artificial intelligence
Why Nebraska Medicine's taking a bet on Palantir
Late last week I dropped by Palantir's Palo Alto offices for AIPCon, a showcase and conference for an artificial intelligence platform that's gaining ground in health care: Customers including Mount Sinai and Tampa General spoke at the conference, discussing AI applications for issues like sepsis management and clinician shift scheduling. And in an announcement shared with STAT, Nebraska Medicine unveiled a 5-year contract with the Silicon Valley company best known for government contracts and defense work. (Palantir and Nebraska Medicine did not share exact financial of the contract.)
I chatted with Michael Ash, Nebraska Medicine's president and chief operating officer, about how the deal came about: A director on the health system's board introduced Ash to Palantir, and after a few reference calls with customers like Tampa General, Mount Sinai and Cone Health, Nebraska Medicine signed up for a pilot at the end of 2023. By June, they'd agreed to sign an enterprise-wide contract.
The pandemic had exposed Nebraska Medicine, like other health systems, to acute inflation, financial pressures, supply chain challenges, and capacity demands, Ash said."We had a negative operating margin [and a] turnover rate that was higher than the number we were recruiting, so we had a net reduction in our number of nurses. We had surgery scheduling challenges to the point that we had surgeons threatening to leave over these issues."
In looking for solutions to scheduling challenges and limited operating room capacity, Ash looked at products like Kronos and Workday, and even features embedded in health records systems like Epic. (Ash, previously chief medical officer of Cerner, is no stranger to legacy health IT.) Palantir's health care team — established just a few years ago — moved quickly and was willing to co-develop solutions, instead of selling services off-the-shelf. Since signing on the with company, Ash said, "we went from negative margins to a positive margin."
from the bay
Should clinical outcomes drive VC investments?
As I mentioned last week, I moderated a panel on the future of health care at Rock Health's annual summit in San Francisco last week (photo from Rock Health). It was a meandering conversation that touched on topics like a physician burnout crisis and how best to ensure longevity care is equitable. What stuck with me most was a back-and-forth on the role of clinical outcomes in venture capital. Asked how much clinical outcome data drove her investment choices, Monique Woodward, founder and managing director of Cake Ventures, said it's often very little — most of the companies she funds are far too early-stage to have gathered that kind of data. Bill Evans, founder and general partner at Rock Health, noted that some health companies don't focus on clinical outcomes, but that investors do look for clinical outcome data where relevant. Whose responsibility, then, Woodward asked, is it to fund promising companies before they've had a chance to drive clinical outcomes?
In another panel, end-of-life care company Guaranteed founder and CEO Jessica McGlory said investors' priorities don't always line up with customers'. (Guaranteed happens to be backed by Cake Ventures.) "I've heard all the time from investors...'Well, we want to be able to see that you're having [patients and caretakers] use an app. And what's the engagement on that?'" But if patients are best able to engage with the company over the phone, " that's the best way they engage with you," McGory said, adding that founders sometimes have to "ignore the investors" and "build toward what actually is needed from the people that you're servicing over anyone else." What are your thoughts? Let me know.
A roster of women's health leaders back Harris
Also from the Bay, I've heard from several health tech leaders rallying around womens' health to drum up support for vice president Kamala Harris in the upcoming election. In a public letter signed by hundreds of investors and founders, signatories asserted that a second Trump term would not only erode women's health services, like reproductive care, but it would also be bad for the health tech businesses that arose and raised valuable venture dollars to offer services like fertility consultations, menopause or abortion care online. Their public stance mirrors that of other influential Silicon Valley investors like Marc Andreessen and Ben Horowitz, who back in July announced support for Trump on the grounds that his administration would be less likely to overregulate technologies like artificial intelligence; but meanwhile a growing group called "VCs for Kamala" has several hundred signatures including from Mark Cuban, Vinod Khosla, and Andreessen Horowitz partner John O'Farrell.
Taking a public stand comes with risks — ruffling investors and putting potential partnerships and deals on the line, for instance. Jessica Bell van der Wal, CEO of fertility care company Frame, who signed the letter circulated by Women Healthcare Leaders for Progress, said she didn't ask her investors for permission. "This definitely is going out on a limb, but I feel the stakes have never been higher," she said. Any current investors or future backers who take issue with womens' health, she said, are likely "not a good fit for me and for Frame." Read more.
Medicare
Drugmakers, payers probe CMS digital health plan
My colleague Mario Aguilar's been hot on the case following insurers' stop-and-go, winding and often unpredictable path toward paying for digital treatments. And latest in that saga is parsing Centers for Medicare & Medicaid Services' July proposal to cover some mental health apps, as well as public comments on that proposal. As Mario's uncovered, some of the largest and most powerful health care and pharmaceutical companies in the country — think Pfizer and CVS Health — are pushing for modifications that would suit them, emphasizing just how much CMS' decisions impact the digital health ecosystem.
Andy Molnar, CEO of the Digital Therapeutics Alliance, told Mario CMS' proposal could reveal how covering software drives costs, patient access and adoption by clinicians.
"There's just a lot of excitement around what the future holds, because CMS has done this," Molnar said, adding, "I think seeing some of these companies come out that haven't been really been publicly speaking about this shows that there is more interest than we could even begin to imagine."
Read more from Mario.
startups
Can embracing new tech boost patient safety?
My colleague Casey Ross has a look at a new documentary following Reetam Ganguli, a 23-year old Brown University graduate determined to prove that machine learning can actually improve, and not impede, patient safety by picking up on problems human clinicians might miss. But his success depends largely on the buy-in he gets from clinicians, insurers and health care leaders."That's what your entire ability to help patients hinges on — just someone happening to be slightly interested in you," Ganguli told Casey.
"Your Instagram algorithm to recommend ads is more advanced than what doctors use to understand if you're likely to die or not," Ganguli says in the "The Pitch," debuting this week. His company is focused on flagging potential pregnancy complications for expectant mothers. "We're allowing our doctors to use these systems from the 1970s and manually calculate it for moms at risk."
"The Pitch" is sequel to "To Err is Human," a 2018 documentary on patient safety. Read more from Casey.
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