Health 2.0: Exclusive Int...
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Health 2.0: Exclusive Int...
  • Amazing portraits from Gilles Frydman at Health 2.0

    Gilles Frydman is a legend  in the online patients’ world, but he has a lesser known side as an amazing photographer. He’ll be taking incredible portrait photos at Health 2.0, so if you want one (including printing at $500), please sign up here. What will you be getting? Something like this!

    Gilles Portrait

    Health 2.0: Exclusive Interview with James Madara, EVP and CEO of the American Medical Association

    Dr. James Madara, EVP & CEO of the American Medical Association (AMA), provides perspective on how digital health will be integrated into health care systems. Matthew Holt, Co-Chairman of Health 2.0, had an opportunity to personally chat with Dr. Madara and find out what the AMA is up to now!

    See AMA’s CEO and Executive Vice President James Madara at the 9th Annual Health 2.0 Fall Conference speaking about how to fix the clinical user experience. To attend the Health 2.0 conference, register here.

    Matthew Holt: James Madara is the CEO of the American Medical Association, which he’s been for about four years now. Before that Jim, you were head of the University of Chicago Medical School. So, you know what it’s like to run a large, complex, and probably dysfunctional organization, I suspect!

    Jim Madara: Well, they are very complex organizations and I have always been a complexity junky, so it satisfies me in both ways. But the AMA is really focused on the health of the nation and we began a long-term strategic plan about two-and-a-half years ago. The three elements of that plan, I would say, give insights on how we are thinking about technology in the future.

    Continue reading →

    Getting the Real Story: Valid Performance Measures 

    If you want the real story about whether a wellness program or health product worked, you want valid, accurate measures.  Getting the real story is the topic of our lively panel discussion at Health 2.0 hosted by the Validation Institute.  By adhering to principles of objectivity and stringent validation processes, the Validation Institute provides healthcare industry consumers with sound and valid information, allowing them to evaluate companies with confidence.

    Care Innovations Validation Institute logo

    I am a population health scientist with training in epidemiology, biostatistics, quality measures, and risk finance and I run Health Economy LLC.

    I will moderate a discussion that will evaluate  health and wellness interventions, apps, and medical devices and share how valid, science-based measurement can guide investors, customers, and insurers, as well as product managers.   This frank and informative discussion will cover what, why and how of measuring impact, as well how accurate measures affect the credibility of the health marketplace. 

    Though virtually everyone wants to buy or invest using accurate data, invalid and exaggerated measures are everywhere.  To determine if a product or service performs as it claims, do you have to try it to find out?  And if you do, are you properly measuring the true impact?   Does your competition exaggerate (invalidly state) their performance, to the detriment of your (validly) stated performance?

    Imagine a world where every company measured its results properly and reported them accurately.  All organizations involved in population health – from health plans to employers to vendors; and from start-ups to established companies – would adhere to the highest standards of validity.  You could decide based on integrity and performance rather than hyperbole.

    Find out more about getting the real story with valid measures, and how the real story can help you improve your product, attract investors, and serve your customers. Sign up today!

    Exclusive Interview: Vishnu Saxena, Diaspark Healthcare

    The head of Diaspark Healthcare, Vishnu Saxena, stopped by share the biggest challenges and opportunities for helping health care organizations achieve their journey toward interoperability with Health 2.0 co-founder Matthew Holt.

    Don’t miss Diaspark at the 9th Annual Health 2.0 Fall Conference. Purchase your tickets here!

    Don’t Miss the Health Data Exploration project at Health 2.0!

    The Health Data Exploration project, sponsored by the Robert Wood Johnson Foundation, is building a network of academic, public sector, and corporate partners working together to catalyze the use of personal health data to conduct research that benefits the public good.

    Individuals are tracking a variety of health-related data via a growing number of wearable devices and smartphone apps. More and more data relevant to health are also being captured passively as people communicate with one another on social networks, shop, work, or do any number of activities that leave “digital footprints.” Self-tracking data can provide better measures of everyday behavior and lifestyle and can fill in gaps in more traditional clinical or public health data collection, giving us a more complete picture of health.

