• by Prodeep Bose , Columnist, November 25, 2014

“Between the idea and the reality falls the shadow.” —T.S. Eliot

The ideas of value-based healthcare delivery optimization, coordinated care, remote monitoring, and predictive health intervention seem to be overshadowed by the realities of a conservative, slow moving industry. However, the bright sparks that are being ignited by venture-capital-funded companies offer a vision of the future and their ability to transform the continuum of care. 

The areas of investment driving innovation within the continuum of care could be broadly categorized into two areas: proactive health management and reactive disease management. The health management continuum comprises risk-awareness through behavior modification programs, whereas the disease management continuum comprises screening/diagnosis through treatment support and outcomes-reporting platforms.

Health Management Platforms

Risk Awareness: Preventice makes a product called BodyGuardian, a high-fidelity wearable technology for remote cardiac monitoring that allows physicians to monitor important biometric patient data. It’s especially useful during ambulatory care, but could also be used extensively beyond acute care environments. It was developed in collaboration with the Mayo Clinic and is FDA approved. Beyond being merely a monitoring device, Preventice has been smart enough to start integrating CRM, patient education, care plan management, and integrated health analytics into the BodyGuardian suite as a software/hardware-enabled platform, which could become a model for future healthcare delivery systems.

Behavior Modification: Oscar is a small but growing health insurance company based in New York City that extends the principle that car insurance companies have used over the past many decades–a reward for not getting into an accident, or, in this case, staying healthy. A mechanism that calibrates rebates or penalties depending on individual behavior or events seems to be an interesting approach to balancing out the universal health coverage mandate. It has sometimes been referred to as the “healthy paying for the unhealthy” model. 

Disease Management Platforms

Screening: HeartFlow is the first company to provide a combined anatomic and physiologic assessment of coronary artery disease in a non-invasive test. The fractional flow reserve or the FFR CT is a patient-specific analysis of coronary blood flow utilizing coronary CT scans and computational diagnostics with 84% accuracy, compared to 59% for CT alone. Such computational mechanisms that triangulate different data points to show what is actually taking place in the body mechanistically without invasive surgery point the way to an important area in the future of diagnostics. 

Risk Detection: More low-tech but equally impressive is the Parkinson’s Voice Initiative, which has an algorithm that can calculate whether a patient is at risk of developing the disease. Max Little, an MIT fellow with a background in digital signal processing and video games coding, teamed up with PatientsLikeMe and Sage Bionetworks to gather voice and other data on Parkinson's to identify speech patterns that can predict the early onset of Parkinson’s disease.

Treatment & Support: HealthTap and Teladoc are platforms that connect doctors and patients remotely–think of them as online versions of the CVS Minute Clinic. The tagline is “doctors are making house calls again.” The ability to “talk to a doctor whenever, wherever, share photos or test results, and get immediate answers, prescriptions” is a powerful use of the Internet and has already begun to shape all aspects of the care continuum.

Proteus has a platform called Helius, a contained social network of clinicians, patients, and families who can use real-time information about medication-taking, rest, and activity to make informed treatment and care decisions . The idea of connecting clinical intervention with caregiver support is a simple one, and one that connects the professional and the personal elements of health management. 

Outcomes: CitiusTech plays a key role in enabling healthcare technology partners, large hospitals/IDNs, payers, and life sciences companies to accelerate innovation in their business — new technologies to enhance patient care and engagement are the primary goals.

2014 has been a year of dramatic growth in funding innovation. So far, 347 companies have raised a total of over $5 billion, and 2014 is on track to almost double 2013’s investment total. Notable areas are big data and analytics, remote monitoring and care, diagnostics, patient engagement, and even insurance. Clearly, the healthcare industry is being transformed. The question is, what role will the established players of today have in this future?