In order to celebrate the next decade (although the internet is confused whether its actually the end of the decade…), we’re taking a step back and listing our picks for the 9 most influential healthcare companies of the 2010s. If your company is left off, there’s always next decade… But honestly, we tried our best to compile a unique listing that spanned the gamut of redefining healthcare for a variety of good and bad reasons. Bon appétit!
1. Epic Systems Corporation
The center of the U.S. electronic medical record (EMR) universe resides in Verona, Wisconsin. Population of 13,166. The privately held company created by Judith “Judy” Faulkner in 1979 holds 28% of the 5,447 total hospital market in America. Drill down into hospitals with over 500-beds and Epic reigns supreme with 58% share. Thanks to the Office of the National Coordinator for Health Information Technology (ONC) and movement away from paper records (Meaningful Use), Epic has amassed annualized revenue of $2.7 billion. That was enough to hire the architects of Disneyland to design their Google-like Midwestern campus. The other amazing fact is that Epic has grown an average of 14% per year, despite never raising venture capital or using M&A to acquire smaller companies.
Over the years, Epic has been criticized for being expensive, non-interoperable with other EMR vendors, and the partial cause for physician burnout. Expensive is probably an understatement. For example, Partners HealthCare (to be renamed Mass General Brigham) alone spent $1.2 billion to install Epic, which included hiring 600 employees and consultants just to build and implement the system and onboard staff. With many across healthcare calling for medical record portability that actually works (unlike health information exchanges), you best believe America’s 3rd richest woman will have ideas how the country moves forward with digital medical records.
It used to be that patients would have to go see a doctor to get lab tests ordered to check their cholesterol or metabolism, but now, thanks to at-home testing companies like Everlywell, those tests (and 30 others, including STI tests) can be ordered online or picked up at some big box retailers. We chatted with Dr. Frank Ong, Everlywell’s Chief Medical and Scientific Officer, about what it means to put patients in charge of ordering their own lab work — and combing through their own testing results — vis a vie the Everlywell platform. As consumers demand more control over their healthcare dollar and the experience it buys, is there a point where patients risk getting in over their heads? How have doctors been responding to patients who come in armed with their own lab results? We check in on how at-home testing kits are ‘testing’ the reaches of patient-led care.
Today on THCB Spotlights, Matthew interviews Carolyn Magill, CEO of Aetion. Aetion is a real world evidence analytics company working to accelerate time to regulatory grade insights. In fact, Aetion recently did a study with Horizon Blue Cross Blue Shield of New Jersey where they analyzed the type 2 diabetes population, identified a subset of patients who should be on a different class of drugs—which are more expensive—that would improve health outcomes and bring down the total cost of care, saving about $5 million for Horizon. Find out where the data and intelligence for this platform came from, and how this female CEO works to empower women both internally and externally.
How can helping a cartoon fox also help your mental health? Enter Socks the Fox and Sinasprite, a world exploration game that teaches players evidence-based treatments and coping methods for anxiety and depression. How does it work? Litesprite CEO Swatee Surve explains that players are charged with helping Socks the Fox become a Zen master (of course) and, in doing so, work through a series of challenges and exercises that teach coping mechanisms that range from journaling to diaphragmatic breathing. With its super-sticky storyline (Socks is adorable) the clinically validated game offers a new, upbeat way to bring tech and game theory into the way we treat mental health disorders.
Filmed at Bayer G4A Signing Day in Berlin, Germany, October 2019.
Today, I’m closing out the year of Health in 2 Point 00 from the ski slopes. In Episode 103, Jess asks me about the ACA ruling that the individual mandate is unconstitutional, whether Sutter Health got what they deserved after the $575 million settlement, health insurer Bright Health raising a huge $635 million round, and a rumor about a $250M Softbank investment coming next week. Wishing you all a very happy 2020! —Matthew Holt
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.