The average American is blissfully unaware of this world, even though it directly affects them, often in hugely personal ways. Your most intimate details, like medical records, may be available for sale online and there’s nothing you can do to prevent it.

When the hack, referred to as a Ransomware Attack, hits closer to home, it becomes public knowledge. Take for instance the attack in early May on American gasoline supplier Colonial Pipeline, which crippled many cities. Americans were soon queuing for gas, hoarding supplies, as gas stations across the US closed or ran out of gas. 

The hackers had taken control of the systems operating the supply of gasoline via pipelines that criss-cross America. This was personal and the American public felt the effects first hand. Ransomeware was all over the news.

What most Americans don’t realize, however, is just how common these attacks are. It’s the perfect digital crime. Take over some company’s system, shut it down remotely from a place of safety, and then demand payment from the company. Once the company pays — the ransom — their systems are unlocked and they can resume business.

Bizarrely, the hacker’s “code of ethics” for want of a better term, seems to hold true. Once payment is made, the systems are released. Payment is a simple matter, digital currencies like Bitcoin make tracking the money all but impossible. 

It could be argued that without access to digital currencies, these hackers would be unable to extort money from their victims without leaving a clear trail for authorities to pursue.

Aside from the obvious inconvenience and potential dangers to essential energy supplies and other critical systems, there is another hugely unreported consequence of these hacks. The bleeding of personally identifying data. That’s your info and mine, all of it fair game. Don’t forget, these hackers are inside the systems they compromise, they have sufficient access to lock down the system.

It would be hugely naive to imagine they simply leave it there. While companies run around trying to secure loans to pay off ransom demands, the hackers are merrily downloading every shred of data they can strip from the systems.

That’s where the real value lies. Your information or data, which is spread throughout numerous systems across the US. This data is worth real hard cash on the dark web, especially certain types of personal data, like your healthcare information. From recent reports, it would appear no systems within the US are immune.

Your Data, Healthcare, and the silent war

Most ransomware attacks never see the public light of day. They’re kept quiet and settled away from the prying eyes of the media and the public. For very good reasons. Investors don’t like companies that appear vulnerable and companies would rather not spend the next six months explaining to their customers that their data was compromised.

Healthcare is particularly vulnerable. It’s a sector favored by hackers. Easy access to poorly protected systems, rich data pickings, and a culture of “keeping it on the QT’ among medical institutions, hospitals, and healthcare systems make this sector almost irresistible. 1 in 3 companies or institutions within healthcare get hit, according to a recent whitepaper from IT Security firm Sophos. Here are the key takeaways from the paper. 

• 34% of healthcare organizations were hit by ransomware in the last year.
• 65% that were hit by ransomware in the last year said the cybercriminals succeeded in encrypting their data in the most significant attack. 
• 44% of those whose data was encrypted used backups to restore data. 
• 34% of those whose data was encrypted paid the ransom to get their data back in the most significant ransomware attack. 
• However, on average, only 69% of the encrypted data was restored after the ransom was paid. 
• 89% of healthcare organizations have a malware incident recovery plan. 
• The average bill for rectifying a ransomware attack, considering downtime, people time, device cost, network cost, lost opportunity, ransom paid etc. was US$1.27 million. While this is a huge sum, it’s also the lowest among all sectors surveyed.

Scripps is an excellent example in case. Scripps began notifying more than 147,000 individuals in early June this year that their protected health information was exposed during a malware attack. They now face 4 class-action lawsuits.

For certain patients, exposed information included names, addresses, birthdates, health insurance data, medical record numbers, patient account numbers, and treatment details. Less than 2.5 percent of individuals’ Social Security numbers and/or driver’s license numbers were involved, according to the health system.

The list of attacks is growing exponentially.

• 500,000 patient files were potentially stolen in a ransomware attack on Iowa clinics.
• 334,000 Ohio Medicaid providers’ data were breached in a vendor hack

Keep in mind that only a small percentage of these attacks are ever made public and the data above should serve as a fair warning to all healthcare organizations. No one is immune and even smaller organizations are targeted.

Protecting yourself

Clearly, we cannot exist in a modern society without sharing our most private details with companies on a daily basis. There is a huge amount of trust involved, and where many Americans now simply take this relationship for granted, assuming companies will protect their information, ransomware exploits have exposed clear flaws in companies’ approaches to protecting our privacy.

We cannot affect or restrict the data we share without compromising, for instance in a healthcare setting, our quality of care and service. In these instances, the onus falls squarely on the shoulders of the service providers to protect our data and they are failing. 

Our only recourse in this instance is to lobby our congressmen and women. Changes need to be urgently brought to bear on the holders of personal data, fines imposed for lack of proper security, and audited processes put in place to ensure our data is safe.

This is going to prove challenging, particularly when not even the federal government’s systems appear immune to attack. Perhaps it is time to apply Bitcoin-style encryption to our data and fight fire with fire.

The post Held for Ransom. A New Pandemic is Sweeping American Healthcare appeared first on Medika Life.

