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Virtual Care Regulatory Round-Up: Ro’s Z Reitano & Virtual-First’s Power to Control the Care Journey

by JESSICA DAMASSA, WTF Health

“What happens when there is a massive shift of where the beginning of a journey occurs…that sort of affords the opportunity for everyone after that to be disintermediated.” So says Zachariah “Z” Reitano, co-founder & CEO of Ro, arguably one of the most successful OG virtual-first care companies which has been providing telehealth-plus-testing-plus-pharmacy-delivery (and now a whole lot more) via its Roman and Rory brands since 2017.

As health tech companies – and now, more and more incumbent orgs and retail health providers – evolve their own “omnichannel” strategies, we talk to Z about Ro’s direct-to-patient care model, and what we can learn from its successful operation and expansion as one of the first “digitally native” healthcare providers.

To Z, the technology is just an enabler to a larger shift in how people are ultimately gaining more control over their health. Technology can turn luxuries into commodities, he says, and, at Ro, that’s translating into a concept they’re calling “goal-oriented healthcare,” which is basically providing the “luxury” of giving a patient what they want, when they want it; easily, conveniently, and affordably.

In short, Z explains: “Patients come to us, and they say what they want to achieve: ‘I want to lose weight…I want to have a child…I want to improve my mental health…I want to improve my skin…I want to have better sex.’ And then, we help them from beginning to end in the most convenient and effective way possible.”

The role of digital in all this is critical. It allows for costs to be stripped out, for providers to be able to practice at the top of their licenses, and for data to be shared between provider and patient asynchronously (aka conveniently.) But, it sounds like what’s most exciting about ‘virtual-first’ to Z is the “first” part – having the opportunity to initialize the relationship with the patient, then “raise the standard of where we guide people afterwards, and have the opportunity to disintermediate and really heavily influence the entire patient journey.”

Oooohh – can’t hear enough about this! Tune in to find out more about how Z sees virtual-first care as changing patients’ relationships with the healthcare system AND, because we had to talk a little policy too, get his thinking on how barriers like state licensure that are often looked at as constraints to ‘virtual care at-scale’ might also be evolving to help enable that shift.

* Special thanks to our series sponsor, Wheel – the health tech company powering the virtual care industry. Wheel provides companies with everything they need to launch and scale virtual care services — including the regulatory infrastructure to deliver high quality and compliant care. Learn more at www.wheel.com.

And you thought Mastadons were extinct…

by KIM BELLARD

Until last week, for me, “mastodon” only meant the giant animal that went extinct several thousand years ago (I was, it appears, unaware of the heavy metal band Mastodon). Now, as the result of Elon Musk’s purchase of Twitter, many Twitter users are being forced to take a look at alternatives, such as the social networking site Mastodon.

It’s possible that we are about the witness the Myspace-ization of Twitter, brought down by competition, bad management, and bad product decisions. In my usual “there must be a pony in here somewhere” fashion, there may be some lessons in the Twitter saga that healthcare might want to pay attention to.

As most know by now, Mr. Musk has been a Twitter power user for many years, and a frequent critic. In March of this year he started discussions about purchasing it. In short order, he threw out a bold bid, was rejected then accepted by Twitter’s board, tried to get out of the deal, was sued by Twitter, and closed the deal late last month. 

Then things got really rocky.   

Mr. Musk tried to reassure squeamish advertisers, only to make them and others even more nervous when he retweeted some disinformation. After a spike in hate speech on the site, he promised that, as much as he was buying Twitter out of his love for free speech, Twitter “cannot become a free-for-all hellscape, where anything can be said with no consequences!” Then he shocked observers (and Twitter employees) by suddenly laying off half the workforce, including much of the content moderation staff. Some are now being asked back, being told they were laid off “by mistake.”   

He then floated a balloon about charging $20 a month for Twitter’s blue verification, had a tweet argument with Stephen King about it, then went forward with a $7.99 plan, only to be punked by users illustrating the flaws. At this writing, the plan now appears to be on hold, at least until Tuesday’s mid-term elections. 

Advertisers appear to be fleeing, or at least curtailing spending.

As The Wall Street Journal put it: “In Elon Musk’s first week at Twitter Inc., he flouted much of the advice management gurus have dished out for decades.” It’s no wonder many Twitter users are looking at Mastodon.

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I’m trying to get AI to write this!

By MATTHEW HOLT

So it’s a new world in blogging about health care, and when I want to write about Digital Health or primary care, I’ve been told that this system at Lex.Page can do it for me

So here goes and lets see what it says about Digital Health or primary care

Digital Health is one of the most rapidly growing and important sectors in health care today. It is a broad term that encompasses the use of technology to improve health and health care.

OK so it wrote that. Which isn’t bad but not too helpful

Perhaps I can ask it whether it thinks that digital health will have a big impact on the future of primary care

The system at Lex writes that it does think digital health will have a big impact on the future of primary care.

