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Matthew Holt

Integrating in Health Care: 6 Tools for Working Across Boundaries

By REBECCA FOGG 

Today’s health care providers face the formidable challenge of delivering better, more affordable and more convenient care in the face of spiraling care costs and an epidemic of chronic disease. But the most innovative among them are making encouraging progress by “integrating”—which in this context means working across traditional boundaries between patients and clinicians, health care specialties, care sites and sectors.

The impulse to do so is shrewd, according to our innovation research in sectors from computer manufacturing to education. We’ve found that when a product isn’t yet good enough to address the needs of a particular customer segment, a company must control the entire product design and production process in order to improve it. This is necessary because in a “not-good-enough” product, unpredictable and complex interdependencies exist between components, so each component’s design depends on that of all the others.

Given this, managers responsible for the individual components must collaborate—or integrate—in order to align components’ design and assembly toward optimal performance. IBM employed an integrated strategy to improve performance of its early mainframe computers, and this enabled the firm to dominate the early computer industry when mainframes weren’t yet meeting customers’ needs.

In health care delivery, such integration is analogous to, but something more than, coordinated care. It means assembling and aligning resources and processes to deliver the right care, in the right place, at the right time. This type of integration is a core aspiration of innovative providers leading hot-spotting and aging-in-place programs, capitated primary care practices, initiatives addressing health-related social needs, and other care models that depart from America’s traditional, episodic, acute-care model. How are they tackling it? They’re leveraging very specific tools to facilitate work across boundaries. Here are six of the most common we uncovered in our research:

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Health in 2 Point 00, Episode 60

Today on Health in 2 Point 00, Jess and I report from a hedgehog cafe in Tokyo. In this episode, Jess asks me about Bright Health’s $200 million raise and the significance of Amazon’s new EMR product. We also talk about Health 2.0 Asia-Japan, which is happening right now (December 4-5) in Tokyo, showing us the health care market outside of the U.S. Look forward to hearing from some great speakers at the conference, including John Bass from Hashed Health on blockchain, Fred Trotter on security, David Ewing Duncan on the new wellness and personalized medicine, and Adam Pellegrini from Fitbit. And, of course, Jess will be interviewing just about everyone—including a hedgehog—about innovation for WTF Health —Matthew Holt

The Reality of Bush I on Health Care and Its Lessons for Today

By MICHAEL L. MILLENSON 

Former President George H.W. Bush may have been every inch the caring individual portrayed in the eulogies of those who knew him, but when it came to health care reform, two words characterized his attitude: Don’t care.

However, compared to Congressional Republicans, Bush was a profile in conservative courage – a lesson with unfortunate parallels to now.

I covered health policy as a reporter for the Chicago Tribune during the Bush years. One strong memory, confirmed by checking original sources, was the presidential debate on Sept. 25, 1988 between Bush and his Democratic challenger, Massachusetts Gov. Michael Dukakis. When Bush was asked what he’d do for the 37 million people without health insurance – about one in seven Americans – he answered that he would “permit people to buy into Medicaid.”

I remember turning from the TV to my wife and saying, “I have no idea what he’s talking about.” Neither, apparently, did anyone else. A Washington Post story that followed, headlined, “Bush’s Mysterious Medicaid Plan” noted that seeking details from the Bush campaign yielded “answers [that] are contradictory.” The story added that “Bush had never publicly mentioned the idea” until the debate.

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WTF Health | Self-Reported Patient Monitoring Startup from Finland, Kaiku Health

WTF Health – ‘What’s the Future’ Health? is a new interview series about the future of the health industry and how we love to hate WTF is wrong with it right now. Can’t get enough? Check out more interviews at www.wtf.health

Central to the ‘WTF Health’ ethos is the idea that around the world, there is a shared passion for creating a new future for healthcare — and that the less-positive ‘WTF moment’ is a shared experience, regardless of which country’s health system one is standing in.

So, I’m going around the world this year — to 17 different health innovation conferences in 11 different countries — to find out what innovators abroad are doing to tackle the problems in their health systems and what we can learn from one another.

Driving down the cost of care, managing chronic conditions, helping people achieve better health, improving care delivery and patient experience — these goals know no borders. What’s different is the framework around them. So, what if the payment model were different? What if there was a single electronic patient record? What if certain laws and regulations didn’t exist?

Different constraints breed different solutions. What a hopeful and inspiring idea. And, with any luck, food for your thoughts and innovative thinking.

So here is the first interview I’d like to share from abroad! Everyone meet Finnish startup Kaiku Health, fresh off closing a €4.4M Euro series A. Their patient monitoring monitoring platform lets cancer patients (and others with chronic diseases) self-report on how they’re doing, using their hospital’s existing patient portal. Stick around until the end: Bonus insight on the strengths of the health tech startup scene in the Nordics for those who want to go explore.

Filmed at Upgraded Life Festival in Helsinki, early June.  

