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Ensuring that the 21st Century Cures Act Health IT Provisions Promotes Interoperability and Data Exchange

By KENNETH D. MANDL, MD; DAN GOTTLIEB;
JOSH C. MANDEL, MD

Josh Mandel

Kenneth Mandl

Dan Gottlieb

The opportunity has never been greater to, at long last, develop a flourishing health information economy based on apps which have full access to health system data–for both patients and populations–and liquid data that travels to where it is needed for care, management and population and public health. A provision in the 21st Century Cures Act could transform how patients and providers use health information technology. The 2016 law requires that certified health information technology products have an application programming interface (API) that allows health information to be accessed, exchanged, and used “without special effort” and that provides “access to all data elements of a patient’s electronic health record to the extent permissible under applicable privacy laws.”

After nearly two years of regulatory work, an important rule on this issue is now pending at the Office of Management and Budget (OMB), typically a late stop before a proposed rule is issued for public comment. It is our hope that this rule will contain provisions to create capabilities for patients to obtain complete copies of their EHR data and for providers and patients to easily integrate apps (web, iOS and Android) with EHRs and other clinical systems.

Modern software systems use APIs to interact with each other and exchange data. APIs are fundamental to software made familiar to all consumers by Google, Apple, Microsoft, Facebook, and Amazon. APIs could also offer turnkey access to population health data in a standard format, and interoperable approaches to exchange and aggregate data across sites of care.

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10 Houses, 2 Days, 1 City SERENDIPITY Returns to SF and We’re Joining In!

By ANNE COCQUYT

On October 26-27 SERENDIPITY is coming back to San Francisco with an opportunity-packed, two-day personal and professional development conference. Hosted by the digital networking platform GUILD, this conference is not your average conference.  With 40 half-day sessions, curated networking meetings, family-style dinners, and an opportunity-filled cocktail reception, it is uniting more than 500 women across experience and industries.

There’s magic to be had and we want you to join us! We’ll be sponsoring the Women’s Health House over the two days where speakers like Laura Kyriazis, Nimisha Gandhi, Jessica Da Massa, Zoya Khan, Medell Briggs, Meghan Conroy, and Lauren Weinger will empower women of all ages, across all industries to build their network and speak about topics that are not usually on an agenda at a tech conference. They are hosting panels on self-care, family planning, FemTech, public health, menopause, and kegel exercises.

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Health in 2 Point 00 Episode 53

Where is Matthew Holt reporting from today? He is at the Novartis Biome Launch Event! And that’s not all, we have some special guest stars for you: Unity Stoakes from StartUpHealth and Zoya Khan from THCB & SMACK.health! Join Jessica Da Massa, as she asks Matthew about what the Novartis’s Biome Event is, updates from StartUp Health (they have a print magazine now!), and talks about JP Morgan Week coming up in January!

A Challenge Posed; A Challenge Answered

SPONSORED POST

By JOHN EL-MARAGHY

What is the first word that comes into mind when someone says “health” or “health tech?” In 2018, the answer is likely “Opioid” and “Artificial Intelligence (AI).” With a growing public interest in combating opioid abuse and advancing AI, the Robert Wood Johnson Foundation (RWJF) teamed up with Catalyst to launch two innovation challenges on those two topics. The first challenge, “the Opioid Challenge,” was designed to address the opioid crisis and support those affected by the opioid misuse while the second challenge, “the AI and the Healthcare Consumer Challenge,” aimed to leverage AI to assist consumer decision making. The challenges sought innovators and entrepreneurs from all around the world and garnered nearly 200 registrations.

Through a rigorous vetting process, 100 amazing competitors proceeded to phase one and five semi-finalists advanced to phase two. Along the way, expert judges analyzed the submissions on a variety of factors such as scalability, impact, UX/UI and more. The final phase of the challenge, a live pitch, was held at the Health 2.0 Fall Conference in Santa Clara where both the expert judges and the audience had a say in who would take home the grand prize.

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Health in 2 Point 00 Episode 52

Today on the 52nd episode of Health in 2 Point 00, Jess reports from InsurTechConnect 2018! In this episode, Jess asks Matthew about RockHealth’s $6.8 billion fundraise to date & its $3 Billion raise in Q3, Weight Watcher’s rebranding itself and pushing into the wellness space, and (just in time we might add) Maven, a women’s digital health clinic, series B round of $27 million from Oak HC/FT

4 Signs that Disruption is Accelerating in Health Care Delivery

By REBECCA FOGG

Hardly a day goes by that I don’t read the term “Disruptive Innovation” cited in relation to health care delivery. This might seem like a good thing, given that our expensive, wasteful, and in some cases frightfully ineffective traditional delivery model is in dire need of transformation. However, the term is frequently misunderstood to refer to any innovation representing a radical departure from an industry’s prior best offerings. In fact, it actually has a very specific definition.

