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Come Together.Health, Right Now…Over Me

By JESSICA DaMASSA, 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

Learning from CVS – When is telemedicine disruptive, and when is it just…cool technology?

By REBECCA FOGG Rebecca Fogg

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.

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Interoperability and Data Blocking | Part 1: Fostering Innovation

By DAVE LEVIN MD 

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.

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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.

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Innovation Amidst the Crisis: Health IT and the Opioid Abuse Epidemic | Part 4 – Resource Allocation and Access

By COLIN KONSCHAK, FACHE and DAVE LEVIN, MD 

Dave Levin

Colin Konschak

The opioid crisis in the United States is having a devastating impact on individuals, their families, and the health care industry. This multi-part series will focus on the role technology can play in addressing this crisis. Part one of the series proposed a strategic framework for evaluating and pursuing technical solutions.

A Framework for Innovation

In part one of our series, we declared the opioid crisis an “All Hands-On Deck” moment and made the case that health IT (HIT) has a lot to offer. Given the many different possibilities, having a method for organizing and prioritizing potential IT innovations is an important starting point. We have proposed a framework that groups opportunities based on an abstract view of five types of functionality. In this article, with an assist from Dr. Marv Seppala, Chief Medical Officer at the Hazelden-Betty Ford Foundation and Dr. Krista Dobbie, Palliative Care physician at the Cleveland Clinic, we will explore allocation of resources and access to care and the role that technology can play.

Resource Allocation and Access for Opioid Management

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Innovation Amidst the Crisis: Health IT and the Opioid Abuse Epidemic | Part 3 – Clinical Decision Support

By COLIN KONSCHAK, FACHE and DAVE LEVIN, MD

Dave Levin

Colin Konschak

The opioid crisis in the United States is having a devastating impact on individuals, their families, and the health care industry. This multi-part series will focus on the role technology can play in addressing this crisis. Part one of the series proposed a strategic framework for evaluating and pursuing technical solutions.

A Framework for Innovation

As noted in part one of our series, we believe the opioid crisis is an “All Hands-On Deck” moment and health IT (HIT) has a lot to offer. Given the many different possibilities, having a method for organizing and prioritizing potential IT innovations is an important starting point. We have proposed a framework that groups opportunities based on an abstract view of five types of functionality. In this article we will explore the role of technologies that provide clinical decision support.

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Innovation Amidst Crisis: Health IT and the Opioid Abuse Epidemic | Part 2 – Fostering Situational Awareness

By COLIN KONSCHAK, FACHE and DAVE LEVIN, MD

Dave Levin

Colin Konschak

The opioid crisis in the United States is having a devastating impact on individuals, their families, and the health care industry. This multi-part series will focus on the role technology can play in addressing this crisis. Part one of the series proposed a strategic framework for evaluating and pursuing technical solutions. 

A Framework for Innovation

Deaths from drug overdoses in the United States jumped nearly 10 percent last year, according to recent estimates by the Centers for Disease Control. One major reason for the increase: more Americans are misusing opioids.

Health IT (HIT) can play a pivotal role in addressing the opioid-abuse epidemic. To maximize impact, however, we believe it’s essential to organize and prioritize IT innovations and approaches. In part one of this series, we proposed a conceptual framework that sorts opportunities based on five types of functionality. In this article, we will explore one of these categories: technologies that enhance situational awareness.

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Innovation Amidst the Crisis: Health IT and the Opioid Abuse Epidemic | Part 1 – A Strategic Framework

Colin Konschak

Dave Levin

By COLIN KONSCHAK, FACHE and DAVE LEVIN, MD

The opioid crisis in the United States is having a devastating impact on individuals, their families, and the health care industry. This multi-part series will focus on the role technology can play in addressing this crisis. In this article, we propose a strategic framework for evaluating and pursuing technical solutions. Future articles will explore specific areas and solutions within this framework.

A Full-Blown Crisis

One of the authors recently had the opportunity to participate in a multi-stakeholder workshop in Cleveland, OH dedicated to finding new, collaborative approaches to addressing the nation’s opioid abuse epidemic. While Ohio might be considered ground zero for this epidemic, the evidence is clear that this is a national crisis and it is getting worse. The numbers are frightening, especially the 2016 estimate that 2.1 million people misused opioids for the first time.

Given the statistics, it is likely that many of you have been personally touched by the epidemic.

In our experience, successful improvement efforts in health care almost always address the role of people, process and technology. Strategic innovations aimed at the opioid abuse crisis should account for all three of these in a holistic manner. Innovation should be pursued as a series of practical experiments that address current gaps, result in near-term improvement, provide insights for future tests of change, and lead to a set of sustainable and scalable solutions that will be essential to ensuring long-term success in addressing this enormous problem.

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AHA’s FutureScan Publication Available Now

Out this week is the AHA (or more precisely their SHSMD division’s) Futurescan publication. This year it’s edited by futurist Ian Morrison @seccurve and it features a bevvy of forecasting articles including one called “Flipping the Stack: Can New Technology Drive Health Care’s Future?” by Indu Subaiya and Matthew Holt (i.e. me)

To take a look at the listing and perhaps even buy a PDF or hard copy (yes, it’s not free, remember that whole capitalism thing, but it’s the cheapest thing you’ll ever get from a hospital!) follow this link  — Matthew Holt

 

Despite Youth On Farm, Abbott Ventures Chief Avoids Spreading Manure

By MICHAEL MILLENSON Michael Millenson

Abbott Ventures chief Evan Norton may have spent part of his youth on a farm, but there’s no manure in his manner when speaking of the medical device and diagnostics market landscape. The key, he says, is to avoid being blindsided by the transformational power of digital data.

“We’ve been competing against Medtronic and J&J, so that has the risk of us being disintermediated by other players that come into the market,” Norton told attendees at MedCity Invest, a meeting focused on health care entrepreneurs. “Physicians are coming to us and asking for access to data for decisions, and they don’t care who the manufacturer [of the device] is. Are we enabling data creation?”

Abbott, said Norton, wrestles with whether they are simply data creators or want to get paid for providing algorithmic guidance on how the data is used. (Full disclosure: I own Abbott shares.) Other panelists agreed making sense of the digital data deluge remains the central business challenge.

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Google Is Quietly Infiltrating Medicine — But What Rules Will It Play By?

By MICHAEL L. MILLENSON Michael Millenson

With nearly 80 percent of internet users searching online for health-related information, it’s no wonder the catchphrase “Dr. Google” has caught on, to the delight of many searchers and the dismay of many real doctors.

What’s received little attention from physicians or the public is the company’s quiet metamorphosis into a powerhouse focused on the actual practice of medicine.

If “data is the new oil,” as the internet meme has it, Google and its Big Tech brethren could become the new OPEC. Search is only the start for Google and its parent company, Alphabet. Their involvement in health care can continue through a doctor’s diagnosis and even into monitoring a patient’s chronic condition for, essentially, forever. (From here on, I’ll use the term Google to include the confusing intertwining of Google and Alphabet units.)

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