Categories

Above the Fold

If It Ain’t Real Time, It Ain’t Really Real

By KIM BELLARD

Here’s a damning opening paragraph from an article in The New York Times about the frustrations that COVID-19 vaccinations are causing:

For a vast majority of Americans, a coronavirus vaccine is like sleep for a new parent: It’s all you can think about, even if you have no idea when you will get it.

Because, as Kaiser Health News reported: “Many states don’t know exactly where the doses are, and the feds don’t either.” 

Think about that: in 2021, we can’t – or don’t – track something as vital as where vaccine doses are, in the midst of the pandemic they were designed in record time to mitigate. Nor, as it turns out, are we doing a good job of tracking how many have already had them, who is now eligible for them, or assuring that essential workers or disadvantaged populations are getting them. 

Amazon tells me when my purchases have shipped, where they are in the shipping process, and when they’ve been delivered.  They even send me a picture of purchases sitting on my porch to make sure I notice. Walmart’s supply chain management is equally vaunted

Health care executives evidently aren’t required to learn supply chain management. 

Continue reading…

#Healthin2Point00, Episode 183 | Oscar IPO, Plume, Sitka, & Alma

Today on Health in 2 Point 00, we’ve apparently got 58 different SPACs looking to acquire health tech companies – so looks like Jess and I will be staying busy! On Episode 183, Jess asks me about Oscar Health filing their S1 and all the dirt people are digging up for IPO, Plume raising $14 million for their full stack clinic for transgender people, Sitka raising $14 million, and Alma raising $28 million providing practice management software for mental health providers. —Matthew Holt

UpHealth’s Exec Leadership Team on the Digital Health Super-Company’s Plans for Market Growth

By JESSICA DaMASSA, WTF HEALTH

The executive leadership team of UpHealth, the self-described “global digital health super-company” that’s headed toward the public market via a SPAC that’s brought together six companies, 10-years of health tech innovation, and a war chest of $285M dollars, stops by to talk about growth plans and grabbing market share. UpHealth’s Chairman & Founder, Dr. Chirinjeev Kathuria, Co-CEO & President Dr. Al Gatmaitan, and future COO Jamey Edwards talk through what Jamey says is “really a revenue story” about the fastest growth areas of digital health. Global telehealth, integrated care management, digital pharmacy, and behavioral health will be UpHealth’s sweet spots. The newco is positioning itself as a “one-stop shop” for the digital healthcare infrastructure that will support a local healthcare organization in rolling out digital care services and integrating them with their in-person care continuums. This is different than, say, a Teladoc or an Amwell, which in addition to providing infrastructure also have their own tech-enabled medical groups, which can sometimes be viewed as competitive to their customers. The global nature of UpHealth is another differentiator, particularly in how it hopes to ultimately make it possible for highly specialized care from the US to be “exported” to countries abroad AND for lower cost care for lower acuity issues to be “imported” in. With $190M in revenue projected for 2021 – and that’s NOT dependent on integrating the six companies – we talk through areas for potential growth, that aforementioned competitive landscape, and whether or not UpHealth is feeling the pressure to hurry their integration.

You Can’t “Elon Musk” Healthcare

By SOFIA NOORI

On January 26th, Philadelphia discovered that the 22-year-old organizer of its largest COVID-19 vaccination site, Andrei Doroshin, had turned away elderly members of the Philadelphia community from their vaccine appointments. Instead, he pocketed extra vaccine vials to administer to 4 friends and girlfriend. An RN witnessed the event and reported it to authorities. 

Local news reporters quickly discovered that this incident was just the tip of the iceberg for Doroshin. A Drexel University graduate student with no experience in healthcare, Doroshin had enlisted his college friends to organize a group that would go on to win one of the biggest vaccination contracts from the city of Philadelphia. He told his friends that “this is a wholly Elon Musk, shoot-for-the-heaven type of thing,” and that “we’re going to be millionaires.” His organization had also amended its privacy policy allowing for patient data to be sold, administered large numbers of vaccines to people ineligible to receive the vaccine yet, and threw Philadelphia’s COVID vaccination program into chaos

For the people in the back: One can’t simply “Elon Musk” healthcare. We have seen this too many times – a privileged young upstart with little experience believes that s/he can transform healthcare and make millions – or billions – doing so. Examples abound: we only have to look a couple years into the past to remember Elizabeth Holmes, the Stanford dropout who founded Theranos and misrepresented its technology, or to Outcome Health, whose former CEO Rishi Shah defrauded investors by overinflating business metrics. If “move fast and break things” works in other sectors, many reason, why won’t it work in the 4 trillion dollar industry of healthcare? 

