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The Death and Rebirth of Primary Care

~ cmonsen ~ Leave a comment

Much ink has already been spilled about the impending primary care crisis. Fifty years ago, 50% of physicians practiced primary care. Now, it is only 30% of them and many of those primary care physicians (PCPs) are approaching retirement. According to a recent Senate report we are short roughly 16,000 PCPs already and this number is expected to grow. Wait times have been steadily increasing and it is becoming harder and harder to access the quality PCP that we all need. It would seem that physician-provided primary care is dying.

In truth, the PCP is already dead. Step inside any PCP office for a moment and reflect on how many substantive interactions there are throughout the day. The average PCP spends less than 15 minutes with each patient, leaving 5 minutes for your history, 5 (generous) minutes for your physical, and 5 minutes for assessment / wrap-up. Somehow, these brief interactions are expected to do some of the most challenging work a physician faces: educating the patient and promoting healthy behaviors. A pediatrician I spent time with during medical school often joked that he needed roller skates to keep up with the patient volume. Something like these babies might’ve helped.

Continue reading The Death and Rebirth of Primary Care on the Symcat blog.

What Does the Massive Health Acquisition Really Mean?

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If you’re like me, you’re extremely excited about the potential for design to reshape health care. I’m not talking health care system redesign (ACOs and such–though that’s great too), I’m talking about the type of design you see on Dribbble: the focus of a recent (awesome) HHS-sponsored competition.

One of the promising upstarts of health care re-design was a 2-year-old-or-so startup called Massive Health founded by ex-Mozillite Aza Raskin. Though I tend towards the skeptical, there was a part of me that thought that not only were they on to something, but they clearly had managed to aggregate real design talent. And in health care, no less! Apparently, I was not the only one as they convinced a number of investors to throw $2.25 million in to test out what they could do.

Continue reading What Does the Massive Health Acquisition Really Mean? on the Symcat blog.

The Real Problem with Physician Decision Support

~ cmonsen ~ Leave a comment

Early in medical school, I was involved in the care of Ted, who could have been my grandfather. At 76 he was as spry as any of the patients on the ward and always welcomed me with a “morning, Doc!” He was admitted because he was having concerning chest pain several times a week. Opening and closing 2.8 billion times throughout his life, his heart valves had gradually become hard and inflexible preventing blood from leaving at its usual rate. Now, it was risking his life. He had several treatment options available to him: valve replacement through open-heart surgery, a new minimally-invasive procedure where they snaked a new valve through the body’s blood vessels and into the heart, or just taking medications to help with his symptoms. It was my job to help Ted figure out which option was best for him.

Continued reading The Real Problem with Physician Decision Support on the Symcat blog.

How the Big Data Trend will Support Medical Research

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It is no secret that research relies critically on data collection. Whether you’re talking about pharmaceutical research, market research, or outcomes research, successful analysis can only be done with robust data that captures the metrics most relevant to the question at hand. Unfortunately, that degree of data collection can be an expensive proposition, especially when it comes to health care.

Continue reading How the Big Data Trend will Support Medical Research on the Symcat blog.

Blueprint Health Startup Accelerator: Was it Worth It?

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blueprint-cover-page-david-craigAs exciting as the digital health space is right now, there is still little guidance or validated path to getting off the ground. As part of an effort to help aspiring health care entrepreneurs, I’ll be writing a series of posts explaining some of the decisions we made for Symcat. It hasn’t been a year since we’ve started, but my hope is that our few months of experience can help those who are just getting started themselves.

One of the questions I’m most frequently asked is if our time at Blueprint Health, a health start-up accelerator, was worth it. To participate, the program requires 3 months of relocation to the NYC offices in SoHo and the forfeiture of a nearly 6% equity stake in the company. The program basically offers $20k, mentorship from its network, and office space. A few other health start-up accelerators (ie Rock Health, Healthbox) have some variations but basically the same theme. They are all very selective accepting 3-5% of applicants. While it’s nice to be accepted, there’s still the important matter of deciding if it is right for you.

Continue reading Blueprint Health Startup Accelerator: Was it Worth it? on the Symcat blog.

Can Health Care Be Disrupted?

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It’s widely recognized that health care must change. Paper charts are still commonly used, providers communicate via fax, and patients wait weeks for an appointment. Given the recent excitement around health information technology and the unusual political will, it may seem not only that health care is ripe for disruption, but that it may even happen.

Or will it? Disruption is one of those “know it when you see it” kind of things. By lowering the costs of distribution for content providers, the Internet, for example, has unmistakably changed, and continues to change, the media industry. Or, if you don’t like that, you can try wikipedia’s take. There is a lot about health care that feels like pre-Internet media: insular, capital-intensive, multiple stakeholders (read: middlemen). And so, it feels as though health care will be disrupted, but where and how can that reasonably happen?

Continue reading Can Health Care Be Disrupted? on the Symcat blog.

5 Steps to Making Your Medical App Idea a Reality

~ cmonsen ~ Leave a comment

You’ve got this great idea for a medical app that will transform health care (or at least a chunk of it).

Now what?

There is no one path to executing your idea. Particularly for those of us in medicine where the course is clearly delineated (pre-med, med school, residency, etc), acknowledging this fact can be disorienting. My goal here is to suggest one path that has helped me personally get beyond the ideation phase.

Continue reading 5 Steps to Making Your Medical App Idea a Reality at iMedicalApps.

Doctors or Algorithms: Who Will Win?

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A recent TechCrunch article instigated some debate as to who will win the title of “Medical Expert:” physicians or algorithms. As a medical student with a background in engineering and machine learning, my perspective has led to a somewhat conflicted opinion. I have, on the one hand, seen how powerful algorithms can be, even in the medical domain, and on the other, watched and learned from master clinicians in medical school.

Continue reading on the Symcat blog Doctors or Algorithms: Who Will Win?