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Explorations in French Health Care! (Or what I did on my vacation!)

By MATTHEW HOLT

This is a personal story about this blog’s publisher (me!) but it has just enough health care stuff to keep it relevant!

This year I finally got invited on the annual week-long mountain bike ride run by my friend JB and his ex Taiwan/Hong Kong buddies. I’ve actually been practicing and training most of the summer and arrived pretty confident even though I knew it would be tough. This edition is in Provence in France.

Before it all went wrong

And then…..2 hours in on the first day it turns out I was too confident…

Back in 2002 I smashed my knee snowboarding into a tree. When I told him my dad said ” You silly twit”

I actually was a silly twit this time too. I was on a new bike (a rental) that was actually much more advanced than my usual one and had a feature I had barely practiced with (a drop seat) that requires a new technique. It had rained heavily the day before so it was wet (& living in California I have very limited experience mountain biking in the rain), and I was behind the pack as my chain had come off. (There was a guide sweeping the rear who fixed it for me). So when I got to the first challenging down hill slope I didn’t do the sensible thing of stopping & walking to the bottom to check it or do what 75% of the group did and walked their bike down it, I just thought, “I can do that’ and plunged down it. Not quite sure exactly why I fell but I went over the bars slightly to the right (luckily missed a tree) & hit the ground on the downslope hard on my right side. In any sport any one of new equipment, new environment, new technique means you should err on the side of caution and I had all 3, yet just went for it! Very bad decision!

After I got up I thought I had just badly winded myself. The guide helped me back on the bike & I rode on. For the next 5 miles or so he helped push me up the steeper bits of a climb (he had an eBike). I actually did a slightly less challenging but still tough downslope section & a friend gave me a big dose of Tylenol at the next stop point. I actually crashed again after that (slipped on a wet rock) but landed ok on my elbow which was padded (as were my knees but not my torso) and only had some slight scratches but I made it to lunch feeling sore but OK.

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The Digital Health Update from Europe: Startups, Funding, Frontiers Health & More

BY JESSICA DaMASSA

Roberto Ascione, CEO of European marketing and innovation consultancy, Healthware Group, and Chairman of Europe’s premier digital health conference, Frontiers Health, literally has a front-row seat to all the happenings in Europe’s scaling digital health, digital therapeutics, and telehealth markets.

With juuuust enough time for American investors and innovators to snag their own ticket for a seat at Frontiers Health in Milan on October 20-21, 2022, we check in with Roberto to see if European health tech startups are fairing any better than their US-based counterparts, if EU-based investors are just as flush with funding as they have been through the pandemic, and if enthusiasm is still high for virtual care and digital health among government healthcare organizations, their health systems, and their patients.

Europe is NOT the same market as the US, and Roberto details some notable differences in the state-of-play and top-of-mind issues facing health tech across the pond. Many of these topics will take center stage at Frontiers Health, including some important governance conversations around digital therapeutics. For the gossip on what’s happening in health tech in Europe, check out this interview and for more on what’s on the agenda at Frontiers (which can be attended virtually for those averse to Milan 😉) head on over to www.frontiers.health.

Truth and Trust in Science: Are They Negotiable?

BY MIKE MAGEE

“The key is trust. It is when people feel totally alienated and isolated that the society breaks down. Telling the truth is what held society together.”

Those words were voiced sixteen years ago in Washington, D.C. It was October 17, 2006. The HHS/CDC sponsored workshop that day was titled “Pandemic Influenza – Past, Present, Future: Communicating Today Based on the Lessons from the 1918-1919 Influenza Pandemic.”

The speaker responsible for the quote above was writer/historian and Johns Hopkins School of Public Health adviser, John M. Barry. His opening quote from George Bernard Shaw set a somewhat pessimistic (and as we would learn 14 years later, justified) tone for the day:

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Health Care Execs Behaving Badly

BY KIM BELLARD

In the midst of a pandemic during which health care workers proved themselves to be very bit the heroes we like to think of them as being, it’s sobering to be reminded that the system they work in is filled with perverse incentives that work against patients’ best interests.  Four pieces of excellent journalism – two from The New York Times, and two from Kaiser Health News — this week brought that front and center.  

