In this 38th edition of Things & Thinks, I have curated three interesting studies in the research brief and several digital health news updates. The monthly sections follow with a Longread, Tweet and Chart of the Month, with the newly introduced Mental Model of the Month. Happy to hear your thoughts and feedback…
Mobile Health Apps and Data Privacy
I have written previously about data privacy and continue to be interested in this area. A recent report by the U.K.-based Organisation for the Review of Care and Health Apps (ORCHA) had several interesting findings-
The report analyzed 25 popular tracking apps built by 24 different developers. It found that 84% of them shared data outside of the developer’s system with a third party and that only one app stored data solely on the device.
- Of the apps that shared information, the reasons mentioned by developers included marketing purposes (68%), while 64% cited legal obligations (64%), sharing data for research (40%), to improve their services (40%).
- Of the 21 apps that shared data with third parties, 9 bundled consent into terms and conditions, while another 11 put some user control within the app and some in the terms in conditions.
- Only one app listed user consent for sharing their data within the app itself.
Primary Health Care in LMICs
A recent series of papers examines the effects of multiple PHC interventions under Egypt’s Health Sector Reform Program (HSRP) between 2000 and 2014.
Since 1997, Egypt introduced a series of healthcare reformsto address how PHC is financed, delivered, organised, and managed. These included
Facility accreditation program: a process for evaluating PHC facilities according to a set of standards that define activities and structures that directly contribute to improving patients’ outcomes. The facility accreditation program aimed to provide the HSRP with a framework for continuous quality improvement.
- A pay-for-performance scheme was integrated into the HSRP later in 2001, according to which governorate-level financial intermediaries became entitled to pay monthly incentives to healthcare providers in “contracted” PHC facilities based on pre-specified performance criteria. The financial incentives were discontinued in 2008 and the pay-for-performance scheme was replaced by case-based reimbursement.
- In 2003, user fees were imposed on a fraction of PHC facilities participating in the HSRP. Previously uninsured beneficiaries became required to pay registration fees, renewal fees, and copayment fees, including visit fees, drug copayments, and copayments for other interventions.
The most interesting finding for me was about the user fees for health services -
‘Charging user fees for health services in middle-income country settings does not necessarily hinder access to health care and can even increase the use of some of these services, as long as it is combined with appropriate exemption policies for vulnerable groups. In some cases, The Ugly turns out to be not that ugly!’
Amazon and healthcare
A lot has been written about Amazon’s continued interest in healthcare, especially with its announcement about One Medical acquisition. This HBR article sums up some interesting points-
- According to the authors, Amazon’s first task is to make its new primary care venture successful. Primary care is difficult to sustain financially because of the low payment rates it commands from third-party payers in the US. In fact, One Medical has been losing money, despite the fact that its patients tend to be well insured by commercial insurers who pay comparatively generously.
- The authors suggest Amazon will likely have to dramatically change One Medical’s model by taking financial risk for the specialty and hospital services that account for much of the high costs and waste in the U.S. health care system. Amazon will have to penetrate the commercial market with new payment models.
- Amazon will also face consolidation among providers as a challenge. It also faces competition from the likes of United’s Optum and the combined CVS Health and Aetna, which have the advantage of providing both insurance and health care services and which already employ physicians and other providers at scale.
Digital Healthcare News
Tech in Digital Health
Amazon sent out mixed messages about Amazon Care; earlier in the month, it announced a partnership integrating with mental health app Ginger. However, later in the month it announced to cease operations of its Amazon Care service, three years after it began piloting a primary care service for its employees that blended telehealth and in-person medical services.
Google announced Sense 2, new addition to its Fitbit smartwatches, calling it its “most advanced health-focused smartwatch.” Its main feature is detecting atrial fibrillation.
Salesforce Health Cloud introduced a suite of new technologies that will streamline the acquisition of patient health metrics through connected medical devices, consolidate patient medication information and patient data protection.
EchoNous announced alliance with Samsung that will enable its Kosmos ultrasound tool to run on off-the-shelf Galaxy Tab Active Pro tablets.
Bodyport received FDA 510(k) for connected scale to noninvasively monitor fluid status changes.
Viz.ai received FDA 510(k) clearance for Viz Subdural (SDH), that automatically detects subdural hemorrhage.
