Are those Mobile Health Apps reliable ?

The line between pharma and health information technology is blurring. SAAD (Software as a Device) stands alongside  SAAS (Software as a Service)

The progress is punctuated by the FDA which will require vetting of health software when it is linked to treatments.  No such requirement has been proposed for electronic health records, but is now being required for mobile health applications and/or remote monitoring.

In the past the FDA (Food and Drug Administration) was responsible for the safety of food stuffs. It is also responsible for the safety and efficacy of pharmaceuticals, and medical devices.  The vetting of pharmaceuticals is complex and very expensive.  The cost of new drug development is quoted as between 450 million dollars and 900 million dollars.  Pharma uses these figures to justify the cost of new proprietary formulations. The patents are valid for 16 years.  When a new drug makes the 16 year mark it becomes available to other pharmaceutical companies to be sold as generic drugs,  and the cost drops significantly.

If and when SAAD becomes available for diagnosis and treatment some SAMD will require FDA approval. Usually this takes at least 12 to 24 months, unless there are urgent medical considerations.  I would expect a price increase for SAAS.

FDA floats new draft guidance, created by international group, on software as a medical device

Therefore it is not at all a guaranteed win.







Finally, mHealth is the winner : Software as a drug? - Health Files by Rajendra Pratap Gupta | ET HealthWorld

Trump upset will force healthcare leaders to rethink the future - Modern Healthcare Modern Healthcare business news, research, data and events

I like to call this "trickle down disruption".

For health care providers it is not a simple rollback to what came before Obamacare. There are several major impediments if there is a repeal or major overhaul of Obamacare.

Huge investments have occured to accomodate the Affordable Care Act, including numerous acronyms to describe quality assurance measures built into the law.

This week the GOP will retreat to hold a planning meeting for their version of  Health Reform, Trump Care



Trump upset will force healthcare leaders to rethink the future - Modern Healthcare Modern Healthcare business news, research, data and events

New Features for Digital Health Space

As Bob Dylan always said   "The times, they are a-changin."

That was fifty years ago.  How young he looks !  So did I !  HIT, EMR, MACRA, MIPS...we had no idea what was coming.  The one constant in our little universe is Change  Politics change, science changes, nomenclature changes and more.........

The ease of access to knowledge has changed immeasurably. First the internet and the world wide web, with search engine giants such as Google, Bing,PubMed, Yahoo.  A quick google search for search engines results in a list of 15 of the top sources to search for any topic.

There are also niche search engines. SEO     Top Social Bookmarking Sites, Top People sites

One of the key attributes of a search often is the overwhelming answer, much of it noise.

Now comes the possible saviour. Analytics. Hidden behind the words are the algorithms. We learned about these in simple algebra. Health analytical algorithms  are much more complicated, but can still  be expressed mathematically in computer codes.

An essential skill for physicians today is to know about some basic coding.  There are many online courses that cover coding, web develop and many languages such as Java, Python, CSS and tools for editing  programs.

Enspektos, LLC

The Thrifty Patient: Vital Insider Tips for Saving Money and Staying Healthy: Davis Liu:

Understanding Value Based Health care 1st Edition (author:Christopher Moriates, Vineet Arora)

The Thrifty Patient: Vital Insider Tips for Saving Money and Staying Healthy: Davis Liu Amazon.com: Books Davis Liu  (Author)

Stay Healthy, Live Longer, Spend Wisely: Making Intelligent Choices in America's Healthcare System  Davis Liu  (Author)

THE PROBLEM: MANY MEDICAL BILLS ARE INFLATED WITH UNNECESSARY CARE

E

veryone agrees that making health care more affordable is a good idea – but having clinicians take responsibility for protecting the patient’s wallet requires new skills, training, and tools.

Health care clinicians ultimately determine how 90% of health care dollars are spent. However, it is challenging for clinicians to know how their decisions will impact what patients pay.

Increasingly, clinicians are finding that patients expect them to look out for their wallets. Costs of Care has collected hundreds of stories from patients, clinicians, and administrators that demonstrate that high value medical decisions benefit individual patients and society at large.

Just as the patient safety movement helped clinicians think about how to prevent unintended harm, a new movement is needed to help clinicians think about unintended financial harms as well.


The idea of the practicing clinician in a face to face encounter with a sick patient, simultaneously balancing diagnostic and/or therapeutic choices as well as analyzing cost is probably not possible, unless computers and analytics are utilized.  Physicians are trained to put the patient and diagnosis first. It places the provider in the untenable position of balancing health vs costs. It is an unreasonable demand which also effects quality of care.

Providers have faced during the past two days an increasing bureaucracy they must face to treat a sick person.  They are like the lobster in the pot slowly brought to a boil.  Now we have reached a point of no return.  Roughly 50% of providers are burned out, depressed, or considering quitting. Many of them have only been in practice  10-15 years.  They are not retiring but they are finding new methods to continue practice life.  Part-time salaried, locum tenens, allied health consulting,  and health technology.

All of these further decrease physician accessibility.  The insurance industry and payment models also contribute to the problem by decreasing physician accessibility with closed panel plans, HMOs, Medicare Advantage Plans.  The Affordable Care Act insured millions of patients, however these same patients cannot access health care.  The ACA was an insurance/payment reform, not a health plan.

The ACA will be amended/repealed, otherwise it is a waste of taxpayer money.  The additional blow back is the number of health insurer mergers, allegedly to save money and/or created an indomitable market presence.  A federal judge this week blocked the proposed merger of Aetna and Humana for that reason.