The end of one decade
and the beginning of another seems to be a time when various pundits like to
look back and/or forward. In particular, I’ve seen a lot of such articles
about tech, both noting important technologies of the 2010’s and speculating on
the tech coming in the 2020’s.
Oddly enough, the
article about new tech that struck me the most was one that seemingly has
nothing to do with healthcare, but which I think has important lessons for
it. It is the introduction of hypersonic missiles.
If you don’t follow
weapons development closely (and I don’t usually), hypersonic missiles are ones that can fly at several multiples of the speed of
sound, such as Mach 5 and above. They fly so fast that there is virtually
no defense against them. Existing anti-missile defenses are problematic
enough against conventional missiles, but a hypersonic missile is at its target
before a defense system can react, due to its speed, low altitude, and
It used to be that patients would have to go see a doctor to get lab tests ordered to check their cholesterol or metabolism, but now, thanks to at-home testing companies like Everlywell, those tests (and 30 others, including STI tests) can be ordered online or picked up at some big box retailers. We chatted with Dr. Frank Ong, Everlywell’s Chief Medical and Scientific Officer, about what it means to put patients in charge of ordering their own lab work — and combing through their own testing results — vis a vie the Everlywell platform. As consumers demand more control over their healthcare dollar and the experience it buys, is there a point where patients risk getting in over their heads? How have doctors been responding to patients who come in armed with their own lab results? We check in on how at-home testing kits are ‘testing’ the reaches of patient-led care.
I have noticed several articles describing how antibiotic development has bankrupted some pharmaceutical companies because there isn’t enough potential profit in a ten day course to treat multi-resistant superbug infections.
Chronic disease treatments, on the other hand, appear to be extremely profitable. A single month’s treatment with the newer diabetes drugs, COPD inhalers or blood thinners costs over $500, which means well over $50,000 over an effective ten year patent for each one of an ever increasing number of chronically ill patients.
Imagine if the same bureaucratic processes insurance companies have created for chronic disease drug coverage existed (I don’t know if they do) for acute prescriptions of superbug antibiotics: It’s Friday afternoon and a septic patient’s culture comes back indicating that the only drug that would work is an expensive one that requires a Prior Authorization. Patients would die and the insurance companies would be better off if time ran out in such bureaucratic battles for survival.
Today on THCB Spotlights, Matthew interviews Carolyn Magill, CEO of Aetion. Aetion is a real world evidence analytics company working to accelerate time to regulatory grade insights. In fact, Aetion recently did a study with Horizon Blue Cross Blue Shield of New Jersey where they analyzed the type 2 diabetes population, identified a subset of patients who should be on a different class of drugs—which are more expensive—that would improve health outcomes and bring down the total cost of care, saving about $5 million for Horizon. Find out where the data and intelligence for this platform came from, and how this female CEO works to empower women both internally and externally.
On January 1, 2020, recreational cannabis use became legal in Illinois. More than 80,000 people in Illinois are registered in the state’s medical cannabis program. Surprisingly, many of their doctors don’t know how to talk with them about their medical cannabis use.
As a health sciences researcher, I have a recommendation that is both practical and profound: Physicians can learn first-hand from their own patients how and why they use medical cannabis, and the legalization of recreational cannabis may make them more comfortable discussing its usage overall.
Nationwide, physicians too rarely discuss cannabis use with their patients living with chronic conditions, such as chronic pain, cancer, multiple sclerosis, epilepsy, fibromyalgia, and Crohn’s disease—all conditions with symptoms that evidence shows cannabis may effectively treat. Why don’t physicians talk with their patients about cannabis use? Research from states with longer histories of legalized medical cannabis shows that many physicians do not communicate with patients regarding their medical cannabis use for a variety of reasons.
First, physicians aren’t well trained in cannabis’ medical applications. Unlike the endocrine or cardiovascular systems, the endocannabinoid system—comprised of receptors which bond with the compounds THC and CBD found in cannabis—is not taught in medical school.
