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agilon health is pleased to announce it has entered into an agreement under which a Babylon Health-associated practice will purchase the Fresno and Madera operations of First Choice Medical Group, inclusive of its associated lines of business (Medi-Cal and Medicare Advantage). Babylon is a globally-leading technology company with the ambitious mission to put accessible and affordable health services in the hands of every person on Earth. Babylon works with governments, health providers and insurers across the globe, and supports healthcare facilities from small local practices to large hospitals; providing digital healthcare tools designed to empower people with knowledge about their health. Babylon covers 20 million people across the globe, and has delivered more than 8 million virtual consultations and AI interactions. Babylon has partnered with 170 impactful worldwide partners, including the NHS in the UK, Telus Health, Mount Sinai Health Partners, the Bill & Melinda Gates Foundation and the Government of Rwanda, to fulfill its vision of accessible and affordable healthcare, for all. Both organizations are enthusiastic about the opportunity to simultaneously broaden Babylon’s footprint while enabling agilon health to focus on its physician partnership model for Medicare Advantage members outside of California. This will enable a seamless transition of continued high caliber support for our existing Central California patients and provider networks with the additional benefit of a unique organization that focuses on advanced technology solutions. We believe this transition serves the well-being of our patients and best interests of all impacted stakeholders. To ensure a smooth transition for patients and providers, there will be an estimated operational transition period of up to six months following the effective date, during which agilon health will continue to provide market facing and MSO functions, including claims processing and utilization management support. Subsequently, Babylon will perform back-office functions currently performed by agilon. Source: https://www.firstchoicemg.com

Background to X In 2010, Google founders Larry Page and Sergey Brin decided to form a new division of the company to work on moonshots: far-out, sci-fi sounding technologies that could one day make the world a radically better place. It was a grand experiment — some might say a moonshot unto itself. 10 years in, X has incubated hundreds of different moonshot projects, many of which have gone on to become independent businesses. X Team X is a diverse group of inventors and entrepreneurs who build and launch technologies that aim to improve the lives of millions, even billions, of people. Our goal: 10x impact on the world’s most intractable problems, not just 10% improvement. We approach projects that have the aspiration and riskiness of research with the speed and ambition of a startup. Project Wolverine: Hearing Technology A new leak from the X division of Google's (technical) parent company Alphabet has shared details of "Project Wolverine", a device that lets the user isolate audio to focus on a specific person or source. The device has other capabilities beyond speech isolation, and the X team is actively working on expanding its utility as part of their focus to "explore the future of hearing." One of the most likely breakthroughs is thought to have come from cancelling out background noise with anti sound in order to isolate audio from one source or location. "Background noise can be cancelled out with antisound. A microphone picks up the noise and an electronic circuit analyses it and very rapidly produces an opposite noise. Where the original sound wave has a peak, the antisound has a trough and vice versa, so the two cancel each other." Read more: https://www.newscientist.com/article/mg13618504-100-how-do-noise-cancelling-headphones-like-apple-airpods-pro-work/#ixzz6oblKMcJg Source: https://x.company

Right after 8.30am is a busy time for the ill in Britain. Many medical surgeries do not allow patients to pre-book appointments with their doctors: people must call up in the morning to book an appointment later in the afternoon. Come opening time, the phone lines are jammed with hacking, spluttering sick people trying to beg an audience with their doctor. Being able to book appointments online and outside of office hours not only makes life easier for patients, but gives them more choice. Zesty, a start-up based in London, has signed up 200 dental practices across ten London boroughs since launching at the end of April. Further healthcare sectors, such as surgeries, physiotherapists and osteopaths, will be implemented into its online booking system later this month. Co-founder Lloyd Price is banking on medicine being the next sector to take advantage of e-commerce. He wagers an online interface to make appointments and to compare doctors and dentists against each other, similar to the hotel-booking and rating model perfected by TripAdvisor and Expedia, will replace the engaged-tone at surgeries up and down the land. There is certainly money to be made from the ill: though Britain provides free healthcare for all via the National Health Service (NHS), a fifth of the population supplements state care with paid private health programmes. Zesty charges dentists £80 ($123) per month to be listed on its site. Yet the notion of a simple online or app-based booking system is an idealistic one, and not without its flaws. Health services are more frequently used by older people: two-thirds of those admitted to hospital in Britain are over 65. They are unlikely to be as comfortable with booking appointments online as the young. Still, claims Mr Price, 60% of Zesty’s bookings are made by those over 45 years old. He can also look across the Atlantic for evidence that people will book appointments via start-up apps. ZocDoc, an American health tech company, allows potential patients to search for a physician by location, speciality or the type of insurance they accept. Patients can schedule an appointment on their smartphones. Investors including Jeff Bezos, founder of Amazon, have put $95m into ZocDoc since its launch in 2007. The company claims 2.5m users a month across 1,800 American cities. Doctors pay $300 per month to be listed on the site. At home Zesty is up against a big established rival. Patient Access says a quarter of Britain’s medical practices use its system, which allows users to book appointments, order repeat prescriptions, notify practices of a change of address or send messages to their general practitioners (GPs). Patient Access requires users to have registered with a practice, rather than searching from nearby doctors signed up with the service. If toothache or a sharp pain strikes during the night, Zesty bets its users will be able to sleep better knowing they have an appointment pre-booked without gambling on the morning phone-line lottery. But whether patients will, in practice, shop around for a doctor like tourists do for a hotel on TripAdvisor is yet to be seen. Source: https://www.economist.com/schumpeter/2013/08/14/e-ppointments

