Grace Cordovano, PhD, BCPA

***From Best Practices to Next Practices*** Digital Health is an Emerging Determinant of Health says OCED's first-ever chapter on Digital Health in their annual Health-at-a-Glance report. Digital health readiness is considered a determinant of health as it influences health data usage, healthcare service delivery, and health outcomes through digital transformation. Countries with higher digital health readiness have better responses to health crises, improved resource utilization, lower costs, and enhanced patient experiences. Perhaps the most important point is featured in the image below, where the HUMAN FACTORS live. We have over-invested the last decade in the technologies and data systems to support Digital Health, however, we have heavily under-invested in the capacity and literacy building, community collaboration, transparent governance, and systems thinking that is required to take advantage of said technology and data. I liken it to 100 years ago, in 1924 when the automobile first arrived. At that time 95% of the world was still operating the horse and buggy, it took 40-50 years later to harness the power of the automobile to transport goods and services to every community. It's time we realize our healthcare system is the HORSE and BUGGY of this century... Here is a link to the copy of the chapter: https://lnkd.in/gzJ-GQbp #DigitalHealth #HealthTech #HealthData #HealthcareInnovation #HealthcareTransformation #DataSecurity #Interoperability #PatientEngagement #AIinHealthcare #PublicHealthImpact #digitalreadiness #communityimpact

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With the volume of employers converting to ICHRA plans growing by the hour, here are some thoughts on what to consider as you make your funding decisions.

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👍 In the first half of 2024, U.S. digital health startups secured $5.7 billion across 266 deals, showing a strong rebound after years of slowed investment, according to Rock Health. With early-stage deals driving the momentum, the sector is on track to surpass funding totals from 2019 and 2023. https://bit.ly/4cCRy2W Via Healthcare Dive #digitalhealth #digitalhealthfunding

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Health tech companies reported strong Q3 2024 earnings, driven by expanded offerings, rapid adoption of AI tools, and increased client demand. Here’s a recap of key updates: - Hims & Hers: A telehealth platform offering personalized treatments across mental health, sexual health, dermatology, primary care, and weight management. Q3 revenue jumped 77% to $401.6M, net income was $75.6M, and subscribers grew 44% to 2M. The company plans to launch a generic liraglutide in 2025 and raised its 2024 revenue forecast to $1.46B-$1.465B. - Doximity: A networking and workflow platform for medical professionals providing tools like telehealth, scheduling, and AI assistants. Revenue increased 20% to $136.8M, with AI tools leading growth and 1M prompts used in Q2. The company raised its 2024 guidance to $535M-$540M in revenue. - Waystar: A healthcare payment and revenue cycle management company serving 30,000+ clients across care settings. Revenue grew 22% to $240M, driven by rapid client adoption after a competitor’s cyberattack. The company raised 2024 revenue guidance to $926M-$934M and expects 2025 revenue near $1B.

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This 👂 podcast episode and insight’s from a16z Bio + Health's Julie Yoo spoke so clearly to the fundamental challenge facing both 🩺 clinicians and 🏥 healthcare systems.  There is a huge disconnect between supply, in the availability of clinicians, and demand, in the increasing volume and complexity of healthcare needs. -     36% of physicians plan to reduce their hours next year according to the AMA -     48% of physicians reported feeling burned out in a 2024 Medscape survey At the same time, the demographic baby boomer bubble and steady increase in the prevalence of major chronic disease, which consumes up to 90% of healthcare expenditures according to some estimates, is driving demand. With this context, Yoo points to a major opportunity for AI adoption in healthcare in 2025. Yeah, a VC hyping a wave of new AI companies that will replace the decades of training and experience of clinicians, the skeptic would say.  But Yoo is thoughtful in pointing to the role AI can play, and is already playing, through solutions such as ambient, autonomous scribe solutions (of which local star Abridge is leading the pack) in not replacing, but freeing up productivity for clinicians. There is so much unstructured context in both the complexity of disease and treatment options and the social/emotional considerations that we shouldn't be looking for AI to *replace* clinicians. But companies are getting better at finding the structured, repetitive and time-consuming places where AI tools can *help* clinicians. Nearly two-thirds of doctors cited bureaucratic tasks as the leading contributor to burnout. Rigorously trained-AI driven solutions can be a force multiplier for clinicians, and I’ve seen several interviews where nurses and doctors go as far as to say some of these solutions are ”restoring their joy in practicing medicine”. Our health is precious; and we rightly want any technology engaging with it to be developed thoughtfully and thoroughly tested. This requires top AI talent and diverse and realistic training data. Pittsburgh’s strengths in both areas is why we are an emerging hub for data-driven healthcare. #AIinhealthcare #clinicianburnout #healthinnovation #digitalhealth

