I interviewed Julia Cheek, CEO of Everlywell about their response to COVID-19. Last week they issued a $1m challenge to labs to promote the rapid capability to develop COVID-19 testing. Her goal is to get the US up to 250K home tests per day within a month, but it won’t be easy. This is the first in a series of news and tracking that THCB & Catalyst @ Health 2.0 will be doing on health tech companies’ response to the pandemic — Matthew Holt
Above the Fold
41 Countries Later, This Doc’s Pick for Best Health System “Hack” | Dr. Niti Pall, KPMG & AXA
By JESSICA DaMASSA, WTF HEALTH
Dr. Niti Pall has experience working in 41 different health systems around the world in her roles as Global Medical Director for KPMG, Senior Mobile Health Advisor for AXA, and as a General Practitioner in the U.K. With that type of diverse experience across health systems rich and poor, tech-enabled and not, OF COURSE we had to ask which was the best health system ‘hack’ she’s seen so far. The answer takes us to Bangladesh, involves a huge telecom company, and leads to a completely new category of healthcare provider. Is this a model we’ll see Amazon, Apple, Google or other non-traditional healthcare players take up as they head into the health industry? Niti talks about how tech is the underpinning of “proper 21st Century healthcare,” but that’s not all it will it take to overcome global clinician shortages and help consumers feel like they are getting value out of their healthcare dollars worldwide.
Filmed at Barcelona Health Hub Summit in Barcelona, Spain, October 2019.
Health in 2 Point 00, Episode 112 | COVID-19, HealthDevJam & loads of deals
Today on Health in 2 Point 00, Jess is joining somebody for their self quarantine in the Oval Office! Shenanigans aside, I give a quick coronavirus update and a shameless plug before diving into our regular coverage of all the deals. As for COVID-19, there’s a ton of activity going on in the digital health world with companies trying to figure out how they can help with this. Catalyst will be presenting some of that, either this weekend or early next week. Next, there’s an FHIR-related HealthDevJam event (free, online) TODAY at 1pm Eastern with lots of great people speaking.
Diving into some non-coronavirus related deals, eConsult company RubiconMD raises $18 million, Lyra Health getes a chunk of change—$75 million—for its mental health platform, Fruit Street Health gets $17 million from an unlikely source, b.well raises $16 million for what’s not a personal health record, and CVS announces that it added 5 digital health companies to its point solution management system. Finally, there’s been some sneaky stuff uncovered about Sanofi. Tune in for all the details on Episode 112. —Matthew Holt
There Is No Time for That
By ROMAN ZAMISHKA, MPA
Some of the most important engineering lessons were demonstrated on the tank battlefields of World War II when German Tigers faced off against Soviet T-34s.
The Tiger tank was a technical masterpiece of for its time with many features that did not appear in allied tanks until after the war. Despite its much heavier armor it was able to match the speed of lighter enemy tanks and keep up with its own light tank scouts. The armor featured almost artisanally welded interlocking plates. The ammunition featured innovative electric trigger primers and high penetration tungsten shells. The double differential steering system allowed the Tiger to rotate in place. A complex system of interleaving wheels distributed weight evenly, improved off-road mobility and even allowed mobility with damaged tracks.
But while the Tiger was a star on the blueprints, it was a disaster on the Eastern front, not because of its combat performance but because it was a logistical and operational nightmare. The heavy armor made the tank a gas guzzler, which made tanks inoperable when supplies were low. The electric trigger primers would fail in cold weather. When rotating in place the gearbox would often break and German training manuals forbid the maneuver. The highly specialized internal mechanics made production slow and meant the tank often could not be repaired in the field but had to be sent back to Germany, and the great logistic costs meant that Tigers couldn’t drive to the front but had to be brought there by rail.
Continue reading…Pandemic Fears: What the AIDS Battle Should Teach Us About COVID-19
By ANISH KOKA, MD
As the globe faces a novel, highly transmissible, lethal virus, I am most struck by a medicine cabinet that is embarrassingly empty for doctors in this battle. This means much of the debate centers on mitigation of spread of the virus. Tempers flare over discussions on travel bans, social distancing, and self quarantines, yet the inescapable fact remains that the medical community can do little more than support the varying fractions of patients who progress from mild to severe and life threatening disease. This isn’t meant to minimize the massive efforts brought to bear to keep patients alive by health care workers but those massive efforts to support failing organs in the severely ill are in large part because we lack any effective therapy to combat the virus. It is akin to taking care of patients with bacterial infections in an era before antibiotics, or HIV/AIDS in an era before anti-retroviral therapy.
