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Category: Health Technology

Health Tech, Part I: Where We Are Going, Not Just How Fast We Can Get There

By MIKE MAGEE

What will be the lasting impact of the Covid 19 pandemic?

We still don’t know the answer to that question in full. But one thing that can be said with some certainty is that it has strengthened the hand of Big Tech and all things virtual. Consider the fact that within the Biden White House administration, 13 senior aides have Big Tech resumes with time spent in firms like Google, Facebook, Twitter, Apple, Amazon, Microsoft and more.

This pandemic-induced scrape with mortality has instigated widely varied responses ranging from existential re-awakenings to explosive entrepreneurship.

In health care for example, health tech start-up’s are altering research, education, care delivery and coordination, data mining, patient privacy and financing.

As we know well from health care, intermingling profit, policy and politics can eventually lead to conflict and recrimination. The current controversy over NIH indirect funding of Shi Zengli’s Wuhan “gain-of-function” viral research through Peter Daszak’s New York based EcoHealth Alliance is a case in point.

But we’ve been there before. In the 1990s, James M. Wilson received a PhD and an MD degree from the University of Michigan, then completed an internal medicine residency at Massachusetts General Hospital and a postdoctoral fellowship at MIT. By 1997, he was one of the leading stars in the new gene-therapy movement, directing his own research institute at the University of Pennsylvania.

The institute focused on adjusting the genes of children born with a hereditary disease called ornithine transcarbamylase deficiency (OTD), which prevents the normal removal of ammonia in the body. Wilson’s experimental technique involved genetic engineering, splicing therapeutic genes into supposedly harmless viruses that, once injected into the body, could carry their payload to defective cells and repair the genetic errors.

Dr. Wilson was attempting to determine the maximum dose of genetically modified material that could be safely injected into affected youngsters. He had enlisted 18 participants, including a teenager named Jesse Gelsinger who had a version of the genetic disease in which some of his liver cells carried the genetic abnormality but other cells were entirely normal. Those who have the full-blown disorder die in early childhood. But with his mosaic, Jesse most of the time felt well, as long as he continued to take 32 pills a day.

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Healthcare’s New “Operating System”: Amwell’s CEO Says Incumbents are Re-Thinking Telehealth

By JESSICA DaMASSA, WTF HEALTH

“We have to look at telehealth as an operating system.” Amwell ($AMWL) President & CEO Roy Schoenberg has a way with analogies, and some of his best land in this interview as we get a highly detailed, insider’s perspective about how payers and health systems are rethinking telehealth as a result of their experiences during the pandemic.

Bottom line: The pandemic taught us that telehealth can be used to deliver a much wider variety of healthcare services than just urgent care and, so the whole idea of ‘telehealth’ is changing from healthcare product to healthcare infrastructure. Mental health care, physical therapy, medication management, primary care, and more have all moved to telehealth and, along with that shift, the “rules of engagement” around those services have started to change.

Payers are looking to become the “digital front door” for their members – providing primary care and navigation. Health Systems are increasingly looking to use their own docs for urgent care, rather than outsource that relationship and miss the potential to build trust with local patients. And, in all this, Roy argues that healthcare’s biggest buyers have stopped looking at telehealth as a “product” and, instead, are starting to see the opportunity to “rewrite their future” around a view of telehealth as infrastructure, as one of healthcare’s “foundational systems” intertwined with (and as mission-critical as) their EHRs or claims and eligibility systems.

My favorite analogy starts around the 20-minute mark, when Roy explains this operating system idea by drawing comparison to how individual Microsoft programs (think Word, Excel, Outlook, PowerPoint) would be infinitely less powerful if they were not running on the same operating system and able to easily transfer information. Another good one? How both the buying and provisioning of healthcare is being re-thought digitally, just as online shopping not only changed buying habits but also changed supply chain for retailers. If you’re looking to hear the latest on what’s happening in telehealth post-Covid, learn how things have changed for payers and health systems, AND also want to dip into Amwell’s market positioning a bit, you’ll love this deep-dive.

