Today on Health in 2 Point 00, the survey says digital health is optimistic! Find out more on the other side. On Episode 207, Jess asks me about Aetion getting $110 million bringing its total to $212 million working on real world evidence for pharma companies, and Indonesian telehealth company Halodoc gets $80 million. MSK startup Vori Health gets $45 million—can they compete with Hinge? Next, Heartbeat Health gets $20 million for cardiovascular health. Finally, Andreesen throws $10.5 million in a Series A to Memora Health which is a patient messaging system. Don’t forget to join us on Clubhouse tonight for more! —Matthew Holt
Above the Fold
Five Weight Loss Myths I am Constantly Fighting
By HANS DUVEFELT
1) EXERCISE MORE
I talk to people almost every day who think they can lose weight by exercising. I tell them that is impossible. I explain that it takes almost an hour of brisk walking to burn 100 calories, which equals one apple or a ten second binge on junk food. To lose a pound a week, you need to reduce your calorie intake by about 500 per day – that would be the equivalent of five hours of moderate exercise every day. We’d have to quit our jobs to do that.
2) EAT MORE FRUITS AND VEGETABLES
The other fallacy I hear all the time is that, somehow, adding “healthy” fruits and vegetables can make a person lose weight. I tell them that adding anything to their daily calorie intake will have the opposite effect. I more or less patiently explain that our job is to figure out what to take away instead of what to add. Maybe substituting a fruit for a Whoopie pie is healthy in other ways, but it has almost nothing to do with weight loss.
3) EAT BREAKFAST
A third fallacy is that eating a healthy breakfast will ensure weight loss. To explore this one, I ask: “Are you often hungry?”
So many of my overweight patients deny ever feeling hungry – that gnawing feeling in the pit of your stomach and the low blood sugar onfusion and weakness I feel by 9 or 10 am after doing barn chores on an empty stomach (only coffee).
When I hear “I never feel hungry”, I don’t recommend starting a good breakfast habit because that would likely increase a person’s daily calorie intake. But when I hear that a breakfast skipper goes for the doughnuts mid morning due to hunger, I certainly recommend eating breakfast. When I do, I always point out that the typical American cereal and banana breakfast, along with soft drinks, is actually the major reason for our obesity and diabetes epidemics.
Continue reading…A Timex Healthcare System
By KIM BELLARD
Those of us of a certain age remember the Timex slogan that bragged about its watches’ durability: “It takes a licking and keeps on ticking.” A recent article about our military, of all things, made me wish we had a healthcare system that prized that kind of durability.
I can never resist analogies between the U.S. healthcare system and the U.S. military system. They’re both huge, they’re both wildly expensive, they both rely on a combination of high tech and front-line people, and they both protect us from threats. In some ways, both are the best in the world, and, in other ways, both have weaknesses that are embarrassing. And, as I wrote last year, both are often still fighting the wrong wars.
The article is by national security expert JC Herz on the Atlantic Council’s website: A plea to the Pentagon: Don’t sacrifice resilience on the altar of innovation. Boy, that sure applies to healthcare too.
Ms. Herz notes how Americans love innovation, but:
This mythos informs a narrative that what is valuable is The New—the upgrade to something bigger, badder, and sexier…What the United States needs to reinvigorate its defense base, compete with China, and win the global economy must be more innovation.
Except the United States does not suffer from a lack of innovation; it suffers from a lack of resilience.
Continue reading…The Catalyst @ Health 2.0/Wipfli State of Digital Health Survey
By MATTHEW HOLT & ELIZABETH BROWN
Last year was a remarkable time for digital health. Obviously it was pretty unusual and tragic for the world in general as the COVID-19 pandemic continued to wreak havoc. We mourn those lost, and we praise our front line health workers and scientists. But for digital health companies, in almost no time 2020 changed from fear of a market collapse to what became a massive funding boom.
