Kim Bellard

See the following -

Uber For Health Won't Play Nice...It Will Sideswipe the Industry

People talk "Uber for health care."  After all, Uber has been wildly successful, valued over $60b, which makes it bigger than Ford and GM.  AirBnB, the Uber of hotels, is worth some $20b.  Heck, even the disposable razor industry has its own Uber, with Dollar Shave Club just getting acquired for $1b.  Any industry that isn't looking in its rear view mirror for potential Uber-type competitors may find itself disrupted into irrelevancy. And, goodness knows, health care could use some disruption. There are no shortage of candidates for health care Ubers...

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We Are Going to Need Bigger Post-ITs if We Want Design Thinking in Healthcare

When it comes to healthcare, we certainly have a lot of things that are big, and probably the only reason more aren't red has to do with that color-of-blood/code red thing. But when it comes to design that one would really call good...not so much. In NEJM Catalyst, Amy Compton-Phillips and Namita Seth Mohta reported on their Care Redesign Survey, which surveyed the NEJM Catalyst Insights Council. The survey found that there was strong support for design thinking (90%+), and was seen as valuable for a wide range of health care issues. Yet less than a quarter use design thinking regularly. When asked to list the top three barriers to applying design thinking to healthcare problems, respondents said:

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We Don't Need No Stinking Batteries

The problem with many IoT devices, though, is similar to with our other devices: what happens when the battery runs low? It's not easy to get a charger into our gut to repower smart pills, and for anyone worried about the ecological risks posed by computer or smartphone batteries, well, imagine tiny versions of those toxic batteries floating around in your body. We'll need sensors to track the damage done by our other sensors' dead batteries. Not with rectennas. Rectennas are powered by Wi-Fi signals, like the kind you use in your house or at Starbucks to get internet access. This is not a new concept, but what is new is that MIT researchers have been able to harvest enough power to make them useful, in a device only a few atoms thick.

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We Have Seen the Future, and It Is...Estonia?

Like me, you may not have been paying close attention to what has been going on in Estonia.  That's probably something many of us should change, at least anyone interested in our digital future(s). OK, I have to admit: I had to look Estonia up on a map.  I knew it was in northern Europe, and that it had been involved in the whole U.S.S.R. debacle.  As it turns out, Estonia sits just across the Gulf of Finland from -- that's right -- Finland, and across the Baltic Sea from Sweden.  Skype was invented there, if you're keeping score. More to the point, over the last twenty years it has evolved into arguable the most advanced digital society in the world.

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What Are We Prepared to Do in the United States to Save Primary Care?

I propose two significant changes to help make primary care relevant in the 21st century...I wrote a longer piece on [Virtual Care] earlier in the year. In short, it's a disgrace that we've put so many hurdles on telemedicine, and that it continues to be so underused. It is widely available in health plans, but rarely practiced by physicians nor by patients. Instead, we still mostly go to our doctors offices, to ERs, or perhaps now to drugstores.A televisit should be the first course of action for non-emergencies. We must remove regulatory and reimbursement barriers, and incent patients to take advantage of the speed and convenience of the option. Moreover, as AI options for diagnoses and advice quickly become more viable, we can use them to triage our needs, help assure continuity with physicians, and eventually reduce the need to talk to a human...

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What Burning Man Can Teach Healthcare

Oh, good: it's Burning Man week.  For some people, it's the highlight of the year, an expression of creativity, community, and freedom unlike any other.  It's Woodstock, Fashion Week, and the Fringe Festival all rolled together, only set in the Nevada desert. For others, it is 70,000 wannabe hippies/hipsters gathering together for a week of hard partying: public nudity, drugs, and sex, plus burning some "art." Either way, it couldn't possibly have anything to teach healthcare, right? Maybe.  But what many do not realize is that Burning Man espouses ten guiding principles, and it is worth taking a look at those and how they could or should be applied to healthcare.

