Dr. Tom Frieden, former director of the Centers for Disease Control and Prevention (CDC), opened up a new front in the Coronavirus War by saying we don’t just need to treat the acute disease, we need to treat the underlying conditions that make people more susceptible to serious disease progression. He focused on heart disease, and managing mitigating risk factors such as CVD, diabetes, hypertension and smoking in order to increase people’s odds for recovery. The initial focus has been pneumonia and acute respiratory distress syndrome (ARDS), with risk factors including asthma, chronic obstructive pulmonary disease, and emphysema.
Dr. Frieden calls for better
management of people’s underlying health problems to help mitigate the impact
of COVID-19. I would take this one step further and say we need to go beyond
managing chronic diseases, and find and treat the pathogens that underlie and
fuel their pathologies. Why?
In 2001, my work as an Army
Reserve medical officer took me to Bolivia to treat 10,000 Andes Indians with
parasite medications. Not only did this resolve their parasite problems, but
many reported it helped them overcome a range of additional chronic health
problems. When I returned to St. Louis, I began to dig deeper with my chronic
disease and “mystery disease” patients and treat some of them for parasite
problems, and saw many improve. I expanded this “search and destroy” mission
with my patients to fungal and dental infections, as I learned many such
infections – often overlooked in medicine today – are overlapping, synergistic,
and can present as chronic illness.
“What’s happening in COVID is those of us living with these chronic conditions are at highest risk — not to contract the disease, but highest risk for outcomes. Our unique ability to be able to see what’s happening in that population and deliver that care remotely is incredibly valuable always, but, particularly, in this strained time.”
Livongo Health has always been committed to helping its members (people with diabetes, heart disease, and other chronic conditions) manage their health “where they are.” Collecting loads of patient data along the way. As the traditional health system grapples with caring for those infected with COVID-19, what changes? What role will digital health companies like Livongo play as they continue to provide front-line, day-to-day care to their members and customers amidst the challenging environment of this pandemic?
Dr. Jennifer Schneider, Livongo’s President, stops by to chat about what’s happening at Livongo now as the country looks to virtual care solutions to help shore up capacity for the traditional health system. As the spotlight is turned to digital health, we get Jenny’s perspective on what it will take for health tech companies like hers to continue to prove their value to healthcare incumbents and to patients who have a growing need for their help managing their everyday health.
What does Glen Tullman, Chairman of Livongo, expect from the health tech market in 2020? Livongo may have started a “race for the exits” in digital health with its 2019 IPO, and Glen says he “wants a healthy, consumer-facing digital health market” to help his own business thrive. Does that mean he anticipates more IPOs from the health tech sector this year? We get Glen’s predictions after we catch up on Livongo’s recent moves to partner with DexCom and test a new pathway to reimbursement via Express Scripts’ Digital Health Formulary.
Filmed at J.P. Morgan Healthcare Conference in San Francisco, January 2020.
On the heels of a $40M Series B funding round led by Bayer, One Drop CEO Jeff Dachis stops by to hit the highlights about how the digital health platform is touching the lives of 1.6 million users in nearly 200 countries. Focused on chronic conditions like diabetes, pre-diabetes, hypertension, etc. One Drop is unique in the BIG direct-to-consumer business they’ve built through partnerships with Walmart and Apple stores. While Jeff says their growth capital will go toward expanding their heath plan and employer business, there’s also room for growth with Bayer, which could help expand the company’s core operating platform into other therapeutic areas like cardiovascular disease, oncology, and women’s health.
Filmed at Frontiers Health in Berlin, Germany, November 2019.
Not only is ‘Ouchie’ what you say when you’re in pain, but now it’s also what you say when you need to find relief! Rachel Trobman, CEO of Upside Health, introduces us to Ouchie, a remote patient monitoring and treatment tool for chronic pain that patients can download onto their phones. Central to the patient experience of the app is the focus on documenting the patient’s “pain journey” where they answer a series of important lifestyle questions that inform the platform to come up with ways to receive support and other health resources. Not only does this self-reported data help patients identify triggers and patterns that impact their pain level, but it is also a treasure trove of information for physicians who can use it to better (and more quickly) tailor treatment to suit individual needs. The business behind Ouchie, called Upside Health, is starting to take off too and Rachel talks through revenue model, funding, and future plans.
Filmed at Frontiers Health in Berlin, Germany, November 2019.
As the adage goes, “health is wealth,” and Wellthy Therapeutics is a startup looking to improve the health of patients with chronic conditions in India by making treatment more accessible. Only 5% of Indians are insured and much of the population is not health literate, so CEO Abhishek Shah hopes the Wellthy app will fill a critical gap in care for those with type II diabetes, hypertension, cardiovascular conditions, and respiratory illnesses. With 15K users, the startup is focused on scaling up to truly capitalize on the potential of India’s enormous population. Learn more about their big plans, including those for a Series-A, to support that expansion.
Filmed at Bayer G4A Signing Day in Berlin, Germany, October 2019.
Bum knees, aching backs, and neck pain are literally a pain-in-the-neck for millions of people – making chronic pain one of the largest areas of healthcare spending. Is it time to disrupt the traditional delivery of physical therapy? Physera CEO, Dan Rubenstein, thinks so, and talks to us about how his healthcare startup is revolutionizing the way physical therapy is being delivered by taking it virtual and driving down the cost. With more than $10M in funding (their $6M Series A was led by BlueCross BlueShield’s Venture Fund) and a major contract with a nationwide health plan provider in the works, the health tech startup is on track to help millions of people feel better and avoid the crazy rush to the PT’s office.
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.
Sean Duffy, CEO of Omada Health, proves why his company is one of those digital health startups everyone’s watching in the chronic condition management space. Never mind the buzz around their latest massive funding round or Livongo’s IPO, the real story here is Sean’s idea about building a “completely digital” care provider for folks with pre-diabetes, type II diabetes, hypertension, and mental health issues — or, at least that’s the goal for the next decade. What does a “full-stack view of supporting someone’s care look like? How do you get there? Tune in to find out about Omada’s proprietary tech-testing litmus test, “The Sean Duffy’s Mom Test,” and some good advice for other health tech startups about what it takes to win over clinicians with your tech.
Filmed at Health 2.0 in Santa Clara, California in September 2019.
Jessica DaMassa is the host of the WTF Health show & stars in Health in 2 Point 00 with Matthew Holt. 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.
So many primary care patients have several multifaceted problems these days, and the more or less unspoken expectation is that we must touch on everything in every visit. I often do the opposite.
It’s not that I don’t pack a lot into each visit. I do, but I tend to go deep on one topic, instead of just a few minutes or maybe even moments each on weight, blood sugar, blood pressure, lipids, symptoms and health maintenance.
When patients are doing well, that broad overview is perhaps all that needs to be done, but when the overview reveals several problem areas, I don’t try to cover them all. I “chunk it down”, and I work with my patient to set priorities.
What non-clinicians don’t seem to think of is that primary health care is a relationship based care delivery that takes place over a continuum that may span many years, or if we are fortunate enough, decades.
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