Docs fleeing Medicare into direct primary care provides many opportunities for technology to take up the slack and help to grow productivity in healthcare. Better patient access to their records would be one, telehealth and remote monitoring of chronic conditions would be others. For that to happen, the emergency order to reimburse virtual visits the same as to face-to-face – or something like it – would need to be permanent. So interesting insights on the future of value-based care from Dr. Alexander Vaccaro at Rothman Orthopaedics. I’m inclined to agree, if we want the telehealth boom to continue post-pandemic, push population health and then the providers have a bigger reason to drive out cost.
The pandemic isn’t helping either, as primary care docs see their visits dry up. As the article notes, one option is to be swallowed by a larger health system. We are all wise with hindsight. But direct primary care practices – subscription based, rather than fee for service – have a more stable revenue stream. Direct primary care may potentially get a legal boost, with the IRS proposing that direct primary care be treated as a qualifying expense for some type of flexible spending account. In the meantime though, some PCP’s are lobbying congress for direct financial support.
I almost feel like I should put a disclaimer on this one: Israeli missile maker claims AI tech can predict virus patients’ deterioration. Fair enough, but I wonder how many physicians would agree with the quote “In data science, it doesn’t really matter whether its data from a satellite or blood measurements of a patient. You put data in and you get predictions out.”
Evidence – if it were needed – that providing patients with frequent, actionable health data can lead to better outcomes: FreeStyle Libre Glucose Monitor Reduces Hospitalizations in Diabetes. I’ve personally found this device very helpful. Although not diabetic, I have a sweet tooth and my blood glucose tends to run higher than ideal. With continuous glucose monitoring (CGM), I had real-time feedback on how specific foods affected my body. In the US, this device only available on prescription. Elsewhere, it’s over the counter. Not sure why…Wouldn’t it be better to help people avoid becoming diabetic than merely helping them to manage the condition further down the road? But which is more lucrative I wonder…?
Medicare ACO’s appear to be driving productivity growth, with the percentage of non-physician practitioners growing significantly. Which is good to see, the kind of changes that we should see.
Sensors in clothing might be bubbling, with MIT pursuing a research project. Also from MIT, an update on something we’ve seen before, using wireless signals to monitor vital signs. I do have a bit of an issue with the statement “While healthcare facilities obviously employ a number of different measures to monitor resident and patient vital signs over time…” Theoretically true perhaps, but if it were consistently done well in practice, organizations like the Patient Safety Movement wouldn’t exist.
Video games as therapy: Akili Interactive gets FDA clearance to treat ADHD.
Highly valued startup, Proteus Digital Health, files for bankruptcy protection. There seems to be a lot of surprise about this, I’m not sure why. The majority of VC funded companies never make it at the best of times. Plus, digital health has been a bubble for a couple of years now. Ultimately though, however strong the company may be, healthcare is a supremely tough market to find product/market fit. Because “market” is a complex mash of clinician, patient, health system, and payer. If they don’t all align, it’s a problem. Focused on using sensors to track medication adherence, the first product was a smart version of Abilify. Granted, physicians would love to know that their patients suffering from mental illness are taking their meds. But asking those patients to effectively spy on themselves may have been a tough ask. The added challenge in healthcare is to try and find alignment of financial incentives in a crazy broken reimbursement system. Which begs the question, who on the provider side makes money if patients are more compliant with their meds…? There’s no obvious answer to that for me. So that’s always going to be an uphill battle. Because even if physicians love your product, there still needs to be a way for providers to make money from it in the US. And payers willing to support that, which takes time. In other countries, where delivering care cost-effectively matters, the path may be easier.
On the topic of patient compliance, I’m curious how well the Neopenda neoGuard is tolerated by patients. I’ve worn a few hideously uncomfortable prototype medical watches before, but newborns are at least limited in their ability to complain.