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American Telemedicine Has Gone Viral

By HANS DUVEFELT, MD

It took a 125 nanometer virus only a few weeks to move American healthcare from the twentieth to the twenty-first century.

This had nothing to do with science or technology and only to a small degree was it due to public interest or demand, which had both been present for decades. It happened this month for one simple reason: Medicare and Medicaid started paying for managing patient care without a face to face encounter.

Surprise! In the regular service industries, businesses either charge for their services or give certain services away for free to build customer loyalty. In healthcare, up until this month, any unreimbursed care or free advice was provided on top of the doctors’ already productivity driven work schedules.

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The THCB Gang, Today at 1pm PT/4pm ET

Starting today we are going to create a new live show on THCB that will be preserved as a weekly podcast. I’m calling it The THCB Gang. Each week 4-6 semi regular guests drawn from THCB authors and other assorted old friends of mine will shoot the shit about health care business, politics and tech. It should be fun but serious and informative!

To kick off this week, joining me I’ll have Saurabh Jha (@roguerad), Jane Sarasohn Kahn (@healthythinker), Deven McGraw (@healthprivacy) & Kim Bellard (@kimbbellard). Join us at 1pm PT and 4pm ET right here! Hopefully if I don’t screw up too badly we will repeat this every week at the same time with a variety of guests! — Matthew Holt

Update, just added Ian Morrison (@seccurve) to the gang!

COVID-19 Update: A Message From Concerned Physicians

By HOWARD LUKS MD, JOEL TOPF MD, FACP, ETHAN WEISS MD, CARRIE DIULUS MD, NANCY YEN SHIPLEY MD, ERIC LEVI MBBS, FRACS, BRYAN VARTABEDIAN MD

“EVERYTHING WE DO BEFORE A PANDEMIC WILL SEEM ALARMIST. EVERYTHING WE DO AFTER WILL SEEM INADEQUATE”

—Michael Leavitt

Last updated 3/18/2020.

Why are we writing this? 

The COVID-19 pandemic has reached a point where containment is no longer possible. The COVID-19 threat is real, and rapidly getting worse. Many of you are very nervous, some are unsure of the validity of the information you are reading. As physician leaders, we felt it was important to craft a resource you can rely on as being scientifically accurate and one which contains as much actionable information and guidance as possible. 

Accurate, actionable information during an epidemic can save lives. Physicians are on the front line of this epidemic. Not only are we treating the sick, but we are also cringing at the misinformation spread through both traditional broadcast and social media. Evidence matters. Unfortunately, evidence is often slow, methodical, and boring and has a tough time against clicky headlines and exaggeration. We believe that an accurate representation of the current COVID-19 pandemic followed by a set of actionable steps you, your loved ones, politicians and local officials can utilize is of paramount importance and ultimately could save tens of thousands of lives. 

COVID-19 isn’t just the flu? 

COVID-19 has been described by some as “just a cold”, or just like the common flu. COVID-19 is not the common flu. COVID-19 is an order of magnitude worse than the flu. The fatality rate is approximately 10 times worse than the flu.

The flu spreads from September through April in the US, and June through August in the Southern Hemisphere. Yes, it does cause severe illness in many, but it does so over a longer time course. Time is a variable that is working against us during this COVID-19 outbreak. COVID-19 victims will be presenting to a hospital in need of critical care at a rate that is far higher than occurs with the flu.

In addition, these patients will be requiring hospital treatment over the course of a few weeks rather than the 3-4 months of a typical flu season. The healthcare system in the USA is not ready to handle tens of thousands or hundreds of thousands of people over a short time frame. In Italy, the healthcare system buckled under the strain and the healthcare teams are now forced to make horrible life and death decisions. 

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Tracking digital health innovation in response to COVID-19

By INDU SUBAIYA & MATTHEW HOLT

Since the COVID-19 pandemic became very real for all of us a couple in the US a couple of weeks ago, our team at Catalyst @ Health 2.0 has been working on a way to support the wider health tech community. 

We have created a list of information on innovators who are working to address the COVID-19 pandemic. In order to maximize our response efforts to the coronavirus outbreak, we are collecting information on specific solutions for COVID-19 issues from digital innovators in several categories like telemedicine, artificial intelligence, and disaster preparedness. Our resource hub includes information on health technology developments, as well as news and interviews. We are by no means the only ones doing this and we are doing this cooperatively with HIMSS, Startup Health, Chilmark, HealthXL and others.

Our goal is to have as comprehensive and searchable a list as possible of these solutions. Today we are making our first effort live. Please come look at the site at covid19healthtech.com and please give us your feedback. In particular if you or your organization is working on a response to COVID-19 or you have expert insights on how to address the outbreak, please tell us about it! 

