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Digital health at the Mid-America Healthcare Venture Forum

In case you haven’t seen the official announcements or caught my tweets, later this month I will be moderating a panel at the Mid-America Healthcare Venture Forum, an event being put on by MedCity News, April 22-23 at the J.W. Marriott hotel in Chicago.

The panel is called “Opportunities (and Challenges) in Digital Health. Per the official description: “Digital health — and its business models — are coming of age. Promising young companies are integrating into healthcare and, in some cases, beginning to find exit partners. But that’s also meant new scrutiny from everyone from investors to the FDA. Learn about the challenges, opportunities and promising new markets in digital health.”

Panelists include: Amy Len, director of Chicago-based accelerator Healthbox; Julie Kling, director of mobile health at Verizon Wireless; and Jack Young, who heads the Qualcomm Life Fund for Qualcomm Ventures. I’ll just be there to keep order, and, of course, to cast my usual, skeptical eye on the field and continue to wonder why investors are throwing so much money at me-too fitness trackers and countless direct-to-consumer products that don’t stand a chance in an industry where nearly everything is paid for by third parties. Or at least that’s my thought at the moment, until we have our conference call next week. :)

The session is scheduled for Wednesday, April 23, at 8:55 a.m. CDT. The hotel is located at 151 W. Adams St. in the heart of the Financial District. Years ago, I worked about two blocks west of there, so I know it’s about 40-45 minutes away from me by public transit, and I’m not a morning person. This could get  interesting. (If any MedCity people are reading this, I’m kidding. I’ll be there on time. Hopefully.)

Our session follows a keynote from James Rogers, chairman of Mayo Clinic Ventures. After the panel is a break, then breakout sessions featuring presentations to investors from startups in digital health, medical devices and pharma/biotech. I hope I don’t prematurely burst anyone’s bubble with too much of a reality check. But, in honor of this week being the 25th anniversary of the release of the great Gen X satire, “Heathers,” I offer this quote from the movie: “Heather told me she teaches people ‘real life.’ She said, real life sucks losers dry.”

Wait, was that too cynical?Let me just say that the panel just got another thing to talk about today, as the FDA, FCC and ONC just released their proposed health IT regulatory strategy, as called for by the Food and Drug Administration Safety and Innovation Act (FDASIA). To nobody’s surprise, they recommend a “risk-based framework” to regulation of health IT and digital health. Now to figure out if there are any details people should be concerned about…

In the meantime, you can register for the conference here.

April 3, 2014 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Keep wasting your money, Silicon Valley venture capitalists

Silicon Valley is at it again.

Last week, digital health accelerator Rock Health unveiled its new offices, and from the news coverage, it seems as if it’s creating an image as much as incubating startup companies.

According to Xconomy, “a big crowd of investors, executives, and other life science industry insiders took time away from JP Morgan to attend the grand opening of Rock Health’s stylish new headquarters in the Mission Bay neighborhood of San Francisco.” And stylish it is.

“Rock Health’s kitchen and community gathering space includes a Cirque-du-Soleil-style swing,” Xconomy reported. Because, you know, incubating companies that will fix a broken $2.8 trillion industry with their “solutions” requires a little avant-garde spectacle à la Québécoise — or perhaps Las Vegas. Having been at the Digital Health Summit at International CES in Sin City myself a week earlier, I was happy to see more focus on substance than style in the meeting room, if not in the exhibit hall.

© Bruce Damonte/Studios Architecture

I bet that swing cost a lot of money. So did the design, since Xconomy saw fit to identify the architecture firm. (For that matter, so did I, but only to give proper credit for the photo.) In an industry where a third or more of spending is wasteful — completely irrelevant to care and probably preventable — according to a 2012 report in Health Affairs, are such frills really necessary? I’m certainly not blaming Rock Health here. It’s the investors who are throwing away their money.

In opening the center, Rock Health reportedly dubbed Mission Bay the ‘United States’ New Digital Health Hub.’” That’s a bold statement. There certainly is a lot of potential there, but, as the person who identified San Diego as “a leader in mobile healthcare” back in January 2010, I still see more substance and tangible results in Southern California than in Northern California. For that matter, the Boston area could make a strong case, as could New York City. Smaller but healthy communities have popped up in places like Madison, Wis. That’s fine, competition is good.

