💡 HTN | Community Brain Trust | 10/24
🧵TOP THREADS OF THE WEEK
In case you missed them, here are highlights of a few interesting conversations from different channels:
Threads included below:
- Looking for vendors to address pain points in lab and Rx ordering
- Impact of Apple's iOS update on mental health apps
- Introducing the 'Executive MD' program: medical education for non-clinical professionals
- Tips for early business validation in healthcare startups
- Unpacking the VBC startup landscape
1. Looking for vendors to address pain points in lab and Rx ordering
Q: Hi everyone, I am looking at potential vendors to help with some pain points that our providers are experiencing in the ordering of labs and rx.
These are the vendors that I filtered down to based on research and reviewing this channel. Is there someone I’m missing in either area that I should really be talking to?
a. Rupa Health
b. Health Gorilla
c. Evexia Diagnostics
Thanks for the help!
– Tom Burdel | via #buildersask
Thread Summary: A member of the HTN community is seeking recommendations for vendors to help with pain points in lab and Rx ordering. They have narrowed down their options but are open to suggestions. The discussion includes suggestions for both lab and rx vendors, as well as insights on integrations with Athena and workflow issues.
a. Traditional labs (Labcorp and Quest ordering)
i. Health Gorilla (API and UI)
ii. Redox (API)
iii. Change (API, maybe also UI)
iv. Ellkay (API)
v. Evexia Diagnostics (UI)
b. Specialty labs (don't think they do Labcorp or Quest)
i. Rupa Health
2. Rx (twitter thread)
a. Mail order pharmacy via API
b. On-ramp to Surescripts (any pharmacy)
ii. Bravado Health
c. New network (electronic and fax)
2. Impact of Apple's iOS update on mental health apps
Q: For those building in mental health, how will apple's recent ios update to easily capture PHQ9 and GAD7 impact patient acquisition or care workflows? wondering how easy is it export data from apple health or integrate with it
– Paulius Mui, MD| via #random
Thread Summary: HTNers discuss the potential impact of Apple's recent iOS update on mental health apps, specifically in terms of patient acquisition and care workflows. The conversation covers topics such as exporting data from Apple Health, integrating with it, user experience friction, trust in the data source, legal considerations, data interoperability, and the overall user experience compared to building a native app.
Mike Gleichman: I'm not building in mental health, but i did pull data from Apple Health previously. it's pretty straightforward to get the data out, and Apple's documentation is reasonably good. the biggest challenges are that:
- Because Apple puts so much emphasis on user privacy controls, getting users to provide your app with access to the data creates a good bit of user experience friction. (they'd tell you this is a feature, not a bug.)
- If you want all patients to complete these surveys, you'd still need to solve for everyone who doesn't use an iOS device in some other way, so you create more complexity for your dev team vs. just building something natively within your own app.
3. Introducing the 'Executive MD' program: medical education for non-clinical professionals
Q: My father, a retired pediatrician and psychiatrist, had an idea to start an "executive MD" program - essentially a "mini medical school" - not for the purposes of getting an MD, but rather medical education for non-clinical professionals. In his words, it would be intended for business folks/engineers who are interested in medicine but don't want to go to medical school. A proposed program would take less than 2 years to complete and offer a certificate (not an M.D. degree). The credit would neither lead nor be confused with the practice of Medicine. It would be to make medical education accessible and "certifiable" for those who want it.
Good idea? Bad idea? Does something like this exist (if so, would love to know so I can connect dad to the co!)?
– Nina Levin | via #topic-new-company-ideas
Thread Summary: A retired pediatrician and psychiatrist proposes the idea of an 'Executive MD' program, which would offer medical education for non-clinical professionals. The program would be shorter than traditional medical school, leading to a certificate rather than an MD degree. HTNers discuss the feasibility and potential benefits of such a program, with suggestions for accreditation, industry placement, and a more focused MOOC approach.
Amitha: An executive MD isn't really like an executive MBA though. The former degree implies a specialized set of skills for direct patient care. An executive MBA is like an MBA, with similar course requirements and standards, and an option for those who would typically be accepted into an MBA program, but are usually busy with their jobs/more advanced. IT would be like creating an executive DDS program - it doesn't make much sense. There's also a danger around people marketing it as an MD (I don't see the ACGME jumping at this idea -- its a liability risk for credentialing). I agree with Nirav -- a MOOC focused on learning about healthcare and medicine more broadly (but in a more focused way) is a good idea -- it might cover some general biomedical things but could be focused on healthcare delivery. There seems to be a gap here, especially as it relates to things not taught in medical school -- the intricacies of value based care, digital health/its role, health policy. It would need to be different form an MPH or an MPP in some way, so perhaps more broad and flexible? a Coursera-like course (that offers a LinkedIn badge) and/or standard certification similar to project management may work and be scalable if its aimed at entrepreneurs or leaders in healthtech.
