I never ceased to be amazed by how smart young clinicians solve problems that they see. Michelle Longmire was in residency at Stanford working with colleagues building point solutions when she realized that what they needed was an easy platform on which to develop medical grade apps. Her company Medable was the result. Then she realized that the other big market was clinical researchers, who now have access to Apple’s ResearchKit, but need an easy way to build a study without using developers. I interviewed her recently and she built a study for me using Medable’s new Axon product.
Secrets to Choosing the Right Medical School
The competition to get into medical school is fierce. The Association of American Medical Colleges just announced that this year, nearly 50,000 students applied for just over 20,000 positions at the nation’s 141 MD-granting schools – a record. But medical schools do not have a monopoly on selectivity. The average student applies to approximately 15 schools, and many are accepted by more than one. Students attempting to sort out where to apply and which admission offer to accept face a big challenge, and they often look for guidance to medical school rankings.
Among the organizations that rank medical schools, perhaps the best-known is US News and World Report (USNWR). It ranks the nation’s most prestigious schools using the assessments of deans and chairs (20%), assessments by residency program directors (20%), research activity (grant dollars received, 30%), student selectivity (difficulty of gaining admission, 20%), and faculty resources (10%). Based on these methods, the top three schools are Harvard, Stanford, and Johns Hopkins.
Rankings seem important, but do they tell applicants what they really need to know? I recently sat down with a group of a dozen fourth-year medical students who represent a broad range of undergraduate backgrounds and medical specialty interests. I posed this question: How important are medical school rankings, and are there any other factors you wish you had paid more attention to when you chose which school to attend?
Biosurveillance at the Point of Care
Living in Atlanta and working within the healthcare delivery innovation community, the mounting Ebola outbreak taught us all how quickly the “global” can become local.
For a healthcare system threatened by infectious disease, complex chronic illness, environmental and population management issues, the outbreak also reinforces how new technologies are advancing patient and caregiver safety, prevention, patient monitoring, diagnosis and even treatment.
The answer, through non-contact medicine, is literally in the airwaves.
Researchers at Stanford are pursuing the combined use of laser and carbon nanotubes to provide a more detailed view of blood flow in the brain – down to single capillaries – to increase the understanding of cerebral-vascular disease beyond the imaging provided by CT scan or MRI.
Matthew Holt Interviews PlushCare Founder Ryan McQuaid
Ryan McQuaid, former Head of Product for AT&T mHealth and friend of Health 2.0, joined Matthew Holt to discuss the launch of his brand new startup PlushCare. And when we say brand new, we mean as of writing this post, their Indiegogo campaign is a mere 23 hours old. PlushCare combines elements of telehealth and concierge medicine to provide basic health care via phone, email, and video chat for $10 per month. Busy working professionals can use the service to connect with Stanford MDs for same-day diagnosis and treatment of illnesses or injuries. The physicians provide advice, prescribe medicine, and will refer directly to primary care providers and specialists if necessary.
PlushCare removes the hassle of scheduling an in-person doctor visit, and provides the same care at lower costs. In addition, for each individual that purchases PlushCare, the company provides one child a lifetime of immunity to measles. PlushCare is currently accepting a limited number of members via their Indiegogo campaign to validate demand and user test. Several other companies are using a similar model of tech-enabled services, including American Well and Teladoc, but the space is sure to see more activity at the prospect of pushing basic care out of the doctor’s office in a way that is convenient for consumers and increases provider efficiency.
The Not Normals Break Through — An Update From the Khan Academy
If you’re going to get ambitious about your next task, don’t go and talk to normal people about it. You’ll only get normal answers. Get out of your comfortable little world and step into a completely alien one. As we say round here, when worlds collide, transformation happens.
Love that passage from Brian Millar’s 2012 Fast Company piece. (Plus, it gives me the awesome chance to nod to the eccentrics and outliers—like Millar’s dominatrix and tattooed hipster set—and their unlikely importance to pioneering, breakthrough ideas).