What Health Care Needs Are Some Zombies

Finally, some good health care news: according to Accenture, half of digital health start-ups are going to fail within two years. No, really: that's the good news. Accenture projects that funding for digital start-ups is going to boom over the next few years, reaching $6.5b annually by 2017.  Their analysis categorized four key areas of funding from 2008 - 2013: infrastructure ($2.9b), treatment ($2.6b), engagement ($2.6b), and diagnosis ($2.1b).  They stress that the start-ups that will succeed will do so by combining capabilities across the four areas, such as by use of integrated Social, Mobile, Analytics, Cloud and Sensor technologies ("SMACS"). This boom shouldn't come as much of a surprise...

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When Artificial Intelligence Robots Start Replacing Physicians, Will We Notice -- Or Care?

There's an interesting verbal battle going on between two prominent tech venture capitalists over the future of AI in health care.  In an interview in Vox,  Marc Andreessen asserted that Vinod Khosla "has written all these stories about how doctors are going to go away...And I think he is completely wrong."  Mr. Khosla was quick to respond via Twitter:  "Maybe @pmarca [Mr. Andreessen] should read what I think before assuming what I said about doctors going away." He included a link to his detailed "speculations and musings" on the topic. It turns out that Mr. Khosla believes that AI will take away 80% of physicians' work, but not necessarily 80% of their jobs, leaving them more time to focus on the "human aspects of medical practice such as empathy and ethical choices"...

When It Comes to Pharmaceuticals and Medical Devices, We Should Ask More and Listen Better

A new study in JAMA suggests that nearly one-in-three drugs approved by the FDA between 2001 and 2010 had post-market safety issues, which caused safety communications to physicians and consumers, "black-box" warnings on labels, and drug withdrawals. It is not clear how many patients may have died or otherwise harmed by these issues...Lead author Joseph Ross, M.D., noted: "No drug is completely safe, and during premarket evaluation, we are not going to pick up all the safety signals," and urged "that we have a strong system in place to continually evaluate drugs and to communicate new safety concerns quickly and effectively."

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Will Octobot Transform Medicine?

Acclaimed futurist Ray Kurzweil has a lot of bold predictions (including that computers will become smarter than us within a few decades), and some of his most interesting ones deal with how technology -- especially nanotechnology -- will soon totally revamp how we manage our health, leading to longer, healthier lives and hugely increased intelligence. Sounds like science fiction, right? Meet Octobot. Harvard researchers have unveiled what they describe as the "first autonomous, entirely soft robot," which they call Octobot (it has eight arms, like an octopus). It has no metal, no battery, no electronics of any sort, yet manages to move under its own power. It uses a "microfluidic logic circuit" rather than a circuit board to control the movements of its arms and to power itself along, using gas reactions...

Your Smartphone or Your Life...or, the Dangers of Addictive Technology

Rep. Jason Chaffetz's recent remarks suggesting that some Americans should invest in their health instead of in a new iPhone reminded me of nothing so much of the old Jack Benny bit, where Benny is accosted by a robber who threatens "your money or your life."  When Benny doesn't immediately respond, the robber prompts him, and the supposedly miserly Benny snaps back, "I'm thinking it over." I suspect that, like Mr. Benny, many of us would have a tough choice between our smartphones (and our other devices) and our health.  It may be not so that we're miserly as it is that we're addicted.

Your Toaster May Be Bad For Your Health IT

the cyberattack last week...shut down access to many major websites...What does this have to do with health care?  Plenty, as it turns out.  IoT devices are increasingly helping us manage our health and medical care.  IoT in health care is expected to be a huge market -- perhaps 40% of the total IoT, and worth some $117b by 2020, according to McKinsey.  Expected major uses include wearables, monitors, and implanted medical devices. The problem is that many manufacturers haven't necessarily prepared for cyberattacks.  Kevin Fu, a professor at the University of Michigan's Archimedes Center for Medical Device Security, told CNBC: "the dirty little secret is that most manufacturers did not anticipate the cybersecurity risks when they were designing them [devices] a decade ago, so this is just scratching the surface."

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