Successful Aging 2030: how far we haven’t come, how far we have to go

click to enlargeThis Editor attended last Wednesday’s (10 May) d.Health Summit 2017–Successful Aging 2030, sponsored by the University of Rochester and West Health. It was an expansive, well-organized and attended seminar at the New York Academy of Sciences at the impressive new 7 World Trade Center. Panels covered economic, housing, health outcomes, government policy, technology innovation, and investing factors key to one central fact: that in the US, nearly 20 percent of the population will be over 65 by 2030. Worldwide, the numbers are already much higher as of 2015: Japan (26 percent), Italy (22), Greece, Germany, Portugal (21) with nearly all of Europe already near that magic number (World Bank).

What was dispiriting to this Editor was that in her now 11 years in related health tech (telehealth and telecare), the status of many issues were the same as in 2006. The inadequacy of ‘aging in place’ supports and “assisted living”; a culture that brutally devalues people as they get older starting after 50; a belief that whiz-bang technology will fix it, but it doesn’t; the non-recognition of ‘aging-consumer-driven healthcare’; the lack of attention from investors because aging is not glamorous–are still there. What was hopeful? The candid recognition of these factors and the open discussion around them. There was a blunt admission expressed somewhat differently by two speakers, June Fisher MD of UC Berkeley and Charlotte Yeh of AARP, that without co-designing solutions with older people, we will get nowhere, and that imposing ‘fixes’ from the outside hasn’t and isn’t going to work. We also have a new middle age of 55-75, but the work market and employers have not adapted to that lengthening of productiveness, with the ‘pasture’ of retirement still pegged theoretically at 65.

Highlights of each panel:

The Longevity Economy, or the Silver Economy, was estimated by Merrill Lynch‘s Surya Kolluri at $7 trillion, with a surprising 90 percent of package goods spending done by 65+, and not just that but also areas such as home improvement. But healthcare spending is about 200 percent over the population average, and caregiving factors into that as well. There are profit opportunities for companies in this market, including developing/future areas such as robotics. (more…)

ATA 2017 dispatch: Devices and doom

click to enlargeBruce Judson, our guest ATA 2017/Telehealth 2.0 reporter, is a bestselling author of books on business and technology issues in the evolving digital era. This is the third and final article this week he’s written from the ATA floor. Mr. Judson writes frequently for The Huffington Post. More on about him may be found in our review of his critique of the RAND telehealth study [25 Mar].

This Editor agrees with his POV that drowning doctors in more and more data, whether previously accessible or not, isn’t a way forward to a successful business model. The current data is overwhelming–and not interoperable with EHRs. More and more data, looking for a home….

Orlando, April 26. Yesterday, I set aside several hours to walk by the booths of the 200+ exhibitors at the ATA show. As I slowly walked the Exhibit Hall, I was struck by the large number of in-home telehealth patient monitoring devices. (Names are omitted to protect the innocent.)

Colleagues had similar reactions. When I asked about exhibitors, the most common response was “I had no idea there were so many new telehealth monitoring devices that are FDA approved or in the process of obtaining approval.”

As I wandered from booth to booth, I was also struck by the failure of so many, if not most, monitoring device manufacturers to focus on the practical uses of their truly revolutionary technologies. At each monitoring device booth, I asked the same question, “How will the data be used?”  All too often, the answer was, “We provide daily patient data for physicians that have never been accessible before, and doctors receive daily graphs.”

My follow-up questions were always, “You believe busy doctors will look at data on their large patient population each day? Why don’t you provide alerts?” Again, there was a frequent answer, which was some variation of “Yes, now doctors can see daily events which will lead to extraordinary improvements in health outcomes, and we don’t want to create alert fatigue” (false positives that suggest a problem where one does not exist).

In my view, monitoring devices without suites of robust predictive analytics will fail. Doctors are already too busy, and anything that adds to their workload is immediately suspect. Moreover, we still live in a fee for service world, and now we are talking about new, uncompensated work.

