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THCB Gang Episode 16

Episode 16 of “The THCB Gang” was on Thursday, July 2nd! You can see the video below!

Joining Matthew Holt were some of our regulars: patient safety expert Michael Millenson (MLMillenson), MD & hospital system exec Rajesh Aggarwal (@docaggarwal), health care consultant Daniel O’Neill (@dp_oneill), and our guest Marcus Whitney (@MarcusWhitney), CEO of Health Further & author of the new book Create and Orchestrate (You can email Matthew for a free signed copy, or get it on Kindle for 99 cents) We talked about the current rise in cases, how we get changes around race (and a lot more) moving in health care and what the future of care will potentially look like if we do.

If you’d rather listen, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels — Zoya Khan

Gastrointestinal Diseases in America: The Costly Impact on Employers and Patients

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SPONSORED POST

By SAM HOLLIDAY

Medically reviewed by Jenny Blair, MD

Gastrointestinal diseases like inflammatory bowel disease (IBD), gastroesophageal reflux disease (GERD), and irritable bowel syndrome (IBS) are more prevalent—and costlier—than many employers realize. Up to 70 million Americans are affected by gastrointestinal (GI) diseases each year—twice as many people as those living with diabetes (34.2 million).[1],[2] Overall direct healthcare costs for GI diseases are estimated to be $136 billion each year in the U.S., more than heart disease ($113bn) and mental health disorders ($99bn) [Figure 1][3]. However, GI conditions are often overlooked by employers as they consider their benefit offerings, even though a large proportion of their workforce is likely living and struggling with these conditions.

The Rising Direct Cost of GI Conditions

Irritable bowel syndrome, characterized by symptoms like recurring abdominal pain, constipation and diarrhea, affects as many as 15% of people worldwide[4]—though only 5 to 7% of people receive a diagnosis.[5] While this low diagnosis rate limits the value of cost estimates, the direct medical costs of IBS, excluding prescriptions and over-the-counter medicines, have been estimated to be $10 billion (or nearly $14 billion in today’s dollars) in the US.[6] Medication spend is another cost driver as IBS patients receive an average of 3 to 7 medications annually.[7] That’s 2 to 3 more prescriptions than a person without IBS would receive over a year.

Another important financial consideration for IBS is out-of-pocket (OOP) spend incurred by patients on over-the-counter medications, probiotics and functional medicine providers. One survey of about 600 people with IBS found that patients spent an average of $288 (2020 equivalent: $693) during a three-month period on over-the-counter and alternative therapies for IBS symptoms.[8] A 2007 study published in the journal Alimentary Pharmacology and Therapeutics looked at the OOP spend among people with IBS and found that individuals incurred an annual average of $406 OOP costs for the treatment of IBS symptoms.[9]

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THCB Gang Episode 15

Episode 15 of “The THCB Gang” was live-streamed on Thursday, June 25th!

Joining Matthew Holt were our regulars: health futurist Ian Morrison (@seccurve), writer Kim Bellard (@kimbbellard), WTF Health Host Jessica DaMassa (@jessdamassa), radiologist Saurabh Jha (@RougeRad), policy expert Vince Kuraitis (@VinceKuraitis), and THCB’s Editor-in-Chief, Me (@zoyak1594)! We got into increasing COVID-19 rates, updates in health policy, what is the future of hospitals, and how the new generation is dealing with the health care industry. All while keeping an eye on the politics of the US.

If you’d rather listen, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels — Zoya Khan

THCB Gang, Episode 14

Episode 14 of “The THCB Gang” was live-streamed on Thursday, June 18th. Tune in below!

Joining Matthew Holt were four regulars: health futurist Ian Morrison (@seccurve), writer Kim Bellard (@kimbbellard), MD turned leadership coach Maggi Cary (@MargaretCaryMD), Consumer advocate & CTO of Carium Health Lygeia Ricciardi (@Lygeia), and two guests: Emergency Room MD, IT consultant and so much more Medell Briggs (MedellBriggsMD), and patient advocate CEO of Patient Orator, Kistein Monkhouse (@KisteinM). It was a very thoughtful conversation about patient care, the role of social movements, what to do about structural racism in health care, and what new legislation might come from the federal level. You can watch below right now.

If you’d rather listen to the episode, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels — Zoya Khan

THCB Gang, Episode 13

Episode 13 of “The THCB Gang” was on Thursday, June 11th. Watch it below or on our YouTube Channel.

Matthew Holt (@boltyboy)was back on the moderating chair! Joining him were patient advocate Grace Cordovano (@GraceCordovano), patient safety expert Michael Millenson (MLMillenson), policy expert Vince Kuraitis (@VinceKuraitis), MD & hospital system exec Raj Aggarwal (@docaggarwal), data privacy expert Deven McGraw (@healthprivacy) and fierce journalist & data rights activist Casey Quinlan (@MightyCasey). This was a doozy, and the conversation ranged from what it’s like re-opening at a big academic medical center to data flow and public health in Taiwan to statues of Confederate losers in Richmond. Not to mention what will happen in the impeding second wave.

If you’d rather listen, the “audio only” version is preserved as a weekly podcast available on our iTunes & Spotify channels — Zoya Khan

Call for Applications: Bayer G4A Partnerships 2020

SPONSORED POST

By BAYER G4A

Digital health is changing the world

From chronic disease management to prevention, G4A’s goal is to empower people with the tools and access they need to take control of their health. G4A does this through fostering a diverse and vibrant ecosystem of digital health partners to support their growth and impact.