But no-one has reported from the ground what this means for digital health companies, of which there are perhaps 10-15,000 worldwide with maybe 6-8,000 based in the United States. Despite the headlines, most are not pulling down $200m funding rounds or SPACing out. So working with professional services firm Wipfli, we at Catalyst @ Health 2.0 decided to find out what digital health companies experienced in this most extraordinary year.
Between Thanksgiving 2020 and mid-March 2021, we surveyed more than 300 members of the digital health ecosystem, focusing on leaders from more than 180 private (and a few public) digital health companies. We asked them about their market, their experience during COVID-19, and what they thought of the environment. We also asked them about the mechanics of running their businesses. The results are pretty interesting.
The Key Message: COVID-19 was very good for digital health companies–on average. Most are very optimistic but, despite the massive increase in funding since the brief (but real) post-lockdown crash, most digital health companies remain small and struggling for funding, revenue, and customers.
We also heard from investors, and a bigger group we called “users” (mostly payers, providers, pharma, non-healthcare tech companies, e-patients & consultants). While these “users” also saw a big trend towards the use of (and, to a lesser extent, paying for) digital health tools and services, they were not as gung-ho as were digital health companies or investors, who were even more optimistic.
The summary deck containing the key findings is below and there is more analysis and commentary below the jump.
#Healthin2Point00, Episode 206 | Walmart buys MeMD, Science 37 SPACs out, Vim & Zoe
Today in #Healthin2Point00, Jessica is not impressed by my stock trading and it’s all Walmart’s fault (well, Amazon’s too)! Part of the reason for that is Walmart buying a no-name telehealth company–well it has a name but not one anyone knows. There’s a SPAC exit on the horizon for fast growing remote clinical trials company Science37, and funds for Vim which does scheduling (we think!), and Zoe which sells a diet so expensive you might actually stick to it!–Matthew Holt
Special Event: The Catalyst @ Health 2.0/Wipfli Survey on the State of Digital Health Results Presentation
TODAY Tuesday, May 11th at 2pm ET/11am PT — RSVP here
Back in November of last year, Catalyst @ Health 2.0, supported by professional services firm Wipfli, launched the Survey on the State of Digital Health, with the goal of creating a comprehensive analysis of the impact of COVID-19 on digital health companies and the rest of the ecosystem. Between the end of 2020 and thru March 2021 we received detailed responses from 300+ digital health aficionados including 180 digital health companies. We’re sure this is the most detailed assessment of what’s happening on the ground in digital health companies you’ll find anywhere.
Join us at 2pm ET/11am PT on Tuesday, May 11th for The Catalyst @ Health 2.0/Wipfli Survey on the State of Digital Health Results Presentation, you’ll see the full results from me & Catalyst’s Elizabeth Brown, hear from Wipfli’s Paul Johnson & Girish Ramachandra, and get reaction to the results from our guests Ryan Johnson, lawyer at Fredrikson & Byron; Sunny Kumar, investor at GSR Ventures;, and digital health CEOs Helena Plater-Zyberk, Supportiv; and Mudit Garg, Qventus.
I think the zoom is full, but you can see it livestreamed below at 11 am PT – 2pm ET – Matthew Holt
Screening for Depression: Then What?
By HANS DUVEFELT
Primary Care is now mandated to screen for depression, among a growing host of other conditions. That makes intuitive sense to a lot of people. But the actual outcomes data for this are sketchy.
“Don’t order a test if the results won’t change the outcome” was often drilled into my cohort of medical students. Even the US Public Health Service Taskforce on Prevention admits that depression screening needs to take into consideration whether there are available resources for treatment. They, in their recommendation, refer to local availability. I am thinking we need to consider the availability in general of safe and effective treatments.
If the only resource when a patient screens positive for depression is some Prozac (fluoxetine) at the local drugstore, it may not be such a good idea to go probing.
The common screening test most clinics use, PHQ-9, asks blunt questions about our emotional state for the past two weeks. This, in my opinion, fits right into the new American mass hysteria of sound bites, TikTok, Tweets, Facebook Stories, instant messages, same-day Amazon deliveries and our worsening pathological need for stimulation and instant gratification.