WTF Health | Oscar’s Schlosser on Consumerizing Health Plans, post-ACA & pre-Amazon/JPM/BH

WTF Health – ‘What’s the Future’ Health? is a new interview series about the future of the health industry and how we love to hate WTF is wrong with it right now. Can’t get enough? Check out more interviews at www.wtf.health

Having formerly worked for a health plan, I geek out over health plan innovation as IMO it’s the underpinning of the true disruption of health care. When the incentives change, everything else will change too…

So when I met Mario Schlosser, co-founder & CEO of Oscar Health at Health Datapalooza, I may or may not have asked him to sign my Oscar insurance card. (Yep, I’m a member.)

Our chat focused his push to continue driving health plan innovation amid the deterioration of the ACA and his plans for Oscar’s latest $165M round. His goal: make the payer “an interface and enabler of new kinds of technologies.” Is that even possible?!

Around 4:15 minute mark we find out if he’s been tapped for advice from the Berkshire Hathaway/Amazon/JP Morgan health alliance as they take on their own challenges disrupting health insurance.

WTF Health | Teladoc’s Gorevic: “We’re feeling A-quisitive”

WTF Health – ‘What’s the Future’ Health? is a new interview series about the future of the health industry and how we love to hate WTF is wrong with it right now. Can’t get enough? Check out more interviews at www.wtf.health

I guess he warned us that Teladoc was feeling ‘A-quisitive’ — the question now is are they done? A few weeks ago I spoke with Jason Gorevic, Teladoc’s CEO at the new HLTH Conference about consolidation in the telehealth space and what’s next for the virtual care giant.

Although he was mum on the company’s $352M mega-buy of Advance Medical, there was a shopping list of other solutions that seem to have caught Teladoc’s eye — everything from tech that turns Alexa into a telemed access point to NLP plug-ins and any number of shiny devices that make remote monitoring easier, less expensive, and more effective.

Perhaps an indicator of where they’ll look next as they continue to sweep up market share? Listen in on some of the details about their CVS partnership (VIRTUAL Minute Clinic, anyone?) and the VERY interesting talks he’s having with the country’s largest payers on redefining benefit designs to push virtual care first.

Health in 2 Point 00, Episode 28

Another late night Health 2.0 Europe related episode of #Healthin2point00. Filmed (yet again by Jennifer Lannon) in front of a live studio audience (well, a bunch of people at the restaurant in Spain), with more reflections on the conference, Indu Subaiya’s talk and where we go next (Hint, way up North!) — Jessica DaMassa & Matthew Holt

Health in 2 point 00, Episode 27

With .health‘s Jennifer Lannon again running the camera and with guest appearances from Bayer’s Aline Noizet and Health 2.0’s Emily Hagermen, Jessica DaMassa asked me about Health 2.0 Europe, DCtoVC, the other goings on in Stiges, Spain. And yes, filmed in a nice Spanish restaurant over a Rioja or 2–Matthew Holt

Health in 2 point 00 — Episode 26

This week we’re on location in Europe! Sitges near Barcelona to be exact, the site of the 2018 HIMSS Europe & Health 2.0 Conference. There, with our friend Jennifer Lannon from .health acting as emergency camera crew, Jessica DaMassa pins me down about HHS CTO Bruce Greenstein, Bayer & cannabis, Entraprenurses and where HIMSS/Health 2.0 is going next in Europe. It’s all in a day’s work (well 2 minutes) in Health in 2 point 00! — Matthew Holt

Bad Blood & Mad Love at Theranos—Psychopaths at Work

I’ve been kidding John Carreyrou on Twitter that I was going to give Bad Blood, his tale about the Theranos fraud, a one star review because he never sent me a preview copy. But it’s a barn burner, and I can’t recommend it enough, even though I spent my own $13.95 on the Kindle version!

By now the story is well known. The young blonde Stanford drop out with the baritone voice says she’s going to change lab testing forever, then hides in stealth in Silicon Valley. I caught a few whispers over the years that this company was doing something but as lab testing was a little away from the mainstream of health tech, I didn’t ever bother to look for more. And then in 2014 Holmes gets into Fortune and from a distance we are all cheering her on because she’s figured out a new way to disrupt a stodgy industry. The first Carreyrou piece is published in the WSJ in late 2015—even though Murdoch was a huge investor–and over the next 2 years massive fraud is exposed.

About when Holmes was starting to talk about stuff, and after the Walgreens deal eventually went live (mid 2014) there was the very odd series of events when Holmes appeared to agree to come talk at Health 2.0 and but shortly afterwards she and her PR team went totally radio silent on us. I was told by one PR flack that he’d heard that another conference had told her to choose between us and them (TedMed? I’m guessing) but who knows. She appeared at TechCrunch in September 2014 and had the interviewer Jon Shieber’s blood drawn with his results coming back while she was on stage—clearly faked we now know. I saw her interviewed by a fawning Toby Cosgrove at Cleveland Clinic, where she said that Carreyrou was lying. I stood at the end of a receiving line full of people asking her to sign things for their daughters as she was such an inspiration. When I got to the front I asked her why she didn’t come to Health 2.0 and invited her to come the next time. With me in line was Medcity News Editor Chris Seper who asked for an interview. After about 15 seconds of her not saying anything, a PR flack jumped in, pulled us away from her, got our cards and said she’d get back to us. I’m still waiting

But what is just remarkable about this whole thing is how little due diligence was done by investors who plunked down hundreds of millions.Continue reading…

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