Gaming the System

This post was originally published by  The Health Care Blog  on February 11. 

As physicians ready themselves for the future of medicine under onerous MACRA regulations, it seems appropriate to glance into the future and visualize the medical utopia anticipated by so many.  Value-based care, determined by statistical analysis, is going to replace fee for service.

Six months ago, I received my first set of statistics from a state Medicaid plan and was told my ER utilization numbers were on the higher end compared to most practices in the region.  This was perplexing as my patients tend to avoid ER visits at all costs and can be found milling about in my parking lot at 7am on Mondays with their sick children waiting for my office to open.

I requested more detailed reports on ER utilization and was given a 20 page list with codes that needed to be hand matched to patient names.  Being a committed and diligent physician, I spent a random Saturday evening matching up 420 names to individual 15-digit codes after putting my children to bed.  Of my top 20 utilizers, only 8 were actually patients.  The remaining 12 had been “on my panel list” during the reporting period but had never set foot in my office.  Of the top 100 utilizers, only 42 were patients.  In the interest of accuracy, I requested they re-run the numbers using my patients only.  Mr. IT informed me the inaccurate panel would make no difference.  He might have failed statistics in college but who is keeping track. (more…)

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Super Bowl 2017

Founder and CEO SageMy™Life.

Founder and CEO SageMy™Life.

Regardless of whether your team won, you’ve no doubt been delighted, entertained and inspired by the commercials that aired last night. There are too many I liked to pick a favorite, but in the spirit of this blogspace, I yield my time and give my vote to Audi.

It’s a beautiful statement, to which I’ll add this. May he never have to explain to her:

  • Why she must pay more for access to health care than the men around her;
  • Why she – and not her male relatives or work colleagues – will need to leave the workforce to be an unpaid family caregiver, suffering a loss of income and retirement benefits; and
  • Why she may suffer unnecessarily because a women’s health didn’t get the attention it deserved.

Perhaps there are things you’d add to this list.

WATCH:


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Hostels for Hope: Easing the Burden for Women with Cancer

This article was originally published on www.impatientoptimists.org on February 2, 2017.

Sarah* is a 46-year-old mother of five and a cervical cancer survivor living in Tanzania. Survival wasn’t easy. She had to travel over 300 miles from her village to one of only two treatment facilities in the entire country; once she got there, she had no place to stay. Like Sarah, many of the over 10,000 Tanzanian women diagnosed with cervical or breast cancer each year face two major challenges – how to pay for transportation to the capital, Dar es Salaam, and where to stay for the duration of their treatment. For some women, the challenge is too great and they have no choice but to stay home and die. Others, like Sarah, make the difficult trip to the hospital, and struggle to survive through the treatment. Many sleep on the hospital grounds, or on the street, while being treated.

We at Pink Ribbon Red Ribbon believe that no woman should die of cervical or breast cancer, no matter where she lives. So we decided it was time for the women of Tanzania to have “homes away from home” near the country’s only two cancer treatment centers that could save their lives. We partnered with the American Cancer Society the Bush Institute HKS, Inc ., Southern Methodist University , and T-MARC Tanzania to sponsor the Hostels for Hope competition.

downloadWe challenged professional and student architects around the world to use fresh thinking, sustainable materials, and resourceful ingenuity to design safe, comfortable lodgings for women undergoing cancer treatments. And they responded! We received nearly 100 designs, and an esteemed jury chose six winners who will be announced on World Cancer Day , February 4, in Tanzania. The top two designs will be adapted according to the needs of the hospitals, and our hope is that they will be built in the coming year. (more…)

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Top 5 Misconceptions and Questions about Public Health Tech

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. (more…)

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17 Disruptive Women to Watch in 2017

DW Women to Watch 2017 - banner

Today, we are proud to launch our 17 Disruptive Women to Watch in 2017.  As is our custom and commitment to our thesis—Disruptive Women seeks to highlight women from a broad cross-section of disciplines, all of whom profoundly impact health and health care. This year we are doing something different. Given the enormity of the issues we are facing globally, when it comes to Alzheimer’s Disease and related dementias, we are focusing this year’s class of extraordinary women on those who are committed to ridding the world of this scourge. Lest you think this affects only the elderly (whatever that means), have a look at the sobering numbers and impact: start with our Brain Health series.

