Each week an episode of “The THCB Gang” (this was Episode 3) is streamed live here (below) and is also preserved as a weekly podcast and available on our Itunes & Spotify channels a day or so later. Each week 4-6 semi-regular guests drawn from THCB authors and other assorted old friends of mine will shoot the shit about health care business, politics, practice, and tech. It tries to be fun but serious and informative!
In the face of Covid-19, health tech startup Evidation Health is leveraging their relationships with the 4-million people on their Achievement app, the “always on” stream of behavioral data these folks bring to the table via wearables, sensors, and surveys, and everything they’ve learned from years of studying and modeling flu outbreaks to examine the Covid-19 virus in the context of people’s everyday lives.
Evidation’s CEO, Deb Kilpatrick, and Sr. Data Scientist, Ernesto Ramirez, stop by to talk about their company’s efforts for large-scale, frequent symptom surveillance of Covid-19 to add new insights to our understanding of the pandemic and, possibly, even help with making predictions about its spread and severity.
The company is already publishing some of its findings in a weekly report called “Covid-19 Pulse” that is already gleaning insights from a 150,000+ person cohort asked to weigh-in specifically on what they’re doing and how their lives are changing as a result of the pandemic. What’s unique in Evidation’s spin is that they’re adding that critical data from “daily life” that is more or less missed by just looking at the data reported from those who’ve entered the hospital.
“Those folks that are presenting into the medical system — that’s not the full picture of what’s going on,” says Ramirez. “What we need to do is better understand, really, what’s going on at the community level to understand community spread, to understand surveillance efforts, to understand mitigation efforts that may or may not be having impact around the spread of Covid-19.”
Today on Health in 2 Point 00, we have a no-nonsense April 1st episode—with deals this time! On Episode 115, Jess asks me about Olive raising $51 million for its AI-enabled revenue cycle management solution, Bright.md raising an $8 million Series C for its asynchronous telemedicine platform, and AristaMD raising $18 million for a different sort of telemedicine, eConsults, which allow primary care physicians to consult with specialists virtually. —Matthew Holt
“[Employers’] top priority is getting their employees and their family members the appropriate care, but there are a lot of unknowns about how this is going to impact their actual total cost of care…”
As Covid-19 testing and treatment rise in U.S., many people — and their employers — may be starting to wonder: who is going to pay for this? How much is this going to cost?
Castlight Health’s CEO, Maeve O’Meara, talks to us about all-things healthcare cost, coverage and benefits administration, drawing from her position leading a company that focuses on helping people make sense of the health insurance benefits they receive through their employers or directly from health plans.
What has employers and health plans most concerned? Making sure people are aware of changes to their plans so they know what’s covered (and what’s not), and when and where to go for care are the top of the list, according to Maeve.
“It’s fair to say that, in Italy, we are doing 10 years of digital health evolution in 10 days.”
Our “man-on-the-street” in Italy (well, man-sheltered-in-place in Italy) Roberto Ascione, CEO of Healthware, reports in on the Covid-19 outbreak and what’s happening with digital health startups, health system partners, and hospitals as Italians continue battling at the forefront of the coronavirus outbreak.
A few weeks ahead of the U.S., there are many things to learn about Covid-19 testing, treatment, outcomes, and timing from the experience in Italy, including some foresight on how pathways for telehealth and digital health continue to evolve as conditions become more serious and the outbreak progresses. (For all you Gretzky fans, this is “skating to where the puck will be” kind of stuff…)
Some navigational guidance on this chat which took place March 26, 2020:
Update on Italian Covid-19 outbreak from health industry insider
10:25 minute mark: Digital Health startup case study, Paginemediche, self-triage chatbot data from 70K Italians, data sharing with Italian government & WHO, telehealth model flipping to give overwhelmed physicians opportunity to triage and “invite” patients based on needs
19:10 mark: How to work with Italian digital health startups to advance Covid-19 work
Today on Health in 2 Point 00, we have a viewer question! For our friends who are wondering what will happen to all the IPOs that were supposed to happen this year, I weigh in on how this crisis will impact IPOs and startup funding. On Episode 114, Jess asks me about the stimulus package granting $117 billion to hospitals and for my thoughts on all the startups coming up with ways to address COVID-19. A few startups that come to mind include Conversa with its virtual care conversation, Coronavirus Health Chats, Biofourmis which is looking for ways to track infected people earlier through its AI-powered arm sensor, and Surveyor Health leveraging its data analytics platform as well. For more on this, check out covid19healthtech.com where my colleagues at Catalyst have put together a resource hub for health tech solutions. —Matthew Holt
This piece is part of the series “The Health Data Goldilocks Dilemma: Sharing? Privacy? Both?” which explores whether it’s possible to advance interoperability while maintaining privacy. Check out other pieces in the series here.
If you live in one of the jurisdictions that have imposed stay-at-home requirements, you’re probably making your essential excursions — grocery store, pharmacy, even walks — with a wary eye towards anyone you come across. Do they have COVID-19? Have they been in contact with anyone who has? Are they keeping at least the recommended six feet away from you? In short, who is putting you at risk?
Well, of course, this
being the 21st century, we’re turning to our smartphones to help us try to
answer these questions. What this may lead to remains to be seen.
We long ago seemed to
shrug off the fact that our smartphones and our apps know where we are and
where we have been. No one should be surprised that location is of
importance to tracking the spread of COVID-19. No one should be surprised
that it is already being used. We may end up being surprised at how it
will be used.
Jamey Edwards, CEO of one of the larger in-hospital B2B telehealth startups in the US, Cloudbreak Health, is already seeing changes in the way hospitals are using his company’s telemedicine services in the wake of COVID-19.
From a noted rise in the rate of infectious disease consults, to “quarantine rooms” where telemedicine equipment is cleverly deployed to practice “clinical distancing” to minimize risk to front-line healthcare workers (and also preserve PPE), Jamey talks about what he’s seeing among hospital clinicians and what they seem to need most right now from telehealth providers amid the COVID-19 outbreak.
With changes to licensing regulations, HIPAA policies, and reimbursement changing the very infrastructure around telehealth, will we finally see virtual care become a true part of the healthcare system at-scale?
“One of the hardest things to do in our healthcare system is match cost to acuity,” says Jamey. “I’m not going to say we’ve overvalued the in-person encounter, but we certainly have been very hesitant to step away from it.”
“The fact of the matter is that that’s a bias. And so it’s up to us to look at these biases and say, ‘Well, no. What is the right way to do this?’”
I got asked the other day to comment for Wired on the role of AI in Covid-19 detection, in particular for use with CT scanning. Since I didn’t know exactly what resources they had on the ground in China, I could only make some generic vaguely negative statements. I thought it would be worthwhile to expand on those ideas here, so I am writing two blog posts on the topic, on CT scanning for Covid-19, and on using AI on those CT scans.
As background, the pro-AI argument goes like this:
CT screening detects 97% of Covid-19, viral PCR only detects 70%!
A radiologist takes 5-10 minutes to read a CT chest scan. AI can do it in a second or two.
If you use CT for screening, there will be so many studies that radiologists will be overwhelmed.
In this first post, I will explain why CT, with or without AI, is not worthwhile for Covid-19 screening and diagnosis, and why that 97% sensitivity report is unfounded and unbelievable.
Next post, I will address the use of AI for this task specifically.