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A Mystery Mission in LA: Aetna, Apple, and a Vision of Digital Health’s Future, Part 1

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By LYGEIA RICCIARDI

It was an invitation too intriguing to refuse: fly to LA to participate in a “top-secret mission” related to digital health. Instructions? Bring workout clothes. Don’t disclose your location. “We can’t say much. Just enough for you to quickly pack your bags, fly to California and participate in an exclusive Apple Watch from Aetna event – all expenses paid.” Generally, I’d file this type of message in the junk mail folder, but knowing that Apple takes secrecy seriously, I did some background sleuthing and decided it looked legit.

The mystery unfolded last week as I stepped into a black car at LAX with a secretive driver who joked that I and his other two passengers (who had received similar invites) would have to cover our faces as we drove through town. (Yikes!) When we arrived at a hip “concept” hotel I felt more at ease, and relaxed into enjoying the so-called mission with a glass of wine and some discussion of trends in the digital health industry. Over the course of a couple of days I was fortunate to join a group of new (and some old) friends to exchange ideas, take a challenging hike to the peak of Runyon Canyon Park, interact with Apple and Aetna execs, try out some new technologies, and get a glimpse of what both Aetna and Apple are envisioning for the future of digital health. I was assigned to one of several teams named after famous movies (in keeping with the Tinseltown theme) a personalized agenda, and some critical tools for the modern adventurer, including a bandana, water bottles, a phone charger, and, naturally, a selfie stick.

For about a year Aetna has used the Apple watch as part of an integrated wellness program available to its 50 thousand employees and those of several partner organizations it insures, such as Hartford HealthCare, which was represented among the participants in the mystery mission. Both companies are poised to expand the program.Continue reading…

Struggling to Get Customers, Revenue and Traction in the Digital Health Market?

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By ELENA LIPSON                                                           SPONSORED POST

Imagine the peace of mind and confidence you will feel if you had a quick, proven process to take your solution or concept from its current state to one that generates sustainable revenue, hoards of customers and value to the healthcare ecosystem.

Elena Lipson has been working with organizations and entrepreneurs in the digital health community for more than 15 years to help them successfully bring new products and services to market, identify and engage new customers and partners, and grow their market share.

For the first time, she is offering a free webinar training to the Health 2.0 community to share the three steps you need to create a blueprint for your digital health solution that will get you customers, accelerate your path to revenue, and help you go to market quickly even if:Continue reading…

Elation’s Kyna Fong on a new type of EMR company

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By MATTHEW HOLT

There’s so much happening in the Health 2.0 world of new technology in health that it’s hard to keep up. AI, VR, AR, Blockchain–and they’re just the buzzwords keeping the VCs happy. So this year I’ve decided to try to interview more interesting new companies to keep you in the know. We’ll see how long that resolution lasts but first up is Kyna Fong, CEO of ElationHealth. Yes, she left a Stanford tenure-track professorship to start an EMR company, and no, she doesn’t sound crazy! This is an in-depth interview including a decent length demo, and it hints at how companies like hers might solve the conundrum of EMRs being necessary but impossible to use.

So what does Trump mean for new health tech?

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By MATTHEW HOLT

Matthew-Holt-colorI’m a pundit who like everyone else was surprised by Trump’s victory in the (profoundly undemocratic and hopefully-to-be-abolished-soon) electoral college, and everything I say here is prefaced by the fact that there was very little discussion of healthcare specifics by Trump. So there’s no certainty about what will happen–to state the obvious about his administration!

What we do know is that Trump said he’d repeal & replace the ACA and the House has voted to repeal it many times (but the Senate has only once & Obama has always vetoed that repeal). A full and formal repeal requires 60 votes in the Senate which it won’t get with the Democrats holding 48. Note that the Democrats needed 60 votes to to forestall a Republican filibuster in order to pass the ACA in 2010. That 60 vote total is a very rare state of events which existed for only only one year–from Jan 2009 until Scott Brown won Ted Kennedy’s old seat in Jan 2010 and one we likely won’t see again for many years.

But this doesn’t does not mean things will continue as usual for two reasons. Congress can change the budget with the Republican 52 seat Senate majority, and the Administration can change regulations and stop enforcing them. So we have to assume that the new Administration and its allies(?) on the Hill will roll back the expansion of Medicaid which was responsible for most of the reduction in the uninsured (even if it didn’t happen in every state). They’ll also reduce or eliminate the subsidies which enable about 10m people to buy insurance using the exchanges. Both of those were in the repeal bill Obama vetoed, although in the bill the process was delayed for 2 years.

