1. What is public health tech anyway?

lab-316553_960_720Public Health Tech, is any tech product or tech-enabled service that prevents the onset of disease or addresses the needs of medically vulnerable populations. This is an emerging niche of Digital Health growing due to the collision of digital health and public health. This collision has been catalyzed by two expanding pressures:

    1. Digital health failures: After a five year boom, 2016 was not a kind year to digital health. According to Rock Health, digital health VC funding made a slight dip to $4.2 billion after a record $4.5 billion in 2015. The overwhelming sense is that the party was over and the industry had entered the “trough of disillusionment.” A few of the factors that brought the over-exuberance down to earth were a renewed focus on evidentiary standards and a  reevaluation of the role of technology. Much of the boom was driven by sentiments that technology was the panacea even those most solutions were built around the fee-for-service model, that validation and claims would inevitably emerge with widescale adoption, and that the adoption of technology would inherently lead to reduced costs. None of these assumption have proven to be true.
    2. Public health spending crunch: Public Health spending had increased significantly from $39 per capita (inflation adjusted) to $275 per capita from 1960 to 2002, but a recent study has found that it has since been declining. Most of the increase in funding (approximately 80-90%) was a result of federal or local government spending. While the ACA in 2010 had originally committed $15 Billion in Public Health funding, it reduced that commitment by $6.25 Billion in 2012 and even further via sequestrations in 2013. Now with the new Trump administration, it is unclear how that funding will change, but if recent efforts to repeal the ACA are any indication, it is unlikely Public Health funding will see any relief in the near future and more likely will continue to experience significant cuts.

2. Public Health. Doesn’t that mean non-profits, government programs and impact investing?

Historically, Public Health has effected change through government agencies and community based organizations. However our healthcare system is changing at a rapid rate that makes it imperative to address needs in a scalable fashion. As fee-for-service begins to transition to value-based care, there will be renewed and growing interest and need on focusing on the biggest drivers of healthcare outcomes.

In 2016, my co-founder Marquesa Finch and I founded P2Health Ventures, the first venture fund investing in Public Health Tech companies. We invest in early-stage startups innovating solutions for population and/or preventative health. We also look for companies who are addressing health inequities, are committed to diversity within their teams and among the populations they serve, and who are implementing evidence-based product development.

As Public Health professionals, we know that access to care is a relatively minor driver. What’s most important is prevention. The United States spends only 3 percent of our health care dollars on preventing diseases (as opposed to treating them), when 75 percent of our health care costs are related to preventable conditions (APHA). This ratio largely holds true whether an individual is healthy or has an illness. Clinical care only drives 20% of our health outcomes. The rest comes from modifiable factors: health behaviors, physical environment and social and economic factors. These have historically been considered to be outside of healthcare from medicine’s perspective but this is the exact purview of Public Health. Adopting a public health lens to Digital Health and innovation opens up opportunities to effect significant and last change on the health of populations.

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Source: http://www.forbes.com/sites/davechase/2016/07/04/health-reform-for-patriots-legislation-bill-kristol-and-robert-reich-can-get-behind/#179e1f17246e

3. But isn’t the ACA going to take that away? How do you make money?

Healthcare is an industry where public policy changes can have a massive impact. There have been numerous thought pieces about what changes are coming but none of us has a crystal ball. While some of the proposed changes to Medicaid could have far-reaching consequences, this shift in coverage could also be an extra push to explore ways Public Health Tech can leverage scarce resources to support the health needs of vulnerable populations. The consensus among experts however, is that value-based care is here to stay. Technology has a major role to play by increasing access to information and services, reducing inefficiency, supporting decision making and early intervention, and reinforcing trust, and strengthening patient-physician relationships. Regardless of what happens with policy, everyone working in healthcare knows that costs have been and will continue to be the top of mind issue. It is a well known issue in health care that 5 percent of the sickest individuals in the population drive about 50% of the costs. The population health approaches utilized by Public Health provide approaches to address the needs of these populations to improve healthcare outcomes and drive down costs.Public health tech offers a roadmap to lower costs and improve outcomes.

One early-stage Public Health Tech startup, Healthify, does just that. Healthify is a SaaS platform that assesses the non-clinical needs of patients that affect health within Medicaid managed care plans. By supporting both caseworkers and patients who are super-utilizers or otherwise at-risk for complications, Healthify reduces costs, boosts quality metrics, and improves case management by improving operational efficiency and steering patients toward support and resources that keep them adherent to their treatment plans.

Besides Medicaid managed care, there is an overabundance of stakeholders and therefore potential customers in healthcare looking for public health tech solutions to meet the need of their super-utilizers and most vulnerable populations: Medicaid ACOs, Accountable Communities of Health and patient centered medical homes just to list a few.

4. But where are the companies?

Public Health Tech  is a small but growing niche. In addition to more mature scale ups such as Omada Health and Clover Health in this space, there are startups popping up all across the country that we are excited to hear about.

  • ConsejoSano is a telemedicine platform delivering a suite of best-in-class health services designed for native Spanish-speakers.
  • Rimidi is a cloud-based enterprise solution for diabetes management for primary care clinics that drives 2-3x improvement in efficiency for managing hard-to-reach, costly populations with diabetes.
  • Qidza is a mobile tool to assess and monitor infant development. With a partnership with First 5, a program that covers 26 states, Qidza is positioned to be the tool of choice for universal screening at both the state and federal level for developmental disabilities.
  • Foodstand helps build good eating habits through community powered challenges to get and stay healthy without calorie counting.
  • bosWell’s platform leverages frontline, community-based organizations (CBOs) to engage vulnerable individuals at the point of care to improve care coordination for Medicaid patients and guide decision-making for their associated health plans to triage the highest risk patients for cost-effective interventions.

5. Wow. This sounds amazing! How can I get involved?

  1. Check out our resource guide to learn more about public health tech.
  2. Apply to be a contributing writer for our Medium publication.
  3. Contact us to be a partner.

post headshotVanessa Mason is co-founder and managing director of P2Health Ventures. Prior, she accelerated digital health innovation for vulnerable populations through her consultancy Riveted Partners and for ZeroDivide’s digital health portfolio. Vanessa fostered talent acquisition and investment through XX in Health, a community of female digital health entrepreneurs and healthcare executives at Rock Health. She also led global health service design initiatives in Mozambique, Argentina and Brazil and supported mobile health product development for clients in west and east Africa. Vanessa earned her BA in psychology from Yale University and her MPH in global health from Columbia University. She serves on the Health IT advisory board for Transdisciplinary Collaborative Center (TCC) for Health Disparities Research at Morehouse School of Medicine. She has been recognized as 40 Under 40 Tech Diversity Silicon Valley and as a TEDMED Research Scholar.

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