Category: Technology

Amazon: Force the healthcare system to become patient-centric

February 6th, 2018 by

The announcement that Amazon will work with JP Morgan Chase and Berkshire Hathaway to create a new healthcare organization for employees has health plans and providers running scared. Initial press coverage has focused on the impact of this group on the market value of CVS, United Healthcare and the like –but how many people really care about that?

CareCentrix CEO John Driscoll has the right idea when he suggests that Amazon should compel provider organizations to put the patient first –for real, not just rhetorically. His three specific suggestions are good ones: mandate self-service scheduling, introduce  a universal patient portal, and improve the quality of provider reviews. As simple and straightforward as those sound, they would require Amazon and its partners to overcome serious resistance. It will be fascinating to watch what happens.

Assuming Amazon can make those basic but challenging changes come to pass, I have two additional, ambitious suggestions to help patients:

  1. Ensure that patients receive clear, consistent, actionable follow-up information when they leave a doctor’s appointment or are discharged from the hospital.
  2. Use the full set of information available about a patient to anticipate their needs and help them navigate the system.

The first idea is a simple one, which should be happening anyway, and occasionally does. The challenge is to get the provider system to care enough about what happens upon discharge and provide the tools, training, information and support to enable more seamless and empowering transitions. I was shocked at how poor the discharge instructions were after my release from the emergency department a few months ago, after I was struck by a car. I received basically nothing and had to count on family and clients in the medical system to help me. I know I’m not the only one who’s had this experience.

The second idea is broader and vaguer, but starts to draw on the expertise of Amazon’s partners who are in the financial services and insurance industries and have a lot of information about their customers. The consortium could help patients chart their financial path through the healthcare system, helping them identify what insurance to select, how much to save in their HSA and FSA, and where and when to get their care. It could be a virtual concierge for patients, relying big data and machine learning to provide insights and continuous improvement.

If these suggestions were implemented they would have a high impact, even though they would not completely transform the system. It seems like about the right level for this group to shoot for. If they try to be bolder they will likely fail.

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By healthcare business consultant David E. Williams, president of Health Business Group.

Telehealth for chronic conditions: Interview with Synzi CEO Lee Horner

January 18th, 2018 by
Lee Horner, CEO, Synzi

Synzi is a new technology company focused on helping healthcare organizations provide virtual care. The Synzi platform enables on-demand video interactions, including for those with limited knowledge of English and for patients with hearing loss.

I sat down with Synzi CEO Lee Horner at last week’s JP Morgan Healthcare Conference to discuss telehealth and Synzi’s role.

Overview:

  • (0:10) People with multiple chronic conditions are responsible for much of the healthcare spending in this country. What are some of the key challenges they face in maintaining their health?
  • (1:18) What role can telehealth play? How does it work in practice?
  • (2:44) What populations are most suited to telehealth? Which less so?
  • (4:09) What’s the value of telehealth beyond the traditional nurse phone call?
  • (5:55) Who pays the bill? What’s the value proposition?
  • (8:03) Do you offer archiving of the video visits?
  • (8:47) When customers archive do they make the archives available to patients?
  • (9:30) Synzi is a new company but it came out of Stratus, which had language services as well as tele heath. How do those fit together?
  • (11:10) What does the future hold for telehealth for people with chronic conditions?


By healthcare business consultant David E. Williams, president of Health Business Group.

Blockchain for healthcare: Interview with Fluree co-CEO Brian Platz

November 14th, 2017 by
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Brian Platz, co-CEO of Fluree

SilkRoad Technology co-founder Brian Platz has turned his attention to blockchain, with Fluree, a new Public Benefit Corporation that has introduced a scalable blockchain database for decentralized applications. Fluree is not healthcare specific, but there is a lot of potential for blockchain.

In this podcast interview we covered the following:

  • (0:10) What is a scalable blockchain database and why is it important?
  • (1:58) What are some of the most pressing database needs in healthcare? How different are they from the issues faced by other industries?
  • (3:07) What are some of the healthcare use cases for Fluree?
  • (5:15) You mention transparency and consensus as key attributes of block chain. Does that contradict healthcare’s needs for privacy and security?
  • (6:35) Who will leverage the technology in healthcare? Who is likely to be left behind?
  • (7:46) What impact, if any, will healthcare consumers and patients see as a result of Fluree?
  • (8:51) Why is Fluree organized as a Public Benefit Corporation?

