Healthcare Innovations Roundup
A newsletter about building, evaluating, implementing and adopting innovations in healthcare (3-18-24)
Hi Everybody,
Welcome to the latest issue of our newsletter. Here what we have in store for you this week:
This issue at a glance :
Digital health offers continuous monitoring and insights beyond traditional healthcare, allowing for better patient management.
Ethical considerations and responsible data usage are crucial for AI's success in healthcare- highlights from the RAISE conference
Trends in patient re-enrollment within health insurance plans, impacting value-based care models.
A regulatory reminder for medical device companies navigating Intended Use, Indications for Use, and Instructions for Use.
Article and art recommendations for a dose of inspiration.
We hope you enjoy this week's exploration of innovation in healthcare. Please share this newsletter with anyone interested in the future of medicine!
I had the pleasure of presenting during our monthly webinar series for the Frankel Cardiovascular Center:
Some highlights from the post :
Current management of atrial fibrillation is often inadequate, with patients only seeing doctors after having the condition for a long time.
Digital health can address many aspects of atrial fibrillation that traditional healthcare misses, including social determinants of health, patient perceptions of treatment options, and emotional states.
Wearable data allows for continuous and remote monitoring of patients, providing a more complete picture of their health.
Mobile applications can collect information about heart rhythm and symptoms in patients with atrial fibrillation and provide meaningful insights for clinical management.
Digital biomarkers are digitally measurable human behaviors or physiology that can provide clinical relevance.
The future of digital health for atrial fibrillation includes using clinical-grade smartwatches to monitor patients and inform treatment decisions.
We need to develop end to end digital health clinics that turn insights from these devices into clinical action that improves outcomes and reduces cost
We have some fantastic guests coming up. Our next event is this Wednesday with Ken Nelson from MedTech Advantage Fund discussing investment trends in cardiovascular medicine. Please join us if you can !
Science Roundup
Academic Papers
To do no harm — and the most good — with AI in health care
The RAISE (Responsible AI for Social and Ethical Healthcare) conference was organized to discuss the importance and critical need for AI in healthcare (AIH) and address its current shortcomings.
AIH should primarily benefit patients and address healthcare system issues.
AI should be considered a complementary tool rather than a replacement.
Responsible patient data usage and AIH's potential to improve access to care are crucial.
Financial models for AIH should align with care improvement.
Adopt AI to augment clinical practice.
Establish transparent financial models for AIH.
Guide optimal AI use and ensure it complements healthcare professional expertise.
Assessment of ownership of smart devices and the acceptability of digital health data sharing
Smart devices, such as smartphones and smartwatches, are increasingly popular, and their data can be used to monitor health and track disease. Different demographic factors influence smart device ownership, usage, and willingness to share personal data for research purposes. Women, Hispanics, and Generation Z are more likely to own wearables, while cost is a significant barrier to ownership across all demographics. Most respondents are willing to share some types of data, with varying levels of willingness based on gender, age, education, and employment. Findings can inform the design of digital health studies to ensure inclusivity and equity.
Blogs
What should society do about safe and effective application of AI to healthcare?
For whom does the AI’s medical counsel truly toll? We walk into a doctor’s office with a trust, almost sacred, that the guidance we receive is crafted for our benefit — the patient, not the myriad of other players in the healthcare drama. It’s a trust born from a deeply-rooted social contract on healthcare’s purpose. Yet, when this trust is breached, disillusionment follows. Now, as we stand on the precipice of an era where language models offer health advice, we must ask: Who stands to gain from the advice? Is it the patient, or is it the orchestra of interests behind the AI — the marketers, the designers, the stakeholders whose fingers might so subtly weigh on the scale? The symposium buzzed with talk of aligning AI, but the compass point of its benefit — who does it truly point to? How do we ensure that the needle stays true to the north of patient welfare?
Healthcare Economics and Policy Roundup
Trends in Disenrollment and Reenrollment Within US Commercial Health Insurance Plans, 2006-2018
One significant impediment to widespread value based care (VBC) adoption is the "time horizon problem." This issue arises when there is a misalignment of incentives due to patients frequently changing their healthcare plans, often as a result of competitive nature of insurance market or life events.
The challenge here is twofold. First, there is a need for continuity to fully reap the benefits of VBC initiatives; frequent plan changes interrupt the continuity of care and disrupt the long-term tracking of patient health outcomes. Second, if you are a private insurer, there's an inherent financial disincentive associated with investing in long-term health measures. Given the transient nature of patient enrollment in insurance plans, the initial investing insurer often does not reap the financial rewards of their investment in preventative health measures because by the time those benefits materialize, the patient may have switched to a different insurer.
This study really questions this assumption or at least makes it more nuanced.
The study, which analyzed data from Anthem, one of the largest national insurers in the US, found that approximately 1 in 5 members disenrolled from a commercial plan between 2006 and 2018. However, over 34% of those who disenrolled returned within 5 years.
Reenrollment rates were higher in the group market (4.5% in 2017) than in the individual market (6% in 2017). Reenrollment was also more likely among members who had been with the insurer for a longer period of time.
The findings suggest that the probability of reenrollment should be factored into decisions about insurance benefit design. For example, an insurer may be more likely to cover a preventive service if they believe that a substantial number of members will reenroll and benefit from the service in the future.
Regulatory Roundup
This week, I have been having the same conversation with several entrepreneurs entering healthcare. Just a reminder:
Three terms – Intended Use, Indications for Use, and Instructions for Use – are essential for labeling medical devices seeking market approval.
Intended Use: The general purpose of the device (e.g., "for measuring blood pressure"). These are simple statements (2-3 sentences) that outline the device’s specific use within a particular market.
Indications for Use: Specific conditions the device addresses (e.g., "for diagnosing hypertension") and a description of the target patient population.
Instructions for Use (IFU): A detailed manual ensuring safe and proper use within the scope of which it was designed to diagnose, treat, or prevent.
Understanding these elements early in development allows medical device companies to navigate the regulatory maze and ensure a smooth launch.
Some cool stuff I read and saw …
Bookish Death Cleaning: On What We Keep, and What It Means
My books tell a story about who I am, what I value, what matters to me. But it will only matter to me, and only for so long.
The point was that when I buy books, I’m spending money on the idea of the book, the idea of being the person who reads it.
What do you want to happen to your books? What are they, to you? Are you a keeper or a giver-away, a collector or a borrower? Do they have a future in your family, or with your friends, or on the shelves of the bookstore next door? Does it matter to you? Do you think about it, about what happens to the pieces of a life?
The Bridge at Le Pecq, André Derain (French, b.1880, d.1954)n
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Talk soon,
Hamid