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“Necessitous Men Are Not Free Men” – Words to Remember

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By MIKE MAGEE

In the second half of the 19th century, Emily Dickinson wrote a short poem that could easily have been a forward looking tribute to two American Presidents – one from the 20th, the other the 21st century.

Dickinson’s poem “A WORD is dead” is hardly longer than its title.

“A WORD is dead

When it is said,

  Some say.

I say it just

Begins to live

  That day.”

She certainly was on the mark when it came to President Franklin Delano Roosevelt’s signature legislation. FDR’s New Deal, extending from 1933 to 1939, ultimately came down to just three words – the 3R’s – Relief , Recovery, and Reform.

He promised “Action, and action now!”  This included a series of programs, infrastructure projects, financial reforms, a national health care program and industry regulations, protecting those he saw as particularly vulnerable including farmers, unemployed, children and the elderly.  And he wasn’t afraid to make enemies. Of Big Business, he said in a 1936 speech in Madison Square Garden, “They are unanimous in their hate for me – and I welcome their hatred.”

But he was also a political realist. And by his second term of office Justice Hughes and his Conservative dominated Supreme Court had begun to undermine his legislative successes and were threatening his signature bill- the Social Security Act. So FDR compromised, and in the face of withering criticism from the AMA, postponed his plans for national health care.

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#Healthin2Point00, Episode 204 | Vida, Headway, & Neuroelectrics, plus RCM acquires VisitPay

Today on Health in 2 Point 00, I am over the moon excited about Chelsea’s Champion’s League semi-final win. But on Episode 204, we have some big deals to cover too. First, Vida Health gets $110 million in a Series D bringing their total to $188 million. Next, R1 RCM acquires VisitPay for $300 million, integrating patient financial engagement into their revenue cycle management offerings. It’s Mental Health Awareness Month, and mental health startup Headway raises $70 million – do they have a chance in that crowded space? Finally, Neuroelectrics gets $17.5 million for their neurostimulation cap helping with epilepsy and depression. —Matthew Holt

THCB Gang Episode 53, Thursday May 6

Episode 53 of “The THCB Gang” was live-streamed on Thursday, May 5 at 1pm PT -4PM ET. Matthew Holt (@boltyboy) was joined by regulars: futurists Ian Morrison (@seccurve) & Jeff Goldsmith; privacy expert and now entrepreneur Deven McGraw  @HealthPrivacy; policy expert consultant/author Rosemarie Day (@Rosemarie_Day1); medical historian Mike Magee (@drmikemagee), & THCB regular writer Kim Bellard (@kimbbellard)

Matthew was celebrating Chelsea’s Champion’s League Semi final win, but the rest of the gang talked about some big picture issues behind public health, COVIUD and health care policy!

The video is below but if you’d rather listen to the podcast. it will be available on our iTunes & Spotify channels from Friday. 

Inside Vida Health’s $110M Series D & Big Push into Digital Mental Health

By JESSICA DaMASSA, WTF HEALTH

It’s another mega-round for a digital health chronic condition management startup, as Vida Health closes its $110M Series D – AND adds a pair of big-name insurers to their cap table. Vida’s Founder & CEO, Stephanie Tilenius, gets into the good news about the funding round, which was led by growth equity fund, General Atlantic, and brought managed care giant Centene (a Vida customer) and multinational insurer AXA into the mix.

Beyond the funding – and the extra “insurance side” endorsement it gives to the virtual chronic condition care space – what’s interesting about Vida now is how its “whole person” approach, which integrates physical health care and mental health care, is very much tilting to mental health these days.

While overall revenue has tripled since last year, Stephanie talks about how the 6000% year-over-year growth for her mental health services has played into that rise, and how the new funding will be used to further expand those offerings.

Does this mean we need to start naming Vida as a competitor to digital mental health companies like Ginger, Modern Health, and Talkspace? And, how does this impact their positioning among the field of other health tech chronic care co’s? For those who may have forgotten, Vida went out the gate with a platform that was designed to treat both the mental-and-physical aspects of chronic disease, while others like Omada and Livongo-now-Teladoc acquired-and-integrated behavioral health providers to augment their physical-first offerings and satisfy customer demands. Will it now prove easier for Vida to scale-up and scale-out, having been built for both “mind and body” from the very beginning? Stephanie’s got her opinion, big plans, and now a treasury to rival those key competitors across both fields of care. Tune in for all the details!

#Healthin2Point00, Episode 203 | Privia goes public, Vocera acquires PatientSafe Solutions & more

Today on Health in 2 Point 00, Jess hardly knows the value of $100 million anymore – is it a salary, is it an entire fund, is it one single round? On Episode 203, Jess and I cover Vocera buying PatientSafe Solutions and Privia going public with a $3.7 billion market cap. Cash-paid healthcare services company Sesame gets $24 million in a Series B, Ceribell gets $53 million in a Series C for its portable EEG, and Summus Global gets $21 million in a Series B providing virtual specialist care. —Matthew Holt

We Are All Designers

By KIM BELLARD

Raise your hand if you had to go through the Hunger Games labyrinth to score a COVID-19 vaccine earlier this year – figuring out which phone number(s)/website(s) to try, navigating it, answering all the questions, searching for available appointments within reasonable distances, and, usually, having to try all over again.  Or, raise your hand if you’ve had trouble figuring out how to use an Electronic Health Record (EHR) or an associated Patient Portal. 

