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Matthew Holt

ONC Awards $300K in Funding to 6 Digital Health Pilot Projects!

By ADAM WONG

The Department of Health and Human Services’ (HHS) Office of the National Coordinator for Health Information Technology (ONC) today announced the six winners of the inaugural ONC Market R&D Pilot Challenge. The six winners will live-test new health information technology (health IT) applications in health care settings administered by their challenge partners.

The winning innovator-health care organization teams will each receive $50,000 to fund their pilot programs which will become operational in August are:

  • ClinicalBox and Lowell General Hospital
  • CreateIT Healthcare Solutions and MHP Salud
  • Gecko Health Innovations and Boston Children’s Hospital
  • Optima Integrated Health and University of California, San Francisco, Cardiology Division
  • physIQ and Henry Ford Health System
  • Vital Care Telehealth Services and Dominican Sisters Family Health Service

The ONC Market R&D Challenge launched on October 20, 2014 with the goal of finding early stage health care startups from across the country and connecting them with health care organizations and stakeholders with whom they could potentially run a pilot program to test the application.

Three in-person matchmaking events were held in January, 2015, focused on connecting health care organizations with innovator companies looking to pilot test their products. Almost 500 organizations expressed interest in finding partners through the matchmaking program. More than 300 in-person meetings were held in New York, New York; San Francisco, California; and Washington, D.C., with many more conducted virtually. These “speed-dating” events allowed startups to meet face-to-face with health care organizations to identify common interests and goals. ONC and the organizer of these meetings, Health 2.0, intended for the events to have additional benefits, including facilitating the exchange of ideas that might lead to new partnerships and relationships.

To be eligible to serve as a host, organizations were required to operate in clinical, public health and community, or consumer health environments while also serving enough consumers or patients to conduct a pilot study. The innovators had to be an early-stage health information technology company with less than $10 million in venture capital funding and a readily available technology solution.

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Why Microsoft May Be the One to Watch

Dale SandersMatthew Holt: I’m talking with one of the most interesting people in healthcare, Dale Sanders who these days is the Senior Vice President for Strategy for Health Catalyst, a really fast growing data warehousing analytics company. Dale, before that, did a bunch of stuff in the Air Force, at Intermountain, was involved with starting the Health Data Warehouse Association, and even for a while running the National Health IT System in Cayman Islands

Anyway we’re here to chat about some work that Health Catalyst is doing, that you guys have been doing these webinars, very successful ones, a few months and years. You actually had a big conference last year, which you’re repeating again this year, I know, but specifically coming up on April 22nd 1 – 2 PM PST is a webinar about Microsoft.

So let me tell you my Microsoft story from HIMSS last week I was in one of the last sessions in Thursday, actually, and it was a guy named Dave Francis talking about the future of consumer health. Someone said, “I am a Microsoft guy. I work for Microsoft. They send me out to health systems and I help in dealing with technical issues. You’re talking about the future of online consumer health. The Google Health guys, they had that thing, it failed. We have Healthvault, we failed and close it down. Oh no, we didn’t officially close it, so I’m not supposed to say that, but anyway”. So that’s the kind of way people think about Microsoft and healthcare. But you’re saying not so fast. So what’s the story here?

Dale Sanders: Yeah, it’s very interesting. In this webinar, I spend the first few minutes talking about my life on Microsoft. So I’ve been an IT now for 32 years, starting out in the Air Force and now in Health Catalyst. So I put this timeline together and I put all these significant events in my life that had some relationship to some event in Microsoft. Most of the time, it’s like horrible, right? I want to poke my eyes out. My Microsoft experience as a healthcare IT guy or just an IT guy in general has been terrible, right? Security problems, backwards compatibility problems, scalability problems. But now I’m very bullish in Microsoft, so it’s kind of unusual that I’ve completely turned my opinion

Matthew Holt: Perhaps because they’re no more the evil monopoly, they’re David vs Goliath?

Dale Sanders: Yeah. Really, it’s fascinating. This webinar is about their cultural transformation as much as it is their technical transformation. It’s fascinating, and I was never a big fan of Bill Gates, never a big fan of Steve Ballmer. They’re just contrary personalities to me.

