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Why Isn’t Price Transparency Working in Healthcare?

By TAYLOR CHRISTENSEN, MD

I strongly believe that getting people the information and incentives necessary to choose higher-value providers and insurers is the solution to improving value in healthcare (see my Healthcare Incentives Framework). But, you say, we’ve tried that and it doesn’t work, and current efforts are a waste of time!

Here’s an example of some great research that you might use to support your opinion:

Examining a Health Care Price Transparency Tool: Who Uses It, and How They Shop for Care (Sinaiko and Rosenthal, Health Affairs, April 2016)

The news media would see this and report the main findings–that only 3% of enrollees used Aetna’s price comparison tool–and argue that even people who have the opportunity to shop for care will not do it, which they will interpret to mean any “consumer-driven” healthcare effort is proven through evidence not to work. People can wrest information to prove whatever they want.

But what if you actually read the study?

Sinaiko and Rosenthal found that only about 60% of enrollees even had a claim during their study period. And of those 60%, I’m guessing a large percentage of those were outpatient visits (primary care or specialty) with established providers, which are claim types that people historically do not shop for. Think about it, if you have your favorite hairdresser who knows you best, you have a relationship with that person, and you like how they cut your hair, are you going to price shop every single time you need to get your hair cut?

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THCB Spotlight: Two old men reminisce about the glory days!

Today on THCB spotlight I have a bit of fun with Ryan Tarzy. Ryan has been to every Health 2.0 conference in a number of guises and now has a new gig at Prealize. We saw each other at the very glitzy, very full HLTH conference last week, so you might title this, “2 old men reminiscing about the glory days of digital health & Health 2.0” —Matthew Holt

Clinical Depth: The Power of Knowing More than the Minimum

By HANS DUVEFELT, MD

In medicine, contrary to common belief, it is not usually enough to know the diagnosis and its best treatment or procedure. Guidelines, checklists and protocols only go so far when you are treating real people with diverse constitutions for multiple problems under a variety of circumstances.

The more you know about unusual presentations of common diseases, the more likely you are to make the correct diagnosis, I think everyone would agree. Also, the more you know about the rare diseases that can look like the common one you think you’re seeing in front if you, rather than having just a memorized list of rule-outs, the better you are at deciding how much extra testing is practical and cost effective in each situation.

Not everyone with high blood pressure needs to be tested in detail for pheochromocytoma, renal artery stenosis, coarctation of the aorta, Cushing’s syndrome, hyperaldosteronism, hyperparathyroidism or thyroiditis. But you need to know enough about all of these things to have them in mind, automatically and naturally, when you see someone with high blood pressure.

Just having a lifeless list in your pocket or your EMR, void of vivid details and depth of understanding, puts you at risk of being a burned-out, shallow healthcare worker someday replaced by apps or artificial intelligence.

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The Untold Reality of Medical Device Shortages in the U.S.

Chaun Powell
Soumi Saha

By CHAUN POWELL, MBA and SOUMI SAHA, PharmD, JD

Say the word “shortage” to a healthcare professional and chances are the first thing that will come to mind is drug shortages. With good reason, too – there are more than 100 drugs currently at risk or not readily available for U.S. hospitals, according to the Food and Drug Administration’s (FDA) drug shortage list. 

Shortages don’t just apply to drugs, however, and as 2019 has shown, healthcare providers must become more focused on shortages of the medical device variety. The shutdown of multiple medical device sterilization facilities in 2019 is poised to jeopardize the availability of devices that are critical to routine patient care. On Nov. 6, the FDA is hosting a panel to hear from stakeholders, including hospital epidemiologists and healthcare supply chain experts, on the risks associated with facility shutdowns and potential action steps.

The industry as a whole is in need of meaningful solutions. As taxpayers, patients and key stakeholders in healthcare, we must collaborate to eliminate interruptions to our healthcare supply chain. For those invested in improving healthcare from the inside, this means working across competitive boundaries and borrowing best practices from sister industries as we work to identify the root cause of these issues and provide meaningful and preventative solutions.

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The Health Data Goldilocks Dilemma | Vince Kuraitis & Deven McGraw

By JESSICA DaMASSA, WTF HEALTH

Which is better: sharing access to all health data across platforms so that interoperability is achieved, or protecting some data for the sake of privacy? Health data privacy experts Vince Kuraitis, founder of Better Health Technologies, and Deven McGraw, Chief Regulatory Officer at Ciitzen, are crowdsourcing opinions and insights on what they are calling The Health Data Goldilocks Dilemma. How much data protection is ‘juuuust right’? What should be regulated? And, by whom? The duo talks through their views on the data protection conversation and urge others to join in the conversation via their blog series called, “The Health Data Goldilocks Dilemma,” on The Health Care Blog.

Filmed at the HIMSS Health 2.0 Conference in Santa Clara, CA in September 2019.

Prehab Tool and AI Win Big at the 2019 RWJF Live Pitch

SPONSORED POST

By CATALYST @ HEALTH 2.0

Six finalists competed in an exciting live pitch for the Robert Wood Johnson Foundation’s 2019 Innovation Challenges at the 2019 Health 2.0 Annual Conference. They demoed their technologies in front of an audience of health care professionals, investors, provider organizations, and members of the media. The Home and Community Based Care Challenge sought technologies that support the advancement of at-home or community based care. The Social Determinants of Health Innovation Challenge called for solutions that increase access to services related to social determinants of health.