An interesting study entitled "Patient portal messaging for care coordination: a qualitative study of perspectives of experienced users with chronic conditions" by Jennifer L. Hefner, Sarah R. MacEwan, Alison Biltz & Cynthia J. Sieck has highlighted the importance of secure asynchronous messaging as potentially the future of patient portals. Click here to read the study in full. Introduction to the Study Patient portal secure messaging (asynchronous electronic communication between physicians and their established patients) allows patients to manage their care through asynchronous, direct communication with their providers. This type of engagement with health information technology could have important benefits for patients with chronic conditions, and a more thorough understanding of the use and barriers of secure messaging among this population is needed. The objective of this study was to explore how experienced portal users engage with secure messaging to manage their chronic conditions. Results of the Study Patients’ motivation for using messaging included the speed and ease of such communication and direct access to a physician. Messaging was used by patients as an extension of the office visit and supported coordination of care among providers as well as patient collaboration with family members or caretakers. Patients identified challenges to using messaging, including technological barriers, worry about uncompensated physician time spent responding to messages, and confusion about what constitutes an appropriate ‘non-urgent’ message. Conclusions of the Study This study highlights the potential of patient portal messaging as a tool for care coordination to enhance chronic disease self-management. However, uncertainty about the appropriate use of portal messaging persists even among experienced users. Additional patient training in the proper use of secure messaging and its benefits for disease self-management may help to resolve these concerns. Source: https://bmcfampract.biomedcentral.com/articles/10.1186/s12875-019-0948-1

Compute Health Compute Health Acquisition Corp. (NYSE: CPUH.U, CPUH & CPUH WS) is a special purpose acquisition company formed for the purpose of effecting a merger, capital stock exchange, asset acquisition, stock purchase, reorganization or similar business combination with one or more businesses. On February 9, 2021, Compute Health closed its initial public offering of $862.5 million. The company is led by the management team of Omar Ishrak, Jean Nehmé and Joshua Fink. The company’s strategy is to focus on healthcare businesses that are already leveraging or have the potential to leverage computational power, with an emphasis on companies in the medical device space, including imaging and robotics. Compute Health is also interested in companies operating in the virtual care space, including telehealth, care delivery and next-generation payor and provider models. The company believes that the knowledge, experience and expertise of both its management team and its directors will add significant value to this space. The efforts of the company to identify a prospective initial business combination target will not be limited to a particular industry, sector or geographic region. Source: https://www.compute-health.com

Even before Covid, health technology was one of the fastest growing investment sectors in the world. This pace has now more than doubled as a result of the pandemic. Along with Dr Pooja Sikka and Shamik Parekh , I’ve recently joined Octopus Ventures to bring operational healthcare experience and sector investment knowledge to the team, particularly in scaling into B2B and public healthcare systems around the world. So from our perspective as investors, medical professionals and NHS policy advisors behind us, what are the trends we’re seeing emerge on the health tech horizon? 1. Femtech and Femcare A growing demand for digital platforms which support women’s health. Whether consumer-led or baked into clinical services (public and private), there is a greater demand for digital platforms connected to services, health professionals and diagnostics, that empower women around specific issues such as pregnancy, fertility, postnatal mental health and access to women’s health diagnostics and services. 2. AI & Radiology As healthcare demand grows and costs rise, the demand for diagnostic imaging also rises. But delivering a bigger specialist healthcare workforce to match demand is impossible. The rise of scans being read and reported by machines is inevitable. The role of the human radiologist will change to support complexity. How quickly this will happen, and which company will be best placed to get to an accurate, safe and scalable tech solution in place, is yet to emerge. 3. Point of Care Diagnostics Point of care diagnostics exist, but the tech and scale are immature. Portable and scalable solutions for real-time diagnostics are needed. Point of care diagnostics which help clinicians make often life saving decisions and improve diagnostic skills will prevent unnecessary delay, improve health outcomes and deliver better convenience to patients. We are incredibly excited by the speed with which technology is being developed to transform ongoing health monitoring in the home and community settings. 