Monthly Archives: March 2015

The Promise Of The Sharing Economy?

“It’s not clear, however, that the people who stand to benefit the most from the sharing economy in an economic model will actually gain those benefits in the real world. There’s not a lot of evidence right now that lower-income consumers are using these platforms in large numbers.

In fact, there’s some evidence of the opposite. Bikeshare systems are a great example of a cheap alternative to transit that could save low-income workers a lot of money. But many cities have struggled to lure low-income riders. Part of the barrier is logistical; you have to have a credit card and a smartphone to access many of these platforms today.

But another piece may be cultural. A lot of survey data suggests that lower-income people are less trusting of their neighbors or society in general than the upper-income. And trust is a key prerequisite in any marketplace where people lend and borrow possessions with strangers.

It’s also worth asking this awkward question: Will upper-income consumers still be as eager to share (or rent) their homes, cars and possessions when these marketplaces expand to include more low-income users? Does this kind of sharing work today, in other words, because most people aren’t sharing across socioeconomic lines?” – http://www.washingtonpost.com/blogs/wonkblog/wp/2015/03/16/the-real-promise-of-the-sharing-economy-is-what-it-could-do-for-the-poor

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Unnecessarily At Risk Now: Community Health Center Cuts Bad For Healthcare Costs

“(C)ommunity health centers stand to lose about 70% of their federal funding in October (2015). While discretionary funding would cover some of the centers’ costs, the report projected that a shortfall in funding could lead to:

  • 7.4 million patients losing access to care; and
  • 57,000 health care workers losing their jobs.

The centers in 2013 served about 23 million Medicaid beneficiaries and other low-income individuals. They are expected to serve about 28 million by the end of 2015.

…services provided by (community health) centers save the health care industry about $24 billion annually (Leonard, U.S. News & World Report, 3/17)…

community health centers produce savings through shorter hospital stays and fewer emergency department (ED) visits.

For example, Medicaid managed care beneficiaries who receive care from community health centers in California have:

Towards Designing Both Attractive and Accessible Wellness Programs

“(I)t is time to start rethinking workplace wellness, and come up with models that are both fairer and more effective.

Why do employees, and in particular those at high risk, choose not to participate? We do not yet have the evidence or insight to understand and convincingly answer that question. When we do, we will be able to design attractive and accessible programs.” – http://healthaffairs.org/blog/2015/03/18/when-it-comes-to-the-value-of-wellness-ask-about-fairness-not-just-about-effectiveness

New Housecalls: “Pager”ing In-Person Visits from Doctors “with” Telehealth “and” Mobile

“One of Pager’s founders, Oscar Salazar, was also on Uber’s founding team. The company currently operates only in New York, but has plans to expand out to other metropolitan areas. Doctors do an initial consult over the phone to determine what sorts of diagnostic and treatment tools they might need to bring, then show up at the patient’s house for the visit.

The service currently costs $49 for the first visit and $199 for each visit after that. If the condition turns out to be treatable over the phone, customers are only charged $25. Otherwise, the price is fixed, no matter what treatment the patient ends up needing. Users can get reimbursed for Pager as an out-of-network provider, and the company is working on becoming an in-network provider under some plans.

‘What Pager has done is they’ve created bags, basically, that would allow the doctor to do high-tech imaging or lab or evaluation of the patient right at the bedside,’ Chief Medical Officer Richard Boxer said at an mHealth Summit session last December. ‘It’s not your grandfather or you father’s house call. But the regulatory issues disappear. The main problem with connected health is there are regulatory agencies in different states which demand that you have a face-to-face evaluation. If you, in fact, deliver a doctor to a patient, you have eliminated all the regulatory issues.’

The VentureBeat report says the funding will be used to expand the company into new markets beyond New York City, to add new connected devices to the doctors’ toolbags, and, interestingly, integrating it’s existing systems with insurance companies.

‘Technology has advanced and evolved very, very quickly, but people haven’t evolved very much…And people still crave a face-to-face interaction with a doctor’ (said Dr. Boxer).” – http://mobihealthnews.com/41227/pager-gets-10-4m-to-take-its-house-call-app-out-of-new-york

Spanish-language Health Content Moving to the Locations of Care

“Hispanics represent 17 percent of the American population — yet close to half of those residents don’t visit a doctor or medical provider in a given year,” Raquel Egusquiza, vice president of community affairs for hispanic enterprises and content at NBCUniversal, said in a statement.

