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Health Innovation in Seattle & the Pacific Northwest | Maura Little of Cambia Grove

By JESSICA DaMASSA, WTF HEALTH

In the Pacific Northwest, “accelerator-slash-think tank” Cambia Grove is quickly expanding as the region’s go-to healthcare innovation hub. Fully funded by Cambia Health Solutions, the organization is functioning as a neutral party to bring startups and healthcare system incumbents together to identify innovation priorities. What else is happening in health tech in Seattle, especially with a few of those famous big consumer tech companies headquartered up there? Tune in to find out!

Filmed at the Together.Health Spring Summit at HIMSS 2019 in Orlando, Florida, February 2019.

The Opportunity in Disruption, Part 1

By JOE FLOWER

The system is unstable. We are already seeing the precursor waves of massive and multiple disturbances to come. Disruption at key leverage points, new entrants, shifting public awareness and serious political competition cast omens and signs of a highly changed future.

So what’s the frequency? What are the smart bets for a strategic chief financial officer at a payer or provider facing such a bumpy ride? They are radically different from today’s dominant consensus strategies. In this five-part series, Joe Flower lays out the argument, the nature of the instability, and the best-bet strategies.

“It’s a buckdancer’s choice, my friend. Better take my advice. You know all the rules by now, and the fire from the ice.”

— Robert Hunter, “Uncle John’s Band”              

Chief Financial Officer: tough gig. Seriously. Whether for a payer or a healthcare provider, the CFO’s job is the exact point where the smiling faces on the billboards meet the double entry, the financing, the payer mix, the debt structure. And it all has to work out in the black. It has to do that sustainably, not only this year but next year and five years from now. Best guess? It’s going to get a lot tougher, with shifting revenue streams, market boundaries, new technologies, growing consumer expectations and uncertain politics. 

Raise your hand if you can tell me the significance of these names: Univac, Control Data, Burroughs, Digital, Honeywell, IBM, NCR.

These companies dominated the computer world in 1980. As of 1990, all but IBM were gone, bankrupt, subsumed into some other company, or just out of the computer business. The one that survived, IBM, is the one that said, “Maybe we should at least get a toehold in this new personal computer game, even though it is risky for our main revenue streams.” All the others went “poof.”

A number of factors—radical new technologies with vast potential, ramifying customer frustration, shifting user base—are coming together to put healthcare today at exactly the place the computing world was in 1980.

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Pilot Your Technology with Help@Hand

SPONSORED POST

By CATALYST @ HEALTH 2.0

According to the California Health Care Foundation, from 2012-2014, nearly 20% of Californian adults who sought mental health treatment did not receive it. It is believed that these figures may even be understated, as The Substance Abuse and Mental Health Services Administration (SAMHSA) has cited that nearly 60% of American adults with mental illness do not receive any treatment. Unmet mental health needs in California are attributed to a lack of access to appropriate services and providers, as well as the cost of care, a factor that is often exacerbated by a lack of health insurance.

While traditional mental health services play an important role in supporting those in need, novel technologies can complement standard care delivery and provide individuals and communities with more accessible and optimized mental health services that focus on prevention, early intervention, family support, and social connectedness. 

The Help@Hand Project is a California statewide collaborative project to bring technology-based mental health solutions to the public mental health system through a highly innovative “suite” of digital solutions. The project aims to expand access to mental health services by engaging and treating individuals that are underserved in the current traditional care delivery model. With technology becoming an integral part of everyday life, the collaborative hopes to leverage familiar devices as means to connect and better serve those in need. This Help@Hand project will utilize applications on smartphones, tablets, digital devices, or computers as a tool to engage, support and give access to treatment using innovative virtual engagement strategies. Focus areas include:

  1. Peer Chat and Digital Therapeutics
  2. Virtual Evidence Based Therapy Utilizing an Avatar
  3. Passive Data Collection for Early Detection and Intervention
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Can Rah-Rah, Blah-Blah and Meh Accelerate Digital Health Innovation?

By MICHAEL MILLENSON

Can combining health tech “rah-rah,” health policy “blah-blah” and the “meh” of academic research accelerate the uptake of digital health innovation?

