Categories

Above the Fold

Home, Sweet Work

By KIM BELLARD

If you’re lucky, you’ve been working from home these past couple months.  That is, you’re lucky you’re not one of the 30+ million people who have lost their jobs due to the pandemic.  That is, you’re lucky you’re not an essential worker whose job has required you to risk exposure to COVID-19 by continuing to go into your workplace.  

What’s interesting is that many of the stay-at-home workers, and the companies they work for, are finding it a surprisingly suitable arrangement.  And that has potentially major implications for our society, and, not coincidentally, for our healthcare system.

Twitter was one of the first to announce that it wouldn’t care if workers continued to work from home.  “Opening offices will be our decision, when and if our employees come back, will be theirs,” a company spokesperson wrote in a blog post.  “So if our employees are in a role and situation that enables them to work from home and they want to continue to do so forever, we will make that happen.”

Other tech companies are also letting the work-from-home experiment continue.  According to The Washington Post, Amazon and Microsoft have told such workers they can keep working from home until at least October, while Facebook and Google say at least until 2021.   Microsoft president Brad Smith observed: “We found that we can sustain productivity to a very high degree with people working from home.”  

Continue reading…

The End of the Game

By IAN MORRISON

Back in the early 2000s I was on the board of the California Health Care Foundation and one day the German Minister of Health paid CHCF a visit as part of a learning tour of American healthcare. Mark Smith MD CHCF’s CEO invited me to join the meeting with the minister. She was a delightful person who didn’t speak much English, but because she was accompanied by her handler/translator we managed to communicate just fine. Mark and I tried to explain to the Minister how the American healthcare system worked, and we got to the point in the conversation about the money. The essence of the “game” we described was that commercial insurers (particularly self-insured employers) paid a significant multiple of cost (sometimes in excess of 300% of costs) in order to make the math work for providers. We explained that the game works only if these purchasers paid much higher prices. I don’t speak German, but I think she said: “What The F**k?!”. Exactly.

As we enter the Post COVID world, a key question is: Will healthcare simply restart this game? Or make it even more extreme, in fact, by providers turning to those commercial insurers and self-insured employers to make up the difference for the COVID “Elective Collapse Recession” that has so traumatized provider’s finances including hospitals, specialists, primary care, and dentists leading to job cuts, furloughs, salary reductions and bankruptcies of providers.

A number of recent articles have pointed to how the game works. In particular, the always superb New York Time’s columnist Sarah Kliff’s review of the Mayo Clinic and the other highflying institutions whose excellence is rewarded not by value based reimbursement but by high prices for commercial activity under a relatively benign payor mix (industry code for “don’t see a lot of poor people, uninsured or on Medicaid”).

Continue reading…

Testing Won’t Get Us Where We Need to Go

By ANISH KOKA, MD

The great pandemic is wreaking havoc, we are told, because the nation is not testing enough.  The consensus from a diverse group that includes public health experts, economists, and silicon valley investors is that more testing will allow the country to restart the economy and do it safely. 

The White House has been a mini laboratory for this testing strategy.  Everyone who comes into contact with the President and Vice President is tested daily.  This is supposedly what allows everyone to sit in meetings together and generally carry out the essential business of the country.  But over this Mother’s Day weekend members of the White House spent their time scrambling to track down contacts of Katie Miller, the press secretary of the Vice president who tested positive.  And contacts were left unclear about what exactly to do.  One official started self-quarantining, while another did not. 

If the White House has trouble with a mass testing, and contact tracing strategy, one wonders how this may work nationwide with thousands of new cases per day.  While it would be tempting to blame administrative incompetence for the difficulties in the most important household in the land, the real difficulties lies with inherent limitations to tests that need to be understood before getting on the testing bandwagon.