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Blue Health Intelligence, a data analytics and software company, undertook an evaluation of almost 170,000 unique GLP-1 users for weight loss, notes less than half of those prescribed stay on the medication for 12 weeks or more. Younger adults were less likely to continue the drug, whereas those who were prescribed the medication by an endocrinologist or obesity medicine specialist were more likely to continue for longer. Indeed, this data states 30% of patients dropped out of treatment after the first four weeks, and 58% at 12 weeks. Those who dropped out are unlikely to achieve clinically meaningful weight loss.  The likelihood of continuance was further exacerbated for those with health inequities or who lived in underserved health regions. The data comes from Blue Cross Blue Shield Association members participating in Plans that provided coverage of these products, from 2014 through to end of 2023. Razia Hashmi, vice president for clinical affairs at Blue Cross Blue Shield wants to ‘…paint a clearer picture of what makes somebody successful.’ The missing piece here is why the patients stopped – side effects, failure to achieve initial weight loss, stigma and discrimination, or coverage issues related to cost and access. My longtime friend, colleague and bariatric surgeon at Stanford University, Dr. Dan Azagury rightly states ‘…The goal is for patients to stay on this for a significant amount of time. Most likely… beyond 12 weeks.’ https://lnkd.in/ediQskQx

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Here's what caught my eye in the Kidneyverse this month! 🤩 https://lnkd.in/exQUavXr Across the Kidneyverse is my monthly recap of top headlines, research, market insights, funding, and perspectives from the kidney community. This month we’re marking major milestones in xenotransplant, biopharma M&A, frictions from CKCC payment cuts, lessons from RPA, and a number of startup financings you should have on your radars. My goal in writing these monthly updates is leave you feeling more curious, optimistic, and knowledgeable about this space. If you find it helpful, please share it with your networks and let us know what you're following! But enough writing, more exploring... This month's Across the Kidneyverse features insights from: Mass General Brigham American Society of Nephrology Benjamin Hippen, MD, FASN, FAST Dr. George Hart Frank Maddux MD, FACP Paul D. Gordon Centers for Disease Control and Prevention Interwell Health Renal Physicians Association Vertex Pharmaceuticals Alpine Immune Sciences, Inc. Biolinq Reshma Kewalramani, MD FASN Mozarc Medical IKONA Health Lifeliqe World Health Organization International Society of Nephrology PitchBook Carta Silicon Valley Bank Centers for Medicare & Medicaid Services Healio Charlotte Dixon Liz F. The New York Times Uptal Patel Eric Topol, MD DaVita Kidney Care Blake Madden Ian Koons Yubin Park, PhD Signals From [Space] #healthtech #innovation #digitalhealth #valuebasedcare #kidneyverse *** What else should people know about? Let us know! 👇🏻

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There is such a need for new innovation in digital health. Whether it is Remote Patient Monitoring to support the new patient at home models, or better ways to streamline provider workflow or leveraging AI for better RCM- digital health investment is so necessary.