So now it’s just spitting back at me what I asked it. Not too sure how to get it to write more for me

I then asked it to follow this sentence — The biggest challenges for primary care are

-Access to care

-Cost of care

-Quality of care

So it seems that digital health can help with all of those things. By providing tools that help patients better self-manage their health, digital health can help to improve access to care. By providing tools that help to lower the cost of care, digital health can help to make care more affordable. And by providing tools that help to improve the quality of care, digital health can help to make

That is pretty damn good given it’s a machine just guessing what I want it to write, even if it didn’t finish that last sentence. I can imagine that pretty soon I’ll be able to spit one of my talks into it and it will be able to write an article out of it quickly. I’ll be playing around with Lex and I can give some invites — if you want one, let me know.

Interview: Sarah MacDonald, Author, The Cancer Channel

by MATTHEW HOLT

I met Sarah MacDonald in the early 2000s. She is the ultimate extrovert who sings, cooks, maintains a huge circle of friends, and lives life to the fullest–all at a pace & level most of us can’t imagine. In the early 2010s Sarah was flying high. Newly married, trying to get pregnant, all while being a Silicon valley business exec who had increasingly senior roles at eBay. Then in 2012 she was diagnosed with two completely separate types of cancer. And in her head “The Cancer Channel” started playing nonstop.

That became the title of her book. I just read it and I literally couldn’t stop. It’s practical, it’s heart-wrenching, it’s warm, it’s funny (yes, funny!). And it’s an amazing look at the exact experience of someone going through cancer. Or in this case cancer x 2. I was lucky enough to interview Sarah (so there is a very happy ending). So please watch this and buy & read the book

The Secret Surveillance Capitalism That Suffuses Medicare

By MICHAEL MILLENSON

Imagine a government program where private contractors boost their bottom line by secretly mining participants’ personal information, such as credit reports, shopping habits and even website logins.

It’s called Medicare.

This is open enrollment season, when 64 million elderly and disabled Americans choose between traditional fee-for-service Medicare and private Medicare Advantage (MA) health plans. MA membership is soaring; within a few years it’s expected to encompass the majority of beneficiaries. That popularity is due in no small part to the extra benefits plans can provide to promote good health, ranging from gym membership and eyeglasses to meal delivery and transportation assistance.

There is, however, an unspoken price for these enhancements that’s being paid not in dollars but in privacy. To better target outreach, some plans are routinely accessing sophisticated analytics that draw upon what’s euphemistically labeled “consumer data.” One vendor boasts of having up to 5,000 “certified variables for every adult in America,” including “clinical, social, economic, behavioral and environmental data.” 

Yet while companies like Facebook and Google have faced intense scrutiny, health care firms have remained largely under the radar. The ethical issue is obvious. Since none of this sensitive personal information is covered by the privacy and disclosure rules protecting actual medical data, it is being deliberately used without disclosure to, or explicit consent by, consumers. That’s simply wrong.

But a more fundamental concern involves the analyses themselves.

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Sylvana Sinha, CEO, Praava Health

Sylvana Sinha is CEO of Praava Health, a primary & specialty care network based in Dhaka, Bangladesh. While the average American may only think about Bangladesh when there’s some disaster on the news it’s a country of 165m+ people with a GDP per capita exceeding India’s. It lacks excellent health services for its growing middle class, and that’s the gap Praava Health is filling. I learned a lot about Sylvana, Bangladesh, and Praava in this quick interview —Matthew Holt

Pfizer’s Biotech Strategy: When a “Market Force” Partners with a “Market Mover”

by JESSICA DAMASSA, WTF HEALTH

The synergistic relationship between biotech’s and biopharma’s can dramatically change the way new drugs and vaccines are bought to market – helping advance innovation on BOTH sides in a very mutually beneficial way. I’ve got an inside look at how Pfizer is working with emerging biotech start-ups, thanks to this in-depth chat with Pfizer’s Senior Vice President of Business Innovation, Kathy Fernando.

Kathy is not only responsible for developing relationships with biotech’s on behalf of Pfizer, BUT during the pandemic she led Pfizer’s mRNA scientific strategy, which was integral to its ability to rapidly develop the Covid-19 vaccine. We geek out on the “cool science” that mRNA is – AND the new platforms that biotech’s are bringing to the table – and talk about the impact both are making on the business of Big Pharma, the hot biotech investment space, and, most importantly, patients.

We also get into a bigger conversation about innovation in the Life Sciences industry – with great insights that can be extended to the rest of healthcare quite easily. I ask point blank: Pfizer is a gigantic, global biopharma company…Why wouldn’t it do these types of innovations internally, in-house themselves? Why partner outside?

Kathy explains the magic that is unlocked when a “market force” partners with a “market mover” for the sake of innovation, and the lessons learned are far reaching and applicable no matter where you are in health innovation.

How is Pfizer looking at new models for collaborating with biotech companies? What are the key characteristics of Pfizer’s culture of innovation that have newly emerged or deepened as a result of their work on the Covid vaccine during the pandemic? We dive deep into the biopharma-biotech model and all it brings in terms of new science, breakthrough therapies, and brand-new business opportunities. Watch now!

