Author Archives

Christina Liu

Health in 2 Point 00, Episode 90 | One year older…

Aug 1, 2019

Today on Health in 2 Point 00, we’re wishing Matthew a happy birthday!

On Episode 90, Jess and I talk about the drama around Amazon PillPack and Surescripts, HelloHeart’s $12 million raise, and Cerner selling its health data. In the end, the data is going to have to flow after this battle between Surescripts and PillPack. For HelloHeart’s blood pressure and cardiovascular health management platform, have they found their niche or is it too little too late with others like Livongo, Omada and Vivify in the space already? Finally, Cerner has put in their earnings call that they’re going to develop a business model around selling their data, sending ePatient Dave on a Tweet storm, but how big of a deal is this really? —Matthew Holt

Healthcare IT Has Failed Providers, but It’s Not Too Late to Redeem Ourselves

Aug 1, 2019• 4

By GUS MALEZIS

It’s no secret that healthcare providers are among the hardest working of all professionals – their skill and intelligence are matched only by their creativity and commitment to their patients. But the healthcare IT sector, while it has made an effort to assist, has failed to support our providers – doctors, nurses and caregivers – with technology solutions that meet the increasing demands for better, faster, more efficient patient healthcare delivery. Instead, we have cast these providers in the dark, forcing them to function blindly, devoid of necessary information, pushing many of them to the brink of what they can withstand as professionals, pushing them to burnout.

The thing about providers is that, in addition to being hardworking, dedicated, and outstanding professionals, they are incredibly creative and innovative, willing to embrace new technologies and workflows – as long as they can add value to their patients. So how about we – the broader healthcare IT solutions vendor community – focus on delivering technologies that don’t force them to compromise care and efficiency for the sake of security, or compliance and access to data?

We need to do so to address an industry crisis. Physician burnout is on the rise, and it’s increasingly clear that overworked providers have reached the breaking point. They spend valuable minutes battling technology on virtual desktops, mobile devices, biomedical equipment, and clinical SaaS applications – typing in usernames and passwords, loading various apps, and more. All the while, standing beside a patient that is desperately seeking their assistance.

Right now, nearly one-half of all physicians (44 percent) report having feelings of burnout (according to Medscape‘s 2019 National Physicians Burnout & Depression Report). While these numbers should alarm everyone, what the healthcare IT industry should be especially concerned about is that a leading cause of this physician burnout are tools that hinder provider productivity. Instead of simplifying work for doctors and nurses, technology tools are having the opposite effect. Isn’t technology supposed to make things easier?

“Alexa, Open Symptom Checker” Gets You This Health Startup’s App | Piotr Orzechowski Infermedica

Jul 31, 2019

By JESSICA DaMASSA, WTF HEALTH

One of Europe’s top health tech startups, Infermedica out of Poland just closed a $3.65M funding round for its suite of tools that help patients figure out the best place to go to get care. It’s a patient-routing / symptom-checker with “AI under the hood” that is delivered via an app, chatbot, and voice application for Alexa. (In fact, they “own” the symptom checker that opens when you ask Alexa to “open symptom checker.”) Piotr Orzechowski talks about the full range of ways Infermedica is engaging patients and how they are scaling up their provider facing products as a result of this influx of funding.

Filmed at HIMSS/Health 2.0 Europe in Helsinki, Finland in June 2019.

Doctors Will Vote With Their Patients

Jul 30, 2019• 5

By MIKE MAGEE, MD

As Robert Muller’s testimony before Congress made clear, we owe President Trump a debt of gratitude on two counts. First, his unlawful and predatory actions have clearly exposed the fault lines in our still young Democracy. As the Founders well realized, the road would be rocky on our way to “a more perfect union”, and checks and balances would, sooner or later, be counter-checked and thrown out of balance.