Maybe you thought it was you.  Maybe you thought you weren’t tech-savvy enough.  But, a trio of usability experts reassure us, it’s not: it’s just bad design.  And we should speak up.

“Everyone everywhere: A distributed and embedded paradigm for usability,” by Professors Michael B. Twidale, David M. Nichols, and Christopher P. Lueg, was published in Journal of the Association for Information Science and Technology (JASIST) in March, but I didn’t see it until the University of Illinois School of Information Sciences (where Dr. Twidale is on faculty) put out a press release a few days ago. 

The authors believe that bad design has costs — to users and to society — yet: “The total costs of bad usability over the life of a product are rarely computed. It is almost like we as a society do not want to know how much money has been wasted and how much irritation and misery caused.”

Whatever the numbers are, they’re too high.

As Dr. Twidale said:

Making a computer system easier to use is a tiny fraction of the cost of making the computer system work at all. So why aren’t things fixed? Because people put up with bad interfaces and blame themselves. We want to say, ‘No, it’s not your fault! It is bad design.'”

He specifically referenced the vaccine example: “When hard to use software means a vulnerable elderly person cannot book a vaccination, that’s a social justice issue.  If you can’t get things to work, it can further exclude you from the benefits that technology is bringing to everyone else.” 

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Digital Mental Health Hits Mainstream: Cigna’s Behavioral Health CMO on National Rollout of Ginger

By JESSICA DaMASSA, WTF HEALTH

Cigna is making digital mental health services available to its entire nationwide network of 14 million members, and it’s selected health tech startup, Ginger to deliver the new benefit. Cigna’s Chief Medical Officer for Behavioral Health, Doug Nemecek, and Ginger’s CEO, Russ Glass, stop by to discuss the deal and why Cigna is making such a commitment to expanding its behavioral health offering.

This is about more than just dealing with mental health in the aftermath of Covid; Cigna is actually looking at Ginger’s behavioral health coaching model as preventative. Will other health plans follow suit? Could expanded coverage for lower-acuity mental health services become commonplace? Doug talks about what’s ahead for mental health care from a population health standpoint, and how services like Ginger’s give primary care docs a standard, trusted provider to which they can refer patients when it comes to increasingly common concerns like depression and anxiety. For Russ and Ginger, who talk about using virtual care to right the “supply-and-demand imbalance” in mental health care, what will more than doubling their current client base (from 10 million to 24 million) do to their own ability to provide supply? It’s a moment-of-truth for the business of digital mental health and we’ve got the details!

Some People Don’t Think Like Doctors (!)

By HANS DUVEFELT

This may come as a surprise for people with business degrees:

Doctors don’t really care when a test was ordered. We care about our patient’s chest X-ray or potassium level the very moment the test was performed. We also don’t care (unless we are doing a forensic review of treatment delays) when an outside piece of information was scanned into the chart. We want to know on which day the potassium was low: Before or after we started the potassium replacement, for example.

In a patient’s medical record, we have a fundamental need to know in what order things happened. We don’t prefer to see all office visits in one file, all prescriptions in another and all phone calls in a third. But that seems to be how people with a bookkeeping mindset prefer to view the world. In some instances we might need that type of information, but under normal clinical circumstances the order in which things happened is the way our brains approach diagnostic dilemmas.

Yes, I have said all this before, but it deserves to be said again. Besides, only 125 people read what I wrote about this six weeks ago, while almost 10,000 people read my post about doxepin.

Patients’ lives are at stake and, in order to do our job, we need the right information at the right time, in the order we need it, even if the bookkeepers prefer it a different way.

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#Healthin2Point00, Episode 202 | Virta, Seqster, Kaia, Capsule & Accolade acquires PlushCare

On Health in 2 Point 00, Jess and I talk about TDOC earnings before getting into today’s deals. First, Virta Health scores $133 million in a round led by Tiger Global for its keto diabetes reversal program. Seqster raises $12 million in its Series A, and there are some interesting investors in this one. MSK startup Kaia Health raises $75 million, bringing its total to $123 million. Online pharmacy Capsule raises $300 million, bringing its total to $570 million. Finally Accolade acquires virtual primary care platform PlushCare in a $450 million deal. —Matthew Holt

THCB Gang Episode 52, Thursday April 29

Thursday’s #THCBGang was another with a special guest. Matthew Holt (@boltyboy) was joined by regulars, employer health expert Jennifer Benz (@jenbenz); patient safety expert and all around wit Michael Millenson (@MLMillenson); WTF Health host & Health IT girl Jessica DaMassa (@jessdamassa); & Consumer advocate & CTO of Carium Health, Lygeia Ricciardi (@Lygeia).

Our special guest was Shantanu Nundy @DrNundy who is Chief Medical Officer of Accolade and more importantly author of new book Care After Covid. We dug into the question about what the post-covid health care system will look like, while I let slip why I’m grumpy Accolade just paid $450m for Plushcare! (You have to wait for the very end for that!)

Then video is up below. If you’d rather listen, the audio is preserved as a weekly podcast available on our iTunes  & Spotify channels.

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