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Tag: Health Tech

Go Ahead, AI—Surprise Us

By KIM BELLARD

Last week I was on a fun podcast with a bunch of people who were, as usual, smarter than me, and, in particular, more knowledgeable about one of my favorite topics – artificial intelligence (A.I.), particularly for healthcare.  With the WHO releasing its “first global report” on A.I. — Ethics & Governance of Artificial Intelligence for Health – and with no shortage of other experts weighing in recently, it seemed like a good time to revisit the topic. 

My prediction: it’s not going to work out quite like we expect, and it probably shouldn’t. 

“Like all new technology, artificial intelligence holds enormous potential for improving the health of millions of people around the world, but like all technology it can also be misused and cause harm,” Dr Tedros Adhanom Ghebreyesus, WHO Director-General, said in a statement.  He’s right on both counts.

WHO’s proposed six principles are:

  • Protecting human autonomy
  • Promoting human well-being and safety and the public interest
  • Ensuring transparency, explainability and intelligibility 
  • Fostering responsibility and accountability
  • Ensuring inclusiveness and equity 
  • Promoting AI that is responsive and sustainable

All valid points, but, as we’re already learning, easier to propose than to ensure.  Just ask Timnit Gebru.  When it comes to using new technologies, we’re not so good about thinking through their implications, much less ensuring that everyone benefits.  We’re more of a “let the genie out of the bottle and see what happens” kind of species, and I hope our future AI overlords don’t laugh too much about that. 

As Stacey Higginbotham asks in IEEE Spectrum, “how do we know if a new technology is serving a greater good or policy goal, or merely boosting a company’s profit margins?…we have no idea how to make it work for society’s goals, rather than a company’s, or an individual’s.”   She further notes that “we haven’t even established what those benefits should be.”

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Health Tech: Part II –Powering Up The Vision

By MIKE MAGEE

Few can disagree that, in the fog of the Covid 19 pandemic, health technology entrepreneurs have been on a tear. In the first year of Covid’s isolation induced new reality, digital health companies experienced a $21.6 billion investment boost, double that of the prior year, and four times 2016 funding.

By year two, the investment community exhibited some signs of self-restraint by raising a few open ended questions. For example, in early 2021, Deloitte & Touche led a Future of Health panel at the J.P. Morgan Healthcare conference, reporting that “panelists suggested that entrepreneurs need to go beyond products that simply improve processes or solve existing problems.”

Panelists predicted that virtual health delivery services will expand; consumers will demand greater involvement including expansion of  home diagnostics; and investment driven mergers and acquistions will explode – all of which has proven to be true.

Adding push to shove, Deloitte added this final nudge: “Entrepreneurs who define new markets, dominate them with a strategy people can understand, and extract value will likely be the most successful.”

Forty years ago, in the early beginnings of Health Tech, words similar to those above triggered cautionary tones from traditionalists. For example,  Dr. John A. Benson, Jr., then President of the Board of Internal Medicine, stated “There is a groundswell in American medicine, this desire to encourage more ethical and humanistic concerns in physicians. After the technological progress that medicine made in the 60’s and 70’s, this is a swing of the pendulum back to the fact that we are doctors, and that we can do a lot better than we are doing now.”

He accurately described the mood then, and for most of the 20th century, of academic clinicians toward technology, a complex love-hate relationship that has rejoiced and cheered on progress, while struggling to accept and master change in a manner that would avoid driving a wedge between academicians, clinicians and patients.

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Health Tech, Part I: Where We Are Going, Not Just How Fast We Can Get There

By MIKE MAGEE

What will be the lasting impact of the Covid 19 pandemic?

We still don’t know the answer to that question in full. But one thing that can be said with some certainty is that it has strengthened the hand of Big Tech and all things virtual. Consider the fact that within the Biden White House administration, 13 senior aides have Big Tech resumes with time spent in firms like Google, Facebook, Twitter, Apple, Amazon, Microsoft and more.

This pandemic-induced scrape with mortality has instigated widely varied responses ranging from existential re-awakenings to explosive entrepreneurship.

In health care for example, health tech start-up’s are altering research, education, care delivery and coordination, data mining, patient privacy and financing.

As we know well from health care, intermingling profit, policy and politics can eventually lead to conflict and recrimination. The current controversy over NIH indirect funding of Shi Zengli’s Wuhan “gain-of-function” viral research through Peter Daszak’s New York based EcoHealth Alliance is a case in point.

But we’ve been there before. In the 1990s, James M. Wilson received a PhD and an MD degree from the University of Michigan, then completed an internal medicine residency at Massachusetts General Hospital and a postdoctoral fellowship at MIT. By 1997, he was one of the leading stars in the new gene-therapy movement, directing his own research institute at the University of Pennsylvania.

The institute focused on adjusting the genes of children born with a hereditary disease called ornithine transcarbamylase deficiency (OTD), which prevents the normal removal of ammonia in the body. Wilson’s experimental technique involved genetic engineering, splicing therapeutic genes into supposedly harmless viruses that, once injected into the body, could carry their payload to defective cells and repair the genetic errors.