4. Advanced Analytics and Access Greater computing power, growing data sets and detailed analytics, will empower healthcare providers and patients alike. As both access to technology and analytic capabilities improve, AI and ML enabled platforms will support healthcare professionals to unlock greater clinical insight. This in turn provides an opportunity to weave together and connect various healthcare stakeholders across the value chain to provide better care and improve outcomes. 5. Precision Medicine Combining multiple health data sources with personalised information about patients such as genomes and preferences will lead to a new way of practising healthcare. The aggregation of healthcare data into a single picture about a person is already happening. Over time, data will become richer, real-time and more consistent, allowing health systems and the way healthcare professionals deliver care to be more precise and better tailored to an individual’s likely response to treatment. 6. High Street Healthcare Patients want better access to healthcare and information, turning to tech and other services to optimise care alongside public healthcare provision. Healthcare services, especially those delivered through digital platforms which can be bought alongside NHS care, will become a mainstream choice for many people. We will start to see greater convergence of healthcare into non traditional settings, perhaps even as a means to breathe life into the post covid high street. 7. Digital Therapies Improving access to alternative therapies and psychotherapy through digital platforms is already happening but not at scale or integrated with the public health system. The use of digital therapies is likely to become integrated into mainstream clinical services as well as patients accessing privately, where access to good quality psychotherapy, nutrition, child health and physiotherapy is important. 8. Employer-led Healthcare Corporate and other employers will provide access to clinical services, delivered by novel health technologies, integrated with private health services, rather than just health insurance for their employees. Employers have great buying power, and countless studies show the economic cost of ill health for the working age population both for the employer and the economy. Access to employer health programmes integrated with innovative health technologies is a likely future trend. Fuelling the health tech revolution Entrepreneurs focusing on the eight trends listed above will help governments, insurers and healthcare providers across Europe and emerging markets fuel the transformation of the world’s most significant investment sector. Source: https://octopusventures.com/insights/future-of-health/8-emerging-trends-on-the-health-tech-horizon/

As far as revolutions go, the one we are living through now seems quiet. Though its effects are profound and touch everybody, not least during these days of Covid-19, the Fourth Industrial Revolution is enabled by technologies that are based on computing and the internet, which largely do their work in the background of our lives. Main applications include the Internet of Things ("smart" toasters and refrigerators), artificial intelligence, autonomous vehicles and medicine tailored to an individual's DNA. Two things are certain: the speed of this revolution is unprecedented, and the impact is relevant to more and more people in increasingly diverse ways. It’s difficult to imagine a world without the Fourth Industrial Revolution's technologies. Yet, as surely as four follows three and five follows four, there will be further industrial revolutions. Signs of the next one are already emerging, and it is set to be just as life-changing as its predecessors. But to understand what's in store for the Fifth Industrial Revolution, we must first look back at where we have been. The original Industrial Revolution, beginning in the late 18th century, mechanised industries with steam engines and replaced agricultural societies. Technologies of this period paved the way toward the use of oil and gas in the late 1800s, when the combustion engine appeared, truly driving industries into the Second Industrial Revolution. Aircraft and automobiles were central to this revolution. Third and Fourth Industrial Revolutions The Third Industrial Revolution, beginning in the 1960s, was characterised by computers and electronics. This enabled some of the earliest journeys into space on less computing power than we carry in our hands today. And now here we are, in the midst of the Fourth Revolution. It is worth noting that the first of the revolutions lasted about 200 years. The second lasted about 100, while the third only about 50. It is easy to see the pattern here. One trend is particularly important in understanding what comes next: the intimacy of technology. Steam engines were important and impressively large industrial tools; They were housed in massive factories, and hundreds of people laboured around them. Then, with the combustion engine and the telephone of the second revolution, we became closely connected to these technologies and to one another. The third revolution was about miniaturising technology and personal computing. During the fourth, we are hyper-connected through our smart devices to most of the planet. The Fifth Industrial Revolution will make that connection closer and seamless, and will feel unmediated. The smart device onto which we tap and into which we speak will disappear. Brain-computer interfaces will replace them. The fifth will stand on the shoulders of the fourth, as technology of diminishing size will be fundamental, and the digital networks will be essential. We are soon finding that the rate at which we type into our smart devices today is a frustrating few bytes at most, while our imagination is orders of magnitude greater. Can we connect our brains – and our minds – to machines? The short answer is yes, and we have done so for some time. The longer answer is more complicated, but more interesting. Man, Machine and Medicine Until a few years ago, machines were connected to the brain and the nervous system principally for medical purposes – for example, to treat Parkinson’s disease or repair spinal cord injuries. Most recently, research has focused on other, non-therapeutic uses, and some of the most high-profile investment in such technology comes from Facebook, Google, Amazon and Elon Musk's Neuralink. This is where the