All of our 17 Disruptive Women to Watch in 2017 personify DW’s mission “to serve as a platform for provocative ideas, thoughts, and solutions in the health sphere.”

Disruptive Women in Health Care would like to take a moment to also salute our 16 Disruptive Women to Watch in 2016 and 15 Disruptive Women to Watch in 2015. (more…)

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Driving Progress in 2017

This article was originally published on January 26, 2017 in www.wewontwaitcampaign.org.

WWW-campaign

In the United States, a change of administration always brings uncertainty. With new leaders entering Congress and the White House, we at WA2 know we can turn that uncertainty into opportunity. Opportunity because we know finding a cure for Alzheimer’s and alleviating its burden on families can bring us together. WA2 is committed to continuing to lead a campaign to promote women’s brain health and fight against Alzheimer’s. 2017 is a critical year in our battle to stop Alzheimer’s in its tracks by 2020.

We are confident in the progress we will make because we know that our passionate partners and advocates can change individual lives and communities, intensify medical and private-sector responses, and shape the national policy landscape. Alzheimer’s is one of the few issues that cuts across party lines, affecting women and caregivers of all ages, races, creeds, and political beliefs. This widespread impact creates a shared basis for sustained action by women leaders across America, from caregivers and community advocates to legislators and executive leaders. This is the central strength of our movement.

To guide WA2 and our supporters, we would like to highlight the pillars of a concerted, nationwide effort to combat Alzheimer’s in the year ahead. This is an overall summary – we will explore each of these in greater depth throughout the year. If we dedicate ourselves to achieving these goals, and encourage others to join us, then 2017 will be a time of advocacy, awareness, and progress towards our goal of ending Alzheimer’s by 2020. (more…)

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There Will Never Be a New World Order Until Women Are a Part of It

This article was was originally posted on January 22, 2017, in Venture Valkyrie.

“There will never be a new world order until women are a part of it.”

Alice Paul

It has been, not just for me but for many, national women’s month. Maybe it’s not officially proclaimed as such, but it has just worked out that way.

It started for me the second week of January at the JP Morgan Healthcare Conference. What has been notable about this conference in past years is the absence of women. I even wrote about this in 2011 in a post called, “Alas, No Line for the Ladies Room,” in which I lamented the stunning absence of my sisters at what is arguably the most important healthcare business conference in the world. I recall noting that, back in 2011, attending JP Morganpalooza was like speed-dating but without the women in the equation, making it considerably less fun.

Suboptimal speed dating

There was a notorious event, hosted by LifeSci Advisors, at 2016’s JP Morgan conference which seems to have had the unintended consequence of waking the sleeping giantess. The firm hired a bunch of female models to entertain mostly male guests and blocked many women from attending. They were pilloried for it (I wrote about it HERE) and then massively apologized by pledging to get enlightened. Um, yeah.

But this year is apparently the year when the tide started to turn. I recall noting a sense of optimism last year, but this year, as I write this the day after the Women’s March that followed the 2016 election, I am hoping we are officially on an unstoppable pink train. Yes, it’s disturbing (to say the least) that the electorate has chosen people and policies that are decidedly anti-female. But this time, it provoked a disturbance in The Force that has roared back 2.5 million strong and growing. Can it be a coincidence that the biggest box office hits so in recent weeks are a) Rogue One, where a badass young woman leads the effort that results in the overthrow of the evil empire?  and b) Hidden Figures, a movie which honors the work of three young black female scientists, programmers and engineers at NASA without whom the space program may not have succeeded as it did.

