The Health Care Blog – Page 183 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

Digital Therapeutic for Chronic Condition Management in India | Abhishek Shah, Wellthy Therapeutics

Jan 21, 2020• 1

BY JESSICA DAMASSSA, WTF HEALTH

As the adage goes, “health is wealth,” and Wellthy Therapeutics is a startup looking to improve the health of patients with chronic conditions in India by making treatment more accessible. Only 5% of Indians are insured and much of the population is not health literate, so CEO Abhishek Shah hopes the Wellthy app will fill a critical gap in care for those with type II diabetes, hypertension, cardiovascular conditions, and respiratory illnesses. With 15K users, the startup is focused on scaling up to truly capitalize on the potential of India’s enormous population. Learn more about their big plans, including those for a Series-A, to support that expansion.

Filmed at Bayer G4A Signing Day in Berlin, Germany, October 2019.

Low Value Testing and Unmet Cascades

Jan 21, 2020• 1

By ANISH KOKA, MD

Mr. Smith has a problem.

He can’t see.

Even this cardiologist knows why. The not so subtle evidence lies in the cloudy lens in front of his pupils. He is afflicted with cataracts that obstruct his vision to the point he can’t really do his job refurbishing antique furniture safely. His other problem is that he hates doctors. He hasn’t had reason to see one for more than a decade. He’s 68, takes no medications, smokes a pack of cigarettes a day, and is a master of one word answers. He’s in my office because he needs a medical evaluation prior to his cataract procedure. Someone needs to attest to medical safety. I’m it.

He just wants to get out of here.

His annoyance of being in the office is justified. Cataract surgery is very low risk. Unless he’s having an acute medical problem, there is little to do. The problem is that in an age of high volume, super specialized care, the eye doctor can’t attest to this, and the anesthesiologists have little interest in finding out the morning of his procedure that Mr. Smith has been having more frequent episodes of chest pain over the last two weeks. Perhaps the chest pain is just acid reflux, or maybe it’s because of a pulmonary embolism related to the tobacco induced lung malignancy no one knows about. It’s possible, and highly likely, Mr. Smith will survive his cataract surgery even if he has a pulmonary embolism. Cataract surgery really is pretty low risk.

But the doctor’s ethos has never been to ‘clear a patient for a cataract’, it is to commit to the health of the patient. Mr. Smith deserves the opportunity to receive good medical care that isn’t made threadbare just because of the cataract surgery on the horizon.

The Digital Physical Therapy Startup for Knee, Neck, & Back Pain | Dan Rubenstein, Physera

Jan 20, 2020

BY JESSICA DAMASSA

Bum knees, aching backs, and neck pain are literally a pain-in-the-neck for millions of people – making chronic pain one of the largest areas of healthcare spending. Is it time to disrupt the traditional delivery of physical therapy? Physera CEO, Dan Rubenstein, thinks so, and talks to us about how his healthcare startup is revolutionizing the way physical therapy is being delivered by taking it virtual and driving down the cost. With more than $10M in funding (their $6M Series A was led by BlueCross BlueShield’s Venture Fund) and a major contract with a nationwide health plan provider in the works, the health tech startup is on track to help millions of people feel better and avoid the crazy rush to the PT’s office.

Filmed at HLTH 2019 in Las Vegas, October 2019.

Health Data Outside HIPAA: Simply Extending HIPAA Would Be a #FAIL

Jan 20, 2020• 2

By DEVEN McGRAW and VINCE KURAITIS

This piece is part of the series “The Health Data Goldilocks Dilemma: Sharing? Privacy? Both?” which explores whether it’s possible to advance interoperability while maintaining privacy. Check out other pieces in the series here.

Early in 2019 the Office of the National Coordinator for Health IT (ONC) and the Centers for Medicare and Medicaid Services (CMS) proposed rules intended to achieve “interoperability” of health information.

Among other things, these proposed rules would put more data in the hands of patients – in most cases, acting through apps or other online platforms or services the patients hire to collect and manage data on their behalf. Apps engaged by patients are not likely covered by federal privacy and security protections under the Health Insurance Portability and Accountability Act (HIPAA) — consequently, some have called on policymakers to extend HIPAA to cover these apps, a step that would require action from Congress.

In this post we point out why extending HIPAA is not a viable solution and would potentially undermine the purpose of enhancing patients’ ability to access their data more seamlessly: to give them agency over health information, thereby empowering them to use it and share it to meet their needs.

Healthcare Might Look Good in Plaid

Jan 17, 2020• 2

By KIM BELLARD

I don’t really follow FinTech — I can’t even keep up with HealthTech! — but it caught my eye when Visa announced that it was acquiring FinTech company Plaid for $5.3b; a 2018 funding round valued the company at $2.65b. A 100% increase in valuation within a year suggests that something important is going on, or at least that people think something is.

I suspect there may be some lessons for healthcare in there somewhere.

