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Category: Uncategorized

Is Telehealth the New House Call?

Posted on March 25, 2019 by Jim Jordan

In the 1930s, it wasn’t at all uncommon for a sick patient to see their doctor from the comfort of their own home. Back then, about 40% of doctor visits took place in the patient home. By 1950, that number dropped to around 10%. Today, thanks in large part to telehealth technologies, checking in with your doctor from home is once again on the rise.

What is Telehealth?

Telehealth provides support and enhancement of healthcare through the use of digital information and communication technologies. It may include remote clinical services (often referred to as telemedicine), as well as remote patient monitoring, training for healthcare providers, and patient education.

Improved Access through Telehealth

A 2016 Commonwealth Fund study found that just over half of US adults were unable to get evening or weekend medical care without visiting the emergency department. In 2017, another survey found that residents in 15 major metropolitan areas waited nearly a month for an appointment with a new family medicine physician. That problem is likely to get worse. The Association of American Medical Colleges predicts that shortages of primary care physicians (PCP) will increase significantly by 2025. Today, an estimated 64 million Americans live in an area where the total number of primary care physicians can only meet 50% or less of the population’s needs.

Telehealth technologies can help alleviate some of these challenges by giving patients access to physicians that may be outside their usual geographic area. Patients may interact with the physician via video, talk, or text, depending on the service, and appointments can take place at any time of day, every day of the week.

Access to Specialist

Telehealth can be used for more than virtual visits to a PCP, and that’s a good thing. Access to specialists can be even more difficult to schedule, particularly in rural areas where there are roughly 40 specialists for every 10,000 Americans (compared to 134 per 10,000 in urban locales.)  An example of this in practice is PSLG portfolio company DermatologistOnCall, which provides an online care delivery platform that connects patients with online dermatologists for skin care diagnoses and treatment plans.

Reduced Cost

The average cost of an in-person doctor visit is $125. Conversely, telehealth visits average about $45. A 2016 article by the American Council on Science and Health reported that an average of $86.64 is saved every time a patient received care online at UPMC instead of visiting the ER or urgent care. Up to 40% of those patients also indicated that without the option of telehealth visits, they would have skipped care altogether.

Improved Follow-Up Care

Telehealth technologies include wearables and digital health apps that allow patients and doctors to monitor health between visits. This exchange of information can help doctors and patients coordinate long-term care and monitor progress. In addition to having a potentially positive impact on patient adherence, monitoring can also help doctors identify when treatment plans aren’t working so changes can be made.

Lack of Broadband as a Health Issue

Telehealth depends on internet access. Without affordable broadband to support reliable access to the technology, adoption of telehealth will be hampered. Unfortunately, rural communities, which are more likely to face physician shortages (both specialists and primary care), are also less likely to have access to the internet connection speeds required to support the transmission of data for telehealth services.

Policy Needs to Catch Up to Technology

As the American Hospital Association aptly suggests in their most recent fact sheet on telehealth, today’s limited Medicare coverage is impeding the expansion of telehealth services. The current statute limits access to services based on geographic locations, the types of technology that may be used, and the list of services covered.

Telehealth also requires compliance with federal and state regulations. Particularly with variances in laws between each state, providers and insurers may be limited on what services can be provided based on legal and regulatory challenges, ranging from coverage and payment to licensure, credentialing, and privileging, among other factors. If telehealth is going to become a viable, value-based care solution, federal and state hurdles must be addressed.

The Future is Now

Telehealth isn’t necessarily new. Nascent applications stretch back as early as the 1940s when radiology images were sent 24 miles between two Pennsylvania towns via a telephone line. Today’s technology, however, has brought telehealth applications into the mainstream as a viable and necessary healthcare service. While challenges remain to widespread adoption, many hurdles have already been overcome. The introduction of 5G networks and the ongoing evolution of government policy pertaining to telehealth will continue to pave the way to improved access of services.

