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THCB Gang, Episode 14

Episode 14 of “The THCB Gang” was live-streamed on Thursday, June 18th. Tune in below!

Joining Matthew Holt were four regulars: health futurist Ian Morrison (@seccurve), writer Kim Bellard (@kimbbellard), MD turned leadership coach Maggi Cary (@MargaretCaryMD), Consumer advocate & CTO of Carium Health Lygeia Ricciardi (@Lygeia), and two guests: Emergency Room MD, IT consultant and so much more Medell Briggs (MedellBriggsMD), and patient advocate CEO of Patient Orator, Kistein Monkhouse (@KisteinM). It was a very thoughtful conversation about patient care, the role of social movements, what to do about structural racism in health care, and what new legislation might come from the federal level. You can watch below right now.

If you’d rather listen to the episode, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels — Zoya Khan

Health in 2 Point 00, Episode 128 | Proteus, Walmart, Kyruus, Headspace and CareAcademy

On Episode 128 of Health in 2 Point 00, Jess and I talk about Proteus filing for bankruptcy, Walmart buying the tech from CareZone for prescription drug management for an unconfirmed $200 million, Kyruus raising another $30 million for referrals and scheduling for large health systems, Headspace raising another $47.7 million, and CareAcademy raising $9.5 million in a Series A to provide online training for professional caregivers for seniors. —Matthew Holt

Your Face is Not Your Own

By KIM BELLARD

I swear I’d been thinking about writing about facial recognition long before I discovered that John Oliver devoted his show last night to it.  Last week I wrote about how “Defund Police” should be expanded to “Defund Health Care,” and included a link to Mr. Oliver’s related episode, only to have a critic comment that I should have just given the link and left it at that.  

Now, I can’t blame anyone for preferring Mr. Oliver’s insights to mine, so I’ll link to his observations straightaway…but if you’re interested in some thoughts about facial recognition and healthcare, I hope you’ll keep reading.

Facial recognition is, indeed, in the news lately, and not in a good way.  Its use, particularly by law enforcement agencies, has become more widely known, as have some of its shortcomings.  At best, it is still weak at accurately identifying minority faces (or women), and at worst it poses significant privacy concerns for, well, everyone.  The fact that someone using such software could identify you in a crowd using publicly available photographs, and then track your past and subsequent movements, is the essence of Big Brother.  

Continue reading…

THCB Spotlights: Allison Martin, UDoTest and Rahul Dubey, AHIP

This is one of the more unusual videos I’ve done as a THCB Spotlight. I’ve been advising Allison Martin at UDoTest for a while. Meanwhile, I met Rahul Dubey when he was running innovation at AHIP. Then I saw his name all over Twitter and everywhere else because he had let a large number of protesters into his house as the police violently broke up a BLM protest earlier this month. What I didn’t know was how well they knew each other, but I got them together late last week and it made for a fascinating conversation about society, health care, and the future. —Matthew Holt

Managing Surgical Wait Times in the Intra-COVID-19 World

Finding the Right Prioritization Model

By JUSTIN SPECTOR

Restrictions on elective surgical volume in hospitals across the United States are causing a dilemma heretofore unseen in the American healthcare system. Surgeons across services have large and growing backlogs of elective surgeries in an environment where operating room (OR) capacity is restricted due to availability of inpatient beds, personal protective equipment (PPE), staffing, and many other constraints. Fortunately, the U.S. is not the first country to experience and deal with this situation; for many countries, this is the normal state of medicine.

By combining the accumulated experience of health systems around the world with cutting-edge technologies, it is possible to make this crisis manageable for perioperative leadership and, potentially, to improve upon the preexisting models for managing OR time.

The first step in creating an equitable system that can garner widespread buy-in is to agree upon a method for categorizing cases into priority levels. Choosing a system with strong academic backing will help to reduce the influence of intra-hospital politics from derailing the process before it can begin.

Why Cases Should Be Prioritized

If your hospital has a mix of surgeons who perform highly time-sensitive cases — cases where patient quality of life is substantially impacted — as well as cases with minor health or quality of life outcomes, it is important to make sure there will be enough capacity to get the higher urgency cases done within a reasonable amount of time. This allows cases in the backlog to be balanced against new cases that are yet to be scheduled and will help to optimize the flow of patients through the OR.

Continue reading…

THCB Spotlights: Stacie Ruth, CEO and Nirinjan Yee, Head of Innovation at AireHealth

The AireHealth Nebulizer

Stacie Ruth left mega conglomerate Philips when she ran into the chance to revolutionize drug delivery via nebulizers, and co-founded AireHealth. Along the way she realized that changing care for patients with respiratory conditions was actually a bigger problem and opportunity. In April she met Nirinjan Yee from Breath Research who had built an AI system that took lung sounds to predict exacerbations. Last week they merged their companies, and I spoke to them about what the new AireHealth will be doing. —Matthew Holt

Contact Tracing: 10 Unique Challenges of COVID-19

Deven McGraw
Eric Perakslis
Vince Kuraitis

By VINCE KURAITIS, ERIC PERAKSLIS, and DEVEN McGRAW

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.

