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Christina Liu

My 22 Oldest Jokes and Why They Still Matter in 2022

Dec 22, 2021

By IAN MORRISON

I have been studying American healthcare for more than 40 years and I have assembled a large number of one-liners over the years. As we enter 2022, I thought I’d share my 22 oldest jokes and why they still matter.

Coming to America

I grew up in Glasgow, Scotland. In Glasgow, healthcare is a right, carrying a machine gun is a privilege. America got it the wrong way round.

Gun violence continues to ravage the United States. We have more guns than people. Kids get gunned down in school playgrounds and classrooms routinely. It happened once in Dunblane, Scotland in 1996 when a local shopkeeper walked into Dunblane Primary School and opened fire, killing 16 5- and 6-year-olds and their 45-year-old teacher. It so galvanized public opinion, according to Smithsonian Magazine: “By the end of 1997, Parliament had banned private ownership of most handguns, including a semi-automatic weapons ban and required mandatory registration for shotgun owners”.

Last time I looked, gun violence was the second leading cause of death in children in the US. In America when we have mass shootings all we get are thoughts and prayers.

And when it comes to healthcare as a right, even if we Build Back Better, it won’t be a right for millions of American residents, especially those who are undocumented.

I am a Scottish Canadian Californian which gives me a unique perspective on healthcare (and all things to do with healthcare, including death and dying) because the Scots see death as imminent, Canadians see death as inevitable, and Californians see death as optional.

This is one of my oldest jokes and it remains true. In Silicon Valley, where I live, my affluent VC friends want to live forever and are working out and taking supplements to achieve that. In contrast, my British friend Dr. Richard Smith (former Editor of the BMJ) is sitting on the Lancet Commission on the Value of Death. Enough said.

Not Just Token Tokens

Dec 21, 2021

By KIM BELLARD

I recently watched some of the recent Congressional hearings on cryptocurrency, and, boy, if there’s anything funnier than watching experts try to educate most members of Congress on anything crypto-related, it’s probably me trying to explain it. I don’t own any digital assets, still don’t see the point of NFTs, and am not going to buy any real estate in the metaverse.

All that being said, there’s something about Web3 that fascinates me. Knowledgeable people are talking about Web3 “reinventing the internet,” “democratizing” it, giving people more ownership of/control over what they do on it. It’s a counterbalance to how the internet – both the traffic and the infrastructure — has grown increasingly dominated by a few very large firms, such as Google, Facebook, or Amazon.

As the Web3 Foundation declares, Web3 is an internet where:

Users own their own data, not corporations
Global digital transactions are secure
Online exchanges of information and value are decentralized

All that sounds very intriguing to me, especially as someone who has dim views of how healthcare likes to silo information, has placed too little value on patient ownership of their own data, and is rushing to centralize.

The Healing Power of Even Virtual Human Connection

Dec 6, 2021

By HANS DUVEFELT

Almost two years into this new age of varying degrees of self quarantine, I am registering that my own social interactions through technology have been an important part of my life.

I text with my son, 175 miles away, morning and night and often in between. I talk and text with my daughter and watch the videos she and my grandchildren create.

I not only treat patients via Zoom; I also participate, as one of the facilitators, in a virtual support group for family members of patients in recovery.

I have reconnected with cousins in Sweden I used to go years without seeing; now I get likes and comments almost daily on things that I post. I have also video chatted with some of them and with my brother from my exchange student year in Massachusetts 50 years ago.

I have stayed in touch with people who moved away. And I have made new friends through the same powerful little eye on the world I use for all these things, my 2016 iPhone SE.

Members of my addiction recovery group stay in touch with each other via phone or text between clinics. They constantly point out the value of the social network they have formed, even though they only meet, many of them via Zoom, once a week. The literature has supported this notion for many years and is very robust: Social isolation is a driver of addiction.

Can Democracy Survive In The Absence of Health Care Security?

Nov 17, 2021

By MIKE MAGEE

In my course this fall at the President’s College at the University of Hartford, we began by exploring the word “right” at the intersection of health care services and the U.S. Constitution. But where we have ended up is at the crossroads of American history, considering conflicting federal and state law, and exploring Social Epidemiology, a branch of epidemiology that concentrates on the impact of the various social determinants of health on American citizens.

What makes the course timely and relevant is that we are uncovering a linkage between health and the construction or destruction of a functional democracy at a moment in America’s history when our democracy is under direct attack.

This was familiar territory for Eleanor Roosevelt. She spent the greater part of World War II creating what she labeled in 1948 “Humanity’s Magna Carta” – aka the “Universal Declaration of Human Rights (UDHR.)”

Embedded in the declaration was a much broader definition of health. It reads “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” The Marshall Plan, for reconstruction of war torn Germany and Japan, embodied these principles, and successfully established stable democracies by funding national health plans in these nations as their first priority.

