⏭️Chris' Newsletter No.8 | Trumpcare, social determinants, open-source hardware, and MSFT earbuds
What's happening & what's next in digital health & hardware
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Good Morning!
The most popular article last week was on BLE throughput, and honestly it was one of my favorites as well. I’ve included something similarly technical this week on end-to-end encryption. I like it. I hope you do too :)
Also, thanks to all of you who alerted me of the broken emoji’s in last week’s newsletter. I think it’s fixed now, but please let me know if you see anything strange.
Chris Loughnane
Actors
⚖️ Government
The FDA doesn’t want to regulate low-risk AI software. Naturally, it prefers to focus on “high-risk”. The guidance elaborates on what the FDA calls “Clinical Decision Support” (CDS) software and includes examples as to how different scenarios align with their framework. This is an ongoing effort and warrants a deeper dive.
💊Pharma & Medtech
🚀Progyny, a fertility benefits company, has filed to go public. I’ve writen about the fertility boom before (No. 4), but what’s most interesting here is that 2 of Progyny’s largest investors are GSK and Merck, the later of which is a major provider of the fertility treatments that Progyny covers. This makes Progyny sounds more like a delivery vehicle than a standalone company, not dissimilar to the news that Pharma backs huge charities that cover co-pays for brand-name drugs (No. 2)
🚀Biofourmis receives approval for AI-powered monitoring device. The system uses AI and machine learning to identify correlations between vital signs and a heart-failure patient’s daily activities, and alerts accordingly.
Novartis announced an AI partnership with Microsoft. The landgrab of partnerships continues (most recently Google & Mayo partnered…No.6). Someone should do a deep dive on the relationships between big tech and pharma/med.
⚕️ Providers
Hospitals large and small are continuing to merge. Hospital administrators say it’s to reduce costs, but many studies (including this very comprehensive one I pulled from healthcarepricingproject.org/), indicate that local monopolies tend to drive up prices. One explanation could be that the larger the hospital system, the more power it has in negotiation with payers.
Uber think non-emergency medical transportation is a $15B opportunity. That’s just for starters, transit and meals for low-income patients could have a huge value per dollar. I think we’ll be hearing a lot about these non-traditional “social determinants of health”… including in the next section. 👇🏻
💸Payers
Cigna and Humana will include coverage for caregiver support, rides to medical appointments, and more in Medicare Advantage plans. These non-healthcare factors that could nonetheless have a significant impact on health (e.g. if you can’t get afford a $20 uber to the doctor your condition might get much worse), are dubbed “social determinants of health” (discussed in the podcast from a16z from No.5). Remember the Medicare Advantage plans are ones where insurers receive a monthly stipend in exchange for taking care of the health needs of an individual, and so are incentivized to do things that work, be they conventional or not.
Some people are seeing ads for “Trumpcare”, which doesn’t actually exist. Aparently clicking on these ads often brings you to barebones plans offered by some broker. Regardless, it’s an indication of how politicized healthcare has become in America… it seems like their is no ceiling to it.
🤖 Tech Giants
Microsoft launched Surface Earbuds They are really ugly, but I feel the same way about the airpods and I still use them, so ¯\_(ツ)_/¯. I Microsoft isn’t pumping out devices at quite the same rate as Amazon (15 announced last week), but at this point it’s tough to see any of the big giants staying out of any category for too long. I continue to believe earbuds are a notable entrant for any player given their potential as a data source for meaningful health info.
Big Topics
⌚Wearables & Apps
Step counts can be distilled into clinically important metrics. Technologically it feels like we’ve moved past “steps”, but it’s important for tech folks to remember that tools don’t become socially interesting until they become technically boring.
🧪In the lab
Rapid DNA machines are showing up in police stations. On one hand this makes sense, on the other hand, the tech is still advancing quickly and having untrained people use cutting-edge technology is likely to result in sloppy results, which is clearly a problem when the results are destined for a courtroom.
🔒Privacy and security
A video on how End-to-End Encryption (E2EE) works. The defining feature of E2EE is that the server (even if managed by a service provider) is physically incapable of reading information. This is great for user privacy but bad for the firms who want to use that data to provide a better service. It’s also shows up in the news often in the context of governments not liking it because then they can’t get access to user information.
🛠️ Enabling tech
RISC-V, an open source competitor to the Arm & Intel duopoly, is having a moment. While the costs of actually fabricating chips are high, the royalties paid to Arm & Intel for using their chip designs can be an even more meaningful cost at high volume. Mix in long contract negotiations and an increasingly unpredictable export restrictions and open source designs have clearly started to look appealing to many, particularly for low-margin devices.
Nordic’s nRF9160 SiP is certified for Verizon’s LTE-M network. These Low-Power, Wide-Area Networks (LPWANs) are going to show up more and more… especially as firms like Amazon crank out smarts and communications into everything.
🔀Other Things
150 Digital Health Startups from CB Insights
“What the british say” vs. “what the british mean” vs. “what the dutch understand” I’ve been thinking a lot about communication lately (not least because some smart people around me have been talking about it). I’ve added The Culture Map to my reading list.
📚Books I’m reading
Why We Sleep: Unlocking the Power of Sleep and Dreams by Matthew Walker
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 :)