The Robert Wood Johnson Foundation (RWJF) has partnered with Catalyst @ Health 2.0 to launch two innovation challenges on Social Determinants of Health (SDoH) and Home & Community Based Care. As a national leader in building a culture of health, RWJF is inspiring and identifying novel digital solutions to tackle health through an unconventional lens.
Health starts with where we live. As noted in Healthy People 2020 social determinants
of health are, “conditions in the environments in which people are born, live,
learn, work, play, worship, and age… [that] affect a wide range of health
functioning, and quality-of-life outcomes and risks.” For example, children who
live in an unsafe area cannot play outside making it more difficult for them to
have adequate exercise. Differences in SDoH heavily influences communities’
well-being and results in very different opportunities for people to be
Despite our knowledge on SDoH, the current healthcare system utilizes care models that often fail to take into account the social and economic landscape of communities– neglecting factors such as housing, education, food security, income, community resources, transportation and discrimination. Little progress has been made on incorporating SDoH into established health care frameworks. Healthcare providers and patients alike either have limited understanding of SDoH or have limited opportunities to utilize SDoH knowledge. RWJF established the “Social Determinants of Health Innovation Challenge” to find novel digital solutions that can help providers and/or patients connect to health services related to SDoH.
Home and community-based care is also important to enable Americans to live the healthiest lives possible. In-patient and long-term institutional care can be uncomfortable, costly, and inefficient. Digital health solutions in the home and community offer opportunities for care that better suit the patient and their loved ones. For example, innovations such as remote patient monitoring (RPM) have created new care models that allow the providers, caregivers, and patients to manage care where a person is most comfortable. RPM serves as a reminder that technologies in the home and community offer alternatives methods to engage the patient, increase access to care, and receive ongoing care. Therefore, RWJF is launching the “Home & Community-Based Care Challenge,” to encourage developers to create solutions that support the advancement of at-home or community-based health care.
You might not know it yet, but there’s a revolution coming
While digitization has driven innovation across the healthcare sector, the advent of 5G is set to spark a fourth industrial revolution.
3G and 4G networks enabled large-scale change and rapid
modernization. However, 5G delivers what these networks could not: blazing
speeds and ultra-low latencies that permit enormous data transfers between
devices in near-real time. That means that technologies like artificial
intelligence, machine learning and augmented reality will be capable of
transforming the industry as we know it.
Whether it’s strengthening telemedicine connections, implementing new teaching methods at medical school, or connecting large hospitals and clinics, see how 5G-powered technologies will open the door for innovation in healthcare.
Facebook is releasing an EMR? Jim Cramer is going to work at Epic? April Fools! On today’s actual Health in 2 Point 00 Episode 76, Jess asks me about the follow up from Health Datapalooza, which ended with the government saying they will be changing the world and that everyone should join them in their initiative to innovate digital health. AHRQ & CMMI ran digital health challenges, and CMMI will be doing an AI challenge for $1 million for startups in the space. Speaking of the government, Seema Verma was in the news for her PR spending and as I said “Evil Twin Seema” and “Good Seema” are joined at the hip and they should “not screw around on the PR front”. In other news, MountSinai launched a digital health institute to develop advances in artificial intelligence and other emerging health care technologies spaces. Clover Health laid off a ton of people, and according to me, they are starting to get serious because running a Medicare Advantage plan is hard work — Matthew Holt
I’ve worked in enough start ups to know that creating
something from nothing can be hard. It is especially tough when you must create
a market and explain to people that what you’re doing isn’t nearly as heretical
as it may sound. When my friends and I started Subimo in 2000, people wondered
why they’d use our product to learn about hospital performance when (in their
words) all they really needed was to have their doctor to tell them which
hospital they should use. What people eventually realized was that there is
variation in outcomes by hospitals and even by service lines within hospitals.
That’s why the recent spate of articles about the newly
emerging direct-to-consumer companies in health care – the ones that are
condition-specific like HIMS, Ro and Keeps – fascinate me. These are companies
that have leveraged all we know about direct-to-consumer marketing and have identified
an unmet market need. In some respects, they’re not dissimilar from companies
like Simple Contacts or 1.800 Contacts or Visibly – companies that offer a
convenient way for people to get what they need (in this case, good vision). Or
companies that offer behavioral health services directly to consumers.
