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Initial Insights from HLTH

With $5 million in VC funding, more than 3000 attendees, and 600 CEOs / Founders, the HLTH team threw quite a conference in Vegas’ Aria convention center.

Here are my initial thoughts, news and new ventures on the 5 most salient topics from the weekend.

1. Removing Care Friction

In order to reduce ballooning costs in healthcare, patients need to be aware of and easily access their care. One of the macro-topics at HLTH surrounded reducing barriers for care delivery. Here are some of the ways that manifested

  • Getting to Care: Getting patients to make their appointments is obviously a fairly critical step in their care. Some estimates put missed visits at around 6-8%, and conditions can worsen (and costs increase) due to inability to see a care provider. Lyft and startup Circulation Health both discussed takes on bringing people to hospitals, clinics and more for care.

  • Care Coming to You: The head of Uber's health strategy discussed how Uber had been delivering flu vaccinations directly to the door.

  • Care Around the Block: Healthcare is local, and many companies focussed on how to better utilize local programs to better serve patients. CityBlock, a new startup rolled out of Google, is building out healthcare services focussed on the community and easy-access. Furthermore, Troy Brennan, CVS' Chief Medical Officer discussed CVS' visions of building out their MinuteClinics to handle a whole new suite of services.

2. Pushing the Boundaries of the Bedroom

Telemedicine and home-care services are huge targets for healthcare, but now they're accelerating in adoption and functionality

(Verily's CTO, Brian Otis, speaking on a panel at HLTH)

  • Doctors a Click Away: Doctor on Demand offers click-of-a-button access to doctors, 24/7, and is expanding access to mental health services remotely, something that's become of a focus of other startups including Joyable, Lyra Health, and Feel.

  • ER Visits Over the Phone: Startup Call9 is working to reduce ER Visits by up to 80% in nursing homes by combining telemedicine with a remote physician with local Call9-trained first responders.

  • Recovery in Your Own bed: Travis Messina, CEO of Contessa Health, a startup focussed on recovery care in patients' homes, spoke on changing post-procedure care. He argued that in 1980 only 12% of surgeries occurred in outpatient while today it's 66%. He believes 40% of hospitalizations will be treated in home in the near future.

  • Research Anywhere: Verily's Brian Otis joined the main stage at HLTH and (amongst many amazing projects) described Verily's Study Watch, a wearable designed to allow non-intrusive biometrics scanning. The watch's sensors can collect electrocardiogram (ECG), heart rate, and movement data to facilitate research everywhere.

3. De-Fragmenting Care

With a focus on reducing costs and improving care, reducing fragmentation of care seemed to be on everyone's minds (and almost an unproven assumption).

  • Vertical Integration: So, obviously one of the biggest strategies to wrestle in care fragmentation has just been provider integration. This has been seen from the CVS + Aetna deal to employers like Apple, rumored to have ended a contract with their on-campus clinics to create their own and experiment with new point-of-care health solutions.

  • The Big New Beast: There seemed to be one question that was constant on nearly every panel: 'What do you think of Amazon + Berkshire + JP Morgan deal?'. First of all, that organization needs an actual name and it needs one STAT. Second of all, no one seems to know what's going on: there's even uncertainty concerning whether it will be non- or for-profit from talks at HLTH. (From their release, the organization seems to be a for-profit but with no expectations of profits in the near term). Hope the furor cools down a bit until there's more information.

  • Down with Data Silos: It seemed like the general assumption of players in healthcare now is data interoperability. While in previous years this may have been the target of new ventures, it's not a requirement. With Apple's move to launch a PHR, to lots of talk about FHIR adoption, all health companies in the 21st Century will NEED to operate on with data interoperability as a requirement. However, while data interoperability was the general assumption, progress here still seems to move at a snail's pace.

4. Genomics

A major key in the future of diagnostics and drug discovery is in our chromosomes. Genetic testing and genetic solutions are racing closer to widespread clinical applicability, with lots of strong views on how that may happen.

23aneMe's Anne Wojcicki

(23andMe's CEO, Anne Wojcicki, Speaking at HLTH)

  • Decreasing Cost: Vinod Khosla lead one of the first general sessions at HLTH and made the bold (and rather Khosla-ian) statement that the most expensive part of genome sequencing will soon be FedEx.

  • Increasing Uptake: Geisinger, one of Pennsylvania's largest health systems will soon begin preventatively genetic testing many of their patients for free, according to David Feinberg, M.D., Geisinger's President and CEO at HLTH. While currently only around 3.5% of tests result in an actionable variant, many argue this number will increase to 10-15% in the near future (AND that data can be retroactively analyzed with new results).

  • Generating Insights: At a HLTH General Session interview, Anne Wojcicki, Founder and CEO of direct-to-consumer genetic testing company 23andMe responded to a question about pharmaceuticals and drug development by saying 23andMe was 'already a drug company', and that they were trying to do the hard work of analysis to sell off insights to pharmaceuticals. She said that more than 80% of their 2 million customers have volunteered their data for research (Anne also mentioned it's easy to remove your data, as fear of the power of genetics data was kindled by the recent Golden State Killer case with an uninvolved genetics company).

5. Supplementing (the Dwindling Numbers of) Physicians

As the number of aging patients increases, the number of doctors (and nurses!) that treat them just cannot keep up. Figuring out how to best use physicians' time is a huge new challenge that was a topic of interest at HLTH.

(AthenaHealth CEO, Jonathan Bush, speaking at HLTH)

  • Chats as Bedrock of Care: As doctors and care coordinators get busier (hard to imagine), new ventures are trying to figure out how to best optimize their time. One company at HLTH, Conversa aims to use their AI backend to scale care coordinators conversations by using automated conversations for post-procedure recovery and other treatments AND to collect data to feed back into the patient record.

  • Optimizing Levels of Care: Another AI-powered startup at HLTH, Buoy, also aims to use conversations with patients to improve the patient experience. Their system asks patients a series of questions, using machine learning and medical literature to assess their condition and route them to the appropriate level of care, reducing unneeded ER and even urgent-care visits.

  • Staffing Care Shortages: Another startup at HLTH, Nomad, focussed on easing the clinician crunch for clinics by building out a platform to replace third-party recruiters. They've had 40,000 clinicians sign up and, by charging a $10,000 placement fee, aim to speed up placement and start to solve the more than 1.2 million expected nursing openings in 2022.

  • Breaking Down Burnout: AthenaHealth co-founder and CEO, Jonathan Bush, joined two panels at HLTH to talk about physician burnout. His goal is to break down the EHR into super easy microservices for physicians, basically creating an API for other physician-serving app to build onto, making an ecosystem play for AthenaHealth. (Notably, Bush did not comment on the $7 billion all-cash takeover offer by Elliot Management which was announced the same day.)

Up Next:

A series of interviews with startup founders at HLTH: Check out the interview with Grand Rounds' Owen Tripp

(HLTH Images from HLTH website, CVS image from CVS release, Uber image from CityLab)