Dr. Wilson was attempting to determine the maximum dose of genetically modified material that could be safely injected into affected youngsters. He had enlisted 18 participants, including a teenager named Jesse Gelsinger who had a version of the genetic disease in which some of his liver cells carried the genetic abnormality but other cells were entirely normal. Those who have the full-blown disorder die in early childhood. But with his mosaic, Jesse most of the time felt well, as long as he continued to take 32 pills a day.

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Will Virtual Care Platforms (VCPs) Become Healthcare’s Mega-Platforms?

Seth Joseph
Vince Kuraitis

By VINCE KURAITIS and SETH JOSEPH

Let’s start with a pop quiz. Take 15 seconds to look at the list below, asking yourself the question “What do all these have in common?”

  • address books
  • video cameras
  • pagers
  • wristwatches
  • maps
  • books
  • travel
  • games
  • flashlights
  • home telephones
  • cash registers
  • MP3 players
  • Day timers
  • alarm clocks
  • answering machines
  • The Yellow Pages
  • wallets
  • keys
  • transistor radios
  • personal digital assistants
  • dashboard navigation systems
  • newspapers and magazines
  • directory assistance
  • travel and insurance agents
  • restaurant guides
  • pocket calculators

The commonality is that all of these were disrupted by smartphones and their operating system (OS) platforms — Google Android and Apple iOS.

Let’s consider a healthcare comparison. Ask yourself, “What do all these have in common?”

  • Primary care
    • Urgent care
    • Office visits
  • Hospitals
    • Inpatient
    • Outpatient
    • ER
  • Specialist access
  • Behavioral health
  • Diagnostics
  • Patient portals
  • Home health services
  • Medication administration\
  • Preventive care
  • mHealth apps
  • EHR functionality/apps, e.g.,
    • Scheduling & check in
    • Billing
    • eRX
    • Medication management
    • Referral management
    • Care planning
    • Care coordination
    • Social care
    • Patient education
    • Patient communications

The commonality is that all of these are potentially disruptable by Virtual Care Platforms (VCPs).

In this essay we ask the question “Will virtual care platforms become healthcare’s mega-platforms?” We believe the potential for such a scenario is strong. We describe and assess parallels between the evolution of the duopoly smartphone operating system (OS) market and the emerging virtual care platform market. Our intent is to describe a plausible scenario for the future – not to make a prediction.

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Health Care: Don’t Be Evil

By KIM BELLARD

Google’s corporate motto – written in its original Code of Conduct — was once “Don’t be evil.”  That softened over time; Alphabet changed it to “Do the right thing” in 2015, although Google itself retained the slogan until early 2018.  Some Alphabet employees think Google/Alphabet has drifted too far away from its original aims: they’ve formed a union in order to try to steer the company back to its more idealistic roots.

Parul Koul and Chewy Shaw, two Alphabet software engineers, announced the Alphabet Workers Union in a New York Times op-ed, vowing to live by the original motto, and to do what they can to ensure that Alphabet and its various companies do as well.  They assert: “We want Alphabet to be a company where workers have a meaningful say in decisions that affect us and the societies we live in.”

It’s past time that health care workers, including physicians and executives, stood up for the same thing.

Ms. Koul and Mr. Shaw cite several grievances, including payouts to executives accused of sexual harassment, the firing of a leading AI expert over her efforts to address bias in AI, and company efforts to “keep workers from speaking on sensitive and publicly important topics.”  Doing the work, even doing it well and being well paid for it, is not enough:

We care deeply about what we build and what it’s used for. We are responsible for the technology we bring into the world. And we recognize that its implications reach far beyond the walls of Alphabet.

Their goal is for Alphabet “to be a company where workers have a meaningful say in decisions that affect us and the societies we live in.”  Alphabet, they say, “has a responsibility to prioritize the public good. It has a responsibility to its thousands of workers and billions of users to make the world a better place.” 

Investors may not quite agree.

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The Wrong Legacies

By KIM BELLARD

I read two articles this week that got me thinking, Robert Charette’s “Inside the Hidden World of Legacy IT Systems” (IEEE Spectrum) and Douglas Holt’s “Cultural Innovation” (Harvard Business Review).   Both deal with what I’ll call legacy thinking. 

It’s a particular problem for healthcare.

———-

If you work in a large organization, especially one that has been around for at least a few decades, the words “legacy system” probably strikes angst in you.  If you’ve dealt with such an organization, legacy systems probably contributed to problems you may have had with them.  Think about health insurance claims systems, hospital billing systems, financial institution account records, or practically any government system. 

Dr. Charette points out:

Though these systems run practically every aspect of our lives, we don’t give them a second thought because, for the most part, they function. It doesn’t even occur to us that IT is something that needs constant attention to be kept in working order.”

