Well, not fashion per se, but clothing. If the old, sexist statement was “clothes make the man,” then soon we may be saying “clothes make your health.”
The Washington Post got my attention when it reported last week about robotic clothing, because, as anyone who has been reading me for long knows, I am fascinated by robots and their role in healthcare. One of the advances the article discussed works on “smart fluid textiles” done by Dr. Thanh Nho Do and colleagues at the University of New South Wales Medical Robotics lab.
It’s been a while but Anish Koka, a one time regular writer on THCB and occasional THCB Gang member, is back publishing up a storm on his Substack channel. You may recall that his political and clinical views don’t always mesh with some of the wooly liberals we feature on THCB (cough, cough, me), but we are delighted to be back publishing some of his pieces–this one is on reimbursement.–Matthew Holt
The subspecialty of Cardiology known as electrophysiology has seen explosive growth over the last few decades in large part because of a massive expansion in the suite of procedures now offered to patients. It used to be that electrophysiologists would spend the majority of their careers implanting pacemakers and defibrillators, but the last 2 decades saw an explosion in electrophysiology procedures known as ablations. Ablations essentially involve burning cardiac tissue in a strategic manner to get rid of arrhythmias that may be afflicting a particular patient. The path humans took from first taking an electrical picture of the heart with a surface ECG to putting catheters into the heart to map and treat dangerous arrhythmias is one of the great achievements of the modern era.
Giants of the field like the recently deceased Mark Josephson essentially created a field by going where no humans had gone before. Dr. Josephson did much of his work in Philadelphia at the University of Pennsylvania publishing seminal papers that lead to a greater understanding and eventual treatment of previously incurable malignant arrhythmias. As is true of all trailblazing work in medicine , there were no reimbursement codes in the beginning , just desperate patients with no place to turn.
The procedures being embarked on were rare and the patients were very complex. The renumeration that was awarded from Medicare was reflective of this. But two things almost always happen once a highly reimbursed procedure code comes on line – technological advances makes the procedure easier, and the population that the procedure is intended for massively balloons.
We’ve been duped! Everyone said nothing’s been going on in digital health, but Amazon bought OneMedical! Keep watching for our thoughts and new deals: Cleery raises $192 million; Health Note raises $17 million; Elation raises $50 million; Caraway raises $10.5 million.
This was a special early in the day edition of #THCBGang. It was at 9.15am PT/ 12.15 pm ET (so if you are coming at 1pm it won’t be live today at the normal time as it’s already happened!). It was part of the Primary Care Transformation Summit which has been running since Monday and continues to the end of Friday. It’s a who’s who of everyone in primary care. You can check out the wider agenda but we were on immediately before the day 3 keynote from head of CMS Innovation, Liz Fowler.
Joining Matthew Holt (@boltyboy) to discuss primary care and more were are WTF Health host & Health IT girl Jessica DaMassa (@jessdamassa); futurist Jeff Goldsmith; & Dan O’Neill (@dp_oneill) who is now at primary care group Pine Park Health.
You can see the video below & if you’d rather listen than watch, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels.
The New York Times had an interesting set of op-eds last week under the theme “I Was Wrong.” For example, Paul Krugman says he was wrong about inflation, David Brooks laments being wrong about capitalism, and Bret Stevens now fears he was wrong about Trump voters. Nobody fessed up about being wrong about healthcare, so I’ll volunteer.
I’ve been writing regularly about healthcare for over a decade now, with some strong opinions and often with some pretty speculative ideas. I’ve had a lot to be wrong about, and I hope I will be wrong about many of them (e.g., microplastics). Some of my thoughts (such as on DNA storage or nanorobots) may just be still too soon, but there are definitely some things I’d thought, or at least hoped, would have happened by now.
It’s been a while but Anish Koka, a one time regular writer on THCB and occasional THCB Gang member, is back publishing up a storm on his Substack channel. You may recall that his political and clinical views don’t always mesh with some of the wooly liberals we feature on THCB (cough, cough, me), but we are delighted to be back publishing some of his pieces–starting with a look at a tweet from one of America’s most prominent cardiologists.–Matthew Holt
Given Twitter’s commitment to the truth in Medicine, I thought I would try to give them a hand by analyzing a semi-viral tweet about COVID and the heart.
Earlier this year (April 2022), the most influential cardiologist in the world tweeted about a study on the long term cardiac effects of COVID (LongCOVID).
