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Navinet: Health 2.0 Poster Child

By KIM KRUEGER & MATTHEW HOLT

What was once an enterprise software company designing bespoke systems for each client has over the course of the past three years transitioned to a national network-as-a-service with configuration tools and a soon-to-come open API. Could there be a better example of Health 2.0 in action? Say hello to the ‘new’ Navinet, a 15 year-old network that connects over 400,000 providers to more than 40 health plans, covering more than 47 million lives.

Matthew Holt spoke with Navinet CEO Frank Ingari about both Navinet’s stealthy evolution, as well as the company’s new goals moving forward. Navinet still performs the core handful of transactions health care providers have always used the system for — eligibility checks, payment status, referral approval, and treatment authorization among others – but now with a connected network, the emphasis is on collaborative workflow and combining clinical information with reimbursement transactions to improve care.

Ingari said it best: the health care communication infrastructure sucks. Consumers know it, and it isn’t any better for payers and providers. To hear more about how Navinet plans to be that communication infrastructure health care is so sorely missing, watch the interview below.

Kim Krueger is a Research Analyst at Health 2.0 where Matthew Holt is the Co-Chairman.  

Looking to Get Funded? Thoughts From An Entrepreneur Who Just Did

By PASCAL LARDIER

GET_imagePascal Lardier, Health 2.0 International Director, recently interviewed Omri Shor, CEO of Medisafe, for the EU funded GET Project. Shor has showcased Medisafe on stage at Health 2.0 several times and recently closed a $6 million Series A funding round. His advice? Shor says “Investors care about two things: the product market fit and the business model fit.” Read on for more.     

Pascal Lardier: Omri, to start can you say a few words to describe your solution and what it does?

Omri Shor: For sure. MediSafe is an intelligent medication management platform helping people manage their medications correctly. When we go into details, we’re a cloud and apps company. We have apps, iPhone and Android, that are synced together for a cloud service that we have developed.

In general, we remind people to take their medications. We keep a log of what they took and what they didn’t take. And we’re able to share that data back with physicians. The new layer that we’ve just added is a personalized feed that is dealing with more than just a reminder, it’s now dealing with persuasive technology to make sure that patients understand the need to take their medications as well as the ability to track some measurements and vital signs inside MediSafe and correlate this with the medication that the patient has actually taken.

PL: Can you say a few words about your niche in digital health? How many competitors and what makes MediSafe different and better than other solutions?

OS: MediSafe is dealing with a big problem called medication non-adherence. The niche is actually patient engagement, specifically in the medication management space. There are hundreds of companies from cloudware companies to software companies to app companies. We’ve chosen to be mobile-first because we thought that this is the best place to help patients manage their medications mostly because we all engage with our smartphones so much and we think it’s only going to grow. We have iPhone, Android, and we have smart watches now as well. Some of that have already come, some of that are coming just around the corner.

In the medication management space in terms of apps, there are hundreds of competitors. MediSafe’s first differentiator is the user experience. We’re quite fanatic about user experience. We made sure that we are well-designed. MediSafe looks like a virtual pill Box. We have the design patent on the way that we integrate with the users.

The second piece that differentiated us from the beginning is our ability to sync via the cloud. We have the ability to sync family members. That means that if my father who is diabetic accidentally didn’t take his meds, I get notified and I can help him get reminded and make sure that he takes his meds or at least that he thinks of taking his meds.

These were the first things that differentiated MediSafe. Currently, the most important thing that is differentiating us is that we’ve taken a personalized approach. That means that we’ve created a feed that is dealing with patient’s condition, medication, et cetera. This feed is communicating to the patient how important it is to take his meds safely, correctly, that it would actually help him; and the ability to connect back to the healthcare system and back to the physician to make the physician more knowledgeable of the immediate outcomes of the medications that the patient is taking.

One other thing that is now differentiating MediSafe is that we currently have well over a million downloads of our solution with hundreds of thousands of active users. This is putting us in a position, I would say, in the class that just a handful of the medication management solutions were actually able to achieve. And this is accelerating, so we will see more of those users coming to choose MediSafe to manage their medications correctly.

PL: You have jumped ahead to my next question. The user experience, the personalized approach, this is what makes you different in the eyes of the users. This is why they’re going to choose MediSafe rather than another solution. My next question is, specifically in your niche that you described with hundreds of solutions, what did you think exactly make a difference in your discussions with investors?

