💡 HTN | Community Brain Trust | 8/29
🧵TOP THREADS OF THE WEEK
In case you missed them, here are highlights of a few interesting conversations from different channels:
Threads included below:
- EMR data analysis on a budget
- Framework for driving effective team meetings
- Health tech cos with high quality outcomes research
- Unpacking Amazon Clinic's ala carte pricing strategy
1. EMR data analysis on a budget
Q: Hi I am working with a provider practice. Trying to extract the EMR data for reports and analysis. Trying to figure out whether to create a data lake or something scrappy like an access database with only the tables relevant for reports. Anyone have experience with something similar and open to chatting? Currently they are using Looker which has limitations.
– Judhajit De | via #buildersask
Thread Summary: HTNers jump in with some advice on best approaches to EMR data extraction from EMR and analysis for a smaller team with a limited budget / resources.
Michael Stratton: Budget and size of group are pretty key here. I’d say just use Postgres on aurora unless you need big query or snowflake size.
I agree w/ Kevin and will add that Looker is pretty powerful relative to other BI tools. (add - another BI tool is unlikely to have that much more functionality)I pretty strongly recommend against flat files on s3 if you’re going to hand this over to less technical people. In my experience you can get a business analyst up to speed w/ a web based SQL client but trying to explain s3, pandas, etc.… adds another layer of complexity that seems to be a hurdle for non-engineers.
2. Framework for driving effective team meetings
Q: Has anyone implemented the Amazon “memo” approach to offering material for internal meetings? curious if there is a template or series of questions that people find effective.
– Anonymous Bot | via #buildersask
Thread Summary: The crew discusses the well known Amazon 6 pager, its impact on meetings, as well as alternative frameworks for hosting effective team meetings.
Tamra Lair: If you mean the Amazon 6 pager, yes. I've done them a number of times. Not sure if there's a template (other than reading Bezo's shareholder letters) but there are some guidelines, as I understand it:
- No bulleted lists. Straight full sentence narrative only.
- 6 pages - not more. Not less.
- The content of the 6 pager provides any information and positions needed to support the topic of the meeting
- Consumed in the meeting on the 6 pager's topic silently together before the discussion
It's magic in it's effectiveness for two reasons:
- It forces the meeting owner to spend time thinking clearly and deeply enough about the topic prior to the meeting. If the 6 pager doesn't align with the "rules", the meeting might be a waste of time.
- It equalizes everyone's understanding going into the discussion.
3. Health tech cos with high quality outcomes research
Q: Hey all - I'm looking for truly good examples of health tech companies/startups who are studying and validating their own outcomes and/or processes and publishing good whitepapers/posts on what they find.
Note: I'm being intentionally broad in focus because my purpose is to gather inspiration and examples to show my clients and discuss options for length, depth, tone, transparency, information display, etc. However, the kinds of whitepapers/posts/studies I'm hoping for are:
- Not (yet) at the level of an academic study, and not written as an academic article, but conducted in a way that you consider to be thoughtful, transparent, and credible
- Designed/structured to persuade and build trust with B2B clients (yes, used for marketing purposes) but NOT just marketing fluff
- Does not need to be limited to outcomes - I'm equally interested in writeups aimed to build credibility by demonstrating process innovation, service differentiation, unique methods, introspection
- The B2B2C product context would be ideal, but I'm open to learning from others who have made an impression on you!
Bonus points for public links, or DM me if you have a file to share!
– Shelby Chartkoff | via #buildersask
Thread Summary: An interesting thread of companies producing high quality whitepapers - top mentions include Omada Health, Big Health, Sword Health, and Brightline.
Bethany Vick: Omada has a large resource center on their website that includes both peer-reviewed studies as well as their own case studies and outcomes. They are one of the better I've seen in terms of sharing real outcomes.
4. Unpacking Amazon Clinic's ala carte pricing strategy
Q: Thought this was a fascinating read on Amazon Clinic yesterday by Katie Jennings and how they're testing out this approach to ala carte pricing. While there's the Ezekiel Emmanuel quote in there about this not actually moving the healthcare needle, I do think it's a really interesting experiment they're working on here.
Some of the interesting points in it:
- message based visits run between $30 - $45, video visits run between $74 - $95; Amazon is trying to surface different prices for different patients. Interesting quote: “If you want the lower cost provider, you can choose that. If you are actually prioritizing the speed at which someone is getting back to you, you can prioritize that as well,” Nworah Ayogu, chief medical officer and general manager of Amazon Clinic tells Forbes. “We think really being able to surface different options for different customers lets them choose what's important to them.”