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Last month, I wrote a piece for Pharmaceutical Commerce Magazine about step therapy (also known as "fail first"), a tool used by health plans to control spending on patients' medications.    With step therapy, an insurance company may require a patient to try different medications and treatments and have those "fail first'' before they're able to access the drug initially prescribed by their physician.     It's a way to contain the cost of prescription drugs, but it can notably result in delayed access and negative side effects.    A national poll from the PAN Foundation Center for Patient Research found that most adults (55%) who have been required to “fail first” say the policy delayed their access to the medication their healthcare provider (HCP) originally prescribed by up to 11 weeks.     - 1 in 6 (16%) adults say their HCP has required them to “fail first” before authorizing drugs prescribed by their HCP.    - The majority (59%) of adults who have been required to “fail first” say they appealed their health insurance provider’s request.    - 1 in 5 adults who were required to “fail first” say they had to visit the emergency room (21%) or be admitted to the hospital (20%) because of the policy.    Although most states have passed laws addressing the issues related to step therapy, there is no federal legislation—and it is direly needed.    Learn more about why Congress should pass the Safe Step Act:  https://lnkd.in/eaPeew_T 

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There is a lot of talk about GLP1's these days. I wanted to share some tips that I shared with my clients this week for you all as well. Importance of Muscle Support in Clients on GLP1 therapy GLP-1 medications (Ozempic, Wegovy, Mounjaro, Zepbound among other brand names), are a fast growing category among prescribers, and as many as "9 million prescriptions of them were written in Q4 of 2022. This means that roughly 2 - 3% of the population in the United States may now be taking one of these drugs."https://lnkd.in/gAX5GgF5. GLP-1 therapy primarily targets fat loss, but combining it with adequate BCAAs and strength training may ensure that fat loss doesn't come at the expense of muscle health. BCAAs can help protect muscle and reduce sarcopenia in patients on GLP-1 therapy for fat loss by supporting muscle protein synthesis, especially when dietary protein intake might be lower due to reduced appetite. In combination with low-carbohydrate diets, BCAAs are also part of ketogenic metabolism, and could further preserve lean body mass by reducing muscle protein breakdown. Getting an adequate intake of daily protein is essential in any diet, and the BCAAs are 3 of the essential amino acids the body needs that specifically target skeletal muscle (as much as 35% of the essential amino acids found in skeletal muscle are the 3 BCAA's; valine, leucine and isoleucine!) More info here: https://lnkd.in/gXUz_Cgi TruMe natural instantized BCAA's are a great option to add daily to help support muscle growth, prevent lean muscle loss, and boost muscle health. 

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🤔 How do (US) hospitals spend money 101? Salaries, Wages, Benefits: 45-55% Professional Services: 12-22% Supplies: 12-18% Depreciation/Amortization: 3-6% Other Expenses: 5-20% 8 key insights: n°1. Hospitals consume 31% of US healthcare spending: Despite being the largest spending category, many hospitals struggle with low operating margins, often below 2%. n°2. Labor costs dominate hospital expenses: Salaries, wages, and benefits account for 45-55% of a hospital’s expenditures, with front-line staff making up 75-82% of the workforce. n°3. Contract labor adds significant costs: Hospitals often resort to staffing agencies due to labor shortages, paying 2-3 times more for contract workers compared to employed staff. n°4. Supplies account for 12-18% of expenses: This includes medical equipment, drugs, and personal protective equipment. n°5. For-profit vs. non-profit hospitals: For-profit hospitals tend to manage costs more efficiently, keeping salaries and expenses lower, but often at the expense of services like Medicaid or charity care. n°6. Economies of scale in larger health systems: Larger systems benefit from negotiating better prices for supplies and services. n°7. Rural hospitals face unique challenges: Limited access to talent and capital means rural hospitals must rely more heavily on expensive outsourced labor and struggle to offer high-margin services. n°8. Staffing shortages remain a key issue: Despite financial recovery post-COVID for many hospitals, staffing shortages continue, driving hospitals to explore different revenue models and operational changes to sustain profitability.​ Great post by the Out-Of-Pocket team Nikhil Krishnan & Ben Chao #healthcare