Disruptive Innovation is the phenomenon by which an innovation transforms an existing market or sector by introducing simplicity, convenience, accessibility, and affordability where complication and high cost have become the status quo—eventually completely redefining the industry. It has played out in markets from home entertainment to teeth whitening, and it could make health care delivery more effective by making providers’ care processes, as well as individuals’ own self-care regimes easier and less costly. This, in turn, would reduce the need for both more, and more expensive, interventions over time.

Unfortunately, disruption has been slow to emerge in the health care sector. It’s been thwarted by the broader health care industry’s unique structure, which tends to prioritize the needs of commercial insurers and large employers (who pay the most for consumer care) over those of health care consumers themselves. It also stacks the deck against disruptive entrepreneurs, since established providers effectively control professional licensing requirements, and (along with insurers) access to patients & key delivery partners.

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THCB Spotlights: TestCard

By ZOYA KHAN

A few weeks back, Matthew met with TestCard (another Brit like him) at TechCrunch Disrupt 2018. Greg, from TestCard, spoke to Matthew about how their device can test multiple different illnesses using urine and a clinical grade camera, which then spits out results (almost) immediately on your smartphone. Currently, the device can be used for detecting pregnancy, glucose, STIs, UTIs, and many more diseases. Their focus is on preventative care for patients, so they are working with insurance companies to use their product as a kit to diagnose problems that are prevalent in UK’s population. Not to mention their slogan is “A bit like Theranos, but our flagship products work.”

Zoya Khan is the Editor-in-Chief of THCB as well as an Associate at SMACK.health, a health-tech advisory services for early-stage startups.

Apple Watch Leaves Patients Connected with No Where To Go

By GRACE CORDOVANO, Ph.D., BCPA

The highly anticipated unveiling of the Apple Watch Series 4 caused a news and social media sensation. Apple coined the iconic timepiece as the “guardian of your health”, with health tracking functionalities such as the ability to detect atrial fibrillation (AFib) by a self-performed electrocardiogram (ECG). But from patients’ and carepartners’ perspectives, there is a long road to a universally accessible, seamlessly implemented, mass-adoption, and meaningful use for this wearable technology.

Many experts, such as Dr. Eric Topol a cardiologist at the Scripps Research Institute, and other reports, were quick to highlight concerns about the consequences of false positives. The Apple Watch was criticized as a source for unnecessary anxiety. A letter from the Center for Devices and Radiological Health (CDRH) of the FDA, which cleared the ECG app as a class II over-the-counter (OTC) device, highlighted the risks to health and potential mitigation measures that the Apple Watch posed. Unfortunately, the vast majority of concerns in the public domain haven’t emphasized the risks to health due to poor implementation, integration, and adoption strategies of digital tools and wearables.

The current health care system needs to be significantly refreshed as it is not positioned to simply drop in advancements, such as those offered by the Apple Watch Series 4, into everyday patient care. Having Dr. Ivor Benjamin, president of the American Heart Association (AHA), endorse the Apple Watch at the Apple Keynote Event did wonders for the mass marketing appeal. It would’ve have been more credible and demonstrated more value if he stated that the AHA devised a strategic clinical practice implementation guide for cardiologists, created patient education materials for using the Apple Watch, partnered with payers to incentivize doctors to adopt the technology, and reimburse for virtual consults to support remote patient monitoring (RPM).

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THCB Spotlights: MIRA Fertility Tracker

By ZOYA KHAN

A couple weeks back, Matthew met with MIRA Fertility Tracker at TechCrunch Disrupt 2018. Sylvia Kang, CEO & Co-founder of MIRA, spoke to Matthew about her new fertility tester for women trying to track their cycles. It also has an AI component built into its system, in order to inform women the days they are most likely to get pregnant. MIRA also took center stage at #Health2con’s Venture Connect, placing 1st among a series of talented health tech startups. 

Zoya Khan is the Editor-in-Chief of THCB as well as an Associate at SMACK.health, a health-tech advisory services for early-stage startups.

Is Medical Imaging a Ricardian Derived Demand?

By SAURABH JHA

Medical Imaging and the Price of Corn

After the Napoleonic wars, the price of corn in England became unaffordable. The landowners were blamed for the high price, which some believed was a result of the unreasonably high rents for farm land. Economist David Ricardo disagreed.

According to Ricardo, detractors had the directionality wrong. It was the scarcity of corn (the high demand relative to its supply) that induced demand for the most fertile land. That is, the rent did not increase the price of corn. The demand for corn raised the rent. Rent was a derived demand.

Directionality is important. Getting directionality wrong means crediting the rooster for sunrise and blaming umbrellas for thunderstorms. It also means that focusing on medical imaging will not touch healthcare costs if factors more upstream are at play.

Medical imaging is a derived demand. The demand for healthcare induces demand for imaging. Demand is assured by the unmoored extent to which we go for marginal increases in survival.

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