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9 Healthcare Companies Who Changed the 2010s

By ANDY MYCHKOVSKY

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.

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Will At-Home Lab Tests Change Healthcare Diagnostics Forever? | Frank Ong, Everlywell

By JESSICA DAMASSA, WTF HEALTH

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.

Filmed at HLTH 2019 in Las Vegas, October 2019.

Chronic Disease Drugs are Big Business, Antibiotics are Not

By HANS DUVEFELT, MD

I have noticed several articles describing how antibiotic development has bankrupted some pharmaceutical companies because there isn’t enough potential profit in a ten day course to treat multi-resistant superbug infections.

Chronic disease treatments, on the other hand, appear to be extremely profitable. A single month’s treatment with the newer diabetes drugs, COPD inhalers or blood thinners costs over $500, which means well over $50,000 over an effective ten year patent for each one of an ever increasing number of chronically ill patients.

Imagine if the same bureaucratic processes insurance companies have created for chronic disease drug coverage existed (I don’t know if they do) for acute prescriptions of superbug antibiotics: It’s Friday afternoon and a septic patient’s culture comes back indicating that the only drug that would work is an expensive one that requires a Prior Authorization. Patients would die and the insurance companies would be better off if time ran out in such bureaucratic battles for survival.

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THCB Spotlights: Carolyn Magill, CEO of Aetion

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.

Doctors Lack Knowledge about Medical Cannabis Use. Their Patients Can Help.

By DOUGLAS BRUCE, PhD

On January 1, 2020, recreational cannabis use became legal in Illinois. More than 80,000 people in Illinois are registered in the state’s medical cannabis program. Surprisingly, many of their doctors don’t know how to talk with them about their medical cannabis use. 

As a health sciences researcher, I have a recommendation that is both practical and profound: Physicians can learn first-hand from their own patients how and why they use medical cannabis, and the legalization of recreational cannabis may make them more comfortable discussing its usage overall.

Nationwide, physicians too rarely discuss cannabis use with their patients living with chronic conditions, such as chronic pain, cancer, multiple sclerosis, epilepsy, fibromyalgia, and Crohn’s disease—all conditions with symptoms that evidence shows cannabis may effectively treat. Why don’t physicians talk with their patients about cannabis use? Research from states with longer histories of legalized medical cannabis shows that many physicians do not communicate with patients regarding their medical cannabis use for a variety of reasons. 

First, physicians aren’t well trained in cannabis’ medical applications. Unlike the endocrine or cardiovascular systemsthe endocannabinoid system—comprised of receptors which bond with the compounds THC and CBD found in cannabis—is not taught in medical school.

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A Clinically Validated Game Teaching Mental Health Coping Strategies | Swatee Surve, Litesprite

By JESSICA DAMASSA, WTF HEALTH

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.

Health in 2 Point 00, Episode 103 | ACA Ruling, Sutter Health Settlement, & Bright Health

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

11 Healthcare Innovation Trends To Watch In 2020

By ANDY MYCHKOVSKY

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.

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Revisiting the Concept of Burnout Skills

By HANS DUVEFELT, MD

I looked at a free book chapter from Harvard Businesses Review today and saw a striking graph illustrating what we’re up against in primary care today and I remembered a post I wrote eight years ago about burnout skills.

Some things we do, some challenges we overcome, energize us or even feed our souls because of how they resonate with our true selves. Think of mastering something like a challenging hobby. We feel how each success or step forward gives us more energy.

Other things we do are more like rescuing a situation that was starting to fall apart and making a heroic effort to set things right. That might feed our ego, but not really our soul, and it can exhaust us if we do this more than once in a very great while.

In medicine these days, we seem to do more rescuing difficult situations than mastering an art that inspires and rewards us: The very skills that make us good at our jobs can be the ones that make us burn out.

Doctors are so good at solving problems and handling emergencies that we often fall into a trap of doing more and more of that just because we are able to, even though it’s not always the right thing to do – even though it costs us energy and consumes a little bit of life force every time we do it. And it’s not always the case that we are asked to do this. We are pretty good at putting ourselves in such situations because of what we call our work ethic.

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Reference Manuals May Be Facing Obsolescence

We must ensure their relevance to contemporary patient care

By LONNY REISMAN, MD

It’s 1992 and disruptive technologies of the day are making headlines: AT&T releases the first color videophone; scientists start accessing the World Wide Web; Apple launches the PowerBook Duo.

In healthcare, with less fanfare, a Harvard physician named Dr. Burton “Bud” Rose converts his entire nephrology textbook onto a floppy disk, launching the clinical tool that would ultimately become UpToDate. Instead of flipping through voluminous medical reference texts, such as the Washington Manual, doctors could for the first time input keywords to find the clinical guidance they needed to make better treatment decisions.

The medical community embraced UpToDate’s unique ability to put knowledge at their fingertips. Today more than 1.7 million clinicians around the world use UpToDate to provide evidence-based patient care with confidence. For many, it along with other reference sources has become foundational to providing high quality medical care.

More than just an easy-to-use reference, UpToDate has gone on to improve patient outcomes, according to the Journal of Hospital Medicine.

In the new era of 21st century digital medicine, however, there are opportunities to go further in support of clinicians and patients. Reference tools must be powered by predictive and prescriptive analytics, be personalized to individual patient circumstances, and be integrated into clinician workflow. In some cases, clinicians may be unaware of which questions to ask of a computerized reference manual, or how to incorporate the nuances of an individual patient’s case into the general insights of a reference. Searching for heart failure treatment, for example, may be too broad a query and the resulting recommendations therefore may not provide optimal care for a specific patient’s unique medical circumstances. New digital health solutions that consider patients’ co-illnesses, contraindications, symptomatology, current treatment regimens, and hereditary risks are essential.

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