As Jonathan Linkous said to me on the first day of the ATA show, “the technology is a tool to provide the service,” not the service itself. Patient monitoring device firms must realize they are offering a service. To succeed, their services must provide actionable analysis, not more and more data. If alerts are ready for prime time, then doctors will value the devices: They can rely on the associated algorithms to indicate when an intervention (also to be compensated) is needed.

Moreover, I strongly suspect doctors would prefer a few false alerts, with algorithms biased toward safety and results that can be quickly checked via the underlying data, as compared to wading through charts looking for anomalies.

A fundamental question for anyone is “what business are you really in?” To succeed, many of the ATA exhibitors need to reorient themselves from the business of providing great technology to the business of providing great service enabled by technology.

Mr. Judson’s first article, a discussion with ATA’s Jonathan Linkous on business models for telehealth is here. The second article on Mercy Health’s catalyzing telehealth innovation at the hospital level is here.

ATA2017 dispatch: Catalyzing telehealth innovation in hospitals

Bruce Judson, our guest ATA 2017/Telehealth 2.0 reporter, is a bestselling author of books on business and technology issues in the evolving digital era. This is the second article this week from the ATA floor. Mr. Judson writes frequently for The Huffington Post. More on about him may be found in our review of his critique of the RAND telehealth study [25 Mar]. His discussion with ATA’s Jonathan Linkous on business models for telehealth is here.

Orlando, April 25. At the ATA show, I stopped at Mercy’s booth, and spoke with Keela Davis, who is Mercy’s Executive Director, Innovation and Product Development. In the booth, was a large, inspirational display of Mercy Virtual’s high-tech, widely-reported $54 millionhospital without beds.” The facility is the nerve center for Mercy Virtual’s telemedicine programs, which include TeleICU (remote monitoring of ICUs by Mercy specialists) as well as multiple other remote services for patients in hospitals and at home.

A great deal has been written about Mercy’s groundbreaking service and large investment in this facility. I asked Davis what led to the decision to build “the hospital without beds.” She said that first, a lot of experience in telehealth proceeded the investment decision. Undoubtedly this experience was required to simply decide what should be built in a facility designed for the technology that exists today and that will undoubtedly accommodate new technologies as they arise. Second, she also said, that it reflected “a visionary” decision on the part of Mercy’s leadership to make this commitment. Now, in her words, the facility has become “a symbol of our work.”

As a student of innovation, our discussion was notable on several fronts:

First, Davis noted that now that the facility exists it serves as a catalyst for innovation. Mercy is actively considering, as might be expected, a range of new telehealth services. While Davis was quick to point out that the facility was not the only source of telehealth innovation at Mercy, she did indicate it’s the hub for innovative ideas and discussions. Organizations build on their experience, their successes, and the demonstrated commitment of management to move forward with good ideas. Mercy’s facility now provides the tangible place that facilitates ongoing growth. In short, after conquering the first level of innovation, Mercy is poised to march forward with new, groundbreaking services.

Mercy’s facility is also a warning to organizations that see the telehealth future, but hesitate to act. As Mercy gains experience, it will have a team that understands the many, complex aspects of assessing and bringing new services to market. Plus, many of the underlying capital and investment requirements associated with creating these services have already happened. In short, it will soon be difficult for other healthcare entities eyeing services in the same arenas to match Mercy’s innovation machine.

ATA 2017 dispatch: The future is about business models and the consumer

Bruce Judson, our guest ATA 2017/Telehealth 2.0 reporter, is a bestselling author of books on business and technology issues in the evolving digital era. This is the first of several articles this week. Mr. Judson writes frequently for The Huffington Post. More on about him may be found in our review of his critique of the RAND telehealth study [25 Mar].

