The great pandemic is wreaking havoc, we are told, because the nation is not testing enough. The consensus from a diverse group that includes public health experts, economists, and silicon valley investors is that more testing will allow the country to restart the economy and do it safely.
The White House has been a mini laboratory for this testing strategy. Everyone who comes into contact with the President and Vice President is tested daily. This is supposedly what allows everyone to sit in meetings together and generally carry out the essential business of the country. But over this Mother’s Day weekend members of the White House spent their time scrambling to track down contacts of Katie Miller, the press secretary of the Vice president who tested positive. And contacts were left unclear about what exactly to do. One official started self-quarantining, while another did not.
If the White House has trouble with a mass testing, and contact tracing strategy, one wonders how this may work nationwide with thousands of new cases per day. While it would be tempting to blame administrative incompetence for the difficulties in the most important household in the land, the real difficulties lies with inherent limitations to tests that need to be understood before getting on the testing bandwagon.
Catalyst @ Health 2.0, in collaboration with the Robert Wood Johnson Foundation, is seeking health technology solutions that can support the needs of the health care system (e.g. providers, government, public health and community organizations, and more) by addressing several obstacles during an emergency such as:
Resource Management: Shortages of equipment, staff, and cash flow
Health Data Exchange: Limited information and access available on patients’ health histories
Training and Communication: Limited training and cumbersome communication between responders and clinicians
Capacity: Limited beds, equipment, and resources and a need to maximize patient flow/throughput
Innovators must submit their tech-enabled solution by June 12th, 2020 at 11:59 PM ET.
Can you create a digital tool that supports the health care system during a large-scale health crisis? Apply today!
Catalyst @ Health 2.0 (“Catalyst”) is the industry leader in digital health strategic partnering, hosting competitive innovation “challenge” events, as well as developing and implementing programs for piloting and commercializing novel healthcare technologies.
We also asked people to rank their concerns about the costs of their care, in five questions that covered cost of care, cost of prescription drugs, cost and availability of insurance, and surprise billing. In the time since we ran the survey, everything has changed in American healthcare. The COVID19 pandemic is filling emergency rooms wherever the epidemic arrives. Bills are likely to be high, for both patients and insurers, and it is still far from clear how they will be paid. Americans are likely to continue to worry deeply about healthcare costs, with good reason, since it’s only in America that someone can go bankrupt due to seeking medical care.
FHIR DevDays, run by Rien Wertheim’s company Firely in conjuncion with HL7, is the premier FHIR event in the world, with editions in the US and Europe. The three pillars for DevDays are Learn, Code and Share. The event runs from 15 to 18 June, 1 to 5 PM EST. This year’s edition will be 100% virtual. Tracks include the ONC and CMS Final Rules and COVID-19 on FHIR. I will be opening and moderating that last track–Matthew Holt.
The Patient Innovator Competition at DevDays US 2020
Have you ever wondered what would happen if patients had access to their data from hospitals, labs and other sources? Some still doubt the value of data at the fingertips of patients. So, we went the extra mile to see how this would look in practice and the results were impressive.
To give some context, every year we run DevDays, which is a semi-annual conference for health data programmers working with FHIR. FHIR is the open and standardized API for healthcare. What APIs have done for other industries, FHIR is doing for healthcare. That is, enabling an app economy: apps for doctors, researchers, payers, even apps for the government and, above all, apps for patients.
A lot of these of these apps are built by EMR vendors, even more by startups, and some by patients. Last year we launched the Patient Innovator Track at DevDays to give patients a voice. The track gives the stage to tech-savvy patients who are taking control of their health using data about their disease and treatment. The track wants to prove a point: access to health data can improve our lives. It also shows the unimagined things people can do with data when their health is at stake.
Four finalists pitched for the Patient Innovator Award. In the end it was John Keyes that blew everyone away. John is a blood disease patient who created a simple app to track his blood count and ongoing test results. The app is called BloodNumbers and it consolidates test data from multiple health care providers, making it easy to view and share results if you want to.
We are looking for more tech-savvy patients, developers and IT experts like John, to apply for this year’s Patient Innovator Track. All you need to do is pitch an app, device or other technology that allows you to use your own health data to improve your wellbeing. The finalists get a free ticket to DevDays US 2020 Virtual Edition where they can learn all about FHIR and connect with the community. The winner gets to walk away with $2,500. On the jury we have Dave deBronkart (“ePatient Dave”) and Grahame Grieve, the founder of FHIR. Check out what Dave wrote about the Patient Innovator Track here.
It is tempting to oppose the harmful effects of COVID-related lockdown orders with arguments couched in terms of trade-offs.
We may contend that when public authorities promote the benefits of “flattening the curve,” they fail to properly take into account the actual costs of imposing business closures and of forced social distancing: The coming economic depression will lead to mass unemployment, rising poverty, suicides, domestic abuse, alcoholism, and myriad other potential causes of death and suffering which could be considerably worse than the harms of the pandemic itself, especially if we consider the spontaneous mitigation that people normally apply under the circumstances.