Fifth Industrial Revolution is in the making. Mr Musk founded Neuralink in 2016. It has since established technologies that can record and stimulate signals from thousands of sites in the brain. Artificial Intelligence is an important component of these achievements and new announcements from Neuralink are expected later in the month. Facebook has recently acquired Ctrl-Labs, a New York-based start-up that had developed a bracelet that detects the intention to move and allows users to manipulate objects on a screen by thought alone. Machine learning is a fundamental ingredient in achieving this. Bryan Johnson, another tech pioneer, has founded Kernel and recently announced the ability to decode a person’s brain activity and identify the speech or song they are hearing. Mr Johnson aims to usher in a "neuro-quantified era" to characterise thoughts and emotions, both conscious and subconscious. Investors seem to be enthusiastic: they funded Kernel with more than $50 million in early July. The direction of travel is clear. The science and technology are progressing quickly, for therapeutic and lifestyle or commercial applications. The demand is growing and the underlying Fourth Industrial Revolution technologies are going to make this a reality. We might communicate with others by thought alone, check in at the airport using a mind-reading bracelet, or do our mind-supported shopping – perhaps, for example, to guarantee our safety from infectious viruses. Eventually, regulation will help to make such devices accessible, safe and mainstream. And our use of these technologies will lay the foundations for yet a new revolution. What might the Sixth Industrial Revolution hold? Dr Patrick Noack is the executive director of future foresight and imagination at the Dubai Future Foundation. Source: https://www.thenational.ae/opinion/comment/the-fifth-industrial-revolution-where-mind-meets-machine-1.1061280

iOS 13.6 Update Apple has added a new category for symptoms in the Health app, including symptoms logged from Cycle Tracking and ECGAbility to log new symptoms, like fever, chills, sore throat or coughing, and share them with third-party apps. The latest update to the health app settings now include symptoms associated with various illnesses such as body and muscle aches, coughing, coughing, appetite changes, dizziness, fainting, headache, nausea, and more. All the new symptoms listed in the app come with a description and allow entry options based on the symptom in question, with options to add details like Severe, Moderate, Mild, Present, or Not Present for an associated symptom. Sources: https://support.apple.com/en-euro/HT210393 Sources: https://appleinsider.com/articles/20/06/09/ios-136-adds-symptoms-to-health-unattended-ios-update-download-toggle Sources: https://www.myhealthyapple.com/apples-health-app-adds-new-symptoms-in-ios-13-6/

RWANDA: COVID-19 RESPONSE In some places in the world right now, getting tested for COVID-19 remains difficult or nearly impossible. In Rwanda, you might just get tested randomly as you're going down the street. "So whenever someone is driving a vehicle, bicycle, motorcycle or even walking, everyone is asked if you wish to get tested," says Sabin Nsanzimana, director general of the Rwanda Biomedical Center, which is the arm of the ministry of health that's in charge of tackling COVID-19. Health officials in personal protective equipment administer the test. Nsanzimana says the testing is voluntary, although some others say refusal is frowned upon. The sample collection — from a swab up the nose — and filling out the contact information paperwork takes about five minutes. "All these samples are sent that day to the lab," Nsanzimana says. "We have a big lab here in Kigali. We have also six other labs in the other provinces." Despite being classified by the World Bank as a low-income country, and despite its limited resources, Rwanda has vowed to identify every coronavirus case. Anyone who tests positive is immediately quarantined at a dedicated COVID-19 clinic. Any contacts of that case who are deemed at high risk are also quarantined, either at a clinic or at home, until they can be tested. Nsanzimana says health workers call or visit every potential contact of someone who tests positive. "We really believe that doing so is important to make sure we detect and trace where the virus could be," he says. TRACK AND TRACE Comprehensive contact tracing is a task that has overwhelmed countries with far more resources than Rwanda. Rwanda's per capita income is roughly $2,000 per year. Yet all testing and treatment for the virus is provided for free. It costs the government between $50 and $100 to run a single coronavirus test, Nsanzimana says. In order to test thousands a day, Rwanda has started using a process called "pool testing." Material from 20-25 nasal swabs are all put into one vial and run through the machine. This allows them to test far more samples at once. If they get a positive result, then all the swabs that went into that initial vial are tested individually to pinpoint the person who's infected. Nsanzimana says Rwanda's experience dealing with other infectious disease outbreaks is helping it now during the pandemic. The country is using systems and equipment it already had in place to address HIV. "The main machines we are using for COVID testing are the HIV machines that were (already) there," he says. "We are using the same structure, same people, same infrastructure and laboratory diagnostics, but applying it to COVID testing." Since recording its first case in mid-March, the country of 12 million has recorded just over 1,500 cases. Ohio has a similar size population and has recently been reporting roughly 1,200 cases a day. BIG DATA & ANALYSIS "Rwanda did a few things that are quite smart," says Sema Sgaier, the head of the Surgo Foundation, which has just launched a new data tool to analyze trends around COVID-19 across Africa. "One is they responded really early. They put some of the most stringent lockdowns in place compared to every other African country. In fact, we've been monitoring physical distancing data across the continent and Rwanda fares, I think, second; they've physical distanced the second most across Africa" — a conclusion based on mobile phone movement data. South Africa is