There’s a new health innovation law firm in town! Rebecca Gwilt & Kaitlyn O’Connor have started Elevare Law to help health tech companies. We spent a little time talking about the new firm and who it’s going to work with, and a lot about the different legal and regulatory challenges facing digital health companies. Deep dives into the regs around RPM, RTM & more, and also a lot about what we might expect from the FDA and the rest of the chaos in the new Administration. Plus a little about how AI helps lawyers be more efficient and a lot about how AI may or may not be influenced by health care regulation (TL:DL, it’s going to be slow & state by state) –-Matthew Holt
League Connect Digital Summit on May 7
I’m thrilled to be working with League and I’ll be MC-ing health care’s must-attend virtual CX event, League Connect Digital Summit on May 7.
An immersive day of inspiration, insights, and incredible speakers is headlined by Moneyball & Big Short Best-Selling Author, Michael Lewis and @HighmarkHealth CEO, @DavidHolmberg, as well as many more.
More than just theory, at the Summit you’ll get actionable strategies and everything you need to drive health care CX forward. – Matthew Holt
Register today to save your spot
The Life365 Demo
Kent Dicks, CEO, and Kendall Paulsen, Telehealth Solutions lead, at Life 365 showed me their comprehensive set of tools and services for remote patient monitoring, or what I call the “continuous clinic”. Kent did this with MedApps, later acquired by Alere. But at Life 365 he’s building a new approach to getting the tools and platforms easy to use for patients, and also getting that collected data ready for AI systems to monitor patients and enable more immediate care. And Kent & Kendall not only talk about it but they show a deep-water demo with both devices and dashboards of both the monitoring and drug adherence devices. A glimpse into where health care ought to be and hopefully is going!–Matthew Holt
Tanay Tandon, Commure
Tanay Tandon is CEO of Commure, which is essentially a startup conglomerate which includes the original Commure, Tanay’s company Athelas, ambient scribe Augmedix, the Strongline staff safety product, Memora Health’s workflows and more. HCA, the big for-profit chain, is one of the biggest customers and an investor in Commure. I grabbed Tanay at HIMSS earlier this month to understand what Commure was building and what he thinks co-pilots/auto-pilots can eventually do in the hospital. Tanay’s aiming for a time when the combo of all the products mean doctors don’t have to touch their keyboard. But what does this have to do with the EMR? And what does their major backer, General Catalyst, intend to do with Commure and its other companies? Hopefully after this things are becoming a little clearer!–Matthew Holt
Sword Health, the Hinge Health S1, and me
By MATTHEW HOLT
The big news in the comeback of digital health is that Hinge Health filed its S1 and is looking to go public soon. I suspect that they’d have preferred to get the IPO done late last year when the AI bubble was expanding rather than deflating, but timing the market is tough! Nonetheless Hinge is almost profitable and at over $350m in revenue at a growth clip of some 75% last year, in terms of a show pony to trot out, it’s about as good as the digital health field has got. The problem is that the last round in 2021 was at a $6bn+ ZIRP-era valuation with Tiger & Coatue paying the idiot price because Teladoc was trading at $15bn market cap then (albeit down from $30bn a year before that!). That is, err, no longer the case. There’s a bunch of weirdness in the IPO structure to pay those guys back, but the main point is that the likely valuation will be in the $1.5-2.5bn range.
But there’s another problem. And it’s one I have some personal experience with. I must stress that my experience is not with Hinge.
As it happens I did a video interview at Hinge’s booth at HLTH in 2022 when my back collapsed, and I got to try out their Enso device (it helped a bit but not much after the first few minutes using it). I discussed the process with PT Lori Walter and got a quick interview with President Jim Pursely (an old Livongo hand BTW).
But this past summer I used the services of their main competitor, Sword Health. As far as I can tell the two companies are very similar in their process and services, both with self-service exercises delivered via the smartphone and both moving from remote care from therapists to AI therapists. But I could be wrong. So for this article I am extrapolating from one company to the other to look at the field of MSK digital services overall.
In total, I thought the Sword experience was good as a standalone program. But the problem was that it was standalone.
My problem was with my left knee. I had a lot of knee surgery in 2002-4 as the result of snowboarding into a tree (Hint. If you snowboard, try to make sure you and the board go the same side of the tree). More than 20 years later in 2024 I managed somehow to induce terrible pain in the knee running for a ferry in January, a train in May and an airport shuttle in June. (It seems that travel and my knee disagree). This didn’t stop me strapping up, taking drugs and snowboarding in the 2024 winter season but it certainly slowed me down a whole lot. Around this time there were many reports of people much younger than me getting their knees replaced.
So I thought I should do something about it. My Blue Shield of California plan offers Solera which is an agglomeration marketplace of digital health apps and services. Sword Health is their PT app, so I selected it, enrolled and off I went.
Note that there was zero integration with my PCP, any orthopedic surgeon, any clinical person at the health plan or basically anyone. This was purely patient-driven and managed.
With Sword I had a 15 min intro call on June 6 – then was sent a box containing a generic tablet and six sensors which fit into straps that you attach to your lower and upper legs and arms.