As I watched the Women’s March from the sidewalk and from the TV screen yesterday, I couldn’t help but think that this women thing is for real and finally so. Even at JP Morgan, the tide seems to have turned. While in past years there was an event or two targeted to the dribble of women who attended the conference, this year there were at least 8 events that I personally heard of that were women-only and overflowing. Silicon Valley Bank, Deloitte, Canaan Partners, Wilson Sonsini, Women Business Leaders, Springboard, Square One Bank, GE Ventures and many others led events that were exclusively or primarily aimed at giving women a chance to celebrate their successes and network with each other. This is a massive upgrade over prior years and speaks to the number of women who showed up to do serious business at the conference this year. It was hard to miss the trend when in many other years it was hard to miss the oversight. A great thing. (more…)

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Navigating Uncertainty: Disruptive Women Style

A Disruptive Women Luncheon

Women spend much of their time learning to work around, work through and work directly on difficult challenges, be they work related, political (large and small p), accessing capital, work/life balance (whatever that means). The one constant we know is uncertainty. 2017 is unfolding to be a year of enormous uncertainty in every dimension of the word. Who better to share tips on navigating through waves of uncertainty than women who know how to throw on a life preserver (and matching shoes) and get stuff done. Join our global panel of experts for a spirited conversation. Lunch included.

February 21, 2017 — 12:30PM EST – 02:30PM EST

Orange County Convention Center - Room 414C

REGISTER NOW  Please register for the HIMSS Conference first then select Disruptive Women Luncheon from the Education tab as an optional event.  

Speaker(s):

Nicole Gardner

Halle Tecco

Ceci Connolly

Sarah Kerruish

Peggy Williams

Robin Strongin

Navigating Uncertainty







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Digital Health, Destiny and Doritos

This post was originally published on January 8, 2017 on Venture Valkyrie.

It’s the first of the new year and of course that can mean only one thing:  the avalanche of stories about how much was or wasn’t invested in digital health and whether the current environment favors/disfavors growth in this sector and all that jazz.

It used to be, once upon a time, that the advent of the new year meant all things biotech as JP Morgan’s Healthcare Conference rolled into town, but no longer.  The “digital health” concept and all it sweeps in with it has become as popular as the biotech talk just like Kanye/Kim have swept JZ/Beyonce to the back of the ballroom.

Given this phenomenon, I have been asked multiple times in the last few weeks to give my predictions about digital health in 2017 and to weigh in on what will be hot, what should be hot and what we can expect, particularly in light of, you know, the change.

So I figured I’d collect my thoughts here and also the responses I have given to various inquiries on the digital health discourse.  This way, when I am working the crowd at JP Morgan this week I can just say “have you read my blog?” instead of “well, you know, it’s all about VR and blockchain now” (hat tip to Matthew Holt).  My thoughts in somewhat random order:

With the burgeoning convergence of all things digital with all things healthcare, the noise level at JPM, the Consumer Electronics Show (where I was last weekend) and a plethora of other geek-friendly events has reached record highs.  It’s tough to find the shiny needles in the repetitive haystack sometimes.  So I have to say I am most on the lookout for real success stories, and particularly those that demonstrate how the confluence of IT and pharma or IT and medtech have meaningfully improved clinical outcome and reduced cost while doing so.  I’d also like to hear some evidence of how all of this big data/AI/machine learning work is resulting in actual activity to change physician and consumer behavior, particularly around improved diagnoses and avoidance of medical errors.  So far most of the talk has been about technology and too little of the talk is about results.  I hereby declare that the digital health theme for 2017 should be: you show me the evidence it works, I’ll show you the money! (more…)

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Congratulations to our November 2017 Disruptive Women in Health Care Man of the Month: Peter L. Levin

Hear Peter Levin’s most recent TEDxWilmington Talk. You are in for a treat.


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Walking in a Venture Fundingland

The post was originally published on December 18, 2016.

Weird Al Visits Visits Music Choice's "You & A"For those of you who have followed me for a while, you know I like to do a holiday song parody at the end of each year.  I love both comedy and music, and if I didn’t have a singlng voice that could raise the dead I could have been the next Weird Al Yankovic.  Lord knows I have the hair for it.

