Author Archives

Christina Liu

RWJF Challenge: Health Care Emergency Tech

May 18, 2020

Americans Are Worried About the Cost of Their Healthcare (and they have good reason)

May 15, 2020• 1

By CASEY QUINLAN, HELEN HASKELL, BILL ADAMS, JOHN JAMES, ROBERT R. SCULLY, and POPPY ARFORD

Last year, the Patient Council of the Right Care Alliance conducted a survey in which over 1,000 Americans answered questions about what worried them most about their healthcare. We asked questions about access to care, concerns about misdiagnosis, and risks of treatment, which we reported on in our last THCB piece about the What Worries You Most survey.

We also asked people to rank their concerns about the costs of their care, in five questions that covered cost of care, cost of prescription drugs, cost and availability of insurance, and surprise billing. In the time since we ran the survey, everything has changed in American healthcare. The COVID19 pandemic is filling emergency rooms wherever the epidemic arrives. Bills are likely to be high, for both patients and insurers, and it is still far from clear how they will be paid. Americans are likely to continue to worry deeply about healthcare costs, with good reason, since it’s only in America that someone can go bankrupt due to seeking medical care.

It’s Not About Tradeoffs

May 14, 2020• 3

By MICHEL ACCAD

It is tempting to oppose the harmful effects of COVID-related lockdown orders with arguments couched in terms of trade-offs.

We may contend that when public authorities promote the benefits of “flattening the curve,” they fail to properly take into account the actual costs of imposing business closures and of forced social distancing: The coming economic depression will lead to mass unemployment, rising poverty, suicides, domestic abuse, alcoholism, and myriad other potential causes of death and suffering which could be considerably worse than the harms of the pandemic itself, especially if we consider the spontaneous mitigation that people normally apply under the circumstances.

While I have no doubt that lockdown policies can and will have very serious negative consequences, I believe that the emphasis on trade-offs is misguided and counterproductive. It immediately invites a utilitarian calculus: How many deaths and how much suffering will be caused by lockdowns? How many deaths and how much suffering will occur without the lockdowns? How exactly are we to measure the total harm? What time frame should we consider when we ponder the costs of one option versus the other?

Building an Intake Valve for New Ideas

May 14, 2020

By SUSANNAH FOX

Imagine this: You and your colleagues know there are problems to be solved. You have resources to offer, such as funding, access to experts, and publicity.

You are pretty sure there are people with great ideas out there, asking questions, defining the scope of the problems you care about, seeing things that you can’t see. Some people are even forging ahead, developing solutions on their own, but you don’t know how to connect with them.

You need an intake valve for new ideas, a honeypot to attract problem-solvers. So you launch a prize competition.

If you have escaped all the buzz around prize competitions and grand challenges over the last decade or so, don’t worry. KidneyX has a wonderful FAQ, including:

What is a prize competition?
A prize competition is a method of problem-solving that describes a problem (usually to the general public) and offers a prize or prizes to whoever comes up with the best solution(s). Prize competitions are a good way to attract ideas and skills from a wide range of fields.

I served as a volunteer judge for the KidneyX Patient Innovator challenge and was bowled over by the creativity of the submissions, both those who won and those who did not. It reminded me to welcome people into the health innovation conversation who may not think of themselves as inventors, but who deeply understand the community at the center of a crisis. The “need-knowers” as Tikkun Olam Makers call them.

Health in 2 Point 00, Episode 123 | Haven Health, Wellth, Vynca, Nanit & many more

May 13, 2020

Today on Health in 2 Point 00, Jess and I cover all the big comings and goings of digital health. But first, what happened with Atul Gawande departing Haven Health as CEO? Moving to a whopping 7 deals in this episode, Jess asks me about Wellth raising $10 million in an A round using behavioral economics to drive medication adherence; Vynca, an end-of-life startup, raising $10.3 million, Carbon Health getting a $26 million add-on investment expanding its telehealth offerings, Nanit raising $21 million for its machine learning baby monitor, Stellar Health raising $10 million in an A round to improve physician incentives to address gaps in care, Lucid Lane raising $4 million in seed funding for its substance use disorder program, and Limbix raising $9 million for its digital therapeutic for teens with depression. —Matthew Holt

How Will COVID-19 Change the Health Care Balance of Power?

May 13, 2020

By KEN TERRY

In any economic disaster, the largest, best-financed organizations have a natural advantage over smaller, cash-strapped organizations. The bigger entities have a greater ability to withstand economic downturns, while the small ones can quickly go out of business because they lack the financial reserves needed to tide them over.

In the roughly 2 ½ months since the COVID-19 pandemic began sinking its hooks into America, the pertinence of this business axiom has been amply illustrated. Small companies across the country are desperate to reopen so they can survive, while many large corporations are seeing their stock prices soar. Most healthcare systems are not for profit, so they don’t issue stock; yet bigger hospitals are not suffering as much financially as smaller and rural hospitals are. Even though the large hospitals’ losses from elective surgery bans have been higher, they have much deeper reserves and greater access to bank lines of credit.

