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Health Innovation & Data: Five Common Missteps (and How to Interrupt Them)

By MARIE COPOULOS

I’ve had the great fortune of spending much of my career at the intersection of health care innovation and the underlying data that drives new models.

For those of us who’ve worked in this space for a long time, there’s a certain pattern recognition that comes with this work that is often immediate and obvious – both in terms of really cool developments but also gotchas. “Ah, you’re stumbling here. Everyone does that.”

The challenge, I’ve found, is that these ‘gotchas’ that can be so visible to the folx who’ve worked in health tech for the past few decades can be counterintuitive in the business and even met with resistance. Why?

I’m going to focus here on pattern recognition, with the goal of highlighting common stumbling blocks and, critically, ways you can interrupt them if you see them.

Pattern #1: Lacking a Clear-Eyed View of Market Data Gaps
Key Question: Do you understand how the market you’re in informs your ability to measure your work and use data to drive insight?

For those of you building models that change the status quo – this is for you. By nature these innovations break from existing care and financial models with the goal to improve them. We need this in health care. However, it’s common to overlook the fact that breaking with the status quo also breaks with the ways that we capture and serve up health data.

To this end, don’t assume you will be able to measure and show success, and that the data you need must be out there. The true differentiator is for both to align. Design with intention.

If you’re at the stage of thinking about a productized solution to a health care problem, then it is also the right time to look at the market with a lens toward data availability. In your problem space, what’s the data set you’re likely to lean on? Is it sufficient?

If the answer is that the data is not available or notoriously problematic in your market space for the problem you’re solving, this merits a pause. Can you find a way to survive in this reality? Can you create the data set you need? Can you adjust what you’re doing in some way to align with what is available? Is qualitative feedback ok?

Pattern #2: Accumulating Non-Technical Roadblocks Key Question: Do you have a good handle on the non-technical challenges impacting your data business?

A decade ago I would have approached this question differently. Technical challenges were often paramount as we tried to figure out how to solve the basics. Today, however, it’s often the opposite, in that business challenges are more likely to slow down technical progress than the other way around.

Continue reading…

Amazon Can Still Surprise Me

By KIM BELLARD

It’s Cyber Monday, and you’ve probably been shopping this weekend. In-stores sales on Black Friday rose 2.2% this year, whereas online sakes rose almost 8%, to $9.8b – over half of which was via mobile shopping. Cyber Monday, though, is expected to outpace Black Friday’s online shopping, with an estimated $12b, 5.4% higher than last year. 

Lest we forget, Amazon’s Prime Day is even bigger than either Cyber Monday or Black Friday.  

All that shopping means lots of deliveries, and here’s where I got a surprise: according to a Wall Street Journal analysis, Amazon is now the leading (private) delivery service. The analysis found that Amazon has already shipped some 4.8 billion packages door-to-door, and expects to finish the year with some 5.9bn. UPS is expected to have some 5.3bn, while FedEx is close to 3bn – and – unlike Amazon’s numbers — both include deliveries where the U.S. Postal Service actually does the “last mile delivery.” 

Just a few years ago, WSJ reminds us, the idea that Amazon would deliver the most packages was considered “fantastical” by its competitors. “In all likelihood, the primary deliverers of e-commerce shipments for the foreseeable future will be UPS, the U.S. Postal Service and FedEx,” the then-CEO of Fed Ex said at the time. That quote didn’t age well.

Amazon’s growth is attributed in part to its contractor delivery program, whose 200,000 drivers (usually) wear Amazon uniforms and drive Amazon-branded vehicles, although they don’t actually work for Amazon, and a pandemic-driven doubling of its logistics network. WSJ reports: “Amazon has moved to regionalize its logistics network to reduce how far packages travel across the U.S. in an effort to get products to customers faster and improve profitability.”

It worked.

But I shouldn’t be surprised. Amazon usually gets good at what it tries. Take cloud computing.  Amazon Web Services (AWS) in its early years was considered something of a capital sink, but now not only is by far the market leader, with 32% market share (versus Azure’s 22%) but also generates close to 70% of Amazon’s profits. 

Prime, Amazon’s subscription service, now has some 200 million subscribers worldwide, some 167 million are in the U.S. Seventy-one percent of Amazon shoppers are Prime members, and its fees account for over 50% of all U.S. paid retail membership fees (Costco trails at under 10%). There’s some self-selection involved, but Prime members spend about three times as much on Amazon as nonprime members.