By healthcare business consultant David E. Williams, president of Health Business Group.

How formidable would Amazon be in pharmacy?

October 31st, 2017 by
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I’m a big fan and customer of Amazon, having placed thousands of orders since 1998. I understand why retailers (and other businesses) quake in their boots at the thought of Amazon disrupting them. As a healthcare insider, I also understand why healthcare companies are especially nervous. Deep down, we understand that US healthcare is tremendously wasteful and inefficient and that Amazon could make the industry look bad and eat its lunch.

Still, I’m not convinced that Amazon is going to take over the pharmacy business, the latest topic of discussion. The Wall Street Journal (Amazon’s push into pharmacy is full of promise and pitfalls) has a piece and we’re also told that CVS’s play for Aetna is a direct result of the Amazon threat.

My own recent experience with Amazon left a bitter taste in my mouth and provided a glimpse of just how hard pharmacy could be. I don’t usually take painkillers, but the past three weeks have been an exception. Since getting hit by a car while crossing the street, I have been a pretty good customer for OTC pain meds. On a recent Sunday I noticed I was running out of ibuprofen, and rather than asking family members to do one more errand, I used Amazon to place a same-day order.

I pressed the button around 9 am, and was promised that my order would be at my doorstep by 9 pm. By around noon the item was “out for delivery” but it hadn’t arrived by 8:30 pm and I was starting to get a little worried. Nine o’clock came and went, and Amazon switched my status to “delayed.” Finally I had to ask my wife to go out to the pharmacy, which luckily for us is close by and open late. I would have had a difficult night without my refill.

Eventually Amazon canceled the order and said my address was undeliverable –a weird claim for a home that receives Amazon shipments nearly every day.

Most of the skepticism about Amazon’s entry into pharmacy focuses on new complexities like third-party payment, which are admittedly pretty serious. But my own experience shows that Amazon’s current infrastructure isn’t robust enough for the basics, so I definitely won’t be among the first to sign up for AmazonRx.

Of course Amazon isn’t the only one with shipment woes, and this experience was an exception to my usual good ones. Still, it gives me pause.


By healthcare business consultant David E. Williams, president of Health Business Group.

Medial EarlySign: machine learning for population health (podcast)

July 7th, 2017 by

Medial EarlySign analyzes standard EHR data to identify individuals at high risk for disease. The company’s first solution, ColonFlag uses longitudinal blood test data to identify patients who are at high risk for colorectal cancer.

I spoke recently with Medial executive Tomer Amit, who filled me in on the company’s approach and explained why the company has been named a Cool Vendor in AI by Gartner.

  • (0:15) What unmet need are you serving?
  • (1:05) You talk about using data that’s already available. What kind of data?
  • (3:02) When you mention “historical data” are you talking about longitudinal data for an individual patient or aggregated data for a population?
  • (4:18) Why is colorectal cancer an initial focus for the company, with your ColonFlag solution?
  • (5:13) Does ColonFlag replace colonoscopy or encourage someone to get one if they have an indicator that they are at greater risk?
  • (6:38) I see how it could help an individual. Would it actually help at the population level?
  • (7:45) You started in Israel and the EU, which have strong longitudinal medical records. Can the approach be applied in the US where that’s not the case?
  • (10:41) You have run your tests in different places around the world. Does the model differ by population or is there a universal algorithm?
  • (12:10) How do you protect your intellectual property? Once you are out there, are there just rules of thumb people can use instead of working with you?
  • (13:14) What traction have you gained with customers or partners? What industry recognition have you received?
  • (14:45) Are there other domains you are investigating beyond colon cancer? Other data beyond blood tests?
  • (15:58) What’s your 5-10 year vision of what’s possible and what Medial’s role will be?

By healthcare business consultant David E. Williams, president of Health Business Group.