So here it is, my last post for the annus horribilis that was 2016: a new entrepreneurial anthem to ring in the New Year (or at least the JP Morgan conference): Thriving Here in Venture Fundingland.

whoville-singingYou know that part in the How the Grinch Stole Christmas where the Grinch and Max and the Whoville Whos are holding hands around the giant tree singing in unison (Fahoo Fores Dahoo Dores….)? Just picture the startup teams you know hand in hand, encircling their obligatory ping pong table and singing my song with their venture investors. Yeah, yeah, I know.  No one wants to hold hands with venture capitalists; but that’s what the Whos once said about the Grinch, so one can dream.

Happy Holidays to all my friends and followers!

Thriving Here in Venture Fundingland

(sung to the tune of Walking in a Winter Wonderland)

NASDAQ bell rings
Are you listening?
Sand Hill Road
Term sheet glistening
A beautiful sight
We're debt-free tonight
Closing here in venture fundingland

Gone away, is the bridge round
Series A, is now inbound
The syndicate‘s strong
Let’s hope they sing our song
Launching here in venture fundingland
In the valley we can build a startup
And write software til we’re all face down
We’ll say yes we’re harried
But it’s OK man,
‘Cuz if we don’t succeed
Next round is down

Later on
We'll conspire
As we dream of values higher
To face unafraid
The Board that we've made
Growth hacking here in venture fundingland
Build the team
No vacation
Chase the dream
Innovation!
With ROI in sight
VCs use pre-emptive rights
Traction here in venture fundingland
Cash burn, we’re optimizing
To avoid a big downsizing
Bring investors along
Pivot when we’re wrong
Scaling here in venture fundingland
In the valley we can build a Newco
And pretend we know what’s in the cloud
Wear black turtlenecks and work in stealth mode
And exit long before markets melt down
When it pays
Ain't it thrilling
By skin of teeth, make a killing
We'll frolic and play, drive our Teslas away
Surviving here in venture fundingland
Thriving here in venture fundingland


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December 2016 Disruptive Women in Health Care Man of the Month – Connor Landgraf

CONNOR-LANDGRAF-DW-BANNER

Universities everywhere would do well to utilize Disruptive Women’s December Man of the Month Connor Landgraf in marketing campaigns, making the point that a single moment in a classroom can change the world.  Landgraf, at age 26, is the co-founder and CEO of Eko Devices, a start-up he created with two fellow graduates of the University of California, Berkeley.  Eko’s first product, the Eko Core, was named by TIME Magazine as one of 2015’s top inventions and he and his colleagues were selected by Forbes for its “30 Under 30” list of the brightest young stars in 15 different fields of endeavor.

For Landgraf, then a biomedical engineering major at Berkeley, this success began in a senior design class featuring guest speakers sharing perspectives on medical technology.  A discussion about the limited utility of the stethoscope and the difficulty of using heart sounds to detect cardiac abnormalities inspired Landgraf to bring 21st century digital capabilities to a health care tool that has remained largely unchanged since the early 1800s. (more…)

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Mental Health: Forward Thinking – The Implementation Plan

Overview

A major transformation programme for mental health is underway, an unprecedented and decisive step towards closing the treatment gap for mental health. The roadmap for change ‘Implementing the Five Year Forward View’ sets out how services will help reach a million more people a year by 2020/21. So how do we make the plans a reality?

“Implementing this plan will benefit people of all ages… As such, our aim to improve mental health and wellbeing cannot solely be achieved by the NHS, but must be delivered in partnership with other local organisations including local government, housing, education, employment and the voluntary sector.” Claire Murdoch, National Mental Health Director, NHS England; Foreword to ‘Implementing the Five Year Forward View (July 2016)

Published in the summer 2016 the document outlines how and when independent recommendations to improve care and services will be implemented on the ground. The report includes new funding, rising to £1bn a year, and details how workforce requirements will be delivered in priority areas, how access to services can be improved and data and payment levers will support transparency. The plan commits to improving access to high-quality care, delivering more integrated services and earlier interventions in a short timescale. National action, across a range of services, is required to put the plans into practice and ensure a long neglected part of the care system is overhauled, expanded and improved upon.