However, I’ve seen more failures in Silicon Valley than anywhere else. But does that stop Silicon Valley’s No. 1 media cheerleader, TechCrunch, from declaring, “VC’s Investing To Heal U.S. Healthcare”? No, it does not.

No flame-out has been as spectacular as that overhyped vaporware known as Google Health. Google is back at it again with its VC arm, but this time the Internet giant seems to have a direction and a clue. Maybe.

As TechCrunch reported, “Google Ventures is addressing the nation’s healthcare dilemma with investments in companies like the physicians’ office and network One Medical Group, which raised a later stage $30 million last March. At the opposite end of the spectrum in December 2013 Google invested in the $3 million seed financing of Doctor on Demand, which sells a service enabling users to video chat with doctors.”

Google appears to be scrapping the torturous direct-to-consumer route in favor of going where the money actually is, from third-party payers and from providers, newly incented under the Patient Protection and Affordable Care Act and private reform efforts to work more efficiently and better coordinate care.

On the other hand, it’s been less than two weeks since Stephen Colbert made fun of Doctor on Demand. (Health 2.0 boss Matthew Holt commented on that post that it was “Kind of unfair that Doctor on Demand get the publicity when American Well and a [scad] of others have been doing this at scale for years.” He was right, but, hey, Google.)

Google Venture General Partner Dr. Krishna Yeshwant told TechCrunch the real motive behind all the VC money flooding into healthcare. “As an entity it is where we’re spending 17 percent to 18 percent of GDP, so any one segment is tens of billions of dollars,” Yeshwant is quoted as saying. “Increasingly you’re seeing IT investors who have a fine sense of disruptive opportunities enter the market.” In other words, it’s all about the Benjamins.

But do they understand that healthcare doesn’t work like any other industry? I’m not so sure. And I haven’t even addressed the bigger questions of privacy, data stewardship, interoperability and workflow.

As you prepare your hate mail for me, check out this site, “What the F*** Is My Wearable Strategy?” (NSFW). Refresh the page for more hilarity, but be forewarned: some of the ideas may hit close to home.

You’re welcome.

January 20, 2014 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Comprehensive coverage of WTN Media’s Digital Health Conference

As you may know from at least one of my earlier posts, I was in Madison, Wis., last month for a great little health IT event called the Digital Health Conference, a production of the Wisconsin Technology Network and the affiliated WTN Media. In fact, WTN Media hired me to cover the conference for them, so I did, pretty comprehensively. In fact, I wrote eight stories over the last couple of weeks, seven of which have been published:

I still have an overview story that should go up this week.

Why do I say it’s a great little conference? The list of speakers was impressive for a meeting of its size, with about 200 attendees for the two-day main conference and 150 for a pre-conference day about startups and entrepreneurship.

Since it is practically in the backyard of Epic Systems, CEO Judy Faulkner is a fixture at this annual event, and this time she also sent the company’s vendor liaison. Informatics and process improvement guru Dr. Barry Chaiken came in from Boston to chair the conference and native Wisconsinite Judy Murphy, now deputy national coordinator for programs and policy at ONC, returned from Washington. Kaiser Permanente was represented, as was Gulfport (Miss.) Memorial Hospital. IBM’s chief medical scientist for care delivery systems, Dr. Marty Kohn, flew in from the West Coast, while Patient Privacy Rights Foundation founder Dr. Deborah Peel, made the trip from another great college town, Austin, Texas. (Too bad Peel and Faulkner weren’t part of the same session to discuss data control. That alone would be worth the price of admission.)

July 2, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

My HIMSS will be all about quality and patient safety

As regular readers might already know, 2012 was a transformative year in my life, and mostly not in a good way. I ended the year on a high note, taking a character-building six-day, 400-mile bike tour through the mountains, desert and coastline of Southern California that brought rain, mud, cold, more climbing than my poor legs could ever hope to endure in the Midwest, some harrowing descents and even a hail storm. But the final leg from Oceanside to San Diego felt triumphant, like I was cruising down the Champs-Élysées during the last stage of the Tour de France, save the stop at the original Rubio’s fish taco stand about five miles from the finish.

