Category Archives: Value Based Care

Fortnightly Healthtech Update #8

Potentially very cost effective – using a smart speaker to monitor respiration of sleeping babies. I wonder if this is something that could be adapted for chronically sick Medicare beneficiaries?

Philips joins physIQCurrent Health, and Isansys – among others – in using machine learning for early detection of patient deterioration. And also works with the DoD to detect infection early in active duty personnel.

More AI, improving radiologists ability to spot breast cancer. One of the goals is to reduce the number of biopsies required. Great in theory, probably not in practice. Imagine the scenario: A patient whose cancer goes undetected until late, sues the radiologist. In court,the lawyer asks the radiologist why they didn’t order a biopsy. Answer, “Because the AI told me not to.” Some medical tests get ordered solely to ward off litigation.

And yet more….Medicare thinks AI could cut fraud. I’m convinced it could – but in my experience, it also takes political will, and that’s not always there in abundance….

Concierge medicine taken to the extreme: The $10,000 dollar all-day physical. Which possibly does more harm that good, with the optional full-body CT scan, since the American College of Radiology advises imaging should only be used when there is a clear medical benefit.

A bit late to the party perhaps, but Fitbit is looking to add apps to help users detect afib. Talking of afib, AliveCor goes to the well again for $6m.

There’s a reason for that: Physician-led ACOs performed better than hospital-led ACOs. Hospitals often stand to make more money from readmitting a patient than they stand to lose in readmission penalties. Physicians have no such conflict of interest.

A very niche solution for patient monitoring, targeting airline passengers who are taken ill during flights. Just how niched..? I’m not sure, Google wouldn’t readily give it up.  But I do know this – I’d readily give up the possibility of in-flight vitals monitoring for an extra inch of legroom.

Working as planned then – Medicare reimbursement and incentives starting to see more patients discharged to home care, fewer to skilled nursing.

Brigham and Women’s experimenting with the Fruit Street Health telemedicine platform to try and ward off dementia.

We often hear about the controversially high price of new, innovative meds. But here’s exploitative pricing for something that’s been around for almost 100 years, the price of insulin increases 600% over 17 years.

Remote patient monitoring continues to show success, with St. Luke’s serving 36,000 patients in the first year.

Maybe I missed it before, but Google’s/Alphabet’s Verily is starting to get more active in population health, working with Atrius in California.

Worryingly, I find myself increasingly skeptical about value-based care. Allegedly, a growing percentage of healthcare payments are tied to value-based care. And yet, very few Medicare ACO’s are taking financial risk, they are in upside only models. In other words, if they beat spending targets, they get a bonus. If they overspend, well, we’ll just let it slide…So, we have value-based care, with payments linked to quality targets, but no penalty if you miss the quality targets. So, where’s the value in that..? Maybe Intermountain Healthcare can restore my faith.

And finally, a couple of new biosensors, from Integrated Device Technology (beware press release), and a team at Duke University.