- HealthTap was originally on the platform but no longer is apparently because Wheel was actually providing HealthTap's clinical services (Wheel is on the platform). That seems like some complex relationship dynamics to figure out between those parties (Amazon / HealthTap / Wheel)
- There's a lot of discussion about the various startups included in Amazon Clinic today (Hello Alpha, SteadyMD, Wheel, Curai Health), but almost no discussion about One Medical and how / if One Medical is ever a part of this offering. Just this one quote on it: He also wouldn’t say whether there would eventually be integrations with One Medical. “I think there are a lot of interesting ways in which we could collaborate in the future. But it'll really be driven by what we think will serve customers' needs most effectively.”
– Kevin O'Leary | via #news
Thread Summary: A helpful thread digging into a recent Forbes article on Amazon Clinic's plan around ala carte pricing - with a handful of HTNers hypothesizing what we can expect to see from the tech giant in the years to come.
Chris Turitzin: There are parts of healthcare that are commodities and it looks like that's what Amazon Clinic is serving with their initial offering. Will be interesting to see if it expands into less commodity services where the longitudinal relationship matters more.
Looking though at their current offering, it’s very interesting to see the trends so far. I did a quick analysis of their services page. They share the services, the number of reviews, and avg review, so we can see some trends from that.
Their most popular services are UTI, Pink Eye, and ED. These seem like similar services that have been available on other transactional telemed services over the last 5 years. Google Trends shows a similar popularity pattern.
Chris Turitzin: There isn’t much pattern to the avg review for the services. High and low ratings appear mainly there because of low number of reviews, so greater chance for variation.
Chris Turitzin: So how many people have used Amazon Clinic so far? This will be a wild estimate, but if you estimate the % of people who leave a rating for the service at 10% (which appears to be similar to review rates for other Amazon products), then you can extrapolate the number of people who have used each service so far. It comes out to a total of 108,190 people. Given this is a guess on 10% review rate (and repeat usage should be factored), probably better to give a range of 50k - 200k people have used Amazon Clinic so far. Will be interesting to see how this evolves!
Here we highlight a question from the Slack that needs some additional community insights - if you have a helpful thought, jump in below!
Q: Are LTC/home health EHRs (e.g., PointClickCare/MatrixCare) not subject to (g)(10) FHIR API requirements? PCC's in CHPL, but it's not (g)(10) certified / its certification hasn't been updated since 2019. MatrixCare appears to be absent.
– Samir Unni | via #buildersask
🤖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!
What are key regulatory changes to monitor in 2023?
Knowledge Bot Answer:
Based on the conversations in the Health Tech Nerds Slack channel, there are several key regulatory changes to monitor in 2023. Here are some of the notable ones:
1. Medicare Remote Therapeutic Monitoring (RTM): The Centers for Medicare and Medicaid Services (CMS) has implemented new regulations for remote therapeutic monitoring in 2023. You can find more information on this topic in the article Medicare Remote Therapeutic Monitoring FAQs 2023.
2. Prior Authorization Rule: The Prior Authorization rule is expected to be finalized in 2023. This rule aims to streamline the prior authorization process for healthcare services. You can refer to the conversation here for more details.
3. MA Equity-related Quality Measures: There will be changes in Medicare Advantage (MA) equity-related quality measures in 2023. This is part of the ongoing efforts to improve the quality of care provided by MA plans. The conversation here provides additional insights.
4. Price Transparency: Price transparency initiatives are expected to have knock-on effects, leading to changes in the fee-for-service (FFS) market pricing and Medical Loss Ratio (MLR). This may also result in a reduction in claims adjudication services and Pharmacy Benefit Manager (PBM) services. You can find more information in the conversation here.
5. LIS Expansion and OOP Cap Reduction: In preparation for 2024, there will be an expansion of the Low-Income Subsidy (LIS) program and efforts to reduce the out-of-pocket (OOP) cap in 2025. This is aimed at providing more affordable healthcare options for low-income individuals. The conversation here discusses this topic.
Please note that these are just a few examples of regulatory changes to monitor in 2023. It’s important to stay updated with the latest industry news and consult official sources for the most accurate and comprehensive information.
Here we highlight helpful resources from across the community:
- Payer strategies for GLP-1 medications for weight loss via Deana Bell - An whitepaper by the Milliman team looking at payer strategies for weight loss medications, providing a helpful care management framework for folks in the space.
- Censinet via Alec Fishburne - A RFP aggregator tool that helps health systems gather third party vendor/partner risk management responses.
- ACO 2022 Performance Explorer V0.0 by Manas Kaushik - A cool resource created by one HTNer to help folks track performance of various ACO models.
- 100 Largest Insurance Brokers of U.S. Business via Matt Hodes - A comprehensive list of the top insurance brokers by revenue in the US (page 28)