The world’s biggest online retailer. The biggest U.S. delivery service. The world’s biggest cloud computing service. The world’s second largest subscription service (watch out Netflix!).  It’s “only” the fifth largest company in the world by market capitalization, but don’t bet against it. 

I must admit, I’ve been a bit of a skeptic when it comes to Amazon’s interest in healthcare. I first wrote about them almost ten years ago, and over those years Amazon has continued to put its feet further into healthcare’s muddy waters.

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TOMORROW: ZS Impact Webinar on Digital Health

Join ZS’s Ahmed Albaiti with me, Matthew Holt, author and founder of The Health Care Blog, as we discuss the considerations and approaches that policy experts, regulators, clinical leaders and the venture capitalist community can take to affect a future for connected health technologies.

Date: Wednesday, November 22, 2023

Time: 12:00 PM Eastern Standard Time

Duration: 30 minutes

Register here

Paul Jaglowski, Feedtrail

Feedtrail is one of a new breed of customer experience companies. Most health care experiences are captured in paper surveys that end up in H-CAPS and Star ratings. These are very important for how providers and plans get paid but probably don’t actually reflect what happens very well and give very poor feedback to organizations and staff about what’s actually going on. They also don’t give a chance for patients to directly give positive feedback to staff who do a great job–which likely helps them feel good about their work. Feedtrail is working to fix all that. I got a full demo and explanation from founding CEO and chief strategy officer Paul Jaglowski–Matthew Holt

Pin Me, Please

By KIM BELLARD

You had to know I’d write about the new Humane AI Pin, right?

After all, I’d been pleading for the next big thing to take the place of the smartphone, as recently as last month and as long ago as six years, so when a start-up like Humane suggests it is going to do just that, it has my attention.  Even more intriguing, it is billed as an AI device, redefining “how we interact with AI.”  It’s like catnip for me.

For anyone who has missed the hype – and there has been a lot of hype, for several months now – Humane is a Silicon Valley start-up founded by two former Apple employees, Imran Chaudhri and Bethany Bongiorno (who are married).  They left Apple in 2016, had the idea for the AI Pin by 2018, and are ready to launch the actual device early next year.  It is intended to be worn as a pin on the lapel, starts at $699, and requires a monthly $24 subscription (which includes wireless connectivity).  Orders start November 16.

Partners include OpenAI, Microsoft, T-Mobile, Tidal, and Qualcomm.

Mr. Chaudhri told The New York Times that artificial intelligence  “can create an experience that allows the computer to essentially take a back seat.” He also told TechCrunch that the AI Pin represented “a new way of thinking, a new sense of opportunity,” and that it would “productize AI” (hmm, what are all those other people in AI doing?).  

Humane’s press release elaborates:

Ai Pin redefines how we interact with AI. Speak to it naturally, use the intuitive touchpad, hold up objects, use gestures, or interact via the pioneering Laser Ink Display projected onto your palm. The unique, screenless user interface is designed to blend into the background, while bringing the power of AI to you in multi-modal and seamless ways.

Basically, you wear a pin that is connected with an AI, which – upon request – will listen and respond to your requests. It can respond verbally, or it can project a laser display into the palm of your hand, which you can control with a variety of gestures that I am probably too old to learn but which younger people will no doubt pick up quickly.  It can take photos or videos, which the laser display apparently does not, at this point, do a great job projecting. 

Here’s Humane’s introductory video:

Some cool features worth noting:

  • It can summarize your messages/emails;
  • It can make phone calls or send messages;
  • It can search the web for you to answer questions/find information;
  • It can act as a translator;
  • It has trust features that include not always listening and a “Trust Light” that indicates when it is.
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Joanna Strober, CEO, Midi Health

Women’s health in their mid-life has been very poorly treated. No one has been managing all of women’s health, and almost no one has been delivering hormone replacement therapy since a now debunked 2002 study. Midi is a new company with protocols for many conditions, and it has been training NPs to deliver the care (because no one has been training them!). CEO Joanna Strober explained how Midi is providing care in 14 states now and will be in all 50 next year, and how Midi is delivering virtual and comprehensive care to women–many of whom do not have access to any other type of regular care. They just raised another $25m from GV (Google) & others–Matthew Holt

