It’s so sad. At least it is if you believe Vinod Khosla, who claims that no one over 45 has new ideas, let alone disruptive ones.

That doesn’t bode well for a new his new healthcare venture.

Amazon is forming a joint venture in healthcare aimed at employees with J.P. Morgan and Berkshire Hathaway, according to a company press release.

Obviously, Khosla and his groupies forgot to tell 54 year-old Jeff Bezos that he is dead in terms of new ideas and that his co-founders, Jamie Dimon, 62 and Warren Buffett, 87, are even deader.

Not only are his co-founders old-to-ancient, one of his first hires was a geriatrician (in case you don’t know, that’s a doctor that specializes in the Medicare crowd)

Must be those dead brain cells at work, since the tech crowd, who are disrupting healthcare with bio hacks and drop-in clinics, know that speed and convenience are what’s needed.

What is it that old guys can see — and the under-40 just don’t get?

If Amazon is looking to disrupt the healthcare industry, why start with geriatrics -— a specialty that hardly seems cutting-edge? But what tech experts don’t know, and what Amazon has figured out, is that to provide high-quality health care for seniors, physicians must be innovative — and disruptive.

Cutting edge IDEO figured that out in 2016.

Just as writers must use their life experience to write with any kind of authenticity, you can’t expect innovations from people who have never experienced or noticed the problem.

When your body, and those in your social circle, work as they should 99% of the time you are unlikely to have a handle on the difficulty of managing multiple, chronic diseases, especially with severely limited resources — financial and human.

So let’s hear it for the old crowd, may they focus their efforts on the problems and challenges of which their younger brethren are barely aware.

Hat tip to Emily White for sending the article.

Image credit: Stuart Richards

AMAZING! Health 2.0’s Precision Health Summit was an absolutely amazing event focused on the future of health, highlighting how technology and big data are transforming healthcare.

Health 2.0, the conference organizer, is a digital health media company, and in addition to its signature event in Santa Clara, has run conferences in Europe, Latin America, India, Japan and more.  The Technology for Precision Health Summit delivered.

I arrived at the summit, was greeted by Joan Hwang of their Marketing and PR team and obtained my badge.  I took the elevators to the 15^th floor and sat at tables with health professionals, researchers, venture capitalists and healthcare entrepreneurs.

The second session, Precision Medicine Pt. 2 – Underlying Technologies Enabling Precision Medicine and Precision Health, perked me up, where I learned that Redox is building an API for healthcare. Genius!

The New Diagnostic Screening Tools and Predictive Analytics – Oncology and Beyond panel was FANTASTIC!  For me, one of the highlights of the conference were the live demos by healthcare companies.

I was super impressed by Color, Helix and Kenzen. Here’s why.

Color offers affordable genetic testing to help understand your risk for common hereditary cancers & hereditary high cholesterol.  Pretty amazing if you think about it.

Helix, founded by a former VC, blew us away. Think of a app store for DNA testing. Using DNA, you can discover your ancestry, slumber habits and more. Welcome to the future: now.

Hands down, my personal favorite was Kenzen. Kenzen uses sweat analysis and continuous health monitoring to help you get ahead of injuries and avoidable health conditions.  Imagine a wearable that provides real time feedback, infinitely more powerful than FitBit or the Apple Watch. INCREDIBLE.

This conference is one of the best I’ve attended.  As a tech professional, I’ve attended many tech conferences.  The Technology for Precision Health Summit was focused, drove excellent conversations on the future of health, showcased healthcare startups leveraging technology as a differentiator and highlighted the importance of data collaboration in order to address today’s health challenges.

In my experience, a culture of collaboration both intra-company and industry wide, leads to greater outcomes for all.

This conference should be attended by every healthcare professional concerned about the future of health and every venture capitalist looking for new platforms to deploy capital.

This is the place to view demos, learn how startups are creating Health 2.0 and understand how to partner with these companies.

I highly recommend the Technology for Precision Health Summit and look forward to their next conference!

Image credit: Health 2.0

Ever noticed how new projects needed by year-end put a cramp in other projects?