Orlando, April 24. Yesterday, the annual convention of the American Telemedicine Association (ATA) moved into full swing. At noon, Jonathan Linkous, ATA’s CEO, took a few minutes to talk with me. During our wide-ranging discussion, three notable themes emerged:

First and perhaps most important, Mr. Linkous believes that the future development of telehealth now stands with establishing viable business models. In his view, the speed of growth of the industry now depends on how the many participants in the healthcare system develop business models that lead to appropriate investments. He noted that this contrasts with the general focus on the evolving technology. Of course, the technology will continue to evolve and major advancements will occur for the foreseeable future. But, Mr. Linkous strongly believes that “the technology is here today.” In short, it’s now about how the technology is used and deployed. New advances will be incorporated into services and infrastructure as they occur. But, the past, telehealth is now moving into mainstream investment discussions. In his view, the leaders of every health organization are now assessing the role telehealth will play in the services they offer, and the investments they need to make now.  Now, it’s about making it work. We are no longer waiting for the technology to be viable.

Second, Mr. Linkous commented on the hype surrounding the industry. He was frank in recognizing that, as with all exciting, transformative industries, the hype cycle is in full swing. One telling comment: “Unlike the past, the industry now has real revenues,” with rapidly growing businesses. In short, we may not be past the hype, but the industry is quickly moving to fulfill realistic expectations.

Finally, Mr. Linkous concluded that the future growth of the telehealth industry would largely depend on the consumer. He cited a variety of factors: the growth of value-based care, the emerging influence of millennials who are comfortable with technology, and the overall consumerization of medicine.

Many industry participants have described themselves to me as B2B businesses. Undoubtedly, they are. It’s hard to refute Linkous’s conclusion: Ultimately, the growth of the industry, like the evolution of healthcare itself, will depend on consumer choices.

Upcoming MedStartr healthcare events in NYC; #RISE2017 videos online

click to enlargeMedStartr is sponsoring two upcoming evening events which will be of interest to our New York metro Readers. Next week’s roundtable includes participants from the Melbourne (Australia) Health Accelerator/Startup61.

The first is next week, Wednesday 22 March, starting at 6pm. The Hospitals 2.0: Hospital Innovation Program Roundtable is a discussion on how hospitals are leading innovation programs of their own and to review their progress. This will feature leaders from Mount Sinai, Northwell Health, NY-Presbyterian, Christopher Kommatas of Melbourne Health Accelerator/Startup61, and others. Location: CityMD, 1345 Avenue of the Americas (6th Avenue to the rest of us), between 54th-55th Streets, 8th Floor, NYC. Event link on Meetup here.

On Wednesday 5 April, also at CityMD and at 6pm will be Doctors 2.0: ¡Viva La Evolución! Three doctors–Jay Parkinson (Hello Health, Sherpaa), Rich Park (CityMD), and Greg Downing (HHS)–will discuss rewriting the story of care delivery and what is coming next in the evolution of care. Event link on Meetup here.

Tickets are $25 for either three-hour event. Advance reservations are required due to building security. Ticketing is being done through the Meetup Group Health 2.0 NYC at the links above. If you are not a member, please email MedStartr directly at members@Medstartr.com.

Videos are now online for 1 March’s Rise of the Healthy Machines (#RISE2017). These include keynotes, panels, and the six pitches for the Challenge.

TTA is a MedStartr and Health 2.0 NYC supporter/media sponsor; Editor Donna is a host for this event and a MedStartr Mentor. Also check the MedStartr page to find and fund some of the most interesting startup ideas in healthcare.

#HIMSS17 roundup: machine learning, Proteus, Soon-Shiong/NantWorks’ cancer vax, Uniphy Health, more

HIMSS17 is over for another year, but there is plenty of related reading left for anyone who is not still recovering from sensory overload. There wasn’t big news made, other than Speaker John Boehner trying to have it both ways about what the House needs to do about replacing the failing ACA a/k/a Obamacare. Here’s our serving:

