Q. Can you give us an overview of Castlight Health?
Ethan Prater: Castlight Health makes tools for self-insured employers and their employees and also the members of health plans to make better decisions about health care primarily on the basis of cost and quality. So we offer tools to help people understand the cost of their care, the quality of their care, and alternatives to their care so they can make good decisions. This is really important in the world where a lot of the cost of health care is being transferred from employers to their employees.
The company has been around about five years and our major market self-insured employers, and our users are the employees and spouses of those large self-insured employers in the U.S.
Q. And what are you specifically working on at Castlight?
A. I’m specifically in charge of product marketing and product management so, what do we build, in what order, and why? The main goal of Castlight is to make sure that our products are easy to use and meaningful to the end employee or the end consumer of health care, and that they make the health care system somewhat accessible and somewhat approachable at least to the end consumer.
Costs vary hugely in health care and if they know before they go, they can get much better quality at lower costs just by using conventional e-commerce style, consumer shopping tools to help make their decisions about which providers to see and which services to get.
There was a lot of humility on stage when members of government organizations presented this week at the Healthy Communities Data Summit (HCDS) in San Francisco: “We could never pull this off on our own.” “We move at snail’s pace.” “We are poor.”
Like its cousin event Health Datapalooza, taking place in Washington, D.C. next month, HCDS’ purpose is to rally different groups around open data. Last year at Datapalooza, the government showcased applications and tools built with the data it had released. It called on private organizations to follow suit and to release their own data. And its strongest call was to anyone and everyone able to make useful things with that data. The message was to keep trying.
Government organizations in the Bay Area, and all local governments for that matter, have a big advantage over the federal government when making the same call to action. On their side is the fact that local developers are motivated to work on projects that can have a direct and observable impact on the place they call home.
Take the technology executive turned fire chief of the San Ramon Valley Fire Protection District in California. He was having lunch one day when he heard sirens nearby. They continued to get closer and closer. It wasn’t until the fire chief left the restaurant that he realized an emergency team was responding to a man who had gone into cardiac arrest next door. Had he known, he could have reached the man and started administering CPR long before EMS arrived.
Goopatient, a personal health record app, is now available for Android. The mobile app allows patients to keep everyday health records, store personal electronic medical cards, use #hashtags to organize records, and attach medical files.
VHA, a network of not-for-profit health care organizations, partnered with Phytel to help its members tackle population management. Phytel’s technology combined with VHA IMPERATIV, a suite of advisory services, will help hospitals establish value-based care delivery models.
Hello Health, an EHR service provider, launched a patient-facing app called Portal Connect. This app allows patients to access and update their health data, and securely exchange information with their providers who use the Hello Health EHR system.
DoctorBase, a provider of mHealth-as-a-Service, grew its user base to 10K physicians, a growth of 104% within one year. DoctorBase’s PANDA software allows more than 4.1M patients to communicate with their health care providers through smartphones.
Vice President of Jawbone Aza Raskin via Rachel Kalmar, a data scientist at Misfit Wearables, managed to put into 140 characters what most people can only intuit. And what better constraint than Twitter to force Health:Refactored attendees to get creative as they summarized, synthesized, and interacted with the conference?
Over the course of two days, Health:Refactored generated nearly 2,000 tweets, averaging 16 tweets per hour and five tweets for each of 387 participants. The folks at symplur did the number crunching, but the #hrefactored stream was a constant companion at the conference.
The selection below is a completely subjective grab bag of tweets, but they all reflect the constrained creativity Raskin alluded to. Let’s just hope the health care constraints we delved into over the course of Health Refactored continue to fuel the sort of creativity we’ve seen thus far and on display in the tweets below.
For all non-techies at the conference, confusion was no constraint. The event was a time to learn something from the experts:
David Fauth-talking about Hadoop and Mortar data (what??)-oh yeah forgot this is a developer’s conference-we talk in code here #hrefactored
— The Doctor Weighs In (@Docweighsin) May 14, 2013
Bryan Sivak issued an invitation to wrestle with bureaucratic constraints when he asked who wanted to be a part of something that could fundamentally change the nation. Many in the room took the bait:
Note: there is an audio file embedded in this post. If the player doesn’t appear, try loading the post in a different browser, or listen here.
A Libyan man named Mafi drives through the streets of Benghazi. Mafi’s vehicle suddenly collides with another car, and the accident leaves him seriously injured. A witness to the accident moves quickly and takes him to the closest hospital.
The problem is that the hospital is closed. A militia group came in, and the staff felt unsafe and left the facility. But Mafi still needs help and he needs it soon.
This is the story that Kim Garcia, a public health graduate student at UC Berkeley, told during a recent presentation. The story isn’t true, but it’s based on true recent events.
“In doing our research we found that this is a reality,” Garcia said. “The Libya Herald reported that four weeks ago, a militia group came into the Benghazi Medical Center and intruded on the laboratory testing center, which forced a closure for about three hours and put patients at risk.”
Garcia was enrolled in a class this past semester called Designing Innovative Public Health Solutions. She and two of her classmates were charged with helping a client to create Benghazi’s first ambulance system.
“We were brought on to address a very specific problem within the establishment of that ambulance system, which is how do you create an ambulance system in a part of the world that has no formal addressing system,” Bobby Stahl, Garcia’s team member, said.
As the group dug into its research, it concluded that the lack of addresses wasn’t the crux of the problem. The issue they first had to tackle was how to create a reliable way to tell residents about hospital closures.
They came up with several text messaging solutions. One allows residents to opt in to a message alert system, which sends a text when a hospital is closed. Another lets users text a number so that they can receive a list of local medical facilities and their current open or closed statuses.