We hope to greatly expand the number of companies and organizations we feature in the coming days, and look forward to working with the wider health tech community to all do what we can to improve health care as much as we can in these very trying circumstances

Indu Subaiya & Matthew Holt are the co-founders of Health 2.0 LLC

Bruce Greenstein to Health Tech: “This is The Make-or-Break Time” | WTF Health on Covid-19

By JESSICA DAMASSA, WTF HEALTH

“Health tech providers — this is the make-or-break time. If you can’t prove your value in the next, say, eleven weeks, then you should NOT be in the health care game. It’s time to get serious.”

Bruce Greenstein, former CTO at HHS and current Chief Strategy and Innovation Officer at LHC Group, one of the country’s largest home health care providers, stops by to share what he’s learned about the federal government’s response to the COVID-19 pandemic.

Bruce represented the home health industry during last Friday’s (3/13/20) White House meeting, which culminated in a Rose Garden press conference starring the ‘who’s who’ of American health care, retail, and pharma leadership. (Bruce was the guy who elbow bumped Trump.)

Lots of attention on virtual care and telehealth during that presser, and Bruce weighs-in for our health tech and digital health audience about how they can get involved and what big health care companies like his are looking for in digital solutions right now (LHC Group works with 350 hospitals caring for 100K patients.) And how about those HHS Interoperability Rules that have been basically lost in this news cycle? We get Bruce’s feedback on how HHS did, plus his insider info on the HHS “hack.”

Some guidance to help you navigate this chat. Hot Tip: Open up the transcript in YouTube and navigate to these different breaks in the conversation.

  • The ‘Trump Bump’ & Gossip from the Rose Garden Press Conference & White House Meetings
  • 8:40 mark — Advice for health tech startups (must-watch)
  • 15:25 mark — Find out what startups can do that would lead Bruce to “put them in Health IT Hell for the rest of their existence”
  • 16.45 mark – HHS “Hack”
  • 18.14 mark – HHS Interoperability Rules
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A Healthcare System, If We Can Keep It

By KIM BELLARD

We are in strange days, and they are only going to get stranger as COVID-19 works its way further through our society.  It makes me think of Benjamin Franklin’s response when asked what kind of nation the U.S. was going to be:  “A Republic, if you can keep it.” 

SAUL LOEB / AFP VIA GETTY IMAGES

The versions of that response that COVID-19 have me wondering about are: “A federal system, if we can keep it,” and, more specifically, “a healthcare system, if we can keep it.”  I’ll talk about each of those in the context of the pandemic.

In times of national emergencies — think 9/11, think World Wars — we usually look to the federal government to lead.  The COVID-19 pandemic has been declared a national emergency, but we’re still looking for strong federal leadership.  We have the Centers for Disease Control, infectious disease experts like Dr. Anthony Fauci, and a White House coronavirus task force.  But real national leadership is lacking. 

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How Concerned Should Patients Be About An Irregular Heartbeat?

By KOUSIK KRISHNAN, MD

As many industries and individuals are struggling publicly with burnout, a new study from the European Journal of Preventative Cardiology links the “burnout syndrome” with atrial fibrillation (afib). The findings are both interesting and valuable. In general, the public benefits from anything that can raise awareness of heart disease, because early intervention directly impacts improved patient outcomes.

However, headlines that describe afib as a “deadly irregular heartbeat” go too far in the name of public awareness. The truth is, afib is not a sudden killer like a heart attack, cardiac arrest, or stroke. While afib is undeniably serious, it can often be identified in advance and managed with evaluation and treatment. 

Afib is a very common arrhythmia that has numerous risk factors, including hypertension, diabetes, obesity, and sleep apnea, to name just a few. When the heart goes into atrial fibrillation, the upper chambers go into a fast, chaotic and irregular rhythm that often makes the pulse race and feel irregular. Other symptoms can include palpitations, shortness of breath, and dizziness. Some people may not have any symptoms at all. Stroke is the most devastating consequence of atrial fibrillation, but is rarely the first manifestation of the disease.

It is also important to note that afib may not always be present. For this reason, often the arrhythmia is gone by the time someone seeks medical attention, making the arrhythmia harder to diagnose. Fortunately, consumer devices, such as the new Apple Watch, have algorithms to help detect atrial fibrillation. These technologies hold immense promise. They are already helping many people manage their health, and even potentially diagnose some people who never knew they had afib.

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Why Peak Viral Load makes temperature screening alone insufficient for COVID-19

By TONY ESTRELLA

And how South Korea and Taiwan’s approach to diagnosis and tracking is leading to positive results

By now, the sight of people wearing surgical masks, flinching at the sights and sounds of someone coughing or sneezing, governments restricting large gatherings, and sports leagues suspending or cancelling matches is familiar across the world.

Even though this newest coronavirus we now call COVID-19 is not the deadliest disease as measured by daily deaths, the concern over the outbreak is forcing urgent actions.

Daily deaths from COVID-19 compared to other diseases. Source: informationisbeautiful

One of the core concerns is limiting how quickly the virus can spread. Having too many people require urgent care can overwhelm healthcare systems. This anxiety has led to a call to ‘flatten the curve’ to avoid this challenge.

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Julia Cheek, Everlywell, & its response to COVID-19

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

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.

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