Squeezing Out The Waste with Digital Health Innovation

By Patricia Salber, MD, MBA | Published 10/5/2017 0

tablet with digital health screen 1200 x 826

As always, there was so much to see and do at Health 2.0 that you hardly know where to start. And you know when you are sitting in one breakout, you are missing 6 or 7 others. I had to make some tough choices, but I did find some very cool things to share with you. I am going start my conference coverage by telling you about two companies that I really like that have been around for a while (that means they have fully formed products and customers) and one that is a newbie but offers a novel approach to an old problem, weight loss. Each of them, in their own way, focus on streamlining processes to improve efficiency—something we need much more of in healthcare.


Bright.MD is streamlining primary care

Bright.MD is one of my favorite digital health companies. I have written about (and filmed) them before so I was delighted to have a chance to catch up with founder and CEO, Ray Costantini at Health 2.0. Since the last time we talked, he has raised $3.5 million in capital and grown from a handful of employees to 23 (with 12 open positions). They have also added many new delivery systems and now offer their services from coast to coast.

Here is what they do in a nutshell: They reduce the time a doctor spends on straight-forward clinical problems from 15 minutes to 2.

What?? Is that good? The answer is yes, indeed, because they are removing routine tasks from the physician’s plate and allowing him/her to use their expensively acquired knowledge and skills to make the diagnosis and prescribe treatment. Bright.md does everything else including taking a detailed history via an elegant online platform, formulating a list of possible diagnoses prioritized by likelihood based on information provided by the patient, and presenting the doctor with a list of possible treatments, again prioritized based on the diagnosis. If photographs could enhance the ability of the clinician to make the correct diagnosis, patients are given recommendations about which photos to take and how to take and upload them. For example, if the issue is a rash, a close up of the lesions are recommended as well as a photo that would show the extent and location of the lesions.

Bright.MD smart exam (580 x 349)All of this information is presented to the clinician in an easy to read document, resembling a SOAP note, that allows a decision to be made in an average of 2 minutes. Because time-consuming history-taking and documentation are performed by Bright.me, the clinician is truly functioning at the absolute top of license, improving efficiency and lowering costs for that encounter. It also frees up time for clinicians to spend more time on complicated patients. Roy tells me they offer this service to patients without health insurance for $20 (Wow!).

Clinicians can easily choose the diagnosis that they think is right from the list presented or they can choose something else. They can also contact the patient to get more information if they think they need it. Bright.md follows up with each patient using its service to be sure they have gotten better.

Note: Bright.md is not making the diagnosis, they are suggesting diagnoses. They do not aim to be a substitute for a doctor, rather a supplement that improves the physician’s workflow. This is not just a bright idea, it is brilliant.


CliniOps: Making clinical trials faster, cheaper, and with high data quality

Full disclosure, I am an advisor to CliniOps. But the reason I am an advisor is because I love what they are doing and believe that we absolutely must streamline clinical trials so that we can get new drugs and other treatments into the hands of doctors and patients much faster than we are doing today.

The CTO of the company, Yerramalli Subramaniam (a.k.a. Subbu), demoed CliniOps’ eSource solution in the Health2.0 breakout titled Personalized Health: Turning Data into Value. In order to appreciate the value they are bringing, you need to understand how clinical trial data is currently collected. It is often entered into a form via pen and paper and later manually entered into whatever data collection platform the clinical trial is using. This invariably results in transcription errors that must be detected by having someone audit the results by comparing what is on the paper form to what is transcribed in the data collection platform. This is time-consuming and costly—accounting for up to 30% of the costs.

Because CliniOp’s eSource solution supports offline data collection, data can be entered directly into the platform, without the dependency on the internet. It can then be synced to their cloud-based platform once the tablet is in range of the Internet. This is something critically important not only in global clinical trials with sites in the emerging world, but also in clinical trials in ambulatory settings in the developed world. In addition to this, CliniOps has digitized and simplified the consent process as well as subject authentication.

CliniOps ProductThe company has three main products:

  1. CliniTrial allows users to set up studies quickly and easily and collect clinical trial data more efficiently using their e-sourcing technology.
  2. CliniSite allows real-time visibility of site performance and offers a centralized way to monitor the progress of study patients once the data has been uploaded.
  3. CliniPatient is used to keep study patients informed and engaged throughout the study duration and help keep drop-out to a minimum.

