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Livongo Takes on Hypertension | Zane Burke, CEO, Livongo

BY JESSICA DAMASSA, WTF HEALTH

Livongo CEO, Zane Burke, has been a busy guy since the company’s IPO late last year. The applied health signals company has seen triple-digit (148%) growth and a robust expansion of the weight management and behavioral health platforms they’ve been building to support the ‘whole health life’ of people with diabetes. Case-in-point, Zane talks through the outcomes of the company’s latest clinical research on Livongo’s hypertension management tool, which showed that clients who used both Livongo’s diabetes management tool and hypertension tool in tandem experienced significant decreases in their hypertensive blood pressure in as little as four weeks. As traditional healthcare companies and digital health startups alike continue to watch Livongo’s every move for an indication of ‘what’s possible’ for health tech startups, we asked Zane to clue us in on how he’s keeping his team focused on product development, market expansion, and issues related to reimbursement.

Filmed at Frontiers Health in Berlin, Germany, November 2019.

Quantum Theory of Health

By KIM BELLARD

We’re pretty proud of modern medicine.  We’ve accumulated a very intricate understanding of how our body works, what can go wrong with it, and what are options are for tinkering with it to improve its health.  We’ve got all sorts of tests, treatments, and pills for it, with more on the way all the time.

However, there has been increasing awareness of the impact our microbiota has on our health, and I think modern medicine is reaching the point classical physics did when quantum physics came along.  

Image credit: E. Edwards/JQI

Classical physics pictured the atom as kind of a miniature solar system, with well-defined particles revolving in definite orbits around the solid nucleus.  In quantum physics, though, particles don’t have specific positions or exact orbits, combine/recombine, get entangled, and pop in and out of existence.  At the quantum level everything is kind of fuzzy, but quantum theory itself is astoundingly predictive.  We’re fooled into thinking our macro view of the universe is true, but our perceptions are wrong.   

So it may be with modern medicine.  Our microbiota (including both the microbiome and mycobiome) both provide the fuzziness and dictate a significant portion of our health.   

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Consumer Weight Loss Platform Noom Heads for Digital Health | Saeju Jeong, CEO, Noom

By JESSICA DAMASSA

Popular weight management app Noom is officially stepping into the world of digital health and digital therapeutics. CEO & co-founder, Saeju Jeong, shares some of the impressive stats that the behavior change platform has been able to help users achieve — including an average 7.5% reduction in body weight in 6 months. With more than 1 million (!) users around the world already, Noom is expanding globally and is venturing further into the healthcare space as a result of their successful pilot with Novo-Nordisk, which saw Noom as a ‘wrap around’ support to the drug company’s diabetes medication. On tap next, Saeju tells us he’s headed further into diabetes management, hypertension, kidney failure, and various cardiac conditions.

Filmed at Frontiers Health in Berlin, Germany, November 2019.

Strategic Interests and the ONC Annual Meeting

By ADRIAN GROPPER, MD

The HHS Office of National Coordinator (ONC) hosted a well-attended Annual Meeting this week. It’s a critical time for HHS because regulations authorized under the almost unanimous bi-partisan 21stC Cures Act, three and a half years in the making, are now facing intense political pressure for further delay or outright nullification. HHS pulled out all of the stops to promote their as yet unseen work product.

Myself and other patient advocates benefited from the all-out push by ONC. We were given prominent spots on the plenary panels, for which we are grateful to ONC. This post summarizes my impressions on three topics discussed both on-stage and off:

  • Patient Matching and Unique Patient Identifiers (UPI)
  • Reaction to Judy Faulkner’s Threats
  • Consumer App Access and Safety

Each of these represents a different aspect of the strategic interests at work to sideline patient-centered practices that might threaten the current $Trillion of waste. 

The patient ID plenary panel opened the meeting. It was a well designed opportunity for experts to present their perspectives on a seemingly endless debate. Here’s a brief report. My comments were a privacy perspective on patient matching, UPI, and the potential role of self-sovereign identity (SSI) as a new UPI technology. The questions and Twitter about my comments after the panel showed specific interest in:

  • The similarity of “enhanced” surveillance for patient matching to the Chinese social credit scoring system.
  • The suggestion that we already have very useful UPIs in the form of email address and mobile phone numbers that could have been adopted in the marketplace, but are not, for what I euphemistically called “strategic interests”.
  • The promise of SSI as better and more privacy preserving UPIs that might still be ignored by the same strategic interests.
  • The observation that a consent-based health information exchange does not need either patient matching or UPIs.
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Disrupting How We Detect Asthma & Hypertension | Edward Allegra, BioLum Sciences

BY JESSICA DAMASSA

BioLum Sciences is introducing new chemistry that has the potential to completely change the way we test for respiratory illnesses, like asthma, and analyze blood samples to identify hypertension. CEO Edward Allegra talks through the science behind both their breath and blood tests, both of which are patent-pending and have the ability to completely bend the cost-curve when it comes to identifying and monitoring these two common chronic conditions. What’s next for the early-stage health startup? A range of applications to detect everything from COPD to lung cancer and more.

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

Why Healthcare Needs Designers

By TINA PARK, MFA

Designing a functional lamp is simple. Building the Mars Rover is complex. Getting a doctor to ask the right questions so that a patient feels confident about their care in a highly regulated and time constrained environment? That’s complicated.

