Ali Diab, CEO & Co-Founder of Collective Health, wants to talk about healthcare affordability and the fact that consumerism doesn’t really exist when it comes to healthcare because we don’t really have a functioning market. The “Real” buyers — from the federal government to large employers — have no idea what things cost in traditional health plans and are making healthcare purchases for their constituents without full price transparency. So, what has he and Collective Health learned now that they’re 6 years into trying to offer these buyers an alternative to that traditional health plan experience? Nothing is more complex than health insurance innovation, but Collective Health is making significant headway and, according to Ali, has made it past the “homicide phase” of being a digital health startup.
Filmed at HLTH 2019 in Las Vegas, October 2019.
Jessica DaMassa is the host of the WTF Health show & stars in Health in 2 Point 00 with Matthew Holt.
Get a glimpse of the future of healthcare by meeting the people who are going to change it. Find more WTF Health interviews here or check out www.wtf.health.
“By the way, Doc, why am I tired, what’s this lump and how do I get rid of my headaches?”
Every patient encounter is a potential deadly disease, disastrous outcome, or even a malpractice suit. As clinicians, we need to have our wits about us as we continually are asked to sort the wheat from the chaff when patients unload their concerns, big and small, on us during our fifteen minute visits.
But something is keeping us from listening to our patients with our full attention, and that something, in my opinion, is not doctor work but nurse work or even tasks for unlicensed staff: Our Public Health to-do list is choking us.
You don’t need a medical degree to encourage people to get flu and tetanus shots, Pap smears, breast, colon and lung cancer screening, to quit smoking, see their eye doctor or get some more blood pressure readings before your next appointment. But those are the pillars of individual medical providers’ performance ratings these days. We must admit that the only way you can get all that health maintenance done is through a team effort. Medical providers neither hire nor supervise their support staff, so where did the idea ever come from that this was an appropriate individual clinician performance measure?
Is healthcare on the way to ‘telehealth at-scale?’ We checked in with American Well’s Danielle Russella, President & GM of Health Plan Solutions, to rumor-check the buzz we’ve been hearing about “digital-first health plans” and what that means for the future of health plan coverage for telehealth services. From provider uptake and payment parity to patient awareness and utilization, Danielle weighs in on the state-of-play of telehealth/health plan relations and how digital health seems to finally becoming part of payer strategy talks within the C-suite. At American Well, that’s meant more growth in last 2 years than in the previous 8 years, says Danielle. Is that why we’re hearing those IPO rumors? Tune in to find out if there’s any merit to that chatter.
given the frequency of seeing death and grief depicted in the media or through
real life encounters with friends, relatives, neighbors, or patients? These
incidents trigger uncomfortable and sometimes uneasy thoughts of how we might
personally deal with potential illness and disease. The same thoughts are soon
displaced by the busyness of living.
dealing with the death of his mother from a brain tumor, we learn David
Fajgenbaum was healthy, living life to its fullest, and a future doctor in the
making. He may have thought about his own mortality as he grieved the death of
his mother, but likely never imagined anything dire would happen to him.
Fajgenbaum was pushing forward on several fronts, including leading a
non-for-profit organization for grieving college students, symbolically named
“Actively Moving Forward” or “AMF” after his mother’s initials, all while first
playing college football and then attending medical school. By all accounts,
this was a vigorous young man, meticulous about his diet and physicality. When he became ill, it was a blunt reminder
that life is unpredictable.
In his book “Chasing my Cure”, Dr. Fajgenbaum takes us back to the time when he first got ill. He vividly describes his physical symptoms and various scans which detected his enlarged nodes. Interestingly, we learn how long he was in denial of these symptoms, thereby delaying medical attention in favor of studying. This neglect of self-care highlights part of his personality, but also represents the pressure and expectations placed upon a majority of medical students.
It’s the ‘holy grail’ of advice for health tech startups. BlueCross BlueShield of North Carolina’s Chief Strategy & Innovation Officer, Bryony Winn, tells what it takes for digital health and digital therapeutics startups to gain partnership agreements, reimbursement, and possible investment from health plans. How do you figure out how to “align incentives” in a way that perks up a payer’s ears? Bryony gives us some VERY FRANK advice about how startups can bring innovation to BCBS of North Carolina, other Blues plans, or their VC funds (which in this case is Echo Health Ventures where BCBS North Carolina partners with Cambia Health Solutions.) To play the game, you have to know the players. Tune in for more.
It took some doing, but I had finally
made it to Bobby’s home.