On April 20th, G4A launched its 2020 Partnership Program with an open call for applications. The aim of the Partnerships Program is to work with companies across the globe on healthcare’s toughest challenges and innovate together towards a future of integrated care. This year G4A is seeking to collaborate with companies that are making an impact in the following areas:

  • Cardiometabolic and Renal Diseases – Heart health requires a 360-approach that encompasses lifestyle behaviors, remote monitoring, biomarker review, risk stratification, and more
  • Oncology – Utilizing targeted therapies and patient performance technologies can identify patients efficiently and slow disease progression
  • Women’s Health – Novel approaches are needed to manage gynecological conditions such as PCOS and Endometriosis, as well as Menopause, and provide answers to the unique needs of women’s health
  • Pharmacovigilance – The opportunity for innovation in drug safety is huge, specifically as it relates to adverse event detection
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THCB Gang, Episode 11

Episode 11 of “The THCB Gang” was live-streamed on Thursday, May 27th and you can see it again below

Joining me were three regulars, patient safety expert Michael Millenson (MLMillenson), writer Kim Bellard (@kimbbellard), health futurist Ian Morrison (@seccurve), and two new guests: digital health investment banker Steven Wardell (@StevenWardell) and MD turned physician leadership coach Maggi Cary (@MargaretCaryMD)! The conversation was heavy on telemedicine and value based care, and their impact on the stock-market, the economy and the health care system–all in a week when we went over 100,000 deaths from COVID-19.

If you’d rather listen, the “audio only” version is preserved as a weekly podcast available on our iTunes & Spotify channels — Matthew Holt

THCB Gang, Episode 10 LIVE 1PM PT/4 PM ET 5/21

Episode 10 of “The THCB Gang” was live-streamed on Thursday, May 21th

Joining me were regulars: writer Kim Bellard (@kimbbellard), policy expert Vince Kuraitis (@VinceKuraitis), patient advocate Grace Cordovano (@GraceCordovano), radiologist Saurabh Jha (@RogueRad), employer consultant Brian Klepper (@bklepper1), Deven McGraw (@healthprivacy) and a guest, former ONC Consumer head Lygeia Riccardi, now at Carium Health (@Lygeia)! The conversation moved onto the new normal of telehealth, how much things would change in the future, and what the story with testing and opening up would look like. You can see the video below

If you’d rather listen, the “audio only” version is preserved as a weekly podcast available on our iTunes & Spotify channels — Matthew Holt

THCB Gang: Episode 9

Episode 9 of “The THCB Gang” was live-streamed on Wednesday (instead of our normal Thursday slot) on May 13th at 1pm PT- 4pm ET! Watch it below! Next week we’ll be back to Thursday

Joining me were health “IT” girl Jessica DaMassa (@jessdamassa), health futurist Ian Morrison (@seccurve), health economist Jane Sarasohn-Kahn (@healthythinker), patient safety expert Michael Millenson (MLMillenson), and MD & hospital system exec Rajesh Aggarwal (@docaggarwal). The conversation looked at the likelihod of big picture change, Medicare Advantage expansion, whether the move to remote care is real and sustainable, and at one point got us to war with China!

If you’d rather listen, the “audio only” version is preserved as a weekly podcast available on our iTunes & Spotify channels from Thursday onwards— Matthew Holt

How to Manage Patients in Quarantine, Smartly

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By MATTHEW HOLT

Smart Quarantine as the next step to combat COVID-19

As the nation and the world grapple with the impact of the COVID-19 pandemic, there is growing consensus among experts that we need a sustainable system of specific lockdowns, social distancing, and extreme resource provision in terms of labor, ventilators and PPE to arm hospitals and health providers as they deal with the onslaught of patients. Even while some American states start to slowly open up, we need a system that can manage COVID-19 over the coming months and years–especially if this Fall brings a second wave.

Writing in the NY Times on April 7, Harvey Fineberg and colleagues summarized an as yet overlooked issue. There are many patients who may or do have COVID-19, but are not sick enough to need hospital care, or who have been discharged from hospitals. We need to keep these patients away from hospitals but if they shelter in place in their household there is a high risk they will infect their families or housemates. This likelihood is even higher if they are homeless,  incarcerated, or living in other group arrangements.

Instead of sheltering in place at home Fineberg and colleagues suggest those patients enter “smart quarantine” in temporary isolated accommodation, such as hotels or college dormitories, where they can be looked after by medical teams and tested semi-regularly. But whether they are at home or in temporary accommodation, leaving those patients with minimal support to be tested at the end of 14 days is not enough. A significant proportion of them will develop COVID-19 and some of those are going to be admitted to hospital. In addition several patients have been discharged from hospital, but still need to be monitored. We are going to need to be able to closely monitor a significant number of people even while the majority of them will need relatively limited amounts of care.

The good news is that we have had a couple of decades of development of the technologies and services required to both care for and monitor these patients, while keeping the main resources such as ventilators for those in hospitals. Pulling together available technologies and services, we will be able to quickly and accurately manage these patients, ensure their best outcomes, and spare scarce hospital resources. There are seven main components of this process, which I am calling “smart care in quarantine.”

The Process

Upon either a positive test for COVID-19 or a suspicion of those symptoms awaiting testing, patients can be admitted to isolation at home or in, say, empty hotels. 

1. Monitoring equipment. Patients can be given FDA regulated monitoring devices which will work using bluetooth and WiFi (or 4G cellular). The main monitoring tools required are:

  • Pulse Oximeters
  • Thermometers
  • Stethoscopes (with acoustic recording)
  • Weight Scales
  • Video & audio via iPad, phone or computer
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