A worldwide dialog about COVID-19 contact tracing is underway. Even under the best of circumstances, the contact tracing process can be difficult, time-consuming, labor-intensive, and invasive — requiring rigorous, methodical execution and follow-up.

COVID-19 throws curve balls at the already difficult process of contact tracing. In this post we will provide some basic background on contact tracing and will list and describe 10 challenges that make contact tracing of COVID-19 exceptionally difficult. The 10 unique challenges are:

1) COVID-19 is Highly Contagious and Deadly

2) Contact Tracing is Becoming Politicized

3) We Lack Scientific Understanding of COVID-19

4) Presymptomatic Patients Can Spread COVID-19

5) Asymptomatic Patients Can Spread COVID-19

6) Contact Tracing is Dependent on Availability of Testing

7) Contact Tracing is Dependent on New, Extensive Funding

8) Contact Tracing is Dependent on an “Army of Tracers” and Massive Support for Patients

9 ) The Role of Technology is Unclear — Is it Critical Support or a Distraction?

10) The U.S. Response Has Been Fragmented and Inconsistent

The thrust of this post is about traditional boots-on-the-ground contact tracing conducted by public health agencies. We will touch on a few aspects of digital contact tracing (e.g., smartphone apps), but we’ll go into much more depth on digital contact tracing in future posts.

How does contact tracing relate to the theme of this series — The Health Data Goldilocks Dilemma? It’s about obtaining the right amount and types of information — not too much, not too little. Not too much data so that privacy rights or civil liberties are infringed, or that contact tracers are overwhelmed with useless data; not too little data so that public health agencies aren’t handcuffed in protecting our safety in tracing COVID-19 cases.

Continue reading…

Health in 2 Point 00, Episode 127 | AireHealth, Sharecare, PlushCare, & PatientPing

Today on Health in 2 Point 00, Jess asks Matthew about AireHealth merging with BreathResearch, adding machine learning-based diagnostics to their respiratory health remote monitoring devices, Sharecare acquiring behavioral health platform MindSciences, the “digital One Medical” telemedicine company PlushCare raising $23 million in a Series B, and PatientPing raising $60 million to expand their e-notifications network to achieve greater interoperability and coordinated care. —Matthew Holt

A Missed Opportunity for Universal Healthcare

Connie Chan
Phuoc Le

By PHUOC LE, MD and CONNIE CHAN

The United States is known for healthcare spending accounting for a large portion of its Gross Domestic Product (GDP) without yielding the corresponding health returns. According to the Center for Medicare and Medicaid Services (CMS), healthcare spending made up 17.7% ($3.6 trillion) of the GDP in the U.S. in 2018 – yet, poor health outcomes, including overall mortality, remain higher compared to other Organization for Economic Cooperation and Development (OECD) countries. According to The Lancet, enacting a single-payer UHC system would likely result in $450 billion in savings in national healthcare and save more than 68,000 lives.

Figure 1. Mortality rate in the US versus other OECD countries.

The expansion of Medicaid under the Patient Protection and Affordable Care Act (ACA or Obamacare) was not the first attempt the United States government made to increase the number of people with health insurance. In 1945, the Truman administration introduced a Universal Health Care (UHC) plan. Many Americans with insurance insecurity, most notably Black Americans and poor white Americans, would benefit from this healthcare plan. During this time, health insurance was only guaranteed for those with certain jobs, many of which Blacks and poor white Americans were unable to secure at the time, which resulted in them having to pay out-of-pocket for any wanted healthcare services. This reality pushed Truman to propose UHC within the United States because it would allow “all people and communities [to] use the promotive, preventative, curative, rehabilitative and palliative health services they need of sufficient quality…, while also ensuring that the use of these services does not expose the user to financial hardship.”

Continue reading…

THCB Gang, Episode 13

Episode 13 of “The THCB Gang” was on Thursday, June 11th. Watch it below or on our YouTube Channel.

Matthew Holt (@boltyboy)was back on the moderating chair! Joining him were patient advocate Grace Cordovano (@GraceCordovano), patient safety expert Michael Millenson (MLMillenson), policy expert Vince Kuraitis (@VinceKuraitis), MD & hospital system exec Raj Aggarwal (@docaggarwal), data privacy expert Deven McGraw (@healthprivacy) and fierce journalist & data rights activist Casey Quinlan (@MightyCasey). This was a doozy, and the conversation ranged from what it’s like re-opening at a big academic medical center to data flow and public health in Taiwan to statues of Confederate losers in Richmond. Not to mention what will happen in the impeding second wave.

If you’d rather listen, the “audio only” version is preserved as a weekly podcast available on our iTunes & Spotify channels — Zoya Khan

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