Members of the Space Force won’t have an annual physical fitness test. Instead, Space Force will give smart rings or other wearable fitness devices to keep track of their members’ physical activity throughout the year. The devices also will be programmed to give feedback about mental health, balanced eating and sleep.
NHS England has launched The Managing Heart Failure @ Home to support heart failure patients with the tools and expertise they need to remotely monitor their condition at home. It will aim to minimise face-to-face appointments for these patients and reduces unavoidable hospital stays and readmissions.
The National Cancer Institute provided $23M to four universities to develop cancer care telehealth centers as part of NCI’s Telehealth Research Centers of Excellence initiative.
Merck will work with Saama Technologies to build a new clinical data management system.
Bayer and Exscientia mutually ended their AI-driven drug discovery collaboration. following the achievement of a milestone.
Funding, Deals, Mergers & acquisitions
Home care provider Cera raised £260M; Cera uses Smart Care technology, which includes devices such as machine learning algorithms that predict health deteriorations before they occur and its Dynamic Tasks platform.
Cleerly raied $192M for heart attack-predicting AI.
To build its AI-powered diagnostic tools for diabetic retinopathy, Digital Diagnostics raised $75 million.
Elation Health raised $50M Series D for innovative primary care supporting practices in new payment models.
Homeward raised $50 M in Series B funding to improve access to high-quality healthcare in rural communities.
Theranica raised $45M for migraine digital therapeutic.
Diagnostic Robotics raised $45M for AI-enabled care management for population health management and triaging patients to the best care site
Patient monitoring company Sibel Health raised $33M for its work on in-home and hospital monitoring.
Medication intelligence startup Arine raised $29M.
Japanese medical AI startup, working on AI Symptom Checker, Ubie raised $26M.
Biofourmis raised $20M from Intel in additional series D funding.
AI-enabled medical documentation startup Abridge raised $12.5M.
J&J and HCA Healthcare formed a partnership to explore better outcomes, nurse training and early cancer detection.
ResMed will buy Mementor, a German Digital Therapeutic company, with focus on insomnia and other sleep disorders.
Health tech player Availity will acquire data firm Diameter Health to improve interoperability with new data platform.
Patient engagement and access platform Upfront will acquire PatientBond.
SelectHealth, a subsidiary of Intermountain Healthcare, has signed on with Pear Therapeutics to cover its reSET-O digital tool for opioid use disorder.
A new release of the athenaOne EHR and practice management suite will include DrFirst’s RxInform automated patient messaging to help patients follow prescribed treatment plans.
Telehealth company Amwell is working with CVS Health to roll out the retail drugstore giant’s new virtual primary care service.
Sharp HealthCare, a leading healthcare system and Sanford Health, the largest rural health system in the United States, have joined Dandelion Health Data Consortium to integrate representative patient data for an equitable healthcare platform for clinical practice diagnostics and decision-making.
Close to 6 in 10 hospital and health system leaders said their organizations had at least one cyberattack in the past two years, according to new data from the cybersecurity company Cynerio and the cybersecurity research center Ponemon Institute.
GE Healthcare and Nex Cubed have selected seven companies focused on artificial-intelligence-augmented medical imaging for the first cohort of the Edison Accelerator in Canada.
Mental Model of the Month
This month’s model is Feynman Razor. A “razor” is a rule of thumb that simplifies decision making, literally allowing its user to “shave off” explanations or actions. According to Richard Feynman, a theoretical physicist and a Nobel laureate, ‘if you couldn’t reduce it to the freshman level, that means we don’t really understand it.’ Many times especially in complex fields, jargon and complexity wins over clarity, which is of course true for so many things today in healthcare innovation!
Longread of the Month
Not really a healthcare related read this time. But I really loved this podcast (h/t@aakashganju)- it talks about one of the most intriguing theories about national dimensions of culture developed by Prof Hofstede and other researchers, Individualism, Power Distance, Masculinity, Uncertainty Avoidance, Long-term Orientation and Indulgence. I continue to think about its implications for healthcare. …
Tweet of the Month
By the end of 2025, US federal agencies must make papers that describe taxpayer-funded work freely available to the public as soon as the final peer-reviewed manuscript is published. Data underlying those publications must also be made freely available “without delay.
Chart of the Month
Top 3 patient barriers to remote patient monitoring- technology, digital literacy, and broadband internet access