CliniOps has won many awards, including the 2017 Technology Leadership award for Digitalization of Clinical Trials from Frost & Sullivan. It is no wonder, considering the contributions they are making to bringing key aspects of clinical trials into the 21st Century.


Klue: Making it easier to track consumption

One of eleven hot tech start-ups to make their debut at this year’s LAUNCH! at Health 2.0’s annual conference in Santa Clara, Klue is offering a new tool in our endless battle to get to the weight we want. It’s a wearable with a twist. Instead of counting steps, they are counting various types of hand movements that they say correlate with different types of eating and drinking behaviors.

Klue eat screenshot (300 x 533)Embedded in an off-the-shelf wearable, Klue’s patent-pending software tracks how often users make hand-to-mouth movements. Not only that, but it can also discriminate between eating and drinking behaviors. CEO and Co-founder Katelijn Vleugels, says,

“Klue is deceptively simple, but also very promising.”

She goes on to say, “We’ve identified the hand as a source of information that can greatly help us understand our individual behaviors and go beyond manual tracking of eating and drinking, which only a few of us can sustain given the difficulty or friction involved.” She’s absolutely right about the last part as anyone who has tried to manually track the calories they consume knows. No matter how well-intentioned or how easy an app makes it for you to do it, almost everyone quits doing it after a few weeks or months. Katelijn told me the key is that Klue collects the information passively, you just have to wear the wearable.

In a pre-conference interview, I learned that Klue can decipher subtle differences in hand gestures that allow the software to determine whether a person is eating or drinking. By tracking when, how often, and how fast the hand goes to mouth, the application is able to graph consumption patterns and, in real time, coach users to eat more slowly or stay well-hydrated.

The company is still in private beta so I wasn’t able to ascertain whether or not Klue actually works the way it is supposed to, but I did learn that some Angels have been intrigued enough with the company and it’s potential to invest $500,000.

Patricia Salber, MD, MBA

Website: https://thedoctorweighsin.com

Patricia Salber, MD, MBA is the Founder. CEO, and Editor-in-Chief of The Doctor Weighs In (TDWI). Founded in 2005 as a single-author blog, it has evolved into a multi-authored, multi-media health information site with a global audience. She has worked hard to ensure that TDWI is a trusted resource for health information on a wide variety of health topics. Moreover, Dr. Salber is widely acknowledged as an important contributor to the health information space, including having been honored by LinkedIn as one of ten Top Voices in Healthcare in both 2017 and 2018.

Dr. Salber has a long list of peer-reviewed publications as well as publications in trade and popular press. She has published two books, the latest being “Connected Health: Improving Care, Safety, and Efficiency with Wearables and IoT solutions. She has hosted podcasts and video interviews with many well-known healthcare experts and innovators. Spreading the word about health and healthcare innovation is her passion.

She attended the University of California Berkeley for her undergraduate and graduate studies and UC San Francisco for medical school, internal medicine residency, and endocrine fellowship. She also completed a Pew Fellowship in Health Policy at the affiliated Institute for Health Policy Studies. She earned an MBA with a health focus at the University of California Irvine.

She joined Kaiser Permanente (KP)where she practiced emergency medicine as a board-certified internist and emergency physician before moving into administration. She served as the first Physician Director for National Accounts at the Permanente Federation. And, also served as the lead on a dedicated Kaiser Permanente-General Motors team to help GM with its managed care strategy. GM was the largest private purchaser of healthcare in the world at that time. After leaving KP, she worked as a physician executive in a number of health plans, including serving as EVP and Chief Medical Officer at Universal American.

She consults and/or advises a wide variety of organizations including digital start-ups such as CliniOps, My Safety Nest, and Doctor Base (acquired). She currently consults with Duty First Consulting as well as Faegre, Drinker, Biddle, and Reath, LLP.

Pat serves on the Board of Trustees of MedShare, a global humanitarian organization. She chairs the organization’s Development Committee and she also chairs MedShare's Western Regional Council.

Dr. Salber is married and lives with her husband and dog in beautiful Marin County in California. She has three grown children and two granddaughters with whom she loves to travel.

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