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When Push Comes to Shove: The AMA v. Dobbs. Part 2.

BY MIKE MAGEE

On November 8, 2022, five days after the 2022 Midterm elections, the AMA raised its voice in opposition to Republican efforts to promote second class citizenship for women by exerting public control over them and their doctors intensely private reproductive decisions. At the same time they sprinkled candidates on both sides of the aisle with AMA PAC money, raising questions whether their love of women includes active engagement or just passive advocacy.

Trump and his now MAGAGA (“Make America Great and Glorious Again”) movement has now returned to center stage. With the help of Senate Majority leader McConnell, Christian Conservatives had packed the Supreme Court with Justices committed to over-turning Roe v. Wade. And they did just that.

On June 24, 2022, a Supreme Court, dominated by five conservative Catholic-born Justices, in what experts declared “a historic and far-reaching decision,” Dobbs v. Jackson Women’s Health Organization, scuttled the half-century old right to abortion law, Roe v. Wade, writing that it had been “egregiously wrong,” “exceptionally weak” and “an abuse of judicial authority.”

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When Push Comes to Shove: The AMA v. Dobbs. Part 1.

BY MIKE MAGEE

Should anyone present know of any reason that this couple should not be joined in holy matrimony, speak now or forever hold your peace.”     Book of Common Prayer, Church of England, 1549

Last evening Trump rose from the ashes and declared it was time to “Make America Great and Glorious Again” (MAGAGA).

This past week, five days after the Midterm elections, AMA President, Jack Resnick, Jr., MD, raised his voice from the podium at the AMA Interim Meeting in Hawaii with the AMA’s own version of a call to action:

“But make no mistake, when politicians insert themselves in our exam rooms to interfere with the patient-physician relationship, when they politicize deeply personal health decisions, or criminalize evidence-based care, we will not back down…I never imagined colleagues would find themselves tracking down hospital attorneys before performing urgent abortions, when minutes count … asking if a 30% chance of maternal death, or impending renal failure, meet the criteria for the state’s exemptions … or whether they must wait a while longer, until their pregnant patient gets even sicker…Enough is enough. We cannot allow physicians or our patients to become pawns in these lies.”

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Is Care Navigation Healthcare’s Next ‘Gold Mine’? Quantum Health’s Move to Win Over Larger Employers

BY JESSICA DaMASSA, WTF HEALTH

One-to-watch as a potential health tech IPO this year is care navigator Quantum Health, and I’m talking to CEO Zane Burke about both their breaking new product launch AND the key differences between Quantum and the increasingly competitive field of other employer benefits advocacy-based businesses like Accolade, Rightway, and Transcarent.

Private equity backed, two-decades old, and EBITA positive, Zane says Quantum Health is delivering an ROI of “over two-and-a-half to one” to its client roster of 450 top large, self-insured employers and saving more than 14% on all healthcare costs over time. The new product – Quantum Health Access – is a streamlined, more flexible version of the soup-to-nuts Complete Care offering capable of yielding these results, and it’s being offered to give the largest of employers (those big enough to be working with multiple health plans, for example) a way to start out with Quantum’s data-driven navigation tools without a total overhaul of their current benefits situation.

Zane explains Quantum’s “real-time intercept tool” and how it not only helps engage high-utilizers in an employer’s plan (aka those who spend more than $10,000 in claims), but how 85% of the time it catches them on their care journey before they’ve spent a thousand dollars – creating an early opportunity to provide better routing and, ultimately, reduce overall costs. The upside for Quantum? “Employers have long thought of the carriers as this is their responsibility, but the carriers are really maximizing around their siloed system to pay a claim, do the disease management, get you off the phone and into somebody else’s queue,” explains Zane. “Our model is, ‘hey…every single one of those interactions is a gold mine.’”

We get further into the details around the new Quantum Health Access product, and, more importantly, what Zane sees as Quantum’s key point of differentiation against Accolade, Rightway, Transcarent, and the rest. Tune in around the 20-minute mark to hear this bit and to find out what Quantum’s doing with provider data that makes “everybody else that talks that game” look like they are just playing “Pick Up Sticks.”

