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#Healthin2Point00, Episode 230 | Commure, Spring Health, UniteUs, Nomad & Xealth

It’s been quite a while since Jess & I did a Health in 2 Point 00 and that one was buried in our Policies|Techies|VCs conference in the first week of September. But, as John Malkovich says, We’re back…

Commure gets $500m and maybe one day we’ll know what it does, Spring Health adds to the mental health funding party, UniteUs buys competitor NowPow; Nomad banks $63m for its nurse hiring service, and Xealth adds $24m, even though I’m not sure it’s more than a feature! – Matthew Holt

Matthew Holt

Metaverse and Health Care – A View From 50,000 Feet

by MIKE MAGEE

dystopian

[disˈtōpēən]

ADJECTIVE

1. relating to or denoting an imagined state or society where there is great suffering or injustice.

NOUN

1. a person who imagines or foresees a state or society where there is great suffering or injustice.

There are certain words that keep popping up in 2021 whose meanings are uncertain and which deserve both recognition and definition. And so, the offering above – the word “dystopian.” Dystopian as in the sentence “The term was coined by writer Neal Stephenson in the 1992 dystopian novel Snow Crash.”

One word leads to another. For example, the above-mentioned noun, referred to as dystopian by science fiction writer Stephenson three decades ago, was “Metaverse”. He attached this invented word (the prefix “meta” meaning beyond and “universe”) to a vision of how “a virtual reality-based Internet might evolve in the near future.”

“Metaverse” is all the rage today, referenced by the leaders of Facebook, Microsoft, and Apple, but also by many other inhabitors of virtual worlds and augmented reality. The land of imaginary 3D spaces has grown at breakneck speed, and that was before the self-imposed isolation of a worldwide pandemic.

But most agree that the metaverse remains a future-facing concept that has not yet approached its full potential. As noted, it was born out of science fiction in 1992, then adopted by gamers and academics, simultaneously focusing on studying, applying, and profiting from the creation of alternate realities. But it is gaining ground fast, and igniting a cultural tug of war.

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#Healthin2Point00, Episode 229 | Headspace & Ginger merge, Connect America buys 100Plus

It’s M&A day here on Health in 2 Point 00! On Episode 229, Jess and I chat about the big news that Headspace and Ginger are merging to create Headspace Health (for more deets tune into Jess’s interview on WTF Health here). Next up, Connect America buys remote patient monitoring platform 100Plus. Finally, AllStripes raises $50 million in a Series B, bringing their total up to $67 million – this is a rare disease play for clinical trial recruiting. —Matthew Holt

Ginger and Headspace Merge: CEOs Let Us In On What’s Next for Digital Mental Health Super Company

By JESSICA DaMASSA, WTF HEALTH

The thinking behind the merger-of-equals between on-demand mental health company, Ginger, and mindfulness and meditation company, Headspace, is revealed in this in-depth chat with Headspace CEO CeCe Morken and Ginger CEO Russell Glass. The combined entity will be known as Headspace Health, with CeCe as its President and Russell as its CEO, and we’re chatting with both of them about go-to-market, strategic direction, and whether or not the next stop is an IPO.

“Low-cost, quality mental healthcare” is where these two minds seem to meet – playing on both Ginger’s reputation for being among the lowest cost providers of on-demand coaching and mental health therapy for the employer market, and Headspace’s budget-friendly, tech-first approach to mental wellness education and training for the masses. This is a critical point of differentiation, especially on the clinical side, where the cost of therapy is oftentimes a barrier for access to it.

Headspace will be rolled out to Ginger’s enterprise clients immediately (playing what sounds like a preventative medicine / early-detection role), but what might be even more exciting are plans to integrate Ginger’s therapy and coaching services into the direct-to-consumer product that has made Headspace a household name.

Is this the move before the BIG MOVE into the public markets? How will the integration work on the data side? And, for you long-time health tech followers and lovers of the digital therapeutics space, I ask about V1 of the Headspace Health brand, which, you might remember, announced bold plans to build the first-ever FDA-approved mindfulness DTx. The new combined entity is not only taking the name – it might one-day get back into the development of mental health digital therapeutics.

Lots to hear in this one as this Headspace Health positions itself to win in both DTC and Enterprise markets, starting Day 1 with 100M lives and 2700 enterprise clients around the world.

George Halvorson HIMSS Changemaker Lifetime Achievement Award Acceptance Speech, Part 2

Former Kaiser Permanente CEO George Halvorson has written on THCB on and off over the years, most notably last year with his proposal for Medicare Advantage for All post-COVID. This month he was given a lifetime achievement award by HIMSS and we are running his acceptance speech in two parts. We ran part one last week, and here’s part two– Matthew Holt

We also initially have an important and continuously improving sense of the epigenetic processes that exist in all of us to develop our own responses to the world we are in at a biological level, and we should be able to use that information to improve our health and our care.

