Artificial Intelligence, Consumer / Employer, Health Tech, Hospitals, Patient Engagement, Startups

7 Hot Takes I Heard at HLTH

At HLTH 2023, I had dozens of conversations with providers, digital health investors, startup CEOs and other players in the healthcare industry. When I got home, I compiled seven refreshingly honest takes I heard from them while at the conference.

Over the three days I spent in Las Vegas for this year’s HLTH conference, I had dozens of conversations with providers, digital health investors, startup CEOs and other players in the healthcare industry. I enjoyed them all. But as expected, some discussions were heavy on niceties and platitudes — and light on actually speaking openly about the industry.

Below, I compiled seven refreshingly honest takes I heard from leaders while at the conference.

We might need to cool it with the AI hype

HLTH was full of hype and news surrounding AI, specifically generative AI, but Atropos Health CEO Brigham Hyde said that “the winning company for generative AI has not been built yet.”

In his view, generative AI in healthcare is still in a very iterative phase. The companies that will end up “winners” will be those that focus on user experience, practical applications and appropriate use cases, Hyde declared.

Ellen Rudolph, CEO of WellTheory, also said that the healthcare industry could stand to reign in some of its AI enthusiasm.

“Everyone’s talking about AI, but overlooking our approach. It comes with gender-specific biases and more. We’re missing the importance of human interaction when it comes to care. Everyone crowded all of the AI panels, but there are still so many more foundational items that’s important to healthcare. And let’s be honest, AI isn’t going to solve for all of the care gaps that still exist in healthcare,” she explained.

Some investors share this sentiment as well. For instance, Morgan Cheatham, vice president at Bessemer Venture Partners, predicted that “the AI-first companies are going to pull away in the next nine to 12 months.” He added that it will be “very apparent” which companies are actually in the business of advancing state of the art methods in AI versus those “that are thinly veiled wrappers over GPT.”

Indirect monetization is a new distribution advantage in the digital health world

Two other Bessemer investors, Sofia Guerra and Steve Kraus, unveiled a report at HLTH that included predictions about where the digital health world is headed in 2024. One of these predictions was that startups selling technology to providers may need to rethink their distribution models.

“One of the biggest challenges in health tech is distribution,” Kraus said. “It’s really challenging to sell to health systems. Companies are trying to find pockets of spend that health systems already have to automate and make more efficient. It’s not like they’re creating a new spend — they’re just trying to use modern technology to make it cheaper, better, faster.”

Because most providers are pretty strapped for cash, startups may need to start offering up their software for free and utilizing indirect monetization strategies, Kraus explained. For example, House Rx, which aims to make specialty medication more affordable and accessible, provides technology to practices and profits from specialty pharmacy prescriptions through distribution agreements with drugmakers.

Additionally, contingency-based pricing is often easier for health systems to swallow than upfront fees, given the financial pressures providers are facing right now, Krause noted. SmarterDx, which provides clinical review and quality audit of medical claims, uses this model. Instead of charging an upfront fee, the company charges customers based on the amount of missing clinical documentation its technology ends up identifying.

Providers must abandon paternalism and start treating patients like decision-makers

Nworah Ayogu, chief medical officer of Amazon Clinic, pointed out that medicine has historically had a reputation of paternalism. To remedy this, he thinks providers should treat their patients as partners in the decision-making process when coming up with care plans.

“Something I’ve been impressed with at Amazon is the way they think about the customer. The customer is the person who makes the decision. The customer is someone who we are there to serve and whose trust we’re there to earn. I think that perspective is helpful in healthcare — thinking about the person in front of you who you’re there to serve. They have an opinion, they have preferences, and those should also be respected,” Ayogu declared.

He added that he sometimes feels uneasy about the term “patient noncompliance,” as it implies that the patient has disobeyed their provider. In Ayogu’s view, patient noncompliance should prompt providers to ask themselves if they did a good job of explaining the benefits of the care plan and how it could fit into their patient’s daily life. 

Sometimes, providers fail to see the barriers to health that patients have in their life, Ayogu noted. That’s why it’s important to have an open dialogue when creating care plans for patients — otherwise, providers could be making decisions on behalf of the patient.