Because they usually work OK, management often doesn’t want to risk the potential disruption of replacing or modernizing them, so they get older and older, with more and more layers built on them, and with the people who originally built them or understand the language they are written in (e.g. COBOL) gone. 

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Catalyst @ Health 2.0 Launches Rapid Response Open Call with Grapevine Health

SPONSORED POST

By CATALYST @ HEALTH 2.0

Attention digital health innovators! Do you have innovative text message-based health tech solutions that can disseminate health-focused video content? Apply to the Grapevine Health Rapid Response Open Call! 

As the COVID-19 pandemic continues, the importance of health literacy and communication is more apparent than ever. Catalyst @ Health 2.0 is proud to host a Rapid Response Open Call (RROC) in collaboration with Grapevine Health. Five semi-finalists will receive $1k each and will have the opportunity to demo their technology. A grand prize winner will receive $5k and the opportunity to collaborate with Grapevine Health! 

Do you have a solution that can fit this need? Apply HERE today! Applications close 8/27.

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Quality Virtual Care Is Within Reach – But Only If We Act Now

By JULIA HU

Though it will be impossible to overstate the devastation that the COVID-19 pandemic is leaving in its wake, we can also acknowledge that it has pushed humanity to creatively adapt to our new, socially-distanced reality—necessity is the mother of invention, as they say. Telehealth is not a new invention, but the necessity of keeping people physically apart, especially those particularly vulnerable to COVID, has suddenly put virtual health care at the center of our delivery system. 

Patients and providers quickly pivoted to at-home care as in-person visits were limited for safety, and use of telehealth spiked early in the outbreak. One survey of over 500,000 clinicians showed that by April—only about two weeks after the first stay-at-home orders were issued in the U.S.—14 percent of their usual number of pre-pandemic visits were being conducted via telemedicine. For many, that involved using unfamiliar technology and a big shift in procedures for providers. Congress recognized the need to support providers through this transition and allocated $500 million for waiving restrictions on Medicare telehealth coverage as part of the emergency funding bill that passed in March. 

But, as restrictions have begun to lift and hospitals and medical offices are beginning to reopen for non-emergent care, we have seen the use of telemedicine start to taper off. The same 500,000 clinicians were surveyed  in June, revealing that telemedicine was used for only 8 percent of the usual pre-pandemic number of visits. Providing quality, virtual health care won’t be as easy as flipping a switch, but we currently have an unprecedented opportunity to carry forward the best version of virtual care and create a more holistic health care system. As we work toward that goal, there are three components our virtual care system needs in order to be sustainable, feasible, and manageable for both patients and providers. 

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Robert Wood Johnson Foundation Innovation Challenges Blog Post Announcing Semi-Finalists

SPONSORED POST

By CATALYST @ HEALTH 2.0

The novel coronavirus (COVID-19) has underscored the need for efficient and innovative emergency response. Major health organizations, such as the American Hospital Association, have provided resources that can be utilized for organizational preparedness, caring for patients, and enabling the workforce during the pandemic.

As COVID-19 brought to light the lack of emergency response preparedness in the health care system, the Robert Wood Johnson Foundation (RWJF) and Catalyst saw an opportunity to highlight digital health’s potential to support health care stakeholders and the general public. RWJF and Catalyst partnered to launch two Innovation Challenges on Emergency Response for the General Public and Emergency Response for the Health Care System. 

The Emergency Response Innovation Challenges asked innovators to develop a health technology tool to support the needs of individuals as well as health care systems affected by a large-scale health crisis, such as a pandemic or natural disaster. The Challenges saw a record number of applications— nearly 125 applications were submitted to the General Public Challenge and over 130 applications were submitted to the Health Care System Challenge. 

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Too Many Small Steps, Not Enough Leaps

By KIM BELLARD

I was driving home the other day, noticed all the above-ground telephone/power lines, and thought to myself: this is not the 21st century I thought I’d be living in.  

When I was growing up, the 21st century was the distant future, the stuff of science fiction.  We’d have flying cars, personal robots, interstellar travel, artificial food, and, of course, tricorders.  There’d be computers, although not PCs.  Still, we’d have been baffled by smartphones, GPS, or the Internet.  We’d have been even more flummoxed by women in the workforce or #BlackLivesMatter.  

We’re living in the future, but we’re also hanging on to the past, and that applies especially to healthcare.  We all poke fun at the persistence of the fax, but I’d also point out that currently our best advice for dealing with the COVID-19 pandemic is pretty much what it was for the 1918 Spanish Flu pandemic: masks and distancing (and we’re facing similar resistance).  One would have hoped the 21st century would have found us better equipped.

So I was heartened to read an op-ed in The Washington Post by ReginaDugan, PhD.  Dr. Dugan calls for a “Health Age,” akin to how Sputnik set off the Space Age.  The pandemic, she says, “is the kind of event that alters the course of history so much that we measure time by it: before the pandemic — and after.”  

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