Ringadoc, a San Francisco startup that helps doctors manage patient phone calls, has raised an additional $700,000 in seed funding, which brings its total round of funding up to $1.9 million.
PingMD, an app facilitating communication between pediatricians and patients, raised $2.5M in new funding from angel investors, as reported by GigaOm. The company recently expanded the scope of this app to include patients from other disciplines as well as allow peer-to-peer communication.
In order to squeeze waste out of the health care system, campaigns have been developed mostly on two fronts, informing both providers and receivers of care about the actions they can take to hold down increasing spending. For example, through education and information, Costs of Care aims to get both doctors and patients to reject unnecessary medical tests and treatments. There’s also Choosing Wisely, which encourages patients to start conversations with their doctors along the same lines. On a third front for nurses, there is Lean Six Sigma.
Lean Six Sigma isn’t actually a formal campaign. It’s a managerial strategy meant to help businesses eliminate process waste, and it’s the basis for a proposed course at the College of Nursing at the University of Alabama in Huntsville. The curriculum is being developed by two UAH associate professors, one in the nursing school and one in the School of Industrial and Systems Engineering and Engineering Management.
Lean Six Sigma incorporates ideas from both the Lean and Six Sigma methodologies. Lean’s goal is to eliminate waste while Six Sigma aims to streamline processes. In the context of health care, it’s easy to imagine that these manufacturing methods promote conveyor belt medicine, encouraging nurses to see patients one by one without paying attention to the individuals and their varied needs.
On the other hand Lean Six Sigma applied to health care is, by definition, patient-focused. That’s because the strategy calls for identifying what customers, in this case patients, define as quality and then using that as a performance measure. For example, since patients value shorter wait times, part of a medical facility’s success would be determined by how well they keep wait times low.
One of humankind’s oldest battles has been the fight against cancer. Ever since Hippocrates first named the disease after the veined underbelly of the crab, we’ve struggled to understand and eradicate cancer in all its forms. While the day when we can declare our society ‘cancer free’ may still be a long way off, doctors and scientists are devising increasingly novel and effective ways of killing it at early stages. Here we take a look at the cutting edge of cancer treatment, the methods, effectiveness and theory of each new method:
Computer Models
It sounds like something from a Sci-Fi film: a frightening dystopia where our care is devoid of human interaction and reliant on cold, unfeeling machines. But studies show new algorithms used in cutting-edge computer models may be better at diagnosing a course of treatment than the most-seasoned health professional. Over the course of two years, researchers at Maastricht University in The Netherlands monitored the progress of 121 lung cancer patients. In the three cases it was used, the computer model outperformed the experts with a blistering degree of accuracy.
The results are unsurprising: we now know that cancer is a complex thing, its growth dictated by a patient’s genes and a host of other factors. In the same way meteorologists now trust computers to predict weather systems more than their own intuition, we’re starting to realise that cancer is too complicated to be beaten by a harassed professional. The day soon may come when this predictive treatment is the standard method used.
May 16, 2013 - By
Adam Wong, Management and Program Analyst, ONC
ONC, along with the Office of the HHS Chief Technology Officer and the Health Resources and Services Administration (HRSA), recently launched the Apps4Tots Health Challenge – a developer challenge to create applications using the new TXT4Tots message library.
Through this challenge, we are calling on developers, researchers, and innovators to use the new TXT4Tots message library by integrating it into new or existing applications that will reach parents and caregivers of young children. There will be a total of $25,000 in prizes awarded to the top three winners, including $17,500 for the first-place challenge winner.
Like TXT4Baby, the TXT4Tots message library can send caregivers appointment reminders, health alerts and parenting advice. The messages provide information about nutrition and physical activity for parents of children between the ages of one and five including:
tips and recipes for healthy snacking, and
ways to encourage physical activity among children through games and play.
While the goal of this app challenge is to integrate the TXT4Tots library and messaging functions into existing or entirely new applications, we aren’t looking for a typical smart phone application. We want to see how the parenting advice content in the TXT4Tots library can be integrated innovatively to reach users. A submission that only delivers the TXT4Tots messages is not enough to win the Challenge.
May 15, 2013 - By
Adam Wong, ONC and Abdul Shaikh, NCI
ONC and the National Cancer Institute (NCI) are challenging app developers to create new tools to help cancer survivors. The new Crowds Care for Cancer: Supporting Survivors Challenge is asking app developers to create new tools meant to help survivors manage their care after they have completed cancer treatment.
HHS has had a series of developer contests that have spawned the creation of tools and apps to help patients and doctors better manage care. Some past app challenges include:
the Million Hearts Risk Check Challenge
the Blue Button Mash Up Challenge, and
the Ensuring Safe Transitions Challenge.
Cancer patients need more care coordination
The number of cancer survivors in the United States is currently estimated at 14 million people. With improvements in cancer screening, diagnosis, and treatment, as well as the aging of the United States, this number is expected to rise.
While celebrating advances in cancer care, there remains a need to help patients manage their health after they have completed their primary treatment. Cancer survivors experience a host of physical and psychosocial long-term and late effects of the disease, and it’s the treatment of this that requires coordinated follow-up care.
Despite significant progress in cancer treatment, the complex and often fragmented state of end-of-treatment care may lead to harmful breakdowns in patient-provider communication. This can result in unmet health care needs. Better communication, data exchange, and care coordination have been shown to help the patients.
Q. Can you give us an overview of Castlight Health?
ONC, along with the Office of the HHS Chief Technology Officer and the Health Resources and Services Administration (HRSA), recently launched the Apps4Tots Health Challenge – a developer challenge to create applications using the new TXT4Tots message library.
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