  • If you are interested in the diffusion of workflow technologies into healthcare, including machine learning and AI, there’s a long-form three-part series in Healthcare IT News that this Editor noted has suddenly become a little difficult to find–but we did. The articles also helpfully list vendors that list certain areas of expertise in their exhibitor keywords.
  • Mobihealthnews produced a two-page wrap up that links to various MHN articles where applicable. Of interest:
    • a wound measurement app that Intermountain Healthcare developed with Johns Hopkins spinoff Tissue Analytics
    • Children’s Health of Dallas Texas is using the Proteus Health ingestible med sensor with a group of teenaged organ post-transplant patients to improve med compliance
    • the Medisafe med management app has a new feature that alerts users to drug, food and alcohol interactions with their regimen, which is to this writer’s knowledge the first-ever med app to do this
    • Info security spending is rising, according to the Thales Data Threat Report. This year, 81 percent of U.S. healthcare organizations and 76 percent of global healthcare organizations will increase information security spending.
  • Healthcare and sports mogul Patrick Soon-Shiong presented on NantHealth‘s progress on a cancer vaccine that became a significant part of the former VP Joe Biden’s initiative, Cancer Breakthroughs 2020. Dr Soon-Shiong stated that the FDA has given approval to advance the vaccine into later clinical trials, and also unveiled Nant AI, an augmented intelligence platform to high-speed process genome activity of cancer tumors and the Nant Cloud, a cloud server which can generate bioinformatic data at 26 seconds per patient. This is in addition to the NantHealth GPS Cancer diagnostic tool used to isolate new mutations in a given tumor. HealthcareITNews MedCityNews takes a dimmer view, noting two recent cancer vaccine failures. Dimmer still is Stat’s takedown of Dr Soon-Shiong, which reportedly was the talk of HIMSS.
  • Leading up to HIMSS, Newark’s own Uniphy Health announced UH4, the latest generation of its enterprise-wide communications and clinical collaboration platform for hospitals and clinics to facilitate the ‘real-time health system’. Release

Not enough? DestinationHIMSS, produced by Healthcare IT News/HIMSS Media, has its usual potpourri of official reporting here.

HIMSS17 dispatches: Mayo maps neonate telemedicine, Amwell-Samsung, Samsung-T-Mobile

Mayo maps out an enterprise telehealth (telemedicine) support structure. Here’s how the Mayo Clinic deployed neonatology remote telemedicine to their sites in Minnesota, Arizona, and Florida. There’s plenty of flow charts and summary points in this presentation deck around team building, staffing consistently and reporting that improves processes. Hat tip to our HIMSS correspondent on the scene, Bill Oravecz of Stone Health Innovations. Update: If you are using Chrome, you may have difficulty downloading session handouts from the HIMSS17 website Schedule pages. Try another browser. If you are interested, you may be able to obtain through contacting the two session presenters, Susan Kapraun and Jenna A. Beck, MHA, directly.

American Well and Samsung are partnering on integrating care delivery. Their joint release is low on details, but towards the end there’s an indication that American Well, its partners, and other providers and payers will be able to offer their services to Samsung customers. Other reports (Healthcare Dive) indicate the partnership is destined to enhance Amwell’s Exchange platform between payers and providers. Partners listed are Cleveland Clinic, New York-Presbyterian Medical Center and Anthem (undoubtedly resting after sparring with Cigna). Also Healthcare IT News.

Separately, Samsung also announced a partnership with T-Mobile for developing IoT in the senior care space. This would pair Samsung’s ARTIK Cloud with T-Mobile’s cellular network for Breezie, a social engagement for seniors interface built on a Samsung tablet which has apps and connects to various peripherals for post-acute care and daily living. It sounds interesting, but once again the release hampers the reporter by being as clear as mud in what it’s all about. See if you can decipher this: ARTIK Cloud permits “Amazon Alexa, Samsung SmartThings, iHealth Feel Wireless Blood Pressure Monitor and the Pulse Oximeter – to intelligently communicate with each other.” “Each Breezie interface has more than 40 preconfigured accessibility settings and sensor driven analytics to adjust for different levels of digital literacy, as well as physical and cognitive ability.” The Breezie website is far more revealing. Healthcare Dive also takes a whack at it towards the end of the above article.