“I will treat you as a decision maker. If we’re making your dietary plan, we’ll agree on the goal. If it’s no salt, but you say ‘No, that’s not my goal,’ we will move to reduced salt. How do we reduce salt? We will choose different foods, use different spices and find some different recipes. When you’re focused on that actual patient goal and you’re viewing them as the person who’s the decision maker, you often get to have a different process, which obviously produces a different outcome — often a better outcome,” Ayogu explained.

Hybrid care is the future

The week before HLTH, TBD Health opened its second brick-and-mortar clinic. The company, founded in 2020, originally focused on providing at-home STD testing and emergency contraception via telehealth, but now patients in Las Vegas and Denver can seek services at TBD’s in-person clinics.

The startup’s co-CEOs and co-founders, Stephanie Estey and Daphne Chen, said that they are seeing an “increasing number of telehealth players realize the unmatched potential of in-person care and the relationship that it fosters with patients.”

“Us at TBD Health realized this a while back and are now finally hearing about other players starting to try and catch up and enter this space,” they added.

Cheatham echoed the comments made by Estey and Chen and added that he has been hearing more and more telehealth companies talk about their plans to open in-person care centers in the past few months.

We need more credible healthcare voices on social media — now

The industry needs to “turn the volume up to an 11” when it comes to the voices of credible healthcare professionals on social media, said American Medical Association President Dr. Jesse Ehrenfeld. He pointed out that online health misinformation is rampant, and these falsehoods can cause harm or even death for people who mistakenly believe them.

“We know that trust in institutions — like the FDA, the CDC and healthcare providers — is declining, and that is a problem. We need to make sure that we can help people cut through the noise. We have asked media companies — all of the major ones — to make it easier for consumers to understand where information is coming from and help them understand whether they can trust a message or not,” Dr. Ehrenfeld declared.

As an industry, healthcare also needs to do a better job of calling out physicians who spread misinformation, he added. Dr. Ehrenfeld said that the AMA has encouraged state medical licensing boards to take appropriate action if they see a physician sharing falsehoods online.

Last year, California passed a law that granted the Medical Board of California power to discipline providers who spread Covid-19 misinformation online. However, the law was repealed this month after complaints that it violated free speech.

But Dr. Ehrenfeld argued that the proliferation of health misinformation is creating widespread consequences across the country.

“We have seen, in most counties, routine childhood vaccination rates decline — for measles, tetanus, rubella. These are having damaging, long-lasting impacts on the healthcare delivery system that we have to counteract. The only way to do that is to be a credible source of information online, so we need to train physicians how to do that. We need to train patients how to recognize misinformation, but we also need the media companies to step up and do their part,” he explained.

We can’t advance healthcare without personalization and defragmentation

Summer Health CEO Ellen DaSilva said her biggest takeaway from the conference was that “everyone agrees we need a much more personalized and holistic care experience rather than the fragmented system that exists today.”

AI can play a huge role in personalization, and industry stakeholders are coming together to innovate care delivery models so that care can become less episodic and siloed, she noted.

“People seem to be pouring dollars and resources into making that vision a reality this year,” DaSilva declared.

If we want to improve Americans’ health, we have to start with children

Nemours Children’s Health CEO Lawrence Moss claimed to have a “three-step prescription for fixing healthcare.” The first step is to understand what health is — this means knowing all the different factors outside the four walls of a doctor’s office that affect a person’s physical and mental health. 

The second step is paying for health. Moss pointed out that our country’s healthcare system incentivizes providing as much medical care as possible and “disincentivizes health.” As long as the fee-for-service structure reigns, providers cannot improve the nation’s health, he added.

The third step is to “start with children,” Moss declared.

“Children are 7% of the $4 trillion we spend on healthcare every year. We can make some pretty bold bets without upsetting the apple cart. Little interventions in children can result in huge outcomes throughout a lifetime,” he explained. “ I don’t always make the argument that you should support children’s hospitals because it’s good to take care of kids. Obviously I believe that, but that argument doesn’t win today with a lot of people. What should win the day is the future of our entire economic productivity and the welfare of the nation.”

Photo: HLTH