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THCB Gang Live Episode 39

Episode 39 of “The THCB Gang” will live-streamed on Thursday, Jan 21. You can see it below!

Matthew Holt (@boltyboy) was joined by regulars: futurists Ian Morrison (@seccurve) & Jeff Goldsmith, surgeon and now digital health entrepreneur Raj Aggarwal (@docaggarwal), radiologist Saurabh Jha (@roguerad), and patient advocate Robin Farmanfarmaian (@Robinff3).

Like the nation we took a big collective sigh of relief. We then talked a lot about COVID vaccinations, what the newly (sort of) Dem-led Senate is going to do on stimulus and health care , and we fnished on all that money pouring into digital health, while the stock market goes crazy. It was all good grist for the #THCBGang’s mill.

If you’d rather listen than watch, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels

#Healthin2Point00, Episode 179 | Inauguration Day Edition

Today on Health in 2 Point 00, we’ve made it to Inauguration Day! On Episode 179, we have over $300 million in deals and a SPAC IPO. Jess asks for my take on Hims & Hers going public, primary care chatbot company K Health raising $132 million, digital pathology company Paige raising $100 million, and ACO management company Aledade getting another $100 million. —Matthew Holt

Hinge Health’s CEO on $3B Valuation, Stretch Toward 2022 IPO

By JESSICA DaMASSA, WTF HEALTH

Hinge Health kicked off 2021 with a massive $300M Series D, driving the digital health musculoskeletal care company to a $3B valuation that, normally, would have sent health tech pundits into full-on IPO rumor mode…except that Hinge Health’s co-founder & CEO Daniel Perez beat them to it! We get into the details behind those comments (from what shall now be known as “the chatty Reuters interview”) where he not only revealed the company’s IPO plans, but also talked about how Hinge is well on it’s way to hit $200M in revenue. If 2021 is a year that Dan says will be focused on getting the business “operationally mature” enough to go public, what, exactly will be on the agenda? We dive into the competitive landscape, talk market size (Dan says more than 50% of employees on employer sponsored plans already have access to Hinge Health), and explore whether or not there are designs to expand into comorbidities common to back and joint pain, like mental health, obesity, diabetes, etc. Says Dan, “We’re going to use the capital to really invest in our innovation and R&D team and to stay different. We’re not just going to do the obvious moves.” Tune in for all the details on exactly what that means and why Dan thinks it’s central to Hinge Health’s market leadership in the MSK care space.

#Healthin2Point00, Episode 178 | Talkspace IPO, Accolade buys 2ndMD & more

Today on Health in 2 Point 00, Jess admires my new COVID-safe ski gear, designed to provide the right amount of coverage to the right part of your face at the right time. On Episode 178, Jess asks me about Talkspace finally getting its SPAC IPO together with a $1.4 billion valuation – this was a long time coming. Accolade acquires 2nd.MD for $460 million, Dina Health raises $7 million in a Series A, and Komodo Health raises $44 million and acquires the consulting business from Mavens. —Matthew Holt

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

By ELIZABETH BROWN

Attention digital health innovators! Do you have a tracking tool that can assist public health care providers in managing the two-phased COVID-19 vaccination administration? Apply to the Alliance For Better Health Rapid Response Open Call for Vaccination Administration Tracking! 

As the COVID-19 pandemic continues, the importance of ensuring health equity in #COVID19 vaccination administration for vulnerable and underserved populations is increasingly critical. Catalyst @ Health 2.0 is proud to host a Rapid Response Open Call (RROC) in collaboration with Alliance For Better Health. 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 1/31.

(This is the first of 2 COVID-19 RROC challenges from Alliance for Better Health. The second will be announced on Thursday 21st but is mentioned in the video from Jacob Reider 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

Time To Change Course!

By MERLE BUSHKIN

With all due respect to the good intentions of Congress, HHS, CMS, ONC and their dedicated advisors, they are pursuing — and for years have pursued — the wrong approach to achieve medical record interoperability. Endless studies, reports and anecdotal evidence conclude that trying to standardize the way medical records are formatted and kept, and linking provider silos via health information exchanges, doesn’t work! It is far too rigid, complex and constraining, and far too costly. Most importantly, it doesn’t meet care providers’ needs for “total interoperability” — instant access at the point of care to a patient’s COMPLETE medical record from all his or her providers. 

Despite having held endless hearings, listening sessions and receiving hundreds of responses to their draft proposals, they continue to ignore reality. Healthcare is dramatically different than banking and travel, the industries they frequently cite as role models. It is perhaps the most massive, complex, diverse and decentralized industry in the country, and requires a very different approach than used in simpler industries. Standardizing record content and formatting simply doesn’t work in healthcare.

Instead of trying to force care providers to accept their pre-conceived technology, they should adopt technology that meets the unique needs of providers. Simply put, they are trying to cut the man to fit the cloth rather than the cloth to fit the man!

Fortunately, there is a simple solution that accommodates the complexities of healthcare and meets the diverse needs of care providers. It focuses on how to MANAGE records rather than how to KEEP them. All we have to do is embrace it!

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This is Not Health Care

By HANS DUVEFELT

We use the word health rather loosely in America today. Especially the expression health care, whether you spell that as one word or two, is almost an oxymoron.

Health is not simply the absence of disease, even less the pharmaceutical management of disease. The healthcare “industry” is not the major portion of our GNP that it is because there is a lot of health out there, but the opposite. What consumes so much money and generates so much profit is, of course, sick care. The sicker people are, the more money is spent and earned in this market segment. It is a spiral, and a vicious one.

