Author Archives

Matthew Holt

Why I’m Starting a Radically Different Kind of Medical Practice

Dec 29, 2014• 52

By ROBIN BERZIN, MD

We hear a lot about how US medicine is broken, from how much we spend annually ($4 trillion) for unimpressive outcomes, to the growing epidemic of obesity and diabetes, to problematic financial models, to the growing malaise amongst doctors.

Across US health care, a lot of smart people are crafting solutions to these problems, but in my view the reality is that many of them are generating efficiencies on top of a broken product.

The real problem is that conventional primary care as it’s practiced today no longer serves the needs of most people, be they wealthy or under-served, be they patient or provider.

I am starting Parsley Health, a new kind of medical practice that directly addresses these problems, first by providing something called Functional Medicine rather than traditional primary care, and second by providing functional medicine in a tech driven, modern and affordable way.

What is Functional Medicine?

I became a functional medicine doctor because early on I recognized two major limitations of the conventional medicine.

Fact vs Fiction – Navigating the Health Care Marketplace with Consumer Reports

Dec 23, 2014

At Health 2.0 WinterTech: The New Consumer Health Landscape speakers and sponsors are exploring the platforms that empower the informed consumer movement by providing objective reviews of consumer products. Senior Director, of Health Impact and Consumer Reports, Tara Montgomery will be joining the event to speak to their research on the health products, prescriptions, and providers that contribute to the changing consumer health landscape.

Health 2.0: Tara can you start by speaking to what really pushed this expansion into research and advocacies surrounding health products and when you sort of saw this started shifting?

Tara Montgomery: Yes. Well, actually, you might not know, but we have been in health since day one, and it was actually in our charter back in 1936 to look out for the well-being of all consumers. We started in our very first issue of our magazine and we rated Alka-Seltzer and said that its claims vanish — like gas bubbles in the air. So that was our first foray into health, but that was in a small scale, and I think it was typical of the kinds of health products being advertised to consumers earlier in the 20th century, but over the decades, we covered health lightly. And then, really, about 10 years ago, we saw the shift in healthcare where the consumer’s role really was shifting much more consciously from a compliant patient to a need to be a more savvy health consumer. That was a real call to action for us because our role in helping consumers out in the world is really to give people savvy information about value, and everything we’ve done in washing machines and cars and toasters has been about helping people evaluate the benefits, their satisfaction, and the value for money of the products and services they choose. When the burden of health costs started to shift towards consumers, and you know that definitely has been more intense in the past couple of years, we’ve needed to rise to the occasion and helpconsumers navigate that new role. So, that was a moment for us along with transparency, because when we wanted to rate healthcare products and services more than 10 years ago, the data wasn’t available, and obviously, you can’t look at health the same way as we look at cars and washing machines and bang — our national lab.Continue reading…

Health is All Around Us : How Our Environment Informs Our Health

Dec 23, 2014• 1

As Health 2.0 gears up for Health 2.0 WinterTech, January 15th in San Francisco, their reporters sat down with Environmental Working Group Executive Director, Heather White to discuss the many pathways consumer health advocacy takes and the barriers that continue to keep many of us in the dark about the relationship between our health and our environment.

Health 2.0: To get things started, Heather, I wanted to talk with you a little bit about some of the insight you’ll be providing at WinterTech, which is in relation to the Skin Deep App. From what I’ve researched, it offers ratings on over 70,000 products. I was hoping you could share your thoughts on how you and your team envisioned this app and the way it’s changing how consumers shop for skin products, and what has been the response thus far?

Heather White: Yeah. Well, it definitely has been making waves in the market for a pretty long time. Our site was developed 10 years ago, but we launched our app last year. So far, we’ve had about 300,000 downloads on iPhone and about 95,000 on Android, so close to 400,000 consumers have downloaded the app and are able to make decisions on safer cosmetics and personal care products right at the store. So, we’ve gotten a lot of response and support from our community, but we’re also finding that our brand is reaching a much broader audience. It’s really exciting for us because EWG is all about making sure people make this connection between our health and the environment and really start thinking about the environment as something that they connect to everyday. It’s not just that place you go on vacation, but it also incorporates the chemicals that you buy and that you put on your skin and the chemicals that you buy and then you bring into your home. Skin Deep is trying to really push the market for safer cosmetics and we’ve really seen a lot of consumers make more switches to safer alternatives and we’re also seeing each day new brands coming onto the markets that are less toxic. So, there’s been a tremendous response so far. It’s a free app. It’s available both on the Android and iPhone and our supporters and people who are interested in this issue have really welcomed it.

