Startups

The HLTH 2022 conference in its fifth year was more expansive than ever before. The conference at the Venetian Expo included drug developers, diagnostics and medtech companies, each with an assortment of health tech components. There was also a great deal of content on the consumer experience in healthcare, mindfulness and wellness both in the form of sessions as well as sponsors. It was also the first year HLTH presented the conference in an open plan setting, which worked surprisingly well.

The conference attracted 2,500 healthcare CEOs, with one-third of the estimated 9,000 attendees coming from the C-suite of their businesses. HLTH also made the splashy announcement that the event producer would debut a European version of HLTH in Amsterdam in 2024. 

Here’s a look at some of the themes of the event.

The clinician exodus in healthcare and what can be done to improve it

After years of consolidation, particularly health systems acquiring hospitals and physician practices, Sachin Jain, SCAN Group CEO, described the toll these deals have taken on physicians as part of a wider conversation with Walmart EVP Health and Wellness Dr. Cheryl Pegus.

“The job of being a front-line clinician is no longer what we imagined it to be in medical school – building meaningful relationships with patients that are long lasting and that produce great outcomes for patients…I would say that with the largest health systems, in many ways, their management infrastructures have not kept up with the needs that they have. We used to have health systems where doctors used to know each other, where they could just pick up the phone and get things done for their patients. We’ve added a lot of bureaucratic red tape as organizations have gotten bigger and bigger and bigger, so that the average physician in a large health system feels anonymous, invisible, and even lonely. They don’t necessarily feel like they have agency or mastery over their work anymore because it’s complex and it’s been made complex in ways that aren’t value-add for patients anymore.”

Pegus observed that last year, over 300,000 healthcare professionals left medicine – over 120,000 were doctors in many different areas.

“[They left] not just because there’s a lot to do. We’ve introduced two times the number of treatment modalities and have allowed no room for people to take that science and put it into practice. If you continue to push that innovation, which we’re all hoping for, into a very narrow funnel, something has to give.”

For Pegus, the solution is to add more clinicians to the care team to support physicians at Walmart. She pointed out that Walmart has come to be a place people in rural communities can rely on for their healthcare and reminded the audience of the role big box pharmacies like Walmart played in providing Covid-19 testing and vaccines. 

SCAN, which serves patients on Medicare Advantage plans, is expanding into new markets, such as Texas, driven by invitations from local health systems and medical groups who align with SCAN’s approach. It also has initiated a program to deliver care to homeless older adults called Healthcare in Action.

Hybrid approaches to care

There was also the recognition that even as they leave traditional hospital settings, physicians are still interested in practicing medicine. Virtual care companies such as Wheel and MD Integrations are providing a way for some of these physicians to continue to practice and set their own hours. Elsewhere at the conference, health tech companies presented refined approaches to natural language processing and clinical decision support tools with the goal of making the job of physicians easier, saving them time, and helping patients get healthier.

In a session discussing different forms of primary care, Zak Holdsworth, co-founder and CEO of Hint Health, acknowledged that the healthcare consolidation trend worries him.

“We are trying to make primary care a revenue generator rather than the heart of healthcare,” said Holdsworth. “We need to make payments predictable and avoid layering additional administrative burdens.”

Another aspect of the care delivery discussion that intersects with the consumerization of healthcare is a growing number of hybrid care models. One of the challenges is that only 40% of physicians feel equipped to do virtual care. The goal is to balance delivering primary care through telemedicine or other types of virtual care with the acknowledgement that in-person care should be a critical component of primary and specialized care.

Assure Health sits at the intersection of virtual care and remote patient monitoring, delivering virtual-first care and helping patients manage chronic conditions. The company recently closed a $8.7 million Seed round from strategic investors. There are not enough endocrinologists to meet diabetes patients in person, so the company enlists the support of nurse care managers who engage with patients.

In an interview at the conference, COO and co-founder Craig Bolz said the business is leveraging devices that rely on cellular connections (rather than bluetooth) around diabetes, hypertension, COPD, and congestive heart failure.

Assure Health has also launched a comprehensive diabetes program where it takes full ownership over the diabetes disease state and can prescribe lab tests.

Bolz said the business has a fee-for-service side and value-based care side. In 2023, it plans to expand its value-based care business, supported by the recent fundraise.

Redi Health co-founder Like Buchanan explained that his startup helps patients improve the way they manage their chronic conditions, in part, by identifying pharmaceutical company programs patients may not be aware they are eligible to participate. Its app enables pharma manufacturers, health systems, and payers to integrate their patient support programs directly into the application.

CEO and bioengineer Jane Zhang founded Remmie Health and developed the Home Ear Monitor / Otoscope as a way to better address her son’s chronic ear infections. as part of the Plug and Play pavilion. The device has two functions, according to Zhang. Embedded with a camera, it works as a monitor to capture ear, nose, and throat symptoms. There’s also an app that helps parents track symptoms, images, and videos, which can be shared with a physician through software plug-ins such as MyChart. Chief Commercial Officer Lorren Wyatt joined the company two years ago — HLTH marked the first time the two met in person.

Among the milestones Remmie Health achieved was a deal with Medtronic Labs last year to provide the device to underserved markets in Asia to treat non communicable diseases. It’s also working on a device to assess hearing loss from noise pollution in these markets.