While I have no doubt that lockdown policies can and will have very serious negative consequences, I believe that the emphasis on trade-offs is misguided and counterproductive. It immediately invites a utilitarian calculus: How many deaths and how much suffering will be caused by lockdowns? How many deaths and how much suffering will occur without the lockdowns? How exactly are we to measure the total harm? What time frame should we consider when we ponder the costs of one option versus the other?
Imagine this: You and your colleagues know there are problems to be solved. You have resources to offer, such as funding, access to experts, and publicity.
You are pretty sure there are people with great ideas out there, asking questions, defining the scope of the problems you care about, seeing things that you can’t see. Some people are even forging ahead, developing solutions on their own, but you don’t know how to connect with them.
You need an intake valve for new ideas, a honeypot to attract problem-solvers. So you launch a prize competition.
If you have escaped all the buzz around prize competitions and grand challenges over the last decade or so, don’t worry. KidneyX has a wonderful FAQ, including:
What is a prize competition?
A prize competition is a method of problem-solving that describes a problem (usually to the general public) and offers a prize or prizes to whoever comes up with the best solution(s). Prize competitions are a good way to attract ideas and skills from a wide range of fields.
I served as a volunteer judge for the KidneyX Patient Innovator challenge and was bowled over by the creativity of the submissions, both those who won and those who did not. It reminded me to welcome people into the health innovation conversation who may not think of themselves as inventors, but who deeply understand the community at the center of a crisis. The “need-knowers” as Tikkun Olam Makers call them.
Episode 9 of “The THCB Gang” was live-streamed on Wednesday (instead of our normal Thursday slot) on May 13th at 1pm PT- 4pm ET! Watch it below! Next week we’ll be back to Thursday
Joining me were health “IT” girl Jessica DaMassa (@jessdamassa), health futurist Ian Morrison (@seccurve), health economist Jane Sarasohn-Kahn (@healthythinker), patient safety expert Michael Millenson (MLMillenson), and MD & hospital system exec Rajesh Aggarwal (@docaggarwal). The conversation looked at the likelihod of big picture change, Medicare Advantage expansion, whether the move to remote care is real and sustainable, and at one point got us to war with China!
If you’d rather listen, the “audio only” version is preserved as a weekly podcast available on our iTunes & Spotify channels from Thursday onwards— Matthew Holt
Today on Health in 2 Point 00, Jess and I cover all the big comings and goings of digital health. But first, what happened with Atul Gawande departing Haven Health as CEO? Moving to a whopping 7 deals in this episode, Jess asks me about Wellth raising $10 million in an A round using behavioral economics to drive medication adherence; Vynca, an end-of-life startup, raising $10.3 million, Carbon Health getting a $26 million add-on investment expanding its telehealth offerings, Nanit raising $21 million for its machine learning baby monitor, Stellar Health raising $10 million in an A round to improve physician incentives to address gaps in care, Lucid Lane raising $4 million in seed funding for its substance use disorder program, and Limbix raising $9 million for its digital therapeutic for teens with depression. —Matthew Holt
In any economic disaster, the largest, best-financed organizations have a natural advantage over smaller, cash-strapped organizations. The bigger entities have a greater ability to withstand economic downturns, while the small ones can quickly go out of business because they lack the financial reserves needed to tide them over.
In the roughly 2 ½ months since the COVID-19 pandemic began sinking its hooks into America, the pertinence of this business axiom has been amply illustrated. Small companies across the country are desperate to reopen so they can survive, while many large corporations are seeing their stock prices soar. Most healthcare systems are not for profit, so they don’t issue stock; yet bigger hospitals are not suffering as much financially as smaller and rural hospitals are. Even though the large hospitals’ losses from elective surgery bans have been higher, they have much deeper reserves and greater access to bank lines of credit.
Physician practices have been hit disproportionately by the pandemic. Most practices have switched to telemedicine visits as patients have shunned in-person encounters and the offices have tried to protect their staffs. But the revenue from virtual encounters has not come close to making up for the loss of revenues from office visits that, in many cases, include lab tests and/or minor procedures.
COVID-19 is changing the landscape of our healthcare system, and, indeed, of our entire society, in ways that we hadn’t been prepared for and with implications that we won’t fully grasp for some time. As we grapple with how to reshape our healthcare system and our society in the wake of the pandemic, though, I worry we’re going to focus on the wrong problems.
Take, for example, nursing homes, prisons, and the meatpacking industry.
Anyone who has been paying attention to the pandemic will recognize that each of these have been “hot spots,” and have been called “petri dishes” for coronavirus (as are cruise ships, but that’s a different article). These institutions aren’t the only places where masses of people congregate, but they seem to do so in ways that create fertile territories for COVID-19. And that’s the problem.
We knew early on that nursing homes were going to be a problem. We knew COVID-19 was a problem in Wuhan, but that was far away — until a few cases emerged in late February in a skilled nursing home in King County, Washington. We know now that these were not the first cases, nor the first deaths, but we were stunned by how quickly it spread in that facility. By mid-March experts were already calling nursing homes “ground zero,” and that has been proven right.
It is now estimated that as many as a third of all U.S. coronavirus deaths have come from nursing home residents or workers. That is (as of this writing) almost 30,000 deaths, and over 150,000 cases.