How can helping a cartoon fox also help your mental health? Enter Socks the Fox and Sinasprite, a world exploration game that teaches players evidence-based treatments and coping methods for anxiety and depression. How does it work? Litesprite CEO Swatee Surve explains that players are charged with helping Socks the Fox become a Zen master (of course) and, in doing so, work through a series of challenges and exercises that teach coping mechanisms that range from journaling to diaphragmatic breathing. With its super-sticky storyline (Socks is adorable) the clinically validated game offers a new, upbeat way to bring tech and game theory into the way we treat mental health disorders.
Filmed at Bayer G4A Signing Day in Berlin, Germany, October 2019.
The World Health Organization has named 2020 the Year of the Nurse and Midwife. However, most Americans have never experienced a midwife’s care. In my over 30 years working in maternal-child health, I’ve heard plenty of reasons why. Families are understandably nervous about that with which they are unfamiliar, and nervous about pregnancy and birth in general, with good reason. The cesarean birth rate in the US has more than quadrupled since the early 1970’s, yet we aren’t seeing healthier mothers and babies as a result. In fact, compared to the prior generation, women in this country are 50% more likely to die in childbirth, and for women of color (particularly black women) that risk is three to four times higher than white women, regardless of the woman’s education level or socioeconomic status. For those expecting a baby in the new year, let me set the record straight about midwifery care.
Today’s certified nurse-midwives (CNM) and certified midwives (CM) have earned a minimum of a Master’s degree, as well as have passed a rigorous certification exam. A third category, certified professional midwives, are not required to have an academic degree, but they must also must pass a certification exam “based on demonstrated competency in specified areas of knowledge and skills.” Midwives are intensely educated both in normal, as well as in complications of, pregnancy and childbirth, and are well-prepared to address emergencies as they arise.
Midwives generally care for women with low-risk pregnancies; however, most pregnancies arelow-risk. And in those instances when a patient’s pregnancy or birth becomes high-risk, the midwife collaborates with physician colleagues to provide comprehensive team care to result in the best outcome for mother and baby.
Today, I’m closing out the year of Health in 2 Point 00 from the ski slopes. In Episode 103, Jess asks me about the ACA ruling that the individual mandate is unconstitutional, whether Sutter Health got what they deserved after the $575 million settlement, health insurer Bright Health raising a huge $635 million round, and a rumor about a $250M Softbank investment coming next week. Wishing you all a very happy 2020! —Matthew Holt
As we near the end of the year, rather than reflect on fond memories of 2019 (for which I’m grateful for my family, friends, readers, and Twitter followers), I’ve already started thinking about 2020. If you ever wanted to get inside my brain for 5-10 minutes (scary proposition I know) related to healthcare startups and innovation, here are some areas or trends that I will be following in the new decade.
1. Medicare-For-All Will Be Everywhere
As we move closer to the Democratic Presidential caucus, some of the top-polling candidates (Sen. Elizabeth Warren, Sen. Bernie Sanders, Andrew Yang) are endorsing a Medicare-For-All (M4A) platform. If one of those candidates receive the nomination for the 2020 Presidential election, private v. public health insurance will be front and center. It will dominate all major news. I’m watching how the weight of the entire healthcare industry will politically respond to a national Medicare-4-All Presidential debate (both publicly and privately).
2. Updating Physician Anti-Trust Rules To Support Value-Based Care
In October, the U.S. Department of Health and Human Services (HHS) released their long-anticipated proposed rules to update the anti-kickback and physician referral regulations, to help spur greater provider participation in value-based care arrangements. Any changes once finalized would affect the Civil Monetary Penalties Law, the Federal Anti-Kickback Statute, and the Physician Self-Referral Law (“Stark Law”). After comments are received, I’m watching how the healthcare machine helps craft these new regulations that some would say, stifles innovation in provider care delivery.
While the “healthcare ecosystem” sounds like a nice place to begin a career, the day-to-day can often make it feel like the industry is about survival of the fittest — especially for young professionals who are just starting out. Enter The Advancement League, an organization-slash-support-system for young leaders and entrepreneurs. Co-founders Alex Maiersperger and Antwan Williams started the organization as a way to unite bright-eyed, up-and-comers from health systems, health plans, and startups who not only want to build big careers in health, but who also want to apply their youthful optimism, new ideas, and tech to changing the experience of healthcare for the better. How can you get involved? Tune in for all the details about the organization’s events, especially their “big one,” the Young Health Leader’s Summit.