Healthcare is simply not the kind of business where one can shoot a rocket into the sky and accept the risk that it might explode. Simply put, this is people’s lives we’re dealing with. But a deeper layer involves trust in the medical establishment. U.S. healthcare is already marred by multiple grave issues: a complex bureaucracy, serious health inequities, and astronomical costs that can bankrupt a person in just one hospitalization. The trust that people have in U.S. healthcare has steadily dropped over the years. Further, the politicization of the COVID-19 pandemic and the U.S. government’s bungled response to it has only sowed further distrust, especially among marginalized and minoritized communities

Continue reading…

Critical Care Nurse Shortage During COVID-19 Pandemic: A Call for Nurse Anesthesia Students to Bedside

By TONYCHRIS NNAKA

In March of 2020, when we had limited knowledge on the infectivity and virulence of the virus that causes COVID-19, I joined a team of critical care nurses who were willing to risk their lives to care for those suffering from COVID-19. As a full-time PhD student in nursing, a new parent to my infant son, a primary caregiver to my 73-year-old mother, and as someone with a known history of severe asthma, I knew that I was embarking on a journey that could potentially cost me my professional and personal dreams and endanger those I care for the most in life: my family. My intentions to practice only part-time as a critical care nurse while pursuing full-time studies were halted after only two weeks of managing critically ill COVID-19 patients early in the pandemic. The countless code blues and unprecedented levels of patient deaths made it clear that we were in uncharted territory.  After seeing the pain and fear on the faces of my nursing peers, I knew I could never leave them behind in this new battlefield. So, I stayed at bedside full-time for a year while also maintaining my full-time status as a PhD student. I had to. I could not turn my back on my practice oath, or my future professional goals as a nurse scientist. It is in this spirit that, on behalf of myself and my exhausted colleagues, I call on those with critical care experience who have stepped away from bedside to return, as they are able, and answer this same call to action. 

The extent of the critical care nursing shortage we are currently experiencing is alarming to me and almost beyond my comprehension. This shortage has forced critical care nurses who have been at bedside since March of last year to remain at bedside even as several of us have reached the breaking point of psychological exhaustion. Our desperate outcry for backup from our fellow critical care nurse colleagues seems to have yielded no outcome. It is obvious that addressing this shortage would require a solution with immediate implementation as we do not have time for the training of more critical care nurses. Thus, an immediate call to all nurse anesthesia students to return to bedside should be a part of any strategy geared towards quickly addressing issues of this critical care nursing shortage.

At a time when the role of critical care registered nurses is most needed, several nurse anesthesia programs continue with their regular admission cycle protocol: pulling critical care nurses away from bedside. At my current hospital, we lost nearly a dozen critical care nurse colleagues to nurse anesthesia programs between March and May of 2020 at the peak of the pandemic. Since the nurse anesthesia program requirements stipulate a minimum of one year of critical care nursing experience, all program applicants possess highly specialized clinical skills needed for the care of critically ill COVID-19 patients.  While there are unarguable reasons as to why some nurse anesthesia students have yet to answer this urgent call to duty, we as a profession, and as a society must do what we can to incentivize them to return to bedside to help relieve the suffering of patients and exhausted nurses who have fought tirelessly at the frontlines since the onset of the pandemic – many of whom have lost their lives as a result. 

Continue reading…

The Art of Asking: What’s Your Biggest Fear?

By HANS DUVEFELT

When a patient presents with a new symptom, we quickly and almost subconsciously create a hierarchy of diagnostic possibilities. I pride myself in my ability to effectively share my process of working through these types of clinical algorithms.

But sometimes I seem to get nonverbal clues of dissatisfaction or simply no reaction at all to my eloquent reasoning. And only then do I remember to ask the important questions, “do you have any thoughts on what’s causing this” and, most importantly, “what’s your biggest fear that this could be”.

It doesn’t matter how brilliant a diagnostician you are if a patient with less medical knowledge than you has a thought, fear or hunch that diseases and symptoms work in ways that don’t make sense to you.

An uncle may have had a burning sensation in his nose minutes before a stroke, so this symptom may seem like a much more obvious harbinger of disaster to your patient than it does to you. How would you know, if you didn’t ask, what the number one question is that your patient wants the answer to?

