Month: September 2018

Escaping COVID-19

Sep 30, 2018

By RAGHAV GUPTA, MD

“In seeking absolute truth, we aim at the unattainable and must be content with broken portions.”
– William Osler

A colleague shared an experience with me about testing one of his patients for the novel coronavirus and it left me a bit puzzled. An elderly gentleman with past medical history of severe COPD and non-ischemic cardiomyopathy came to ER with shortness of breath, edema and fatigue. Chest X-ray suggested pulmonary edema. He wanted to test him for SARS-CoV-2 but hesitated. Eventually he was able to order it after discussions with various staff administrators. Dialogue included sentences like “why do we need testing? He has CHF, not COVID-19” and “it could create panic amongst staff taking care of him”. I applauded my colleague’s persistence as eventually the test was done. Few of us have probably gone through or are going to encounter a similar scenario as we ‘re-open’. To not test is counter-intuitive and more like an escape from diagnosing the virus rather than the virus itself.

One – the mere fact that we might hesitate before testing for a virus which is a cause of a (currently ongoing) pandemic should ring all the bells of concern about lack of an optimal strategy. Inadequate testing has remained the Achilles heel of our stand against COVID-19 because, to have a lasting stand, we must know where to take the stand.

You Can’t “Elon Musk” Healthcare

Sep 30, 2018

By SOFIA NOORI

On January 26th, Philadelphia discovered that the 22-year-old organizer of its largest COVID-19 vaccination site, Andrei Doroshin, had turned away elderly members of the Philadelphia community from their vaccine appointments. Instead, he pocketed extra vaccine vials to administer to 4 friends and girlfriend. An RN witnessed the event and reported it to authorities.

Local news reporters quickly discovered that this incident was just the tip of the iceberg for Doroshin. A Drexel University graduate student with no experience in healthcare, Doroshin had enlisted his college friends to organize a group that would go on to win one of the biggest vaccination contracts from the city of Philadelphia. He told his friends that “this is a wholly Elon Musk, shoot-for-the-heaven type of thing,” and that “we’re going to be millionaires.” His organization had also amended its privacy policy allowing for patient data to be sold, administered large numbers of vaccines to people ineligible to receive the vaccine yet, and threw Philadelphia’s COVID vaccination program into chaos.

For the people in the back: One can’t simply “Elon Musk” healthcare. We have seen this too many times – a privileged young upstart with little experience believes that s/he can transform healthcare and make millions – or billions – doing so. Examples abound: we only have to look a couple years into the past to remember Elizabeth Holmes, the Stanford dropout who founded Theranos and misrepresented its technology, or to Outcome Health, whose former CEO Rishi Shah defrauded investors by overinflating business metrics. If “move fast and break things” works in other sectors, many reason, why won’t it work in the 4 trillion dollar industry of healthcare?

Healthcare is simply not the kind of business where one can shoot a rocket into the sky and accept the risk that it might explode. Simply put, this is people’s lives we’re dealing with. But a deeper layer involves trust in the medical establishment. U.S. healthcare is already marred by multiple grave issues: a complex bureaucracy, serious health inequities, and astronomical costs that can bankrupt a person in just one hospitalization. The trust that people have in U.S. healthcare has steadily dropped over the years. Further, the politicization of the COVID-19 pandemic and the U.S. government’s bungled response to it has only sowed further distrust, especially among marginalized and minoritized communities.

A Whole New Ball Game. Same Problems to Solve, Though.

Sep 30, 2018

By STEVEN FINDLAY

I’ll dive right in, with the stipulation that this blog is initial reaction in a very fluid, unprecedented and soon-to-be even-more-intense political environment. Fasten your seat belts!