If you haven’t read them yet, I urge you to do so, but, while you might enjoy the writing, don’t expect to enjoy their content.

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NeuroFlow & The Tech that Jumps the Care Gaps Between Physical Check-ups & Mental Health Care

By JESSICA DaMASSA, WTF HEALTH

Mental health infrastructure company, NeuroFlow, is a tech platform that integrates into care management systems and EHRs to help clinicians and care managers identify behavioral health conditions in patients as they are getting physical health exams like annual check-ups, post-partum exams, and more. Founder & CEO Chris Molaro joins us from NeuroFlow’s new headquarters just hours before their grand opening to talk about how the startup – which has raised a total $32 million, including a $20 million Series B led by Magellan Health – is helping health systems and health plans integrate and automate workflows so they can better identify, risk-stratify, and serve patients who need mental health services.

Right off the bat, Chris starts out by explaining what NeuroFlow IS by what it IS NOT; NeuroFlow is not a telehealth company and it doesn’t directly deliver mental health care to any patients. Instead, it is a platform that makes it easier for those who are working with patients to be able to more consistently screen for mental health issues, provide follow-up support, and transition patients to the right level of mental health care via a step-care model complete with referral pathways.

The care management component of NeuroFlow gets splashier from here, with the ability to integrate and analyze data from wearable devices and free-form data sources like text messages with providers to flag anomalies in everyday behaviors that might be clues that could indicate that someone may in distress. How else does the tech help build a bridge from physical check-up to mental health care providers, particularly in an era where the supply-and-demand imbalance for mental healthcare is so off? We talk all things scaling-up, how the “modular” business model works, AND we find out why NeuroFlow’s new offices are so important to the company and its Philly roots. Watch now!

THCB Gang Episode 105, Thursday September 22 at 1pm PT, 4pm ET

Joining Matthew Holt (@boltyboy) for #THCBGang on Thursday September 22 are delivery & platform expert Vince Kuraitis (@VinceKuraitis); THCB regular writer and ponderer of odd juxtapositions Kim Bellard (@kimbbellard); and in a quick late switch everyone’s favorite cynical radiologist Saurabh Jha (@RogueRad) joins us too

You can see the video below & if you’d rather listen than watch, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels.

The Society for Participatory Medicine Presents a Creative Learning Exchange: Community Health Access and Equity 

I’ve been on the board of the Society for Participatory Medicine for a few years and we are kicking off a series of “Creative Learning Events”. There’ll be two in the balance of 2022 and hopefully one a quarter thereafter. Should be great in-person AND online exchanges about getting participatory medicine into the hear of the health care system. Here’s details on the first one, October 20, in Boston and everywhere else!–Matthew Holt

Participatory Medicine is a movement in which patients, caregivers and healthcare professionals actively collaborate and encourage one another as full partners in healthcare. 

The Society for Participatory Medicine with the support of our sponsor NRC Health Presents A Creative Learning Exchange(CLE): Community Health Access and Equity

Date: October 20, 2022 Time: 12:00 noon – 4:00pm (Lunch Is Included for In-Person)

Location: Brown Advisory, 100 High Street, 9th Floor, Boston, MA 02110

For more details and to REGISTER TODAY click here.

The Society for Participatory Medicine believes that the culture of healthcare is not benefiting everyone equally and needs to change. And healthcare won’t get better until healthcare culture gets better. We want to drive this change by enabling collaboration, education, information sharing, and communication among patients, caregivers, and health care professionals. Join the movement! 

This Creative Learning Exchange, in-person and online hybrid event, will be highly interactive and participatory, using a ‘Neighbors at Each Table’ approach to engaging you in facilitated discussion and brainstorming. 

These discussions will focus on applying the Participatory Medicine Manifesto behaviors in culturally and racially diverse communities to enable access and equity in care. Your ideas, insights and solutions that emerge will be curated by SPM to build a toolkit of participatory medicine guidelines. These will be shared with you and through SPM’s social networks, website and blog. 