Our Plants Should Be Plants

BY KIM BELLARD

It seems like most of my healthcare Twitter buddies are enjoying themselves at HLTH2022, so I don’t suppose it much matters what I write about, because they’ll all be too busy to read it anyway.  That’s too bad, because I was sparked by an article on one of my favorite topics: synthetic biology.  

Elliot Hershberg, a Ph.D. geneticist who describes his mission as “to accelerate the Century of Biology,” has a great article on his Substack: Atoms are local.  The key insight for me was his point that, while we’ve been recognizing the power of biology, we’ve been going about it the wrong way.  Instead of the industrialization of biology, he thinks, we should be seeking the biologization of industry.

His point:

Many people default to a mindset of industrialization. But, why naively inherit a metaphor that dominated 19th century Britain? Biology is the ultimate distributed manufacturing platform. We are keen to explore and make true future biotechnologies that enable people to more directly and freely make whatever they need where-ever they are.

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The “Comstockery” of Justice Clarence Thomas

BY MIKE MAGEE

“When we think about the past, we think about history. When we think about the future, we think about science. Science builds upon the past, but also simultaneously denies it.” These are the words of Jim Secord, a Professor of History and Philosophy of Science at the University of Cambridge. His research and teaching are on the history of science from the late eighteenth century to the present, with a special focus on Darwinian evolution. 

His perspective is especially relevant when it comes to the recent Dobbs decision. The history of this contemporary struggle is as clear as is the science disputed by modern day left and right. It began on March 7, 1844, with the birth of this man, Anthony Comstock, in New Canaan, Connecticut. Raised in a strict Christian home, his religiosity intensified during a two-year stint in the Union Army during the Civil War.

A member of the 17th Connecticut Infantry, he took great offense to the profanity and debauchery he witnessed in and among his fellow soldiers. With the strong support of church-based groups of the day, and as the self-proclaimed “weeder in God’s garden”, he sought out a purpose and found a political vehicle in New York City’s Young Men’s Christian Association, and parlayed that to a post as the United States Postal Inspector.

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Patient Journey or Customer Journey? How Salesforce’s CRM Aims to Reposition the EHR

BY JESSICA DaMASSA, WTF HEALTH

While at Dreamforce 2022, one of most thought-provoking things I heard was that, in order to really meet the needs of the healthcare consumer, we in healthcare need to once-and-for-all let go of the idea that there will be “one tech system to rule them all” and adopt an “and both” approach that integrates both the EHR and a CRM. The EHR is how we’ll “know the patient” and the CRM is how we’ll “know the customer.”

Dr. Geeta Nayyar, Salesforce’s SVP & Chief Medical Officer and Amit Khanna, SVP & GM of Salesforce’s Health & Life Sciences business join me to unpack this “and both” approach to infrastructure technology and talk all-things healthcare consumer. The paradigm shift that comes with this duality – we are at times “patients”, we are at times “customers” – is a big one. Especially in healthcare.

Dr. G speaks to the strategy that Salesforce is operating under to take its tech further into the healthcare and life sciences space, while Amit introduces us to some of the new Healthcare 360 product features launched at Dreamforce that fully show-off Salesforce’s expertise at integrating different technology solutions (Slack, MuleSoft, telehealth) and making perfect sense of massive amounts of real-time data (longitudinal record, health scoring).

As Salesforce advances further into the health market with more care-forward features in its CRM and a strategic focus on healthcare-important issues like improving equity and access to care, will our traditional view of the importance of the EHR change? What if the replacement tech comes with ‘self-service at-scale’ and more ‘seamless experiences?’ Could we head away from “and both” and choose CRM “instead of?” Tune in – the EHR IT infrastructure may have finally met its match!

Promises Made – Promises Kept:  President Biden’s Support for “Obamacare.”

BY MIKE MAGEE

As the saying goes, “History repeats!” This is especially true where politics are involved. 