This is not the post I was planning to go with the interviews, but when it’s 1 am and your deadline is upon you, you do what’s necessary,

We’ve all been there.

One interview was with a researcher, who preferred to be anonymous. I’m not sure why, but his DNA privacy concerns really resonated with me.

The second was with Reed Tayler, founder of Method Yoga.

I hope you enjoy the interviews and will join me Friday for a more personal view of the Summit.

Image credit: Health 2.0

Muema At The Precision Health Conference

Today I’m pleased to welcome Muema Lombe, a new voice at MAPping Company Success. He’ll be sharing news from conferences and interviews with founders.

Health 2.0 runs some of the best conferences for anyone passionate about the future of healthcare and medicine.  I just attended  its Technology for Precision Health Summit which focuses on predictive health and predictive medicine.

Linda Molnar, Chair of the Technology for Precision Health Summit, set to the tone for the day, speaking of what we can do today to improve care for the future.

In 2005, the market cap of Illumina, now the major gene sequencing company, was only $250 million. There was a relatively negligible amount of venture capital investment in digital healthcare. Now, in 2017, the market cap of Illumina, I checked this morning, is approaching $32 billion. And 2017 was a record-breaking year for venture capital invested in digital healthcare. When you start past $4 billion…

I sat next to Carmen Perez, a Healthcare professional passionate about innovation. Other attendees included physicians, researchers, oncologists and venture capitalists.

Claudia Williams, CEO of Manifest MedEx gave the Keynote.  Claudia served as Senior Advisor for Health Innovation and Technology in the Obama White House.  Claudia’s goal is to create an open platform of data, a health information exchange for the 21st century that brings together plans, providers, hospitals to share data and make it accessible through open API platform.

When I was at the White House, I helped launch and lead the precision medicine initiative, which was an ambitious project to found the framing hand of the 21st century, bringing together data, genomics data, health record data, wearable data from a million or more Americans, making that accessible on an open platform and with the goal of revolutionizing the discovery of new therapies and treatment.

Following Claudia’s Keynote, the first panel focused on Precision Medicine Pt. I – How Science and Technology are Changing Patient Care in Oncology.  We heard from Jonathan Hirsch, founder and president at Syapse, which is in the business of implementing precision medicine in oncology.

Also on the panel was Anna Barry, a molecular pathologist and the Scientific Director at the Personalized Medicine Program at Swedish, a large private hospital that’s very research focused. They have over 700 clinical trials.

We heard from Vineeta Agarwala, a Director of Product Management at Flatiron Health. Vineeta shared that she had the epiphany that if we don’t figure out how to annotate genomic data well, and annotate it well at scale, sequencing data will never make it into the clinic in a meaningful way.

At it’s core, one of Flatiron’s mission, we are an oncology focused health-tech company based in New York. We make both provider facing software, such as an EMR product that’s used by a significant fraction of the community of oncology practices all across the country as well as research product and data sets, that are gleaned, again, largely the wealth, the majority of cancer patients today, in American who happen to be seen at excellent community centers all across the country.

Trained as a Neuro-Oncologist, Andrew Norton, Chief Medical Officer at Koda Health was also on the panel.   Koda is a healthcare data analytics company, which focusing on cancer.

Essentially our core innovation that led to the founding of the company was the idea that without deep clinical data, and without the ability to stratify patients into meaningful, clinically determined sub-groups, you really can’t compare patient treatment pathways and outcomes across centers and across geography.

So essentially what we do, is we go into electronic medical records. We pull out all of the clinically relevant data that oncologists have told us matter in making treatment decisions, we condense that information into a digital code and then we use it to track patient treatment paths and outcomes over time. And really the fundamental goal of all that work is to enable providers to perform under value-based care contracts.

During the panel, Hirsch brought up that we have to think about it as how we combine molecular and clinical data and use that insight to enable a provider to make a better care decision for the patient.

He also made a very clear distinction between personalized medicine and precision medicine.