No. 1. Rwanda mobilized community health care workers and police and college students to work as contact tracers. It set up national and regional command posts to track cases. It's even using human-size robots in the COVID-19 clinics to take patients' temperatures and deliver supplies. Tolbert Nyenswah, who ran the Liberian ministry of health's response to Ebola in 2014, gives Rwanda high marks for how it has been handling COVID-19, even if at times it's heavy-handed. "Rwanda, from all indications, is a success story for Africa," Nyenswah says. The strong leadership from President Paul Kagame, which Nyenswah says can even be authoritarian, has been effective during this crisis. Kagame demands accountability from his health ministry. Whether the people trust or fear the government, Rwandans listen to their government and have been following the orders regarding masks, washing hands and staying home. Nyenswah worries that the worst is yet to come in Africa with this pandemic. "No country is out of the woods yet," he says. However, he adds that Rwanda is an example to other low-income countries that even with limited resources, this virus can be contained. "So what needs to be done is to follow the (prevention and containment) measures. Political leadership is very, very crucial. Rwanda should continue what it is doing now. And other countries should emulate Rwanda. Source: https://www.npr.org/sections/goatsandsoda/2020/07/15/889802561/a-covid-19-success-story-in-rwanda-free-testing-robot-caregivers RWANDA: THE DIGITAL HEALTH PIONEER PART 1 Read Part 1 here - https://www.healthcare.digital/single-post/2017/11/03/Rwanda-The-Digital-Health-Pioneer Introduction to Rwanda Rwanda has made remarkable socioeconomic progress in the past decade with real GDP growth averaging 8.2% annually. This has translated into improvements in the health situation. Major health reforms took place, including the health insurance improvement, which aims to guarantee access for all to health care; and experience from Rwanda has shown that it is possible to achieve universal health coverage in a country with 90% of its population in the informal sector. Life expectancy has doubled during the 20 years following the devastating 1994 genocide against the Tutsi, as a result of increase in the number of health facilities, improvement in immunization coverage, good access to safe drinking water, and improved housing. All targets related to the three health-MDGs were met, with a notable success in reduction of child mortality and considerable improvements in maternal health. "Rwanda’s eHealth Strategic Plan for 2016–2020 is the key driver to economic growth and to improving the lives of people. Digital health improves service delivery and clinical outcomes, and we know that cannot happen if we don’t look at the data." Dr. Patrick Ndimubanzi, Honorable Minister of State, Public Health and Primary Health Care, Rwanda Digital Health Innovation in Rwanda ... https://www.healthcare.digital/single-post/2017/11/03/Rwanda-The-Digital-Health-Pioneer

As lockdown shifts to downturn, we have seen how many companies have adapted to new low-touch, socially-distant norms. Cafes and restaurants have developed thriving street-food and delivery businesses, cinemas and theatres have become drive-in experiences, students study online together, contactless payment has finally replaced cash. In sport, Norway created the “Impossible Games” with athletes from Europe and Africa competing synchronously by video-link in different locations. In business, Apple hosted its annual developer conference (WWDC20) virtually, with impressive online keynotes, animations and interactions, shared by more people than ever. London Fashion Week did likewise. Fundamentally, we are seeing a rapid shift to what I call “liquid” business models. In chemistry, you will remember, a “liquid” state exists between a solid and a gas – between a structured and unstructured state. In the business world, between a physical and digital world. “Liquid” means that we can fuse together the best of physical and digital formats, devices and channels, and also give consumers much more choice in how it is constructed. Liquid businesses are more accessible and agile, responsive and personal. These “liquid” attributes permeate both the inside and outside of business – shaping the new ways in which we work – how we communicate, collaborate and learn – and the new ways in which we compete – sell, create, manufacture, and support customers. “Liquid” is a much better word than hybrid, or multi/omni-channel, or physigital, as I’ve even heard the combination of digital and physical called. (Plus, I haven’t heard “liquid” applied to business, or business models, before, so I’m claiming it right here!) The pandemic has seen rapid adoption of new technologies, and more significantly a shift to “digital me” with elevated Maslow-style human needs of belonging and connectedness. New formats emerge, responding to the new consumer, fusing the best of digital and physical: Liquid Health… the fluid combination of digital technologies like Babylon Health and Good Doctor, providing smartphone consultations, AI-enabled diagnostics, robotic surgery, together with empathetic care. Liquid Work… the fluid combination of more distributed yet collaborative working from anywhere, more flexible jobs and employment, more diverse and talented teams, creative people augmented by tech.