Epidemics don’t appear in isolation of geography, social status, race or economics.
In a recent Kaiser Family Foundation article, the authors reviewed case numbers and death rates organized by race/ethnicity. It will come as no surprise that the most vulnerable populations death rate is nearly three times greater than the least vulnerable. But what may surprise you is that the population at greatest risk was neither self-identified as Black or Hispanic, but Native American.
Sadly, this is not a new story, but in the analogs of American history, it has been papered over by a partially true, but incomplete, narrative. That storyline was largely popularized by the book, “Guns, Germs, and Steel.” Published in 1997, author Jared Diamond explained that European colonists, arriving in the Caribbean islands in the late 15th century, carried with them a variety of diseases like smallpox and measles, and transmitted them to indigenous people that had no prior exposure to these deadly microbes.
When my siblings and I were young, we were fascinated by my father’s Uncle Byron. Handsome and confident, he drove a big, 1960s-era Chrysler Imperial, had a glamorous job — an executive at a Baltimore radio station — and radiated panache.
He also was part of a small family mystery. His father, Louis, was married three times, and Byron was raised by Wife № 3. But he was the biological child of Wife № 2, who died just a few years after his birth from an unknown cause.
Thanks to some persistent genealogical research, I recently discovered that cause: Annie Millenson had a botched abortion, and it killed her. It also destroyed her surviving family.
Speaking as a sometimes forgetful “senior citizen,” when I found out that non-invasively zapping brains with electricity can result in measurable improvements in memory, that’s something I’m going to remember.
In research published in Nature Neuroscience by Grover, et. al., a team lead by Boston University cognitive neuroscientist Robert Reinhart produced improvements in both long-term and short-term (working) memory through a series of weak electric stimulation – transcranial alternating current stimulation (tACS). The authors modestly claim: “Together, these findings suggest that memory function can be selectively and sustainably improved in older adults through modulation of functionally specific brain rhythms.”
The study provided the stimulation using something that looks like a swimming cap with electrodes, applied for twenty minutes a day for four days. The population was 150 people, broken up into three separate experiments, all ages 65 to 88.
The results were amazing. “We can watch the memory improvements accumulate … with each passing day,” Dr. Reinhart marveled.
Apparently, the US Food and Drug Administration (FDA), that has long been charged with the safety and efficacy of drugs and devices now also controls who can prescribe drugs.
I was under the mistaken impression that in our highly rule based society you would need to pass a law to allow that to happen. Passing laws , of course, can be a long, messy, process that involves having to convince constituencies, and ruling by executive order is just way more efficient apparently.
So by decree of the FDA patients can now get Paxlovid, an anti-viral for the virus that causes COVID19, “directly from their state licensed pharmacist” if they so choose. Apparently, someone in government decided that there wasn’t enough Paxlovid being prescribed, and the major rate limiting step for many patients is not having access to a provider to prescribe the drug. I have to say provider now because physicians long ago lost the monopoly they enjoyed for prescribing medications to nurses with advanced degrees and physician assistants. The next obvious step is to cut out the ‘clinicians’ completely by allowing patients to get medications from a pharmacist without a prescription.
There are surprise profits in an overfunded sector, but then there are funding deals for staffing company Incredible Health ($80m), voice recorder Abridge ($12m), meditation company Interaxxon (Muse Headband) ($9m), medication company Arine ($29) & new virtual care medical group Keycare ($24)–Matthew Holt
“If I continue to hear how difficult it is for hospitals to make money, I would like for them to see what it’s like to operate a real business. They are overstaffed…they are overpaying…they are not responsible for quality or outcomes…there are no guarantees on their services…they can block competition from entering their markets…they can buy up market share – that’s not a real business.”
Well, lesson learned. If you ask Roger Jansen, Michigan State University Health Care’s Chief Innovation & Digital Health Officer, how he think things are going in US health systems when it comes to digital transformation and the integration of technology and value-based business models in hospitals, be prepared for a blunt conversation about how US healthcare model is failing and how the lack of incentive for change is keeping us all stuck in the same-old, same-old.