    HDEThe HDE team works on a variety of projects that demonstrate the value of using personal data in research and create reusable templates, policies, and infrastructures for using new forms of data. Core research projects address cross-cutting issues relating to personal health data including exploring barriers to data sharing (including privacy and consent issues) and addressing methodological challenges that arise from these new forms of data.

    The HDE project has also funded a number of agile projects focused on questions related to personal health data and conducted by small, multidisciplinary teams of network members. These shorter-term projects offer the research Network an opportunity to make incremental investment to open new research opportunities, create open infrastructure and data sources for the research community, and help create new training opportunities for the field.  You will hear about the latest developments in both of these types of projects at our workshop.

    The HDE Network also hosting a series of webinars on topics related to personal health data research, including IRB and informed consent, research ethics, privacy, and N of 1 trials.

    To learn more about the HDE project please join us at Health 2.0 for an interactive dialogue on Monday, October 5, 9-11:30 AM, in Ballroom H. We would like to hear your ideas about how we can accelerate the development of new collaborative relationships between companies and researchers that will be critical if we are to realize the benefits of new opportunities such as the Precision Medicine Initiative or the NIH and the ongoing efforts in NIH’s Big Data to Knowledge program. You’ll hear insights from industry leaders about how their companies are collaborating with researchers and learn about opportunities for public-private sector partnerships — and why it’s good for business.

    Finally, join our network!  It’s free and will ensure you stay up-to-date on our projects, webinars, and new developments in personal health data.

    Join Us at the First-ever Sleep Technology Summit & Expo – It’s Time to “Disrupt” Sleep!

    sleep tech summit large

    Sleep is a vital measure of overall health and wellness, even more so than diet and fitness. As consumers increasingly look to technology to help improve their health, the ability to gain valuable insights into sleep has emerged as the next frontier in digital health.

    There is much at stake: A whopping 41 million Americans say they are dissatisfied with their sleep, which we know has far-reaching consequences for health. Research has proven that sleep has a significant impact on mood, concentration, memory, productivity and the ability to maintain a healthy weight.

    That’s why we’re thrilled to be working this year with Health 2.0 to produce the first-ever Sleep Technology Summit & Expo. We’ve invited the top sleep experts in the world to share the stage with technology innovators who are making dramatic changes in the way we think about sleep.

    The Sleep Technology Summit will explore the future of sleep technology, from the most promising business opportunities to how sleep technology can improve peak performance in the workplace. We’ll also unveil the results of a new consumer research study conducted jointly with the Consumer Electronics Association that will reveal new insights into consumer attitudes, awareness and purchase intentions related to sleep technology.  The full agenda is available here. We hope to see you there!

    Iron Yard Ventures presenting 9 companies at upcoming Health 2.0 Fall Conference!

    The Iron Yard Ventures, a nationally ranked startup accelerator and investment program located in South Carolina, launched their 5th cohort of companies funded in their Digital Health accelerator program. They will pull back the curtain on what they have been working on during the Health 2.0 Fall Conference. The companies will present on Tuesday, October 6th at 12pm in Ballroom F-G with lunch being provided.

    Key highlights:

    • The nine startups receive $20,000 investment, office space at The Iron Yard in Spartanburg, SC, mentorship from successful tech and healthcare leaders as well as perks including marketing, branding, legal work, accounting services, office space and demo days in South Carolina as well as Health 2.0 Conference in Silicon Valley.
    • The teams all moved to Iron Yard for 3 months of heads-down focus on building their product and companies as well as reaching their next big milestones.
    • Iron Yard Ventures has now made 58 investments into startup companies in the last 3 years, those companies have gone on to attract more than $70 Million in follow-on funding.
    • This year’s cohort comes to the Iron Yard from Atlanta, Chicago, Houston, Kansas City, San Francisco, New Jersey and Virginia.
    • Two of the companies in the cohort were founded by graduates of The Iron Yard Academy, the largest coding bootcamp in the US.
    • The Startups were joined by a Designer and Developer in Residence who also graduated from The Iron Yard Academy, as well as an Executive in Residence.
    • In 2014 Iron Yard was named a Top 6 program to launch a Healthcare startup in the United States
    • In 2015 Iron Yard was named an overall top 20 accelerator program in the United States by the annual MIT Seedrank Project.