Although our nation signed the UDHR, it carried no legal obligations or consequences. In fact, the U.S. medical establishment’s bias was to embrace a far narrower definition of health – one that targeted disease as enemy #1. They believed that in defeating disease, health would be left in its wake.

In contrast, neighboring Canada took the UDHR to heart, and as a starting point asked themselves, “How do we make Canada and all Canadians healthy?” Where our nation embraced profiteering and entrepreneurship, leaving no room for solidarity, Canada embraced the tools of social justice and population health.

How Unhappy are Patients with Info Coming from Providers, Payers? Pega’s Survey Shows It’s Not Good

Nov 15, 2021

By JESSICA DaMASSA, WTF HEALTH

Is this a big surprise? Even during Covid, Pega’s annual 2,000-person Patient Engagement Survey shows that 63% of patients are unhappy with the communication they receive from their payers and providers. Which begs the question… just how bad was it before? (Answer: 86% unhappy– yikes!)

Pega’s VP of Healthcare & Life Sciences, Kelli Bravo, has run this survey three years and counting and drops in to share the highlights (if we can really call them that) of the survey results and how she thinks enterprising young health tech startups can capitalize on the opportunity to help.

For those in the business of trying to talk to patients — which is all of us — let’s look at this as a wake-up call. Let’s stop speaking “health care” and start using language everyone can understand about their care, what it will cost, and what all the options really are. Pega is attempting to do its part in that department, and we get an update on how they’re fairing at helping to make healthcare feel more like retail. The rise of the healthcare consumer is a real thing. Now, with new data to back up claims about what they’re demanding in terms of how they prefer to be talked to and communicated with.

Click to see the data and report on Pega’s site.

CareCentrix CEO on Walgreens Taking Majority Stake, How Post-Acute Care Will Fair in Retail Health

Nov 10, 2021

By JESSICA DaMASSA, WTF HEALTH

The same day Walgreens announced its $5.2B investment in VillageMD to snag a majority stake in the growing primary care clinic, it ALSO revealed it had made a $300M investment in CareCentrix that scored 55% of that company and another opportunity to expand its reach beyond the pharmacy – this time into the home.

CareCentrix’s CEO John Driscoll takes us behind the deal, which lands Walgreens into the world of post-acute care (home nursing, hospital discharge recovery, home infusion, palliative care, etc.) which he describes as the “long-form sexy-cool” segment of the healthcare market that’s not only worth $75B annually now, but that’s also set for massive growth over the next 20 years.

Walgreens is clearly seeing the opportunity John’s seeing, particularly when it comes to positioning its pharmacies as “local health distribution and support centers” – hubs that leverage both the trust patients have in their pharmacists and the frequency with which they visit a Walgreens store compared to a doctor’s office or hospital. In the Walgreens Health strategy, what’s the vision for how CareCentrix and VillageMD will ultimately work together to take care of these regular Walgreens customers? Will post-acute care fair as well as primary care when it comes to a retail distribution channel? And, of course, we HAVE to go behind the scenes on the deal itself and ask John what we were all wondering: Why didn’t Walgreens just acquire both VillageMD and CareCentrix outright??

Woman’s Health Startup Pollie Wins Bayer G4A’s Attention With Female-Focused Chronic Condition Play

Nov 5, 2021

By JESSICA DaMASSA, WTF HEALTH

Forget being pigeon-holed as a “femtech” company! VERY early-stage women’s health startup, Pollie, is taking an integrated care approach to complex chronic conditions that either just affect women, OR impact women differently or disproportionally than men. Think not only about conditions caused by hormone imbalances like PCOS (polycystic ovarian syndrome) or endometriosis, but also auto-immune disorders and digestive disorders that present differently or more frequently in women.

Co-Founder and CEO, Jane Sagui, drops by to talk us through the platform Pollie is building (and I mean, building-as-we-speak) which will ultimately teach women how to manage their chronic conditions via a highly-personalized program that includes all possible treatment management solutions, from pharmaceuticals to lifestyle-based treatments like diet and exercise. The company is currently piloting a version of their solution with a cohort of PCOS patients, but, has grand plans to expand their multi-modality pill-plus approach into other categories of women’s health that are NOT reproductive system related. Their biz has already caught the eye – and some investment dollars – from Bayer, as the company is one of four that’s been selected for this year’s Growth Track within G4A’s Digital Health Partnerships Program.

Jane gives us the details behind Pollie: their business, the pilot, the round they’re currently raising, and the types of partners they’re seeking as they evolve their offering. What’s also exciting? An early-stage bet from a big pharma co like Bayer that signals a future for women’s health care that may (finally) be about MORE than just reproductive health.