Jean-Claude Saghbini, Lumeris

Jean-Claude Saghbini is the CTO of Lumeris and also the President, Lumeris Value-Based Care Enablement. Lumeris has been in business quite a while now, providing the technology which (in general) hospitals and medical groups use to manage to their workflows predominantly for Medicare Advantage. It also owns a big medical group (Essence in St Louis) and has close connections with John Doerr of Kleiner Perkins fame, whose brother was involved in its formation. Kleiner also funded Healtheon (the precursor to WebMD) of which current Lumeris CEO Mike Long was the founding CEO. I interviewed Jean-Claude at HLTH to get the update on Lumeris. How are they helping those providers manage their patients at risk? How are those providers actually getting paid? And how that makes them behave. Plus his views on how CMS is adjusting the way Medicare scores and pays his clients! Matthew Holt

THCB Gang Episode 137, Thursday October 26

Joining Matthew Holt (@boltyboy) on #THCBGang on Thursday October 26 at 1pm PST 4pm EST were delivery & platform expert Vince Kuraitis (@VinceKuraitis); author & ponderer of odd juxtapositions Kim Bellard (@kimbbellard); futurist Ian Morrison (@seccurve); and our special guest was Kat McDavitt(@katmcdavitt) President of Innsena.

The video is below. If you’d rather listen to the episode, the audio is preserved from Friday as a weekly podcast available on our iTunes & Spotify channels

Y2Q and You

By KIM BELLARD

Chances are, you’ve at least somewhat concerned about your privacy, especially your digital privacy.  Chances are, you’re right to be.  Every day, it seems, there are more reports about data beeches, cyberattacks, and selling or other misuse of confidential/personal data.  We talk about privacy, but we’re failing to adequately protect it. But chances are you’re not worried nearly enough.

Y2Q is coming. 

That is, I must admit, a phrase I had not heard of until recently. If you are of a certain age, you’ll remember Y2K, the fear that the year 2000 would cause computers everywhere to crash.  Business and governments spent countless hours and huge amounts of money to prepare for it. Y2Q is an event that is potentially just as catastrophic as we feared Y2K would be, or worse. It is when quantum computing reaches the point that will render our current encryption measures irrelevant.

The trouble is, unlike Y2K, we don’t know when Y2Q will be.  Some experts fear it could be before the end of this decade; others think more the middle or latter part of the 2030’s.  But it is coming, and when it comes, we better be ready.

Without getting deeply into the encryption weeds – which I’m not capable of doing anyway – most modern encryption relies on factoring unreasonably large numbers – so large that even today’s supercomputers would need to spend hundreds of years trying to factor.  But quantum computers will take a quantum leap in speed, and make factoring such numbers trivial. In an instant, all of our personal data, corporations’ intellectual property, even national defense secrets, would be exposed. 

“Quantum computing will break a foundational element of current information security architectures in a manner that is categorically different from present cybersecurity vulnerabilities,” warned a report by The RAND Corporation last year.

“This is potentially a completely different kind of problem than one we’ve ever faced,” Glenn S. Gerstell, a former general counsel of the National Security Agency, told The New York Times.  “If that encryption is ever broken,” warned mathematician Michele Mosca in Science News, “it would be a systemic catastrophe. The stakes are just astronomically high.”

The World Economic Forum thinks we should be taking the threat very seriously.  In addition to the uncertain deadline, it warns that the solutions are not quite clear, the threats are primarily external instead of internal, the damage might not be immediately visible, and dealing with it will need to be an ongoing efforts, not a one-time fix.

Even worse, cybersecurity experts fear that some bad actors – think nation-states or cybercriminals – are already scooping up troves of encrypted data, simply waiting until they possess the necessary quantum computing to decrypt it.  The horse may be out of the barn before we re-enforce that barn. 

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Fay Rotenberg, CEO, Firefly Health

Fay Rotenberg is CEO of Firefly Health, which is an advanced virtual primary care group (a bastardized phrase she hates). That means they are both providing virtual care, with an integrated care and health plan coverage model, and are also a risk-bearing medical group working with other payers. They adjust the model using health guides, MDs, NPs, etc. and they help their patients manage their in person experience with specialists, labs, imaging, etc. — they have 1900+ partners nationwide who will actually know the patient is coming, and is integrated into Firefly’s model. Clinical outcomes are great, and costs are 12-15% lower, yet they have 5,000 members per MD. Maybe it really is the 21st century Kaiser?