This of course may not happen or may be replaced by something equivalent because many of the people who voted for Trump (the rural, white, lower-income voters) fall into the category of those helped by the law, and in a few of his remarks he’s also said that he’ll be taking care of them. Even this week Senator Wicker (R-Mississippi) said that they weren’t going to take away 20 million people’s insurance. In Kentucky which went from a Democratic to Republican governor 2 years ago, the new administration ended their local exchange (from 2017), but in fact not much consequential happened as people were sent to the Federal exchange. If there are changes to the exchanges and the individual mandate or they’re both abolished, there’ll be lots of commotion but it won’t be completely system changing.

My day job at Health 2.0 involves running a conference and innovation program based on a community of companies using SMAC technologies to change health care services and delivery–either by starting new types of health care services or selling those technologies to the current incumbents. So I’m acutely interested in what happens next, albeit somewhat biased about my preferences!

Overall I think that (unlike many other areas of American life) health care technology won’t be that greatly affected. Continue reading…

(Even) More Disruption, Please !!

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By KYLE ARMBRESTER

Screen Shot 2015-07-08 at 10.04.02 AM

There are two questions I hear all the time from digital health care entrepreneurs: 1) How can I gain initial market traction? 2) How do I grow my client base?

Health care is an incredibly tough market to sell into. Even if you have a highly-differentiated solution with proven value, the barriers to access and scalability are extremely high.

For entrepreneurs trying to break in, the problem is two-fold.  First, the majority of providers are focused on patient care – getting on their radar is difficult. Second, even if an entrepreneur does gain buy-in and proves value to a single provider or group, it’s difficult to build upon that success. 

Negotiate Strategic Partnerships

The first lesson to get ahead: Learn how to spot a valuable partnership and negotiate a good deal—whether with an accelerator, incubator, or VC.

There are 87 accelerators (and counting) dedicated to jumpstarting the most promising health care startups in the country, and each is as differentiated as the companies they nurture. These accelerators vary in how structured their programs are, as well as the threshold of capital they invest.  Timeframes differ, the amount of equity required varies, the level of mentorship fluctuates, and the quality of contacts/potential clients runs the gamut. Despite the differences, the objective is the same: to help propel entrepreneurs into health care.

Continue reading…

Health 2.0 Quarterly: What’s New in Q2?

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By KIM KRUEGER

Every quarter, Health 2.0 releases a summary set of data that explains where industry funding is going, which product segments are growing fastest, and where new company formation is happening. Health 2.0’s precision and clarity when it comes to market segmentation and product information make this quarterly release the cream of the freebie crop.

The major news this quarter is that funding has slowed compared to this time last year, notwithstanding a significant bump from Allscripts’ $200M investment in NantHealth on the last day of the month. Yet, we’re still seeing growth in the Health 2.0 Source Database — both in number of products and companies. We also highlight the release of the Apple Watch, the growing momentum around FHIR, some key moves in the data analytics space, and the success of the latest Health 2.0 IPOs. For more, flip through below.

Kim Krueger is a Research Analyst at Health 2.0

It’s Time to Stop Calling Them EHRs

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By JACOB REIDER, MD

Jacob RiderIt’s time to stop calling them EHRs.  Yes – we also need to stop calling them EMRs.  In 2011, ONC discussed the difference between the two terms, but I think that conversation missed the point:  whether it’s “medical” or “health” that is the focus, these aren’t (shouldn’t be) RECORD systems at all.  We need to expand our expectations from CRUD to something that we really need: smart tools that help us collaborate toward improving health for individuals.   In November, when I floated this concept, I was teased (corrected?) for focusing on terminology and missing the point that we need EHRs to do more than just store data.

But it’s more than just terminology.  Our words mean a lot. A “record” system is for storage of records.  It saves information.  Our expectations will always focus on storing and retrieving information.  

Continue reading…

ONC Awards $300K in Funding to 6 Digital Health Pilot Projects!

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By ADAM WONG

The Department of Health and Human Services’ (HHS) Office of the National Coordinator for Health Information Technology (ONC) today announced the six winners of the inaugural ONC Market R&D Pilot Challenge. The six winners will live-test new health information technology (health IT) applications in health care settings administered by their challenge partners.