    Screen Shot 2015-09-28 at 11.59.44 AM

    Here is a run down of the nine companies that will be presenting at Health 2.0:

    • ProAlert  (– Mobile app that helps First Responders save lives by saving time
    • Prenovate ( – Personalized food recommendation engine for chronic conditions
    • Play-it Health (– Software and Services for medication and behavioral adherence
    • Headsup Health (– Empowering patients with centralized health and fitness records
    • Intuneto (– Smart CRM for fitness facilities that monitors business performance
    • Hygeia Health (– Health Kiosk and point of care devices for remote patient care
    • Data Minded Solutions ( – Defining patient care
    • GlassChart ( – A platform for Smarter Healthcare

    ChartSpan ( – Chartspan helps doctors and patients engage with each other

    Interested in learning more about these companies or Iron Yard Ventures? For more information visit or contact

    Health 2.0: Exclusive Interview with Susannah Fox, CTO of HHS

    Susannah Fox, CTO of HHS, shares how she is fostering patient empowerment and engagement through technology. Matthew Holt, Co-Chairman of Health 2.0, had the opportunity to personally chat with Susannah and learn more about the democratization of healthcare!

    Don’t miss Susannah Fox at the 9th Annual Health 2.0 Fall Conference. Purchase your tickets here!

    Matthew Holt: Matthew Holt here, delighted to be on with a really wonderful amazing person in healthcare who is not only my friend but also the CTO of HHS, Susannah Fox.  Susannah, thanks so much for joining us.

    Susannah Fox: I am thrilled to be talking with you.

    Matthew Holt: Well, so those of you who don’t know — Susannah originally was a journalist at U.S. News and World Report and spent many, many years at Pew Research, and is basically leading the survey research understanding the patient experience — probably in healthcare as a whole but studying the patient experience with the use of technology.  She happens to be the first proper keynote speaker we ever had at a Health 2.0 conference back in 2008, attended Health 2.0 in many different places with us, and has been a great friend and colleague.

    And then she more recently spent about a year at the Robert Wood Johnson Foundation as an Entrepreneur in Residence.  And amazingly enough, RWJ and HHS today did a player swap in which Bryan Sivak who was the CTO of HHS went to Robert Wood Johnson and Susannah went to HHS as CTO.  So, Susannah, I hope I got that history about right.

    Susannah Fox: Yes indeed, yes.  What was fun about Bryan and I is that when I was being recruited for the CTO role, I didn’t tell anyone at RWJ, and then when I left they had been quietly thinking about Bryan for the role of Entrepreneur in residence anyway.

    Matthew Holt: Who gets the player to be named later?  And who is the player to be named later?  All right, so let’s talk a bit.  I want to capture a couple of things that we’re going to talk about.  Obviously, you’re going to be at this year’s Health 2.0.  We’re going to have a little chat and then you’re going to be sitting on our panel mostly about the patient experience and the impact of technology on patient experience and patient outcome, something like that, that’s very close to your heart.

    So why don’t we start off a bit on just a little bit about the work you’re doing at RWJ because some people don’t know exactly what you’re doing there and you’re doing some really interesting, deep research there.  So why don’t you say a little bit about your brief experience there?

    Susannah Fox: At the Robert Wood Johnson Foundation, I was the second entrepreneur in residence.  The first one was Thomas Goetz.  It’s a really interesting role because they want to bring in an outside perspective to the foundation.  What I decided to look at was how to encourage the foundation to open up more doors and windows to the outside world.  How might we listen more to the communities that we want to serve and therefore serve them better?

    The other initiative that I was working on while I was there was recognizing the importance and really the gift of failure that when there is a grant that’s made that doesn’t go very well, that can be as much of a positive learning in the end as a grant that goes really well.

    Entrepreneurs know this that if you try out a new project or a new product and customers say, “No, I won’t use that,” that’s actually a gift because you know what not to do.  And so, those are the sorts of principles that I was talking about with the foundation.

    Matthew Holt: Sounds good.  Speaking as a “forced entrepreneur,” I’m not sure I like that whole “failure is a gift notion.”  You come to the gift that you pay for, not the other way around.