We are often so focused on our own thinking process, especially with our time pressures and the bureaucratic requirements of medical encounters these days, that we risk forgetting our patients may not think the way we do.

Continue reading…

Local Doctors Get the “Centers of Excellence” Treatment: Embold Health’s CEO on Data-Driven Quality

By JESSICA DaMASSA, WTF HEALTH

Apparently, self-insured employers hot on better managing their healthcare spend are finding truth (and dollars) in Embold Health’s mantra that “quality is the best, most sustainable way to control costs.” This health tech startup is applying the old “Centers of Excellence” framework to the individual physician level; helping identify high-performing primary care docs and specialists in local markets for employers who not only want to offer their employees better quality care, but also improve the healthcare system in the communities in which they live and work.

Daniel Stein, Embold Health’s co-Founder & CEO, explains the company’s model, which is being perfected with one of the most demanding-yet-coveted “health activist” employers out there: Walmart. In this particular case, Walmart is actually incentivizing its employees to go to the providers ranked highest by Embold’s assessment, which looks at physician performance along three categories: 1) appropriateness of care; 2) outcomes; and 3) cost-effective compared to peers in-market. Backed by the robust national BlueCross BlueShield dataset, the information Embold Health is collecting, analyzing, and doling out to employers can definitely cause some health systems to take pause — and their docs to bristle. So, how does Embold Health diffuse potential blowback? Here’s where the competitive nature of local healthcare, particularly in the world of primary care, becomes clutch. Tune in to hear the details, including some very interesting stats, as well as Embold’s latest endeavors to help docs make better referrals to specialists.

Better Get Your Quantum Computer

By KIM BELLARD

By all rights, I should be writing about the battle between Reddit forum WallStreetBets and Wall Street hedge funds. Depending on one’s point of view, it’s hilarious, frightening, or a searing indictment on stock trading – maybe all three. 

But I’m going to let Elon Musk and Elizabeth Warren handle that one.  Instead, I want to talk about quantum computing – and why healthcare needs to be looking ahead to it.

Let’s start with this: for the low, low price of $5,000, you could have your very own quantum computer.  Spin Q Technology, a Chinese company, has recently introduced its Spin Q, a less expensive, less powerful version of its Spin Q Gemini, which went for $50,000.  Other quantum computers, such as those by Google, IBM, or D-Wave, have a few more zeroes in their price.  Spin Q Technology has a clear goal in offering this version:

We believe that low-cost portable quantum computer products will facilitate hands-on experience for teaching quantum computing at all levels, well-prepare younger generations of students and researchers for the future of quantum technologies.

You may remember that Steve Jobs and Apple had a similar strategy in the 1980’s, establishing a presence in the education market and among a generation of users that has served it well. 

If you’re looking for something more powerful, maybe even use for business purposes, you are also in luck: today Microsoft announced that Azure Quantum “is now open for business.”    Microsoft bills Azure Quantum as “the world’s first full-stack, public cloud ecosystem for quantum solutions.” 

Continue reading…

THCB Gang Live, Episode 41–Thurs 1pm PT – 4pm ET

THCB Gang will be held live on Thurs Feb 4 at 1pm PT -4pm ET.

Joining me, Matthew Holt (@boltyboy), will be consultant/author Rosemarie Day @Rosemarie_Day1), patient advocate/entrepreneur/author Robin Farmanfarmaian (@Robinff3), Suntra Modern Recovery CEO JL Neptune (@JeanLucNeptune), health futurist Jeff Goldsmith (@JeffcGoldsmith), Digital health futurist Fard Johnmar (@fardj).

The Biden Administration is now getting into the grist of governing. What happens next?

You can see the video below live and it’ll be on our podcast channel (Apple/Spotify) from Friday

#Healthin2Point00, Episode 182 | Sidecar Health, Folx, TimelyMD & more

On Episode 182 of Health in 2 Point 00, we’ve actually got deals less than $100 million. Starting off with one though, Sidecar Health raises $125 million bringing their total to $163 million. Folx raises $25 million providing telehealth for the LGBTQ+ community and growing fast, TimelyMD raises $60 million providing telehealth for colleges, another MSK company SWORD Health raises $25 million and GetWellNetwork acquires Docent Health for an undisclosed amount of money. —Matthew Holt

assetto corsa mods