OS: Investors care about two things. Investors care about the fact that there is a product market fit. That means that patients are using our solution. The second thing that investors care about is that there is a business model fit. That means that our customers, pharmaceutical companies, are willing to pay us money for the use of MediSafe and for different things that we do with them. These two together, the growth that we’ve seen organically without investing money and marketing and the ability to monetize users, brought them to the conclusion that the company has the ability to be a leading company or a leading solution for a multi-billion dollar problem.

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The Individual Mandate, a Brief History — Part I Conservative Origins

By BRADLEY LATINO

In recent years, politicians of every stripe have eaten their words about the wisdom of requiring all Americans to possess health coverage. This hasn’t been real news since the 2007 Democratic primary debates, when candidate Obama claimed his reasons for opposing the mandate were similar to those expressed by Hillary some 15 years ago.

A few years later it was President Obama’s turn. And by 2010, the entire Republican party performed a synchronized heel-face turn, virulently opposing the solution they advocated decades earlier. All of this culminated with the recent passage of the “Repealing the Job-Killing Health Care Law Act” in the House, by which point the mandate had become a 21st century Intolerable Act.

The media have dutifully reported each foible as if such strategic backpedaling were something new under the sun. But the 22-year path to ACA § 1501(b) is a story in its own right, a sort of philosophical history of American health reform policy.

Part I – The think-tank solutions (1989 – 1992)

Back in the late 1980s, the individual mandate wasn’t controversial at all–just another idea being kicked around in conservative think tanks. Although economist Mark V. Pauly, an adviser to the first Bush administration, is often cited as the mandate’s creator, conservative thinkers Stuart M. Butler and Edmund F. Haislmaier were dreaming up similar proposals at the Heritage Foundation as early as 1989.Continue reading…

Susannah Fox on Teens & Digital Health Study

By JESSICA DAMASSA, WTF Health

How are teens and young adults engaging with digital health? Results of a national survey asking just that were released today by Susannah Fox (Former CTO at US Dept of HHS) and her research partner, Victoria Rideout.

You can check out the full report of the findings here, but I spoke with Susannah in April, just as she and Victoria were starting to draw some insights from their work.

Hearing her talk about the survey at this stage of synthesis is not only unique (most researchers won’t talk until the findings are published) but more so because it adds a layer of understanding to the final results now that they’re here.

We get her candor about how teens and young adults are a wildly viable – yet very overlooked – market for digital health…

We see how she’s trying to formulate a much larger hypothesis about what healthcare can learn about social media from a generation that has never lived without it and, more importantly, view it as having a positive impact on their well-being…

And, probably most inspiring to me, we see an approach to health data that stands out for its warmth. For it’s love, really. In a world of big data and clinical trials, it’s endearing to hear from someone who is taking a more anthropological approach and who has fallen absolutely, head-over-heels in LOVE with the personal side of her dataset.

As we all clamor for a patient-centered end, we’d be remiss to underestimate the value of a human-centered starting point. Watch Susannah Fox for a strong model of how this can be done in health research.

Filmed at Health DataPalooza, Washington DC, April 2018. Find more interviews with the people pushing healthcare to better tomorrow at www.wtf.health. 

Digital Health and the Two-Canoe Problem

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By DAN O’NEILL

Digital Health and the Two-Canoe Problem

As healthcare gradually tilts from volume to value, physicians and hospitals fear the instability of straddling “two canoes.” Value-based contracts demand very different business practices and clinical habits from those which maximize fee-for-service revenue, but with most income still anchored on volume, providers often cannot afford a wholesale pivot towards cost-conscious care.  That financial pressure shapes investment and procurement budgets, creating a downstream version of the two-canoe problem for digital health products geared toward outcomes or efficiency. Value-based care is still the much smaller canoe, so buyers de-prioritize these tools, or expect slim returns on such investment.  That, in turn, creates an odd disconnect.  Frustrated clinicians struggle to implement new care models while wrestling with outdated technology and processes built to capture codes and boost fee-for-service revenue. Meanwhile, products focused on cost-effectiveness and quality face unexpectedly weak demand and protracted sales cycles.  That can short-circuit further investment and ultimately slow the transition to value.

To skirt these shoals, most successful innovators have clustered around three primary strategies.  Each aims to establish a foothold in a predominantly fee-for-service ecosystem, while building technology and services suited for value-based care, as the latter expands.  A better understanding of these models – and how they address different payment incentives – could help clinicians shape implementation priorities within their organizations, and guide new ventures trying to craft a viable commercial strategy.