What do these companies have in common? Aside from a strong marketing
foundation, they have identified a market need that can be met with a new
approach that leverages technology. They are convenient, offer a high level of
customer service and may even be easier to work with than traditional players.
Today on Health in 2 Point 00, Jess and I are at 10th annual Health Datapalooza in Washington D.C.! Jess talks to me about Xealth’s $11 million round to develop out its company, and Change Healthcare is applying for a $100 million IPO. The big takeaways from Health Datapalooza are that many people and companies have integrated data into their systems, but they haven’t been able to gain many actionable insights from it. Also, if you haven’t heard of the complaint Andrea Downing, Fred Trotter, and David Harlow wrote to the FTC concerning the privacy and data that can be downloaded from Facebook’s groups, you better check it out. It details out the concern that Facebook is not protecting the data of patients as anyone can download sensitive data from the groups and use it — Matthew Holt
Today on Health in 2 Point 00, Jess and I are standing on a roof answering health tech questions from the Digital Health Commercialization Panel event in San Francisco. In this episode, Jess asks me about all the money that is being raised or spent in the health tech worlds of Europe and the US. DoctoLib, a company that is like ZocDoc in the US, raised 150 million Euro, which is probably the largest raise for a European company involved in health tech. Meanwhile, in the US, Teledoc also stretches its way into Europe, buying MédecinDirect, which is a telehealth company in France. We also see health tech companies in the employer health space taking home large piles of cash. Cleo, which is a platform entirely run by women serving women’s’ health postpartum, raises 27 million. UniteUs, which is a company focused on improving people’s social determinants of health, raises 30 million, but I still worry about this type of initiative and want to see if there is a market for this type of care and if hospitals are willing to pay for it–Matthew Holt
Google’s Verily has a $1Billion dollar investment fund and a nearly limitless talent pool of data scientists and engineers at the ready. So, how are they planning to invest in a better future for health?
Luba Greenwood, Strategic Business Development & Corporate Ventures
for Verily told me how the tech giant is thinking about the big data
opportunity in healthcare – and, more importantly, what they see as their role
in helping scale it in unprecedented ways.
So, where should other health tech investors place their bets, then?
Luba’s previous successes investing in digital health and health technology
while at Roche (FlatIron, MySugr, etc.) give her a unique perspective on the
‘state-of-play’ in healthcare investment…but has the game changed now that she’s
in another league at Verily? Listen in to find out.
Filmed at the Together.Health Spring Summit at HIMSS 2019 in Orlando,
Florida, February 2019.
Get a glimpse of the future of healthcare by meeting the people who are going to change it. Find more WTF Health interviews here or check out www.wtf.health.
At HIMSS19, the year-old ‘Digital Health Collaborative’ announced its relaunch as ‘Together.Health.’ More than just a feel-good name, the new moniker is indicative of how the organization is literally trying to help the health innovation world ‘get its #%&! together.’
“We’re building a hub-and-spoke model,” says Stephen Konya of the US Office of the National Coordinator for Health IT (ONC).
He and Nick Dougherty of MassChallenge Health Tech are founding co-chairs for Together.Health and the pair have managed to build a roster of more than 40 different partners – including almost every digital health accelerator and incubator in the country. Add into the mix some of the biggest health innovation investors in the biz, the usual healthcare incumbents, and a number of different government organizations and economic development groups with local, regional, and federal reach and one begins to clearly see how Together.Health is filling a void for ‘spokes’ that were definitely missing the connecting power of a ‘hub.’
But, what’s the real value of all this together-ness? According to Konya and Dougherty, faster uptake for innovation in healthcare.
For example, the organization’s first project is the development of a standard Business Associates Agreement (BAA) for startups and health systems to use to streamline the onerous paperwork process required before piloting or deploying new solutions. This is a process that currently takes 9-12 months and varies by health system. Together.Health thinks they can shorten that timeframe to 2-3 months just by getting the right people into the room and agreeing to keep 80% of the questions in the assessment in a standard format. The idea is meant to help prevent startups from ‘running out of runway’ (and their health system champions from simply ‘running away’ in frustration), while everyone waits for the necessary paperwork to make its way through Legal.