Posted in Uncategorized, Health IT, Words of WisdomLeave a comment

Understanding Population Health and Public Health

Posted on March 12, 2019 by Jim Jordan

Understanding Population Health and Public Health

The terms “population health” and “public health” sound similar. If you’ve used them interchangeably, you’re not alone. The similarities, both in name and concept, make it easy to overlook their nuanced differences. However, in order to have a productive conversation about the evolution of modern healthcare, it’s important to understand the distinction between these terms.

How Are They Similar?

Some of the confusion involving population health vs. public health stems from the fact that both focus on the health and wellness of a group or community. These concepts look beyond individual care to identify patterns of health and illness within groups of people. By monitoring trends, both population and public health seek to identify interventions or preventive models that can promote health, improve patient outcomes, and reduce overall costs.

Population Health

Population health is concerned with the medical outcomes of individuals in a specific group with a similar characteristic. This can be defined by geographic location or by other factors such as ethnicity, chronic illness or disability, socioeconomic status, employment, and age. Of course, individuals may belong to multiple populations. When studying population health, researchers look at societal structures, attitudes, and common behaviors that might influence health outcomes with the goal of identifying patterns of determinants and, ultimately, identifying what can improve those outcomes.

Public Health

Focusing on society at large, public health puts its attention on wellness programs and initiatives designed to prevent disease or injury. Researchers in this arena look to identify steps that can be taken to create conditions in which individuals can be healthy. The focus is often on large-scale initiatives such as smoking cessation, improved air quality, vaccinations, or management of disease outbreaks.

The Role of Health IT in Population and Public Health

The era of digital health tools has made it easier to collect relevant data used to identify specific populations and the social detriments that impact them. Further, innovations like artificial intelligence can be used to sift through the data to more efficiently identify patterns, and later automate tasks that facilitate improved outcomes.

For example, PLSG portfolio company Mental Health Metrics uses statistical process management techniques to intervene in patient care before adverse events occur. A great example of the way health IT can be used for population health initiatives, this start-up provides early detection of a pending patient crisis and triggers a treatment sequence. In turn, the early intervention may translate to a more effective and less expensive approach.

Digital health tools also help collect data used to identify public health issues and then widely disseminate information related those issues. A great example of a company working within this space is another PLSG portfolio company, Health Monitoring Systems (HMS), which aggregates healthcare data from more than 600 U.S. hospital systems and 3,600 ambulatory systems in order to monitor and quickly identify emergent threats to community health. HMS’s novel weather-map-like design is the largest private repository of this data.

Both population health and public health play significant roles in upgrading healthcare systems by improving access, reducing costs, and enhancing outcomes. They are two powerful disciplines working to make meaningful changes to better meet the healthcare needs of individuals.

Posted in Words of Wisdom, Uncategorized, Health ITLeave a comment

HIMSS 2019: Solutions combine cutting-edge technology with government policy

Posted on February 19, 2019 by Jim Jordan

Last week, I had the opportunity to participate in a truly transformative event. The Healthcare Information & Management Systems Society, or HIMSS, held their global Health IT conference, where more than 45,000 healthcare professionals attended.

Tech leaders and industry executives networked with government policy makers, healthcare providers, and payors to discuss the future of healthcare. As expected, the results were eye-opening, and I would like to share them with you.

But before we talk about healthcare’s future, we need to take a step back and review the past to understand the significance of recent developments.

Shortly after the end of World War II, employers introduced the concept of health insurance as a perk to entice workers in an increasingly tight job market. Quickly, the practice took hold, and employer-sponsored, private health insurance became the norm in the United States.

The number of individuals covered by health insurance continued to grow significantly, but another issue had been thrust into the spotlight: Older and poorer Americans, without the benefit of employer-sponsored health insurance, were left out of the system. With the introduction of Medicare and Medicaid in the 1960s, senior citizens and those in lower-income brackets were provided a lifeline, but the cost of healthcare in the United States had skyrocketed.

And while healthcare costs continued to rise at a greater pace than the U.S. GDP, there were still many people who did not have access to affordable healthcare. The introduction of COBRA and other measures in the 1980s helped to bring some Americans back into the system, but the issue still persisted. And as Baby Boomers continued to age, healthcare costs began spiraling out of control.