“With Prevenir Es Vivir (Prevention Is Life), Telemundo (the Spanish language television division of NBC Universal) is focused on leveraging their expansive reach and trusted influence to break language barriers and provide a broad resource for relevant health information to la comunidad.” – mobihealthnews.com/41185/telemundos-spanish-language-health-content-moves-to-the-point-of-care

The VA’s App Store — and More

“…Give an Hour, a nonprofit that connects veterans with free mental health sessions offered by volunteer professionals. The app uses telehealth to facilitate these sessions: it previously partnered with Google Helpouts, but as Helpouts phases out its service, owing to lack of adoption, Give an Hour is looking to video visits provider Doctor on Demand to power its services.

But the VA also gave the Washington Post some updates on its in-house mobile health projects, such as the VA’s family caregiver pilot, which has now been expanded into a full app store for veterans and their families. While the program originally included 10 apps, the store now boasts 17 health and wellness apps, although not all of those are actually mobile-enabled yet; some are still desktop apps.

The VA distributed more than 10,000 tablets to clinicians when the app store launched last year, and has seen 300,000 downloads of the apps since launch. In addition, nearly half of veterans undergoing prolonged exposure therapy for post-traumatic stress syndrome use the PE Coach app designed for that purpose.

Many of the VA apps that are currently released for mobile are care resources that don’t need to be connected to Veterans’ electronic health record. But the three mobile apps that the VA is set to launch later this year — Launchpad, Summary of Care, and Mobile Blue Button — will all allow users to access their records in the EHR. A fourth, an under-development app called MyVAHealth, will allow users to upload data into their health record, to be accessed by their doctors.

In addition to the app store, which the VA created with the help of a $9.3 million contract with Longview International Technology Solutions, a large part of the VA’s Connected Health initiative is telehealth. According to data released by the VA in October, 690,000 US veterans received care in the 2014 fiscal year via telehealth, with 2 million telehealth visits scheduled. That means that 12 percent of all veterans enrolled in VA programs received telehealth care of some kind in 2014.

Last fall, the VA made another announcement in the digital health space. The department said that they would soon begin reimbursing its doctors for certain clinical-grade activity trackers used for rehabilitating veterans with prosthetic limbs. The change the VA made is to introduce a new mandatory template for providers to use when negotiating contracts with the vendors that sell prosthetic limbs and custom orthotics for injured veterans.” – http://mobihealthnews.com/41202/va-app-store-has-17-health-apps-300000-downloads-so-far

Apple ResearchKit “versus” Google Baseline Study

Apple ResearchKit “versus” Google Baseline Study: “Not that the two initiatives are overly similar, but both their differences and the similarities that do exist are interesting. In many ways, the headline is just this: Apple and Google, two of the biggest consumer technology companies at the forefront of mobile technology, have both set their sights on tackling the world of medical research and clinical trials which, Apple rightly points out, is currently pretty outdated in its practices.

‘Up until now if someone wanted to do a research study they might put a bunch of flyers up and hope someone comes along and tears off the phone number,’ Mike O’Reilly, Apple’s Vice President of Medical Technology, said in a video at shown at Apple’s event. ‘Methods for conducting medical research haven’t really changed in decades.’

This isn’t news to anyone working in healthcare innovation, where the promise of innovating clinical trials has been hanging in the air for years. But right alongside it has always been the question:

What will it take for mobile-enabled trials to really take off?

Google and Apple are each approaching the problem of medical research more or less the way you would expect them to: Google is launching a single, large and expensive ‘moonshot’ research project, while Apple is creating a framework that could potentially facilitate any research project, and improve its efficiency and the quality of its data.

Both projects are rooted in one of the biggest promises of mobile health: that it’s now possible to collect data on individuals continuously, creating a much more complex and complete picture than if health data is only collected at regular intervals — like office visits. And the two projects have the potential to complement each other: Part of the value of Google’s baseline data will be in comparing the data from those healthy patients to data from patients who aren’t healthy, which is exactly what the five starting projects on ResearchKit are collecting.

Of course, Google is also collecting genetic data in the Baseline project, which is definitely not part of Apple’s current vision. And ResearchKit, as an open-source product, has the potential to be much more far-reaching than a single study from Google, however groundbreaking.” – http://mobihealthnews.com/41189/apple-and-googles-different-but-complementary-approaches-to-medical-research