegas, October 2019.

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Top 3 Myths About Digital Identity in Healthcare

By GUS MALEZIS

Healthcare is in the midst of a digital transformation, creating information security, compliance, and workflow challenges. The engagement of an increasingly decentralized workforce along with anytime anyplace healthcare and the proliferation of cloud-based applications, databases, and mobile devices have now (or soon will have) eroded the once well-defined network perimeter.

The healthcare industry remains one of the most highly targeted for cyber-attacks – a recent report from Beazley Breach Insights showed that, 41 percent of all breaches in 2018 occurred in the healthcare sector. This means that, going forward, healthcare organizations must pay particular attention to cybersecurity and do so without restricting or compromising access to the systems and services providers and patients are now using and may do in the future. A successful cybersecurity plan requires these organizations to focus on establishing and managing trusted digital identities for all users, applications, and devices throughout the entire extended digital healthcare enterprise – from the hospital, to the cloud, and beyond.

Why are modern hackers targeting healthcare? Because they can, and they have the opportunity to do so! Hackers also know the value of the data stored within provider systems. Today, medical records fetch up to ten times more money on the dark web than the average credit card.  

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