In 2010, the issues of healthcare access and rising costs were addressed with the passage of the Affordable Care Act. The number of uninsured Americans decreased from 44 million in 2008 to 11 million in 2011. And with more people in the insurance pool, a value-based reimbursement system, and other measures designed to rein in costs, the decades-long growth in healthcare spending had finally begun to slow.

But while the ACA has improved access to healthcare and slowed the growth rate of actual cost, it has also limited choices for many Americans who are unable to see providers who are not within their insurance networks. This lack of competition will inevitably inhibit the best value being delivered by the system.

So this is where we are today. At the HIMSS Conference, we discussed recently proposed legislation and many ideas that will help tackle some of the pressing healthcare issues we are now facing. A few of the ideas presented include:

  • A dedicated focus on improving core outcomes, including access to affordable healthcare, reduced healthcare costs, and improved quality.
  • A shift in our current healthcare model. Through newly proposed legislation, there is an effort to convert our current provider-and-payor-centered healthcare system to a patient-centered model.
  • This new consumer-centered model will allow patients to have access and electronic portability of their medical records across the care continuum.
  • Providing this interoperability will lead to consistency across health IT systems, better communication among healthcare providers, and greater patient control over healthcare data.
  • Interoperability will also allow the capture of social determinants of health (lifestyle factors), which are now recognized as being equally as important as genetic information. This will give health providers a more complete picture of a patient’s health status, leading to better, more cost effective diagnostic and therapeutic decisions.
  • Leveraging cutting-edge technology to enhance outcomes. This will lead to greater healthcare access, more patient involvement in their own care, and the alleviation of our growing shortage of healthcare providers.

After speaking with healthcare, technology, and government leaders, one conclusion has become crystal clear: Healthcare problems cannot be solved in silos. The only way we can address our pressing challenges is by developing a holistic solution that combines cutting-edge technology with government policy. Only when these two forces work together will we be able to make meaningful changes in our healthcare system. It will require a combined effort of lawmakers, health IT companies, healthcare providers, payors, and patients to adopt new practices and new mindsets, and tackle our challenges once and for all.

I believe that the HIMSS Conference was a powerful step in the right direction, and I remain excited about the future of healthcare.

Posted in Uncategorized, Business Development, Health IT, Words of WisdomLeave a comment

Artificial Intelligence (AI) coming to Ambulances

Posted on November 19, 2018 by Pittsburgh Life Sciences Greenhouse

Artificial Intelligence (AI) has the power to improve healthcare delivery across the continuum of care. AI can more quickly identify hemorrhages on CT scan in the emergency department; it can make surgeries safer in the operating room, reduce mortality in intensive care units; and it can help patients recover faster after being discharged.

 

Artificial Intelligence could also assist emergency medical service (EMS) providers in treatment and triage decision-making in the pre-hospital environment. Take stroke for example. Patients suffering stroke need to be taken to designated stroke hospitals in order to receive adequate lifesaving treatment. Though stroke can be diagnosed with brain imaging at any hospital, it can only be treated at about 20% of them. Artificial intelligence can help EMS providers get stroke patients to the right hospital faster and reduce delays in treatment. Creators of artificial intelligence diagnostic tools, MaxQ AI (formally MedyMatch) has partnered with Samsung to deploy computer vision software on the approximately 15 ambulances in the country that have on-board CT scanners.  Forest Devices is developing a portable AI stroke identification device designed to be like an electrocardiogram (EKG) for the brain.

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Using Public Disclosures to Prevent Competitive Patents

Posted on August 15, 2018 by Alan West

When does disclosing a secret actually help the secret-keeper?  In the world of patents and patent protection, it can be a key strategy.

Most entrepreneurs understand that an invention must be truly novel to receive a patent.  According to the U.S. Patent and Trademark Office (uspto.gov), an invention cannot be one that has been previously “patented, described in a printed publication, or in public use, on sale, or otherwise available to the public before the effective filing date of the claimed invention.”

