Fortnightly Healthtech Update #16

Walmart moves into radiology, opening a clinic in Calhoun Georgia with x-ray facilities. Which is a nice lead in to will big retail disrupt healthcare more than big tech?

Profusa’s Lumee tiny oxygen sensor gains a CE mark. Intended for conditions such as peripheral artery disease, the device operates for 28 days, clinical study here.

Apple highlights it’s healthcare presence in its earnings release, claiming 100% of F500 companies in the healthcare sector use Apple. Which sounds impressive, but when you think about it, that’s a small number. You might even be able to count those companies on the fingers of one hand. 

Medicare’s bundled payment isn’t perfect, it rewards doctor’s who take lower risk patients. Really would be nice if it worked the other way around perhaps.

The legal fight over price transparency continues. Meaningful transparent hospital pricing would lead to meaningful competition among hospitals. Competition among hospitals would lead to lower prices. Hence, the AHA is obliged to fight it on behalf of its members. But the American Academy of Family Physicians is not.

On the theme of overpaying, Medicare paid $7.8bn for insulin. If it paid the same prices as another federal government department (the VA) it would only have paid $3.4bn. That is just one of many examples of Medicare overpaying because of a lack of political will.

Verily partners up with Santen for vague eye are projects.

Continuous vital sign monitoring in hospitals is becoming a thing at glacial pace. (See Isansys in the last post). This study compares the performance of devices from EarlySenseSensiumVitalConnect, and Masimo. In summary, all are accurate for heart rate, some better than others for respiratory rate.

The lack of continuous monitoring still hits the broader headlines occasionally. In this case,  Cleveland area hospitals are highlighted for their tardy adoption following the tragic loss of a patient in 2016. 

Also continuous monitoring, continuous monitoring of urine for the early detection of kidney problems from Serenno Medical.

Virta Health – treating diabetes the old school way with diet – has been running a pilot with the VA for a year.

Scientists in Korea have developed a biosensor test for the early detection of Alzheimer’s.

An opinion piece from a Professor at Stanford University School of Medicine, outlining how a simple market segmentation would improve healthcare delivery. In practice, I think market forces are already doing this to some extent. The reasonably wealthy/reasonably healthy are starting to adopt concierge medicine, or direct primary care. But, I can’t figure out how direct primary care is going to work for the chronically ill. The direct primary care model often touts unlimited primary care access as a benefit. But, unlimited access to a primary care doc is just like having unlimited paid time off. It only works if you don’t take the “unlimited” literally. And that won’t apply to many chronically ill people with multiple comorbidities of course. And if that mild criticism wasn’t enough for you, Molly Osberg well and truly shreds direct primary care – the comments are definitely worth a read too.

Oh, and Iora Health, one of the pioneers for direct primary care, just closed $126m in funding.

Apple finds itself squaring up to Epic and assorted hospitals in the fight to allow patients to easily access and share their healthcare data. Epic and friends voice concerns about patient privacy. But, dig deeper. Allowing Apple access to health records is a long-term threat to Epic’s dominant position in the EMR business. And, as noted above (on price transparency), hospitals aren’t keen on competition either. Preventing people from easily moving their data from one provider to another is just one more way to lock in a patient’s revenue stream. Which is really unfortunate. Because, if consumers had better access to quality data, better access to pricing, and could easily move their health records from one provider to another, hospitals that delivered greater value to consumers would ultimately thrive. And those that did not would either raise their game or wither and die. Everybody wins – except sucky hospitals.

Also in the EMR connectivity game, Innovaccer raises $70m to create longitudinal patient records to support the transition to value-based care. I imagine it will find “patient privacy concerns” to be a challenge too. 

Caretaker Medical of finger-cuff blood pressure fame, adds ECG via a partnership with VivaLNK. Ditto VitalConnect, partnering with CorVitals to add arrhythmia detection.

Researchers in New South Wales come up with a superior algorithm for early detection of sepsis.

Machine learning is steadily making inroads into the diagnostic space. PhysIQ adds a patent to estimate cardiopulmonary function from wearables.

Challenging assumptions or a little Christmas humor…Parachute use to prevent death and major trauma when jumping from aircraft: randomized controlled trial.