Real World Evidence (RWE) is becoming more important in US healthcare, but the fragmented system and lack of interoperability makes it hard to collect and analyze. In this podcast, Life Image CTO Janak Joshi discusses the state of the field and how it’s evolving.
(0:12) How would you describe the evolution of medical data?
(2:36) Real world evidence and real world data are becoming more prominent in healthcare –and for good reason. What are some of the challenges in assembling RWD and RWE? How can they be overcome?
(6:36) Is it really true that unstructured notes are becoming quantifiable and useful?
(9:46) There are major efforts by the US government and private sector to improve interoperability and end data blocking. You have groups like CommonWell and Carequality –now working together. What’s the current state of play and how are things changing?
(13:56) You talk about data brokers like Datavant and HealthVerity. How much of their success is because the US system is so broken? Do you see them having the same success elsewhere?
(17:31) Promoters of AI and Machine Learning –including Life Image—tout the opportunity to revolution healthcare with these new techniques. Is it for real or overhyped? And how does interoperability tie in?
(22:20) What are you most excited about over the next few years?
Kidney dialysis is one of the most opaque and problematic sectors of the healthcare economy. It’s controlled by a duopoly that extracts big dollars from private payers while maintaining a symbiotic relationship with the Federal government. Patients aren’t particularly well served and costs are rising.
President Trump’s executive order aims to encourage the use of home dialysis. That’s a good thing, as CareCentrix CEO John Driscoll and I discuss in this edition of #CareTalk Shorts.
She conducted a rigorous study to measure the peak loudness of dryers at two distances from the wall, both with and without hands in the dryer’s air flow. She measured the sounds at different heights, corresponding to the ear canal height of younger and older kids and of adult men and women.
I encourage you to read the article. It is brief and well-written.
When I saw the write-up in the Washington Post, I immediately remembered writing about this very issue back in 2013 (when the author was about 7 and starting to develop an interest in the topic).
I’m not so fond of the Excel Xlerator. Sure it’s powerful, but it’s also incredibly noisy. I have sensitive ears, and I’m not embarrassed to admit that when I’m exposed to a loud sound I cover my ears with my hands. But of course if I’m drying my hands I can’t use them to protect from the noise.The Xlerator is loud enough that I suspect it’s a threat to hearing. At the very least it’s so annoying that I bet some people skip hand washing to avoid using it. My gym has one of these beasts and after being bothered by it for a while I decided to research the noise level.
I didn’t do any original research but I found a paper by Jeffrey Fullerton and a colleague from an acoustical consulting firm and corresponded with Jeff about the subject. He told me that the airstream is a major factor in the noise level and advised me to lower my hands a foot or so below the nozzle , which helps make things quieter. This is the approach I use to this day, with some success –although sometimes the sensor doesn’t see my hands and it does take a bit longer to dry.
The new research by Keegan quantifies the difference made by placing hands in the airflow and also identified the Xlerator as the number one bad boy.
When I read the article I circled back to my original sources. The article I cited is gone (maybe the firm snuffed it when the author moved on) but the Acoustical Society of America still has a summary on its site.
My favorite tidbit is that there is (was?) a noise reduction nozzle for the Xlerator. Presumably the manufacturer understood there was a problem.
Adherence to medication regimens is a huge challenge, with patients failing to get the benefit of their drugs and payers not getting the results they’re paying for. Adherence is also a major opportunity; for example over half of Medicare Star ratings are based on adherence.
In this podcast interview, AdhereHealth CEO Jason Rose offers his perspective:
(0:12) What are the biggest challenges in the pharmacy field? (Here’s the article Jason references in his reply)
(1:52) What does adherence really mean? Is it a big deal?
(6:15) Who has a financial incentive to do something about it?
(8:38) You claim over half of Medicare Star ratings are based on adherence. Is it really true?
(12:18) Is adherence a patient-centric term? It sounds more top down.
(13:58) How do social determinants of health tie in to adherence?
(18:15) What role does AdhereHealth play?
(22:27) Is your Pharmacy at Home program just a mail order pharmacy?
(24:56) Why did your company change its name?
(26:38) Can we expecting sweeping changes in adherence, with the introduction of new tools like AI and wearables?