⏭️Chris' Newsletter: No. 2
A weekly newsletter where I try to distill what's noteworthy and what's next in digital health & hardware.
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🙏 Trials & Studies
Nearly 200k of the participants in the NIH’s “All of Us” study will be getting the results of their genetic analyses soon. The study is a part of the NIH’s Precision Medicine Initiative and is similar to Alphabet’s baseline study in that it doesn’t intend to address a specific disease, but rather to collect a bunch of data and see what they can do with it later. It’s also noteworthy that Verily (a subsidiary of Alphabet) is managing the data from the All of Us study. Link
Deepmind’s AI system can quickly interpret eye scans and correctly recommend treatment for over 50 sight-threatening eye diseases. Alphabet is really all over the front lines. There’s been a lot of interest (from others as well) in the eyes. As far as non-invasive tech goes it’s one of the more data-rich sources we have access to. There is a lot more coming. Link
💸 Healthcare Economics
Ciitizen has built a Patient Record Scorecard ranking how well (or not) providers comply HIPAA’s “Right of Access” clause. Everyone claims to be HIPAA compliant, but it’s still often very difficult to obtain health records. This increases friction in the system and ultimately hurts consumer choice. Currently Electronic Medical Records are buried within organizations with poor interoperability between them. The firm that is able to make the data more centered on the patient (rather than the organization) will reap huge rewards.
Top US medical centers have been rolling out DNA sequencing for their healthy clients. The success of 23andme’s sequencing kits have more “pro” institutions (e.g. Brigham & Women’s as well as firms like Veritas) offering more extensive service offering. As the numbers of detailed genomes rise the data is going to start making it’s way into the diagnostic pathways. Digital Health firms that don’t consider the genome right now should start thinking about how they might (or how to explain to their customers why they don’t). Link
America’s biggest charities are owned by pharmaceutical companies. These charities often exist to cover co-payments. Essentially when a patient needs a type of drog the option is a branded drug (e.g. Lipitor with a co-payment $165/mo) or a generic (Atorvastatin for $/10 mo). With help from the charity, the out-of-pocket costs are equal, making a brand-name prescription more likely. These economics (and how they change over the coming years) will be relevant to digital health firms as pharmaceutical firms look to leverage digital solutions for more precise, personalized dosing. Link
⌚ Wearables
Fitbit won a bid over Apple (among others) to provide 100k-1M Fitbit Inspire’s to the Singaporean government. Last week I mentioned how Fitbit hasn’t been able to shift into services in the way they had hoped (one of the several reasons for their terrible financial performance). This is definitely a step in the right direction for them; the combination of cheap devices (esp. compared to Apple) and high-value services on top is one a lot of organizations and government will find fruitful, at least until Fitbit’s sensor set is totally commoditized. Link
AliveCor ends sales of Kardia Band. It was super clear Apple would do this and their embodiment was much better than Kardia Band. It still remains to be seen how much actual value is generated by spot-check ECG at the wrist. Link
Speaking of Apple, their health team is facing some departures. There appears to be some tension between the those who want to do more faster than the inevitably slow pace of a company with an installed base larger than population of many rich countries. In general Apple’s approach is to take their time to get things right for the general population. Unfortunately that’s not as exciting as making a big splash for users with a particular disease or revolutionizing data management… that seems to be the domain of startups. Link
📖 Other Things
The American Medical Association hosts a “Clinical Problems Database”. Speaking of niches.Link
Juul Raises $325M in financing for expansion. This is a new way of getting addicted to nicotine… I expect new ways will follow to help people kick the habit. Link
Exposure to fluoridated water increases women's earnings by approximately 4 percent, but has no detectable effect for men. Link
Most opioid patients never get addicted and most people who do get addicted didn’t start their opioid addiction with a doctor’s prescription. Nuance matters, especially with so many firms working on addiction. Link
Best,
Chris
P.S. We should be better friends. Send me a note, I’ll buy you tea/coffee :)