Facebook is releasing an EMR? Jim Cramer is going to work at Epic? April Fools! On today’s actual Health in 2 Point 00 Episode 76, Jess asks me about the follow up from Health Datapalooza, which ended with the government saying they will be changing the world and that everyone should join them in their initiative to innovate digital health. AHRQ & CMMI ran digital health challenges, and CMMI will be doing an AI challenge for $1 million for startups in the space. Speaking of the government, Seema Verma was in the news for her PR spending and as I said “Evil Twin Seema” and “Good Seema” are joined at the hip and they should “not screw around on the PR front”. In other news, MountSinai launched a digital health institute to develop advances in artificial intelligence and other emerging health care technologies spaces. Clover Health laid off a ton of people, and according to me, they are starting to get serious because running a Medicare Advantage plan is hard work — Matthew Holt
Amazon, Google, Microsoft Healthcare Takeover | Dr. Rasu Shrestha, Atrium Health
By JESSICA DAMASSA, WTF HEALTH
One of the fastest growing chronic condition management companies in healthcare, Livongo just made some big new hires and minted a new category in health tech called “Applied Health Signals.” What’s this? Well, if your new health solution ties together devices, data science, coaching, and clinical management, YOU might be an Applied Health Signals company. CEO Glen Tullman walks us through the new concept, shares his insight on the good & bad of consumer tech companies heading into health… then explains the strategery behind changes to the company’s C-suite and confronts the rumors I’ve been hearing about an IPO.
Filmed at the JP Morgan Healthcare Conference in San Francisco, CA, January 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.
Addressing Heresy in Healthcare
SPONSORED POST

By ANN MOND JOHNSON
I’ve worked in enough start ups to know that creating something from nothing can be hard. It is especially tough when you must create a market and explain to people that what you’re doing isn’t nearly as heretical as it may sound. When my friends and I started Subimo in 2000, people wondered why they’d use our product to learn about hospital performance when (in their words) all they really needed was to have their doctor to tell them which hospital they should use. What people eventually realized was that there is variation in outcomes by hospitals and even by service lines within hospitals.
That’s why the recent spate of articles about the newly emerging direct-to-consumer companies in health care – the ones that are condition-specific like HIMS, Ro and Keeps – fascinate me. These are companies that have leveraged all we know about direct-to-consumer marketing and have identified an unmet market need. In some respects, they’re not dissimilar from companies like Simple Contacts or 1.800 Contacts or Visibly – companies that offer a convenient way for people to get what they need (in this case, good vision). Or companies that offer behavioral health services directly to consumers.
What do these companies have in common? Aside from a strong marketing foundation, they have identified a market need that can be met with a new approach that leverages technology. They are convenient, offer a high level of customer service and may even be easier to work with than traditional players.
SCOOP: Facebook enters EMR business