    Susannah Fox: Well, that’s with trying small things and trying little experiments all the time so that you don’t get caught investing a huge amount of money on something that’s not yet tested.

    Matthew Holt: Yeah, I think that’s probably very true across foundations as a whole.  Many of them have been guilty enough for any malfeasance of starting long, long initiatives that in the end didn’t pay off much and not doing sort of that fail-fast experimentation at the start that you’re trying to encourage now and you’re actually trying to encourage at HHS.  That’s great.  Can you say a bit more about your patient experience?  You were doing at little bit of it at RWJ as well.

    Susannah Fox: Sure.  What I have been doing for the last 15 years, I started doing it while at the Pew Research Center and then continued it with the Robert Wood Johnson Foundation, was always staying as close as possible to the frontlines of healthcare. Tim O’Reilly has this great phrase that “If you want to see where the future is heading with anything but especially with technology, you need to follow the alpha geeks, the hackers.”  In healthcare, the alpha geeks are people living with rare disease and life-changing diagnoses.

    And so, what I tried to do is spend time in communities either in real life going to conferences or online in virtual communities, spending time with people who are living with rare conditions because they’re going to push the envelope in every direction in healthcare and in technology.  It’s really by following them that I get my best ideas and see where things are headed.  And that’s also what I’m bringing into HHS, the sense that we need to stay close to the customer, close to the end user.

    Matthew Holt: Wonderful.  So now you’re at HHS, let’s talk a bit about that.  First off, you’re the chief technology officer.  But strictly speaking, although you’re following someone who is a deepwater geek in Bryan Sivak who is a technologist who ran technology companies, you’re a sort of journalist/researcher with a deep interest in technology.  That probably implies something about what HHS is looking for in terms of its technology interaction.

    We started with Todd Park who was all about opening up data sources and Bryan Sivak who was about — and you can correct me if I’m wrong — building tools and relationships to use that data on top of those data sources and obviously following on Todd’s work.  That work I’m sure is continuing.  I know I’ve seen some great stuff at HHS in the technologies offices and you can talk a bit about who’s doing what there.  And great foundations have been laid for that.  And obviously, there is Health 2.0 and Health Data Initiative and a bunch of other areas and a bunch of other people as well obviously working on that and that’s continuing.  But give me a sense about your special interests and your special flavors that you’re going to bring to this.

    Susannah Fox: Well, I’ve always been interested in understanding how people are engaging with technology and engaging with healthcare.  That turned out to be a keyword also for the people who were interviewing me for this job.  When I kept saying, “Now, you understand that I’m more of an anthropologist than a technologist?” they would say, “Yes, yes.”  And I would say, “Okay, I’m really interested and even to the point of obsessed with patient empowerment and patient engagement.”  And they said, “Yes, exactly, thank you,” because they understand that technology these days is not necessarily about the code, it’s about culture.

    In bringing me in as the chief technology officer now, they’re acknowledging that what we really need to do is have a holistic view of how technology is affecting American healthcare. What’s great is that this really is a continuation of the work that Todd and Bryan did because part of being the chief technology officer, it’s really the chief innovation officer.  Bryan added the title also of “Entrepreneur in Residence” at HHS.  It’s bringing that sensibility of an outsider view into the secretary’s office so that our role here and the Idea Lab and as CTO is to look across the landscape and look a little bit into the future and help people here at HHS to anticipate the future better.  The best way to do that is to, again, follow the alpha geeks to make sure that you have the perspective of your customers which again is a core principle of being a great entrepreneur, to always be sure that you’re serving your customer.

    Matthew Holt: Can you say a little bit about the infrastructure you already have there and the kinds of projects that you’re actually working on now and what we can expect to see?

    Susannah Fox: Yeah. We divide the work of the Idea Lab into three areas.  The first is promoting internal innovation.  That is where we teach the entrepreneurial principles and design thinking to people who work here at HHS and across all the 11 operating divisions.  We do that in three ways.  We have an Ignite Accelerator program, that’s a three-month program that’s pretty competitive to get in.  Once people get in, they bring in a problem to be solved.

    Matthew Holt: Is that internal HHS stuff or is that anybody?

    Susannah Fox: Yeah. People apply who work at the CDC or the FDA.

    Matthew Holt: Somewhere across the organization.

