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Category: Health Technology

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.

#Healthin2Point00, Episode 226 | DomaniRx, Connections Health Solutions, Veda, and Connie Health

Today on Health in 2 Point 00, we have more deals for you! First up, DomaniRx: Anthem, Humana, and a software company SS&C are teaming up to launch a PBM. Connections Health Solutions raises $30 million working on comprehensive behavioral health care, and Veda Data Solutions raises $45 million, bringing their total to $52.2 million, applying AI to provider data. Finally, Medicare navigation platform Connie Health raises $13 million, bringing their total to $16 million. —Matthew Holt

The Rise of the Health Coach: YourCoach.Health on Market Opportunity Between Healthcare & Wellness

By JESSICA DaMASSA, WTF HEALTH

According to the team at YourCoach.Health, health coaching is “the ‘glue’ that’s connecting the $4-trillion wellness economy with the $8-trillion healthcare economy.” And by learning about the growing number of nearly 2,000 health coaches who are engaged in their practice management solution – and the small and mid-sized employers who want to tap into it to provide health coaching to their workforces – its seems like they might be right.

YourCoach’s CEO Marina Borukhovich and COO Eugene Borukhovich walk through the work they are doing to build a platform that both helps health coaches do their jobs better AND find clients within the SMB health benefits market. While “coaching” might often get wrapped around everything from remote monitoring devices and digital therapeutics to care plans for chronic conditions and long-term illnesses, “health coaching” as a credentialed discipline is different.

Marina and Eugene de-mystify the terminology for us, along with the certifications required to be a health coach, the current reimbursement climate for the health service, and where they think the discipline is headed as demand for “human-led, compassion-driven” healthcare booms among both healthcare consumers AND practitioners. A couple little scoops in this one too as we learn about some soon-to-be-released tech features on their platform AND the seed-funded startup’s plans to raise a Series A.

Let’s Meet in the Metaverse

By KIM BELLARD

I really wasn’t expecting to write about the Metaverse again so soon, after discussing it in the context of Roblox last March, which itself followed a look at Epic Games CEO Tim Sweeney’s vision for the Metaverse last August.  But darn that Mark Zuckerberg!

Not many noticed when Mr. Zuckerberg told Facebook employees in June that the company would become focused on building a metaverse, but he got some attention when he expanded on his vision for The Verge in late July.  Then last Monday Andrew Bosworth, Facebook’s head of AR/VR, confirmed a product group had been formed to bring it about.  And, finally, in an earnings call last Wednesday, Mr. Zuckerberg and his executive team couldn’t stop gushing about the importance of the metaverse to the company, and the world.

So, yeah, the metaverse is in the news.  And, once again, I worry healthcare is going to be late to the party. 

I won’t go into too much detail about what the metaverse is; for those who want a deep dive, there’s Matthew Ball’s nine part primer, or you could just read Ready Player One.  Mr. Zuckerberg described it to The Verge as follows: “you can think about the metaverse as an embodied internet, where instead of just viewing content — you are in it.”  In the earnings call, he clarified: “The defining quality of the metaverse is presence – which is this feeling that you’re really there with another person or in another place.” 

Depending on your age/preferences, the concept of “an embodied internet” is either chilling or thrilling.  Maybe both.   

It’s potentially a big deal.  Gene Marks, writing in Forbes, says, “business interactions will forever change.”  The Conversation’s Beth Daley goes further, stating “creating a virtual world for users to interact with their friends and family is not just a fancy vision, it is a commercial necessity.”

It’s not VR, it’s not AR, it’s not 3D internet, although all those may be part of it.  It’s not gaming, it’s not entertainment, it’s not social network, although all of those will be part of it too.  Mr. Zuckerberg promises: “It’s going to be accessible across all of our different computing platforms; VR and AR, but also PC, and also mobile devices and game consoles.”  Not to overstate it, but he sees the Metaverse as the “next generation of the internet.”  Mr. Zuckerberg also described it as “the next computing platform.”

He is openly telling people that the goal is for Facebook to transition to a metaverse company, “within the next five years or so.”  Analysts on the earnings call pressed Facebook to confirm an estimate of a $5b investment, but only got an admission that, yes, the investment was “billions.”

Significantly, for Facebook, Mr. Zuckerberg believes: “this is going to be not something that one company builds alone, but I think it is going to be a whole ecosystem that needs to develop.”   As Mr. Zuckerberg said in The Verge interview, “Hopefully in the future, asking if a company is building a metaverse will sound as ridiculous as asking a company how their internet is going.”

