Today on Health in 2 Point 00, Jess is braving the oncoming blizzard in Boston for MassChallenge. In this episode, Jess asks me about some crazy things happening in health tech, from the recently announced Microsoft-Walgreens partnership to compete with Amazon, to Google buying new smartwatch technology from Fossil, to Jim Cramer’s suggestion that Apple should buy Epic. Also in some HIMSS news, Atul Gawande has pulled out of HIMSS. But—I’ve got a booth for Smack Health at HIMSS this year, so stop by to find some Smack startups & Jess doing WTF Health interviews as well. –Matthew Holt
A Bizarre Claim of Right to Try
By ARTHUR CAPLAN, KELLY MCBRIDE FOLKERS, and ANDREW MCFADYEN
A patient with glioblastoma recently received an experimental cancer vaccine at the University of California, Irvine. Notably, this is being hailed as the first case of someone utilizing the Right to Try Act of 2017. ERC-USA, a U.S. subsidiary of the Brussels-based pharmaceutical company Epitopoietic Research Corporation, says it provided its product, Gliovac, to the patient at no cost. The vaccine is currently undergoing Phase II clinical trials. A handful of people in Europe have received access to it through “compassionate use.” This patient did not qualify for ongoing clinical trials in the U.S. The patient, who remains anonymous, is the first known individual to receive an experimental medicine that has not been approved by the FDA, as permitted under the federal right to try law.
Glioblastoma is a nasty cancer – John McCain and Ted Kennedy passed away after battling the disease for just over a year. We believe that patients with terminal illnesses, like those with glioblastoma, should have every reasonable tool at their disposal to treat their disease.
That being said, we’ve argued before that right to try laws are not the best way to help desperate patients. They still aren’t. The number of cases claimed to date is exactly one. And, further examination of what we know about this case does not make a strong argument for the widespread usage of the right to try pathway.
Venture Capitalism & Radiology
By SAURABH JHA MD
Can radiologists make their way to Silicon Valley? In this episode of Radiology Firing Line, Ajay Kohli MD, a physician entrepreneur, explains what it takes to make a medical app.
Listen to our conversation here.
Saurabh Jha is a contributing editor to THCB and host of Radiology Firing Line Podcast of the Journal of American College of Radiology, sponsored by Healthcare Administrative Partner
The Perfect Office Note? SOAP, APSO or aSOAP?
By HANS DUVEFELT MD
I’ve been toying with this dilemma for a while: SOAP notes (Subjective, Objective, Assessment, Plan) are too long; APSO just jumbles the order, but the core items are still too far apart, with too much fluff in between. We need something better – aSOAP!
Electronic medical record notes are simply way too cumbersome, no matter in what order the segments are displayed, to be of much use if we quickly want to check what happened in the last few office visits before entering the exam room.
It is time we do something different, and I believe the solution is under our noses every day, at least if we read the medical journals:
I can be aware of what’s going on in the medical literature without reading every article. How? Think about it…
The Growing Problem of Military Suicides
By MSW@USC STAFF
U.S. veterans are dying by suicide at an alarming pace.
The national veteran suicide rate was almost 30 per 100,000 people in 2015, or about 20 deaths every day, according to the Department of Veterans Affairs. The age-adjusted rate of suicide among veterans increased more than 30 percent from 2005 to 2015, compared to an almost 20 percent increase among the non-veteran population. Female veterans in particular saw a 45 percent spike over that time period.
“Military life is hard for a variety of reasons, including an increased exposure to trauma, frequent moves that disrupt one’s social support networks and prolonged separations due to deployments,” said Carl Castro, associate professor, retired U.S. Army colonel and director for USC’s Center for Innovation and Research on Veterans and Military Families (CIR).
To address climbing suicide rates among active-duty service members and veterans, the USC Center for Artificial Intelligence in Society (CAIS), in collaboration with USC CIR and the USC Viterbi School of Engineering External link , will use artificial intelligence to examine engagement on social networks by military personnel to identity risks such as depression and anxiety.
Continue reading…
Despite Youth On Farm, Abbott Ventures Chief Avoids Spreading Manure
By 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.
Health in 2 Point 00, Episode 64 | J.P. Morgan Healthcare Conference
Today, for the first episode of Health in 2 Point 00 of 2019, Jess and I are reporting from the J.P. Morgan Healthcare Conference. In this episode, Jess asks me about the big news from the conference and whether there should be a second event in New York. We also have our special guest star, Dr. Iya Khalil, to tell us about the non-profit Female Equity –Matthew Holt
Net Effect of Expanding Medicaid
By SAURABH JHA MD
What is the effect of expanding Medicaid on overall healthcare costs and use of the emergency room? This type of question can’t easily be answered by observational studies and requires a randomized controlled trial (RCT). But an RCT isn’t easy to perform. However, a natural RCT serendipitously happened in Oregon a few years ago when Medicaid was expanded and the eligibility was deemed by a lottery system.
On this episode of Firing Line, Saurabh Jha (@RogueRad) speaks to Professor Katherine Baicker, a leading economist and the Dean of the Harris School of Public Policy, and principal investigator of the Oregon Health Insurance Experiment, about the landmark study.
Listen to our conversation here at Radiology Firing Line Podcast.
Commissioning Healthcare Policy: Hospital Readmission and Its Price Tag
By ANISH KOKA MD
The message comes in over the office slack line at 1:05 pm. There are four patients in rooms, one new, 3 patients in the waiting room. Really, not an ideal time to deal with this particular message.
“Kathy the home care nurse for Mrs. C called and said her weight yesterday was 185, today it is 194, she has +4 pitting edema, heart rate 120, BP 140/70 standing, 120/64 sitting”
I know Mrs. C well. She has severe COPD from smoking for 45 of the last 55 years. Every breath looks like an effort because it is. The worst part of it all is that Mrs. C just returned home from the hospital just days ago.
Not Fake News! A Trump Administration Rule Models Government Civility
By MICHAEL L. MILLENSON
A Trump administration regulation issued just hours before the partial federal shutdown offers quiet hope for civility in government.
What happened, on its face, was simple: an update of the rules governing a particular Medicare program. In today’s dyspeptic political climate, however, what didn’t happen along the way was truly remarkable – and may even offer some lessons for surviving the roller-coaster year ahead.
A regulatory process directly connected to Obamacare and billions in federal spending played out with ideological rhetoric completely absent. And while there were fervid objections to the draft rule from those affected, the final version reflected something that used to be commonplace: compromise.
Think of it as Survivor being replaced by Mr. Smith Goes to Washington. Or, perhaps, a small opening in the wall of partisan conflict.
More on that in a moment. First, let’s briefly examine the specifics.