Recently RWJF extended another grant to the Khan Academy; this one for $1.25 million. I say another as we started this health education journey with Sal, Rishi and the Khan team—right after Sal’s outstanding 2011 TED/Long Beach talk. That discussion resulted in a preliminary 2012 $350,000 bet on this great team. We were intrigued by their big idea—and we thought the world might be too.
What’s that big idea again? Just this: an entirely free, utterly fantastic health education for anyone in the world with a computer and an Internet connection.
Potentially crazy? Perhaps. Ambitious? No kidding. But for RWJF’s pioneering work, that’s right where we like to be. We thought there just might be something there. One year later, we are even more convinced. In that time, the Khan team has pushed intensely and hard—creating its new Healthcare and Medicine Initiative basically from scratch.
For instance, with our support, Khan staff have developed about 200 videos now posted on that Healthcare and Medicine Initiative site—as well as their YouTube medical channel. These videos have received about 800,000 views, and the site has over 10,000 new subscribers. Khan continues to work with Stanford Medical School. That collaboration includes developing and posting Stanford Medical School content on the Khan site as well as integrating the online format into traditional medical school courses.Continue reading…
New Johnson & Johnson CEO Discusses Medical Device Futures at Stanford Event
It will take more than a Band-aid to fix the medical device market. This was the message delivered by Alex Gorsky, future Johnson & Johnson CEO, to an auditorium full of students and entrepreneurs at the Stanford Biodesign From the Innovator’s Workbench event last week.
Gorsky, who in a few weeks will take the helm of the world’s largest health-care corporation, discussed challenges and opportunities in medical device market, as his company navigates through a turbulent world economy and a string of product recalls.
“It’s a difficult market,” he said. “The days of incremental innovation are over.”
And, while Gorsky thinks population growth will drive up worldwide demand for health care, it’s unclear who will pay for it.
Gorsky sees a fundamental shift in the way medical devices are purchased, which may change the innovator’s design approach. In the United States, buying decisions will shift from surgeons to cost-conscious hospital buyers. And that may create demand for keep-it-simple medical devices – designs that provide 50 percent of the bells-and-whistles of current devices for 15 percent of the cost. In addition, he cited the need for more clinical information on efficacy and safety, to help hospital administrators justify medical device purchases.
As the U.S. struggles to stem rising health care costs, his company will look to emerging markets – especially China – for growth. He predicts that these health care markets will grow at 4 to 5 times the rate of the domestic market.
Reverse Innovation & The Cost Crisis in American Healthcare
The realization that the American health care system must simultaneously decrease per-capita cost and increase quality has created the opportunity for the United States to learn from low and middle-income countries. “Reverse innovation” describes the process whereby an inexpensive innovation is used first in countries with limited infrastructure and resources and then spreads to industrialized nations like the United States.
The traditional model of innovation has involved the creation of high end products by companies in industrialized nations and the spread of these products to the developing world by adapting them to function in low and middle-income countries. Reverse innovation reverses the direction of spread with the United States borrowing new ideas and products designed for less wealthy countries in order to deliver health care more efficiently. (1)
Resource challenged low and middle-income countries are different from the United States in at least six ways that can serve as catalysts for such reverse innovation: 1) affordability, 2) leapfrog technologies, 3) service ecosystems, 4) robust systems, 5) new applications, and 6) the absence of intermediaries. (2,3)
These nations can’t afford expensive goods so they have to find inexpensive materials or manufacturing options. They also lack 20th century infrastructure and so they have leapfrogged to newer technologies such as mobile phones or solar energy instead of landlines and petroleum based energy sources. Service ecosystems develop in developing countries because entrepreneurs have to rely on others for help by creating new partnerships like video-game cafés where gamers test new products. Emerging markets require products that work in rugged conditions, and customers in poor countries have few product choices, providing market openings for add-ons that update and extend the lives of existing merchandise. (2) Intermediaries such as venture capitalists, universities, and regulators are also often underdeveloped in poorer countries. (3)Continue reading…