Continue reading…

RWJF Challenge: Health Care Emergency Tech

SPONSORED POST

By CATALYST @ HEALTH 2.0

Catalyst @ Health 2.0, in collaboration with the Robert Wood Johnson Foundation, is seeking health technology solutions that can support the needs of the health care system (e.g. providers, government, public health and community organizations, and more) by addressing several obstacles during an emergency such as:

  • Resource Management: Shortages of equipment, staff, and cash flow
  • Health Data Exchange: Limited information and access available on patients’ health histories
  • Training and Communication: Limited training and cumbersome communication between responders and clinicians
  • Capacity: Limited beds, equipment, and resources and a need to maximize patient flow/throughput

Innovators must submit their tech-enabled solution by June 12th, 2020 at 11:59 PM ET.

Can you create a digital tool that supports the health care system during a large-scale health crisis? Apply today!

Catalyst @ Health 2.0 (“Catalyst”) is the industry leader in digital health strategic partnering, hosting competitive innovation “challenge” events, as well as developing and implementing programs for piloting and commercializing novel healthcare technologies.

Americans Are Worried About the Cost of Their Healthcare (and they have good reason)

By CASEY QUINLAN, HELEN HASKELL, BILL ADAMS, JOHN JAMES, ROBERT R. SCULLY, and POPPY ARFORD

Last year, the Patient Council of the Right Care Alliance conducted a survey in which over 1,000 Americans answered questions about what worried them most about their healthcare. We asked questions about access to care, concerns about misdiagnosis, and risks of treatment, which we reported on in our last THCB piece about the What Worries You Most survey.

We also asked people to rank their concerns about the costs of their care, in five questions that covered cost of care, cost of prescription drugs, cost and availability of insurance, and surprise billing. In the time since we ran the survey, everything has changed in American healthcare. The COVID19 pandemic is filling emergency rooms wherever the epidemic arrives. Bills are likely to be high, for both patients and insurers, and it is still far from clear how they will be paid. Americans are likely to continue to worry deeply about healthcare costs, with good reason, since it’s only in America that someone can go bankrupt due to seeking medical care.

Continue reading…

Patients proving the life-saving value of data

SPONSORED POST

By RIEN WERTHEIM

FHIR DevDays, run by Rien Wertheim’s company Firely in conjuncion with HL7, is the premier FHIR event in the world, with editions in the US and Europe. The three pillars for DevDays are Learn, Code and Share. The event runs from 15 to 18 June, 1 to 5 PM EST. This year’s edition will be 100% virtual. Tracks include the ONC and CMS Final Rules and COVID-19 on FHIR. I will be opening and moderating that last track–Matthew Holt.

The Patient Innovator Competition at DevDays US 2020

Have you ever wondered what would happen if patients had access to their data from hospitals, labs and other sources? Some still doubt the value of data at the fingertips of patients. So, we went the extra mile to see how this would look in practice and the results were impressive.

To give some context, every year we run DevDays, which is a semi-annual conference for health data programmers working with FHIR. FHIR is the open and standardized API for healthcare. What APIs have done for other industries, FHIR is doing for healthcare. That is, enabling an app economy: apps for doctors, researchers, payers, even apps for the government and, above all, apps for patients.

A lot of these of these apps are built by EMR vendors, even more by startups, and some by patients. Last year we launched the Patient Innovator Track at DevDays to give patients a voice. The track gives the stage to tech-savvy patients who are taking control of their health using data about their disease and treatment. The track wants to prove a point: access to health data can improve our lives. It also shows the unimagined things people can do with data when their health is at stake.

Four finalists pitched for the Patient Innovator Award. In the end it was John Keyes that blew everyone away. John is a blood disease patient who created a simple app to track his blood count and ongoing test results. The app is called BloodNumbers and it consolidates test data from multiple health care providers, making it easy to view and share results if you want to.

Source: BloodNumbers.com

We are looking for more tech-savvy patients, developers and IT experts like John, to apply for this year’s Patient Innovator Track. All you need to do is pitch an app, device or other technology that allows you to use your own health data to improve your wellbeing. The finalists get a free ticket to DevDays US 2020 Virtual Edition where they can  learn all about FHIR and connect with the community. The winner gets to walk away with $2,500. On the jury we have Dave deBronkart (“ePatient Dave”) and Grahame Grieve, the founder of FHIR. Check out what Dave wrote about the Patient Innovator Track here.