As an example, I once worked at a company that acquired a medical device patent from a physician.  The resulting product achieved rapid market penetration, and the physician inventor received substantial royalty payments – until a competitor discovered that the inventor had described the concept to a group of physicians during a Grand Rounds at a small hospital a few days before he had filed the patent.  As a result, the patent was invalidated, the competitor began marketing a look-alike product, and the company and inventor had to deal with the rather nasty legal business of all the royalties that had been paid.

You have to be especially cautious to not disclose a patentable idea to anyone before filing a patent, unless your audience has signed non-disclosure agreements in advance.  Otherwise, it is considered to be a “public disclosure,” even if it is to one person.

You can, however, use such public disclosures to your advantage.  Let’s say you are a start-up company with a patent covering your first product.  A common defensive patent strategy is to file additional patents covering improvements and line-extensions to your original patent – a tactic known as the “picket fence.”  In this way you create a “fence” surrounding your product, making it much more difficult for competitors to get around your patent.

These new patents are all subservient to your core patent in that they are offshoots of the original and cannot be independently practiced.  As a start-up company, however, you may not have the cash to file all these new applications.  A well-financed competitor, on the other hand, may decide to file patents covering improvements to your product as an offensive strategy.

By filing enhancements to your original patent, they can create bargaining chips to use with you to negotiate a cross license, giving them the right to your original patent in exchange for you to use their patents covering product improvements.  It is a common and effective strategy, but it’s crucial to realize that it can also undermine your company’s competitive advantage.

A simple way to avoid becoming fenced in by a competitor in this way is to publish a description of the improvement in a paper or on your website.  If you are not going to file a patent on the improvement, publicly disclose the idea so no one else can patent it.  In that case your product would still be protected by your core patent.

The Intellectual Property Pyramid Assessment©, a workbook published by the Pittsburgh Life Sciences Greenhouse, will soon be available to order on Amazon. To sign up to get more details please email info@plsg.com.

Posted in Diagnostics, Portfolio Companies, Therapeutics, Biotechnology Tools, Uncategorized, Business Development, Health IT, Words of Wisdom, Concentrations, Medical DevicesLeave a comment

Can you really create a “community?”

Posted on July 12, 2018 by Delvina Morrow

The United Nations defines community development as “a process where community members come together to take collective action and generate solutions to common problems.”

Each of us, as individuals, plays a critical role in community development. It is up to each of us to help our communities to thrive and grow for the betterment of all members; to ensure that our region not only excels, but also truly makes an impact.

Since joining the PLSG I have found myself connected and rooted in a new community; the life sciences entrepreneur community.

While getting to know this community, I began attending Tuesday morning BioBreakfasts where I had the opportunity to meet Thomas Voigt. Thomas became a regular face and comforting friend in my explorations of understanding the life sciences community.  At Innovation Works, I befriended Terri Glueck who not only showed me the “the way,” but at each networking event, allowed me to follow her as she introduce me to each and every person she spoke with.  At every PLSG Open House, I knew that Cassie Ruane (founder of Mental Health Metrics, Inc.) would be there to share kind words on how much she enjoyed our events. At industry networking events I often met people who would share interesting stories about one of my colleagues that made me realize that our community may be small at times, but, as Margaret Mead once said, “A small group of thoughtful people could change the world.”

So, how are we, as a community, working towards changing the small yet mighty world we live in?

As an organization, we have worked hard to redefine how we connect and engage within our life sciences and entrepreneur community. It is our goal to further develop our community by creating transparent and high value community engagement activities for all while lowering the barriers of participation.

When you walk into the PLSG building today, there are notable changes that help to define us a community space. We have created a visually appealing meeting/event space, which not only showcases our impact by listing the 484 companies we have worked with, but also allows members of the community to see the sheer impact of the life sciences on our community.

As an organization, we have and will continue to redefine our events, making them more accessible and collaborating with other likeminded organizations and groups to ensure that each PLSG engagement is representative of the region we serve. We have hosted groups like the Young Nonprofit Professional Network of Pittsburgh for both board meetings and social events. We have hosted feminist maker space Prototype PGH for board meetings and have opened our doors to the ACHE of Western PA, the Fourth Gear cohort of 2018, Duquesne University, and many more local organizations.

We believe that it is our role, to help support a strong and vibrant life sciences community.