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THCB Spotlights: Marta Zanchi, Founder & Managing Partner at Nina Capital

Today on THCB Spotlight, Matthew sits down with Marta Zanchi, who is the founder and Managing Partner at Nina Capital. Nina Capital is a micro venture capital firm in Barcelona, and in this interview, Matthew asks Marta about her decision to move from Silicon Valley to Barcelona and start this fund. Marta talks us through some of the investments they’ve made in the past couple of years so tune in to find out more.

Mental Health Startup SonderMind Lands $150M to Tackle ‘THE’ Health Issue of Our Generation

By JESSICA DaMASSA, WTF HEALTH

SonderMind closes a $150M Series C funding round co-led by Drive Capital and Premji Invest, and we get CEO Mark Frank’s take on what sets THIS digital mental health startup apart from a pack of very well-funded competitors. SonderMind has its own behavioral health therapists, built its own tech stack, delivers care virtually AND in-person, is covered by some of the biggest health plans in the country — Aetna, Anthem, Bright Health, Cigna, Kaiser, Optum, and United Healthcare. (They can also namedrop health-tech-infamous Board member, Jonathan Bush, in an interview, but that’s beside the point!)

What’s most remarkable – and what Mark says most impressed investors this time around – is not only the health of SonderMind’s business model, but also its balance sheet. This raise marks the bulk of the total $183M the startup has raised to-date, and Mark reveals that they’ve only deployed about half of the $27M Series B funding they received in April 2020 in a round led by General Catalyst. How will such a “capital efficient” business begin to deploy these new funds? We hear Mark’s plans for nationwide expansion and improvements to that tech stack, particularly when it comes to better matching therapists and patients based on expertise and need, and more appropriately measuring process and outcomes. Two areas ripe for more tech integration as the mental health provider tackles what Mark calls THE defining health issue of our generation.

The Most Important Thing

By KIM BELLARD

Jack Dorsey has some big hopes for bitcoin.  In a webinar last week, he said: “My hope is that it creates world peace or helps create world peace.”  The previous week Mr. Dorsey announced Square was starting a decentralized financial services (DeFi) business based on bitcoin, joining the previously announced Square bitcoin wallet.  

None of this should be a surprise.  At the Bitcoin 2021 conference in June, Mr. Dorsey said: “Bitcoin changes absolutely everything.  I don’t think there is anything more important in my lifetime to work on.”

I’m impressed that someone with as many accomplishments as Jack Dorsey picks something not obviously related to those accomplishments and decides it is the most important thing he could work on.  So, of course, I had to wonder: what might accomplished people in healthcare say was the most important thing they wanted to be working on?

For many these days, of course, it is the COVID-19 pandemic.  Not much has had a higher priority.  Highly effective vaccines have been developed, COVID-19 treatments have greatly improved, supply chains have been adjusted and readjusted, and countless public health measures have been tried.  Healthcare professionals have worked themselves to extremes.

For others, perhaps, it would be to address the extreme financial hardships the U.S. healthcare system can cause.  A new study in JAMA confirmed what is hiding in plain sight – hundreds of billions of medical debt.   Debt continued to rise despite ACA, especially in states that perversely chose not to expand Medicaid.  Efforts such as requiring hospital “price transparency” have largely failed.  Many large hospital systems continue to sue patients who can’t pay.  These hardships are unfair, immoral, and unique to the U.S.; addressing them should be important.

However, both the pandemic and financial obstacles contributed to, but did not cause, the big health inequities in the U.S. healthcare system.  People of color, people in lower socioeconomic classes, even women all face numerous inequities in the health care they receive and in the health they achieve.   These may reflect broader social inequities, but no one in healthcare should look at these without wanting to address them. 

Digital health has never been hotter. The pandemic reminded people how valuable telehealth can be, and investors are pouring money into digital health at astounding levels – some $19b in the first half of 2021 alone.  We may be in bit of a manic phase right now, but few doubt that digital health is going to be a big part of healthcare’s future. 

Then there’s artificial intelligence (A.I.).  No industry in 2021 can be ignoring it. Some well-publicized mishaps with IBM’s Watson or Babylon Health notwithstanding, A.I. in healthcare has already made impressive strides, such as DeepMind’s recent protein predictions or its successes in imaging.  A.I. is going to be built into our health care in the future, either in a supporting role or directly, and working on it has to be on many people’s wish list.  

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