    Susannah Fox: Somewhere all across the operating divisions.  They then come in for individual mentoring and training to try and solve a problem that they’ve encountered in their work.  What’s wonderful is that we also bring in advisors from the University of Maryland.  We give these folks who are working for the federal government the opportunity to think like an entrepreneur and to learn some of those skills.  We give them a little bit of money.  But the most important thing is that we give them some air cover so that they get permission from their supervisor to work on something new and to essentially try and create a minimum viable product that they then put in front of their customers.

    It’s very accelerated. Our demo day is actually going to be this Thursday where it’s kind of the graduating class of the current crop.  One of the projects has been so successful that it actually has already launched because they created something that their supervisor and colleagues were so in favor of that they said, “We’re not going to wait for your graduation from this program.  This is fantastic, we’re doing this.”

    The other thing that we do is we have a Ventures Fund where we seed projects that might not get noticed otherwise but we have a little fund that we try our hand in a little venture capital within HHS.  We also hold award ceremonies, the Innovates Awards.

    The second area that we look at is leveraging external innovation.  And this is wonderful.  We bring in external entrepreneurs and innovators into the federal government for short sprints, either one or two years, again, to tackle a specific problem.  If you’ve heard about the Presidential Innovation Fellows program at the White House, that actually is based on our entrepreneur in residence program.  It’s something that Todd started here and then brought with him when he became the White House CTO.  What that does is it first of all brings in outside skills that maybe people within government don’t have, and there are some really fantastic examples which I can talk about.  But what we also really want to do, part of the ulterior motive is to infect people with this idea that innovation can happen in the federal government.

    And so, half of our EIRs and IIRs have been asked to stay on and many of them do.  That’s a way for us to build the talent within the federal government to attract people who never really thought they would do federal service, like me.  They bring them in and show what great impact you can have working here.

    The third area that the Idea Lab looks at is building collaborative communities.  With that, the Health Data Initiative is the most well-established of those programs.  We’ve really created a community around open health data.  Not only a community, but a marketplace where there is so much interesting development going on around the data that the government releases about healthcare.

    We also have something called “Buyers Club” which is about something that I really honestly didn’t know anything about before I started here which is government acquisition.  But we really, really need to modernize it.

    Matthew Holt: “Buyers Club,” you said?

    Susannah Fox: “Buyers Club,” isn’t that a great name?

    Matthew Holt: It’s like the Dallas Buyers Club, yeah, illicit distribution of medication in HHS?  No, you’d better deny that part.

    Susannah Fox: One of the themes across all of these is that we need to have interdisciplinary teams.  That’s something that we promote across all the areas that we work on.  And it’s true for Buyers Club as well.  It’s something that you need to bring in, for example, a contracting officer as soon as you have an idea for a new government program because that person can help you design a contract that, for example, is agile instead of waterfall design understanding that anything having to do with digital or software these days, you need to have a different kind of acquisition of that kind of service. Now, what I’m really interested in is that all of these programs point towards democratizing and opening access to information data and tools.

    And you’ll notice, Matthew, but the thing that I’m currently obsessed with is the “Maker Movement.”  Do you know about the Maker Movement?

    Matthew Holt: Of course, yeah.  In fact, years ago, Health 2.0 had a booth at the Maker Faire.

    Susannah Fox: Really?

    Matthew Holt: It was really funny.  That Health 2.0 actually was like a whole pavilion, they (00:15:25) worked on this together.  It was on a county fair ground, and because they had to have the same vendors as any other fair in the county fair ground, immediately outside the Health 2.0 sign was the funnel cake, right there.

    For those of you listening who don’t know, the Maker Movement is the modern-day tinkerers, people who are building things with their hands and technology and the physical embodiments of technology.  So then you’ve got the got the backyard building rockets and building robots and building stuff.  There are applications all over the place.  It’s really quite fascinating.

    Susannah Fox: Yeah.  And it’s our answer to sort of the homebrew computing club.  What’s built in garages is now coming out for show and tell at Maker Fairs and other places.  I started picking up signals about this about five years ago in my fieldwork where I would be talking to people with diabetes or rare disease.  I would be asking them about access to information, access to data, and access to crowdsourcing techniques.  And they would say, “Yes, yes, I can tell you about that.  But let me show you what I made.  Let me show you this device that I had to create for my kid.”  Or, “I’m a caregiver for someone and this is the way that I had to create something to prevent, for example, my loved one who has dementia from flushing her adult diaper down the toilet.”