“And just to amplify that, we sometimes thing that there’s been a shift and personalized medicine and precision medicine are actually the same thing, and we’re just using different language. I don’t think that that’s the case. I really do think that there are these two complementary concepts of precision medicine being a data-driven approach and personalized, hopefully incorporating precision, but really thinking about the holistic care of the patient, supportive care services, psychological counseling, nutrition, etc. So I do think there are these two separate concepts, we shouldn’t confuse them. And both of them are incredibly important.”

Agarwala highlighted key questions we should consider including,

• Where is the data to help physicians help make a decision about whether or not a particular therapy will work?

• Where is the data to generate our collective understanding of what mutations confer resistance to therapy?

And I think today, while in some parts of the country there are molecular tumor boards and studies and post-effective studies that are extraordinary in their depth and characterization of patient outcomes they are not pervasive.

Unfortunately, for every patient who was in a study like that there are typically about a hundred who are undergoing the same type of care somewhere that’s completely silent to the research community. In a way that’s passive exhaust in our healthcare system that no one can access to learn from.”

There’s much more that I’ll share with you next week.

Image credit: Health 2.0

IBM Watson Health and Broad Institute launch major research initiative to study why cancers become drug resistant.

Hi Folks,

I had the chance to attend one of the largest healthcare IT conferences this week in Orlando known as HIMSS or Healthcare Information and Management Systems Society.  

What this mouthful of a name means is if you want a venue showcasing the cutting edge technology in healthcare with 40,000 of your closest friends…well you’re in the right spot.

I was there as a representative of my company and had a chance to have some meaningful conversations, but it was the conversations off the floor that were perhaps more valuable.

As anyone who has attended a convention of this size knows, you’re in for a menagerie of vendor sites and sounds. It can be overwhelming and enlightening 

While I had some downtime I took a walk on the floor to see what else is occurring within the medtech sector.

During one of these occasions I had a chance to meet with some folks from IBM. Now IBM needs no introduction, but within healthcare they are a new entrant.

They have utilized their Watson cognitive thinking system to tackle some of the toughest problems in medicine today.

They are currently focused on oncology and determining patients at risk or treating mutations earlier than currently possible.

Something that struck me was the fact that this technology is very affordable to their customers. Their mindset is that all people, regardless of income, location, background or country should receive the same level of care as anyone else.

I was floored.

Healthcare is big business and while most mean well, the stated goals are not so noble.

Where did this culture come from at IBM? 

As of now I don’t have that answer, but I wanted to at least inform you that a company of that size has genuine concern for the well being of us all.

Flickr image credit: IBM

his year’s Vator Splash Health, which took place at Kaiser HQ in Oakland, was Startup focused and well worth the price of admission.

As we’ve come to expect, it featured a very impressive line-up of panelists and speakers dealing with extremely relevant topics ranging from opening remarks (kidding), tackling cancer with technology, to patient-centered healthcare, to telemedicine and patient engagement, to protecting yourself as the founder, to uncovering new data from API’s and platforms, to big picture items, such as the future of healthcare altogether.

There were supercharged Splash competition presentations featuring three of Health Tech finalists creating an opportunity for new businesses to effectively message their product.

Participating vendors were easily accessible; including Bloom Technologies, DocDelta, Lighthouse, from the American Diabetes Association, Lab Sensor Solutions, Carrum Health, and Crediyo.

Event partners included KPMG, SAP Startup Focus, Bread & Butter, Artis, Scrubbed, Stratpoint, and Healthiest.

On the agenda throughout the day were fireside chats with the likes of Helmy Eltoukhy, founder & CEO, Guardant Health and Vator founder/CEO Bambi Francisco.

Other splash talk topics showcased — when software eats bio, funding the science behind healthcare, Who’s financing the digital health ecosystem?, and Are You in Kaiser’s Line of Sight: A Buyer’s Perspective.

Big data was discussed at length, crystallizing the notion that it is the current ability, made accessible by modern technology, to put meaningful patterns together that are deployable that will affect outcomes and achieve objectives.   

An additional topic or two that I was pleasantly surprised by was the acknowledgement by Dave Schulte, Managing Director at McKesson Ventures, of the importance of the virtue of humility, in admitting “not knowing”. Kudos to Dave because this, of course, comes against the backdrop of Silicon Valley’s famed hubris. 