AcademyHealth, the health services research policy group, is co-locating its Health Datapalooza meeting, rooted in cheerleading for “Data Liberación,” with the National Health Policy Conference, rooted in endless debate about policy detail.

Sharing a hotel room, however, does not a marriage make. In order to get better digital health interventions to market faster, we need what I’m calling a Partnership for Innovators, Policymakers and Evidence-generators (PIPE). As someone who functions variously in the policy, tech and academic worlds, I believe PIPE needn’t be a dream.

The potential of digital health is obvious. Venture funding of digital health companies soared to $8.1 billion in 2018, up 40 percent from 2017, according to Rock Health, with another $4.2 billion invested during the first half of this year. Meanwhile, MedCityNews proclaimed 2019 “the year of the digital health IPO,” such as HealthCatalyst and Livongo.

Separately, Congress has sought to speed digital health innovation through bipartisan efforts such as the 21stCentury Cures Act and the formation last year of the Bipartisan Health Care Innovation Caucus. The Department of Health and Human Services (HHS) is also pursuing innovator and advocacy group input on regulatory relief.

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What’s Hitting “Escape Velocity” in Health Innovation & Technology? | Todd Park, Devoted Health

By JESSICA DaMASSA, WTF HEALTH

Todd Park is known for being excited, but THIS TIME the co-Founder and Executive Chairman of Devoted Health is excited that it’s the 10th Anniversary of Health Datapalooza, a gathering and initiative he had a hand in creating when he served Barack Obama as the Chief Technology Officer of the United States. What else is energizing Todd? How about value-based payment finally taking hold and the opportunities that’s opening up for payment model innovation and that will allow the disruption of healthcare to achieve ‘escape velocity.’

Filmed at Health Datapalooza in Washington DC, March 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

Thinking ‘oat’ of the box: Technology to resolve the ‘Goldilocks Data Dilemma’

Marielle Gross
Robert Miller

By ROBERT C. MILLER, JR. and MARIELLE S. GROSS, MD, MBE

This piece is part of the series “The Health Data Goldilocks Dilemma: Sharing? Privacy? Both?” which explores whether it’s possible to advance interoperability while maintaining privacy. Check out other pieces in the series here.

The problem with porridge

Today, we regularly hear stories of research teams using artificial intelligence to detect and diagnose diseases earlier with more accuracy and speed than a human would have ever dreamed of. Increasingly, we are called to contribute to these efforts by sharing our data with the teams crafting these algorithms, sometimes by healthcare organizations relying on altruistic motivations. A crop of startups have even appeared to let you monetize your data to that end. But given the sensitivity of your health data, you might be skeptical of this—doubly so when you take into account tech’s privacy track record. We have begun to recognize the flaws in our current privacy-protecting paradigm which relies on thin notions of “notice and consent” that inappropriately places the responsibility data stewardship on individuals who remain extremely limited in their ability to exercise meaningful control over their own data.

Emblematic of a broader trend, the “Health Data Goldilocks Dilemma” series calls attention to the tension and necessary tradeoffs between privacy and the goals of our modern healthcare technology systems. Not sharing our data at all would be “too cold,” but sharing freely would be “too hot.” We have been looking for policies “just right” to strike the balance between protecting individuals’ rights and interests while making it easier to learn from data to advance the rights and interests of society at large. 

What if there was a way for you to allow others to learn from your data without compromising your privacy?

To date, a major strategy for striking this balance has involved the practice of sharing and learning from deidentified data—by virtue of the belief that individuals’ only risks from sharing their data are a direct consequence of that data’s ability to identify them. However, artificial intelligence is rendering genuine deidentification obsolete, and we are increasingly recognizing a problematic lack of accountability to individuals whose deidentified data is being used for learning across various academic and commercial settings. In its present form, deidentification is little more than a sleight of hand to make us feel more comfortable about the unrestricted use of our data without truly protecting our interests. More of a wolf in sheep’s clothing, deidentification is not solving the Goldilocks dilemma.

Tech to the rescue!

Fortunately, there are a handful of exciting new technologies that may let us escape the Goldilocks Dilemma entirely by enabling us to gain the benefits of our collective data without giving up our privacy. This sounds too good to be true, so let me explain the three most revolutionary ones: zero knowledge proofs, federated learning, and blockchain technology.