The ACA. Replace is the critical word in “repeal and replace.” Consensus is already emerging that Trump and the Republicans will indeed repeal the ACA in early 2017, via the reconciliation process Congress used earlier this year. That resulted in the Senate’s first an only full ACA repeal vote. Obama vetoed the bill, of course. But Republicans demonstrated the do-ability of the reconciliation process. Lacking 60 votes in the Senate, they’ll very likely try repeal again that way. Continue reading…

Apple Watch Leaves Patients Connected with No Where To Go

Sep 28, 2018• 13

By GRACE CORDOVANO, Ph.D., BCPA

The highly anticipated unveiling of the Apple Watch Series 4 caused a news and social media sensation. Apple coined the iconic timepiece as the “guardian of your health”, with health tracking functionalities such as the ability to detect atrial fibrillation (AFib) by a self-performed electrocardiogram (ECG). But from patients’ and carepartners’ perspectives, there is a long road to a universally accessible, seamlessly implemented, mass-adoption, and meaningful use for this wearable technology.

Many experts, such as Dr. Eric Topol a cardiologist at the Scripps Research Institute, and other reports, were quick to highlight concerns about the consequences of false positives. The Apple Watch was criticized as a source for unnecessary anxiety. A letter from the Center for Devices and Radiological Health (CDRH) of the FDA, which cleared the ECG app as a class II over-the-counter (OTC) device, highlighted the risks to health and potential mitigation measures that the Apple Watch posed. Unfortunately, the vast majority of concerns in the public domain haven’t emphasized the risks to health due to poor implementation, integration, and adoption strategies of digital tools and wearables.

The current health care system needs to be significantly refreshed as it is not positioned to simply drop in advancements, such as those offered by the Apple Watch Series 4, into everyday patient care. Having Dr. Ivor Benjamin, president of the American Heart Association (AHA), endorse the Apple Watch at the Apple Keynote Event did wonders for the mass marketing appeal. It would’ve have been more credible and demonstrated more value if he stated that the AHA devised a strategic clinical practice implementation guide for cardiologists, created patient education materials for using the Apple Watch, partnered with payers to incentivize doctors to adopt the technology, and reimburse for virtual consults to support remote patient monitoring (RPM).

Will Apple Track Your Mind, Not Just Your Heart?

Sep 27, 2018• 5

By MICHAEL MILLENSON

If your heart throbs with desire for the new Apple Watch, the Series 4 itself can track that pitter-pat through its much-publicized ability to provide continuous heart rate readings.

On the other hand, if you’re depressed that you didn’t buy Apple stock years ago, your iPhone’s Face ID might be able to discover your dismay and connect you to a therapist.

In its recent rollout of the Apple Watch, company chief operating officer Jeff Williams enthused that the device could become “an intelligent guardian for your health.” Apple watching over your health, however, might involve much more than a watch.

The iPhone models introduced at the same time as the Series 4 all deploy facial analysis software. The feature works in part by projecting a grid of more than 30,000 infrared dots on the user’s face in order to create a three-dimensional map for user recognition. Continue reading…

Making Healthcare a Consumer Biz: Livongo’s Glen Tullman on his New Book & IPO Rumors

Sep 26, 2018• 1

By JESSICA DA MASSA, WTF Health

“If we just shop for healthcare like we shop for everything else…we would take care of a lot of the problems…”

So says Glen Tullman, CEO of Livongo, a very hot startup with a chronic condition management platform that has been batting away IPO rumors since earlier this year when it closed a $52.M round funded by existing investors.

Glen has just literally written the book on consumerizing healthcare and stopped by to talk about it at the HIMSS TV set on location at Health 2.0’s Fall Conference (where I was guest hosting interviews!)

Called On Our Terms the book tries to push us toward thinking about the buying-and-selling of healthcare the same way we’d think about buying-and-selling anything else. Glen argues it’s possible if we start looking at healthcare as an ‘information business’ – and pivot our thinking and our business models accordingly to provide greater access to that information.

Are we as consumers ready for all this responsibility? Is the healthcare system ready for us and our purchasing power? Is anyone doing this right?? Glen fires back with some strong examples of where he already sees this working, and gets real about who’s in trouble if they don’t pivot and pivot fast. (We’re looking at you, payers.)