Leading to another interesting point in that, at a minimum, the possibility (if not certainty) exists, that there will be a falling away or clearing of many of the startups and downturn both in investment activity and new business creation.

A sober but fair assessment and reminder of the unavoidable cyclical nature of business that correctly tempers expectations. 

More than simply being a fun event, populated by interesting shakers and market makers, with good,  healthy food (a very pleasant change), it was a phenomenal networking forum and that, perhaps, is its most intrinsic value.

No matter your age healthcare is/should be a serious concern.

If not for yourself then for your parents and others you care about.

And not just a new app that delivers services a different way, no matter how good.

What needs to change is the culture of not only insurance companies, but medical service providers (doctors, labs, testing, hospitals, etc.), other various and sundry vendors within the ecosystem, not to mention the government in the form of Medicare and Medicaid.

When you look at the deeply entrenched interests on that list the possibility of anything actually happening in the near-term seems remote, if at all.

Not even the proverbial 500 pound gorilla, think Google or Facebook, has the clout to even dent that crowd.

But what about Aetna Insurance under CEO Mark Bertolini, a 1000 pound gorilla and long-time global player in healthcare that has the clout, since it insures two thirds of the Fortune 100 and a great number of the 500?

…Bertolini called the sector “too bloated and accountable to no one.” The system — which will cost US$4.6 trillion, or 20 percent of U.S. GDP, by 2020 — “charges patients and rewards care providers on services delivered, not patient outcomes,”…

Aetna is taking a three prong approach that includes, paying for positive outcomes, as opposed to fees for services; changing corporate health offerings in order to tap into positive consumer behavior and eating its own dog food — as every good startup does.

The big question is whether Aetna will walk its talk.

Based on the comments it’s questionable.

Flickr image credit: Aetna

Emily White is a long-time friend of mine.

We met at the end of the last century over our startups.

Like me, Emily isn’t a twenty-something-guy-in-a-hoodie.

She founded OnlineHR, one of the earliest social networks, in 1999. Then 47, “I didn’t know what I didn’t know.”

Emily is back with a vengeance as an entrepreneur, although she never really left. She reached into her past to pay the bills, while searching for her next startup idea.

In search of that next unidentified problem and solution, White returned to social work 30 years after earning a masters degree. Working for five organizations—all of them related to geriatrics, a personal interest and expertise—over the course of seven years, she “saw the problem was in care transition.”

In doing so, she also tapped into her passion for better senior care and combined it with technology to find a viable, affordable solution in the booming healthcare arena.

All of that led her, at the age of 61, to two 20-somethings, both MIT graduates, with a big idea. In 2014, White joined GeriJoy as co-founder and vice president of strategic alliance. GeriJoy is a tablet-based chronic care management and virtual caregiving tool backed by real health advocates. Bottom line? GeriJoy leads to lower hospital readmission rates. (…)GeriJoy has already successfully reduced emergency room readmissions for users and, in tests, had good results with people who are experiencing various forms of dementia. The combination of a human interface and artificial intelligence puts GeriJoy at the forefront of healthcare tech start-ups.

Contrary to popular media, nearly a quarter of startups are founded by the over 55 crowd.

Leaping in to entrepreneurialism as an older adult, White is not alone. According to the Kauffman Index of Entrepreneurial Activity, 1996-2011, 23.4 percent of American entrepreneurs in 2013 were people between the ages of 55 and 64, up from 18.7 percent in 2003.

Read the full story here.

Image credit: Emily White

If any consumer industry is ripe for disruption it’s healthcare—not just its recordkeeping.

Yet it would be hard to find any industry in which the established players are more resistant or just plain obstructive.

But thanks to people such as Elizabeth Holmes, founder of Theranos, and Dr. Isaac Yonemoto, founder of open-source IndySci, real disruption is happening.

Eleven years ago at 19 Holmes decided that she would spend her Stanford tuition on changing the healthcare status quo, which she did by upending one of the oldest, most expensive, completely ubiquitous, and least changed diagnostic tools—blood testing.