Reflections on HLTH2021: The Lens of the Patient and Carepartner

Nov 3, 2021

By GRACE CORDOVANO

Attending HLTH 2021 in-person in Boston solidified that there is no comparison between attending live vs. virtual conferences. While content and presentations can be solid both virtually or in-person, it is the energy of the connections that are made between scheduled presentations and the conversations that are shared throughout that move the needle. Kudos to the organizers of HLTH 2021 for prioritizing the safety of all in-person attendees with COVID-19 vaccination requirements, proof of negative PCR testing within 3 days of arrival, and mask requirements on-site.

After reflecting on all the proceedings, the conversations, and the experiences at HLTH 2021, here are eight reflections on the event from the patient and carepartner perspective.

1) Patients and Carepartners (Not) Included

These words were the taglines of HLTH2021:

Dear Future: We’re coming for you. #HLTH2021

The largest and most important conference for health care innovation

A battle cry for improving health care, but I can’t help but wonder, who’s “we’re”?

The agenda and stages at HLTH2021 were filled with some of the biggest, most respected names in the health care ecosystem. Unfortunately, no patients were speaking from these stages. A search of the agenda and speaker list for “patient” showed entries for “patient experience” or “patient” in the form of an executive title. Many panels and discussions fell short of the real-world experiences of living life with a diagnosis or multiple comorbidities, the difficulties of barriers to healthier living that are caused by social determinants of health (SDoH), and disgraceful realities of the inefficiencies of workflows patients and their families face. There were no patient or carepartner champions sharing the positive impact that a company’s brand has had on their or their loved ones’ lives.

We are Asking Our Physicians to Do Too Much. It’s No Wonder They are Burnt Out.

Nov 1, 2021

By GAIL PEACE

We have heard the phrases “physician fatigue” and “burnout” too often in the last year – and for good reason. Covid-19 has placed an incredible burden on our healthcare providers. However, as healthcare professionals, the stats representing physician burnout are not new for us.

We have seen similar trends and stats for years. Covid-19 did not cause the current state of physician burnout, it has just exacerbated it and further exposed critical issues with the expectations placed on physicians in today’s healthcare system. Ludi conducted a survey of physicians across the country confirming that exact theory:

68 percent of physicians feel pessimistic or indifferent about their occupation
48 percent describe the relationship with their hospital partners/employers as combative or transactional at best

We need to ask ourselves: What is actually causing this dissatisfaction and how can hospitals better align with their physician partners?

According to the physicians surveyed, 68 percent agreed they have too much administrative burden placed on them. More often than not, our industry blames EHRs for dominating administrative time, but from the physicians we surveyed, EHRs are just part of the problem. In fact, 54 percent of physicians indicated they spend 1-3 hours per day on administrative work outside of EHR time, with another 35 percent spending more than 4 hours per day on similar tasks.

Let’s put that into perspective. On top of seeing patients, charting in EHRs, and all the other things physicians are expected to do to take care of patients, physicians are also spending at least another 1-3 hours per day on “everything else.” This everything else includes meetings, training, compliance, policy, etc.

We are asking our physicians to do too much. It’s no wonder they are burnt out.

Medicine May Be an Art, but AI May Be Artists

Oct 26, 2021

By KIM BELLARD

Six hundred years ago, Swiss physician/scientist/philosopher Paracelsus disclaimed: “Medicine is not only a science; it is also an art.” Medicine, most people in healthcare still believe, takes not just intelligence and fact-based decision-making, but also intuition, creativity, and empathy. This duality is often cited as a reason artificial intelligence (A.I.) will never replace human physicians.

Perhaps those skeptics have not heard about Ai-Da.

Now, I have to admit, “she” wasn’t on my radar either until recently, when she was imprisoned/impounded at customs by Egyptian authorities on her way to an art exhibit at the Great Pyramids of Giza, where she was scheduled to show her work. Egyptian authorities first objected to her modem, then to the cameras in her eyes. “I can ditch the modems, but I can’t really gouge her eyes out,” said her creator Aidan Meller. After a 10 day stand-off, she was released late last week.

Let me back up. Named in honor of famed 19^th century mathematician/programmer Ada Lovelace, Ai-Da is “the world’s first ultra-realistic humanoid robot artist.” She was created in 2019, and uses AI algorithms to create art with her cameras/eyes and her bionic arms. She can draw, paint, even sculpt, and had her first major exhibit – Ai-Da: Portrait of the Robot — this summer at London’s Design Museum.

The description of her exhibit says:

As humans increasingly merge with technology, the self-titled robotic artist, Ai-Da, leads us to ask whether artworks produced by machines can indeed be called ‘art’…Ai-Da can both draw and engage in lively discussion…These features, and the movements and gestures that Ai-Da is programmed to perform, raise questions about human identity in a digital age.

Her website elaborates:

…current thinking suggests we are edging away from humanism, into a time where machines and algorithms influence our behaviour to a point where our ‘agency’ isn’t just our own. It is starting to get outsourced to the decisions and suggestions of algorithms, and complete human autonomy starts to look less robust. Ai-Da creates art, because art no longer has to be restrained by the requirement of human agency alone.