Continue reading…10 Design Considerations for Vaccine Credentials
By ADRIAN GROPPER
As COVID-19 vaccines become widely, if not fairly, available in different regions, both the public and private sector are working to develop vaccine credentials and associated surveillance systems.
Information technology applied to vaccination can be effective, but it can also be oppressive, discriminatory, and counter-productive.
But these systems can be tuned to reflect and address key concerns.
What follows is a list of ten separable concerns, and responsive design strategies. The concept of separation of concerns in technology design offers a path to better health policy. Because each concern hardly interacts with the others, any of them can be left out of the design in order to prioritize more important outcomes. Together, all of them can maximize scientific benefit while enhancing social trust.
- Authenticity
An inspector should be assured that a vaccine certificate was not tampered with and that it was issued to the presenter. This need not imply any privacy risk, or even need a network connection. One such method for authenticating vaccine credentials adds a human-recognizable and machine-readable face photo to a standard 2D barcode. It works with paper as well as mobile phone presentations.
- The digital divide
For this concern, paper credentials have equity and privacy advantages. Equity, because paper is cheap and well understood. Privacy, because there is no expectation that a person must unlock and show a mobile phone. Digitally signed certificates that also include a photo, like #1 above, can be copied for convenience without risk of fraud.
Continue reading…This Mother’s Day, Let’s Get Mothers the Health Care Coverage They Need
By ROSEMARIE DAY and DEBORAH GORDON
Mothers deserve more than a day of recognition this year—they deserve the whole month, and more. The pandemic has been particularly hard on women, especially poor women and women of color.
To demonstrate the appreciation mothers deserve this Mother’s Day, we should get them something they really need: health care. To improve maternal health, we should look to the Medicaid program, long a pathway to accessible, quality health care for low-income Americans. Medicaid is especially important for mothers; it covers close to half of all births in the U.S.
Now, states have the opportunity to do even more for moms.
The American Rescue Plan signed into law in March gives every state the option to extend Medicaid maternity coverage for up to 12 months postpartum, a significant increase from the current limit of just 60 days. Illinois has already announced it will extend postpartum coverage; other states should follow. Extending the guaranteed coverage period will increase access to postnatal care during this ‘fourth trimester’ to ensure that women can access treatment for common conditions like postpartum depression as well as preventing organ prolapse or hemorrhage. Not only mothers will benefit. Parental insurance is associated with better health for children, including a lower risk of adverse childhood experiences.
In addition, the American Rescue Plan offers an opening to expand Medicaid with even more federal funding than is currently available through the Affordable Care Act. The 12 states, mostly in the South, that have not expanded their Medicaid programs are leaving hundreds of thousands of women without the support they deserve.
Expanding Medicaid programs will provide robust access to health care to more women and reduce maternal morbidity and mortality, which has reached crisis proportions among many women of color. Black and Indigenous women are more likely than other women to die during pregnancy, childbirth, and the postpartum period. According to the CDC, the maternal mortality rate is 2.5 times higher for Black women than white women. Disparate access and uneven quality of care, higher rates of chronic illness, and racism all play a part in that grim statistic.
The disproportionate burden of maternal mortality and adverse outcomes from childbirth has long-lasting effects on mothers and their children. Black newborns have an increased risk for long-term complications resulting from pre-birth complications. They may also face generational poverty and trauma in the long run if they are born to a mother who dies during childbirth.
Continue reading…#Healthin2Point00, Episode 205 | Groups, Collective Health, Oura Ring & Ciitizen buys Stella
Today on Health in 2 Point 00, it’s time for the silliness to end, and for Jess DaMassa and I to take digital health deals seriously. Groups gets $60 million from a bunch of famous investors. Oura, they of the tracking ring used by the NBA, gets $100m, and TPA substitute Collective Health gets a whopping $280m from a big Blues plan. And our favorite privacy maven Deven McGraw gets a mention as her company Ciitizen buys interoperability tech company Stella. Did we maintain our serious demeanor? You’ll have to watch to find out but you can probably guess the answer! —Matthew Holt