Matthew Holt: They may care less about what you think.

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In Search of Intra-Aero-Bili-ty

Today is the kick-off of the vendor-fest that is HIMSS. Late last week on THCB, ONC director Karen De Salvo and Policy lead Jodi Daniel slammed the EMR vendors for putting up barriers to interoperability. Last year I had my own experience with that topic and I thought it would be timely to write it up. (I’ll also be in the Surescripts booth talking about it at 3.45 Monday)

I want to put this essay in the context of my day job as co-chairman of Health 2.0, where I look at and showcase new technologies in health. We have a three part definition for what we call Health 2.0. First, they must be adaptable technologies in health care, where one technology plugs into another easily using accessible APIs without a lot of rework and data moves between them. Second, we think a lot about the user experience, and over eight years we’ve been seeing tools with better and better user experiences–especially on the phone, iPad, and other screens. Finally, we think about using data to drive decisions and using data from all those devices to change and help us make decisions.

Slide47

This is the Cal Pacific Medical Center up in San Francisco. The purple arrow on the left points to the door of the emergency entrance.

Slide48
Cal Pacific is at the end of that big red arrow on the next photo. On that map there’s also a blue line which is my effort to add some social commentary. To the top left of that blue line in San Francisco is where the rich people live, and on the bottom right is where the poor people live. Cal Pacific is right in the middle of the rich side of town, and it’s where San Francisco’s yuppies go to have their babies.
Slide49
Last year, on August 26, 2014 at about 1 am to be precise, I drove into this entrance rather fast. My wife was next to me and within an hour, we were upstairs and out came Aero. He’s named Aero because his big sister was reading a book about Frankie the Frog who wanted to fly and he was very aerodynamic. So when said, “What should we call your little brother?” She said, “I want to call him Aerodynamic.” We said, “OK, if he comes out fast we’ll call him the aerodynamic flying baby.” So he’s called Aero for short.

Slide51
Thus began the Quest for Intra-Aero-Bili-ty –a title I hope will grow on you. The Bili part will become obvious in a paragraph or two.

Something had changed since we had been at Cal Pacific three years earlier for the birth of Coco, our first child.

Slide53
If you look carefully at the top of Amanda’s head, there’s now a computer system. Like most big provider systems, Sutter–Cal Pacific’s parent company–has installed Epic and it’s in every room or on a COW (cart on wheels). Essentially we have spent the last few years putting EMRs in all hospitals. This is the result of the $24+ billion the US taxpayer (well, the Chinese taxpayer to be more accurate) has spent since the 2010 rollout of the HITECH act.Continue reading…

The Coming Health Tech Disruption

Mark Cuban has been actively commenting in Saurabh Jha’s THCB post about him. We thought this comment was worthy of being a standalone post (and he agreed)–Matthew Holt

The tech sector will leave people better off at a lower cost. Moore’s law will have its day. But we are 5 years off from minimal impact. 10 years off from Marginal Impact.

In 20 years we will all look back and think 2015 was a barbaric year of discovery.

To give perspective. We pioneered the Streaming Industry TWENTY YEARS AGO. And now we are finally seeing streaming becoming mainstream as a technology but it still cant scale to handle mega live events.

HealthTech will continue to move forward quickly with lots of small wins. It will slow down when there is an inevitable recession in the next 20 years, then jump again afterwards.

In 30 years our kids/grandkids will ask if its true that there were drugstores where we all bought the same medications , no personalization at all, and there were warnings that the buyer may be the one unlucky schmuck that dies from what used to be called over the counter medication.

We will have to admit that while unfortunate it was true. Which is why “one dose fits all ” medications were outlawed in 2040 🙂

By then hopefully we will have a far better grasp on this math equation we call our bodies.

Of course it will be long before then that we make decisions based on optimizing health rather than trying to reduce risk.

The biggest challenge will be training health care professionals.

Medicine today seems to be in that 1980s phase that tech went through where no one got fired for hiring IBM. So IBM got lots of business because it was the safe choice rather than the best choice.