HIMSS17 dispatch: developing a telehealth IT team in health system and multi-site networks

Reader Bill Oravecz of Stone Health Innovations is attending HIMSS17 in Orlando, and was kind enough to forward a ‘hot off the presses’ link to this presentation deck given by Jay Weems of Avera eCARE (downloadable as PDF). The subject is ‘Telehealth Workforce Offers Unique Competencies & Opportunities’ and covers how telehealth/telemedicine IT is developed in a health system, mentoring rural originating sites in building proficiencies, and Avera’s experience in supporting a 13-state, multi-system, multi-specialty network. This is more about telemedicine (virtual consults) but offers lessons in developing both in a B2B model.

Update If you are using Chrome, you may have difficulty downloading session handouts from the HIMSS17 website Schedule pages. Try another browser.

Weekend viewing: NYeC Digital Health Conference presentations

Now that the bustle of the holidays is over and the frigid days of winter are here, this weekend grab your cup of hot cocoa, an afghan rug or snuggie, and click through a one-page compendium of the NYeC Digital Health Conference in NYC last December. The page links to presentation slides and video; most have both. (Unfortunately, not all presentations nor the lunch breakouts are included.)

This Editor highly recommends the following:

  • The Tuesday keynote on ‘The Digital Doctor’ by Dr Robert Wachter, who is influencing the NHS. (Yes, EHRs and e-prescribing have turned physicians into data entry clerks.)
  • ‘Turning Impossible on Its Head’ on disrupting healthcare with technology: Robert Putrino of Burke Rehabilitation Center on a miracle of 3D printing
  • DSRIP 2017 and readmissions may not sound very interesting, but the presentations by Veyo‘s Josh Komenda on how transportation assistance can also aid compliance, and the discussion on the missing link of population health may be social determinants of health care, are.
  • Wednesday’s ‘Universal Patient Identity’ presentation by Tom Foley of Lenovo Health; a must-see by anyone interested in preventing identity fraud and theft at the provider level
  • “The Patient Room of the Future’ by Joan Saba, partner of NBBJ Architects. Responding to this Editor’s question via Twitter on how design can prevent nosocomial (healthcare-acquired) infections, I was directed to an excellent Becker’s Hospital Review article written by two of their firm’s leaders.
  • The very last presentation, ‘Resuscitating the Child’, was one of the finest and may also break your heart. Peter Antevy, MD, medical director of two EMS in Palm Beach County, Florida, presented the human cost of both EMTs/paramedics in rescue and the frustration of not having the proper tools to calibrate medication and procedures quickly on a patient who cannot be administered full doses, all in emergency situations. His company, Pediatric Emergency Standards, is developing software that can do so quickly and on-scene. Dr Antevy’s passion for his work and for applying technology to this situation is abundantly present.

NYeC Digital Health Conference final presentations pageTTA was a conference/media partner of the 2016 NYeC DHC, and thanks Jesse Giuliani and Andie Egbert for their invitation and coordination assistance.

CES 2017

The Consumer Electronics Show is half a century old this year and it click to enlargeis promising to be the biggest show yet. Here are some items that may be of interest to TTA readers.

The conference programme includes a Digital Health Summit and a Wearable Tech Summit (the organisers obviously haven’t been reading the TTA view on wearables so recently produced by Editor Donna). In the Digital Health Summit the top topics are going to be advances in genomics and precision medicine (not sure why this is digital health), Digital medicine and current trends such as “tele-everything”, wearables, aging, digital therapies (what’s that?) and VR. The wearable Summit top topics are the science of wearables, hottest wearable tech thus far and interactive jewelry.

There is a new “Sleep Tech Marketplace” presented by the National Sleep Foundation (no, really, I am not making this up) with 10 companies exhibiting everything from sleep tracking devices (Beddit), a system to mask noise during sleep (Cambridge Sound Systems), ultra thin earphones to wear in bed (Dubs Labs), a water mattress-topper to keep you cool while you sleep, an app to record your dream talking and snoring (Snail App) and a stress reducer.

If you are not attending between tomorrow and the 8th, then you could do worse than follow it on the official CES website or on engadget

Connecting with Connected Health (PCHA Connected Health Conference)

click to enlargeGuest contributor JC Muyl attended the PCHA Connected Health Conference last week and contributed his thoughts on the event.