The winning innovator-health care organization teams will each receive $50,000 to fund their pilot programs which will become operational in August are:

  • ClinicalBox and Lowell General Hospital
  • CreateIT Healthcare Solutions and MHP Salud
  • Gecko Health Innovations and Boston Children’s Hospital
  • Optima Integrated Health and University of California, San Francisco, Cardiology Division
  • physIQ and Henry Ford Health System
  • Vital Care Telehealth Services and Dominican Sisters Family Health Service

The ONC Market R&D Challenge launched on October 20, 2014 with the goal of finding early stage health care startups from across the country and connecting them with health care organizations and stakeholders with whom they could potentially run a pilot program to test the application.

Three in-person matchmaking events were held in January, 2015, focused on connecting health care organizations with innovator companies looking to pilot test their products. Almost 500 organizations expressed interest in finding partners through the matchmaking program. More than 300 in-person meetings were held in New York, New York; San Francisco, California; and Washington, D.C., with many more conducted virtually. These “speed-dating” events allowed startups to meet face-to-face with health care organizations to identify common interests and goals. ONC and the organizer of these meetings, Health 2.0, intended for the events to have additional benefits, including facilitating the exchange of ideas that might lead to new partnerships and relationships.

To be eligible to serve as a host, organizations were required to operate in clinical, public health and community, or consumer health environments while also serving enough consumers or patients to conduct a pilot study. The innovators had to be an early-stage health information technology company with less than $10 million in venture capital funding and a readily available technology solution.

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The Data Response Curve (In Honor of the Dose Response Curve)

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By JORDAN SHLAIN, MD


Data Response Curve

All medical students learn about the dose response curve in pharmacology lectures. The dose-response curve informs us of how we should dose a medication in the context of its efficacy and its toxicity. Too little medicine won’t have the desired effect, and too much medicine can be toxic.

In the era of digital health, data have become the new “big pharma,” and we are facing the emergence of a data-response curve in which access to too little data is inactionable, and access to too much data can be overwhelming. Digital health devices abound today, and has enabled quantification of nearly every health and wellness metric imaginable. Sadly, in our exuberance about these new sources of data, we often conflate “more data” with “better data.”

In the era in which data have become the booming commodity of exchange in healthcare, we describe an emerging data-response curve. Large data sets can be at best clarifying or at worst self-contradictory. Too little data on the data-response curve, as with medication dosing, can be insufficient for effective action or decision-making. Too much data can be toxic to the user such as the physician, leading to poor decisions or worse, to analysis paralysis.

We live in a world of exploding data, and we need to be thoughtful. Medicine is a people business in need of data, not a data business on need of people. In reductive form, all humans make decisions based on inputs (data) from their environment and on individual analysis of the data in the form of non-linear, non-quantifiable perception. When we as doctors, policy-makers, or simply as human beings receive these inputs, one of three things happens: 1. We make a decision to do something (for example a treatment decision based on abnormal data), 2. We make a decision to do nothing (for example, normal data which we believe requires no action), or 3. We need more data in order to make an informed decision to do item #1 or item #2. More does not necessarily equal better data. More data is simply more.

Better data are actionable data wrapped in the context of the patient and the patient’s condition. Imagine each piece of objective data connected to concurrent subjective data, and surfaced in the context of a specific condition relevant to the patient. HealthLoop enables patients to generate contextual objective data married to their subjective symptoms and served to a clinician in an actionable context. High signal and low noise are the digital health equivalents of on the dose-response curve of a favorable therapeutic window.

See where some folks live on the Chart. Where do you live?

Apple Enters the Healthcare Software Ecosystem

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By Henry Feldman, MD

Apple Senior Vice President of Software Engineering Craig Federighi

I am writing this from the Apple Worldwide Developer Conference (WWDC) here in San Francisco, where I got to substitute for John Halamka at the Keynote (now I keep having urges to raise Alpacas); John missed the most amazing seats [front row center!].

There were many, many, many (I can not recall a set of software announcements of this scale from Apple) new technologies that were announced, demoed and discussed, but I will limit this entry to a few technologies that have implications for healthcare.

If you remember the state of digital music, prior to the introduction of the iPod and iTunes music store, that is where I feel the current state of the healthcare app industry is at; there is no common infrastructure between any of the offerings, and consumers have been somewhat ambivalent towards them as everything is a data island; switching apps causes data loss and is not a pleasant experience for patients.

Amazingly there are 40,000+ apps on the App store at Apple alone, showing huge demand from users, but probably a handful can talk to each other in a meaningful way; this is both on the consumer and professional side of healthcare.

Individual vendors such as Withings have made impressive strides towards data consolidation on the platform, but these are not baked into the OS, so will always have a lower adoption rate. If we take the music industry example further, Apple entering a market with a full push of an ecosystem at their scale, legitimizes the technology in ways that other vendors simply can’t match.

Continue reading…

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