That is extremely relevant to you because it is very much a systems and coding issue to bring epigenetics into care delivery and care systems.

The magnificent, wonderful, and extremely powerful new CRISPR tool kit actually used computer like coding approaches and created a vaccine for Covid that explicitly triggered our body’s immune responses exactly as our epigenetics are naturally programmed and coded to do for other vaccine approaches.

We will be able to use that set of tools to improve our responses to cancer and multiple other diseases in a growing variety of important ways. We actually now can choose to evolve as a species because that particular tool actually allows us to change our genetic code in very channeled and intentional ways. That capability and reality is hugely important — and we will now be able to use those new tools in a growing range of ways.

We should be able to stabilize or reduce the amount of money we spend on care when we put these full sets of tools in place.

However — we also do need to become better and smarter buyers of care to make that full set of enhancements happen.

Every economic system on the planet does what it is paid to do. Care is not an exception to that reality.

That full connectivity level and organized team care for patients will only happen if we decide as a nation to stop buying all care by the piece — and if we move to paying for total care for our patients to teams of appropriately supported caregivers who are rewarded financially for continuous improvement.

Care sites everywhere in the world do what they are paid to do. They also do not do things they are not paid to do. They function as businesses everywhere, so they do what every business does in every industry and they give their customer exactly what the customer pays for.

No business in any industry uses any other model.

With that reality in mind — we all need to understand the fact that we Americans buy care very badly.

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George Halvorson HIMSS Changemaker Lifetime Achievement Award Acceptance Speech, Part 1

Former Kaiser Permanente CEO George Halvorson has written on THCB on and off over the years, most notably last year with his proposal for Medicare Advantage for All post-COVID. This month he was given a lifetime achievement award by HIMSS and we are running his acceptance speech in two parts. Here’s part one — Matthew Holt

Thank you for giving me this first ever HIMSS Changemaker In Health Care Lifetime Achievement Award.

You are honoring an extremely impressive set of other current changemakers at this particular national meeting for 2021 and I am very honored and pleased to be the first person to be given the Lifetime Achievement version of this Changemaker award.

Changemaking is a good thing.

Changemaking is actually happening at a massive level for health care systems right now and that is good for health care and it is good for health care patients.

We are actually at the dawn of a golden age for health care systems, and I deeply appreciate being recognized for having done several fun, useful, and interesting things over time to help get us to where we are now.

As you pointed out, I have personally had a chance to work very directly on rolling out full electronic medical record systems in a couple of real and functional care systems to tens of millions of people.

It worked well.

We ended up with care sites in those settings that literally had no internal paper flows and that had and still have instantly available medical information for thousands of caregivers about their patients.

That tool kit worked extremely well.

Those care sites ended up with the highest ratings in the country for both quality of care and service and that high level of performance happened because the sites had both a culture of continuous improvement in their care settings and the highest levels of continuously available data for the caregivers in those sites about the patients they served.

“All-All-All.”

That was a mantra, a goal, and a strategy — and it became an actual functional capability.

Having All of the information about All the patients All the time — All-All-All is a good mantra, an extremely practical goal, an extremely functional strategy, and a very solid working practice for the delivery of care — and that data strategy worked even better than we had hoped it would work when we started down that path.

Having full electronic data on every patient improved diabetic care, chronic heart disease care, and stroke and heart damage prevention — and it created major reductions in the complications of care for chronic care patients in every category of care in all of those settings.

The data about patients was expanded at Kaiser Permanente to be the first major site and system in the world to add race and ethnicity to the care data for millions of patients.

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EHRs Are Workarounds, Rerouting the Way Physicians Work

By HANS DUVEFELT

IT GUY: Hey, Doc, don’t make up workarounds, use the EHR the way it was designed.

DOCTOR: Listen, your whole EHR is a workaround itself – around the way medicine is practiced.

– Hans Duvefelt, MD

This was a tweet I posted a while ago. I expected it to either go viral among doctors or catch the ire of administrators and IT folks. Neither happened. So I’m back on my soap box:

Imagine creating a computer simulation or video game that people expected to prepare them for or refine their skills in any given sport. Then, assume that this game altered the rules of the game – using a volley ball instead of a hockey puck, scoring goal attempts rather than goals, rewarding slowness rather than speed and so on.

Then, imagine you, the programmers/code writers, went to the team owners and proposed athletes and coaches should abandon the time-honored rules of the game and instead play like it plays out on the pixelated imitation you just created. And just to be clear: You, the programmer, actually never played the game yourself.

You’d get shown the door and sent back to the digital drawing board.

But that’s not what is happening in medicine.

FIRST: Is finding the clinically relevant information easier than, or at least as easy as, the regulatory information? (The cumbersome ways we have to enter information is a big topic, better covered separately.)

