Sloane & Company Co-CEO Darren Brandt

Digital Health

Sync Fast and Solve Things

The “move fast and break things” motto might work wonders with consumer products, but a new editorial in npj Digital Medicine makes a compelling case that healthcare needs to flip that paradigm on its head and co-create with clinicians to “sync fast and solve things.”

The editorial argues that healthcare practitioners (HCPs) should play an active role in driving digital health innovation, as opposed to being passively “consulted” so that developers can tout the fact that their product is backed by clinicians.

• The breakneck pace of digital innovation in the wake of the pandemic has outpaced the inclusion of HCPs in the co-creation of new solutions, leading to a fight-or-flight response where clinicians are reluctant to adopt said solutions to defend their traditional responsibilities. Separate research seems to back that up.

• If new tools lack product insight and buy-in from HCPs, they’re significantly more likely to be doomed to clinical irrelevance, as showcased by a recent analysis that found 44% of digital health companies have a clinical robustness score of 0 out of 10.

Although it isn’t an earth-shattering revelation that HCPs have a solid grasp on the exact workflows needed to inform clinically relevant solutions, the authors offer three considerations for shifting from “passive” to “active” co-creation.

• First, financial incentives alone aren’t enough to ensure busy clinicians can engage in meaningful co-creation. The most important incentive that companies can offer clinicians is time, particularly by delivering a product that can optimize workflow efficiency or help deliver quicker treatments.

• Second, the article stresses a need to embed digital health technologies in clinical curricula so that HCPs can learn about not just using these new tools, but also translating their experience into better-informed products.

• Lastly, the authors lay out why there’s a role for regulators to mandate that HCPs participate in digital health innovation, and suggest that payors and legislators consider augmenting their approval processes by requiring HCPs be involved in the development of new solutions to serve as a proxy for their clinical safety and efficacy.

The Takeaway

Healthcare clearly isn’t the best sandbox to “move fast and break things,” but this article is an important reminder that “sync fast and solve things” shouldn’t mean trading clinician input for speed. While passive co-creation might help with the marketing materials, giving clinicians an active role in product development is the only way to ensure their experience is reflected in digital innovation.

Navigate the Future of Healthcare AI at Elevate

Join Medallion at Elevate on October 30th and experience the top minds in healthcare coming together to share bold ideas and connect in an informal, down-to-business setting. This was hands-down the best virtual conference we attended last year, and the lineup for 2024 is packed with execs from orgs like from VillageMD, Multiplan, and Community Health Systems. Take advantage of Elevate by registering here.

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The Wire

• Particle Sues Epic: The highly publicized beef between Particle Health and Epic is culminating in an antitrust lawsuit alleging that the EHR behemoth is using its monopolistic control of patient data to stifle competition from payor platforms that need access to relevant medical records. The litigation estimates that 94% of American patients have at least one record stored in an Epic EHR, and that Epic has “made it commercially impossible” for rivals to use that data. Check out our deep dive on the data exchange debate for a timeline of events leading up to the suit.

• Progyny Loses Amazon: Shares in fertility benefits provider Progyny plummeted over 30% after an 8-K filing revealed that a 670k life employer terminated its contract for 2025. That employer turned out to be Amazon, which contributed over $142M to Progeny’s total revenue in 2023 before signing a new contract to have Maven Clinic supply its fertility benefits next year. That’s a massive blow for Progyny, and also highlights just how much key-client risk can impact many employer-focused vendors.

• AI Targets Healthcare Roles: A PNAS Nexus paper found that cardiovascular technologists have the greatest likelihood of being impacted by AI across all U.S. occupations. The researchers cross-referenced 749 job titles to 24.8k AI patents, with other healthcare roles in the top-20 list including nuclear medicine and MRI techs (#3 & #5), neurologists (#9), radiologists (#16), and medical transcriptionists (#20). The authors noted that “impact” could mean AI augments rather than replaces jobs, especially in industries that have workforce shortages. 

• Dario Integrates Twill Behavioral Capabilities: Chronic condition management company DarioHealth is integrating Twill’s condition-specific peer groups into its cardiometabolic solution to improve member engagement and outcomes. The integration allows Dario members across programs for diabetes, hypertension, and weight management to join Twill’s intertwined approach of community support groups, medical expert advice, and customized educational content. When Dario acquired Twill in February, it said it expected moves like this to double its revenue before the end of the year.

• Hippocratic Adds $17M: Hippocratic AI bolted on another $17M to its recent Series A round that was led by NVIDIA’s venture arm, bringing its total raised to $137M as it continues to develop safety-focused AI agents for non-diagnostic, patient-facing applications. CEO Munjal Shah announced that the NVIDIA collaboration has reduced AI latency so much that Hippocratic has been able to use that “latency surplus” on bigger models with better reasoning that are apparently safer for patients without sacrificing responsiveness.

• VA Outlines Major EHR Incidents: A report from the Veterans Affairs OIG found that the VA’s Oracle Health EHR experienced 826 major performance incidents across the six facilities it was rolled out to between October 2020 and March 2024. Most of those incidents, which included outages, performance decay, and incomplete functionality, occurred after further deployments were put on hold last April, collectively impacting the system’s performance for nearly 80 days. The report outlines the details of the incidents in an effort to get new implementations restarted sometime next year.

• Nabla Debuts on athenahealth Marketplace: Nabla is now officially available through the athenahealth Marketplace, bringing its ambient AI assistant to athena’s extensive network of providers. Nabla will automatically populate core EHR details such as History of Present Illness, Physical Exam, Assessment & Plan, Social History, and Patient Instructions. The move follows Nabla’s expansion to 35 languages and 55 specialties to help break down communication barriers across both in-person and tele-health visits.

• HHS-OIG Goes After RPM: The HHS-OIG is calling for greater oversight and more stringent criteria regarding remote patient monitoring to avoid fraud in Medicare. About 43% of Medicare beneficiaries who received RPM didn’t receive all three components of the service, missing either the monitoring device, education / setup, or ongoing management. The agency recommended that CMS modernize how it monitors and reimburses RPM providers to ensure remote care is appropriate and effective.

• Digital Investment to Prevent Chronic Conditions: New research from the WHO found that investing an additional $0.24/patient/year in digital health interventions could prevent 2M deaths and 7M acute events within the next decade. Chronic conditions are linked to over 74% of global deaths each year, and the WHO makes the case that digital tools, such as telehealth and chatbots, can help individuals understand the modifiable risk factors having a negative impact on their health while encouraging them to develop healthier habits.

• Oak Street Kickback Settlement: Oak Street Health is forking over $60M to settle kickback allegations related to its Client Awareness Program that gave brokers $200 for patient referrals. The DOJ found that the program violated the False Claims Act because it was explicitly intended to incentivise brokers to refer patients to Oak Street, reportedly resulting in over 20k individual transactions that boosted member growth by around 20% between September 2020 and January 2022.

K Health’s First-of-its-Kind AI Knowledge Agent

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The Industry Wire

1. Novo Nordisk CEO testifies on Capitol Hill over high GLP-1 costs.
2. LAPD officer’s gun sucked into MRI machine during raid.
3. Smaller companies consider having employees get their own health plans.
4. One in seven scientific papers may be at least partly fake.
5. Santa Clara county to acquire HCA hospital, make it public.
6. Four ways to keep physicians from quitting.
7. NJ might penalize HCPs for spreading healthcare misinformation.
8. Medicaid enrollment surpasses pre-pandemic levels.
9. Harvard Med researchers use AI to match existing drugs with rare diseases.
10. Penn Medicine residents and fellows reach tentative labor agreement.