​ Liquid Production… the fluid combination of made remotely and on demand, embracing 3D printing to print what we like as we need it, the shift from fragile slow supply chains to dynamic personal ecosystems. Liquid Retail… the fluid combination of digital consumers, with physical delivery – dark kitchens of Deliveroo delivering restaurant meals to our home, luxury brands selling direct, from Tiffany & Co. diamonds to Amazon’s Common Threads. Liquid Mobility … the fluid combination of multi-modal transport, as we shift to electric and autonomous cars, we shift from ownership to subscription, enabling a choice of transport modes, as we become more local. Liquid Learning… the fluid combination of distance and physical learning experiences, for children to executives, lifelong learning becoming the norm with flexible qualifications, topped up over time, relevant and applied. Babylon and Liquid Health Babylon Health … Ali Parsa’s “liquid healthcare” app uses AI to diagnose your problem, leading to a smartphone consultation, connected to a network of pharmacies, and specialist doctors and hospitals if needed. Babylon, based in London, now employs over 750 doctors, scientists, engineers and data analysts. They offer a subscription-based service to individuals wanting faster, on-demand health advice. A deal with the UK’s NHS to create a version of Babylon’s service called “GP at Hand” has dramatically scaled-up the service, with similar partnerships internationally. For the NHS it creates a fast, more personal service to patients, directly on your smartphone, and relieves the pressure on physical resources. Parsa sees Babylon as “the biggest doctor’s brain in the world”, and loves to show how his AI-based analytics can more effectively diagnose patients’ needs than a real person. His real ambition is to create personal and predictive healthcare, using a range of wearable sensors that can monitor individual health, and take action before it’s ever needed. Source: https://www.thegeniusworks.com/2020/07/liquid-business-models-the-fusion-of-digital-and-physical-concepts-devices-channels-from-babylon-health-to-singularity-sushi/

The healthcare industry is rife with runaway costs and unrivaled bureaucracy, with established companies either unwilling or unable to fix their most fundamental problems. Amazon's entry into this market will no doubt pressure traditional players to shake things up. Amazon is a company that scans business landscapes with a mercenary's eye. The healthcare sector appeared in its crosshairs several years ago, and its early ventures have already forced traditional companies into action. For example, Amazon acquired PillPack, an online pharmacy service, in June 2018 for $753 million. No doubt this acquisition influenced the $69 billion CVS-Aetna merger a few months later, followed quickly by Cigna's acquisition of Express Scripts for $67 billion. And there are frequent rumors of potential mergers between large corporations and healthcare companies. One persistent rumor has Walmart acquiring Humana Inc., the country's fourth largest health insurer, which Aetna tried to bag in 2015. There is serious money in play in the healthcare industry. Global healthcare spending totals nearly $8 trillion a year, according to figures from Forrester and CNBC. For comparison, global retail spending totals $2.4 trillion annually. In 2018, private sector employers in the U.S. spent nearly $700 billion on healthcare for employees. Per capita cost of healthcare in the U.S. in 2018 was $10,224, which is 28% higher than any other nation. Amazon healthcare initiatives The healthcare industry lacks Amazon's logistical expertise, said Jeffrey Becker, a senior healthcare strategy analyst at Forrester Research. "The leadership behind Amazon's healthcare effort is equally put off by over-complications, having been described as 'incredibly allergic to market inefficiency,'" he said. "This is a team we expect to tackle the most complex healthcare problems head on with simple solutions and a relentless pursuit of process improvement." With its expertise in cost cutting and reengineering for greater efficiency, Amazon has embarked on multiple healthcare initiatives. A central part of that strategy is Haven Healthcare, a joint venture Amazon formed in January 2018 with Berkshire Hathaway and JPMorgan Chase, which was intended to drive down insurance costs for the three companies' 1.2 million employees. Haven is a nonprofit with the main objective to work directly with big healthcare providers, for example, Fresenius, Catholic Health Initiatives, or Cedars-Sinai, for better coverage and pricing. Haven bypasses health insurance companies to reduce premiums, deductibles and other costs. Other companies, such as Walmart, use this strategy of buying healthcare direct from providers instead of insurers. To achieve the desired savings, a company must have legions of employees, Amazon counts 840,000 on its payroll, that are also well distributed geographically. Amazon's healthcare forays in 2019 alone include: It introduced Amazon Care, a telemedicine app for its own employees. Care provides video consults and dispatches medical professionals as needed to an employee for tests, shots and in-person procedures. It bought Health Navigator, an online provider for symptom checking and triage tools for routing patients appropriately. It joined forces with healthcare companies via AWS, its cloud computing business, to create HIPAA-compliant conversational interfaces to support virtual clinics. It launched Amazon Comprehend Medical, which detects useful information in unstructured clinical text, such as physician's notes, discharge summaries, test results and case notes. With Haven as the centerpiece, Amazon's various healthcare offerings could be repackaged into some kind of healthcare-as-a-service option. Healthcare must embrace technology Healthcare companies must overcome technology resistance, said Elizabeth Mitchell, CEO of the Pacific Business Group on Health (PBGH), a consortium that includes Boeing, Safeway, Walmart and Wells Fargo, among others. "Healthcare is about 30 years behind any other industry with regard to effectively using technology," she said, adding that too many proprietary products make real integration impossible. Electronic medical records are an example of this, Mitchell explained -- billions are spent on incompatible systems that work poorly, if at all. "It's amazing to me how little effective technology has been leveraged," she added. Mitchell said she witnessed such dynamics firsthand as a former executive at Blue Shield of California, a health plan provider. "I know there's awareness of this, but there hasn't been much movement." Signs of change Forrester's Becker said he sees change afoot. Humana recently signed a seven-year partnership with Microsoft's Azure for cloud services, artificial intelligence capabilities and collaboration technologies. Humana also partnered with Doctor On Demand for virtual primary care physician services that triage and route patients more efficiently to the correct services. UnitedHealth Group, the nation's largest health insurance company, built the United Nerve Center, which combines IoT