Is Andreessen-Horowitz Right That Software's Poised To Eat Healthcare? - Forbes

The question perhaps should read, "How fast will Software eat  health care, and will there be anything left ?

Many of us have adapted what HIT has to offer (it actually was forced down our throats), and now we have severe GERD.  (gastrointestinal esophageal reflux disorder).  This frequently occurs in those who are obese and who overeat.

I think that is where we are now. Will we be able to keep it down, or vomit IT back to where it came from.  I think both may happen.

 “When Bio Meets Computer Science.” As expected, it was articulate, thoughtful, and relatively grounded. Nevertheless, I realized at the end I didn’t entirely agree with all the assertions, and I thought it might be worth some discussion.

A16z’s high level thesis – with which I strongly agree– is that there are profound opportunities at the confluence of biology and technology, especially as more undergraduates emerge who are trained in both (apparently the majority of Stanford students take at least one computer course, even though most don’t wind up in computer science or engineering). It’s also true that the new opportunities aren’t simply being able to do existing activities faster or at larger scale – rather, it’s the opportunity to ask and pursue questions you couldn’t have even conceptualized in an earlier era.

The a16z view of this space, as a whole, can be divided into three parts: 

(1) Digital therapeutics. Many healthcare problems are behavioral, and digital health companies might address these challenges more effectively, and less expensively, than drug companies. Representative (and portfolio) company:Omada Health (my 2012 post on the company is here; our recent Tech Tonicsinterview with founder Sean Duffy is here)

(2) Cloud Biology. The arrival of highly automated labs will revolutionize biology startups in the same way the arrival of cloud computing revolutionized technology startups. These lab facilities will enable biotech startups to do the experiments they need with greater reliability and without the capex spend; scalable research facilities will be available when needed, and you only pay for what you use (again, like cloud computing). Representative companies in this space: Emerald Cloud Labs; Transcriptic.

(3) Computational Medicine. Physicians and researchers must contend with an overwhelming and ever-increasing amount of data. For instance, a key challenge in oncology is matching many potential cancer drugs to the exact characteristics of the tumor in question. These sorts of problems can be solved with software, which is continuing to get better and cheaper.  Representative companies: Foundation Medicine cited as company in the oncology diagnostics space.

Collectively, a16z says, these three trends will lead to an “explosion” of experimental biology and digital health startups, offering the opportunity to develop clinically impactful products for a fraction of the cost of a traditional life science startup, and representing a pointed contrast to the ever-increasing cost of traditional biotech drug development, which seems to follow so-called Eroom’s Law (Moore’s Law in reverse).

First, I worry a16z profoundly underestimates the difficulty of developing a behavioral intervention that’s actually clinically effective, and also underestimates the cost of rigorously proving this (and payors are going to demand credible data before agreeing to cover the cost of an intervention such as Omada’s or Propeller Health’s, which both, by design, target a relatively large number of covered lives).  (Addendum: A thoughtful response from Omada notes that they “take on meaningful financial risk,” collecting a “significant portion” of their revenue from customers “only as individual patients achieve clinically-meaningful milestones” — an approach they acknowledge makes for a “nerve-wracking business model.”)

Is Andreessen-Horowitz Right That Software's Poised To Eat Healthcare? - Forbes

IBM Watson wants to buy a Merge Health Care & combine Merge's medical imaging technologies with IBM's Watson.

 IBM on Thursday announced that it will spend a cool $1 billion to acquire Merge Healthcare deal that will combine Merge's medical imaging technologies with IBM's Watson.re in  

Watson will gain the ability to "see" by bringing together Watson's advanced image analytics and cognitive capabilities with data and images obtained from Merge Healthcare's medical imaging management platform, IBM executives said in announcing the deal.

Watson will gain the ability to "see" by bringing together Watson's advanced image analytics and cognitive capabilities with data and images obtained from Merge Healthcare's medical imaging management platform,

Merge's technology platforms are used at more than 7,500 U.S. healthcare sites, as well as most of the world's leading clinical research institutes and pharmaceutical firms to manage a growing body of medical images.

Organizations could use the Watson Health Cloud to surface new insights from a consolidated, patient-centric view of current and historical images, electronic health records, data from wearable devices and other related medical data, in a HIPAA-enabled environment.

This is IBM's third major health-related acquisition – and the largest – since launching its Watson Health unit in April, following Phytel, a population health company and Explorys, a cloud-based intelligence firm. [See also: With 2 acquisitions, IBM builds out Watson Health.]

Why Medicare Has Been Slow to Adopt Telemedicine | KQED Future of You | KQED Science

This story originally ran on Kaiser Health News (KHN),

 a nonprofit national health policy news service. 

Nearly 20 years after such videoconferencing technology has been available for health services, fewer than one percent of Medicare beneficiaries use it. Anthem and a University of Pittsburgh Medical Center health plan in western Pennsylvania are the only two Medicare Advantage insurers offering the virtual visits, and the traditional Medicare program has tightly limited telemedicine payments to certain rural areas. And even there, the beneficiary must already be at a clinic, a rule that often defeats the goal of making care more convenient.

Congress has maintained such restrictions out of concern that the service might increase Medicare expenses. The Congressional Budget Office and other analysts have said giving seniors access to doctors online will encourage them to use more services, not replace costly visits to emergency rooms and urgent care centers.

In 2012, the latest year for which data are available, Medicare paid about $5 million for telemedicine services — barely a blip compared with the program’s total spending of $466 billion, according to a studyin the journal Telemedicine.

Medicare has already invested much more in studies to define where telehealth can be used to deliver improved access and reduce costs.