What Does It Mean To Be Human?

By MIKE MAGEE

“These are unprecedented times.”

This is a common refrain these days, from any citizen concerned about the American experiment’s democratic ideals.

Things like – welcoming shores, no one is above the law, stay out of people’s bedrooms, separation of church and state, play by the rules, fake news is just plain lying, don’t fall for the con job, stand up to bullies, treat everyone with the dignity they deserve, love one another, take reasonable risks, extend a helping hand, try to make your world a little bit better each day.

But I’ve been thinking, are we on a downward spiral really? Or has it always been this messy? Do we really think that we’ve suddenly bought a one-way ticket to “The Bad Place”, and there are no more good spots to land – places that would surprise us, with an unpredicted friendship, a moment of creative kindness, something to make you say, “Wow, I didn’t see that coming.”

I’m pretty sure I’m right that human societies, not the least of which, America, will never manage perfection. But is it (are we) still basically good. What does it mean to be human, and more specifically American?

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Explorations in French Health Care! (Or what I did on my vacation!)

By MATTHEW HOLT

This is a personal story about this blog’s publisher (me!) but it has just enough health care stuff to keep it relevant!

This year I finally got invited on the annual week-long mountain bike ride run by my friend JB and his ex Taiwan/Hong Kong buddies. I’ve actually been practicing and training most of the summer and arrived pretty confident even though I knew it would be tough. This edition is in Provence in France.

Before it all went wrong

And then…..2 hours in on the first day it turns out I was too confident…

Back in 2002 I smashed my knee snowboarding into a tree. When I told him my dad said ” You silly twit”

I actually was a silly twit this time too. I was on a new bike (a rental) that was actually much more advanced than my usual one and had a feature I had barely practiced with (a drop seat) that requires a new technique. It had rained heavily the day before so it was wet (& living in California I have very limited experience mountain biking in the rain), and I was behind the pack as my chain had come off. (There was a guide sweeping the rear who fixed it for me). So when I got to the first challenging down hill slope I didn’t do the sensible thing of stopping & walking to the bottom to check it or do what 75% of the group did and walked their bike down it, I just thought, “I can do that’ and plunged down it. Not quite sure exactly why I fell but I went over the bars slightly to the right (luckily missed a tree) & hit the ground on the downslope hard on my right side. In any sport any one of new equipment, new environment, new technique means you should err on the side of caution and I had all 3, yet just went for it! Very bad decision!

After I got up I thought I had just badly winded myself. The guide helped me back on the bike & I rode on. For the next 5 miles or so he helped push me up the steeper bits of a climb (he had an eBike). I actually did a slightly less challenging but still tough downslope section & a friend gave me a big dose of Tylenol at the next stop point. I actually crashed again after that (slipped on a wet rock) but landed ok on my elbow which was padded (as were my knees but not my torso) and only had some slight scratches but I made it to lunch feeling sore but OK.

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The Society for Participatory Medicine Presents a Creative Learning Exchange: Community Health Access and Equity 

I’ve been on the board of the Society for Participatory Medicine for a few years and we are kicking off a series of “Creative Learning Events”. There’ll be two in the balance of 2022 and hopefully one a quarter thereafter. Should be great in-person AND online exchanges about getting participatory medicine into the hear of the health care system. Here’s details on the first one, October 20, in Boston and everywhere else!–Matthew Holt

Participatory Medicine is a movement in which patients, caregivers and healthcare professionals actively collaborate and encourage one another as full partners in healthcare. 

The Society for Participatory Medicine with the support of our sponsor NRC Health Presents A Creative Learning Exchange(CLE): Community Health Access and Equity

Date: October 20, 2022 Time: 12:00 noon – 4:00pm (Lunch Is Included for In-Person)

Location: Brown Advisory, 100 High Street, 9th Floor, Boston, MA 02110

For more details and to REGISTER TODAY click here.

The Society for Participatory Medicine believes that the culture of healthcare is not benefiting everyone equally and needs to change. And healthcare won’t get better until healthcare culture gets better. We want to drive this change by enabling collaboration, education, information sharing, and communication among patients, caregivers, and health care professionals. Join the movement! 

This Creative Learning Exchange, in-person and online hybrid event, will be highly interactive and participatory, using a ‘Neighbors at Each Table’ approach to engaging you in facilitated discussion and brainstorming. 

These discussions will focus on applying the Participatory Medicine Manifesto behaviors in culturally and racially diverse communities to enable access and equity in care. Your ideas, insights and solutions that emerge will be curated by SPM to build a toolkit of participatory medicine guidelines. These will be shared with you and through SPM’s social networks, website and blog. 

For more details and to REGISTER TODAY click here.


Thank you to our series sponsor NRC Health. Thanks to Massachusetts General Hospital Equity & Community Health for sponsoring the meal. Thanks for Brown Advisory for proving the venue & AV.

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