During the 3-day Conference, Jessica DaMassa, Executive Producer & Host of @WTF_Health, spoke with the finalists about their experience competing in the RWJF Innovation Challenges, their personal highlights, and what’s next!

Home and Community Based Care Innovation Challenge Finalists

First Place:

Ooney’s home-based web-app for older adults, Prehab Pal, delivers individualized prehabilitation to accelerate postoperative functional recovery and return to independence after surgery.

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The FDA has approved AI-based PET/MRI “denoising”. How safe is this technology?

By LUKE OAKDEN-RAYNER, MD

Super-resolution* promises to be one of the most impactful medical imaging AI technologies, but only if it is safe.

Last week we saw the FDA approve the first MRI super-resolution product, from the same company that received approval for a similar PET product last year. This news seems as good a reason as any to talk about the safety concerns myself and many other people have with these systems.

Disclaimer: the majority of this piece is about medical super-resolution in general, and not about the SubtleMR system itself. That specific system is addressed directly near the end.

Zoom, enhance

Super-resolution is, quite literally, the “zoom and enhance” CSI meme in the gif at the top of this piece. You give the computer a low quality image and it turns it into a high resolution one. Pretty cool stuff, especially because it actually kind of works.

In medical imaging though, it’s better than cool. You ever wonder why an MRI costs so much and can have long wait times? Well, it is because you can only do one scan every 20-30 minutes (with some scans taking an hour or more). The capital and running costs are only spread across one to two dozen patients per day.

So what if you could get an MRI of the same quality in 5 minutes? Maybe two to five times more scans (the “getting patient ready for the scan” time becomes the bottleneck), meaning less cost and more throughput.

This is the dream of medical super-resolution.

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ACCESS Act Points the Way to a Post-HIPAA World

By ADRIAN GROPPER, MD

The Oct. 22 announcement starts with: “U.S. Sens. Mark R. Warner (D-VA), Josh Hawley (R-MO) and Richard Blumenthal (D-CT) will introduce the Augmenting Compatibility and Competition by Enabling Service Switching (ACCESS) Act, bipartisan legislation that will encourage market-based competition to dominant social media platforms by requiring the largest companies to make user data portable – and their services interoperable – with other platforms, and to allow users to designate a trusted third-party service to manage their privacy and account settings, if they so choose.”

Although the scope of this bill is limited to the largest of the data brokers (messaging, multimedia sharing, and social networking) that currently mediate between us as individuals, it contains groundbreaking provisions for delegation by users that is a road map to privacy regulations in general for the 21st Century.

The bill’s Section 5: Delegation describes a new right for us as data subjects at the mercy of the institutions we are effectively forced to use. This is the right to choose and delegate authority to a third-party agent that can manage interactions with the institutions on our behalf. The third-party agent can be anyone we choose subject to their registration with the Federal Trade Commission. This right to digital representation by an entity of our choice with access to the full range of our direct control capabilities is unprecedented, as far as I know.

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YTH Live 2020

By ERIN MCKELLE

There are many public health conferences that focus on young people, or that center around youth issues, but very few that actually include the young people’s voices that we are claiming to uplift as public health professionals.

There are also very few conferences that emphasize innovation in healthcare, that are pointed towards solutions rather than discussing problems at length without clear ways of solving them.

These core issues are at the heart of the annual YTH Live conference. Each year (we’re on our twelfth!), we showcase the boldest technologies in health and cutting-edge research in all facets of youth health and wellness. We also have attendees that range from IT professionals to high school students, with over 25% of last year’s attendees and speakers being young people themselves.

YTH’s Communications Coordinator Erin McKelle has first-hand experience of this. “I first attended YTH Live when I was a senior in high school. It was the first conference I ever spoke at and all of my fears about being the only young person in the room were quickly put to rest, once I saw that YTH plans a youth conference that actually centers around youth voices,” she says. “I’m proud to now be working for the organization years later, after serving on the Youth Advisory Board, paying the mission of youth empowerment forward to the next generation of youth leaders.”

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Health in 2 Point 00, Episode 99 | (Reverse) Takeover Edition with Bayer G4A

Today on Health in 2 Point 00… hold on, where’s Jess? On Episode 99, I do a reverse takeover with Priyanka Kashyap and Sophie Park at Bayer’s office in Berlin. Priyanka tells us about what Bayer G4A is doing these days with the 5 startups in their Advance Track: Blackford Analysis in radiology; Carepay and RelianceHMO improving affordability and access for patients in Africa; NeuroTracker, which is in the neuro space but is working with the oncology team at Bayer; and Prevencio, a diagnostic solution in the cardiovascular space. Sophie also gives us a rundown of the 6 startups in the Growth Track at G4A: Wellthy, a digital therapeutics company out of India; Litesprite, for mental health; BioLum, a pulmonology startup working on detecting nitric oxide levels in the blood; Upside Health with its chronic pain management software; and finally Visotec and Okko Health in ophthalmology. —Matthew Holt

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