Thank you, ONC for the opportunity you gave me to speak in June. Also, thank you for the format of your August meeting where the Zoom chat feature offered a wonderful venue for an inclusive commentary and discussion as the talks were happening. Beats lining up at the microphone any day.
Here is a brief recap of my suggestions, in no particular order:
It’s Health in 2 Point 00’s 150th Episode or Sesquicentennial anniversary! On this episode, we have the return of Softbank money—$100M goes to Biofourmis platform for AI & Clinical Trials. Next, Amwell prices their IPO at $14-16 a share, and Grand Rounds raises $175 million led by the Carlyle Group. Finally, we have real foul play to report – former Zocdoc CEO Cyrus Massoumi filed a lawsuit accusing his fellow cofounders and CFO of foul play, so Jess asks me to dish the dirty details.—Matthew Holt
Episode 24 of “The THCB Gang” was live-streamed on Thursday, September 10th! Watch it below!
Joining Matthew Holt (@boltyboy) were some of our regulars: WTF Health Host Jessica DaMassa (@jessdamassa), patient & entrepreneur Robin Farmanfarmaian (@Robinff3), writer Kim Bellard (@kimbbellard), policy & tech expert Vince Kuraitis (@VinceKuraitis), and guest Mike Magee, a medical historian & health economist (@drmikemagee). The conversation was incredibly wide-ranging and one of the best we’ve had in a while–not the least because Mike Magee gave us a great base with how our non -health system somehow did actually act as a cohesive force in society before tech, then COVID19 broke it up!
If you’d rather listen to the episode, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels — Zoya Khan
In surprising news this week, CMS (the Centres for Medicare & Medicaid Services) in the USA approved the first reimbursement for AI augmented medical care. Viz.ai have a deep learning model which identifies signs of stroke on brain CT and automatically contacts the neurointerventionalist, bypassing the first read normally performed by a general radiologist.
From their press material:
Viz.ai demonstrated to CMS a significant reduction in time to treatment and improved clinical outcomes in patients suffering a stroke. Viz LVO has been granted a New Technology Add on Payment of up to $1,040 per use in patients with suspected strokes.
This is enormous news, and marks the start of a totally new era in medical AI.
Especially that pricetag!
Doing it tough
It is widely known in the medical AI community that it has been a troubled marketplace for AI developers. The majority of companies have developed putatively useful AI models, but have been unable to sell them to anyone. This has lead to many predictions that we are going to see a crash amongst medical AI startups, as capital runs out and revenue can’t take over. There have even been suggestions that a medical “AI winter” might be coming.
Applications for the #COVID19 Symptom Data Challenge close in three weeks!
Amidst #COVID19, using analytic approaches to maximize available information and data is paramount. Hosted by Margolis Center, sponsored by Facebook Data for Good (@academics), and in partnership with the Joint Program in Survey Methodology, Carnegie Mellon University, and ResolveToSaveLives, the Challenge seeks to analytic approaches that utilize COVID-19 symptom data to develop insights into the trajectory of the novel coronavirus.
Have a solution? Finalists can win up to $50k and the winning analytic approach will be featured on Facebook’s (@academics) Data For Good website!
Much, much more information is on the Challenge Website. Apply by 11:59:59 pm ET on September 29!
Much more about the Challenge Background in this interview or in this slack channel.
Farzad Mostashari is CEO of Aledade, former National Coordinator for Health Information technology, and former Deputy Commissioner at the New York City Department of Health and Mental Hygiene. Indu Subaiya is the President at Catalyst @ Health 2.0
(This is the fifth in a series of excerpts from Terry’s new book, Physician-Led Healthcare Reform: a New Approach to Medicare for All, published by the American Association for Physician Leadership.)
Real healthcare reform depends on an effective plan to reduce cost growth. To achieve this goal, it makes a whole lot more sense to cut waste than to limit access to necessary services or slash provider payments to the bone, noted Donald Berwick, MD, a former acting CMS administrator, and Andrew D. Hackbarth, a RAND Corp. researcher, in a 2012 JAMA article. In their telling, a significant reduction in waste would allow us to bend the cost curve without hurting healthcare quality or access.
Berwick shared with me that he doesn’t know how much unnecessary care physicians or hospitals could safely eliminate. “Some of it is marbled into the daily activities of healthcare organizations,” he said. “There would have to be systemic changes to get it done. But it’s a matter of will. With enough will, a lot of it could be eliminated. And when you’re talking about $1 trillion [worth of waste], even if you get 10% of it, that’s a tremendous amount that could be applied to other activities.”