4. Tips for early business validation in healthcare startups
Q: I'm seeking tips on early business validation for healthcare (or more specifically device) startups - how to validate quickly despite regulatory/compliance requirements. I come from simple B2B SaaS with fast validation via quick deployment & sales. What has worked for you all for speedy validation in the complex healthcare environment?
– Gabe Ruttner | via #buildersask
Thread Summary: In this thread, HTN members discuss strategies for quickly validating healthcare startups, particularly those involving medical devices, despite the challenges of regulatory and compliance requirements. The conversation highlights the importance of early validation before design freeze, which allows for iteration and testing without being hindered by regulations. User research, including interviews, hands-on labs, and phone calls with paid or unpaid consultants, is considered the gold standard for validation.
Roshy Iranitalab: Typically early validation is done prior to design freeze - here you can iterate and test concepts without worrying too much about regulations. It’s really post design freeze that things get more cumbersome. Changes can be made, but typically/ideally not on as large of a scale. Validation testing prior to design freeze would consist of interviews, hands on labs, phone calls, etc. using paid or unpaid consultants, depending on the size/stage of the company. Happy to chat more if you have additional questions.
5. Unpacking the VBC startup landscape
Q: Oak street, Iora (now one medical), and ChenMed represents three of the more successful value based care initiatives. I'm surprised there haven't been more value based senior care copycat startups - am I missing those?
– Anonymous Bot | via #buildersask
Thread Summary: The crew offers up several similar VBC-based business models as compared to other companies like Oak Street Health and Iora. The thread also touches on the complexities of building in the space, such as long sales cycles, generally capital intensive business and more.
Chris Miller: Yeah agree with the above that there are a lot of companies who are performing:
- The same services solely (e.g., Centerwell, Cano, Caremax, loads of small PCPs in South Florida, etc.),
-The same services in addition to providing other services (e.g., VillageMD, Optum, Intermountain, Geisinger, Ochsner, etc.), or
- A similar service (e.g., Agilon, Privia, InnovAge, PACE models, etc.)
And why aren't there more? It's hard and expensive. It isn't a coincidence that once a number of these players started getting big, they started burning a ton of cash and sought stronger balance sheets (Iora->One Medical-> Amazon, Oak Street->CVS, ChenMed is reportedly seeking a buyer, Cano sold a bunch of its operations, Centerwell has a PE JV, Caremax found a more capital efficient growth path in its Steward partnership).
As Patrick pointed out, getting payers to delegate risk and patient panels is difficult and can take several years. Opening and operating brick-and-mortar centers with large care teams is expensive. The cash cycles are insane, with risk-based providers often not getting appropriately paid for 12-18 months after they start caring for a patient. Acquiring patients is competitive (and only getting more competitive) and YoY retention is low. Finding clinicians who want to / can adjust their work style to fit a value-based model is challenging. And paying for all this in an environment of rising interest rates and declining stock prices for these assets makes it all even tougher.
🤖HTN KNOWLEDGE BOT
If you have your own question(s) to ask, don’t forget that a good place to start is our HTN Knowledge Bot. It’s our smart search tool that makes it easier to access the wisdom shared within the HTN powered by ChatGPT. You can log in and use it on the website (here) or see how to use it directly in Slack here.
Check out the example ask below!
Who are the competitors in the AI medical scribe space?
Knowledge Bot Answer:
There are several competitors in the AI medical scribe space. Here are a few:
1. Suki: Suki is an AI-powered digital assistant for doctors that helps with clinical documentation. You can find more information on their website: Suki.
2. DeepScribe: DeepScribe offers an AI-powered medical scribe solution that transcribes and summarizes clinical encounters. You can learn more about their offering on their website: DeepScribe.
3. Augmedix: Augmedix provides a platform that combines artificial intelligence with human medical scribes to assist with clinical documentation. You can find more details on their website: Augmedix.
4. Abridge: Abridge is a clinical documentation solution that uses machine learning to generate SOAP note drafts. They aim to improve the patient and clinician experience. You can learn more about their offering on their website: Abridge.
Please note that the availability and features of these solutions may vary, so it's important to visit their respective websites for the most up-to-date information.
Here we highlight helpful resources from across the community:
- WELL Career Accelerator via Clare Purvis – WELL Career Accelerator helps women clinicians and scientists in digital health get fluent in business, deliver strategic impact, and unlock their next level of leadership.
- Silicon Valley Trauma Start-Up Offers Complimentary Mental Health Support Amidst War via Vicki Shaw – Space of mind, an AI-powered, anonymous group support platform for trauma, has announced its commitment to providing complimentary weekly sessions to individuals affected by the ongoing Gaza-Israel conflict.