Bonus Intel: Will Glen take Livongo to an IPO like he did Allscripts? It’s a multi-million dollar question…

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. Filmed at Health 2.0’s Fall Conference in Santa Clara, September 2018.

THCB Spotlights: MIRA Fertility Tracker

Sep 25, 2018

By ZOYA KHAN

A couple weeks back, Matthew met with MIRA Fertility Tracker at TechCrunch Disrupt 2018. Sylvia Kang, CEO & Co-founder of MIRA, spoke to Matthew about her new fertility tester for women trying to track their cycles. It also has an AI component built into its system, in order to inform women the days they are most likely to get pregnant. MIRA also took center stage at #Health2con’s Venture Connect, placing 1st among a series of talented health tech startups.

Zoya Khan is the Editor-in-Chief of THCB as well as an Associate at SMACK.health, a health-tech advisory services for early-stage startups.

Health in 2 Point 00 Episode 51

Sep 25, 2018

In this Episode of #healthin2pt00 Jess & I do a real recap of the Health 2.0 Conference. I mention some of the startups that I thought were great, including Supportiv, Tag.bio, Nebula Genomics, Bluestream Health, Medically Home, b.well, and Medsafe. I also want to highlight Krista from Project HEAL that started an organization to raise awareness about mental health & eating disorders. We also discuss #CMS and Ro receiving $88 million in its funding round- Matthew Holt

“Remember that Oath?”: EPCS and the Fight Against Opioid Abuse

Sep 25, 2018• 4

By SEAN KELLY, MD

As doctors, we all took an oath when we graduated from medical school to “do no harm” to patients. It is, therefore, our duty to speak up and take action when there is an opportunity to prevent harm and improve patient care, safety and well-being. On average, the opioid crisis is killing more Americans on a monthly basis than traumatic injuries. It is time for the medical community to raise its voice even more loudly in support of proven technology that helps curb this crisis.

This month, California Governor Jerry Brown became the latest state lawmaker to embrace electronic prescribing for controlled substances (EPCS) — joining nearly a dozen other states that have passed legislation mandating that health care providers and pharmacies use the technology. The Golden State law was signed at the same time the U.S. Senate passed a bill requiring e-prescriptions for any reimbursement under Medicare Part D.

Clearly, EPCS is emerging as a key tool in the fight against opioid abuse. And legislators aren’t alone in driving the trend — corporations are playing a key role as well. Walmart, one of the nation’s largest pharmacy chains, is requiring EPCS by January 1, 2020. In their press release, it was noted that “E-prescriptions are proven to be less prone to errors, they cannot be altered or copied and are electronically trackable.”

The Biggest Trend You’ve Probably Never Heard Of: A Status Report on 138 Healthcare ICOs

Sep 24, 2018• 5

By ROBERT MILLER & VINCE KURAITIS

You’ve probably heard of Bitcoin, but we doubt you’ve heard of Dentacoin, MedTokens, or Curecoin.

These are healthcare specific cryptocurrencies born from Initial Coin Offerings or ICOs. In this article, we’ll briefly recap the trend of ICOs (aka token offerings) and provide you with a summary financial analysis of how this trend has played out among 138 healthcare ICOs. The results to-date are enlightening, but disappointing. We believe there’s still potential for some projects to be successful.

Background

What’s an ICO? Here’s a quick take from Wikipedia and we’ll point you to an Appendix that will guide you to additional resources:

An ICO is a type of funding using cryptocurrencies…In an ICO, a quantity of cryptocurrency is sold in the form of “tokens” (“coins”) to speculators or investors, in exchange for legal tender or other cryptocurrencies. The tokens sold are promoted as future functional units of currency if or when the ICO’s funding goal is met and the project launches.

Autonomous Research found that ICOs raised over $7 billion in 2017 and are slated to raise $12 billion in 2018, with some mega projects raising billions of dollars each.