But the months before that were difficult. My grandmother passed away at the end of November at the ripe old age of 93, but at least she lived a long, full life and got to see all of her grandchildren grow up. The worst part of 2012 was in April and May, when my father endured needless suffering in a poorly run hospital during his last month of life as he lost his courageous but futile battle with an insidious neurodegenerative disorder called multiple system atrophy, or MSA. (On a personal note, March is MSA Awareness Month, and I am raising funds for the newly renamed Multiple System Atrophy Coalition.)

That ordeal changed my whole perspective, as you may have noticed in my writing since then. No longer do I care about the financial machinations of healthcare such as electronic transactions, revenue-cycle management, the new HIPAA omnibus rule or reasons why healthcare facilities aren’t ready to switch to ICD-10 coding. Nor am I much interested in those who believe it’s more worthwhile to take the Medicare penalties starting in 2015 for not achieving “meaningful use” than to put the time and money into adopting electronic health records. I’m not interested in lists of “best hospitals” or “best doctors” based solely on reputation. I am sick of the excuses for why healthcare can’t fix its broken processes.

And don’t get me started on those opposed to reform because they somehow believe that the U.S. has the “best healthcare in the world.” We don’t. We simply have the most expensive, least efficient healthcare in the world, and it’s really dangerous in many cases.

No, I am dedicated to bringing news about efforts to improve patient safety and reduce medical errors. Yes, we need to bring costs down and increase access to care, too, but we can make a big dent on those fronts by creating incentives to do the right thing instead of doing the easy thing. Accountable care and bundled payments seem like they’re steps in the right direction, though the jury remains out. All the recent questioning about whether meaningful use has had its intended effect and even whether current EHR systems are safe also makes me optimistic that people are starting to care about quality.

Keep that in mind as you pitch me for the upcoming HIMSS conference. Also keep in mind that I have two distinct audiences: CIOs read InformationWeek Healthcare, while a broad mix of innovators, consultants and healthcare and IT professionals keep up with my work at MobiHealthNews. For the latter, I’m interested in mobile tools for doctors and on the consumerization of health IT.

I’m not doing a whole lot of feature writing at the moment, so I’d like to see and hear things I can relate in a 500-word story. Contract wins don’t really interest me since there are far too many of them to report on. Mergers and acquisitions as well as venture investments matter to MobiHealthNews but not so much to InformationWeek. And remember, I see through the hype. I want substance. Policy insights are good. Case studies are better, as long as we’re talking about quality and safety. Think care coordination and health information exchange for example, but not necessarily the technical workings behind the scenes.

And, as always, I tend to find a lot more interesting things happening in the educational sessions than in that zoo known as the exhibit hall. I’m there for the conference, not the “show.”

Many of you already have sent your pitches. I expect to get to them no later than this weekend, and I’ll respond in the order I’ve received them. Thank you kindly for your patience.

February 13, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Podcast: This time, I’m the interviewee

In a rare turn of events, I’m the one being asked the questions on a podcast by Sivad Business Solutions, which hosts regular audio discussions on a variety of business topics. I give kind of a high-level view of health IT and offer my very strong opinions on patient safety and healthcare reform. There’s an interesting discussion about EHRs being designed to maximize reimbursements rather than assure safety.

Interestingly, we recorded this via Skype. I like the audio quality, if not the nasal quality of my own voice, more than usual that day.

Hopefully the embedded audio works. If not, click here.

September 18, 2012 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Join the discussion on substance vs. style in healthcare innovation

I definitely ruffled a few feathers with my commentary last month in MobiHealthNews about the arrogance of Silicon Valley when it comes to healthcare and health IT. More importantly, I seem to have provoked exactly the kind of discussion I had hoped for, most notably in the Wireless Health group on LinkedIn. (It’s an open group, so please join if you haven’t already).

