The Health Care Blog – Page 135 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

THCB Gang, Episode 40

Jan 28, 2021

THCB Gang was held live on Thurs Jan 28 1pm PT -4pm ET. The recording is below.

Joining me, Matthew Holt (@boltyboy) were fierce patient activist Casey Quinlan (@MightyCasey), consultant/author Rosemarie Day @Rosemarie_Day1), THCB regular health writer Kim Bellard (@kimbbellard); employer health expert Jennifer Benz (@jenbenz) & patient safety expert and all around wit Michael Millenson (@MLMillenson).

There was almost nothing to talk about. No inauguration, no riots, pandemic under control via vaccination….oh wait. Actually a lot to talk about with the vaccination rollout, the likelihood of health policy changing in the COVID relief bill, and how the wild world of Gamestop stock trading might impact Digital Health –well we didn’t talk about that but we did talk about employers and what they were going to do!

The video is below but if you’d rather listen to the episode, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels.

We’re Ready for Mamala

Jan 28, 2021• 1

By DEB GORDON and ROSEMARIE DAY

With the long-awaited inauguration day behind us, America is finally getting something we desperately need: an elected woman in the White House.

On the heels of chaos and violence at the Capitol and after four years of the Trump Administration, we are ready for strong female leadership in the executive branch to help put the country on the right course. In fact, it is long overdue.

Kamala Harris didn’t just need our votes to make history as America’s first female Vice President. To be successful, she’ll need every ounce of our ongoing support as she steels herself to direct threats to her life and faces the challenge, along with President-elect Biden, of healing a deeply fractured nation.

Female leaders around the world have modeled that strong leadership through 2020’s most difficult times. Women have led some of the most effective pandemic responses worldwide. Countries led by women leaders had six times fewer confirmed COVID-19 deaths — and fewer days with confirmed deaths — than countries led by men. New Zealand, Taiwan, Germany, and Iceland — all led by women — are among the coronavirus management success stories.

These women acknowledged the threat from coronavirus rather than underplaying it. They were decisive, and used data and science to drive their decision-making. They took a long-view when designing their response, prioritizing long-term well-being over short-term economic pain. They listened to outside voices to ensure they had the best possible input and solutions for their countries. And they showed empathy. Having a female leader became a symbol of inclusive, open-minded, effective leadership.

And the world took notice, lauding leaders like Jacinda Ardern, who was rewarded with a decisive victory in New Zealand’s October national elections.

Medable’s CEO: Covid19 Vaccine Will Start Big Pharma’s Era of De-Centralized Clinical Trials

Jan 27, 2021

By JESSICA DaMASSA, WTF HEALTH

Covid 19 vaccine development may have mainstreamed questions about how to hasten drug development timelines, but Medable, a health tech startup that offers researchers a way to de-centralize clinical trials, has been working to solve this problem for five years. Freshly funded with a $91M Series C raise, co-founder and CEO Michelle Longmire talks through the benefits of “liberating” clinical trials from academic research centers and sending them onto devices into patient’s homes. Traditionally, drug development processes average more than 10 years, cost millions of dollars, and are limited in the diversity of patients they can recruit because of the heavy focus on the geographic location of the research team conducting the trial. Medable’s digital platform breaks these limitations, reducing drug development timelines and costs by making it easier for researchers to draw study participants from anywhere. More importantly, it makes the novel medicines being tested by the trial available to a bigger, more diverse array of patients. Despite the gains made in 2020 toward the de-centralized clinical trial model (Medable’s revenue shot up 500%), there’s concern that Big Pharma may return to the business processes of old once the pandemic is under control. Does Michelle think last year make enough of an impact to change their business model for good? Find out what’s ahead for the future of pharma.

And You Thought Health Insurance Was Bad

Jan 27, 2021

By KIM BELLARD

I spend most of my time thinking about health care, but a recent The New York Times article – How the American Unemployment System Failed – by Eduardo Porter, caught my attention. I mean, when the U.S. healthcare system looks fair by comparison, you know things are bad.

Long story short: unemployment doesn’t help as many people as it should, for as much as it should, or for as long as it should.

It does kind of remind you of healthcare, doesn’t it?

The pandemic, and the associated recession, has unemployment in the news more than since the “Great Recession” of 2008 and perhaps since the Great Depression. Last spring the unemployment rate skyrocketed well past Great Recession levels, before slowly starting to subside. Still, last week almost a million people filed for unemployment benefits, reminding us that unemployment is still an issue.