by MATTHEW HOLT
Big news out of Mountain View, California today as Facebook COO Sheryl Sandberg announced that the social networking giant was going to formally enter the EMR business. Sandberg explained that Facebook already has all Americans and most of the world’s population on its system and that adding a little bit of information about their health would be trivial given that it’s easy with AR to abstract that information from their profiles, not to mention that everyone’s phone is already sending data back to Facebook.
In particular, Sandberg highlighted the fact that Facebook has already captured almost all the personal health information of many people with cancer and plenty of other rare diseases in the thousands of health communities that it has been pushing hard over the past few years. Not only have those individuals not known what Facebook is allowing third parties to do with that data, or which hackers have already stolen it in a SICGRL hack, but they have also found it impossible to extract themselves or their data from those groups. As Sandberg says “We already have the EMR business model down, now we just have to provide the products”
When it was pointed out to Sandberg that Facebook didn’t actually have any professional EMR tools that could be used by clinicians or doctors, a scruffily dressed guy hiding his bad haircut under a hoodie grabbed the mike and shouted “We’ve seen the schlock that Epic, Cerner and the rest put out–my wife has to use it and she spends every evening catching up on her data entry. Shouldn’t be too hard for our engineers to knock that off–just ask those guys at Snapchat.” Sandberg commented that while EMR vendors move slowly and break things, Facebook has shown over the years that it can do that much faster. “Have you seen what we did to American democracy or the EU?”
Later today Cerner stock was trading off 25%. When asked, an Epic spokesperson commented that even if you added their ages together, Sandberg and Zuckerberg were far too young to run a proper EMR company.
Matthew Holt is the Publisher of THCB
Will Digital Therapeutics be ‘The End’ of Digital Health? | Eugene Borukhovich, G4A Bayer
By JESSICA DAMASSA, WTF HEALTH
How are ‘digital therapeutics’ different than what we’ve already been doing in ‘digital health’? Eugene Borukhovich, Global Head of Digital Health for Bayer, talks about how he thinks eventually the term ‘digital health’ will just disappear. What’s behind this prediction? Listen in to find out.
Filmed at JP Morgan Healthcare Conference, San Francisco, January 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.
Investment State-of-Play in Big Pharma: Bayer’s Eugene Borukhovich Weighs In
By JESSICA DaMASSA, WTF HEALTH
Bayer’s G4A team launched their 2019 program today, so here’s a little help for anyone curious about the state of pharma startup investment and what it takes to land a deal there these days.
I had the chance to pick the brain of Bayer’s Global Head of Digital Health, Eugene Borukhovich, during JP Morgan Healthcare Week and pulled out these three gloriously thought-provoking soundbites from our conversation to give you some insight as to the mindset over at big Bayer.
- “Digital therapeutics are shining light on the convoluted, complex mess of digital health”
If you’ve wondered what lies ‘beyond the pill’ for Big Pharma, wonder no more. It seems the answer is digital therapeutics. Eugene predicts that “within the next couple of years, ‘digital health’ as a term will disappear,” and calls out organizations like the Digital Therapeutics Alliance for their efforts to set standards around evidence-base and behavior modification so regulators and strategic investors alike can properly evaluate claims made by health tech startups. As time goes on, it looks like efforts to ‘pharma-lize’ the ways startups take their solutions to market will increase, pushing them into more traditional go-to-market pathways that have familiar and comforting guidelines in place. As Eugene says, “Ultimately, what we say in my team, is that it’s about health in a digital world today.” Sounds like that’s true for both the products he’s seeking AND the way pharma is looking to bring them to market…
- “These multi-hundred million [dollar] press releases are great to a certain extent, but what happened to the start-up style mentality?”
When asked about Big Tech getting into Big Health, in the end, it seems, Eugene shakes out to be in favor of the ‘Little Guy’ – or, at least, in their approach. Don’t miss his comments about “cockiness in our healthcare industry” and how Big Tech is working around that by partnering up, but the salient point for startups is that big companies still seem very much interested in buddying with smaller businesses. It’s for all the same reasons as before: agility, the ability to iterate quickly, and the opportunity to do so within reasonable budgets. Eugene offered this telling rhetorical musing: “Just because it’s a combination of two big giants…do you need to do $500 million? Or, do you give some…traction, milestone, [etc.]…to prove it, just like a start-up would?”
- “In large organizations, transformation equals time, and…we don’t have time.”
“To me,” says Eugene, “the biggest challenge is actually landing these inside the organization.” He’s talking about novel health solutions – digital therapeutics or otherwise – after learning from previous G4A cycles. Culture, precedent, and years of market success loom large in big healthcare companies across the ecosystem, which is one reason why innovation inside them is so challenging. Eugene says he’s “a big believer in a small team – even in large organizations – to take something by the cojones, and get shit done, and move it forward, and push the envelope from the bureaucracy and the process.” There’s a sense of urgency to ‘innovate or die’ in the face of the growing competition in the healthcare industry. “Back to this earlier conversation around whether it’s tech giants or other companies,” he adds, “it is a race to the speed of the organization. How quickly we learn and how quickly we make the decisions. Bottom line, that’s it.”
There’s plenty more great insights and trend predictions where these came from, plus the juicy details behind how G4A itself has pivoted this year. Check out the full interview now.
Economics Lessons from the Subcontinent: India’s Coronary Stent Policy

By ANISH KOKA MD
It is commonly believed that deliberate, careful price regulation by enlightened technocrats trumps the haphazard and chaotic regulation of prices imposed by the free market—especially when the market is subject to greed and corruption.
A most interesting case study challenging that belief comes courtesy of the largest Democracy in the world: India.
In 2017, an arm of the Indian Government, the National Pharmaceutical Pricing Authority (NPPA) took action to control the price of coronary stents in India by capping their retail price. The problem that stimulated this action was their exorbitant price that made them unaffordable to many Indians.
The retail prices of US made drug-eluting stents ranged from Rs 80,000 – 150,000 (~$1000 – ~$2000), while the price of Indian made drug-eluting stents ranged from Rs 45,000 – 90,000 (~$600 – ~$1200). Considering that a good job for 90% of the Indian labor force pays about Rs 180,000 per year, these prices put most coronary stents out of the reach of a vast swath of the populace.
What regulators knew, however, was that the price point at which coronary stents were being imported into India was a fraction of the price being charged to Indians. The up-charge had everything to do with what happened after the stent was brought onto Indian soil: The Indian subsidiary of the US stent manufacturer would sell its product to a domestic distributor that would then employ all means necessary to ensure their stent was chosen by cardiologists to be implanted.