technology with disease-specific programs for tracking and other functions. The United Nerve Center issues real-time streaming data for UnitedHealthcare's chronically ill patients and allows its providers to spot deterioration in the early stages. These moves by Humana and UnitedHealth Group are more advanced than Amazon's healthcare initiatives at the moment, according to Becker. So far, Haven has kept a low profile, except for shuffling executives; COO Jack Stoddard left the company after less than a year and Atul Gawande relinquished his CEO title in May 2020 but is still chairman of Haven's board. In the midst of a global pandemic, Becker would like to see Haven use the opportunity to showcase its expertise and innovation while the nation's attention focuses on healthcare. Amazon's influence in healthcare goes beyond technology Becker points to another nontechnology phenomenon in healthcare driven in part by Amazon's entrance: Insurance companies, known as "payors" in the insurance industry, buying medical provider groups. The CVS-Aetna merger, for example, now has 1,700 digital clinics. These clinics are typically operated by provider groups as the first point of contact for someone who needs medical attention. Handled properly, being that first point of contact can save an employee and their employer money. It's also a way for companies to "own" a customer -- in this case, a lot of customers. "United [Healthcare] is the largest employer of providers in America because [it's] gone on a buying spree," Becker said. "The payors are aggressive about vertical integration and using a merger and acquisition strategy to own the first point of contact with that brick and mortar healthcare market." Payors are also buying primary and urgent care centers but not hospitals, which are less cost effective, he added. Whether Amazon can transform healthcare with its technology and logistics expertise is still an open question. But there's not much debate over whether the company is up to the task. Haven faces some big obstacles as it tries to work directly with providers and re-create all the administrative systems and processes that insurers typically handle. But Amazon shows time and again it's willing to play the long game. "Companies look to maximize revenue and that's what markets do, but it's often at odds with good patient care," PBGH's Mitchell said. It's a health imperative to have patient, drug interaction and other information shared effectively. "This is not a technology problem, this is a business problem," she said. Source: https://searchaws.techtarget.com/feature/Amazon-healthcare-initiatives-wake-up-an-industry-slow-to-change

I believe Apple has a 2 year vision to make the iPhone a 'One-Stop Shop' for medical information, records and data ... so expect an Apple electronic health record in 2020. Apple have been actively involved in the Argonaut Project for the last 18 months deepening their knowledge and technical expertise of Health IT, electronic medical records and personal health records. What is the Argonaut Project? The Argonaut Project is an initiative dedicated to accelerating the development and adoption of HL7's Fast Healthcare Interoperability Resources. FHIR is a standards framework featuring a RESTful API designed to enable the exchange of health care information between applications and systems. The FHIR framework is designed to allow implementation of health care standards across all systems, devices and applications, regardless of the variability caused by diverse health care processes. The Argonaut Project comprises both health care IT industry provider organizations and electronic health records vendors, including Mayo Clinic, Intermountain Healthcare, Partners HealthCare, Epic Systems and Athenahealth. Argonaut Project participants are working together to modernize nationwide health care interoperability through the increased adoption and development of the HL7 FHIR framework and API. Enabling nationwide health care interoperability is an extremely difficult goal to achieve as there are hundreds of EHR systems available today and thousands of EHR system implementations. Apple and the Argonaut Project According to multiple sources and industry rumours, Apple has a "secretive team" operating within its health unit currently communicating with developers, hospitals, insurers and interoperability specialists about storing clinical data on the new iPhone 8. In theory, with all of their medical and patient data at their fingertips, iPhone users can access a much broader view of their health, learn from insights and share as much or as little information as they wish with doctors and healthcare professionals. Apple has been hiring developers familiar with protocols dictating the transfer of electronic health records and has talked with several health IT industry groups, including "The Argonaut Project," which promotes the adoption of open standards for health information, and "The Carin Alliance," a group aiming to give patients more control over their medical data. A centralized way to store all of a person's health data would allow the medical community to overcome existing barriers that prevent the transfer of patient information between medical providers. Hospitals and doctors offices often don't have a simple way to transfer patient information, and online medical portals are sometimes difficult to use with little info available to patients, Apple already allows iPhone users to record medical data and health information gathered by the Apple Watch and other connected devices in the built-in Health app, and it has delved into health research with CareKit and ResearchKit, but based on these rumors, the company's goal is to expand its health efforts far further in the future. Patent US 9723997 B1 : Electronic device that computes health data Further evidence of Apple's potential to launch an electronic health record can be seen in its recent US patent filing 9723997 B1 for an "electronic device that computes health data". INTRODUCTION An electronic device includes a camera, an ambient light sensor, and a proximity sensor. The electronic device uses one or more of the camera and the proximity sensor to emit light into a body part of a user touching a surface of the electronic device and one or more of the camera, the