Keep in mind that unemployment rates do not tell the full story, as they don’t count those only “marginally attached” to the workforce – people who would like to work but have given up – and counts part-time workers who would like to work full time as “employed.” The “true” unemployment rate is reckoned to be much worse than the official rate.

Congress has enacted several COVID relief measures, including in late December, to extend duration, amount, and applicability of unemployment benefits, but our unemployment systems remain predominantly state designed and administered. The shortcomings of these systems have been severely exposed over the past few months: neither the processes nor the actual technologies supporting them proved robust enough for the volume of applicants. Last December Pew Trusts reported that “unemployment payments were weeks late in nearly every state.”

#Healthin2Point00, Episode 180 | Signify Health IPO, OneDrop-Bayer-SCOR Partnership, & more

Jan 26, 2021

On Health in 2 Point 00, this time we have Jess tell us about OneDrop, Bayer, and SCOR’s new partnership, creating a chronic condition-specific life insurance policy using OneDrop’s platform and SCOR’s risk predictive engine. On Episode 180, Jess asks me about Signify Health filing for IPO – a real IPO, not a SPAC one, Lumiata getting $14 million working on predictive analytics, and Neuroflow getting $20 miillion in a Series A led by Magellan. —Matthew Holt

There Are Three Kinds of Primary Care, Not to Be Confused With Each Other

Jan 25, 2021• 1

By HANS DUVEFELT

Primary care doctors, the way things are organized in this country, perform three kinds of services. If we don’t recognize very clearly just how fundamentally different they are, we risk becoming overwhelmed, burned out, inefficient and ineffective. And, if we think about it, should we really be the ones doing all three?

SICK CARE

Historically, people called the doctor when they were sick. That service has, at least in this country, become more or less viewed as a nuisance in primary care offices. We keep a few slots open for sick people, in part because the Patient Centered Medical Home recognition process requires us to. But our clinics may worry that those slots go unfilled and lead to lost revenue.

Instead, sick people scatter toward emergency rooms with crowding, high overhead and liability driven testing excesses or to freestanding walk-in clinics that only sometimes are integrated with the primary care office but universally staffed by providers who don’t know the patient. These providers, due to staffing cost strategies, are sometimes the least experienced clinicians within their organizations, doing what I feel is the most challenging work in health care – sorting the very sick from the only moderately ill or even completely healthy but worried patients.

In the worst case scenarios, the walk-in clinic is freestanding, operating without any access to primary care or hospital records, starting from absolute scratch with every patient. Some of these clinics are well equipped, with laboratory and x-ray facilities and highly skilled staff. But some are set up in a room in the back of a drug store and staffed by a lone nurse practitioner with minimal equipment and no backup.

Because health care in this country has no master plan, this is what has emerged. If we had a national strategy for health care services, does anybody think it would look like this?

Catalyst @ Health 2.0 & AFBH Launch Call For COVID-19 Vaccine Scheduling

Jan 22, 2021

By ELIZABETH BROWN

Attention digital health innovators! Do you have a health tech solution that can aid community-based care coordinators in COVID-19 vaccine screening and appointment scheduling for their underserved and vulnerable patients? Apply to the second Alliance for Better Health Rapid Response Open Call, hosted by Catalyst @ Health 2.0 & sponsored by the Robert Wood Johnson Foundation!

As the COVID-19 pandemic continues, the importance of ensuring health equity and access is vital. This RROC is looking for solutions to help community care coordinators and providers schedule appointments for COVID-19 vaccines for vulnerable and underserved patients who may be facing barriers to self-scheduling those vaccine appointments. The intended care providers are those working with patients who may lack resources, health literacy, or face other barriers to self-scheduling appointments. A select group of semi-finalists will have the opportunity to demo their technology. A grand prize winner will receive $15k and the opportunity to collaborate with Alliance for Better Health!

Do you have a solution that can fit this need? Apply HERE today! Applications close 2/2.

