healthcare tech reports notes

Some reading I did for getting up to speed on healthcare tech.

“Claims 2030: A talent strategy for the future of insurance claims”

Claims 2030: A talent strategy for the future of insurance claims

  • Using the old AI agent sidekick idea to take care of decision making. You still have a human face to walk you through stuff. Other roles are a person to sort out more complex things that a computer can’t do and the data scientists who monitor decision making and do new ML-stuff training.

“The productivity imperative for US life and annuities carriers,” McKinsey March, 2021

Productivity is imperative for US life and annuities carriers | McKinsey

  • Life insurance companies have been looking for growth for a long time.
  • Cost cutting is a big priority: “In a proprietary McKinsey survey conducted before the onset of the COVID-19 pandemic, senior life-insurance executives estimated the industry needed to reduce its costs by 35 percent in the medium term, far higher than the typical 10 to 15 percent reductions realized in most cost-cutting programs.”

“How insurers can act on the opportunity of digital ecosystems,” interview with Markus Warg, McKinsey

The opportunity of digital ecosystems for insurance | McKinsey

  • Insurance providers looking for new revenue streams, also new ways to optimize/save money, inc. lesser payouts.
  • This guy is all about engaging with the “ecosystem” or partners and other people to layer on new features to health insurance. HealthKit on the Apple Watch is an interesting aspect. Why don’t more insurers do that?
  • Offering new features to improve the business: “Take, for instance, health insurance. Health insurance’s value is in covering financial risks. However, this product can be enhanced substantially through further services related to telemedicine or health management—resulting in better prevention and reduced costs through more appropriate care settings. This benefits both the customer and the insurer. Similarly, innovations such as digital care assistants prove that traditionally lengthy processes can be completed via an app in just a few minutes. At the same time, such services help to create touchpoints with caregivers along the way.”
  • Some pushing to getting faster develop lifecycles.

“The Time For Strategic EHR Workflow Is Now,” Forrester, July 2019

  • Electronic Health Records (EHR) are not delivering on the promise of optimizing. Doctors don’t like them, they spend too much time in them. The UIs haven’t improved that much: ‘Providers now spend approximately 2 hours in
    the eHr for every hour spent engaged in patient-facing activities.4 in addition, providers report spending an added 1 to 2 hours of “pajama time” catching up on work each night after hours.’

2019 priorities:

FDA wants to regular off-label use of ML-driven devices

Obtaining FDA approval can be a difficult and long process. “The traditional paradigm of medical device regulation was not designed for adaptive AI or ML technologies, which have the potential to adapt and optimize device performance in real – time to continuously improve healthcare for patients,” the report said.

“The highly iterative, autonomous, and adaptive nature of these tools requires a new, total product lifecycle (TPLC) regulatory approach that facilitates a rapid cycle of product improvement and allows these devices to continually improve while providing effective safeguards.”

For example:

If a manufacturer decides that its device that studies retinal scans for diabetic retinopathy can also measure if a patient has high blood pressure or not, it’ll have to contact FDA officials to check if the device can be used for that purpose.

Meanwhile, we can’t even figure out how to figure out the ethics of AI.

This is probably a good space for that Talebian thinking that goes “start with what’s worked for thousands of years, and probably don’t stop.”

Source: Not so fast AI Doctor, the FDA would like to check how good you really are at healthcare

Link: DOJ approves $69B CVS-Aetna merger as healthcare industry restructures

CVS, which racked up about $185 billion in revenue last year, runs the country’s largest retail-pharmacy chain and provides prescription plans to more than 94 million customers. By joining forces with Aetna—the nation’s third-largest health-insurance provider with over 22 million medical members, earning $60 billion in revenue in 2017—CVS will have a tight grasp on the market. The combined enterprise aims to be a first-line health care hub with clinics in its ubiquitous brick-and-mortar stores.
Original source: DOJ approves $69B CVS-Aetna merger as healthcare industry restructures

Link: The Bezos-Buffett-Dimon health care venture: Eliminate the middlemen

“There’s ample room to replicate that success in health care, because the system in the U.S. has long been plagued by excessive transaction costs – the expenses incurred when buying or selling goods and services. These include irrational pricing, as evidenced by the price of services varying wildly for hospitals, insurers and patients. This, along with unnecessarily complicated billing systems, creates the need for extensive bureaucracies to manage all the varied relationships.”
Original source: The Bezos-Buffett-Dimon health care venture: Eliminate the middlemen

Link: Warren Buffett reveals more details about healthcare venture with JPMorgan and Amazon

“We have got a huge, competitive disadvantage in American businesses, far more important than any tax change, in terms of our healthcare costs.”
Original source: Warren Buffett reveals more details about healthcare venture with JPMorgan and Amazon

Link: Amazon, Berkshire Hathaway, JPMorgan form health care mega-company

‘There aren’t many, but the announcement says this new entity focuses on “technology solutions that will provide U.S. employees and their families with simplified, high-quality and transparent healthcare at a reasonable cost,” beginning with the companies’ own workers.’
Original source: Amazon, Berkshire Hathaway, JPMorgan form health care mega-company

China healthcare IT market to be $6.5bn by 2020

China’s overall healthcare IT solutions market reached a size of US$3.8 billion in 2015. Market size is expected to hit US$6.5 billion, with a CAGR of 11.1% in the 2015-2020 period.

That’s a lot of growth. See the full press release for some details on sub-markets.

Source: IDC: Healthcare Reform and 3rd Platform Technologies Drive Healthcare IT Solutions in China

Beyond manual entry

This is a fun point with a good enterprise-y use case on how much change is actually required to “go digital”:

A typical approach to digitalization in this scenario is to have a nurse carry an electronic tablet rather than a clipboard with papers, and use the tablet to enter data directly into the EHR system while conducting the rest of the process the same way as before. While “mobile-enabling” the process adds a few new benefits (more accurate data available more quickly), it does not present a fundamental change to the work. It still involves manual entry data and still takes a lot of time. Worse, Peter is still spending a significant time on activities that don’t involve providing direct care to his patients.

Instead, if caregivers like Peter and others work with a team of technical and management individuals with healthcare experience and skills, the hospital where he works could radically rethink the work and embrace even more digital technology. Such Internet of Things (IoT) technologies will vary according to the problem they need to solve, but in a hospital this could include smart beds, connected physiological monitors, and smart ventilators and IV pumps. By instrumenting the bed and a variety of other physical objects, vital patient information can now be transferred electronically directly into the EHR environment – no paper, no human data entry.

Otherwise, yeah, you’re just moving manual entry to tap entry. It might solve back-end problems of cleaning the data, cut that’s likely not enough.