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The Digital Doctor – The Review

Digital Doctor

Bob Wachter has been about as influential an academic doctor as there’s been in recent years. He more or less invented the concept of the hospitalist, he’s been a leader in patient safety, and even dressed up and sang as Elton John at the conference he runs! (He’s also pissed off lots of doctors by being a recent one year chair of the newly controversial and perhaps scandalous ABIM). But for the last 2 years he’s been touring the good and the great of health care and IT to try to figure out what the recent introduction of EMRs at scale has meant and will mean. The resulting book The Digital Doctor is one of this year’s “must reads” and yes we will have Bob as the keynote at this Fall’s Health 2.0 Conference.

The immersion research he conducted was fantastic. Bob interviewed just about anyone you’ve ever heard of and a few you wish you hadn’t (more on that later). And in fact he’s been running interviews on THCB and elsewhere sharing some of the stuff that didn’t get in the book. But I’m still wrestling a little with what I think about the book itself. And I think it’s because I largely agree with him and his angst.

There is lots of wonderful stuff in this book. The change in the role of radiology post PACS, how patients are using open notes, whether Vinod Khosla agrees with Vinod Khosla about algorithms replacing doctors–all this and much more are here. But the book is largely about the introduction of the current generation of EMRs into the everyday practice of ordinary clinicians. There are by and large three camps of opinions about what’s happened.

One is that the EMR is a pox visited on physicians that costs a fortune, has worsened quality, heightened medical errors, blown up successful processes, and ruined the lives of doctors–unless they were given scribes. The second is that because of the “rush to judgement” caused by the HITECH Act and Meaningful Use, we put in EMRs that were based on 1990s client-server technology but they were the only ones mature enough for the job. Most of this camp thinks that they were way better than paper, will slowly improve, and that doctors and patients will find that these technologies will soon integrate with easy to use iPhone-like apps as their APIs open up–and that if we hadn’t mandated EMRs when the great recession gave us the chance, nothing would have happened. The third camp agrees that EMRs are better than paper but felt that the way HITECH was rolled out kept a bunch of dinosaurs in business, and is preventing the health IT equivalent of Salesforce displacing Siebel (or Slack displacing email).Continue reading…

Livongo Health adds $20m, Tullman interview

Livongo Health is creating a tech-based service that aims to supersede the glucometer. Headed by former Allscripts CEO (and THCB interview regular) Glen Tullman, it raised another $20m from Kleiner Perkins, DFG & General Catalyst today. I grabbed 10 minutes to talk to Glen Tullman this morning. he had very interesting things to say not only about his business but Cerner, Epic & open systems too.
[youtube]https://youtu.be/4w-pHj91PKM[/youtube]

Let’s Play “What If”—the Data for Health Edition!

Optimized-MichaelPainterWhat if I asked you to talk data—about lots and lots of health data? By that I mean data about you and your community that you and others could use to improve your health.

What if I asked you to sit for hours with others from your community to talk about using the giga-bytes of data from your devices and other sources like electronic health records to help improve health—your health and the health of your community?

Would you play?  Would you do that?

Or would you blanch, shake your head incredulous, yawn with boredom and possibly run in the opposite direction?

Well, your colleagues in five cities, Philadelphia, Phoenix, Des Moines, San Francisco and Charleston, SC, played that very game with the Robert Wood Johnson Foundation and members of our Data for Health advisory committee along with the National Coordinator for Health Information Technology and members of her staff.

Boy, did they play.

Last fall in our initiative, Data for Health, the Foundation asked people in those places to spend an entire day talking with us about their hopes, aspirations, worries and concerns with using digital data to improve health.

Honestly, we weren’t at all certain people would play this particular game. We understood—in fact some people told us—that this discussion could seem turgid, distant, maybe even a boring academic hypothetical discussion.

That was not the case.

Turns out it was very easy to draw people into this conversation. People attended and engaged passionately and vigorously. It was a powerful thing to behold.

These people were very interested in using data to improve both their individual as well as their community’s health. Continue reading…

Rooting and Leveraging the Innovation Economy


The use of the term ‘innovation’ is getting pretty worked up lately. In fact, almost every healthcare entity whether health plan, health system, IDN or even ‘mature ACO’ (morphed from an IPA or risk bearing PHO “chassis” or “carcass” as the case may be) seem to have anointed a ‘CIO’ as in ‘chief innovation officer’ to steward the critical transformation from volume-to-value during a yet to be determined period of conflicting if not schizophrenic incentives coupled with its legacy cultural inertia.