Risk-based contracts, whether shared savings or capitation, can incentivize physicians to reduce waste. From the viewpoint of long-suffering primary care physicians, value-based-care agreements that let them share in the savings they generate are a godsend. Of course, not all primary care doctors are willing to take financial risk or change their practice patterns. But if maintaining their current income depends on it, most physicians will embrace change.
Specialists, too, can benefit by embracing the new paradigm. If they’re mainly being paid fee for service, they’ll have to forgo a lot of lucrative tests and procedures. But they can still keep their incomes up by delivering more-appropriate procedures and tests to a larger patient population.
This is probably the strangest Labor Day in decades, perhaps ever. Tens of millions of workers remain unemployed due to the COVID-19 pandemic. Many of those who are still working are adapting to working from home. Those who are back at their workplace, or never left, are coping with an array of new safety protocols.
Those who work in the right industries – like the NBA – may get tested regularly but most workers have to figure out for themselves when to quarantine and when to get tested. For many workers, such as health care workers, people of color, and workers with underlying health issues, going to work is literally a life-or-death calculation.
No wonder that experts, like Dr. David B. Agus, are calling for companies to have Chief Health Officers.
Labor Day was originally intended to celebrate the labor movement, but these days labor unions don’t have much to celebrate. Only around 10% of U.S. workers belong to a labor union; both the number and the percent of unionized workers has been in steady decline over the past few decades.
Now Labor Day is mainly an extra day off for most, the unofficial end to summer, and, this year, possibly the springboard to a new surge in COVID-19 cases, due to holiday celebrations. Dr. Anthony Fauci warned:
(This is the fourth in a series of excerpts from Terry’s new book, Physician-Led Healthcare Reform: a New Approach to Medicare for All, published by the American Association for Physician Leadership.)
Many other countries’ healthcare systems outperform ours for one simple reason: They place a much greater emphasis on primary care, which occupies the central place in their systems. “The evidence is that where you have more primary care physicians, where you coordinate care, and where you pay to keep people healthy, you get better outcomes at lower cost,” says David Nash, MD, founding dean of the College of Population Health, part of Thomas Jefferson University in Philadelphia.
The evidence that Nash mentions includes studies by Barbara Starfield and her colleagues at Johns Hopkins University. In a 2005 Health Affairs paper, they showed that a higher ratio of primary care physicians to the population is associated with a lower mortality rate from all causes and from heart disease and cancer; in contrast, having more specialists in a particular area does not decrease the overall mortality rate or deaths from cancer and heart disease.
Another study of Medicare data found that states where a higher percentage of physicians were PCPs had higher quality care and lower cost per beneficiary. This factor alone accounted for nearly half of the variation in Medicare spending from one state to another. A separate study found that in the areas of the country that had the most primary care providers, the average Medicare cost per beneficiary was a third lower than in areas with the least PCPs.
One reason for this is that primary care doctors provide comprehensive, continuous care, including preventive and routine chronic care. Chronic illnesses drive 90% of health costs, and some studies show that intensive primary care can reduce ER visits and hospital admissions and improve the health of chronically ill people.
Yesterday it was Fortune’s 40 under 40, and a lot of great people, most of whom I thought were much older or at least seem to have been around a while, got listed in the health care section–including Andre Blackman, Ambar Bhattacharyya & Julia Cheek. Lisa Suennen (@venturevalkyrie) and I got into a Twitter exchange about whether we were eligible for the under 40 category or for that matter the category above that. The answer was, amazingly, “no”. Somehow she came out with the line that “we are old”. Knowing her love for 80s pop, I reminded her that this was the inverse of the first line of the Pat Benatar classic “Love is a Battlefield.” Somehow this ended up in us tweeting a new set of lyrics for that song to each other all day. Of course I feel compelled to share them with you. I encourage you to play the video below and sing along!
We are old Wheelchair to wheelchair we sit…. No Promise ring, yes Depends Don’t want my age revealed
Before Long They will all sing our swan song Scans of our hearts show something wrong Both of us slowing.. Don’t want my age revealed
Ads begging me to Ro Then making me pay Why do my knees hurt so bad? It would help me to know Should I stand a different way? My hip hurts too, I might add