Dallas-based startup Listeners on Call is trying to solve the problem through its consumer listening services connecting people in need to an empathetic listening ear. The company believes in the power of meaningful conversations.

Listeners on Call launched in July of 2020 in response to the growing pandemic of loneliness exacerbated by Covid-19. The platform promotes mental health by connecting callers to a trained team of listeners. The company website states, “Everyone has something they need to share. Not everyone has someone to listen.”

The Dallas-based startup matches Listener on Call users to others who provide an empathetic ear and share experiences. The company believes sharing with someone who can relate to your problem can be life-changing. Callers can rest assured their privacy is protected as all calls are anonymous.

The Listeners are not trained medical professionals and do not give out medical advice. The platform is not designed to provide therapy or counseling. Instead, Listeners on Call’s goal is to be a “first step” for those seeking support. Dallas-based CEO Cole Egger told the Dallas Business Journal, “the company isn’t looking into the crowded field of telehealth companies providing professional services instead of seeing itself as the first step in seeking care and support.”

After downloading the app from the Apple App Store or Google Play, users can select their listener to find someone who shares a connection to what they are experiencing. The company website states, “We are committed to connecting anyone, anywhere, anytime with someone who has a related personal experience and is ready to listen and are proud to offer on-call empathy, privacy, and support for millions of people who need to feel heard.”

The next step is to find a convenient time to speak directly to the listener. The app allows users to connect immediately for urgent conversations or to schedule a time in the future when it is convenient.

Next, Listeners On Call connects the user to the listener on a private line to help maintain privacy and anonymity. The calls can be as long or as short as needed. Users pay $0.50 per minute to use the service.

Every day people can apply to be listeners and be paid for their time. The application process is spelled out on their website. The company seeks out people who have empathy and who have a “natural spark of curiosity that makes people want to open up to them.” The listeners are trained through the company’s Listening Academy.

The Listening Academy involves a series of short courses focused on the art of Connected Listening, which the company explains as “how to create a bond with strangers based on a shared experience.” The program provides listeners with tools and techniques to help callers feel heard and valued.

The techniques employed by Listeners On Call is backed up by data showing an individual’s emotional state can be improved by exposing them to an empathetic listener. The company performed research evaluating callers disposition before and after engaging with a listener on their platform.

Listeners on Call partnered with Morphii, an experience measurement technology to complete the study. Morphii’s patented technology quantifies users’ emotions and feelings after engaging with various technologies.

During the study, Listeners on Call evaluated a caller’s disposition before and after a call with a trained listener. The Morphii system then quanitfied the caller’s pre and post-call emotional state.

The results were summarized in a press release as:

• Almost all Callers (97% leave the Listeners On Call platform in a more positive state.
• Overall, Callers experienced a 115% improvement in disposition from pre-to-post call.
• Callers identifying isolation/loss as the reason for seeking Listeners reported an average improvement of 151%.
• Callers seeking Listeners to cope with stress demonstrated a 184% improvement.
• Lastly, Callers who did not designate a specific topic, but who simply needed to talk/vent averaged an 89% improvement from pre- to post-call.

The mission of Listeners on Call is to make sure no one ever feels like they are alone. We all need someone to talk to sometimes. Perhaps, this platform can help the world feel more connected.

The post Listeners On Call Tackles Loneliness Through the Art of Listening appeared first on Medika Life.

His mission has its roots in personal loss; his father died of cancer at a young age. When Jeff discovered that the cancer was largely a result of lifestyle choices, it demonstrated how unhealthy behaviors go unaddressed until it is too late to intervene.

It led to the realization of how backward our traditional health care system has become: it’s really a reactive sick care system that treats people after they’ve already become sick, rather than a proactive health care system that works to keep people healthy and prevent illness through primary prevention.

Jeff’s belief in the critical importance of prevention led him to establish several innovative health care startups prior to founding his current company, Newtopia, a tech-enabled habit change provider that helps health insurers prevent disease and save costs through sustainable habit change instead of late-stage condition management.

As Jeff says:

Health care providers often offer patients lifestyle-related platitudes — eat healthier, exercise more, get more sleep, reduce stress — but they are not trained or incentivized to take the time to really get to know their patients and their unique needs and work with them to make the daily choices that will build new, incremental healthy habits. So how do we make sure that these recommendations actually turn into change in people’s lives? A new front door and front line is required. Changing and stacking habits requires both a hyper-personalized approach (taking into account factors such as genetics, medical history, social determinants of health, behavioral profile and personal preferences, for example) and a strong human connection supported by technology to ensure inspiration, build confidence and accountability..

Jeff is committed to helping health insurers re-envision their investment in health and realize the greater returns of creating pro-health and pro-wellbeing workplace cultures. By addressing the unhealthy life choices that are a major risk factor for many noncommunicable diseases –
including obesity, type 2 diabetes, heart disease and stroke – health insurers can proactively intervene to change the trajectory of chronic disease development, saving lives and reducing costs.