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Who Cares About the Doctor-Patient Relationship? A Review of “Next In Line: Lowered Care Expectations in the Age of Retail- and Value-Based Health”

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By KIP SULLIVAN, JD

A mere two decades ago, the headlines were filled with stories about the “HMO backlash.” HMOs (which in the popular media meant most insurance companies) were the subject of cartoons, the butt of jokes by comedians, and the target of numerous critical stories in the media. They were even the bad guys in some movies and novels. Some defenders of the insurance industry claimed the cause of the backlash was the negative publicity and doctors whispering falsehoods about managed care into the ears of their patients. That was nonsense. The industry had itself to blame.

The primary cause of the backlash was the heavy-handed use of utilization review in all its forms –prior, concurrent, and retrospective. There were other irritants, including limitations on choice of doctor and hospital, the occasional killing or injuring of patients by forcing them to seek treatment from in-network hospitals, and attempts by insurance companies to get doctors not to tell patients about all available treatments. But utilization review was far and away the most visible irritant.

The insurance industry understood this and, in the early 2000s, with the encouragement of the health policy establishment, rolled out an ostensibly kinder and gentler version of managed care, a version I and a few others call Managed Care 2.0. What distinguished Managed Care 2.0 from Managed Care 1.0 was less reliance on utilization review and greater reliance on methods of controlling doctors and hospitals that patients and reporters couldn’t see. “Pay for performance” was the first of these methods out of the chute. By 2004 the phrase had become so ubiquitous in the health policy literature it had its own acronym – P4P. By the late 2000s, the invisible “accountable care organization” and “medical home” had replaced the HMO as the entities that were expected to achieve what HMOs had failed to achieve, and “value-based payment” had supplanted “managed care” as the managed care movement’s favorite label for MC 2.0.

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Will Computers Really Replace Radiologists?

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By SAURABH JHA

There is hope, hype and hysteria about artificial intelligence (AI). How will AI change how radiology is practiced?  I discuss this with Stephen Borstelmann, a radiologist in Florida and a scholar in machine learning.

Listen to our discussion on the Radiology Firing Line Series, hosted by the Journal of the American College of Radiology and sponsored by Healthcare Administrative Partners.

About the author:

Saurabh Jha is a radiologist and contributing editor to THCB. He hosts the Radiology Firing Line Podcasts

Giving Consumers the Tools and Support They Need to Navigate Our Complex Healthcare System

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By CINDI SLATER, MD, FACR

As physicians and healthcare leaders, we are already well aware that the majority of patients do not have the information they need to make a medical decision or access to appropriate resources, so we didn’t need to hear more bad news. But that is precisely what new research once again told us this spring when a new study showed that almost half of the time, patients have no idea why they are referred to a GI specialist.

While the study probably speaks to many of the communications shortcomings we providers have, across the board our patients often don’t know what care they need, or how to find high-value care. Last year, my organization commissioned some original research that found that while a growing number of patients are turning to social websites such as YELP, Vitals, and Healthgrades to help them find a “high quality” specialist, the top-ranked physicians on these sites – including GI docs – are seldom the best when we look at real performance data. Only 2 percent of physicians who showed up as top 10 ranked on the favorite websites also showed up as top performers when examining actual quality metrics. (The results shouldn’t surprise you as bedside manner has little to no correlation with performance metrics such as readmission rates).

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As providers and health care leaders, we lament that our patients are not better informed or more engaged and yet across the board, we have not given them the tools or resources they need to navigate our complex system. But now for some good news: all hope is not lost, and patients can become better consumers, albeit slowly, if we all do our part.

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Health in 2 Point 00, Episode 41

After the longwinded-ness of last episode, Jessica DaMassa runs a tight ship today. Lantern’s demise, GSK & 23andme’s huge deal, yet another big chunk of change for American Well, and what was going on at #GoogleNext18 with Google Cloud in health –all asked by Jessica and answered by me, in under the 2 minute wire–Matthew Holt

AI to the Rescue: 5 Semi-Finalists Advancing Through the RWJF AI and the Healthcare Consumer Challenge!

By DIANA CHEN

Decision making is a daunting task. Combined with navigating health insurance jargon, scattered health information, and feeling crummy as you rush to find care during the onset of a cold, making decisions can be an absolute nightmare. However, artificial intelligence (AI) enabled tools have the potential to change the way we interact with and consume healthcare for the better. AI’s ability to comprehend, learn, optimize and act are keys to organizing the varying nuisances of the healthcare experience.

In a 2018 survey by Accenture, healthcare consumers indicated they would likely use AI for after hours care, support in navigating healthcare services, lifestyle advice, post-diagnosis management, etc. While AI in health is not limited to these functions, the report highlights consumers’ trouble in making informed healthcare decisions, hence this may be an area where AI can truly help.

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