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Adolescent diabetes care: the power of GLP-1 medications What I envision is for physicians to embrace a comprehensive approach to metabolic health, especially when treating adolescents. It is crucial to be open to all available treatments and to initiate conversations about GLP-1 receptor agonists. By doing so, we can begin to address insulin resistance and type 2 diabetes more effectively in this young population. Physicians need to expand their knowledge about these medications and consider their potential benefits. For instance, the TODAY2 study provides valuable insights into type 2 diabetes in adolescents and highlights the efficacy of these treatments. It’s important for us as medical professionals to stay informed and proactive, given that our training may not have covered these newer developments extensively. Furthermore, assessing your patients thoroughly is essential. Obtain their lab results and avoid assumptions that they will simply outgrow their conditions. Don't shy away from discussions about potential treatments out of fear of causing harm. Many teens are struggling significantly with metabolic health issues, and their parents often feel lost in how to support them. As physicians, we must take the lead in ordering labs, discussing insulin resistance, exploring medication options, and considering prescriptions when appropriate. Karla Lester, M.D., FAAP is a pediatrician, certified life and weight coach, and diplomate, American Board of Obesity Medicine. Link in bio or visit https://lnkd.in/eEgKJj_6 #TeenHealth #MetabolicHealth #GLP1Medications #InsulinResistance #AdolescentDiabetes #DiabetesCare #TODAY2Study #PhysicianTips #TeenDiabetes #HolisticHealth

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In 2019, the average hospital produced 50 petabytes of data per year, with 97% of the data going unused: the equivalent of streaming a two-hour movie about 25 million times annually. Physicians writing in STAT ask ‘…what we are actually gaining from our unscalable mountains of digitalized health care data?’ The article focuses on prevention of the environmental damage caused by massive data storage and management. My ask is simpler – data, data, everywhere… but what are we doing with it all? https://lnkd.in/eHiNqt6x.

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Alot of bad actors and a few good actors. $2.5T HC capital raised & $1T invested by PE in last decade. $31B in 2013 vs. $217B in 2021. We know the story. Misaligned incentives - unrealistic multiples, short-term profit focus, aggressive cost-cutting, unrealistic scaling, misunderstood market dynamics, just to name a few. However, our industry needs money. But our industry is more infrastructure asset class than tech start-up (James Nicholls gave me that epiphany). Mic drop on the lyrical genius of Alex Fair of MedStartr Ventures as he literally gives the whole story poetic justice as he reads HIS POEM on this "On The Road at VIVE" episode of The Reverse Mullet Healthcare Podcast w/BP2 Health. This is the perfect episode for a Friday afternoon! He and Paulo J Machado donned the actual reverse mullets and joined us back in February at #VIVE2024 to talk about the need for REAL change in healthcare, startup focus and investor expectations. It was one to remember and one that is in desperate need of a full-length follow-up episode. Give us a like and a watch or a listen https://lnkd.in/e4w4mjkv https://lnkd.in/egmK3kMB

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New #GTM Canvas for Health Institutions in prep. How to apply Marketing principles to health institutions when most of the regulation articles are preventing patients from bad marketing? WIP

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OpenAI enters healthcare 😷 They’re partnering with Color to produce computer-generated personalized care plans for cancer patients. Here’s what they’re doing: 📄 Using GPT-4o for a copilot they’ve built 📄 Identifying missing diagnostic tests 📄 Creating tailored plans for patients 📄 Having a clinician analyze every recommendation made 📄 Relying on APIs to integrate patient data with evidence-based healthcare guidelines and HIPAA-compliance 📄 Building an #AI model that includes family history and individual risk factors 📄 Generating documentation for diagnostic workups like insurance pre-authorization 📄 Extracting information buried in unstructured data So far, providers are able to identify 4x as many missing labs, imaging, biopsy, and pathology results compared to not using this copilot. On average, it takes about 5 minutes to use this tool. This year’s goal is to use this for 200,000 patients. Color has other partners, such as American Cancer Society and University of California, San Francisco, to measure the impact of this tool. It’s great to see more #healthcareinnovation for complex conditions and partnerships across industries! #startupjourney #startup #healthtech

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