Based in Seattle with offices in San Francisco, Los Angeles, London, Remmie won an SBIR grant last month. The $350,000 grant from the National Institutes of Health’s National Institute on Deafness and Other Communication Disorders will be used to support the development of a deep learning diagnosis assistance engine for ENT diseases.

Health equity

In a panel discussion on different approaches to primary care, Dr. Kyu Rhee, senior vice president and Aetna chief medical officer with CVS Health, talked about the importance of promoting “techquity” or using health tech to promote health equity. He also urged newcomers to the space to embrace these tenets.

1. “Ensure that your workforce represents the people you serve. One thing I’m very proud of at CVS Health is that 40%-50% of pharmacists and pharmacy technicians represent the people they serve and have made a difference with vaccine delivery across the country by brokering that trust.
2. You have to collect race, ethnicity, and language data. Aetna was the first to do this. You have to collect the data to show the inequities that exist.
3.  You need to have a health equity dashboard as standard when you do assessments and contracts to reduce the disparities.
4. Need to ensure AI is ethical and transparent.
5. It’s not enough to know; you have to be prepared to act.”

Intersection of mind and body 

The connection between our state of mind and how we physically feel was also a significant theme at the conference as many of us try to reduce the stress and anxiety that exploded with the onset of the Covid-19 pandemic.

Calm, a company that promotes breathing and other mindfulness exercises to help people reduce stress and anxiety, shared its plans to expand from its d2c business through its app into the b2b world. Calm Health and Calm for Business serve self-insured employers, health systems and payers. CEO David Ko noted that a combined 400 million people have downloaded the app or visited its website.

Ko pointed out that the first set of customers who used Calm did it mainly for meditation. Then people came to the app because they had trouble sleeping. But during Covid-19 pandemic they’ve seen a spike in users arising from depression and loneliness. As more people return to the office after years of working remotely, anxiety is increasing.

The recent launch of Calm for work seeks to make employees happier and healthier in the workforce, Ko said.

“Three thousand employers are coming to us to help with their workforce and employees. We wanted to take what we’ve done with Calm and bring that to healthcare.”

Lucid is another company focused on the mind but uses music therapy to help users relax, energize, and sleep. Based in Toronto, Ontario, the company is also working with research institutions to use music to manage symptoms of Alzheimer’s disease and work with patients’ caregivers.

Making diagnostics more easily accessible 

Meeting patients/consumers where they are was a theme that permeated several areas, not just primary care delivery. In-home testing has been on the rise for years, whether it’s for genetic testing, STDs, or more recently, Covid-19. Pouria Sanae, ixlayer CEO and founder, offered an overview of the company, which provides lab testing services to people through CVS Health and health systems, as well as testing as part of clinical trial support for CROs.

“The goal is to be a new layer that lives on top of diagnostic testing that integrates many different services, to power remote testing — in-home and in-office testing,” Sanae said. “We focus on preventive care and consumerization of healthcare.”

In 2018 when ixlayer launched, its first test was a polygenic Alzheimer’s test for Alzheimer’s patients’ family members. Since then, it has rolled out testing services for people with chronic conditions, such as Type 2 diabetes. The Covid-19 pandemic led the company to rapidly expand its testing capabilities. Among its customers are DNA testing business PlumCare, Him & Hers, and the U.S. Coast Guard. Its board includes Paul Martino, co-founder and chief strategy officer of VillageMD, David Shulkin, a former Secretary of the U.S. Dept of Veterans Affairs, and Moncef Siaoul, chief adviser to Operation Warp Speed — the public-private partnership created to speed up the development, manufacturing and distribution of Covid-19 vaccines, therapeutics and testing.

Food as medicine

The acknowledgement that access to fresh, nutritious food is a social determinant of health and plays a critical role in helping people manage chronic conditions has led to the launch of healthcare startups focused on this niche as well as initiatives by healthcare organizations. A panel discussion on this topic led to some compelling insights from players in the space on how making access to fresh, nutritious food could reduce the need for some medications to manage chronic conditions, making such programs cost effective.

Sven Gierlinger, chief experience officer with Northwell Health, deplored the quality of food hospitals and health systems serve to patients. He discussed an initiative to change that on a few fronts. Gierlinger said the health system made a commitment five years ago to serve food with the best ingredients available prepared by a team of chefs. The health system also began offering cooking classes to physicians in training so that they could appreciate the benefits of preparing their own meals. Northwell also formed a partnership with a 400-acre farm in Queens, New York.

“Incentives need to be aligned better – the U.S. health system isn’t set up to incentivize a healthy population,” Gierlinger said. “The food industry has to change and that’s where I think the government and policy need to work together or it will never move forward.”

To address food insecurity, Gierlinger noted that the health system connects patients to resources and community-based organizations through the Unite Us app.

Ashley Tyrner, FarmboxRx founder and CEO, shared that the company, which started in 2014, is moving into its third year of being offered as a benefit by health plans supporting Medicaid, Medicare and Medicare Advantage programs. Its condition-specific food boxes are designed by a team of Registered Dietitian Nutritionists to support the wellness of those with certain health conditions.

Tyrner said a health plan that piloted its program reported that FarmboxRx was an effective care management tool to engage members in their health and to spur them to get their flu shot. She also emphasized that it’s important for providers to make patients aware of their eligibility for Farmbox Rx.

Photo: HLTH