For more details and to REGISTER TODAY click here.


Thank you to our series sponsor NRC Health. Thanks to Massachusetts General Hospital Equity & Community Health for sponsoring the meal. Thanks for Brown Advisory for proving the venue & AV.

The Future of Clinical Trials at Pfizer

BY JESSICA DaMASSA

From de-centralized clinical trials to real world data (RWD), real world evidence (RWE), and even social media, the future for clinical research at Pfizer sounds increasingly tech-enabled and focused on meeting and engaging patients where they are.

Pfizer’s Head of Clinical Trial Experience, Judy Sewards, and Head of Clinical Operations & Development, Rob Goodwin, drop in to chat about what Pfizer’s approach to clinical research looks like now, after the rapid evolution it underwent to “lightspeed” the development of the Covid-19 vaccine.

The big change? Rob says they are “obsessed” with de-centralized trials, with nearly 50% of clinical trial visits still happening virtually. And, beyond the convenience factor, both point to de-centralization as a critical factor in being able to recruit more patients into trials as well as improve the diversity of their participant groups. In the end, the decentralized approach, says Judy, is “not just a matter of equity, but good science as well.”

And what about improvements to the cost of drug development? Is it too soon to tell if de-centralization will make an impact on the bottom line? Innovation may be expensive to implement at first, but, explains Rob, “If you can recruit your trial faster, overall, the cost of development goes down and speed to the patient goes up.”

We chat through the full suite of benefits that de-centralized clinical trials are bringing Pfizer and its patient populations, and get into the utility of real-world data, which also saw new notoriety when the Covid-19 vaccine was being developed. How is RWD impacting clinical research even when it’s not being used as evidence in a regulatory approval process? Watch and find out more about how data innovation is shaping the future of pharma!

Ribbon Health & Provider Data’s Holy Grail: The Accurate Provider Directory

BY JESSICA DaMASSA

It’s one of the greatest mysteries of the era of health data digitization: Why is provider directory still so hard to get right?? Ribbon Health’s co-founder & CEO Nate Maslak explains how Ribbon (which started out in the symptom-checker biz) pivoted to take on, once-and-for-all, the miserable state of provider data management to not only fix provider directories (which are still wrong 50% of the time!), but also referral management systems, health plan enrollment data, and now, thanks to those new price transparency rules, price lists.

“All of the different use cases we focus on around enrollment, referral management, provider data management for directory…” explains Nate, “These are actually the same problem that use different words to describe it because of the different parts of the ecosystem that we’re in.” So, as Ribbon gets the process right for provider directory by building an underlying tech platform that uses predictive analytics and network effect methodologies to work its magic to validate-and-verify that kind of healthcare data, then it can apply that framework to ANY healthcare data to the same end. And, maybe one day, layer member-facing services – like instant-booking with a doc – on top of them.

Backed by nearly $54 million from Andreesen Horowitz and General Catalyst, and we get into what makes this startup’s take on one of the oldest healthcare infrastructure issues so appealing. From platform to business model (which serves a mix of health plans, provider orgs and patient-facing solutions) to grand plans for the future (which include figuring out how “API as a platform” can further productize provider data management and power care decisions) we chat with Nate on all things Ribbon Health.

When Medical Error Becomes Personal, Activism Becomes Painful

BY MICHAEL MILLENSON

In the mid-1990s, researching a book about the quality of medical care, I discovered how the profession had for years been ignoring evidence about the appalling death toll from preventable medical error. Though I’d never myself experienced an error, I became an activist.

Recently, however, a relative was a victim, and the frustrating persistence of error became personally painful.

Thanks to my relative being acutely aware of the need to be alert (and a bit of luck), no harm was caused by what could have been a serious medication mistake. That was the good news. The bad news is that even Famous Name Hospitals, like the one where my relative was treated, are rarely doing everything possible to forestall the impact of inevitable human fallibility.

September 17 was World Patient Safety Day, and the theme for the next 12 months is “Medication Without Harm.” That makes this an opportune time to examine more closely what the profession euphemistically calls a “medication misadventure.”

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