Medical trainees who trained in the early 2000s like I did know Dr. Topol as an absolute legend in the field of Cardiology. He was responsible for seminal work in Cardiology in the 1980’s on the use of clot busting drugs for patients having heart attacks, and became head of cardiology for the famed Cleveland Clinic at the age of 36! (I vaguely recall feeling like I was starting to understand Cardiology at the age of 36.) He’s since moved on to do many other things, and is a potent voice that may have been instrumental in the FDA delaying approval of the mrna vaccines until after the 2020 election.
Nonetheless, this paper that he is giving his significant stamp of approval to has significant issues. As far as I can tell individuals with LongCOVID were recruited by advertising in LongCOVID support groups. No independent assessment carried out as far as I can tell clinically. If you say you have it—> you’re in.
Mental health digital therapeutics startup Happify Health has spent the past 5 years quietly ‘self-actualizing’ into a brand-new, tech platform company that just launched this week: Twill. This is a big pivot – not just a brand change – and we’ve got co-founder & President Ofer Leidner and newly-hired Chief Operating Officer Megan Callahan (who formerly ran Lyft Health) here to tell us how it all went down AND what will happen to the old Happify app.
Wellness-app-no-more, Twill has emerged as a health tech infrastructure company. Its core product (called Sequences) is the open architecture, digital back-end that ties together a health plan, employer, or pharma co’s various digital point solutions – wellness apps, digital therapeutics, virtual coaching, peer support groups, telehealth platforms, etc. etc. – to create one neat-and-tidy, hyper-personalized, automagically-navigated patient care journey based on condition or patient population.
Big brands like Elevance Health (Anthem), Biogen, and Almirall have already bought-in, with products already in market for conditions as diverse as maternal health, multiple scleroses, and psoriasis. Not forgetting its mental health roots, Twill is bringing in its own vast resources from the ole Happify days to run digital mental health support under each of these disease-specific point solutions. Ofer and Megan say that Sequences can be developed for ANY condition or to target specific populations of patients and they plan to launch 2-3 new Sequences each year.
What else is ahead for Twill now that it’s revealed from its stealthy start? Happify Health had raised $73 million in March 2021 in a big round lead by Deerfield Management Company – what should we expect next? Tune in for all the details on the transformation, the new products, and how other digital health companies can expect to work with Twill in the future.
I was at the AHIP conference in Vegas late last month and caught up with a number of CEOs & execs for some quick bite interviews — around 5 mins getting (I hope) to the gist of what they & their companies are up to. I am dribbling them out–Matthew Holt
Next is Julia Kastner, CPO & Chris Molaro, CEO, Neuroflow, and it includes a great brief product demo from Julia
In the ‘point solution versus platform’ debate, mark another score for integration as Vida Health jumps into the musculoskeletal (MSK) care space. This is a move we’ve seen before among the digital health chronic condition management set (remember when Omada acquired Physera, Dario Health acquired Upright, and everyone was waiting to see if Livongo would make a play for Sword or Hinge?) so why is Vida just jumping in now?
Dr. Patrick Carroll, Vida Health’s Chief Medical Officer, lets us in on the strategy behind the startup’s move into the MSK space and what it signals about how employers (and their employees) are starting to view digital health and virtual care within the larger scope of available care options out there.
As for Vida’s MSK program, it’s different than what you might expect. According to Pat, the program is strictly focused on lower back pain and helping members quickly find the physical therapy and, if needed, mental health care that can make a real difference to their overall health in a manner of weeks. If something more complex is discovered, Pat says Vida is working with partners – including those digital-first MSK clinics – to refer out. Is this the long-term play or will Vida eventually build out or buy its way further into MSK? We find out what’s ahead for the cardiometabolic care company as it launches yet another new offering to improve access to care.
I saw a great quote by Alfred North Whitehead the other day: “It is the business of the future to be dangerous.”
Now, I was a math major many years ago, so I know who Alfred North Whitehead was: the coauthor (with Bertrand Russell) of the Principia Mathematica, a landmark, three-volume treatise that proved – in excruciating detail — that all of mathematics (and thus, arguably, all of science) can be reduced to mathematical logic. I always thought Lord Russell was the eloquent one, but it turns out that Professor Whitehead had a way with words too.
So, of course, I want to apply a few of his particularly pithy quotes to healthcare.