“The very advantage of telehealth, its ability to make care convenient, is also potentially its Achilles’ heel,” Ateev Mehrotra, a Rand Corp. analyst, told a House Energy and Commerce subcommittee last year. “Telehealth may be ‘too convenient.’ ”

“There is no question that telemedicine is going to be an increasingly important portal for doctors and other providers to stay connected with patients,” former Surgeon General Richard Carmona said in an interview.

Some health experts say it’s disappointing that most seniors can’t take advantage of the benefit that many of their children have.

“Medicare beneficiaries are paying a huge price” for not having this benefit, said Jay Wolfson, a professor of public health, medicine and pharmacy at the University of South Florida in Tampa. For example, he said, telemedicine could help seniors with follow-up appointments that might be missed because of transportation problems.

In addition to Medicare Advantage plans, several Medicare accountable care organizations, or ACOs — groups of doctors and hospitals that coordinate patient care for at least 5,000 enrollees — have begun using the service. Medicare Advantage plans have the option to offer telemedicine without the tight restrictions in the traditional Medicare program because they are paid a fixed amount by the federal government to care for seniors. As a result, Medicare is not directly paying for the telemedicine services; instead, the services are paid for through plan revenue.

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Aetna and UnitedHealthcare cover telemedicine services for members younger than 65, regardless of whether enrollees live in the city or in the country. About 37 percent of large employers said that they expect to offer their employees a telemedicine benefit this year, according to a survey last year by Towers Watson, an employee benefits firm. About 800,000 online medical consultations will be done in 2015, according to the American Telemedicine Association, a trade group.

Medicare’s tight lid on telemedicine is showing signs of changing.

“Medicare . . . is still laboring under a number of limitations that disincentivize telemedicine use,” said Jonathan Neufeld, clinical director of the Upper Midwest Telehealth Resource Center, an Indiana-based consortium of organizations involved in telemedicine. “But ACOs and other alternative payment methods have the possibility of changing this dynamic.”

AARP wants Congress to allow all Medicare beneficiaries to have coverage for telemedicine services, said Andrew Scholnick, a senior legislative representative for the lobbying group. “We would like to see a broader use of this service,” he said. He stressed that AARP prefers that Medicare patients use telemedicine in conjunction with seeing their regular doctor.

The American Medical Association has endorsed congressional efforts to change Medicare’s policy on telemedicine, as has the American Academy of Family Physicians. “We see the potential for it . . . to improve quality and lower costs,” said Robert Wergin, president of the academy and a family doctor in Milford, Neb. He said such technology can help patients who are disabled or don’t have easy transportation to the doctor’s office.

Anthem, which provides its telemedicine option to about 350,000 Medicare Advantage members in 12 states, expects the system to improve care and make it more affordable. “It’s also about the consumer experience and giving consumers convenience to be able to be face to face with a doctor in less than 10 minutes, 365 days a year,” said John Jesser, an Anthem vice president. Anthem provides the service at no extra charge to its Medicare Advantage members.

While seniors are more likely to have more complicated health issues, telemedicine for them is no riskier than for younger patients, said Mia Finkelston, a family physician in Leonardtown, Md., who works with American Well, a firm that provides the technology behind Livehealth.com. That’s because the online doctors know when they can handle health issues and know when to advise people to seek an in-person visit or head to the emergency room, she said.

Why Medicare Has Been Slow to Adopt Telemedicine | KQED Future of You | KQED Science

Health Trackers Are Changing The Experience of Pregnancy

There seems to be no end to electronic devices for pregnancy. It seems to fit in the categoreis of wearables in HIT.



Mothers-to-be have always worried about the health of their unborn child, and fathers often place their ear on Mom' abdomen, listening to the infant's  heartbeat.  The 'quickening' when the baby's first movements are felt is a never forgotten moment.

A whole new generation of devices can be worn, and transmit information wirelessly and transparently allowing 24 hour real time data recording.


Health Trackers Are Changing The Experience of Pregnancy

by Dr. Bertalan Meskó on July 30, 2015

Wearables during pregnancy

Smart scales, smart socks, music and heart rate devices in pregnancy.

In many of my videos, I have talked about how I quantify my health with trackers and wearable gadgets. I thought that fitness and sport enthusiasts would come to me asking questions about these gadgets, but I have received the biggest number of questions from pregnant mothers who wanted to first quantify their own health, plus the health of their babies.

Pregsense (coming soon) provides information during the pregnancy, monitors the fetus’ health and sends the activity to the mother to a smartphone.

Ritmo Pregnancy provides expectant families with a simple way to safely and effectively deliver sounds.

Sound Beginnings‘ high quality speakers are designed to keep the volume to a level that is safe for baby

Lullabelly is a prenatal music belt that can be used whether the expectant mother is on the go or just relaxing at home. It has a patented hands-free design and is easy to use and safe for the baby.

Bellybuds are also used to deliver special music to the fetus through the belly belt with high quality speakers

MyHealth Bee offers a whole range of devices categorizes by trimesters.

BleepBleeps plans to create a whole range of devices for ovulation testing, baby monitoring, a motion alarm, an ultrasound scanner, and even a digital thermometer to use at home.

iBabyGuard has an award winner baby sleep monitor.

Teddy The Guardian is the first smart teddy on the market; a personal guard equipped with sensors that monitor the baby’s well-being.

There are multiple devices for monitoring baby's breathing, movements, temperature and even a diaper Pixie Scientific with sensors.

MySensibleBaby can monitor the child’s position, temperature, and even the movements.  Owlet Care designed smart socks that alert mothers if the baby stops breathing.  Sproutling is also a baby monitor. 

Health Trackers Are Changing The Experience of Pregnancy | ScienceRoll