Health is a naturally occurring phenomenon, a state of perfection. Modern life has corrupted many natural, self-healing biological mechanisms and upended the natural order of things in our bodies – just the way it has altered our environment.

Our bodies are pretty ingenious in their ability to heal. When I crushed my finger in my garage door a few years ago, my disfigured fingertip, bisected nail and contused nail bed slowly regained their original shape, almost like a lizard grows a new tail. Yet in an opposite scenario, a person with scleroderma can lose their fingertip to gangrene without physical injury because of what we call autoimmunity – instead of self healing, our bodies can engage in self destruction. My fingertip could heal perfectly but some people’s skin or stomach ulcers fail to do so.

We intuitively seem to have accepted that, most of the time, nature takes care of itself if we don’t mess with it. And when temperatures rise, forests burn or species go extinct, we are quick to assume our industrial or agricultural processes are the cause.

Yet, we have this head-in-the-sand view of disease that it is a random occurrence, the sudden manifestation of ancient and rare genetic glitches or I don’t know what. The real answer is that much of it is a consequence of what we eat and otherwise expose our bodies to – how we produce and refine food, how we alter its natural properties and how we over- or under-consume basic nutrients.

Functional Medicine asks and answers many of these questions and promises to be the future of medicine. I believe in this, but I also believe that the sick-care industrial complex is powerful enough to severely slow down this revolution. I also believe the food industry will double down its efforts to continue misleading the public.

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Is there a Julie Yoo fallacy?

By MATTHEW HOLT

Andreesen Horowitz’s digital heath investor Julie Yoo has been building quite the theory of the present and future of health tech. I am going to try to write up a longer response to her but first, please view her presentation on the New Tech Stack for Virtual-First Care — a compelling 8 minute watch. And then have a quick read about how I am (trying to) put her in context.

Her first argument is that the digital services that you need to run health care (things like accounting/revenue management, network management, credentialing, pharmacy, etc, etc.) are getting really good. That means that startup digital heath companies can build services really quickly. No argument there. The second part of her argument is that incumbent organizations will also use these tools (actually already are using these tools) to improve their offerings.

Her argument is somewhere in the middle of three themes I’ve been banging on for a while.

My first argument is that too much VC money has been spent on new tech companies intending to prop up the incumbents and the incumbents by definition can’t change to become the type of virtual-primary care first chronic care management consumer friendly organizations that we need. I called this the Lynne Chou O’Keefe fallacy (which is why Julie wants one of her own!) and wrote it up on THCB about a year ago.

The second is the rather longer theme that I (with Indu Subaiya) have been banging on about called “Flipping the Stack”. The basic idea is that health care services now have the potential to go from an event-driven, encounter-driven acute-care delivery model to one where technology is able to measure, manage, message and monitor patients wherever they are, and that virtual services and physical interventions are layered over the top.

The third is my idea about the “continuous clinic” which is an attempt to describe the activities that an organization needs to run a 24/7 patient management organization. (I’ve presented on this many times but haven’t totally written it up–a version of how it might work for COVID patients is here).

Somewhere in what Julie is doing and in my fumbling towards new models is the idea of what a new health system will do and what it will look like.

Of course the related question is who will be the players? While we have United Healthgroup buying anything that moves and the incumbent hospital systems collectively sitting on an Apple/Google sized mountain of cash reserves, it’s hard to see the current system being changed dramatically by the people running it now.

But it needs to.

If you need to be reminded why, take a look at the comments about half way down in this piece in which a patient blogger Luke O’Neill asked his readers about their relationship with “their” doctor and the health system. And then consider whether we should trust the current incumbents to make that transition.

I’ll be back with more on this next week….

Matthew Holt is the publisher of THCB

THCB Gang Live Episode 38

Episode 38 of “The THCB Gang” was live-streamed on Thursday, Jan 14. You can see it below!

Matthew Holt (@boltyboy) was joined by regulars: medical historian Mike Magee @drmikemagee, policy & tech expert Vince Kuraitis (@VinceKuraitis), Consumer advocate & CTO of Carium Health, Lygeia Ricciardi (@Lygeia), Suntra Modern Recovery CEO JL Neptune (@JeanLucNeptune) WTF Health host Jessica DaMassa (@jessdamassa) &  fierce patient activist Casey Quinlan (@MightyCasey).

We did indeed touch on that mob riot in the Capitol. We discussed the impeachment, the inauguration, and virtual JPMorgan AND virtual CES and talked about reparations and reconciliation–and how that might influence the whole world of telehealth and primary care. This conversation was wide ranging and fascinating!

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

The Cost of Free Speech

By KIM BELLARD

Well, you’d have to say that the past week has been interesting.  It’s not every week that Joe Biden “officially” won the 2021 election, again, as Congress certified the election results.  It’s not every century when the U.S. Capitol is overrun by hostile forces.  And it’d never been true before that Twitter and Facebook banned President Trump’s accounts, or that various tech companies belatedly acted on the threat that Parler poses.  Oh, and we hit new daily records for COVID-19 deaths (over 4,000) and hospitalizations (over 132,000) in case you’d forgotten there is still a pandemic going on. 

Yes, all in all, a very “interesting” week.

I’m going to skip talking about the horror that was the Capitol insurrection, in part because I fear that we’re going to find out more details that will make it clear that it was even worse than we now know.  Similarly, I’m not going to dwell on the shame that Republicans should feel about the fact that two-thirds of their House members still voted to object to certifying the election results even after they’d been forced to flee from the terrorists who sought that very goal with their violence.

Instead, let’s talk about “free speech,” and the social media platforms that helped foster the violence and are now trying to do something about that. 

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