Senior Caregiving Startup Papa: “Hanging Out & Helping Out” Backed by Health Plans & $91M in Funding

By JESSICA DaMASSA, WTF HEALTH

Since it was founded in 2017, “family-on-demand” senior care startup Papa has raised a whopping $91M from a veritable who’s who of health innovation investors. How has this startup that matches “authentically nice people” up with seniors to “help out and hang out” convinced the likes of Tiger Global, Comcast Ventures, and Canaan Partners (and those are just the investors who chipped in for Papa’s $60M Series C round this April) to invest? And, probably more importantly, how has Papa won more than 40 health plans as clients (a number set to triple for 2022) EAGER to foot the bill to provide their members with the support of a Papa Pal?

Founder & CEO Andrew Parker walks us through the business model and what it will and won’t be providing in the near future. Companionship, house help, chatting, and grocery shopping all fall under the purview of a Pal – so does filling non-clinical gaps in care like making annual check-up appointments, picking up prescriptions, and providing telehealth tutorials. Andrew says Pals are like “ninjas for a health plan,” building relationships and trust one weekly visit at a time. With 240 million people that could get access to a Papa Pal either via a Medicare, Managed Medicaid, or even employer sponsored health plan (good employees with aging parents need caregivers…) the potential for growth is tremendous. Will the biz hit a ‘supply’ issue? How long do Pals stick around? As we work to combat loneliness, isolation, and a myriad of social determinants of health issues within a rapidly expanding senior population, find out what Andrew thinks will keep Pals around and the service sticky for seniors, their real families, and their health plans.

Better Broadband for Better Health Care

By KIM BELLARD

Here’s a question that we don’t often ask: which is the U.S. more likely to accomplish – getting everyone health insurance, or broadband?  Hint: it’s probably not what you think.

The health insurance part of it is often debated.  We passed ACA, but the number of uninsured stubbornly remains at nearly 30 million, almost 10% of the population.  Still, except for residents of those 12 states that have refused to pass Medicaid expansion, everyone in the country has at least access to public or private health insurance, with subsidies available to many. 

Broadband hasn’t been around as long a health insurance, but it has become an integral part of our society, as the pandemic proved (ever try remote work or learning without broadband, much less telehealth?).   Unfortunately, some 20 million households lack broadband; assuming an average household size of about 2.5, that’s some 50 million people, which is way more than the number of uninsured. 

Welcome to the digital divide.   

Everyone seems to agree increasing access to broadband is a good goal.  It’s part of President Biden’s proposed infrastructure plan, and even many Republicans support some funding towards the goal, as in a recent bipartisan proposal

We often think about the issue as being a rural problem, similar to the problem of electricity availability in rural areas before the Rural Electrification Act (1936).  It’s just hard, or at least expensive, to wire all those vast spaces, those farms and small communities that comprise much of America. 

The fact of the matter, though, is that of those 20 million households without broadband, some 15 million of them are urban households.  A higher percent of rural households may lack broadband, but, in terms of actual numbers of households lacking it, it is urban dwellers.  For the most part, broadband is available in their neighborhood; they just can’t afford it (or don’t see the need).  

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Jonathan Bush Launches Zus with $35M & “Build-Your-Own EMR” Proposition for Health Tech Startups

By JESSICA DaMASSA, WTF HEALTH

Jonathan Bush has “More Disruption Please-d” himself and is back at it with a new company, Zus (get it…like the father of Athena) backed by a $35M Series A led by Andreessen Horowitz, F-Prime Capital, Maverick Ventures, & Rock Health.

“It’s ‘Build-A-Bear’ for EMR, patient relationship management, CRMs…” says Jonathan, and meant to help digital health startups work around incumbent EMR companies by providing a developer kit of components common to the “middle” of a health tech stack — AND a single shared record backend where all Zus clients can land and access patient data.

The intention is to help digital health startups reduce the time and cost of developing their tech by eliminating the redundant, generic aspects of building a healthcare tech stack in the same way companies like Stripe or Twilio have taken the burden out of writing code to process payments or integrate messaging. Zus intends to be the go-to for code used to make an appointment, create a patient profile, connect to a telehealth platform, etc. And the shared record on the back end? Does that make Zus a next-gen EMR company?? Find out more about Zus’s business model, current client list, and why, exactly, Jonathan believes that NOW is the time that the dream of the shared patient medical record is within reach.