On the second count, Trump has most effectively revealed weaknesses that are neither structural nor easily repaired with the wave of the wand. Those weaknesses are cultural and deeply embedded in a portion of our citizenry. The weakness he has so easily exposed is within us. It is reflected in our stubborn embrace of prejudice, our tolerance of family separations at the border, our penchant for violence and romanticism of firearms, our suspicion of “good government”, and –unlike any other developed nation – our historic desire to withhold access to health services to our fellow Americans.

In the dust-up that followed the New York Times publication of Ross Douthat’s May 16, 2017 article, “The 25th Amendment Solution for Removing Trump”, Dahlia Lithwick wrote in SLATE, “Donald Trump isn’t the disease that plagues modern America, he’s the symptom. Let’s stop calling it a disability and call it what it is: What we are now.”

Recently a long-time health advocate from California told me she did not believe that the majority of doctors would support a universal health care system in some form due to their conservative bend. I disagreed.

It is true that, to become a physician involves significant investment of time and effort, and deferring a decade worth of earnings to pursue a training program that, at times, resembles war-zone conditions can create an ultra-focus on future earnings. But it is also true that these individuals, increasingly salaried and employed within organizations struggling to improve their collective performance, deliver (most of the time) three critical virtues in our society.

Security Crisis of Cardiac Pacemakers Paves the Way for IoT Security Evolution in Cardiology

Jul 29, 2019

By INGA SHUGALO

While the healthcare IoT demand forecasts are more than generous, anticipating the market to hit $158.07B by 2022, there is still a certain delay in IoT adoption across the industry. Connected medical devices, especially those that are directly involved in patient care, are adopted cautiously due to potential security vulnerabilities and risks to patient safety.

One of the reasons behind the hesitant adoption of healthcare IoT in cardiology is preexisting concerns about the security of implantable medical devices, such as pacemakers.

The recent pacemaker crisis revealed the vulnerabilities in pacemaker software across several major vendors. If exploited, software vulnerabilities would allow hackers to take over the device and control it fully. The crisis led to device recalls, certain features disabled, and even remote updates cut off completely to avoid unacceptable health risks.

This series of events led to a cautious attitude toward the emerging cardiology IoT. Since we can’t be sure that all exploits and vulnerabilities are eliminated in less advanced systems, are we really ready to take a step forward to more elaborate healthcare software solutions at this point?

The fact of the matter is, cardiology is already taking these steps. The new generation of pacemakers has embedded sensors to monitor a patient’s blood temperature, sinus node rate, breathing, and other vitals. This data is used to flexibly alter the heart rate, slowing or speeding it depending on a patient’s current activity level. They also inherited remote control from their predecessors. Practically, next-gen pacemakers are IoT devices.

Accordingly, the industry can either stigmatize the security concerns or choose to adopt a new perspective, seeing the pacemaker crisis as an opportunity to create a solid platform for unbiased adoption of upcoming connected cardiac devices.

Health in 2 Point 00 Episode 89 | IPOs, Oscar and Fitbit

Jul 26, 2019

Today on Health in 2 Point 00, it’s IPO day! On Episode 89, Jess asks me about the recent IPOs, Oscar Health getting into Medicare Advantage, and Fitbit accuracy in people of color. Jess asks me to weigh in on whether Livongo’s IPO was better than we expected and it’s safe to say that they are growing fast. On the flip side, the “silent” IPO that no one seems to be talking about is Health Catalyst, which is also doing quite well with a $1.6 billion valuation although they are not growing as fast as Livongo is. Next, Oscar Health decided to enter into Medicare Advantage, which is not surprising because that’s where the real money is in the insurance side. Finally, Fitbits and other wearables may not be tracking heart rates accurately in people of color, so what does this mean for the wearables industry—and their potential use for medical purposes? —Matthew Holt

Health Reform Job One: Stop the Gouging! | Part 3

Jul 26, 2019• 3

By BOB HERTZ

We Need Legal Assaults On The Greediest Providers!

When a patient is hospitalized, or diagnosed with a deadly disease, they often have no choice about the cost of their treatment.