(This is the second of 2 COVID-19 RROC challenges from Alliance for Better Health. The first was for vaccine administration tracking announced on Tuesday 19th. Both are mentioned in the video from Jacob Reider, Alliance for Better Health’s CEO, which you can see below)

CEO Jacob Reider introduces the challenges

About Alliance For Better Health: Alliance For Better Health engages medical and social service providers in developing innovative solutions to promote people’s health, with a goal of transforming the care delivery system into one that incentivizes health and prevention. Established in 2015 as a Performing Provider System in the New York State Delivery System Reform Incentive Payment program (DSRIP), Alliance partners with more than 2,000 providers and organizations across a six-county area in New York’s Tech Valley and Capital Region.

Elizabeth Brown is a Program Manager at Catalyst @ Health 2.0

What If Healthcare Was Like Wikipedia?

Jan 22, 2021• 2

By KIM BELLARD

Last week I wrote about, well, how awful social media has become, so this week it’s nice to write about pretty much the opposite: Wikipedia turned twenty last Friday (January 15).

In person years that’s not even old enough to buy alcohol, but in Internet years that makes it one of the grand old masters, like Google or Amazon. Wikipedia is one of the most visited Internet destinations, with its 55+ million articles, in 300+ languages, getting some 10b+ views per month.

It is something that, by all rights, shouldn’t exist, much less be successful. A non-profit, volunteer written/edited, online encyclopedia? An online resource widely trusted for its objective, generally accurate articles in a world of fake news? As the joke goes, it’s good that it works in practice because it does not work in theory.

That’s sort of the opposite of our healthcare system: it’s good that it works in theory, because it sure doesn’t work in practice.

Wikipedia works due to its army of editors (“Wikipedians”); some 127,000 have edited the English edition alone within the past 30 days. They work in virtual real time; when someone wins an Oscar the update happens almost immediately. When the U.S. Capitol was stormed two weeks ago, Wikipedia had a page up before the protesters were gone.

Hims & Hers CEO on IPO, Push into Primary Care, Target & More

Jan 21, 2021

By JESSICA DaMASSA, WTF HEALTH

On the eve of the finalization of their SPAC IPO and New York Stock Exchange debut as $HIMS, Hims & Hers CEO, Andrew Dudum, sat down with Jess DaMassa to talk about his wellness company’s transition into full-on healthcare provider. With new primary care, mental health care, and covid19 testing services launched as a result of the pandemic, Hims & Hers has expanded beyond their initial dermatology and sexual health core to provide telehealth-plus-pharmacy services for a growing range of chronic conditions, mental health issues, and everyday health concerns commonly tackled by PCPs. How far into healthcare delivery will Hims & Hers go? What types of acquisitions or innovations will be necessary to compete with the likes of Teladoc/Livongo, Optum, or the slew of virtual-first primary care clinics currently vying to be healthcare’s “digital front door”? And, what are we to make of that fact that Hims & Hers has gone retail: appearing on the shelves of every Target store in the US? Healthcare’s changing, and we get a fired-up Andrew to wax philosophical on why companies like his — that are consumer-focused, disrupting the healthcare “experience,” AND slowly eroding the healthcare payment model with a customer base willing to pay out-of-pocket — will be leading the way to a next-generation healthcare model.

Restorative Justice: Don’t Presume “We’re Better Than This”

Jan 21, 2021• 2

By MIKE MAGEE

“We’re better than this” is the common refrain heard from many political leaders following the deadly assault on our democracy on January 6th. We hear empty appeals for blind appeasement from the likes of Kevin McCarthy in the interest of “bringing our country together.” But for those of us who study medical history, pursuing this course takes our nation in exactly the wrong direction.

Rather, the model we must follow is the model of Germany in 1945, or South Africa in 1995. In both cases, strict legal and public accountability (retributive justice) were married with fundamental expansion of universal social services to rebuild confidence and trust in their government’s ability to assure safety and security, and an equal playing field for all of their citizens (restorative justice).

In sorting through the legacy of Hitler’s regime in Germany, the Allied forces established the International Military Tribunal. One of the series of trials, opened on November 19, 1945 in the Palace of Justice in Nuremberg, delved into egregious examples of medical criminality, including Nazi experimentation on human subjects. These trials are often cited as an example of “retributive justice.” Of 23 defendants, 7 were hanged, 7 acquitted, and the rest given sentences of from 10 years to life in prison.

These judgments were conducted under the direction of U.S. judges and prosecutors and fully compliant with U.S. standards of criminal procedure. Yet another 25 years would pass before any of the 10 agreed-upon medical ethics research standards were integrated into US trial law.