To date, a link to my story has elicited 53 comments. Some of my favorites:

  • “Whatever the opinion on how Neil chose to wrote the piece he does appear to have started a real conversation. And that my friends is one thing that’s been missing for years. If I had to pick one thing to contribute as someone who’s been at it for over a decade it’s to reiterate there has been a lot of wasted investment due to ego and/or naiveté regardless of where the money or developers come from.”
  • “What gets my hackles up is to see good companies, with proven products/services and customers, with reasonably sound management, struggle and beg for serious money financing to break through, and can’t get it. You and I have been up close and personal on that! VCs want to get in, get out with bucks and are driven by their investors. You cannot count on staying power and confidence there, and that’s not their purpose–but the lines between VC and private equity (the traditional next stage) have become a blur. On the other hand, there has been so much money thrown at half-baked technologies, or mismanaged by companies themselves, it gets me ill. It is all just slightly unhinged from reality–and why the heck we’re pursuing this in the first place.”
  • “What’s ‘sexy’ are apps that use the iPhone (or other smart phone). Not sure that any of these apps, by themselves, will create the market “buzz” that get’s investors excited. The next Groupon or Zillow….
    “Washington can write guidelines and set policies, even implement laws, but the problem is fundamental: Physicians need reasons (incentives and proof of efficacy) to recommend and use apps. A big part of this is basic…we need to focus on meeting the needs of the healthcare consumer. “
  • “The issue is not whether Silicon Valley gets it, but whether technology alone will solve the problem. I think we all agree that it won’t, so we need collaboration between technologists and healthcare professionals, and the patient (or consumer if you are younger than me) to solve the problem.
    “Neil’s willingness to demonstrate that the Technology Emperor really isn’t wearing any clothes is critical for us to start having the real discussion of how the three groups collaborate to form a solution
  • “Having followed in the industry and VC community for decades the problem is that not every problem can be solved in isolated for-profit islands and silos.
    “We can’t even do something so trivial as share calendar information as a way to manage medical appointments. This may sound silly but when the idea of keeping a checklist is seen as a big idea with major impact the idea that we can save the world by cashing in on a trend is problematic.”
  • “he evidence suggests that doctors understand healthcare in terms of delivering poor outcomes at a price that’s killing our economy, which is the real determinant of health – every dollar that the healthcare system takes out of someone’s wages or cost structure is a dollar not spent buying decent food or givng someone a job or a raise that can raise their overall well-being.
    “The existing system arguably can’t be fixed – if we knew how to do that, we already would have. (That may risk making as the same kind of fact-free assertion as the one about the centraility of the doctor-patient relationship, but what the hey.) My personal opinion – and it’s only an opinion – is that we’re going to build a new one in its place. What we in Silicon Valley do understand is how to disrupt.
    “My point is that growing a new health system (notice I didn’t say healthcare) rquires partnership between clinicians, patients, families, payers, policy makers – and technologists in Silicon Valley who can enable this new and better system. My dad was trained as a cardiovascular surgeon, who are widely known (again I don’t have data to support this) as having delusions of god-hood). Of course, we in Silicon Valley collectively might have our own delusions of god-hood. That said, to get us as a society somewhere, would suggest you re-examine yours.”
  • “Much of what is labeled “innovation” is simply something that is ‘cool.’ Real innovation is as much about commercialization as it is about the invention. Marketing beats technology. My sense is that VC’s see a lot of cool inventions, but are looking for the discipline it takes to effectively commercialize an idea. This is particularly challenging in healthcare because there are so any stakeholders that influence the consumer/patient’s decisions. And our priorities and behavior change radically as I move from consumer to patient.

I invite you to join in the discussion.

August 11, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Podcast: Dr. David Brailer on his new venture and progress in health IT

SAN FRANCISCO—Dr. David Brailer is a very popular man these days. Having $700 million of Other People’s Money to invest, as his company Health Evolution Partners does, tends to do that. At the Health 2.0 Conference today, it took an hour and 15 minutes for him to fend off the suitors and finally sit down with me for this brief but lively podcast about his new venture and about the current state of health information technology in America. I think it was worth the wait.

(Everyone else is blogging this event live. I can’t keep up, so thought I’d try something different.)

Podcast details: Interview with Dr. David Brailer on Health Evolution Partners and progress in health IT. MP3, mono, 64 kbps, 4.5 MB. Running time 9:53.

0:34 Investment strategy
1:05 Surprise since he started the fund
1:40 About the company
2:25 Why he’s not looking at biotechnology
2:55 Health 2.0
3:35 Investing through venture partners
3:45 Assessment of national health IT adoption
4:35 Health IT hasn’t become politicized
5:05 Tough issues still unsettled
6:13 RHIOs
6:50 Shakeout in health IT (and interruption from siren outside the window)
7:50 Advice to people involved in RHIOs
8:08 Personal health records and consumerism

September 20, 2007 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.