Fortnightly Healthtech Update #33

In Taiwan, iWEECARE claims the world’s smallest continuous temperature monitor, and $2.5m in seed funding. 

Plenty has been written about Medicare’s bundled payment experiments (mostly known as BPCI). Much less has been written about how commercial payers have been working on bundles too. A review shows some success, but also points out some things which may be a challenge for Medicare. Namely, that tight coordination and data integration between providers and payers is one of the keys to success. In contrast to that, I can remember an executive from Remedy Partners on a podcast maybe 5 years ago. (Remedy Partners was A VC-funded startup launched to help providers adapt to bundled payments). Apparently one of the early challenges that Remedy had was that communication and data sharing from providers was bad. Just to be clear, to improve outcomes and lower costs over a bundle, the entity carrying the risk (ie. Remedy Partners) has to manage the bundle from start to finish. So, for a knee replacement, that would be pre-hab, surgery, and then 30, 60, or 90 days post-discharge – including all the rehab. In the case quoted by the Remedy exec, patients were being discharged from hospital before Remedy was even informed that the patient was one that should be managed in a bundle. End result, most of the money had been committed, and most of the outcome determined, before Remedy had a chance to intervene and affect either. Healthcare reform…? I don’t think so.

Apparently some parts of the health insurance industry have decided that the COVID-19 pandemic is over. Or at least, UnitedHealthcare and Anthem are stopping the waiver of patient co-pays for telehealth that was introduced earlier in the year. What happens if the second wave hits..? Or did the first wave never end….

A fortnight ago I touched on the somewhat meagre savings from the Medicare Shared Savings Program (MSSP). That’s not to say there aren’t valuable lessons from the program, because there are. The use of data, clinical transformation, financial incentives, preventative healthcare, and population health are all part of the success. My point is that we’re not taking these lessons and applying them rapidly – and more widely – to more providers and more Medicare beneficiaries. We’re moving at a glacial pace, and each year we pay more for healthcare.

Advocating for underserved populations: Is remote patient monitoring the answer? Well, it is if we’re smart about how we use it. As I’ve suggested before, telehealth and virtual care solutions provide a golden opportunity to lower the overall cost of care. And that has to be part of the solution to bringing better healthcare to underserved populations. After all, the reason they’re underserved is probably because there’s less money to be made.

New to me from Phili, RTM Vital Signs. The company is working on a number of possible solutions, but first up is a miniature implantable continuous blood pressure monitor.

Researchers investigate the use of a PPG sensor in a smartphone to measure blood oxygenation and find that it does really rather well.

Hearing tests by smartphone for underserved communities.

Plenty of gushing articles have been written about the potential for consumer wearables to move into the healthcare space. Less virtual ink devoted to the problem of false positives. So now news that the Apple Watch abnormal pulse feature generates 6 false alarms for every genuine situation it catches. That’s frustrating for overworked doctors staring down burnout. But, healthcare CFO’s must be rubbing their hands, it’s all billable. There’s potential for wearables to play a powerful role in preventive medicine, enabling early intervention, reducing the need for later, more expensive interventions. But only if they’re much more accurate and reliable than this.

I touched on the BodyCompass contactless monitoring approach from MIT in issue #32. Over in Switzerland, Sleepiz just received a CE mark for contactless sleep monitoring using millimeter wave technology

Biobeat releases a clinical study that compares its cuffless blood pressure monitor favorably to traditional solutions.

I’ve also written about Clover Health in the past.The company just announced it’s going public with a $3.7bn valuation. I have a bit of an issue with the CEO’s claim that “this is the ultimate healthcare disruptor”. It’s bread-and-butter is serving Medicare Advantage beneficiaries better, so really more incremental improvement than disruptive. That said, the company sees a future in direct contracting to grow quickly. The investor pitch deck is 111 slides. It makes very generous use of white space, and could’ve been done in a third of that. It’s still worth skimming through.