Reactive vs. Proactive Health Care: The Intersection of Payment Reform & Consumer Data Powering Clinical Insight

Dec 23, 2014• 1

By JOSHUA SEIDMAN

One of the greatest opportunities that exists in moving from “turnstile medicine” (or fee-for-service) to value-based payment models is the shift from reactive to proactive health care. The focus on accountability for population health forces providers to adopt a completely different mindset: Instead of waiting for sick patients to come knocking on your door, you need to figure out what they need, when they need it, and how to get it for them.

At the upcoming conference, Health 2.0 WinterTech: The New Consumer Health Landscape (January 15, San Francisco), I will moderate a panel on “Consumer Data Powering Clinical Insight.” The panel features several different perspectives on how consumer-facing technologies can translate discrete consumer-generated data into useful information that providers and others can use to deliver more personalized and proactive support and care management.

The dramatic proliferation of electronic health records (EHRs) in the last five years means that much more clinical patient data exists in electronic form than ever before. True meaningful use of that data involves organizing it into meaningful and useful information by building algorithms, leveraging machine learning principles and delivering the right information to the right person at the right time. In addition, de-identified data in the cloud provides a scale for that kind of data analytics. Practice Fusion, a cloud-based EHR company uses patient-derived data—everything from booking an appointment to patient intake questionnaires—to drive proactive health management. CEO Ryan Howard will discuss how, in early 2015, they’ll begin incorporating qualitative and quantitative data from the patient and machine learning based on how physicians react to it to better target diagnosis, treatment and other support.

Let’s Have APIs for Those Provider Directories!

Dec 23, 2014• 7

This was a comment I submitted submitted to this proposed set of regulations on health plans participating in the ACA. (Use ctrl-F to search “provider directory” within the page). HHS is proposing forcing insurers to make their provider directories more accurate and machine readable, and it would be great for consumers if that was made the case–especially if APIs (which means basically giving access for other computers to read them) were mandated–here’s why:

By MATTHEW HOLT

Subject–Immediately updated provider directories machine readable via APIs should be mandated for health insurers.

Finding accurate information about providers is one of the hardest things for consumers to do while interacting with the health care system. While regulation cannot fix all of these issues, these proposed regulations in section 156.230 can greatly help, But they should be strengthened by requiring (under subsection 2) that health insurers immediately add new information about providers in their networks to a publicly available machine readable database accessible via a freely available API.

Currently companies trying to aid consumers in provider search and selection tell us that the information pertaining to which providers are in a particular network is the least accurate of all data they can receive. For consumers the biggest question for plan selection is trying to find out which provider is in their plan, and at the least this requires searching multiple websites. Worse, particular insurer’s plans can even have the same name but can have different networks (in one instance in our personal experience Aetna in New York state had two different plans with effectively the same name but different networks). This is essentially impenetrable for consumers and that is assuming that the information on the websites is accurate or timely–which it is often not.

What has Surveyor Health been up to?

Dec 22, 2014• 2

By Matthew Holt

Erick & Linda von Schweber started Surveyor Health around the time Health 2.0 started back in 2007, with the BHAG of massively improving medication safety using some very complex technology. And it has taken them a long time to embed themselves in the bowels of some huge health care organizations and to start getting traction. But it is finally happening and the impact may be substantial. I interviewed Erick and he gave me a comprehensive demo and update on their latest results. If you care about drugs and clinical care, this is compelling (if not lightweight!) viewing. (I suggest you switch to full screen for the demo).

Is Deborah Peel up to her old tricks?

Nov 23, 2014• 38

By Matthew Holt

Long time (well very long time) readers of THCB will remember my extreme frustration with Patients Privacy Rights founder Deborah Peel who as far as I can tell spent the entire 2000s opposing electronic health data in general and commercial EMR vendors in particular. I even wrote a very critical piece about her and the people from the World Privacy Forum who I felt were fellow travelers back in 2008. And perhaps nothing annoyed me more than her consistently claiming that data exchange was illegal and that vendors were selling personally identified health data for marketing and related purposes to non-covered entities (which is illegal under HIPAA).

However, in recent years Deborah has teamed up with Adrian Gropper, whom I respect and seemed to change her tune from “all electronic data violates privacy and is therefore bad”, to “we can do health data in a way that safeguards privacy but achieves the efficiencies of care improvement via electronic data exchange”. But she never really came clean on all those claims about vendors selling personally identified health data, and in a semi-related thread on THCB last week, it all came back. Including some outrageous statements on the extent of, value of, and implications of selling personally identified health data. So I’ve decided to move all the relevant comments to this blog post and let the disagreement continue.