Physician practices have been hit disproportionately by the pandemic. Most practices have switched to telemedicine visits as patients have shunned in-person encounters and the offices have tried to protect their staffs. But the revenue from virtual encounters has not come close to making up for the loss of revenues from office visits that, in many cases, include lab tests and/or minor procedures.

Keep Petri Dishes in the Lab

May 12, 2020• 1

By KIM BELLARD

COVID-19 is changing the landscape of our healthcare system, and, indeed, of our entire society, in ways that we hadn’t been prepared for and with implications that we won’t fully grasp for some time. As we grapple with how to reshape our healthcare system and our society in the wake of the pandemic, though, I worry we’re going to focus on the wrong problems.

Take, for example, nursing homes, prisons, and the meatpacking industry.

Anyone who has been paying attention to the pandemic will recognize that each of these have been “hot spots,” and have been called “petri dishes” for coronavirus (as are cruise ships, but that’s a different article). These institutions aren’t the only places where masses of people congregate, but they seem to do so in ways that create fertile territories for COVID-19. And that’s the problem.

We knew early on that nursing homes were going to be a problem. We knew COVID-19 was a problem in Wuhan, but that was far away — until a few cases emerged in late February in a skilled nursing home in King County, Washington. We know now that these were not the first cases, nor the first deaths, but we were stunned by how quickly it spread in that facility. By mid-March experts were already calling nursing homes “ground zero,” and that has been proven right.

It is now estimated that as many as a third of all U.S. coronavirus deaths have come from nursing home residents or workers. That is (as of this writing) almost 30,000 deaths, and over 150,000 cases.

After COVID-19, What Next? A Recovery Blueprint for Health System Leaders

May 8, 2020

By JAMES GARDNER

Is the beginning of the end in sight? Perhaps. After much stress and strain, many experts believe we’re seeing early signs of a COVID-19 plateau in some states and cities. Everything could change tomorrow, but healthcare leaders should be preparing now to reopen their shuttered operating rooms and get back to business.

When restrictions loosen, lost days and weeks could have dire implications for health systems already weakened by months of deferred and canceled elective procedures. These surgeries — joint replacements, tumor biopsies, gallbladder removals, and cosmetic procedures, for instance — underpin the economics of hospitals and physician groups. Delay some of these surgeries for too long and patient care can also suffer. Essential? Absolutely.

Unfortunately, healthcare leaders will be reopening their doors to a world unlike anything they’ve seen before. Aren’t we all seeing our personal health through a new lens?

Is Covid-19 the Argument Health Data Interoperability Needed? | WTF Health

May 7, 2020

By JESSICA DAMASSA, WTF HEALTH

“This pandemic highlights why we need that free flow of healthcare data. So that we can make better decisions sooner.”

In the way that Covid-19 has proven the utility of telehealth as a means for health systems to reach their patients, has the pandemic also become the final argument for healthcare data interoperability? Has this pandemic been the worst case scenario we needed to make our best ‘case-in-point’ for why U.S. healthcare needs a national health data infrastructure that makes it possible for hospitals to share information with one another and government health organizations?

Interoperability advocates have been clamoring for this for years, but Dan Burton, CEO of data-and-analytics health tech company, Health Catalyst, says this public health crisis has likely created an inflection point in the interoperability argument.

Can AI and radiographs help in resource-poor areas for the fight against COVID-19?

May 7, 2020

By POOJA RAO, TARUN RAJ, BHARGAVA REDDY, MANOJ TLD, and PREETHAM SRINIVAS

In March 2020, we re-purposed our chest X-ray AI tool, qXR, to detect signs of COVID-19. We validated it on a test set of 11479 CXRs with 515 PCR-confirmed COVID-19 positives. The algorithm performs at an AUC of 0.9 (95% CI : 0.88 – 0.92) on this test set. At our most common operating threshold for this version, sensitivity is 0.912 (95% CI : 0.88 – 0.93) and specificity is 0.775 (95% CI : 0.77 – 0.78). qXR for COVID-19 is used at over 28 sites across the world to triage suspected patients with COVID-19 and to monitor the progress of infection in patients admitted to hospital

The emergence of the COVID-19 pandemic has already caused a great deal of disruption around the world. Healthcare systems are overwhelmed as we speak, in the face of WHO guidance to ‘test, test, test’ [1]. Many countries are facing a severe shortage of Reverse Transcription Polymerase Chain Reaction (RT-PCR) tests. There has been a lot of debate around the role of radiology — both chest X-rays (CXRs) and chest CT scans — as an alternative or supplement to RT-PCR in triage and diagnosis. Opinions on the subject range from ‘Radiology is fundamental in this process’ [2] to ‘framing CT as pivotal for COVID-19 diagnosis is a distraction during a pandemic, and possibly dangerous’ [3].