From digital health and telehealth to EMR and value-based care business models, we cover a lot of health innovation ground in this chat and get a reality check on whether or not things are really evolving inside health systems – and which stakeholders Roger believes hold the key to driving that change. (Hint: He identifies them as those who are already “footing the bill for the lavish lifestyles that healthcare administrators live that are probably well out-of-balance with the value that they actually bring to their corporations.”)
Roger on digital health? There’s better adoption and receptivity when it’s combined with “a service component that doesn’t add additional burden to the clinical component.” On virtual care and telehealth?
Down 70% since the pandemic’s lockdown days and more of a “behavior change problem” at this point than anything else.
When we get to EMRs around the 19-minute mark, things get extra spicy and we take a turn into “all this gibberish about volume versus value” and how value-based care models aren’t gaining meaningful traction either. It’s a big, bold reality check on the state-of-play of health tech, virtual care, and healthcare payment model innovation in health systems… watch now and let us know what you think!
Our rural health care system has suffered badly during the COVID-19 pandemic. It entered the pandemic with severe structural weaknesses, including magnified health disparities and inequities, lower rates of vaccination in the general population, and high risk of rural hospital closures. Beginning with these challenges, rural providers have been harder hit by the pandemic than just about any other health care sector.
Juxtaposed against this struggle is the optimism for digital health – one of the few bright spots of the pandemic. We have witnessed a veritable digital health revolution – record capital infusions of $37.9 billion to digital health companies in 2021, a proliferation of digital health companies (11,000 by some estimates), a wave of healthtech IPOs (29), and an unprecedented talent migration of Silicon Valley programmers, technologists, and engineers into health care. With this investment and talent boom comes staggering growth in new digital health tools. From telemedicine to remote diagnostics to the delivery of medications directly to a patient’s home, it seems that for every health care access need there is a digital solution.
Joining Matthew Holt (@boltyboy) for the 101st #THCBGang on Thursday August 18 are medical historian Mike Magee (@drmikemagee); patient safety expert and all around wit Michael Millenson (@mlmillenson); delivery & platform expert Vince Kuraitis (@VinceKuraitis); THCB regular writer and ponderer of odd juxtapositions Kim Bellard (@kimbbellard);
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.
Unless you have been off the grid for the past few months (which frankly sounds kind of nice right now), you know that the digital health market has changed dramatically. While not surprising to those of us who have been through the boom-and-bust cycles of the past two decades, it nevertheless has been an awakening for many investors and entrepreneurs.
As an entrepreneur, there are some things you cannot control – the macro-economic climate, supply chain disruptions and narcissist led wars halfway around the world. But what is entirely within your control is how you tell your company’s story and your ability to make investors want to join you on the journey.
As a longtime storyteller for several digital health companies and a current story listener (aka investor), I’ve been thinking about this topic a lot lately. Though the word “storyteller” can have negative connotations for some people, I value and appreciate great storytellers who engage me right off the bat, get me excited about the “why” and clearly articulate why it’s in my best interest to invest in their company.
The art of storytelling has always been important, but in the current digital health funding environment, it is quickly becoming essential for success. Are you telling your company’s story in the most effective way? Read on to find out.
Lyle Berkowitz has been very well known as a techy doc for years. He’s ran an innovation center at Northwestern, written books, been featured at tons of conferences (including Health 2.0), had a stint at MDLive and was founder and Exec Chair at HealthFinch which was bought by Health Catalyst. But instead of lying on the beach drinking MaiTais, Lyle has decided that there’s room for yet another virtual care play, and today his new company Keycare is announcing a $24m round and a deal with Spectrum Health (Michigan). What is it? It’s a virtual medical group that’s going to be supporting traditional health systems with care after-hours, out of state and much more. Is there room in the telehealth market for yet another niche play? You may guess that I asked and Lyle explained why!–Matthew Holt
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