    You might remember that I talked about this onstage during the unmentionables panel one year.  This is something that I’m very, very interested in.  I think that the Maker Movement will have as significant an effect on health and healthcare as we’ve seen for data particularly as the costs of manufacturing go down and 3D printers and other technology start to become very, very common.  Just like cloud computing with the accelerants that got poured on the fire for big data, the lowering cost of manufacturing is the accelerant that’s going to get poured on the fire of what I’m calling the “inventing health” or “health maker ecosystem.”

    Matthew Holt: That’s very cool.  Actually, Indu and I were talking about this, how to describe what I was starting to call — I call it the democratization of diagnosis, it’s one thing, and then the sort of lowering and up streaming of treatment.  And then you’re talking now about all the other pieces that go around that including, like you said, flushing the adult diaper down the toilet, what kind of tools can prevent that and what can be built openly?  And this is happening obviously not just in health but in energy and in manufacturing, across the board.  But it’s fascinating.

    Susannah Fox: Yeah, absolutely.  And in joining the federal government, there actually is already an interest group of people who are interested in the Maker Movement.  There are people at, actually, FDA and NIH as well as USAID and the VA.  There are all kinds of people who are already interested in this in all sorts of sectors of healthcare.  So drawing that together and understanding what we in government can do to understand this ecosystem and to, frankly, get out of the way sometimes.  That sometimes is the best role for government.  To, again, open up doors and windows so that people can see in and so that we can learn from people who are really on the front lines of healthcare.

    Matthew Holt: Fabulous.  Okay.  Well, let me say thank you very much to my guest, Susannah Fox, CTO of HHS.  We’re looking forward to seeing Susannah onstage.  She’s on a panel, as she ought to be, on the patient experience, the new patient experience and outcomes which is coming on Monday afternoon.  We are on just after Chelsea Clinton.  Well, after Chelsea Clinton and Indu herself which is very, very impressive.

    And there is going to be a lot of great technology on that panel showing a lot of the things that may impact patient experience.  We’ll have a patient, Kym Martin who you know well, who has had more bouts of cancer than most people can imagine, and Sachin Jain who is now the CMIO down at CareMore.  But it’s going to be a great panel and I’m looking forward to chatting with you there and seeing you then.  So, Susan, I thank you so much for your time today.

    Susannah Fox: Thank you.

    Machine Based Learning – Part III of A Brave New Health Care

    This is a mini-series about technologies that are radically changing healthcare. In each part I preview how a technology came about, how it is being used and how it will evolve, illustrated by my conversations with some of the health care entrepreneurs bringing this technology to life.

    Part III – Machine Based Learning
    Guest: Gary Velasquez - CEO of Cogitativo

    In 1773 Charles Messier first described the famous Whirlpool Galaxy in a simple hand sketch. Centuries later, we can now see intricacies of the galaxy’s spiral arms studded with majestic blue purple and red with the Hubble Telescope.

    messier hubble

    What if we can dig deep into healthcare behaviors with the same granularity? What if a hospital can save millions in  spending by identifying one doctor’s behavior in using expensive instruments in an OR? Or if an insurance company can identify stage 4 cancer patients who are having trouble using their benefits? Even better yet, what if we can compare cost and quality variability for say, a Total Knee Replacement surgery?

    A group of highly talented individuals, predominantly Mathematics doctorates, are building a “Hubble Telescope for healthcare behaviors”.

    The idea is to collect datasets and feed it into a customized algorithm that can use real-time updates to learn patterns, predict gaps and recommend a more efficient healthcare. Pretty neat, huh?

     “I spent the last 30 years trying to come up with the perfect if/then statement for healthcare that would make things snap together. The epiphany I had 3 years ago was that healthcare is not a rules-based system, it’s all about the behaviors of everyone involved in care delivery.”

    Gary founded Cogitativo (co-hee-tee-tivo), to analyze healthcare as a set of behaviors rather than a set of rules. They use a mixture of domain expertise and machine based learning, to quantify healthcare behaviors and predict them in the future.

