Innovation Roundup
A newsletter about innovation, technology, health economics, regulation and empathy in medicine (7/25/23)
Hello,
Welcome to the latest edition of our newsletter. Here's what we have in store for you this week:
Remote Cardiovascular Hypertension Program Enhanced Blood Pressure Control During the COVID‐19 Pandemic. This study highlights the potential of remote healthcare programs to adapt and deliver effective care even during times of disruption.
Large language models encode clinical knowledge. Med-PaLM, an AI system, has surpassed passing scores on USMLE-style questions and provided answers aligned with medical consensus
CardinalKit: open-source standards-based, interoperable mobile development platform to help translate the promise of digital health. CardinalKit is an open-source project that aims to address these challenges by providing a mobile template application and web dashboard for developing digital health applications
2023 digital health funding. The first half of 2023 saw a decrease in digital health funding compared to previous quarters, indicating a potential shift in investment trends
Designing a Value-Based Formulary for a Commercial Health Plan. This study explores the potential of a Value-Based Formulary (VBF) to reduce patient and health plan spending by aligning drug prices with plan prices and incentivizing the use of high-value drugs
Decentralized Clinical Trials for Drugs, Biological Products, and Devices. This document provides recommendations for implementing decentralized clinical trials (DCTs) for drugs, biological products, and devices.
Science Roundup
A team of pharmacists, nurse practitioners, physicians, and non-licensed navigators used an evidence‐based clinical algorithm to optimize hypertensive treatment. Among enrolled patients with sustained hypertension, 51.1% reached BP goals. Within this group, rates of achieving goal BP improved to 94.6% during the pandemic from 75.8% pre-pandemic (P<0.0001). They showed that a remote clinical management program can be successfully adapted and deliver significant improvements in BP control and increased home BP monitoring despite a nationally observed disruption of traditional hypertension care.
Large language models encode clinical knowledge
How much do cutting-edge AI systems really know about medicine and health? Medical question-answering is one way to find out. Med-PaLM is the first AI system to exceed passing score on USMLE-style questions, & answered consumers’ questions with qualities approaching real physicians - e.g. clinicians rated 92.6% of Med-PaLM answers "aligned w/medical consensus", vs. clinician-generated answers at 92.9%. More from this link
The collection, transmission, and storage of sensitive health data using mobile devices presents unique challenges that serve as significant barriers to entry for care providers and researchers alike. Compliance with standards like HIPAA and GDPR requires unique skills and practices. These requirements make off-the-shelf technologies insufficient for use in the digital health space. The CardinalKit platform is an open-source project addressing these challenges by focusing on reducing these barriers and accelerating the innovation, adoption, and use of digital health technologies. CardinalKit provides a mobile template application and web dashboard to enable an interoperable foundation for developing digital health applications.
Industry Roundup
H1 2023 digital health funding: A Brave New (lower funding) World
In the first six months of 2023, U.S. digital health startups raised $6.1B across 244 deals, with an average deal size of $24.8M. Compared to Q1 2023 ($3.5B over 131 deals), Q2 registered only $2.5B in funding across 113 deals—joining Q3 and Q4 2022 as recent sub-$3B quarters. Should H2 2023 funding continue at the rate of H1, we’re on track for the lowest funding year since 2019.
Healthcare Economics and Policy Roundup
The value of each drug is assessed by aligning drug prices with plan prices to derive plan-specific incremental cost per quality-adjusted life-year gained estimates. The study uses microeconomics concepts of own price elasticity to model changes in annual medication utilization. The study concludes that designing a VBF for antidiabetic medications in a US employer–based health plan has the potential to reduce patient and health plan spending.
As the healthcare systems are moving toward value-based care, the VBF design may be a useful framework for both commercial and public payers that are interested in innovative cost-sharing mechanisms that will incentivize the use of high-value drugs and dis-incentivize the use of low-value drugs. The concept of a Value-Based Formulary (VBF), as described in the paper, is primarily applied to medications. However, the underlying principles of a VBF, which involve aligning the cost of a product with its value or effectiveness, could theoretically be applied to medical devices as well. In the context of medical devices, a VBF would involve assessing the cost-effectiveness of different devices, considering factors such as the device's impact on patient outcomes, its cost relative to other devices or treatments, and the needs of the patient population. This could help guide decisions about which devices to cover under a health plan and how much patients should pay out-of-pocket for different devices.
Regulatory Roundup
Decentralized Clinical Trials for Drugs, Biological Products, and Devices
The document provides recommendations for sponsors, investigators, and other stakeholders regarding the implementation of decentralized clinical trials (DCTs) for drugs, biological products, and devices. It defines DCTs and discusses their potential benefits, such as expanding access to more diverse patient populations and improving trial efficiencies. I am going to refer to this next time we design one of our DCTs.
Miscellaneous Roundup
Internet Search Tips by Gwern
Everyone can learn from this. It starts with simple advice, such as on how to master Boolean operators and search hotkeys, and then goes through increasingly advanced strategies for finding research papers, books, theses and other references online.
Art of the week
Moses Strikes Water from the Stone
Jacob Jordaens1618/1620
Staatliche Kunsthalle Karlsruhe (State Art Gallery Karlsruhe)
Artist I am listening to
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Talk soon,
Hamid