Some thoughts on the takeaways from HLTH

October 31, 2024 | by

HLTH, which was in Las Vegas last week (19-22 Oct), has moved from an ‘also-ran’ to a lead dog in healthcare conferences for the innovation oriented set, along with sister conference ViVE (with CHIME) for digital health in February. They offer an alternative to the broadly tech-focused CES and the HIMSS leviathan, which seems to have lost a bit of its mojo since HIMSS turned the management keys over to Informa. 

Like all industry meetings, there were the usual rash of announcements, panel meeting interpretations, and tea leaves reading by reporters on the scene. Both MedCity News and Healthcare Dive covered HLTH. MedCity News’ Katie Adams had seven hot takes resulting from conversations she had with various leaders from health systems, digital health, and VCs/investors. They were candid and as she put it, ‘refreshingly honest’. Your Editor’s comments follow.

AI could be worsening health disparities. This came from FDA commissioner Robert Califf who believes that health systems are using AI to segregate profitable patients from those who are not. “What we need is for AI to bring up the people who are currently disadvantaged.” Absent any proof at this stage that health systems are actually doing this while they are in at best early stages of attempting to integrate AI into an absurdly complicated network of systems without breaking them, this strikes me as Chicken Little-ism and Finger Wagging. 

Retail companies should stop trying to be something they’re not. A hospital CEO is quoted as stating that retailers are trying to apply their model to the healthcare space because healthcare delivery is wholesale. This deduction has some truth and then veers into the woods. Yes, Walgreens and CVS tried to apply a transactional model to primary care and got into Big Trouble. From the customer (patient) perspective, that person wants to get in, get fixed or examined–and get out with maximum speed and convenience. This didn’t happen. Will Amazon, a far bigger retailer, pull this off with One Medical brick-and-mortars, or run it as a membership ‘division’ linked with Amazon Prime? Their building of relationships with 20+systems like Cleveland Clinic for specialty care referrals (and in return primary care referrals) indicates they have the flexibility that Walgreens and CVS lack.

And since when is healthcare wholesale? It surely isn’t to the end user, the patient. This mindset is puzzling.

Strict abortion laws are likely already resulting in economic consequences. It seems that states with few to no limits on abortion are attracting OB/GYN residents and practices versus states with restrictions. This is a sad commentary on both the state of medical practice and public perception in dealing with human lives. There are alternatives.

Many investors have realized they backed products, not companies. The bloated investments and valuations that we saw in 2021 and 2022 (in actuality, 2020 into early 2022) could not be sustained. Well, yes, and the bubble burst last year. There was more to this. Easy IPOs through SPACs and the Fear of Missing Out (FOMO) led otherwise sensible retailers into buying brick-and-mortar primary care practices as extensions of their stores, investors into another iteration of ‘value-based care’, copycat virtual mental health providers, and digital health businesses that were essentially sinkholes, like Babylon Health. The companies may have had a good product or a nucleus of same. Then investors woke up and started to think about how impossible their exits were.

Healthcare leaders should remember they’re in the customer service industry. Exactly the opposite of the ‘wholesale’ delivery model. Patients are customers–but a special type of customer.

Next year, exit activity will likely still be lifeless in the digital health space. “Private equity firms might start acquiring more healthcare businesses.” Agreed. We’ll be seeing a lot more mergers of convenience to rationalize services and in some cases, survival–below the line of DOJ/FTC scrutiny.

We need to stop treating AI like a buzzword. In this view, it’s a tool that can transform healthcare delivery and make it better for both providers and consumers in speed and efficiency. In this Editor’s view, AI still needs to prove it can do this in a way that it is trustworthy, secure, and easily integrated into present systems.

Healthcare Dive highlighted a report by Silicon Valley Bank (SVB) and a Monday panel discussion on the decline of healthcare sector funding after the highs it reached during the Covid pandemic. It was a ‘sugar high’ that drew in non-healthcare sector “tourist” investors. Even at that time, it was not considered sustainable. Now the funding buzzwords are ‘pruning’ and ‘consolidation’. Investors are also looking for senior leaders with financial acumen and for companies that can create a fast path to profitability. SVB’s Megan Scheffel said that “One opportunity is for private equity firms to buy up multiple companies to create a platform” and create synergies. However, as this Editor has previously noted, this is yet another area where the DOJ and FTC are also scrutinizing. 

Big Tech–Microsoft, Google, Amazon, GE Healthcare and Nvidia–also saw opportunities at HLTH to promote their AI offerings, emphasizing use cases and partnerships with health systems, to solve a range of problems in documentation and scheduling, creating platform solutions customized to a specific health system. The big questions out there are readiness of clinicians to use the tools and how to offer them to systems responsibly. The tech providers do step back from telling health systems what to do. As Google’s Greg Corrado put it in the Healthcare Dive article, “It does need to be pioneered by healthcare systems that are willing and able to do the research on the ground, and not every health system can do that.” Exactly, as well as the implementation research and modifications.

One last thought–it was surprising how little news was generated at HLTH, versus before and after.

Early detection of Parkinson’s via AI (and a surprising medium); Ed Marx on the digital transformation (or not) of health systems and COVID treatment at home

November 20, 2020 | by

Somewhat off our normal beat….but of interest.