The pragmatism doesn’t stop there. Listen in to my interview with Stephen Konya to hear about the two other challenges Together.Health is taking on this year: putting together a common curriculum for health accelerator programs and mapping the US Health Innovation Ecosystem.
Want to get a jump on learning what’s happening in some of those health innovation pockets in the US? I had the opportunity to interview 10 ecosystem leaders at the Together.Health Spring Summit at HIMSS and the variety of conversations (and concerns) they share is pretty remarkable.
You can check out the whole Together.Health playlist here, or wait for a few of my favs (and their dishy gossip!) to make an appearance here on THCB over the next week.
Get a glimpse of the future of healthcare by meeting the people who are going to change it. Find more WTF Health interviews here or check out www.wtf.health.
The Theory of Disruptive Innovation, defined by Harvard Business School (HBS) Professor Clayton Christensen in 1997, explains the process by which simple, convenient and affordable solutions become the norm in industries historically characterized by expensive and complicated ones. Examples of disruption include TurboTax tax preparation software, which disrupted accountants, and Netflix, which disrupted retail video stores and is now giving Hollywood film studios a serious run for their money.
According to Christensen, a critical condition of disruption (but not the only one) is an “enabling technology”—an invention or innovation that makes a product or service (or “solution”) more accessible to a wider population in terms of cost, and ease of acquisition and/or use. For instance, innovations making equipment for dialysis cheaper and simpler helped make it possible to administer the treatment in neighborhood clinics, rather than in centralized hospitals, thus disrupting hospital’s share of the dialysis business.
However in an interview in Working Knowledge, the online newsletter highlighting HBS research, marketing Professor Thales Teixeira asserts that it’s not innovative technology that disrupts a market. Rather, it’s companies recognizing and addressing emerging customer needs sooner than incumbents. “…In many industries, both the disrupter and the disrupted had similar technologies and similar amounts of technology,” he points out. “The common pattern was that the majority of customers in those markets had changing needs and wants, and their behavior was changing.”
Well that’s interesting. Does Teixeira’s view on the role of technology in disruption, at least as summarized in the interview, contradict Christensen’s groundbreaking work? Not at all. In fact, Teixeira effectively reinforces an oft-overlooked nuance of the latter: disruption is not just about the innovative solution, no matter how novel, dazzling or slick the technology it may employ. It’s about using the solution to do a job for consumers that makers of incumbent solutions are ignoring—usually in a cheaper, simpler and more accessible way; and maximizing likelihood of success by aligning the innovator’s whole business model toward that end.
The Office of the National Coordinator (ONC) and the Centers for Medicare and Medicaid (CMS) have published proposed final rules on interoperability and data blocking as part of implementing the 21st Century Cures act. In this series we will explore the ideas behind the rules, why they are necessary and the expected impact. Given that these are complex, controversial topics, and open to interpretation, we invite readers to respond with their own ideas, corrections, and opinions.
Health IT 1.0, the basic digitalization of health care, succeeded in getting health care to stop using pens and start using keyboards. Now, Health IT 2.0 is emerging and will build on this foundation by providing better, more diverse applications. Health care is following the example set by the rest of the modern digital economy and starting to leverage existing monolithic applications like electronic health records (EHRs) to create platforms that support a robust application ecosystem. Think “App Store” for healthcare and you can see where we are headed.
This is why interoperability and data blocking are two of the biggest issues in health IT today. Interoperability – the ability of applications to connect to the health IT ecosystem, exchange data and collaborate – is a key driver of the pace and breadth of innovation. Free flowing, rich clinical data sets are essential to building powerful, user-friendly applications. Making it easy to install or switch applications reduces the cost of deployment and fosters healthy competition. Conversely, when data exchange is restricted (data blocking) or integration is difficult, innovation is stifled.
Given the importance of health IT in enabling the larger transformation of our health system, the stakes could hardly be higher. Congress recognized this when it passed the 21st Century Cures Act in 2016. Title IV of the act contains specific provisions designed to “advance interoperability and support the access, exchange, and use of electronic health information; and address occurrences of information blocking”. In February 2019, ONC and CMS simultaneously published proposed rules to implement these provisions.