As we near the end of the year, rather than reflect on fond memories of 2019 (for which I’m grateful for my family, friends, readers, and Twitter followers), I’ve already started thinking about 2020. If you ever wanted to get inside my brain for 5-10 minutes (scary proposition I know) related to healthcare startups and innovation, here are some areas or trends that I will be following in the new decade.
1. Medicare-For-All Will Be Everywhere
As we move closer to the Democratic Presidential caucus, some of the top-polling candidates (Sen. Elizabeth Warren, Sen. Bernie Sanders, Andrew Yang) are endorsing a Medicare-For-All (M4A) platform. If one of those candidates receive the nomination for the 2020 Presidential election, private v. public health insurance will be front and center. It will dominate all major news. I’m watching how the weight of the entire healthcare industry will politically respond to a national Medicare-4-All Presidential debate (both publicly and privately).
2. Updating Physician Anti-Trust Rules To Support Value-Based Care
In October, the U.S. Department of Health and Human Services (HHS) released their long-anticipated proposed rules to update the anti-kickback and physician referral regulations, to help spur greater provider participation in value-based care arrangements. Any changes once finalized would affect the Civil Monetary Penalties Law, the Federal Anti-Kickback Statute, and the Physician Self-Referral Law (“Stark Law”). After comments are received, I’m watching how the healthcare machine helps craft these new regulations that some would say, stifles innovation in provider care delivery.
The question of how much time I spend in front of the screen has pestered me professionally and personally.
A recent topic of conversation among parents at my children’s preschool has been how much screen time my toddlers’ brain can handle. It was spurred on by a study in JAMA Pediatrics that evaluated the association between screen time and brain structure in toddlers. The study reported that those children who spent more time with electronic devices had lower measures of organization in brain pathways involved in language and reading.
As a neurologist, these findings worry me, for my children and for myself. I wonder if I’m changing the structure of my brain for the worse as a result of prolonged time spent in front of a computer completing medical documentation. I think that, without the move to electronic medical records, I might be in better stead — in more ways than one. Not only is using them potentially affecting my brain, they pose a danger to my patients, too, in that they threaten their privacy.
As any practicing physician can tell you, electronic medical records represent a Pyrrhic victory of sorts. They present a tangible benefit in that medical documentation is now legible and information from different institutions can be obtained with the click of a button — compared to the method of decades past, in which a doctor hand-wrote notes in a paper chart — but there’s also a downside.
It’s the ‘holy grail’ of advice for health tech startups. BlueCross BlueShield of North Carolina’s Chief Strategy & Innovation Officer, Bryony Winn, tells what it takes for digital health and digital therapeutics startups to gain partnership agreements, reimbursement, and possible investment from health plans. How do you figure out how to “align incentives” in a way that perks up a payer’s ears? Bryony gives us some VERY FRANK advice about how startups can bring innovation to BCBS of North Carolina, other Blues plans, or their VC funds (which in this case is Echo Health Ventures where BCBS North Carolina partners with Cambia Health Solutions.) To play the game, you have to know the players. Tune in for more.
The American Medical Association (AMA) announced Health 2047, its accelerator and investment fund in 2018. A year later, Andrew Elkind and Stas Sokolin, both Principals at the fund, stop by to get us up-to-speed on the progress the AMA has made so far with its $45 million accelerator fund and $30 million investment fund. What kinds of health tech startups are piquing the attention of this physician-led fund? Get the details behind the Health 2047 investment thesis here!
Today on THCB Spotlights, Matthew chats with Omri Shor, the CEO and Co-founder of Medisafe. Way back in 2014, Medisafe took home the gold at Health 2.0, winning first place at Traction. Since then, their consumer medication management tool has evolved quite a bit. While the app is available for patients with over 6 million users today, they also have folks across the health care continuum partnering with Medisafe to manage the medication journey for their patients. Matthew picks Omri’s brain on how things will continue to evolve, what he’s learned to help people in health care think about the problem of medication management, and how Medisafe fits in with the numerous medication management and chronic disease management tools out there.
Neuroscience startup, NeuroTracker, has a virtual training tool with a proven ability to help improve “cognitive fitness.” Jean Castonguay, co-founder, board member and Head of Global Strategic Partnerships at NeuroTracker, explains the science and clinical validation behind their tech and drops some big name users in the process — Manchester United, German and French soccer teams, US special forces, as well as some of the world’s leading sports concussion rehabilitation clinics. What sets the startup apart from other companies in the mental performance space? How have they shored up their science in the face of Lumosity’s Federal Trade Commission suit against false claims about brain health outcomes? It shook up the industry, and NeuroTracker actually feels it strengthened their business and their value proposition.
Filmed at Bayer G4A Signing Day in Berlin, Germany, October 2019.
Today on Health in 2 Point 00, Jess is in Las Vegas while I’m all the way in Tokyo for Health 2.0 Japan. In Episode 102, Proteus Digital (finally) announces that they’re running out of money. Does this put the whole category of digital therapeutics at risk? In other news, Seema Verma’s jewelry was stolen and she wants taxpayers to pay her back! How is she going to survive this? And find out what’s going on in Tokyo at Health 2.0 Japan—a whopping 50 startups pitched in a contest yesterday and we’re really seeing the coming of age for this market. —Matthew Holt
AI in medical imaging entered the consciousness of radiologists just a few years ago, notably peaking in 2016 when Geoffrey Hinton declared radiologists’ time was up, swiftly followed by the first AI startups booking exhibiting booths at RSNA. Three years on, the sheer number and scale of AI-focussed offerings has gathered significant pace, so much so that this year a decision was made by the RSNA organising committee to move the ever-growing AI showcase to a new space located in the lower level of the North Hall. In some ways it made sense to offer a larger, dedicated show hall to this expanding field, and in others, not so much. With so many startups, wiggle room for booths was always going to be an issue, however integration of AI into the workflow was supposed to be a key theme this year, made distinctly futile by this purposeful and needless segregation.
By moving the location, the show hall for AI startups was made more difficult to find, with many vendors verbalising how their natural booth footfall was not as substantial as last year when AI was upstairs next to the big-boy OEM players. One witty critic quipped that the only way to find it was to ‘follow the smell of burning VC money, down to the basement’. Indeed, at a conference where the average step count for the week can easily hit 30 miles or over, adding in an extra few minutes walk may well have put some of the less fleet-of-foot off. Several startup CEOs told us that the clientele arriving at their booths were the dedicated few, firming up existing deals, rather than new potential customers seeking a glimpse of a utopian future. At a time when startups are desperate for traction, this could have a disastrous knock-on effect on this as-yet nascent industry.
It wasn’t just the added distance that caused concern, however. By placing the entire startup ecosystem in an underground bunker there was an overwhelming feeling that the RSNA conference had somehow buried the AI startups alive in an open grave. There were certainly a couple of tombstones on the show floor — wide open gaps where larger booths should have been, scaled back by companies double-checking their diminishing VC-funded runway. Zombie copycat booths from South Korea and China had also appeared, and to top it off, the very first booth you came across was none other than Deep Radiology, a company so ineptly marketed and indescribably mysterious, that entering the show hall felt like you’d entered some sort of twilight zone for AI, rather than the sparky, buzzing and upbeat showcase it was last year. It should now be clear to everyone who attended that Gartner’s hype curve has well and truly been swung, and we are swiftly heading into deep disillusionment.