Here’s a silly example: One of the EMRs I work with displays prominently that the smoking assessment requirement has been satisfied, but I’ll be darned if I can see whether the patient smokes or not. Whom does the Holy Grail serve here?

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Digital Health: A Promise of Health for All

SPONSORED POST

In this interview Sophie Park, Chief Strategist at Bayer G4A, talks about the pandemic’s effect on the digital health landscape, digital health’s promise of Health Equity and Bayer G4A’s upcoming Digital Health Forum.

G4A is Bayer’s digital health partnerships and investments team dedicated to scaling digital health companies to change the experience of health. To attain this goal, G4A works with startups, innovation groups, commercial partners, thought leaders, health systems, and public institutions to accelerate and expand digital health innovations. In that context, G4A is offering opportunities for early stage to advance digital health companies to partner with Bayer.

Sophie, Covid-19 has clearly opened everyone eyes on the need to better our healthcare systems and raised awareness for digital health solutions. From your perspective, did the pandemic accelerate digital health on a long-term basis?

Clearly, the Covid-19 crisis spurred a momentum for digital health. During the crisis, I have observed two dynamics which advanced digital health in a never before seen pace.

On the one side, the needed adoption of digital health tools led to a mindset shift and more openness among health consumers and providers. The pandemic was a great chance for many people to get familiar with digital health tools and acknowledge their value. Covid-19 made it clear to individuals that their own health is a personal responsibility as well. Therefore, people more actively took care of their own health(care) and became more open to collect and securely share healthcare data. I believe that all these factors will lead to increasing use of digital health tools also in post-Covid times.

On the other hand, the pandemic exposed the pain points of our healthcare systems. The quality of care one gets is determined by social determinants- where you live, where you are from, what education you receive and what job you have. The pandemic left no doubt that there is still a long way to go to reach health equity and better health access. At Bayer G4A we believe that digital health can and should play a vital role in closing existing care gaps and ensuring health for all.

“Health for All” – that is the goal. Not only is it Bayer G4A’s leading vision it also is the title of this year’s Digital Health Forum hosted by G4A on September 9th. Why did you choose that theme for this year’s event?

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Health Care You Do Not See

By KIM BELLARD

Within a mile from my home in one direction, there are two pharmacies and a primary care office.  In another direction, there’s a multi-specialty physician practice, complete with lab and pharmacy.  And in a third direction, an urgent care center.  Widen the circle another mile, and there are more physician offices, a plethora of other health care professionals, another urgent care, a retail clinic, and an imaging center.  Add a couple more miles and hospitals – plural – to start show up.

I’m not sure that’s a good thing.

Admittedly, not everyone has so many options.  If you live in a rural area or a disadvantaged neighborhood, there may not be so many choices.  Chances are, though, even in those places, whenever you find retail activity, some portion of it is probably healthcare-related.

Retail clinics helped blur the lines between retail and healthcare, and early moves by retail giants like Walmart or Kroger to incorporate first pharmacy, then primary care, into their stores made getting care easier for millions.  All in all, probably a good thing.

Still, though, you know when you’ve gone from shopping for home goods or groceries to getting your healthcare.  You know because there’s more waiting.  You know because there are more forms to fill out.  You know because you don’t know what will happen to you. 

And you definitely know when you are getting health care services.  You get an injection, you take a pill, you have an image taken, your body is invaded by a tube or a scalpel.  That’s why we go, isn’t it?  We go because we fear something may be wrong and we want someone to do something about it.  Advising us to make lifestyle changes is all well and good, although usually not effective; we want some concrete treatment.

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Behind-the-Scenes Look at New Multidisciplinary Healthcare Conference LIFEITSELF

By JESSICA DaMASSA, WTF HEALTH

From Bill Gates to Goldie Hawn, Dr. Fauci and Rochelle Walensky to Astronaut Scott Kelly, and magician Penn Jillette to digital health’s own Dr. Daniel Kraft, new conference LIFE ITSELF (Sept 28-Oct 1) promises an eclectic mix of big thinkers from across tech, business, government, entertainment, and healthcare and a truly unique look at 10 big topics shaping the future of health and wellness.

Created, curated and co-hosted by Marc Hodosh (former owner and creator of TEDMED) and CNN’s chief medical correspondent, Dr. Sanjay Gupta, the four-day discussion is intended to be a mind-expanding, multidisciplinary discourse on healthcare topics that range from cost of care to human longevity. We’ve got Marc here to dish about the agenda as it’s being developed, and we’re lucky he’s willing to share a little bit about some of the surprises he and his team have planned.

Quick word to the wise if you’re interested in attending this one: check it out quick and register ASAP. The event is designed to be intimate to facilitate mixing-and-mingling among speakers and attendees within the iconic Hotel del Coronado and that means space is limited. Tune in to hear more and check out all the details at www.lifeitself.health.

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