It should be a familiar feeling for at least one of the leading physicians charged with managing the current crisis – Dr. Anthony Fauci. Dr. Fauci started as an immunologist at the NIH in the 1960s and quickly made breakthroughs in previously fatal diseases marked by an overactive immune response. Strange reports of a new disease that was sweeping through the gay community in the early 1980’s caused him to shift focus to join the great battle against the AIDS epidemic.
Continue reading…A Patient’s View of the Cures Regulations
By ADRIAN GROPPER, MD
How should we react to 1,718 pages of new regulation? Let’s start by stipulating the White House and HHS perspective:
“Taken together, these reforms will deliver on the promise to put patients at their center of their own health care — you are empowered with control over your own health care choices.”
Next, let’s stipulate the patient perspective via this video lovingly assembled by e-Patient Dave, Morgan Gleason, and the folks at the Society for Participatory Medicine. In less than 3 minutes, there are 15 patient stories, each with a slightly different take on success.
Can the US health care system “pull an Italy?”
By MATTHEW HOLT
There has been a ton of analysis about COVID-19 and how bad it will get. Some like Joon Yun and Jeremy Faust say the panic is worse than the disease. Others have run the infection rate numbers and predicted that the US will run out of hospital capacity in early May and in Washington state much earlier (end of March).
But there’s no doubt that in the last week or so, sentiment has changed. This week I and 45,000 of my best friends are at home, not at HIMSS in Florida. Many big gatherings like SXSW, Comic-Con and Coachella have been cancelled. Most corporations that can are asking employees to work from home. Just this morning my local school district in California called off school plays and any gatherings with more than 100 people.
Part of this is the inevitable response to the ridiculous posing of Trump. He showed up at the CDC wearing a campaign hat and declared that he was a great doctor to be because his uncle was at MIT. The Director of the CDC and later the Surgeon-General made toadying remarks about how amazing he was. And neither Pence, Azar, Carson or anyone else allegedly in charge can give a straight answer to anything.
The nation has realized that there is no help or even basic honesty coming from the Federal government. This is after the CDC screwed up the creation of basic testing kits which put the US in a situation where it just can not know the extent of the outbreak. China denied the outbreak, then had to put Wuhan and much of their economy on lockdown. Iran may be in worse shape.
Meanwhile South Korea, Singapore and Taiwan have managed their outbreaks with very rapid testing, quarantining of those infected, and extremely rapid response. The US is still blundering around. Now the private sector is trying to step in as the Feds misstep again and again.
But a likely scenario is that many regions in the US will become like Northern Italy.
Continue reading…Health in 2 Point 00, Episode 111 | #HIMSSpocalypse2020
Live from the tradeshow floor of HIMSS, it’s Health in 2 Point 00! And no, I’m not fading away from coronavirus on this episode—but how many people could I have singlehandedly infected had the conference gone forward? On Episode 111, Jess and I have some fun with virtual backgrounds and talk about all of the things we’re missing at HIMSS right now. From what Trump would’ve said had he gotten the opportunity to speak, to what conversation would’ve gone on about the new ONC rules, to the big funding announcement we missed, here’s everything that succumbed to #HIMSSpocalypse2020. —Matthew Holt
A Full-Scale Assault on Medical Debt, Part 3
By BOB HERTZ
The only way to fully eliminate medical debt would be a comprehensive single payer plan, which allowed no fees at the point of service.
However, such a plan would require setting all prices for all doctors, hospitals, labs, and drug companies. All providers would have to be satisfied – in advance — with what the government is going to pay them on each procedure.
Countries like Germany accomplish this through collective bargaining. Japan, France, Taiwan, Israel and Scandinavia also have national fee schedules. However, I do not think you could get all the providers in Toledo to agree on one schedule, much less every provider group in America.
Single payer would also require new income and payroll taxes of at least ten per cent more than we pay now, if we want first-dollar coverage.
Continue reading…A Full-Scale Assault on Medical Debt, Part 2
By BOB HERTZ
The first section of this article stated that many forms of medical debt can be reduced or cancelled by stronger enforcement of consumer protection laws. These debts are not inevitable and are not due to poverty. It would not require trillions of federal dollars to cancel them, either – just the willingness to go against lobbyists.
Therefore I advocate the following attacks on medical debt:
Phase One
We must cancel balance bills and surprise bills if there was no prior disclosure.
In most cases, providers will not have the right to collect anything more than what the insurers pay them.
Phase Two
We must cancel the older, inactive “zombie debts” that are being purchased by collection agencies.
This line of business must terminate. Providers throughout the country are selling uncollected medical debt for pennies on the dollar to collection agencies, who aggressively attempt to force patients to pay the full amount due. These debt collectors harass patients at work and at home, deploying unscrupulous tactics even after the statute of limitations on the debt has expired.
Continue reading…
