⏭️ Chris' Newsletter No. 14 | What is HIPAA?, 50 Ohms, Classpass trends, & Apple Watch studies.
What's happening & what's next in digital health & hardware
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Good Morning!
Thanks for your patience last last week. I'll try not to make skipping it too frequent of an occurrence.
The upside though is there's lots going on. To be in digital health these days is to truly be in the mix. Presidential candidates have radically different visions for healthcare, tech giants are getting data deals with tons of competitors, shipping new devices, and offering health insurance. Startups are building new tools and therapies (and increasingly being eyed by Big Tech and Pharma), and the handling of data that pumps through the veins of all these players is under more scrutiny than ever.
I don't really have a point, it's just an exciting time.
Chris Loughnane
⚖️ Government
Congress Eyes Privacy Protections for Wearable Data. The bill would place heavy restrictions the transferring, selling, and sharing of data unless its anonymized. I like these types of protections so long as accommodations exist for user-approved sharing.
Lessons on sharing clinical trial data. Main lesson from the Yale Open Data Access (YODA) project is that sharing data has overhead and it must be accounted for from the start. Progress has been made in the past years (see clinicaltrials.gov), and I hope it continues.
💊 Pharma & Medtech
The Digital Medicine Society has released a library of digital endpoints An "endpoint" is how a measure is evaluated in a trial. This library has 37 entries, but the details are useful to understand how digital measures are being used in clinical trials.
Machine Learning Predicts Life Expectancy in Heart Failure Patients. Accuracy is 88%. This will naturally extend beyond ill patients and into the lives of the rest of us. The real question is how it will the treatment/care plan.
Biofourmis, a digital health firm, acquires Biovotion, maker of a clinical wearable This underscores what I think will be an increasing trend: digital-only firms and hw-only firms combining forces (or otherwise expanding their services organically) to offer full-stack solutions to large pharma and medtech firms.
⚕️ Providers
Silicon Valley's digital health firms rely on faraway coaches. Digital health is new. Successful firms will leverage human practitioners to ensure a useful service. The real question is whether tech will be able to replace or significantly augment them.
🚀Mira offers access to urgent care clinics for cheap. I just came across this company and it seems neat. For $25/mo and $99/visit patients can get access to lab tests, X-rays, EKG, etc. A sort of "insurance-lite"
💸 Payers
Value-Based Care Models Gain Steam, Cut 20% of Medicare Advantage Spending. It even seems to be working out for providers, who earned $0.16 for every dollar that went to primary care. Those in fee-for-service or other models pocketed about $0.06 for every primary care dollar spent.
Value-based care is 💪
🚀Wellframe Raises $20M from BCBS Ventures. Wellframe acts as a digital layer between payers and patients. It's similar in that way to vivify health, which was recently bought by United Health , an insurer.
Insurers are keen on these types of firms.
🤖 Tech Giants
Apple launches virtual health studies Apple will allow participants to delete their data within 24h of collection.... after Apple can use the data to refine it's HR, activity and other algos. Honestly it feels like a good balance of utility vs privacy.
Large-Scale Assessment of a Apple Watch to Identify Atrial Fibrillation
419,297 enrolled
2,161 notified of irregular heartbeat
450 followed up with ECG
153 were confirmed to have Atrial Fibrillation
Not bad.
Here's how Amazon employees get health care. The "Amazon Care" app is now launched in app stores and employees are starting to get onboarded. Nothing stunning... the biggest news is still the existence of this and the biggest question is the rate at which it will expand.
⌚ Wearables & Apps
🚀ClassPass forecasts The Top Workout Trends For 2020. Classpass has a great vantage point on workout trends. Considering how technically and socially relevant exercise is becoming it's an interesting thing for those of us in digital health to watch.
Whoop raises $55M. I'm surprised by this. From a distance they don't appear to be pushing anything new HW-wise so I presume investors are convinced they (like Fitbit) will have collected enough valuable, labeled data to be useful to a larger tech firm. The main thing they have going for them at this point seems to be that no one else has really cracked into sport. Will be interesting to see how they expand in the next year.
🧪 In the lab
🚀Invitae, a genetics firm, looks to correlate genetics with cardiovascular disease by using Apple Watch. I've said before that firms who consider themselves in a non-genetic field (i.e. cardiovascular) should still have a plan to address genetic components.
🔒 Privacy and security
Apple has revamped their /privacy page. At first I was thought Apple's privacy push was opportunistic. Now I'm convinced they are positioning themselves for a deeper push into our lives. What convinced me was the news about their lifestyle AR headset in 2023. No doubt the first firm to be successful with an outward-facing camera will be one in which society has placed much trust... Apple is trying to be that firm.
There is a renewed push from law-enforcement to limit encryption. Back in No.8 I shared a link showing how End-To-End-Encryption (E2EE) works. The magic of E2EE is that only the sender and recepient can view a message, not the server in between (and by extension not the company who operates the server or the government whose country the server is located in). Law enforcement has disliked it for a long time and it seems to be pushing harder now that tech firms are less popular than they've ever been.
What is HIPAA, and what does it cover? HIPAA is in the news a lot lately. This 92-second primer will help you get a sense on how the 1996 (remember 1996?) works in practice. This is especially important to keep in mind as we hear about things that sound like violations (such as the Google/Ascension story) but are probably not.
🛠️ Enabling tech
Why 50 Ohms for radios? I'm not the guy to teach you about antennas, but being around smarter people than myself I've silently wondered why the need to set precisely to 50 ohms? This article spells it out. The conversation about it at HN is worth checking as well.
🔀 Other Things
A great summary of how investment attitudes in VC have moved over the past decade
Privacytools.io and Prism-break. These are great resources for learning what tools you should (and shouldn’t use) if you want to protect your data.
📚 Books I’m reading
The Score Takes Care of Itself by Bill Walsh
P.S. We should be better friends. Send me a note, I’ll buy you tea/coffee 😃
P.P.S. I just want to be right as soon as possible, so if you see anything that looks like a mistake, please comment 😃