Healthcare is filled with complicated challenges. Increasingly, healthcare companies and institutions are attacking these challenges with cross-disciplinary teams — doctors, data scientists, marketers, quality officers, financial experts, information technologists, and more. An often missing member of these teams are design leaders. Designers can provide an invaluable role in healthcare, but too often healthcare does not take advantage of all that design can offer.

Good design is invisible. Think about the last time you obtained or purchased something that was well designed. When you get a new blender, you plug it in and turn it on without looking at the user manual, and it works. You don’t necessarily think “Wow, they put that on button right where I thought it would be.” You use it and get on with your day. And every day you use that blender, putting in new mixtures of fruits and vegetables. Sometimes you get a delicious jackpot mix and think this is the best blender ever. Sometimes you get something brown and sticky and you make a mental note never to try that one again, even as you choke it down.

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Announcing the Finalists of GuideWell’s Caring for Caregivers Challenge

SPONSORED POST

By CATALYST @ HEALTH 2.0

GuideWell, in collaboration with Catalyst @ Health 2.0, is excited to announce the finalists of the Caring for Caregivers Challenge! GuideWell sought organizations with programs, platforms, technology systems or services that enable family caregivers to provide in-home care of adult family members and improve the quality of life for both caregivers and care recipients.

$50,000 was awarded to the Caring for Caregivers Challenge finalists:

Carallel, LLC (Lake Forest, Ill.): Through the use of a digital platform, Carallel provides tools and personal guidance to help caregivers manage their caregiving responsibilities in one place. “MyCareDesk” is a fully-integrated support system that assists caregivers with planning and coordinating tasks and accessing resources across a range of topics including senior living, in-home care, health, wealth and lifestyle.

Embodied Labs (Los Angeles): Using a virtual reality (VR) training platform designed for family caregivers, care partners or anyone providing support to care recipients, Embodied Labs simulates what it is like to live with certain health conditions. The immersive technology provides a unique learning experience that allows caregivers to experience life from the perspective of someone in need of caregiving.

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Digital Therapeutics Category Outlook for Reimbursement | Megan Coder, Digital Therapeutics Alliance

BY JESSICA DAMASSA

What’s ahead for digital thereaputics as the category carves out its place in the broader world of digital health and health tech? Megan Coder, Executive Director of the Digital Therapeutics Alliance (the professional org founded in 2017 to guide the development of the category), swings by to level set with some definitions, talk reimbursement trends in US and Europe, and explain the intention behind the DTA’s recently published code of conduct and best practices for DTX companies.

Filmed at Frontiers Health in Berlin, Germany, November 2019.

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Asinine, Backasswards Colonoscopy Insurance Rules Make Patients Decline Medically Necessary Testing

By HANS DUVEFELT, MD

I’ve had several telephone calls in the last two weeks from a 40-year-old woman with abdominal pain and changed bowel habits. She obviously needs a colonoscopy, which is what I told her when I saw her.

If she needed an MRI to rule out a brain tumor I think she would accept that there would be co-pays or deductibles, because the seriousness of our concern for her symptoms would make her want the testing.

But because in the inscrutable wisdom of the Obama Affordable Care Act, it was decided that screening colonoscopies done on people with no symptoms whatsoever are a freebie, whereas colonoscopies done when patients have symptoms of colon cancer are subject to severe financial penalties.

So, because there’s so much talk about free screening colonoscopies, patients who have symptoms and need a diagnostic colonoscopy are often frustrated, confused and downright angry that they have to pay out-of-pocket to get what other people get for free when they don’t even represent a high risk for life-threatening disease.

But, a free screening colonoscopy turns into an expensive diagnostic one if it shows you have a polyp and the doctor does a biopsy – that’s how the law was written. If that polyp turns out to be benign, or hyperplastic, there is no increased cancer risk associated with it, but you still have to pay your part of a diagnostic colonoscopy bill because they found something.

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Artificial Intelligence vs. Tuberculosis – Part 2

By SAURABH JHA, MD

This is the part two of a three-part series. Catch up on Part One here.

Clever Hans

Preetham Srinivas, the head of the chest radiograph project in Qure.ai, summoned Bhargava Reddy, Manoj Tadepalli, and Tarun Raj to the meeting room.

“Get ready for an all-nighter, boys,” said Preetham.

Qure’s scientists began investigating the algorithm’s mysteriously high performance on chest radiographs from a new hospital. To recap, the algorithm had an area under the receiver operating characteristic curve (AUC) of 1 – that’s 100 % on multiple-choice question test.

“Someone leaked the paper to AI,” laughed Manoj.

“It’s an engineering college joke,” explained Bhargava. “It means that you saw the questions before the exam. It happens sometimes in India when rich people buy the exam papers.”

Just because you know the questions doesn’t mean you know the answers. And AI wasn’t rich enough to buy the AUC.

The four lads were school friends from Andhra Pradesh. They had all studied computer science at the Indian Institute of Technology (IIT), a freaky improbability given that only hundred out of a million aspiring youths are selected to this most coveted discipline in India’s most coveted institute. They had revised for exams together, pulling all-nighters – in working together, they worked harder and made work more fun.

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