There was a conversation in the app with a PT and then it spat out a selection of exercises for me. The example below is my second exercise session. If you want to check out more, I have put more of the exercise and the chat with the PT here.
Sword suggested, instead of regular 45-60 minute physical PT sessions, that I did four 15 minutes sessions a week. Essentially one every other day.
The end result was that I did eight sessions between June 12 & June 30.
Continue reading…Linus Health–In-depth demo of cognitive health tool
The decline in cognitive health, especially that leading to Alzheimer’s and other brain diseases, is one of the most feared conditions by patients and their families. It’s also one of the most expensive. But if we can predict it early there are things we can do to prevent or ameliorate it. The issue has been finding an easy and comprehensive way to monitor it as part of primary care. The team at Linus Health has been building a diagnostic solution for exactly that and claims that it’s now the right time to roll it out as part of general primary care. CEO David Bates, John Showalter, Chief Product Officer (a primary care doc) and Alvaro Pascual Leone, a neurologist and Chief Medical Officer, took me through an extensive end to end demo. This is a long and fascinating look at the state of play in neurology diagnosis, and discussion about what the future of brain health looks like. Matthew Holt
Stuart Blitz, Hone Health
Stuart Blitz is COO and founder of Hone Health. He comes from a long career in health tech, notably at diabetes device pioneer Agamatrix. Stuart’s been working on his aggressive social media career, but in the background he co-founded Hone Health in the male health online telehealth/pharmacy space in March 2020 (great timing!). It’s now raised real money ($33m last month), has expanded to the other half of the population (women, too!), and is finding a space for itself in the cash-pay space where HIMS, Roman et al are well known. We had a great conversation about how that space is playing out and what Stuart thinks will work there, and what it means for health care overall–Matthew Holt
Natalie Schneider, Fort Health
Natalie Schneider is CEO of Fort Health, a relatively new entrant into the children’s mental health market. Fort Health’s modus operandi is to partner with (i.e. market via) pediatricians to get them to refer patients. They are delivering integrated care and something called collaborative care…a newer model that has more frequent and shorter interventions and is more affordable. Natalie is concerned that only 20% of current psychiatric care for pediatric patients is currently evidenced-based and measured. Part of their secret sauce is through a partnership with the Child Mind Institute, and they also deliver a series of educational offerings for parents. Fort Health has raised $16m & they’re pursuing a market by market expansion working with those pediatricians starting with New Jersey–Matthew Holt
What would a rational DOG(gi)E do(o)?
By MATTHEW HOLT
DOGE, or Doggie as Kara Swisher has been calling it, has gone from being a meme about Shiba Inus to a crypto scam to a group tearing the Federal government apart.So I thought I would use the title of this piece to make a joke. Like Musk’s humor it’s puerile and not funny. What’s also not funny is what Musk’s team has done to small government agencies, like USAID & CFPB that really help people, not to mention the irrational firing of thousands of government employees that appear to be screwing up the NIH, the National Parks, the FAA and much more. But it’s all got me thinking, what in health care should an effort to quickly rationalize government spending do?
Now I’m not proposing that there’s anything OK with the way Musk and his team have been blundering around the Federal government, telling lies about what it does and indiscriminately firing the people who have the most important responsibilities and then desperately trying to get them to come back. This has been pure ignorance theater, and it would be hilarious if it wasn’t so damaging. Equally importantly the places DOG(gi)E has started are stupid because they don’t spend much money. But the government spends a lot on health care –between two and three trillion dollars, depending on how you count it.
So if you wanted to save some money and potentially change the system, what would you do? First you’d take a deep breath and get some real data, and improve your understanding about what is actually happening. There are some areas in health care where the issues are well understood and the data is clear and there are others where it’s less obvious.
Let’s start with a relatively small one–spending on Federal Employees health benefits. Chris Deacon’s Linkedin posts are a constant source of fun and games, and she has been highlighting screwups in the FEHBP administration for a long time. Essentially the government via the OPM pays lots of different insurance companies to manage Federal employees’ health care. There is very poor oversight of what happens in those programs and when the OPM’s OIG points that out, not much happens. The plans (including Horizon Blues in NJ and BCBSNC and many others) have been caught being sloppy or fraudulent but not much has happened. All DOG(gi)E needs to do is read the report on the audits, or look at what GOA said about $1bn being spent on ineligible members in 2022 and apply their recommendations.
Next let’s get into something that requires a little more investigation. In America we buy (and sell) drugs in a mind-bogglingly complex way.
Continue reading…Lynda Brown-Ganzert, RxPx
Lynda Brown-Ganzert is CEO of RxPx. The company is the 2022 merger of the company she founded, Curatio, which was a support system for rare disease patients, with RxMx, a complementary service that helped clinicians manage patients on treatment or clinical trials. Lynda says that somehow I inspired the merger! (Although I don’t remember it, nor did she send me my 10%!). Now the company is supporting rare disease patients, funded primarily by pharma, across the globe. Lynda gives a full demo of both the clinician and patient experience–coordinating meds, labs, imaging, appointments, content, symptoms, patient reported outcomes, peer and coach support, and more. And she discusses how a great PE takeover works. (Not all of them are!)–Matthew Holt