#Healthin2Point00, Episode 216 | Datavant acquires Ciox, plus deals for AllyAlign, Cerebral & more

Today on Health in 2 Point 00, Jess is trying to replace me with the other Matthew Holt. But on Episode 216, I am still around to talk about some deals. First, Datavant acquires Ciox Health in a $7 billion deal, aiming to create the nation’s largest health data ecosystem. Next, Avenue Health is a new company that has just been launched, working on seamless, end-to-end data integration and blockchain, and AllyAlign Health raises $300 million as a new Medicare advantage plan. Finally, Cerebral raises $127 million – this is like a Ro or Hims but specifically for mental health. —Matthew Holt

#Healthin2Point00, Episode 215 | Monogram, LetsGetChecked, Transcarent, Lenus, and Ada

Amazon Cares already has customers, Clover has become a meme stock, Transcarent has got a Series B that they closed already, and OneDrop has hit 25 billion biometric data points – what the hell is going on in digital health? Today on Health in 2 Point 00, we still have lots of deals to cover. Monogram, an end-stage kidney disease company, raises $160 million. LetsGetChecked raises $150 million in a Series D – all of these at-home testing companies are getting a push because of COVID. Next, Lenus raises €50M in a Series A, making it the biggest ever single A round in Denmark. Transcarent gets $58 million in a Series B already, and Ada Health raises $90 million for their symptom assessment chatbot. —Matthew Holt

UpHealth Hits the NYSE: CEO & President on SPAC Merger Completion, Virtual Care Competition & More

By JESSICA DaMASSA, WTF HEALTH

Another virtual care company hits the New York Stock Exchange as UpHealth ($UPH) emerges from the combined merger of UpHealth Holdings and Cloudbreak Health with the GigCapital2 SPAC. We’ve got UpHealth’s CEO Ramesh Balakrishnan and President Jamey Edwards here on “Listing Day” to catch us up on the strategic developments and integrations that have occurred since UpHealth’s SPAC IPO was first announced at the end of 2020.

You might remember this deal as the one that brought together six different companies across four of the fastest growing areas of digital health: global telehealth, integrated care management, digital pharmacy, and behavioral health. The story there is still the same, but the value proposition around the combined offering has gelled. UpHealth views itself as a partner to local healthcare providers around the world who need a hand building the integrated digital care model needed to meet growing patient demands and economic realities of a “digitally transformed” healthcare experience. How is this different than what we’re seeing from other publicly-traded telehealth companies like Amwell, Teladoc, and Hims? Or, what about those telehealth-empowered retail giants like Amazon, Walmart, and CVS Health who, like UpHealth, see a lot of upside in the duality of both making care more convenient digitally, while also seamlessly integrating with local in-person care centers? We’ve got all the talk you’ll want about UPH’s positioning, business model, revenue guidance (still $180M-190M for 2021) AND even some client name dropping (Amazon? Really?!) as the stock hits the market.

Bonus: Want to go deeper into this deal? For more on UpHealth, check out our earlier chat with Chairman Chirinjeev Kathuria, Jamey Edwards, and Al Gatmaitan from February 2021. The link is right here: https://youtu.be/50PIVdUjnPU

#Healthin2Point00, Episode 214 | One Medical acquires Iora, plus funding for HumanFirst & many more

Today on Health in 2 Point 00, Jess pokes fun at me because my primary care provider has acquired a Medicare provider – One Medical buys Iora Health for $2.1 billion in stock. This deal is curious because these are two very different organizations. Next, HumanFirst (formerly Elektra Labs) raises $12 million in a Series A, bringing their total to $15 million, working on distributed clinical trials. Medallion raises $20 million in a Series A to address barriers for digital health providers around state licensing rules, and Aunt Bertha raises $27 million working on the social determinants of health and getting social care resources to patients. Finally, Grand Rounds and Doctor on Demand acquire Included Health, an LGBTQ+ focused care navigation platform. —Matthew Holt

#Healthin2Point00, Episode 213 | Babylon’s SPAC IPO, plus big raises for Thirty Madison & Intrinsic

Today on Health in 2 Point 00, we’re talking about our new conference in September: Policies, Techies, & VCs: What’s Next for Health Care. On Episode 213, Jess ask me about some massive deals. Thirty Madison gets $140 million – they are now a unicorn. Babylon Health is going public via a SPAC – $575 million expected to be raised during this with a $3.6 billion valuation. Coming out of stealth, Intrinsic raises $113 million in the eCommerce space — and Dr. Oz is in this one. —Matthew Holt

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