It was a rowhome tucked into one of those
little side streets in the city that non-city folks wouldn’t dream of driving
down. As I step in, I’m met by the usual set up – wooden steps that hug the
right side of the wall leading up to the second floor. Bobby certainly hasn’t made it up to the
second floor in some time. At the moment she is sitting in her hospital bed in
the living room. The bed is the focal point to a room stuffed to the gills with
all manners of stuff. At least three quarters of the stuff seems to be food.
Cinnamon buns, Doritos, donut holes, chocolate frosted Donuts, crackers,
Twinkies. The junk food aisle at Wawa would be embarrassed by the riches on
Bobby weighs in at four hundred pounds, 5
foot 5 inches. She has a tracheostomy from multiple prior episodes of
respiratory failure that have required ventilatory support. I’m here at the
request of a devoted primary care physician that still makes home calls. I’ve
looked through the last number of hospital stays. The last few discharge
summaries are carbon copies of each other. Hypoxemic respiratory failure
related to pulmonary edema complicated further by morbid obesity. Time on the
vent. Antibiotics. Diuretics. Home. Return to the hospital 2 weeks later. The
last echocardiogram done was 3 admissions ago. A poor study. Not much could be
seen due to ‘body habitus’.
I sit on the side of the bed trying to acquire my own images of her heart. I talk to her as I struggle. Bobby is 58, the youngest of three sisters, and the only surviving member of the family. Her elder sisters died of respiratory complications as well. They both died with tracheostomies. The conversation is circular. The problem according to Bobby is the tracheostomy. Everything was fine before that. I explain that a prolonged period of time on the ventilator on a prior admission prompted the tracheostomy, and that the multiple recent admissions to the hospital that required a ventilator seemed to validate that decision. She doesn’t waver. Both her sisters died shortly after they got tracheostomies. Bobby thinks the physicians taking care of her sisters had a hand in their demise. “They didn’t care.” “We told them they were sick.”
The American Medical Association (AMA) announced Health 2047, its accelerator and investment fund in 2018. A year later, Andrew Elkind and Stas Sokolin, both Principals at the fund, stop by to get us up-to-speed on the progress the AMA has made so far with its $45 million accelerator fund and $30 million investment fund. What kinds of health tech startups are piquing the attention of this physician-led fund? Get the details behind the Health 2047 investment thesis here!
Today on THCB Spotlights, Matthew chats with Omri Shor, the CEO and Co-founder of Medisafe. Way back in 2014, Medisafe took home the gold at Health 2.0, winning first place at Traction. Since then, their consumer medication management tool has evolved quite a bit. While the app is available for patients with over 6 million users today, they also have folks across the health care continuum partnering with Medisafe to manage the medication journey for their patients. Matthew picks Omri’s brain on how things will continue to evolve, what he’s learned to help people in health care think about the problem of medication management, and how Medisafe fits in with the numerous medication management and chronic disease management tools out there.
One big theme in AI research has been the idea of interpretability. How should AI systems explain their decisions to engender trust in their human users? Can we trust a decision if we don’t understand the factors that informed it?
I’ll have a lot more to say on the latter question some other time, which is philosophical rather than technical in nature, but today I wanted to share some of our research into the first question. Can our models explain their decisions in a way that can convince humans to trust them?
I am a radiologist, which makes me something of an expert in the field of human image analysis. We are often asked to explain our assessment of an image, to our colleagues or other doctors or patients. In general, there are two things we express.
What part of the image we are looking at.
What specific features we are seeing in the image.
This is partially what a radiology report is. We describe a feature, give a location, and then synthesise a conclusion. For example:
There is an irregular mass with microcalcification in the upper outer quadrant of the breast. Findings are consistent with malignancy.
You don’t need to understand the words I used here, but the point is that the features (irregular mass, microcalcification) are consistent with the diagnosis (breast cancer, malignancy). A doctor reading this report already sees internal consistency, and that reassures them that the report isn’t wrong. An common example of a wrong report could be:
Neuroscience startup, NeuroTracker, has a virtual training tool with a proven ability to help improve “cognitive fitness.” Jean Castonguay, co-founder, board member and Head of Global Strategic Partnerships at NeuroTracker, explains the science and clinical validation behind their tech and drops some big name users in the process — Manchester United, German and French soccer teams, US special forces, as well as some of the world’s leading sports concussion rehabilitation clinics. What sets the startup apart from other companies in the mental performance space? How have they shored up their science in the face of Lumosity’s Federal Trade Commission suit against false claims about brain health outcomes? It shook up the industry, and NeuroTracker actually feels it strengthened their business and their value proposition.
Filmed at Bayer G4A Signing Day in Berlin, Germany, October 2019.