Consider for example the past three decades in health care. It is striking how many of the players in our nation’s health policy drama remain front and center. And that includes President Biden who recently commented on the 12th anniversary of the passage of the Affordable Care Act (Obamacare): 

“The ACA delivered quality, affordable health coverage to more than 30 million Americans — giving families the freedom and confidence to pursue their dreams without the fear that one accident or illness would bankrupt them. This law is the reason we have protections for pre-existing conditions in America. It is why women can no longer be charged more simply because they are women. It reduced prescription drug costs for nearly 12 million seniors. It allows millions of Americans to get free preventive screenings, so they can catch cancer or heart disease early — saving countless lives. And it is the reason why parents can keep children on their insurance plans until they turn 26.”

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Rethinking Newer Events

BY KIM BELLARD

It’s a lot more fun to write about exciting new technologies, or companies in other industries that healthcare could learn from, than to pick on healthcare for its many, well-known shortcomings, but there was an article in JAMA Forum last week that I had to note and perhaps expand on: A New Category of “Never Events” – Ending Harmful Hospital Policies, by  Dave A. Chokshi, MD, MSc and Adam L. Beckman, BS (he is also an MD/MBA student).  

The concept of a “Never Event” is well known by this point.  Coined some twenty years ago by Ken Kizer, MD of the National Quality Form (NQF) and soon widely adopted and expanded, it recognizes that healthcare sometimes has egregious errors that shouldn’t happen:  the wrong foot is amputated, the wrong drug/dosage is given, surgical instruments are left inside a patient, and so on.  Organizations like The Leapfrog Group exist largely to try to measure and compare hospitals on such patient safety issues.

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Does Surviving The Plague Mean You Will Eventually Contract An Autoimmune Disease?

BY MIKE MAGEE

This Fall, I am teaching a 4-week course on “How Epidemics Have Shaped Our World” at the President’s College at the University of Hartford. It is, of course a timely topic, but also personally unnerving as we complete a third year under the shadow of Covid-19.

Where does one begin on a topic such as this? Yale historian, Frank M. Snowden, in his book “Epidemics and Society: From the Black Death to the Present”, made his intentions obvious. He would begin with the plaque. Why? His answer, “The word ‘plague’ will always be synonymous with ‘terror’”, and especially references:

Virulence: “It strikes rapidly, causing excruciating and degrading symptoms, and, if untreated, achieves a high case fatality rate (CFR)…of at least 50%.”

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Future of Big Data in Health? LexisNexis® Risk Solutions Says Next-Gen Tokenization & Health Equity

BY JESSICA DaMASSA, WTF HEALTH

Data-juggernaut LexisNexis® Risk Solutions is making a big data play in healthcare, launching a new capability that allows for unprecedented accuracy in the kind of de-identified data that payers, providers, and pharma are clamoring to use for everything from cutting admin expenses to improving patient outcomes and health equity.

Jeff Diamond, President & General Manager of The Health Care Business of LexisNexis® Risk Solutions and Andrea Green, Director of Healthcare Strategy, SDoH, drop in for a chat about all things VERY big data, including this concept of “next-gen tokenization” which leverages LexisNexis’s massive amount of consumer data as a way to connect data “personas” to create a much more accurate, actionable, and longitudinal view of a patient.

The thing to understand is just how much health data LexisNexis® Risk Solutions is working with and who they are working with it for: 90% of commercial payers in the US; 8 of the Top 10 pharma manufacturers; 10 of the Top 10 retail pharmacies; and hundreds of hospital systems.

So, how is this data “turned” into insightful and actionable information that appeals to this top-tier clientele? Jeff and Andrea walk through use case after use case that demonstrate the ‘business of healthcare’ applications of the LexisNexis data processing platform (think patient safety, risk stratification, claims analytics, provider directory, etc.) with special emphasis on how their new analytics suite, focused on Social Determinants of Health data, is helping with such clinical initiatives as improving diversity in clinical trials and providing predictive insights about patients who might need mental healthcare support. The data comes to life in this one. Watch now!