An industry analysts pretty jaded view of the state of innovation and meaningful change in healthcare from the JP Morgan Healthcare Conference.

Isansys claims a small deployment down under as the world’s first hospital-wide wireless monitoring install. If you know a better claim to first, please let me know….

The internet of insecure things…..GE has a problem with the security of its patient monitors.

Hips and knees are falling out of favor with participants in Medicare’s bundled payment program. Two reasons are given. First, providers have wrung all the excess cost out of the bundle – primarily by cutting skilled nursing for rehab. Second, the shift to outpatient surgical centers might increase the risk. As noted in the last fortnightly, this saving has been achieved without a drop in quality. Good news is, providers are moving onto more complex bundles. Let’s hope they don’t lose their shirts.

For a well-sourced read on – well, just about everything wrong with US healthcare – thank the American College of Physicians. One of the observations is that an eye-watering 31% of US healthcare spending goes on admin. A number that is so high in my view because of the massive fragmentation of both providers and payers. That complexity just needs so many administrators to coordinate everything – and often still dropping the ball in my personal experience. How can we cut that admin overhead that we all pay…? One way is single payer (aka Medicare For All). Another might be direct primary care with healthcare cost sharing ministries.

More on what the US could learn about universal healthcare from other countries here.

And One Medical, a direct primary care startup, has filed for an IPO. Direct primary care for the price of a latte a week…

And yet more on new primary care models here.

The personal health wearables business has another casualty with UnderArmour dropping out.

Plenty of players (eg. Isansys above), but precious little adoption: VivaLNK elbows its way into the wireless vital sign monitoring market.

As does BioIntelliSense, with FDA clearance for a 30 day patch to monitor vitals in the home. The home use and 30 day life position the BioIntelliSense BioSticker squarely in the “readmission prevention” market, so it should appeal to many hospitals. Not clear to me if the device is semi-reusable, but that would help to keep the unit costs down if that’s true. Most interestingly, the company is pursuing a subscription model, with sensors provided free to providers.

Evidence that Medicare is overpaying docs for post-surgical follow-up that never happens. On the face of it, this could be an argument against bundled payments. But it’s not. Bundled payments pay for outcomes. If a doc decides they can achieve a perfect outcome without burdening the patient with unnecessary follow-up visits, good luck to them. Let them keep the extra, because the total price of that bundle should be cut by a fraction each year to encourage innovation in clinical practice.

McKinsey has a piece on what hospital care will look like in 2030. It’s mostly a rosy picture for patients – mhealth apps that avoid hospital visits altogether, online appointment booking, no waiting rooms (just-in-time visits), walls that change color to reflect or enhance a mood etc. It’s all good – but overlooks the obvious question. Why would our healthcare industry pay for any of that when they don’t get reimbursed for it in turn? And hospital visits aren’t going to dry up anytime soon while the American Hospital Association spends $26m a year on lobbying. Unless we push really hard on the ACO model and make sure value-based care fulfills its promise. Better outcomes at lower cost.

Tangential I know, but US life expectancy actually increased for the first time in four years. But only by a month. Lower death rates from cancer and opioid overdoses are the reason.

Alphabet’s Verily playing catchup with Apple, adds FDA cleared irregular heartbeat capability. Although Verily is more focused on clinical trials than Apple is on the face of it.

Allegheny Health Network reports both good financial and clinical outcomes by adopting a faster test for sepsis that gives results in just 90 minutes. Aiming to better that, researchers in Switzerland are working on a sepsis test that can be completed in 15 minutes.