Last week I drove down from NYC to spend an afternoon at the Connected Health Conference (#CHC16) at the Gaylord Convention Center outside DC. The majority of my time was spent in the exhibit hall meeting digital health vendors.

I walked away fascinated by just how eclectic the digital health industry is. By approaching it from so many different angles, we’re bound to find some solutions that will stick. I thought I’d spread my optimism by sharing a sample of what I saw for those who couldn’t make it. Here’s my take on my day:

  • The most represented category was patient engagement solutions, probably as a function of the conference itself. Also, when you think about it, a proliferation of proactive patient engagement solutions makes sense in the context of value-based payments. What I like about patient engagement is that it has applications across multiple segments (payers, providers, employers, etc.) which means a bigger market. I met with the folks at Fitango Health (customizable care plans & member engagement), CareWire (member engagement via text), PokitDok (a development platform for care management / patient engagement), Utila (a text-based behavior health engagement solution) and Dacadoo (a cool health score app for patients based on proprietary algorithms).
  • Dacadoo was the play that felt most natively consumer-centric, especially because the user is able to track their health score in the app. The other solutions were for providers looking to manage and interact with patient populations. I like the notion of designing these products from the standpoint of how consumers want to navigate their healthcare experience.
  • In telehealth, I visited SwyMed, a ruggedized telehealth kit for emergency workers (makes a lot of sense), and VGo (see left above), a friendly-looking telehealth assistant that combined a Segway with a camera and a screen. They demoed how they could remotely drive it to the patient for a telehealth consult. I really think this product has legs…well wheels, actually! Seriously, it made me wonder how soon until we use drones to deliver meds & pick up samples?
  • I was surprised by the number of international companies: Medelinked from the UK, EarlySense from Israel, Voluntis from France, Dacadoo from Switzerland, most with a local presence here in the US. These foreign companies are usually pretty big in their home country, with a (clinically) proven product, yet are approaching the US market with the agility but also possibly the financial needs of a startup. I bet they would make good prospects for investors.

(more…)

WLSA merger with PCHAlliance: the digital health conference scene contracts a bit more

Over the weekend, the Personal Connected Health Alliance (PCHAlliance) and the Wireless-Life Sciences Alliance (WLSA) announced that the San Diego-based WLSA would be combining its operations with the PCHAlliance. This follows on the earlier announcement [TTA 21 Oct] that the Boston-based and Partners HealthCare- owned Connected Health Symposium would be folding its operation into the PCHAlliance. Both Robert B. McCray, co-founder and CEO of WLSA, and Dr Joseph Kvedar of Partners HealthCare are now Senior Advisers to the PCHAlliance, with Mr McCraw heading Thought Leadership and Dr Kvedar now Program Chair of next year’s event.

WLSA has been largely inactive on the conference scene since 2015, when it staged its last Convergence Summit in May and the Wireless Health event in October of that year. The Convergence Summit has been merged into PCHAlliance’s Connected Health Conference kicking off today near Washington, DC. The Wireless Health event will continue through a collaboration with IEEE/EMBS cooperating with the National Institutes of Health (NIH) and the National Science Foundation (NSF).

In their release, PCHAlliance emphasized WLSA’s experience in research within engineering, computer science, biomedical and health disciplines. Patricia (Patty) Mechael, PhD, Executive Vice President, PCHAlliance in the release was quoted that “Their focus on medical and health research communities is a perfect compliment to our commitment to accelerate the adoption of clinical grade technology in consumer-friendly health outcomes- based business models.” Life science companies will be welcomed for membership in the PCHAlliance. PCHAlliance also includes Continua, which for well over a decade has been promoting engineering standards for device interoperability.

As this Editor looked back in October, when most of these organizations and events started about 2007-8, there were few Big Health conferences that took what was then dubbed eHealth and mHealth (later Digital Health) seriously. Now, of course, they do. There are also multiple events, large and small, expensive and popularly priced, every month in many cities–we attended and reported on #MedMo16 which will be branching out to multiple cities in 2017.