    Healthcare As a Set of Behaviors

    radarWhen the patient comes and presents with their symptoms, the physician has a specific intent for the care plan, or a signal. The problem is that clinical and administrative behavioral “noise”, takes this signal off course.

     “It all started with the idea of finding a signal in a bunch of noise, just like how they used the radar in WWII to differentiate between a flock of seagulls and German bombers.”

    Inspired by the guys behind DARPA’s signal processing, Gary found himself thinking how could we quantify the behaviors?  They took the administrative and clinical physician order systems (CPOE), linked it to EMRs, and link that to coding and billing.

     “I can then tell you exactly what is going on, and almost every time there is a human involved, there is a variability linked to behavior.” Gary explained “ So I can tell you exactly what’s happening, what’s causing that variability, who did it and why they did it.”

    During a study Gary’s team was doing for a big hospital in California, they went into one OR room and talked to the surgeon. They realized that this OR was set up differently than all the others. 

    “The doctor had to use his tools differently, and that cost the hospital around several million dollars in reimbursement.” Gary recounted.


    The Surprising & Ridiculous Variability of Healthcare

    One of the biggest problems in US healthcare is the lack of transparency and the ability of large research hospitals to mark up their prices several folds of what services cost.

     “Feeding systems with data, can eventually make these discrepancies visible and allow people to identify what is going on.” Gary explained.


    Let’s say I hurt my knee tomorrow, get arthroscopic surgery and I’m billed 20,000 bucks. I would assume that the price change across hospitals would be a normal distribution graph, looking like the Seattle space needle. I would also think that the price varies with quality of care, just like any other industry. In reality, neither is true.

    mountainsWhen you look at the data, it can be tri-modal or quad-modal looking like the tip tops of a bunch of mountains. There is nothing normal about this distribution. The same could probably be said about the quality of care.

    Accountable Care, you said?:

    Though 1.2 Million newly insured people now have access to care, there is confusion and a lack of guidance on how to use these new benefits. Gary thinks evolving and self-learning data systems can help identify those who need help.

     “What Obama did was take the healthcare snow globe, which everyone understood as static, and he shook it up.” Gary said, as he spun an imaginary sphere in the air. “The more insights we can give to the stakeholders that can bring these closer, the better off Americans will be. It’s not good having them seek care without guidance.”

    The Cogitativo team identified 10,000 newly insured patients with stage IV cancer that are going around California, with no clue about how or where to receive the care they just got access to!

     “Why would a prostate cancer patient, living in LA who go to MD Anderson or Cleveland Clinic rather than UCLA or USC?!  I mean, they’re lost! They don’t have someone guiding them to the delivery system.” Gary exclaimed as he jumped to the edge of his seat.

    The things is, it isn’t the payer’s fault either. With an unprecedented 60,000 new members through Covered California, there was an inevitable large amount of variability. Things have to be done in a different way, but the whole system is still figuring it out.

    The good news is that there are ways to apply predictive engines to decrease just that.

    Where do we go from here?

    It's been "big" for a while

    It’s been “big” for a while

    The overused and abused term “Big Data” is nothing novel in the field of Healthcare. The data itself has been pretty big for at least 30-40 years, but there was no affordable way of extracting it from feet-long papers and disc drives with platters.

    Now the technology isn’t just here, but it is also cheaper than ever before. These powerful predictive data-driven machines can be the link between our healthcare behaviors and how we use our other technologies to change them.

    We would have the luxury of asking ourselves: What are the technologies we can bring to this group of people? Can we use Telemedicine or Home-Based care? These are all avenues we can explore after identifying the problem and need by machine-based learning.

    After that turning point in Gary’s career he went back to the executives he worked with over 30 years and explained the existence of a Hubble Telescope for health care behaviors.

     “You have a moral imperative” he told them,  “You can’t come out like the CEO of GM and say I couldn’t know. The capability of knowing…is here.”

    “So the questions I pose to you is, what are you going to do about it?”


    Other articles in series:

    Part I – Telemedicine with FirstDerm

    Part II – Bioprinting with Biobots

    Omar Shaker completed medical school in Egypt, followed by internships in the US. He soon left primary care for the world of digital health, moving to San Francisco to work on his own projects. These posts represent his reflections on a series of interviews he conducted with some of the more exciting entrepreneurs working in digital health today. Omar can be reached at


    Health 2.0 announces Launch! and Traction Finalists

    Big news for the Health 2.0′s upcoming 9th Annual Fall Conference!


    Our annual Launch! competition is on the last day of the conference, Wednesday, October 7th. Ten digital health companies will demo their products for the first time. The audience votes for their favorites. Previous Launch! winners have included Castlight Health, Basis, and OM*Signal. This year’s finalists:

    • Bloom Technologies will debut their discrete, wireless wearable for expecting mothers to track contractions and other changes to improve maternal and neonatal outcomes.
    • Flow Health connects consumers, providers and payers around shared patient data including Patient Check-In, an iPad app replacing the standard medical clipboard.
    • Sensentia is a fully-automated inquiry using natural language processing and more to empower patients to make better health care decisions.
    • PeerWell matches and connects teams of peers working together on evidence based health interventions spanning a variety of areas including mental health, diabetes, CHF, and other cardiometabolic conditions.
    • Nurx is an easy and fast way to obtain oral contraceptives, including prescriptions and drug delivery directly from a mobile app.
    • MedWand  is a revolutionary telemedicine device that allows providers to remotely perform physical examinations via a secure Internet connection.
    • is a portal for physicians to create rich educational modules and share them with their patients.
    • Vivor helps patients seek financial assistance through a matchmaking platform facilitated by a financial advisor.
    • Gliimpse collects and organizes a patient’s entire health history, across vendors, health systems, and more, to create a streamlined health profile.
    • uncleCare is a streamlined experience for patients treated with anticoagulant therapy to easily transmit data to a clinic and receive medication dosage updates, lifestyle reminders and more.


    Health 2.0 is looking for the most promising health tech companies to present their business plan and face off to win the title of Startup Champion! Traction, kicking off the conference on Monday, October 5th, returns for a second year featuring companies who are ready to raise a Series A round of $2-$15M. Our selected group of mentors will advise the companies’ pitches. Judges decide which company can scale the most quickly. See ten of the most promising startups compete for funding in front of leading venture capitalists including GE Ventures, DRX Capital, New Atlantic Ventures, Mohr Davidow Ventures, and many more.

    Professional Services Track

    • Redox Engine is an integration platform that allows software to easily and securely interoperate with EHRs, allowing health systems to integrate with cloud-based vendors.
    • QueueDr is a platform allows providers to automatically fill their cancelled appointments with their ideal patients, increasing revenue and patient satisfaction.
    • PatientPop has developed the first Practice Growth Platform for healthcare providers – an all-in-one marketing solution for patient acquisition, retention, reputation management and business insights.
    • Admetsys has developed a novel artificial pancreas for hospital and surgical care that improves health outcomes and health economics through high-tech automation.
    • Medtep unifies passive and active data and presents it to the patient and healthcare professional in a meaningful way by helping to upgrade prevention and monitoring care processes.

    Consumer Solutions Track

    • Vericred brings transparency to provider networks enabling individuals, businesses and insurance brokers to identify and compare health insurance plans based on costs, benefits and provider network fit.
    • SilverCloud is an online mental health & wellness delivery platform – improving outcomes, extending care, lowering costs.
    • CirrusMD develops “continuous loop” virtual care solutions for value-based healthcare organizations, providing virtual access to integrated care.
    • Noona Healthcare is a mobile service that provides cancer centers with a holistic, real-time view of their patients’ wellbeing.
    • Ayogo’s Empower™  is a chronic illness management tool that helps motivate patients to adopt a self-management program that includes medication and lifestyle.

    Join an audience of over 2,200 professionals, innovators, venture capitalists, and thought-leaders who are driving the digital health revolution at Health 2.0’s 9th Annual Fall Conference in Santa Clara, CA on October 4-7. With over 200 LIVE product demos, over 100 thought leaders and 10 new company launches, Health 2.0 annually convenes the leading conference linking health care with new digital technologies.

    Learn more about the agenda here and visit the registration website to attend.

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