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Health in 2 Point 00, Episode 93 | Ginger, VillageMD, & Health Recovery Solutions

The drought is over! On Episode 93 of Health in 2 Point 00, Jess and I talk deals, deals, deals. Ginger, which provides digital mental health services, raises $35 million and is growing quite fast; VillageMD, one of numerous companies who are trying to figure out a new way to do primary care, raises $100 million; Health Recovery Solutions, which does remote patient monitoring, gets $10 million. In other news, Livongo’s stock price collapsed a little bit, but it was crazy when it first came out so now prices are more “normal”; uBiome files for bankruptcy, and Tula Health’s $2.5 million raise gets quite possibly the best press release we’ve ever seen (you’ve got to hear this). —Matthew Holt

Radiology Firing Line | Choosing Wisely, Wisely

By SAURABH JHA, MD

How easy is it for physicians to choose wisely and reject low value care? Who decides what’s wise and what’s unwise? In this episode Saurabh Jha (aka @RogueRad) speaks with William Sullivan MD JD. Dr. Sullivan is an emergency physician and an attorney specializing in healthcare issues. Dr. Sullivan represents physicians and has published many articles on legal aspects of medicine. He is a past president of the Illinois College of Emergency Physicians and a past chair and current member of the American College of Emergency Physicians’ Medical Legal Committee.

Listen to our conversation here.

Saurabh Jha is a contributing editor to THCB and host of Radiology Firing Line Podcast of the Journal of American College of Radiology, sponsored by Healthcare Administrative Partner

WW (aka WeightWatchers) Is Watching Health Tech & Behavior Change Thinking | Zoe Griffiths, WW

By JESSICA DaMASSA, WTF HEALTH

What’s WeightWatchers, now WW, doing at a health tech conference? Zoe Griffiths, Global Director of Nutrition, talks about what’s next for the company’s 4.5M members worldwide as their “wellness partner” embraces the latest trends and thinking that help make the behavior changes that lead to weight loss easier and more sticky. With the obesity epidemic in full swing, weight management stands on that increasingly blurry line between ‘wellness’ and ‘healthcare.’ How will WW continue to help its members see results?

Filmed at HIMSS/Health 2.0 Europe in Helsinki, Finland in June 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

Barbarians at the Gate

By ADRIAN GROPPER, MD

US healthcare is exceptional among rich economies. Exceptional in cost. Exceptional in disparities. Exceptional in the political power hospitals and other incumbents have amassed over decades of runaway healthcare exceptionalism. 

The latest front in healthcare exceptionalism is over who profits from patient records. Parallel articles in the NYTimes and THCB frame the issue as “barbarians at the gate” when the real issue is an obsolete health IT infrastructure and how ill-suited it is for the coming age of BigData and machine learning. Just check out the breathless announcement of “frictionless exchange” by Microsoft, AWS, Google, IBM, Salesforce and Oracle. Facebook already offers frictionless exchange. Frictionless exchange has come to mean that one data broker, like Facebook, adds value by aggregating personal data from many sources and then uses machine learning to find a customer, like Cambridge Analytica, that will use the predictive model to manipulate your behavior. How will the six data brokers in the announcement be different from Facebook?

The NYTimes article and the THCB post imply that we will know the barbarians when we see them and then rush to talk about the solutions. Aside from calls for new laws in Washington (weaken behavioral health privacy protections, preempt state privacy laws, reduce surprise medical bills, allow a national patient ID, treat data brokers as HIPAA covered entities, and maybe more) our leaders have to work with regulations (OCR, information blocking, etc…), standards (FHIR, OAuth, UMA), and best practices (Argonaut, SMART, CARIN Alliance, Patient Privacy Rights, etc…). I’m not going to discuss new laws in this post and will focus on practices under existing law.

Patient-directed access to health data is the future. This was made clear at the recent ONC Interoperability Forum as opened by Don Rucker and closed with a panel about the future. CARIN Alliance and Patient Privacy Rights are working to define patient-directed access in what might or might not be different ways. CARIN and PPR have no obvious differences when it comes to the data models and semantics associated with a patient-directed interface (API). PPR appreciates HL7 and CARIN efforts on the data models and semantics for both clinics and payers.

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