Thank you for being part of our vibrant and growing community.

Posted in Under 40 Underserved Advisory Board, Uncategorized, Words of WisdomTagged Community, Development, Life Sciences, EntrepreneurLeave a comment

Management accounting necessary, but underappreciated

Posted on November 8, 2017 by John Manzetti

When I was growing up, I always wanted to be an accountant. I guess I thought my math interests and skills were a good fit for that profession. When I was in college, I quickly found out that math skills were certainly a help, but analytical skills and basic understanding of a process and logical structure were extremely important. After undergraduate school, I contemplated the CPA route, as that was the thing to do, right?

But, after checking more, I felt the CPA or “financial accounting” route was a little too much like memorizing the phonebook for me. I wanted to explore getting more involved in business decisions.
After meeting with my mentor at my first management job, I decided to play out my career a bit, not get embroiled in the CPA study and exam process, and focus on the MBA route, which I did at the University of Akron, whose program embraced management accounting in a big way.

Numbers driving decisions

So, what is management accounting? You can look up the definition for yourself, but in my words, it is putting emphasis on the numbers that impact management decisions, and is not related to debits and credits and financial statements and balance sheets. This became perfectly clear to me when I was named controller for a new environmental division of Babcock & Wilcox. We had plenty of financial “numbers” to deal with, but my boss and the new team needed to know what impact various product decisions would have and were having on the business. The models my team and I built helped drive business decisions and reports that helped keep us all on track for success. Oh, our debits and credits were all good too, don’t get me wrong, but we took that for granted.

The role of financial models

This focus on reporting and modeling continued through my career, as CFO at Carnegie Group, CFO and CEO at Best NOMOS and even recently at PLSG in our efforts to raise our own funding and plan investments, and with our portfolio companies, where we needed an accurate portrayal of the decision process and cash needs.

This is even following me into my new venture with Manzetti Group, where clients are looking for accounting accuracy to keep their books clean. In a recent call with a new client, they need “management accounting” information. The CEO is in the dark with his growth plans and a tough capital market is making him rethink his product line expansion plans and look for an alternative. Financial models will play a big role in this process for him as he weighs one pathway against another, looking for the best for his shareholders and the paths he can afford to take.

So, for all my CPA buddies, chill out. I am not tossing you under the bus. I am merely saying that management accounting is underappreciated, and when business leaders are making tough decisions, they demand and need this information.

Posted in UncategorizedLeave a comment

Taking the Long View

Posted on October 6, 2017 by Jeff Rhodes

As the Pittsburgh Life Sciences Greenhouse marks its 15th Anniversary this year, one member of the team has enjoyed the long view of the organization’s history, evolution, and impact.  His is the first face you see when you walk into PLSG’s offices – mine, in fact.

Holding the record as the longest-serving PLSG employee at 13 years, I joined the organization in 2004 and have enjoyed the every bit of the ride.  That’s because I’ve been lucky enough to experience the ever-changing, ever-expanding, ever-exciting environment the Greenhouse generates.

I’ve seen so many changes, in management, initiatives, even how we’re funded.  Even though I’ve been here all these years, it feels like I’ve had the chance to work at a number of new places along the way.

My history with PLSG began when I was asked to help with promotional activities like setting up and conducting trade shows.  Soon my role evolved into a variety of responsibilities, to the point where my job today encompasses so many areas that no day is like the one before, or the one tomorrow.  Through it all, I have to say, the Greenhouse’s mission provides the central theme and reason I have chosen to stay.

After all, our challenge is to attract and keep top talent in this region.  We have the resources here in Pittsburgh with the universities and the hospital systems, and the Greenhouse’s role is so important in bringing all of those pieces together.  When I started here, medical equipment was the big driver.  Now it’s more health care IT.  Who knows what it will be in the years to come?

There’s an air of excitement here these days.  The 15th Anniversary is a good reason to celebrate, but to me this has always been an enjoyable place to be.  I’m proud to be part of this group.  I have never actively sought to find another place to work.  It would be nice to be here another 13 years.  I’m sure the Greenhouse will be here a lot longer than that.

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