What started the conversation was a throwaway paragraph at the end of a comment I left in which I basically told Adrian to rewrite what he was saying in such a way that normal people could understand it. Here’s my last paragraph

As it is, this is not a helpful open letter, and it makes a bunch of aggressive claims against mostly teeny vendors who have historically been on the patients’ side in terms of accessing data. So Adrian, Deborah & PPR need to do a lot better. Or else they risk being excluded back to the fringes like they were in the days when Deborah & her allies at the World Privacy Forum were making ridiculous statements about the concept of data exchange.

Here’s Deborah’s first commentContinue reading…

ONC launches Pilot Program to Catalyze Health IT Innovation

Nov 10, 2014

Investments in digital health have never been higher, with reports indicating that $5 Billion has been invested in health tech startups in 2014. Encouraged by the increasingly favorable changes being made to health policy in the U.S., many entrepreneurs have answered the call to action to solve problems related to health care delivery and access, disease management, and cost reduction. Venture capitalists recognize the value of innovation in health care through technology yet few of these tools have gained widespread adoption. Health care organizations and providers are wary of implementing new technologies that haven’t been tested for fear of disrupting their workflows and causing more problems than before.

Market R&D Pilot Challenge Website

Recognizing these high barriers to entry for digital health startups the Office of the National Coordinator for Health Information Technology (ONC) is hosting the Market R&D Pilot Challenge to bridge the gap between health care providers and innovators. This competition, which is administered by Health 2.0, may award pilot proposals in four different domains: clinical environments (e.g., hospitals, ambulatory care, surgical centers), public health and community environments (e.g., public health departments, community health workers, mobile medical trucks, and school-based clinics), consumer health (e.g., self-insured employers, pharmacies, laboratories) and research and data (e.g, novel ways of collecting data from patients).Continue reading…

SENSING XCHALLENGE, with Google Hangout Wednesday at 10 PST

Oct 21, 2014• 5

By Matthew Holt

Yesterday XPRIZE announced the 11 finalists for the second phase of the Nokia Sensing XCHALLENGE. This is a $2.25m prize competition to advance the ability to use sensors to measure and manage health, and it’s something that we’re fascinated by at Health 2.0. You may recall that the first round’s winners were unveiled live on stage at the 2013 Health 2.0 Fall Conference by our friends at XPRIZE and Nokia.

UPDATE–The hangout is embedded above. To find out a little more, please come to a Google Hangout at 10 am Pacific/ 1pm EST Wednesday where I’ll be chatting with Dr. Erik Viirre, Medical and Technical Director of the Qualcomm Tricorder XPRIZE and the Nokia Sensing XCHALLENGE; Jonanthan Linkous, Chief Executive Officer of the American Telemedicine Association; Jon Dreyer, President of Health IT Strategic Partners; Dr. Manas Gartia from team MoboSense, a Distinguished Award winner in the Nokia Sensing XCHALLENGE Competition #1; and Dr. Marc Bailey from Nokia Technologies.

You can also see videos of the finalist teams and their breakthrough technologies can be viewed and voted on beginning today through October 30 at http://www.nokiasensingxchallengevoting.org. More on the teams below the fold:

3 Reasons Why Healthcare Needs Hackathons

Oct 3, 2014

AMAN BHANDARI and SACHIN JAIN

Medicine and public health have had a long history and strong roots in experimentation and solving problems through iteration. As healthcare now begins to intersect with tech like never before, the health focused hackathon offers an unprecedented opportunity for us to embrace this past while giving a home to the tinkering, experimentation, and solution-building that is needed now more than ever in our industry.

The first recorded use of the word “hack” occurred 900 years ago, but the more common and positive use of “hack”—to write a computer program for enjoyment—originated in the hallowed halls of MIT in the 1950s. The “hackathon, a portmanteau of ‘hack’ and ‘marathon’,” was first born out of a challenge posed to programmers at a conference in Silicon Valley by John Gage of Sun Microsystems in 1999.

Borrowing from what became a tech sector institution, one of the first health focused hackathons was launched at a national scale over a decade later in 2010 as a part of a public-private partnership between the US Government and Health 2.0 (co-launched by Aman Bhandari and Indu Subaiya as the Health2.0 Developer Challenge).

Since that time, the practice has expanded rapidly: we have found and analyzed over 100 health-focused hackathons (the full living database is available for download, analysis and editing on the MIT Hacking Medicine website here: