Breaking Health

At the Digital Healthcare Innovation Summit WEST 2024, leaders of the AI technology industry discussed the tangible progress that’s been made, identified which tools are useful (and not so useful), and charted the realities—and sensationalism—around how generative AI will reshape the future of health systems, care delivery, and personalized treatments. They also shared their thoughts on new challenges that have arisen, such as what characteristics are associated with organizations that can make it in this new age, regulatory framework, liability cases that have occurred since AI’s deployment, and more. 
 
Links from this episode:  

DHIS West 2024
PANEL DISCUSSION: Generative AI in Healthcare: Hype or Hope 

When is the best time to make an investment? In the healthcare industry, this can be tricky to determine. In this episode of Breaking Health, host Steve Krupa speaks with Andrew Adams, Co-Founder and Managing Partner at Oak HC/FT, about organizing capital into the right companies, where the healthcare industry is going in terms of deployment of technology, and the state of the market today. With a broad and impressive portfolio, Adams provides valuable insight and techniques on finding the right opportunities to invest, as well as value-based hotspots and new ventures that Oak HC/FT is conducting.   

Links from this episode:  
HealthEdge 
Oak HC/FT 

When patients receive prescriptions, many find themselves at a loss over the lack of information on the medications’ clinical uses, costs, and more. In this episode of Breaking Health, host Steve Krupa speaks with Kyle Kiser, CEO of Arrive Health, about giving patients the ability to access information on medications to help them make better healthcare decisions. Kiser also delves into what real time benefits are, the company mantra “Lucy up,” and how Arrive Health calculates and provides valuable data to their customers, such as general savings. He also talks about his journey from being a healthcare insurance wholesaler to starting Arrive Health, as well as tips for aspiring entrepreneurs on patience and perseverance.

Links from this episode:  
HealthEdge
Arrive Health 

From sports goods salesman and stand-up comedian to co-founder and CEO of a software company, Chris Severn is helping patients by providing price transparency in healthcare through an easy-to-use platform. In this episode of Breaking Health, host Steve Krupa speaks with Severn about how he got the idea for a service that provided patients with upfront quotes, the value of such price transparency, and how to compare plans to help patients discern the best rates. Severn also shares his perspectives on new laws’ impact on the healthcare industry and the potential future of a competitive market for medical procedures. 

Links from this episode:  
HealthEdge
Turquoise Health 

For the past few years, digital health has made great strides in providing new ways of healthcare access for patients. But this also means new challenges and obstacles have emerged. This year, at the Digital Healthcare Innovation Summit, leaders in women’s health talked about how they and their companies are finding ways to help patients access healthcare more easily, as well as the creation of sustainable business models, understanding the market, and how to measure success. They also share their own experiences of working with patients and what inspired them to find new ways to help the underprivileged. Finally, they address generational needs and differences and discuss their hopes for the future of women’s health. 

Links from this episode:  
HealthEdge  

Kamal Jethwani began his medical training in India and soon found himself more intrigued by solving of the administrative issues around care delivery. This interest came to a head when he found himself on the front lines of crisis response when his 10-bed emergency department received—and treated—1,700 patients in 72 hours. Afterward, Jethwani realized that there was a whole field of medicine focused on the design of care delivery, he told Breaking Health host Steve Krupa. He knew he had found his focus. After coming to Harvard to earn a master's in public health and finish his medical training, Jethwani worked closely with digital health tools to improve care for patients. He launched Decimal.health during the pandemic to solve the administrative issues around connecting both patients and providers to evidence-based, valid, repeatable, reliable digital health tools. 

Links from this episode:  
HealthEdge 
Decimal.health 

Vijay Kedar, co-founder and CEO of Tomorrow Health, was raised in a family of physicians, often joking that he was “pre-med coming out of the womb.” However, it wasn’t until he took on managing his mother's care through stage III colorectal cancer and acute respiratory distress syndrome that the idea for Tomorrow Health was born. In this episode, Kedar speaks with host Steve Krupa about using technology to coordinate high-quality home-based care for patients and families who find securing such care increasingly difficult to navigate. 

Kedar also discusses how home-based care improves health outcomes, alleviates the administrative and healthcare burden for providers, and is often the most economical option for patients requiring long-term treatment. He says, “Treating a patient with the same conditions at home can be one-tenth the cost of doing so in a hospital-based setting and one-third the cost of doing so in a post-acute setting like a skilled nursing facility.” Kedar goes on to outline how Tomorrow Health’s launch during the pandemic essentially changed how home-based care was ordered, delivered, and purchased to meet an ever-growing demand. 

 Links from this episode:  
HealthEdge 
Tomorrow Health
Vijay Kedar’s direct email 

AJ Loiacono’s experience in supply chain consulting for pharmaceutical manufacturing afforded him a world-class education in supply chain logistics, drug pricing, and software implementation. However, it wasn’t until he worked with healthcare payers that he realized the glaring problems in the U.S. drug pricing system and that pharmacy benefit managers retained much of the control and profit. He says, “The reason why our drug pricing is the way it is today… is because no one has either had the resource, bravery, or perseverance to stand up and say, ‘This is what’s wrong, and we’re going to fix it instead of profiting off of the system.’” 

Looking to disrupt the status quo, Loiacono founded Capital Rx. As one of the fastest growing healthtech companies in America, Capital Rx reconstructs prescription pricing and puts savings back in the patient’s hands. Loiacono speaks with host Steve Krupa about his desire to simplify drug pricing and increase transparency, how Capital Rx’s novel cloud-native enterprise pharmacy platform, JUDI, reduces labor costs by up to 80%, how they maintain a 99.5% retention rate with their clients, and why their books have demonstrated a negative drug trend for the past three years. 

Links from this episode:  
HealthEdge 
Capital Rx
JUDI Enterprise Pharmacy Platform 
Capital Rx Facebook 

Dr. Schneider’s interest in medicine began when she was diagnosed with type 1 diabetes as a preteen living in a small rural Minnesota town. After becoming a physician, her journey to CEO started with a return to her roots and a desire to help decrease the exorbitantly high mortality rates observed in rural communities across the nation.  

In this episode, host Steve Krupa speaks with Dr. Jenny Schneider, CEO of Homeward Health, about the company’s recent launch, how it leverages technology to scale healthcare for underserved patients, and the mobile clinic that builds trust with rural communities and increases access to care. Schneider says, “The good and bad news about healthcare is that it’s so highly inefficient that there’s a lot that can be improved… Our ability to engage and allow people to interact with the healthcare system allows them to improve their health and ultimately costs less money.” 

 Links from this episode:  
HealthEdge 
Homeward Health 

From working nights in the Prudential mailroom during college to securing leadership roles at big names like IBM Watson Health, Allscripts, and Pfizer, Steve Tolle, now general partner at HLM Venture Partners, has seen it all. With a multi-faceted skill set and a wealth of knowledge in technology and healthcare, he eventually transitioned from an operator to an investor at one of the nation’s oldest and most established healthcare venture capital firms. Given his background, it is no surprise that Tolle knows a thing or two about the growing needs of the healthcare industry and how to spot a winning investment. 

In this episode, Tolle speaks with Breaking Health host Steve Krupa about HLM’s focus on behavioral health, member engagement, access to care, value-based care enablement, and tech-enabled services. He also talks about the six-point test every company must pass before he considers investing and what each founder should know to win over investors in under five minutes. 

Links from this episode:  
HLM Venture Partners 
HealthEdge Software 

Healthcare’s most vulnerable patients meet a fragmented system when they seek to simultaneously address chronic comorbidities, behavioral health challenges, and social needs (i.e., navigating access to food, transportation, and housing). In response, ConcertoCare employs a multidisciplinary team and offers an integrated approach to clinical care, behavioral health, and social services. The organization takes its name from a musical composition involving a soloist and an orchestra. With ConcertoCare, the patient (soloist) and interdisciplinary team (orchestra) work in tandem to meet the patient's needs beyond clinical care. Chairman and CEO Julian Harris, MD, MBA, talks with Breaking Health host Steve Krupa about the company’s clinical model, delivering exceptional care backed by technology and data, developing a brick-and-mortar health center, and its role in helping senior patients receive in-home care for as long as possible. 

Links from this episode:  
ConcertoCare 

Payers and providers spend unnecessary time and energy approving medical and diagnostic procedures. CEO and Co-Founder Siva Namasivayam, believing that the digital health market has yet to leverage the full power of technology, launched Cohere Health in 2019 to transform utilization management into proper care management. Cohere Health employs individual and cohort medical data, records, and proprietary algorithms to generate approvals for nearly 90% of authorization requests. Evidence suggests that Siva and his team will soon realize their goal of a 96% approval rate. With more automatic approvals, providers can focus on what matters most while patients receive timely and appropriate care. Additionally, payers experience up to 15% savings when Cohere Health suggests cost-effective yet high-quality alternative treatment options. Siva and his team serve over 5.5 million members and approximately 100,000 physician offices today. 

 When Bill Taranto pitched the Global Health Innovation (GHI) Fund, he envisioned an independent venture that mimicked a private firm but maintained the backing and power of a big health company. The Fund's partnership with Merck allows them to make groundbreaking investments in the digital health space. Following what is often known as "ecosystem investing," the GHI Fund matches two or more companies, each solving a portion of a healthcare problem, to solve the issue effectively and thoroughly. In addition, GHI maintains a strong focus on the future of healthcare, including patient identification and aggregation as well as data security, integration, analytics, and informatics. Boasting a success rate of over 95%, Bill talks about GHI's mission to scale companies using an integrated approach, data science, and revolutionary technology.

Links from this episode: 
GHI Fund 

After several deployments in the Middle East as a US Air Force Pilot, Unite Us CEO Dan Brillman served as a trusted confidant and aid to fellow veterans looking to secure housing, employment, sustenance, and healthcare. However, he became increasingly frustrated with the fragmented and ineffective system most veterans navigate to secure social services and health resources. As a result, Brillman co-founded Unite Us, a leading innovator among digital health companies designed to build a bridge between healthcare, food, housing, and various other non-profit services. With over 7,000 organizations across 44 states, Unite Us aims to serve every American in need. With Breaking Health host Steve Krupa, Brillman talks about the ecosystem used to supply coordinated care and hold service payers and providers accountable. 

Links from this episode: 
Unite Us 

While the pandemic may have dramatically advanced our virtual care ambitions, even pre-pandemic many people noted that care outside of the hospital resulted in improved outcomes for some groups of patients. In a recent conversation at the Digital Healthcare Innovation Summit, leaders in care delivery for a variety of patient needs—as well as payer representatives—explored how innovative care models can better address complex diseases like eating disorders, can engage and empower home caregivers and community pharmacies and physicians, and better employ a limited healthcare workforce. In many ways, the panelists explained, it’s a logistics problem. But smarter approaches to predictive modeling, assessment triage, and needs-matching are helping solve some of our biggest healthcare disparities.  

PANEL MODERATOR: 
Billy Deitch, Partner, Oak HC/FT 

PANELISTS:
Mark Prather, MD, Co-Founder & CEO, DispatchHealth
Kristina Saffran, Co-Founder & CEO, Equip
Brandon Kerns, President & CFO, Russell Street Ventures
Katherine Knutson, MD, MPH, Senior Vice President, United Health Group; CEO, Optum Behavioral Care

LINKS:
Cambridge Healthtech Institute  
Breaking Health  
HealthEdge  
https://dhis.net/  

Sid Viswanathan doesn’t believe that a pre-existing passion is essential to entrepreneurial success, instead he recommends choosing an area with plenty to learn. “Find something you can spend a lot of time obsessing over,” he told the Breaking Health podcast. When he co-founded Truepill, Viswanathan didn’t know much about healthcare, but now it is a passion. “It’s such a meaty industry; there’s so much stuff to do,” he said. Truepill launched as a virtual pharmacy in 2016, offering everything from the digital consumer-facing front end to pill packing and shipping on the back end. But the vision, Viswanathan said, is virtual healthcare, which now includes telemedicine and diagnostics as well. Truepill serves as a collaborative partner, he said, for payers, life sciences, healthcare, and providers.  

Breaking Health boiler: Conversations between VCs and entrepreneurs typically occur in boardrooms or coffee shops. In the Breaking Health Podcast, you get a seat at the table. Healthcare Chief Executive Officer Stephen Krupa, HealthEdge Software, Inc., brings his more than 20 years’ investor experience insight to revealing conversations with the most disruptive CEOs in healthcare. Listen to understand how these leaders are building the companies—and fostering the cultures—that will change everything. 

Breaking Health Links:  
Cambridge Healthtech Institute
Breaking Health
HealthEdge 
Truepill 

Enam Noor has been an entrepreneur since he graduated from college with a degree in computer programming. After honing his skills in digital analytics and digital workflow, he’s taking what he learned and applying it to the healthcare field. His company, Insightin Health, brings vast healthcare data to bear on care decision-making, empowering health plans to use data as an asset—not just an operational byproduct. By tearing down silos and combining data from physician practices, pharmacies, customer service interactions, and much more, Insightin is using machine learning and natural language processing to drive the next best action for customer health. 

Reimbursement coverage for behavioral health services hit a milestone in 2008 when Congress passed the Mental Health Parity and Addiction Equity Act (MHPAEA) which required insurers to equalize coverage for behavioral health and medical health benefits in terms of co-pays, deductibles, lifetime caps and access to providers. Fast forward to present day when demand for behavioral health services outpaces the availability of treatment and the COVID-19 pandemic ushers in unprecedented levels of anxiety and isolation. A panel of behavioral and mental health executives dig into how the care model has shifted during the pandemic, what changes are still essential to deliver quality behavioral health care, the unique role technology can play in behavioral health care, and how both payers and providers are currently defining value for their patients.   

“A lot has happened in healthcare in the past two years,” Lucienne Ide, Founder and CEO of Rimidi, says. “We went from a miniscule adoption of telemedicine—much less remote monitoring—to now everybody’s looking at the future and saying, ‘This is here to stay. How are we going to do it in a scalable and sustainable way?’” Rimidi has the plan. Ide’s focus is patients with chronic diseases. Episodic care is not working for them, she says, and a once-a-year or once-a-quarter trip to the doctor feels more like being called to the principal’s office than a health-focused partnership. At Rimidi, Ide and her team are building sustainable progress by pushing healthcare past just digitizing data into true decision support for both patients and providers, innovating in care delivery and doing the “dirty work” of truly setting patients up for success. Ide and host, Steve Krupa, talk about the pain points in shifting to a value-based models; how EHRs, patients, and providers are responding to Rimidi’s decision-support tools; and her best advice for healthcare entrepreneurs.

Lucienne Marie Ide, MD, PhD, is the Founder and Chief Executive Officer of Rimidi, a cloud- based software platform that enables personalized management of health conditions across populations. She brings her diverse experiences in medicine, science, venture capital and technology to bear in leading Rimidi’s strategy and vision. Motivated by the belief that we can do so much better as individuals, in industry and society, Lucie left clinical medicine to join the ranks of healthcare entrepreneurs who are trying to revolutionize an industry.

Doctors making house calls might seem like a relic of the past, but the act of caring for patients in their own home is experiencing a revival. Only this time, it’s highly dependent on technology. This special episode features a panel discussion from a Digital Healthcare Innovation Summit (DHIS) Spotlight Episode earlier this year. Moderated by Ellen Herlacher, Principal, LRVHealth, this panel offers insights from entrepreneurs who founded some of the most innovative tech startups that are bringing change and disruption to the home health field. Hear how they’ve approached this dynamic and fast-moving market, learn about the challenges they’ve faced and their strategies for overcoming them, and leave with an understanding for where they see the biggest opportunities ahead.