ambient light sensor, and the proximity sensor to receive at least part of the emitted light reflected by the body part of the user. The electronic device computes health data of the user based upon sensor data regarding the received light. In some implementations, the electronic device may also include one or more electrical contacts that contact one or more body parts of the user. In such implementations, the health data may be further computed based on the an electrical measurement obtained using the electrical contacts. SUMMARY The present disclosure discloses systems, apparatuses, and methods related to an electric device that computes health data. An electronic device may include a camera, an ambient light sensor, and a proximity sensor. The electronic device may use one or more of the camera and the proximity sensor to emit light into a body part of a user touching a surface of the electronic device and one or more of the camera, the ambient light sensor, and the proximity sensor to receive at least part of the emitted light reflected by the body part of the user. The electronic device may compute health data of the user based upon sensor data regarding the received light. In some implementations, the electronic device may also include one or more electrical contacts that contact one or more body parts of the user. In such implementations, the health data may be further computed based on the an electrical measurement obtained using the electrical contacts. In some implementations, the electronic device may utilize the camera to determine the user's body part is misaligned with the camera, the ambient light sensor, and the proximity sensor for purposes of detecting the information about the body part of the user. In such implementations, the electronic device may provide guidance to correct the misalignment. In various embodiments, a mobile personal computing device may include a camera, an ambient light sensor, a proximity sensor, and a processing unit communicably coupled to the camera, the ambient light sensor, and the proximity sensor. The processing unit may be configured to: use at least one of camera and a proximity sensor to emit light into a body part of a user touching a surface of the mobile personal computing device; use at least one of the camera, an ambient light sensor, or the proximity sensor to receive at least part of the emitted light reflected by the body part of the user and generate sensor data; and computing health data of the user, utilizing the processing unit, using at least the sensor data regarding the received light. In some embodiments, a method for using a mobile personal computing device to obtain health data may include: using at least one of camera and a proximity sensor to emit light into a body part of a user touching a surface of the device; using at least one of the camera, an ambient light sensor, or the proximity sensor to receive at least part of the emitted light reflected by the body part of the user and generate sensor data; and computing health data of the user, utilizing the processing unit, using at least the sensor data regarding the received light. In one or more embodiments, a method for guiding use of a mobile personal computing device to obtain health data may include: detecting, utilizing a camera, a profile of a body part of a user contacting the camera; determining, using the profile, if the body part is misaligned with a combination of the camera, an ambient light sensor, and a proximity sensor for purposes of obtaining health data for the user; and providing guidance to correct the misalignment. In various embodiments, a computer program product including a non-transitory storage medium may include a first set of instructions, stored in the non-transitory storage medium, executable by at least one processing unit to use at least one of a camera and a proximity sensor to emit light into a body part of a user touching a surface of a mobile personal computing device; a second set of instructions, stored in the non-transitory storage medium, executable by the least one processing unit to use at least one of the camera, an ambient light sensor, or the proximity sensor to receive at least part of the emitted light reflected by the body part of the user and generate sensor data; and a third set of instructions, stored in the non-transitory storage medium, executable by the least one processing unit to compute health data of the user using at least the sensor data regarding the received light. It is to be understood that both the foregoing general description and the following detailed description are for purposes of example and explanation and do not necessarily limit the present disclosure. The accompanying drawings, which are incorporated in and constitute a part of the specification, illustrate subject matter of the disclosure. Together, the descriptions and the drawings serve to explain the principles of the disclosure. From OS developers to health providers CB Insights reportedly recently that Apple were not the only Tech company interested in the mobile and electronic health record market, their analyst stated ... "Apple and Google are competing to capture users’ health and wellness data via connected devices. Google is looking to create a suite of alternative wearable devices and sensors for harnessing real-time health diagnostics. Google is mainly interested in creating novel forms of noninvasive sensors for identifying when a user of a wearable is injured or at risk. These wearables include electronic skin adhesives that collect diagnostic information, and more. Apple’s health innovations primarily rely on the existing sensors, camera, and computing power already in Apple products such as the iPhone, Apple Watch and even AirPods. Using the iPhone or Apple Watch, collected wellness data can be stored and shared with physicians and caretakers. Similarly, Apple has designs for enabling a patient to initiate a telemedicine session for treatment using a mobile device. Apple’s focus on wellness and lifestyle management, combined with the AirPods and the AI assistant Siri, could mean that Apple will explore the coaching and fitness space to proactively keep people healthy." https://www.cbinsights.com/research/innovation-patents-apple-google-amazon-facebook-expert-intelligence/