Thursday, February 23, 2017

The Scope Of Digital Health Seems To Be Widening In All Sorts Of Interesting Ways.

This appeared last week.

Five digital health trends investors are watching in 2017

February 16, 2017

Digital health technologies will transform healthcare. Mobile phones have given health care providers the ability to engage with patients 24-7 and patients are able to capture and share data that may be helpful in tracking and personalizing their health care. Genomics, analytics, artificial intelligence and deep learning technologies are all making inroads in this emerging sector. Although the amount of money invested in the sector slightly decreased from last year, according to Rock Health, venture capital interest in the digital health sector is still significant with $4.2 billion invested in 2016.  
It’s a very diverse sector that spans from general wellness applications targeting consumers to highly clinical solutions that typically require FDA approval. At AMV, we focus more on clinically oriented digital solutions tackling healthcare problems and have invested in dozens of early-stage companies since we began looking at digital health in 2003.
The healthcare market is enormous with over $3.2 trillion of annual spend in the United States in 2015, and the sector has had significant regulatory changes over the past seven years largely driven by the Affordable Care and HITECH Acts.  Most observers are expecting further significant changes as the new administration pursues legal and regulatory reforms.
We expect more regulatory changes but we believe the dramatic shift towards industry digitization and value-based care will continue unabated. We will begin to see the next wave of technology innovation, such as Internet of Things (IoT), Machine Learning and Artificial Intelligence (AI) move from consumer and commercial use into healthcare applications. As the digital health industry moves into the second wave of innovation, we see the following as exciting areas that entrepreneurs are focused on.
1. Digital Interventions
We’ve seen a wave of new apps that seek to improve patient health in ways that are clinically demonstrable. These digital interventions use health, behavioral and contextual data -- such as glucose levels, sleep, weight, food, activity, time of day and weather -- to improve patient treatment plans. Interesting companies in this sector target diabetes prevention (Omada Health), Type 2 diabetes (WellDoc), mental health (Pear Therapeutics) and respiratory illness (Propeller Health). In some cases such as WellDoc, these interventions are FDA-approved therapeutics. These apps have such compelling clinical efficacy that insurance companies are starting to pay for them due to improved patient outcomes at reduced cost. 
Pharmaceutical companies are also interested in integrating digital interventions with their drugs to improve outcomes, differentiate their products, and engage directly with patients. For example, Proteus Digital Health, which manufactures an FDA-approved sensor that is embedded in pills and tracks medication adherence, is working with Otsuka on a bundled solution that treats bipolar disorder and schizophrenia.

2. Provider Workflow Solutions (or Healthcare Scalability Solutions)
In the United States we have a problem efficiently delivering care. It often takes weeks or months for patients to schedule an appointment. Physicians are often rushed when providing care and, according to a study by the AMA, spend twice the time entering patient data into electronic medical records that they do seeing patients. I believe digital technologies can help give our time-crunched healthcare professionals the ability to see more patients in less time, while delivering a better patient experience, by using data analytics for decision support, more efficient workflow and different forms of mobile communication.
Additionally, we can shift the cost curve to less expensive labor. Given decision support tools, artificial intelligence and data analytics, primary care physicians should be able to do some of the work specialists currently do. Nurses and case managers will be able to reduce a physician’s workload and, increasingly, patients will be able to administer self-care at home with mobile devices.
In this sector I’d keep my eyes on companies like HealthTap (enabling patient/physician interaction outside of the office), Augmedix (utilizing Google Glass to enable remote scribes to enter patient data into the EMR) and Welkin Health (tools to improve communication with patients.)
3. Data Integration and Analytics
In the past few years we’ve seen a dramatic increase in the amount of digitized health data stored in EMRs, health data captured from smartphones, and genomic data.
There are many uses for these new healthcare datasets. For example, insurance companies and companies that pay for employees’ health care directly, can use additional data to help refine actuarial models. Physicians can use analysis of this data for diagnosis and decision support. Lastly, patients may benefit from the mining of data for predictive prognosis. Consequently, real-time alerts to patients and healthcare professionals are becoming feasible.
Lots more here:
A useful detailed article that is well worth a browse.


Anonymous said...

And the ADHA, how is leading the way to enable Australia to be a fertile investment hub, tinkering with old world issues, rather than how we can quickly change before we miss a revolution because the cost is to high. Genomics has measurable value, be good to see a position from the Strategy and Innovation EGM on its future and the MyHR

Anonymous said...

Government should step in when there is important market failure, for whatever reason. If the market is now generating so many digital innovations internationally, its not clear why there is a role of government in the innovation business itself. There is a role for government to preserve the safety and privacy of individuals - through regulation and standard setting for example.

If we are not keeping up with international competitors, and we think for whatever reason we should be (remember we don't make cars here and all seem to be happy to buy them from elsewhere - so its not always the case that we will be in a market) then there needs to be a reasoned analysis of the causes of that failure. I can make a guess that there are cultural issues (for some reason many of us don't see our selves as innovators but rather as early adopters), and structural issues (such as the historical poor but now improving access to venture capital).

Personally I doubt government can do much directly to stimulate genuine innovation - but maybe others have good example son where this has worked.

Terry Hannan said...

David, I like this statement-"providers the ability to engage with patients 24-7 and patients are able to capture and share data that may be helpful in tracking and personalizing their health care".
From the mhealth reports out of Hopkins (Alain Labrique) and the WHO the words "ability" and "may be helpful" stand out for me. From these studies there is a very low percentage of applications in mHealth that have produced significant and lasting improvements in care delivery and most of the ones showing benefit have been in Low and Middle Income Countries (LMIC). A prime example is exercise Apps. My reading indicates durable success is not much above zero.
Also there was a study (I think Australian) that demonstrated the orthopods had labs and X rays on their Tablets at the bedside and one of the major outcomes was NO communication with the patient.

Terry Hannan said...

David, this article highlights some of the points I was trying to make.

One-way Versus Two-way Text Messaging on Improving Medication Adherence: Meta-analysis of Randomized Trials David S. Wald, MD, FRCP, Shahena Butt, MSc, Jonathan P. Bestwick, MSc Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United KingdomThe American Journal of Medicine (2015) 128, 1139.e1-1139.e5