In looking back at our articles, the WLSA was engaged with the conference almost from the start, when the mHealth Summitwas one of the first ‘big name/big support’ conferences. Its tack then was governmental policy and what international NGOs were doing as a model for developed nations. It was organized by the Foundation for the National Institutes of Health, the National Institutes of Health and the mHealth Alliance up to 2012, when HIMSS took it over.

Grizzled Pioneers, and even the non-grizzled, can testify to the multiple phases in a decade up and down the Hype Curve: device-driven, mobile-driven, sensor-driven, telehealth, wearables, Big Data, population health, patient engagement, analytics, data integration, outcomes-based and a few others. This move confirms that many factors are blending: academic, engineering, software, biotech, genomics, social, behavioral, governmental–and that technology is not standalone or sitting in isolation, but is integrating and manifesting itself in all sorts of interesting places both behind the consumer scene and in policy, and to consumers on mobiles and in the home (IoT, which hasn’t resolved its multiple and obvious security problems).

Also Neil Versel in MedCityNewsTTA is a media partner of the PCHA CHC for the 8th year, starting in 2009 when it was the brand new mHealth Summit. Conference tweets on #connect2health.

Patients as People: creating clinically relevant social insights (part II)

Guest Editor Sarianne Gruber (@subtleimpact) continues her interview of Mandi Bishop, founder and Chief Evangelist of Aloha Health. Ms Bishop’s goal with Aloha Health is to put the ‘patient as person’ into the present healthcare model. Ms Gruber interviewed Ms Bishop at #MedMo16 where Aloha Health won the People’s Choice award in the Equity Crowd Challenge. The first half of the interview was previously published in Part I.

How does Social Determinants Of Healthcare (SDOH) data relate to me as a patient?

Bishop: SDOH attributes are available both the individual patient level and a “high propensity that this is you” level via micro-segmentation. Optimally, there will be personalization of information where personalization is possible and micro-segmentation profiles for when it is not.  Also, we are not trying to give the doctor more data since we think that is a big part of the problem.  “What about your lifestyle” matters which respect to you as a patient, and we at Aloha Health convert that data into insights.  When the doctor pulls up an encounter, based on our models, the EHR is populated with the insights that are available about you and your conditions.

As a workflow example, I pull up your encounter.  Aloha then pings the Aloha insights section and gets all this information about you. This is the use case we are going after:  a diabetic patient and this is the demographic information we are going after about that person.  Pertinent and clinically relevant information would be pulled up about you and on your profile.  We are only showing things that matter.  The fact that you are a 40-year woman is information the doctor already knows.  But the fact that you are a single mother, who just got divorced 3 weeks ago, is caring for an elderly parent, and has all of these other “things”, all of these “things” would influence your ability to have an insulin pump.

What makes SDOH data a must have for patient engagement and patient-centered care? (more…)

#MedMo16: finalists, winners, and what they tell us about the state of health tech

click to enlargeHaving attended two conferences in the past two weeks, and squinting to read the tea leaves in the cup, there are some trends that this Editor is picking up. They are quite different from what has been seen over the past year or two. They’ll be expanded on in articles to follow. From the top:

  • Successful companies fit into a bigger picture. Startups into early-stage companies, which were the focus at #MedMo16, are now playing the niches like genetics, patient-focused discovery, condition management and cost-effective specialized clinical innovations.
  • Anything that simplifies a process and saves money is attractive. Complex ‘big data’, analytics and ‘population health/integration’ solutions aren’t in the lead anymore because there are a lot of them and they all look alike.
  • Nothing is revolutionary. The idea that an app, device or software will ‘revolutionize healthcare as we know it’ is now recognized as absurd. (The cocktail/drinks party is ovah!) Cases must be proved first, usually on your self-funded or FFF (families, friends and fools) dime, if you want to partner with the Big Dogs.
  • Value-based care, this year’s darling, is already being seen as a vague ‘catch-all’ in a way that Triple Aim and ‘outcomes/evidence-based care’ were eventually found to be. As a meme, it’s turning out to have the life of a fruit fly.
  • It has to be easy to access, preferably on something the average patient or clinician already has or can acquire easily, like a laptop, tablet or smartphone. The idea of having to place a special purpose-built device in, let’s say, a home, is looking more and more ‘analogue’ indeed, a trend we are seeing in the traditional hub-based telehealth market and even slowly in telecare and traditional PERS.
  • Funding models are changing, with more bootstrapping, self-funding, expand you go and less emphasis on big investment and selling out fast. As funders on a NYeC DHC panel pointed out last Wednesday, don’t raise more – or less – than you need.