For those of you who are equally as unfamiliar with FinTech’s terrain, Plaid has been described as the “plumbing” that supports many other FinTech companies. Launched in 2013, one in four people with a U.S. bank account are now believed to use Plaid to connect with 2,600 FinTech developers connected to more than 11,000 financial institutions. Its customers include Acorns, Betterment, Chime, Coinbase, Gemini, Robinhood, Transferwise, and Venmo. Plaid claims it connects with 200 million consumer accounts.

THCB Spotlights: Scott Shreeve, CEO of Crossover & Jay Parkinson, Founder of Sherpaa

Jan 17, 2020

Today on THCB Spotlights, Matthew chats with a couple of the OGs from the original days of Health 2.0—Scott Shreeve, founder and CEO of Crossover Health, and Jay Parkinson, founder of Sherpaa, who were the first ones doing something different in terms of doctors figuring out this digital health stuff. The two of them ask the question, what would happen if you married the physical world with the online world and created a new care model that exceeds at both? While Scott was putting in onsite primary care clinics to employers like Apple and Facebook, he realized Crossover wasn’t reaching 70% of the people they were contracted with because many employees were geographically remote. Meanwhile, Jay was doing something similar with virtual primary care—which differs from traditional telehealth in that his model enables a true relationship between patient and provider—and the rest is history.

Digital Health Experts Needed for Landmark International Forum

Jan 16, 2020

Why Do We Have Residency Training?

Jan 16, 2020• 3

By BRYAN CARMODY, MD

Surely every resident has had the experience of trying to explain to a patient or family what, exactly, a resident is. “Yes, I’m a real doctor… I just can’t do real doctor things by myself.”

In many ways, it’s a strange system we have. How come you can call yourself a doctor after medical school, but you can’t actually work as a physician until after residency? How – and why – did this system get started?

These are fundamental questions – and as we answer them, it will become apparent why some problems in the medical school-to-residency transition have been so difficult to fix.

In the beginning…

Go back to the 18th or 19th century, and medical training in the United States looked very different. Medical school graduates were not required to complete a residency – and in fact, most didn’t. The average doctor just picked up his diploma one day, and started his practice the next.

But that’s because the average doctor was a generalist. He made house calls and took care of patients in the community. In the parlance of the day, the average doctor was undistinguished. A physician who wanted to distinguish himself as being elite typically obtained some postdoctoral education abroad in Paris, Edinburgh, Vienna, or Germany.

A New Era for One Digital Health’s First Unicorns? | Maeve O’Meara, CEO, Castlight Health

Jan 15, 2020

BY JESSICA DAMASSA, WTF HEALTH

Is Castlight Health suffering a case of ‘first-mover’ curse? One of digital health’s first unicorns, Castlight Health, IPO’d back in 2014 with a valuation of over $3 billion dollars (reportedly, 107 times revenue) at a share price of $40. Today, the stock trades around $1.20, and the company has endured years of frustration from shareholders who’ve complained about customer churn and questioned the company’s business model. A recent change in leadership at the top of the organization has ushered in new CEO Maeve O’Meara, a long-time employee of the trailblazing company, who’s now responsible for blazing a new path toward forward herself. Refreshingly candid about the road ahead, Maeve explains how some new high-touch (but cost-effective) offerings are opening up new markets for the biz and hints at potential partnerships emerging with Big Tech. A must-watch for any digital health startup, investor, or industry analyst who wants longitudinal perspective on health tech’s market resilience and the importance of timing. Maeve, who was a health investor herself before joining Castlight, sums up the challenge of trailblazing tech in healthcare like this: “In healthcare, you always want to be one step ahead and not two steps ahead — you can get burned easily by being two steps ahead.”

Filmed at HLTH 2019 in Las Vegas, October 2019.

9 Things Every Healthcare Startup Should Know About Business Development

Jan 15, 2020• 1

By ANDY MYCHKOVSKY

In this post, I write down all my strategy and business development knowledge in healthcare and organize it into the top 9 commandments for selling as a healthcare startup. I think everyone from the founder to the most junior person on the team should know these pillars because all startups must grow. I should also note these tenets are most applicable for selling into large enterprise healthcare incumbents (e.g., payers, providers, medical device, drug companies). Although I appreciate the direct-to-consumer game, these slices are less applicable for that domain. If your startup needs help developing or implementing your business development strategy, shoot me an email and we can discuss a potential partnership. Enjoy!

1. Understand Everything About the Product and Market

You must also understand the competitive landscape, who else is in the marketplace and how they appear differentiated? What has been their preferred go-to-market approach and is your startup capable of replicating a similar strategy with your current team members? Also, do you understand the federal and state policy that most affects your vertical, whether that be pharmaceutical or medical device (e.g., FDA), health plans (e.g., state insurance commissioners), or providers (e.g., CMS)? For example, if your company is focused on “value-based care” and shifting payment structures of physicians to downside risk, do you intimately understand The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and the requisite CMS Demonstration Models from the Innovation Center (e.g., MSSP, BPCI-A, etc.)? Make sure you do or at least hire someone to explain what is important now and in the future.