Digital health news update: How will HCAHPS score our new robot overlords?


  • The latest entrant in the fierce debate over what AI and automation will do to the professions argues that doctors and lawyers will be largely phased out. Writing in the Harvard Business Review, a pair of Oxford legal eagles forecasts “a fundamental shift in professional service,” saying that “Within professional organizations (firms, schools, hospitals), we are seeing a move away from tailored, unique solutions for each client or patient towards the standardization of service. Increasingly, doctors are using checklists, lawyers rely on precedents, and consultants work with methodologies. More recently, there has been a shift to systematization, the use of technology to automate and sometimes transform the way that professional work is done — from workflow systems through to AI-based problem-solving.”
  • On the other hand, a study looking at the accuracy of symptom checkers versus doctors found that diagnostic apps have a long way to go before they’re a match for physicians. Human doctors whomped the apps, with 84% accuracy on the first try, versus 51% for the 23 apps studied. On the other other hand, Watson has beat physicians handily at lung cancer diagnosis.
  • Here’s a new digital health acronym for you: SaMD, or Software as a Medical Device. It features in a new draft guidance from FDA that addresses the question of what clinical validation the agency will demand of manufacturers, and when. FDA has, in previous guidance, spelled out the scope of its planned regulation of digital health tools (wellness and lifestyle tools are broadly exempted). Now they’re trying to establish “globally harmonized principles of when and what type of clinical evaluation is appropriate based on the risk of the SaMD.”
  • Prospects for a medicalized Apple Watch got a bump last week as the wearable came out on top in a study of wrist-worn heart rate monitors published in JAMA Cardiology. The study looked at 4 heart rate monitors and one chest strap monitor. Apple’s entrant ran about even with the Mio Fuse for best among the wrist-worn options, with 91% accuracy to the Fitbit Charge HR’s 84% accuracy, while the chest strap outperformed them all with 99% accuracy. Apple is also exploring use cases including using the watch’s heart rate sensor for personal identification, gesture-based functionality and eldercare.
  • That eldercare project involves a partnership with IBM and a Japanese insurer. Enrollees will get an Apple Watch and an iPad preloaded with custom apps for patients, caregivers and HCPs. The watch will collect heart rate and movement data, while patients are prompted to answer wellness questions on the tablet. There’s a growing demand for digital tools that address this growing population.
  • Whoa, slow down, there, IBM! The computing behemoth has also formed a population health partnership with Siemens, a medical imaging giant, whereby the companies will seek to leverage their combined clout with hospitals. One bank projects that Watson, with current revenues estimated at $500 million, might bring in $17 billion by 2022. Two out of three Watson employees work on its healthcare book of business.
  • IBM employees diagnosed with cancer will soon have access to Watson for Oncology tools to help them identify appropriate treatments and clinical trials.
  • And Google’s Verily is jumping into the population health game through a partnership with 3M which aims to launch “a joint technology platform … designed to analyze quality performance data across healthcare delivery systems and patient population, and deliver meaningful information that can be used to promote real and systainable improvements in healthcare quality and cost.”
  • Meanwhile, automakers are looking at integrating heart rate monitoring into vehicles, along with virtual assistants and a host of other Internet of Things-connected services.
  • A pair of studies measuring the impact of coupons on prescription drug costs found that they increase spending – by $700m-$2.7b over five years, according to one – and that costs passed on to payers come back to patients in the form of higher premiums and deductibles. One study author called them “Wolves in sheep’s clothing” and recommended that states follow the lead of Massachusetts, which has banned the use of coupons for drugs with a generic equivalent.
  • MACRA, a sweeping and highly-controversial overhaul of how physicians are compensated under Medicare that stands to accelerate the move from volume to value, went into effect after years of bitter debate.
  • The Affordable Care Act’s individual insurance marketplace will offer no frills, no deductible “Simple Choice” plans next year. It’s a reflection, in part, of concerns that high-deductible plans are deterring enrollees from utilizing care, and a reflection of the unanticipated way enrollees have been buying policies so far – by price, for the most part, rather than coverage.
  • Researchers are matching Yelp reviews to HCAHPS patient satisfaction scores – and finding evidence that Medicare patients gravitate towards providers that deliver a better patient experience.
  • The White House says its Cancer Moonshot project needs more funding. Here are some of the things it’s working on: research into developing a liquid biopsy, a huge Pentagon longitudinal study into biomarkers, and particle beam radiotherapy, which would deliver targeted doses of radiation to the cancer site – and not to surrounding tissue.
  • Pfizer is leaving 42nd Street, though a “substantial majority” of NYC-based employees will remain in the city after they move out of their global headquarters in Midtown, which could happen as early as 2019.