At #MedMo16, Crowd Challenge participants were judged by a combination of the interested MedStartr/Health 2.0 NYC community through the MedStartr funding platform, and then by a panel of judges who have leading clinical, technological, patient advocate and funding experience. In short, a group that has seen a lot over the past decade plus, has been up and down the Hype Cycle, and is down to Brass Tacks.

The innovations that bubbled up through the finalists (more…)

#MedMo16 video highlights on YouTube (Day 1)

Courtesy of the MedStartr crowd-based healthcare investment fund and HealthTechTalkLive is the first day video of #MedMo16 from City Winery in NYC. It’s a tick over 7 hours of six Momentum talks, two final exams for Mega Challenge competitors in population health and devices/wearables plus three panels. Your Editor is running the presentations so you know the dastardly doer of any ‘goofs’ you see! Day One is on YouTube here. The finalist list in the Mega Challenge presentations differs from the program here–start times are in parentheses:

  • Pop Health, Payers and Pharmatech: Mymee, AudibleRx, EllieGrid, Agewell Biometrics US, Aloha Health (1:03:00)
  • Devices and Wearable Health Tech: GlucoSight, Rx Bandz, HeartIn, tonguenacity, Ceeable (4:56:00)

Day 2 will be posted tomorrow.

Digital Epidemiology: on-demand public health

Guest Editor Sarianne Gruber (@subtleimpact) reviews the meta-trend of digital epidemiology, which gathers ‘digital exhaust’ information through social networks, chat rooms and other online media, analyzes it at the population level and tracks localized outbreaks of diseases like the Zika virus and flu. It even has inspired new models of vaccine delivery and patient transportation such as Uber Health and Circulation.

The Internet has a rather detailed picture of the health of the population, coming from digital sources through all of our connected devices, including smartphones. This is digital epidemiology: the idea that the health of a population can be assessed through digital traces, in real time. Digital Epidemiology: Tracking Diseases in the Mobile Age. M. Salathé, J. Brownstein et al.

As a Harvard Medical School Professor and the Boston Children’s Hospital Chief Innovation Officer, the plights of patients and the hurdles in care are Dr. John Brownstein’s starting points for questions and discovery. When the Community Transportation Association study reported “an estimated 3.6 million patients the United States miss at least one appointment due to lack of access to transportation”, Brownstein was determined to make this challenge his own. This fall, he launched the first customizable patient-centric digital transportation system – Circulation – a new vision for non-emergency medical transportation. As a Klick Health Muse attendee and having had the privilege to speak with John Brownstein, Ph.D., co-founder of Circulation, I would like to share what I learned about his journey as an epidemiologist, public health educator, and innovator.

Social Media’s Big Data: Preventing Epidemics and Tracking Drug Safety
Digital epidemiologists think in terms of “digital phenotype” to understanding the health of individuals. Uncovering critical information about what is happening at the population level is collectively called “digital exhaust”. These digital traces that are left behind, help track local outbreaks around the world. “In fact, you don’t need surveys, just mine what people are saying online. We combine social media to get real insights as to what is happening on the ground: facts and sentiment. The ability to understand risk and population health is fantastic with these emerging technologies,” opened Dr. John Brownstein at the 2016 New York City KlickMuse event.

Social media mixed with disparate sources of health data was how Brownstein began solving public health risks. (more…)