The fourth annual Mental Health conference will support NHS staff, organisations and other parts of the system in delivering the changes required to improve mental health care for all. The agenda will examine how to practically implement key recommendations and priorities, detail real life examples of new models of care and provide insightful progress on the local and national service improvements that are driving better outcomes.

View the event programme for the day.

Sponsorship opportunities.

Benefits of Attending.

Phone Telephone: (0161) 376 9007      email Email: tickets@openforumevents.co.uk      Book now


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Mobile Mirror, Mobile Mirror on the Brain: Mind, Maps, and Memory

Connected-Health-Conference-Banner

Room: Potomac 1-3
Tuesday, December 13, 2016
12:00 PM – 2:00 PM


Description

** This event requires a separate registration and add-on fee. It is NOT included with General Conference Passes.But, if you use our special code: DISRUPT16, you can attend at no charge.

REGISTER HERE

A Disruptive Women in Health Care Roundtable: Tackling Brain Health

Women. We bring home the bacon and freeze our eggs. We learn from an early age how to multi-task (in heels while walking backwards—you have to be of a certain age to get that one).  We take care of things, and people. That’s what we do.  But what happens to us, to our brains, as we are busy taking care of everyone and everything?  Women are twice as likely to suffer from Alzheimer’s as men, making up two thirds of the 5.4 million people in the United States slowly dying with the disease; and women are two thirds of the caregivers. Once women reach 65, they have twice the likelihood of developing Alzheimer’s than breast cancer. The burden multiplies when you consider caregivers. They frequently put their careers on hold and drain their own savings to provide care. One in five switches to part-time work, sacrificing hundreds of thousands of dollars in lost wages and benefits. Brain disease goes far beyond Alzheimer’s of course.  There are so many women who are on the bleeding edge of this work—in the labs and in the think tanks, in the trenches and in our homes. Come meet the brains behind numerous innovative advances in the study of brain health.  Learn about provocative new technologies and bold solutions as our panelists unabashedly share how they are tackling the hard stuff.  They’ve got the chutzpah, the moxie, and the smarts to power through the status quo.  Join us for a memorable conversation.

Moderator

Robin Strongin, Founder of Disruptive Women in Health Care, will moderate this roundtable.

Panelists

Corinna E. Lathan, Ph.D., Board Chair and Chief Executive Officer, Anthrotronix

Meryl Comer, President and CEO, Geoffrey Beene Foundation Alzheimer’s Initiative,

Glenna Crooks, Ph.D., Founder, SageLife, LLC

 


Sponsored by:

Verizon

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The Sandwich and Boomer Generation’s Dilemma

Are you like us, part of the sandwich generation? We all likely know and help an aging family member, friend, or neighbor who has health issues, few community supports, and lives alone or with someone else who needs support. We also have our own concerns about one day facing the same challenges, or not being able to choose where we live. But we also aspire to have a quality of life that is not solely defined by our health status.

The Boomer generation is unprecedented in size, living well and longer into older years, but when frailty occurs and supports are needed, many older adults find that there are few informal and formal caregiver supports available, and that those that do exist are financially out of reach. Compounding the problem, oftentimes one’s living circumstances may lead to significant social isolation that can negatively impact health and well being. Regardless of how many times we hear about the costs and quality of life issues staring our older adults in the face, little seems to change in terms of policies, programs, and personal planning. But denial and inaction are no longer viable in the face of the unprecedented aging population and the strong preference older adults have to age in place.

There may be a silver lining for the silver tsunami. Nascent but positive trends are emerging in the form of innovative policies and programs that integrate health and community-based services with the goal of helping people stay healthier as they age and manage difficulties better when they do emerge. Complementing these are a variety of grass roots, community-based initiatives — cohousing, villages and livable communities – that are creating infrastructure and support for aging in place. These promising policies and programs could be the start of a bridge between health-related community-based services and the grass-roots initiatives. Sustained funding to support these promising approaches, however, remains a challenge. (more…)

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