Ardigen and The BioCollective are collaborating on early detection research for Parkinson’s Disease, based on a microbiome-based biomarker. Ardigen has developed an Artificial Intelligence (AI) Microbiome Translational Platform. The BioCollective has a bank of metagenomic and patient metadata generated from an unexpected source: Parkinson’s patients’ stool samples. Release

The BioCollective is headed by Martha Carlin, who came from well outside of healthcare and pulled together a research group to address her husband’s diagnosis. A visit to this website is worth an examination on how these samples are collected for microbiome extraction. An interesting twist is the marketing of a probiotic mix developed using their BioFlux metabolic model for ‘gut health’.

Ed Marx, the former CIO of the Cleveland Clinic, has written a new book, ‘Healthcare Digital Transformation: How Consumerism, Technology, and the Pandemic are Accelerating the Future’. It’s billed as a wake-up call for healthcare systems and hospitals under challenge by Big Retail, Big Pharma, and Big Tech. This Editor met Mr. Marx when he premiered his entertaining memoir, ‘Extraordinary Tales from a Rather Ordinary Guy’, a few years ago. On treatment for COVID patients, except for the very sickest, he advocates it being done from home. From the release: “When the pandemic hit, a lot of progressive organizations would send most of their Covid patients home with monitoring equipment hooked up to phones unless they needed a ventilator. It’s a lot cheaper than staying in the hospital.”

Mismanaging a healthcare IT transition: what’s the cost?

June 20, 2017 | by

Many of our Readers may consult HIStalk on occasion, especially the provocative weekly columns by a physician known as Dr. Jayne. She has a great deal to do with HIT for her practice, was a CMIO, and her Monday Curbside Consult is about the high cost of changing EHR platforms in a healthcare organization–an event that’s happening a lot lately (think DoD and VA). It’s the story of her friend who worked in IT for a health system that migrated to a single vendor platform and practice management system. The friend was given the option to remain with the legacy platforms support team for the transition, with the employer promising that those people would move to the new platform team following the migration. Routine, correct?

Not so routine when the cutover completion resulted in two weeks notice for those perhaps two dozen people. It wasn’t about headcount, because the organization posted jobs, but all new hires are required to be certified on the new system which the transition staff were not. And this health system, a non-profit, spent half a billion dollars for an EHR migration.

What’s the cost, in Dr. Jayne’s book?

  • The health system jettisoned a group of its most experienced people, with 15-20 years experience on average, with long-standing customer relationships (customers being doctors, practices, and health facilities). The knowledge base and track record they have in handling ‘Dr. Frazzled’s high maintenance billing team’, now wrestling with a new system, walked out the door.
  • These people, due to age, may never work, or find positions at the same level, ever again–and may very well wind up in the uncompensated healthcare system.
  • The health system may, through getting rid of experienced people, evaded the hard work on its own legacy of people and process. She points out that they “treated this migration simply as a technology swap-out” versus an “opportunity for further standardization and clinical transformation”. New people can freshen an organization, but will they be allowed to, or be fitted into the same stale setup?

Dr. Jayne is optimistic about her friend finding a new position. This Editor will let her write the conclusion which applies beyond HIT in how healthcare is being managed today, from small to giant organizations:

Too often, however, that mission is keeping up with the proverbial Joneses rather than being good stewards. It reminds me of when I was in the hospital this winter, when I didn’t get scheduled medications on time due to a staffing shortage. Is it really cheaper to risk a poor outcome? When did people become less valuable of an asset than mammoth IT systems or another outpatient imaging facility or ambulatory surgery center? And do we really need another glass and marble temple to healing when the actual patient care suffers?

76% of health systems to adopt consumer telemedicine by 2018: Teladoc survey

June 13, 2017 | by

We normally don’t feature corporate or sponsored surveys, but are making an exception here as it demonstrates two trends: that hospital systems can’t fight consumer telehealth** anymore, and that the future mix of usage is starting to change. Teladoc’s/Becker’s Healthcare Hospital & Health Systems 2016 Consumer Telehealth Benchmark Survey projects that by 2018, 76 percent of health systems will adopt consumer telehealth (vs. site-to-site), double from 2016, and that most who have it will be expanding offerings. As a benchmark survey, it tracks services offered or plan to offer, organizational priorities, and goals.

An interesting part is how the mix of services under telehealth is evolving. Presently, the top three among current users are urgent care, primary care, and psychiatry/mental health. For new users, their priorities are ED/urgent care (45 percent), readmission prevention (42 percent), primary care, including internal medicine and pediatrics (42 percent), chronic condition management (41 percent). Nearly one in five (18 percent) plan to include cardiology services.

As implemented by health systems, telehealth has run into problems that were totally predictable and will provoke the ‘Duh?’ response from our Readers. From the report:

  1. They didn’t measure patient or physician satisfaction with their telehealth programs, even though improving patient satisfaction is a leading motivator for offering telehealth services.
  2. Gaining physician buy-in was cited by 78 percent of respondents, and rated as the #1 lesson learned
  3. The second most important? The importance of aligning telehealth initiatives with organizational goals (75 percent). (more…)