They are legally helpless, and vulnerable to price gouging.

We need more legal protection of patients. In some cases we need price controls.

In the final part of this series, I discuss how we need to empower patients by allowing them to challenge their medical bills in courts.

Assault Phase Four – Binding Arbitration of Medical Bills

We must allow patients to challenge their medical bills in expanded ‘Health courts.’

Patients should be able to contest any bill over $250, especially if they have not given ‘informed financial consent’ to the provider.

Such ‘consent’ would require that if a procedure can be scheduled in advance, it can also be quoted in advance. If the patient requests an estimate, they must be notified in writing at least seven days in advance. This would allow the patient to request a different provider, or to investigate other alternatives. If an estimate is requested but never produced, the patient has no liability. (That will shake up the providers rather quickly.)

Health Reform Job One: Stop the Gouging! | Part 2

Jul 25, 2019

By BOB HERTZ

We Need Legal Assaults On The Greediest Providers!

When a patient is hospitalized, or diagnosed with a deadly disease, they often have no choice about the cost of their treatment.

They are legally helpless, and vulnerable to price gouging.

We need more legal protection of patients. In some cases we need price controls.

Next in this three-part series, I discuss how we could challenge Big Pharma by lessening regulation of generic drugs, having the government take over production and establishing price review boards.

Assault Phase Three – Challenge Big Pharma

Step One – Less Regulation of Generic Drugs

If an off-patent drug has been approved by other first-world nations, this would constitute automatic approval by the FDA.

The price gouging around Epipen would have ended quickly, if new versions of genetic drugs did not require an FDA approval process. We should let reputable drug companies produce whatever generic drugs they want.

Health Reform Job One: Stop the Gouging! | Part 1

Jul 24, 2019

By BOB HERTZ

We Need Legal Assaults On The Greediest Providers!

When a patient is hospitalized, or diagnosed with a deadly disease, they often have no choice about the cost of their treatment.

They are legally helpless, and vulnerable to price gouging.

Medicare offers decent protection — i.e. limits on balance billing, and no patient liability if a claim is denied.

But under age 65, it is a Wild West — especially for emergency care, and drugs and devices. The more they charge, the more they make. Even good health insurance does not offer complete financial insulation.

We need more legal protection of patients. In some cases we need price controls.

‘Charging what the market will bear’ is inadequate, even childish, when ‘the market’ consists of desperate patients. Where contracts are impossible and there is no chance for informed financial consent, government can and should step in.

This series describes the new laws that we need. Very little is required in tax dollars….but we do require a strong will to protect.

Zeev Neuwirth Reframes Primary Care…Brilliantly

Jul 22, 2019

By AL LEWIS

I would urge THCB-ers to read Reframing Healthcare by Dr. Zeev Neuwirth. While much of the territory he covers will be familiar to those of us with an interest in healthcare reform (meaning just about everyone reading this blog), Chapter 5 breaks new ground in the field of primary care.

Primary care is perhaps the sorest spot in healthcare, the sorest of industries. Primary care providers (PCPs) are underpaid, dissatisfied, and in short supply. (The supply issue could be solved in part if employers didn’t pay employees bonuses to get useless annual checkups or fine them if they don’t, of course.)

They are also expected to stay up to date on a myriad of topics, but lack the time in which to do that and typically don’t get compensated for it. Plus, there are a million other “asks” that have nothing to do with seeing actual patients.

For instance, I’ve gone back and forth three times with my PCP as she tries to get Optum to cover 60 5-milligram zolpidems (Ambien) instead of 30 10-milligram pills. (I already cut the 5 mg. pills in half. Not fair or good medicine to ask patients to try to slice those tiny 10 mg pills into quarters. And not sure why Optum would incentivize patients to take more of this habit-forming medicine instead of less.)

This can’t be fun for her. No wonder PCPs burn out and leave the practice faster than other specialties. What some of my physician colleagues call the “joy of practice” is simply not there.