| | | |   | Good Election Day morning! Health and science issues are on the ballot — here’s what my colleagues are tracking. And throughout the week we’ll be monitoring third quarter earnings from the largest players in health tech. | | | Microsoft note taking tool’s privacy tradeoff  Hyacinth Empinado/STAT
Nuance Communication’s AI-guided voice tool offers what sounds like a major timesaver for clinicians: A system that records conversations with patients and transcribes them, saving them the arduous task of notes after appointments. But the product, acquired by Microsoft in its Nuance deal, presents clinicians with a difficult tradeoff: Save time or hand patient data over to a technology whose privacy protections aren’t universally trusted by health systems, my colleague Casey Ross reports. Casey’s investigation finds that health systems aren’t all in agreement about whether the data sharing Nuance requires could lead them to violate HIPAA nor how to explicitly inform patients or get their consent. “Our organization’s policy in general is that we do not allow vendors to keep our data — and this is an exception,” Ann Cappellari, a chief medical information officer at the hospital chain SSM Health, which is using the AI system, called Dragon Ambient eXperience, or DAX, told Casey. “AI is just so blurry,” Nupur Shah, a physician and informatics fellow helping to guide use of DAX at Rush University in Chicago, said. “For the providers using it, we explain it’s AI — machine learning. But these are still nebulous terms.” Read Casey’s full story here. | ECRI sounds the alarm on Meta’s website tracking Patient safety research group ECRI is warning health systems that third-party analytics tools hooked up to their websites could expose patient data, and urging them to more closely audit these tools and spin up more specific policies around their use. An ECRI alert shared with STAT references The Markup’s reporting from June revealing that a Meta tool known as Pixel, which offers health systems analytics about visits to their websites in exchange for data that could be used for advertising, could also be exposing sensitive information about patient appointments when used in conjunction with Epic’s MyChart. ECRI recommended that health systems notify their legal teams if any prior information might have been breached through the use of third-party analytics tools. Their bulletin comes after Advocate Aurora admitted in October that a data breach potentially affecting millions of patients was linked to these types of tracking tools, which could have sent data to Google and Facebook’s parent company Meta. “We’re just beginning to seeing the tip of the iceberg with health data breach notifications where, if they’re following the law, they’ll be at a scale we haven’t seen,” Andrea Downing, a security researcher who co-authored a study on the trackers in February, told me.
Congress is waking up to the issue. Sen. Mark Warner, who has long made cybersecurity a priority, published a policy paper outlining options for improving protections across health care — including beefing up federal leadership on the issue. (He’s accepting comments at cyber@warner.senate.gov.) | More on health tech’s equity metrics problem Last week, I published a story on a theme I’ve been hearing from entrepreneurs, investors, and health tech industry analysts: It’s really hard to measure and define progress when it comes to health equity. I got a lot of feedback — including some pointing out established quality metrics like the HEDIS measurement, and arguing that efforts to measure impact on underserved patients shouldn’t deviate from these. “If you’re seeking to address serious mental illness in populations of folks who struggle with mental health challenges and social needs, then we can all agree that a text message is not enough,” Cityblock CEO Toyin Ajayi told me. “If you’re seeking to move the needle on getting someone who has insurance, who has a primary care provider, to see their primary care provider for a preventive visit, and you know they’re digitally engaged, maybe a text message is enough,” she said. “I agree there isn’t a standard measure. But I would argue that that may not be the right thing to push for.” Ajayi told me Cityblock has different benchmarks depending on a patients’ health risk — and those complex and unique analytics that could differentiate it from competitors. “We certainly have built out those types of metrics that are very bespoke to our understanding of our population, and a recognition that that one size fits all is not going to be the right answer,” she said. I also heard from MedArrive’s Dan Trigub, who used to lead health operations at Uber and Lyft. He said MedArrive’s customers — health plans and providers — and investors do expect standardized metrics demonstrating improved health outcomes and lowered costs. “[W]hile I do believe that engagement can be a good metric to be held accountable for, we often provide more concrete metrics like hospitalization reduction rates, emergency department utilization reductions, net promoter scores and how well we're identifying social determinants of health needs during member visits,” he said. | Why are patients waiting so long for their specialty medications? Four in five specialty prescribers and pharmacists say it should take no more than two weeks to start a new specialty therapy. In reality, most of their patients must wait three to four weeks. What challenges do they face, and what gaps can technology bridge to improve time to therapy and patient safety? Find out in the data brief. | Gazing into health tech’s crystal ball We’re expecting more insight into the health tech sector’s performance following a week of earnings announcements by companies like Babylon and Amwell. Last quarter we saw leaders reining in projections in the face of looming economic uncertainty.
Following a year of executive shakeups and business rejiggering, Talkspace’s third quarter earnings came with some good news, my colleague Mario Aguilar tells us: The company finally appointed a new CEO — and key numbers continue to point in the right direction. The struggling virtual mental health company will now be helmed by Jon R. Cohen, who joined the board in September and was previously executive chairman and CEO of BioReference Laboratories. But Talkspace, which is trying to transition from a direct-to-consumer business to one that sells to insurers and employers, is still losing money. And the company’s stock has been trading below $1.00 since early October. Many investors may begin to ask: “How long are we supposed to wait for this to work?”
Industry analysts are also mulling what the industry's performance last year means for this quarter and 2023. Here's the latest: - A Silicon Valley Bank report reminds us that investment might have contracted since the 2021 peak, but that the market is simply “rebalanc[ing]from last year's unsustainable activity.” And women-founded companies raised almost 20% of all capital invested in health tech this year, analysts noted.
- While market research firm Forrester predicts increasing hospital bankruptcies, it also expects retail health clinics — like those operated by Walgreens, Amazon, and Walmart — will double their share of primary care.
- The shift away from traditional health care may already be happening. Hims & Hers tells us it’s setting quarterly records for subscribers to its service, which prescribes and dispenses medications including hair loss treatment. The company racked up 170,000 new subscribers in the third quarter.
| | | What we’re reading - An effort to outlaw online suicide assistance could make sites liable, The New York Times
- Elizabeth Holmes awaits sentencing after bid for new trial fails, Associated Press
- Breaking down digital health’s M&A trends, Rock Health
| | | Thanks for reading! More on Thursday,  | |
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