In fact some institutions via branded ‘Centers for Innovation or Transformation‘ have made substantial investments in people and infrastructure (“bricks, sticks and platforms”) as well as the promise of the essential ‘firewall inoculation’ and separation from the ‘mother-house’ to catalyze the required re-engineering during a likely period of cannibalization of traditional revenue streams.

So the ancient Chinese curse (paraphrased below) most likely applies here:

..we live in ‘interesting times’ with both ‘danger and opportunity’ before us.

For those tasked with this challenge and fortunate enough to participate in conferences (Health 2.0Exponential MedicineHealth DatapaloozaTEDMED to name a few of the trophy organizers) at the disruptive and transformational tip of the spear, the nature of the challenge including opportunities to meet and leverage connections of like minded and focus colleagues is a distinct strategic advantage.Continue reading…

HxRefactored Interview: Care Delivery Innovation with Mulesoft

Matthew Holt, Co-Chairman of Health 2.0 recently interviewed David Chao, Director of Industry Solutions at Mulesoft. Mulesoft is a “connectivity company” with a vision to connect the world’s data, devices, and applications. During this interview, David shares the challenges within health care and gives an insight into how Mulesoft is re-framing health care delivery and ensuring health data moves freely between multiple systems as well as within organizations to be delivered at the point of care when and where it’s needed the most.

You can see David during the Care Delivery Innovation: Reinventing Access and Expectations session at HxRefactored on April 1-2 in Boston, MA.

The Real Story Of How I Sold Two Startups, The Chaos Afterwards, And What’s Next

alex christmas

Today we’re starting a series of more personal stories, looking at what makes interesting people in health care tick. Alex Carmichael is a rare multiple time CEO in health technology, and she has a very interesting tale to tell–Matthew Holt

Don’t worry, this isn’t your typical, syrupy founder story. Matthew asked me to share my experience selling my startup CureTogether to 23andMe, what ensued after that, and how I ended up at uBiome today.

So I thought, if I’m going to share, I might as well *really* share. Let you in behind the scenes to see what it was actually like.

(Bonus: at the end I’ve listed my top 11 life lessons, so make sure you read all the way through for that!)

The story starts…

October 1, 1976: I came into the world in Toronto, Canada, with striking violet eyes. My lawyer/politician mother and management consultant father gave me the name Alexandra, which means “leader of all mankind,” as they often reminded me. Talk about a family having high expectations!

Childhood: I remember loving to read and walk my dogs, who were probably my best friends. I went to a progressive Montessori school with an amazing teacher who believed in me and taught me the power of patience.

Teenage years: The “best” school in Toronto was a repressive and aggressive all-girls private school. My insane work ethic was drilled into me there, as well as at my mom’s political campaign offices, where I would work after school until late into the night.

College years: I met my first love, Danny, in a biochemistry lab at the University of Toronto. I chose the most difficult major (Molecular Genetics and Molecular Biology), because it would drive me hardest. Masochist much?

First startup, 1999: I dropped out of grad school, much to the horror of my extremely educated parents, to join a bioinformatics software company Danny had started in his bedroom in 1997. I taught myself how to code, design, sell, and run a company. We worked so much that we hardly left our apartment, except to get married, have a baby, and occasionally go to Tai Chi class. We lost most of our money in the dot com bust, and scraped by on rice and beans for a few years. It was so isolating and intense that I got really depressed and even suicidal once.

First exit, and move to California, 2005: We were seriously running out of money, so one day I made a big wall chart of all the possible companies that could acquire us, and we started going after each one relentlessly. After a few months, we got a meeting with Hitachi. They were interested, but didn’t seal the deal until we decided to put our stuff in storage and just show up in California, baby daughter Samantha in tow. One way or another, we were determined to make it work. They did end up acquiring us, for a few hundred thousand dollars. Not much for 8 years of invested time and energy, but really we just wanted to get to California, where the sun shines and the opportunity abounds. We finally made it!
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