The new tests can be done without going to the doctor, which saves both money and time. Most results are available in about four hours, which means that you could swing by a pharmacy and have a test done the day before a doctor’s visit, and then the results would be available for the physician.

Each test costs less than 50% of standard Medicare and Medicaid reimbursement rates. If those two programs were to perform all tests at those prices, they’d save $202 billion over the next decade.

As an example of how helpful that can be, Holmes told Wired that Theranos charges $35 for a fertility test, which is usually paid for out-of-pocket and costs up to $2,000.

Those who aren’t partial to needles and vials of blood (most of us) should note that the Theranos test requires only one drop of blood from a prick of the finger.

Last year the company cut a deal with Walgreens to roll out Theranos Wellness Centers inside each of its 8000-plus pharmacies.

Dr. Isaac Yonemoto is used crowdfunding (campaign ended October 28) to finance Project Marilyn to create open sourced, patent-free cancer drugs.

The global market for these drugs surpassed $1 trillion this year. The average monthly cost of a brand-name cancer drug in the U.S. is about $10,000, according to the IMS Institute for Healthcare Informatics. (…) “The big picture is we’ll be trying to solve the problem of expensive pharmaceuticals by releasing drug candidates that put downward pressure on price through competition.”

Elizabeth Holmes’ one-drop blood test is the start of true disruption and if Dr. Isaac Yonemoto’s Project Marilyn is even half as successful as Linus Torvalds’ Linux they will change the face of medicine and the pharmaceutical industry forever.

Innovation is often a direct result of research, but they both depend on a willingness to look at the tangible and intangible in new ways and healthcare and medicine (not the same thing) are starting to benefit. Here are a few things that caught my interest.

The Cleveland Clinic in Ohio, which has long been a medical innovator, has turned its attention to better ways to use IT to improve patient outcomes. (For many years the Clinic has had its own company formed specifically to commercialize its discoveries, leading to conflict-of-interest accusations.)

The clinic is a pioneer in providing information to patients and linking patient involvement with medical records and healthcare practice improvement. It is also vigorously experimenting with medical IT in new forms of patient engagement and education, including social media.

Startup Healthy Labs is creating social websites that target specific chronic medical conditions, such as Crohn’s Disease and Colitis, which are verifiably for patients.

…patient-only networks — people have to be verified as actually being diagnosed with the relevant issues before they can join. This is meant to keep out people shilling for pharmaceuticals and certain holistic “cures,” and keep the community centered around the real folks who are dealing with chronic diseases at hand.

Practice Fusion is for the rest of us, providing the kind of central medical repository that has been talked about for years, but doing it cost effectively.

… a massive database of information for medical professionals and patients that includes everything from records and vitals to doctor reviews, has data for more than 50 million patients. More than 150,000 medical professionals use it to keep track of patient data.

Experts researching the outlandish rising costs of US Healthcare are finally focusing on a major cause—the American attitude of ‘more is better’.

But an epidemic of overtreatment — too many scans, too many blood tests, too many procedures — is costing the nation’s health care system at least $210 billion a year, according to the Institute of Medicine, and taking a human toll in pain, emotional suffering, severe complications and even death.

Thanks to false information that vaccinations are the cause of autism many childhood illnesses that were seen as vanquished have made a comeback. Multiple studies have found that autism is securely tied to the world of auto immune diseases and the problems start in the womb—but the information has not been popularized.

Danish study, which included nearly 700,000 births over a decade, found that a mother’s rheumatoid arthritis, a degenerative disease of the joints, elevated a child’s risk of autism by 80 percent. Her celiac disease, an inflammatory disease prompted by proteins in wheat and other grains, increased it 350 percent.

Finally, did you know that low sperm count is a global problem? And that it is worst in Israel.

… that his stable of superior donors includes only tall, twentysomething ex-soldiers whose sperm has passed rigorous genetic testing. But finding such super sperm isn’t as easy as it used to be. Only 1 in 100 donors makes the cut. A decade ago, it was 1 in 10.

Flickr image credit: pedroelcarvalho