You can register and find more details here.

Rien Wertheim is CEO of Firely and the host of FHIR DevDays

It’s Not About Tradeoffs

By MICHEL ACCAD

It is tempting to oppose the harmful effects of COVID-related lockdown orders with arguments couched in terms of trade-offs. 

We may contend that when public authorities promote the benefits of “flattening the curve,” they fail to properly take into account the actual costs of imposing business closures and of forced social distancing: The coming economic depression will lead to mass unemployment, rising poverty, suicides, domestic abuse, alcoholism, and myriad other potential causes of death and suffering which could be considerably worse than the harms of the pandemic itself, especially if we consider the spontaneous mitigation that people normally apply under the circumstances.

While I have no doubt that lockdown policies can and will have very serious negative consequences, I believe that the emphasis on trade-offs is misguided and counterproductive.  It immediately invites a utilitarian calculus: How many deaths and how much suffering will be caused by lockdowns?  How many deaths and how much suffering will occur without the lockdowns? How exactly are we to measure the total harm?  What time frame should we consider when we ponder the costs of one option versus the other?

Continue reading…

Building an Intake Valve for New Ideas

By SUSANNAH FOX

Imagine this: You and your colleagues know there are problems to be solved. You have resources to offer, such as funding, access to experts, and publicity. 

You are pretty sure there are people with great ideas out there, asking questions, defining the scope of the problems you care about, seeing things that you can’t see. Some people are even forging ahead, developing solutions on their own, but you don’t know how to connect with them.

You need an intake valve for new ideas, a honeypot to attract problem-solvers. So you launch a prize competition. 

If you have escaped all the buzz around prize competitions and grand challenges over the last decade or so, don’t worry. KidneyX has a wonderful FAQ, including:

What is a prize competition?

A prize competition is a method of problem-solving that describes a problem (usually to the general public) and offers a prize or prizes to whoever comes up with the best solution(s). Prize competitions are a good way to attract ideas and skills from a wide range of fields.

I served as a volunteer judge for the KidneyX Patient Innovator challenge and was bowled over by the creativity of the submissions, both those who won and those who did not. It reminded me to welcome people into the health innovation conversation who may not think of themselves as inventors, but who deeply understand the community at the center of a crisis. The “need-knowers” as Tikkun Olam Makers call them.

Continue reading…

THCB Gang: Episode 9

Episode 9 of “The THCB Gang” was live-streamed on Wednesday (instead of our normal Thursday slot) on May 13th at 1pm PT- 4pm ET! Watch it below! Next week we’ll be back to Thursday

Joining me were health “IT” girl Jessica DaMassa (@jessdamassa), health futurist Ian Morrison (@seccurve), health economist Jane Sarasohn-Kahn (@healthythinker), patient safety expert Michael Millenson (MLMillenson), and MD & hospital system exec Rajesh Aggarwal (@docaggarwal). The conversation looked at the likelihod of big picture change, Medicare Advantage expansion, whether the move to remote care is real and sustainable, and at one point got us to war with China!

If you’d rather listen, the “audio only” version is preserved as a weekly podcast available on our iTunes & Spotify channels from Thursday onwards— Matthew Holt

Health in 2 Point 00, Episode 123 | Haven Health, Wellth, Vynca, Nanit & many more

Today on Health in 2 Point 00, Jess and I cover all the big comings and goings of digital health. But first, what happened with Atul Gawande departing Haven Health as CEO? Moving to a whopping 7 deals in this episode, Jess asks me about Wellth raising $10 million in an A round using behavioral economics to drive medication adherence; Vynca, an end-of-life startup, raising $10.3 million, Carbon Health getting a $26 million add-on investment expanding its telehealth offerings, Nanit raising $21 million for its machine learning baby monitor, Stellar Health raising $10 million in an A round to improve physician incentives to address gaps in care, Lucid Lane raising $4 million in seed funding for its substance use disorder program, and Limbix raising $9 million for its digital therapeutic for teens with depression. —Matthew Holt

Registration

Forgotten Password?