According to Michael Palmer, the former Chief Innovation and Digital Officer at Aetna, and current Newtopia Board member:

Jeff proved his solution works – for Aetna he netted out over $1,500/year in medical cost savings per member per year, kept over 70% of them engaged to achieve their goals, and materially reduced risk of obesity, diabetes and cardiovascular disease for a large percentage of our at-risk people. We even co-published the results of a randomized controlled trial – and Aetna would only put our stamp of approval on a solution that is proven safe, effective and economically beneficial. In addition to finding the secret sauce of personalized habit change, Jeff has built an inspiring team of health coaches, technologists and habit change gurus who will likely change the trajectory of healthcare for good.

Prior to founding Newtopia in 2008, Jeff was co-founder and chief operating officer of Cleveland Clinic Canada, a collaboration between the Cleveland Clinic Foundation and Canyon Ranch, and Canada’s leading destination for preventive health and lifestyle management; co-founder and chief operating officer of Life Screening Centers Inc., a cancer screening and prevention company; and co-founder and head of operations of Genetic Diagnostics Inc., an early-stage biotechnology company commercializing a new genetic diagnostic testing platform. 
 
Jeff holds a joint Juris Doctor and Master of Business Administration from York University’s Osgoode Hall Law School and Schulich School of Business in Toronto. He received his bachelor’s degree from Western University in London, Ontario. 

If you’re interested in the push to create a more sustainable approach to health care, Jeff is someone you’ll want to have on your radar. If you’d like to connect with him, you can do so via the links below.

Getting in touch with Jeff

The post Jeff Ruby, Founder & CEO, Newtopia appeared first on Medika Life.

Digital health is part of our lives and has become a part of “us,” and I respect your leadership to make patients’ lives better. Along with digital health, leaders of healthcare organizations make decisions to implement and use digital products in our work environments. The collaboration of both parties makes up today’s healthcare, hence open and transparent communication channels are crucial to a healthy ecosystem in healthcare. 

I have experienced almost every level of digital health integration in our industry and feel obliged, based on my experiences and the issues I have observed, to speak up. Being passionate about patient safety and empathy in healthcare, the frustrations and concerns raised by providers and colleagues, and the accompanying instances of patient harm are of deep concern to me. As I have worked in both inpatient and outpatient settings, here are direct quotes from people I have interacted with. 

Let me start from the inpatient setting: 

“I can’t get my medication from the Pyxis (medication dispensing machine)! It has been 2 hours past the schedule!” says one nurse, trying to give an insulin dose for high sugar to a patient. She couldn’t get her login figured out after her bioID or password did not work. 

“I spent 50 minutes just trying different workarounds!” says an infusion nurse trying to scan an IV bag to assemble with an antibiotic that will not scan because of a glare from the plastic wrap. There is no clear solution. 

“Can pharmacy come and help? I have a patient in surgery already!” says a surgery technician, frantically asking for anesthesia medication because she has an issue with a new login process for accessing Pyxis.

Is it an upgrade or a downgrade?

Whenever there is an upgrade for a health IT product or process we are using, these upgrades are accompanied by cries for help. It is an almost standard response accompanying the upgrade from staff trying their utmost to access medications for their patients. Even when there is no upgrade in progress, we continuously need to develop a process to get around the problems created by AI and IT. 

“I spent 2 hours talking directly to the support members of all the involved products, and none of them are willing to accept the onus of addressing issues created by their technology in the field. Nurses are calling nonstop, and orders are piling up.”, says a colleague.

“The message on the screen said to check the power cords and to try other things, then call if none of those would work. Do you know what the real problem was? It was the browser. The application would only work in Chrome! Why didn’t the message say it then? I wasted 2 hours troubleshooting an issue that I could have resolved within minutes. 

I did not see that sticky note.”, says another colleague.

Is the outpatient setting any better?

“I cannot make an appointment for a vaccination. There is no feature that allows me to enter my problem in the appointments portal! Why isn’t there an option to enter free text? There is no one answering the phone at the time I can make a call, so instead of being able to use this conveniently located vaccination center, I had to drive 100 miles to get the vaccine through a different pharmacy.”, says a friend.

“Thanks for covering my shift. Do you know what happened? I got to the appointment, and the receptionist said she couldn’t find me in the system. I had the confirmation number and everything. I am never going back there, and now I have to figure out everything all over again, time, work, family.”, says my coworker. 

“I went to all the pharmacies I used before, and none of them had my prescription ready! The doctor said it was sent to the pharmacy electronically, and his office was closed when I called to find out which pharmacy he’d used. Can you guess where I found it the next day? It was at the outpatient pharmacy at the clinic!” says a patient.

Many of these flawed digital options I’ve described above are forced on patients without their consent, choice, or support. When calling a medical office, patients get directed to go to the digital solutions offered by providers’ websites. 

For clinicians, we use various products, from checking products in crash carts for Code Blue to Epic for electronic medical records to record notes and communicate with various participants to care for patients. For patients, these records get accessed through Epic’s MyChart portal. When I attended South by Southwest (SXSW) in 2013 as a student startup attendee, speakers were already talking about a future where every patient would be wearing devices like the Apple Watch to measure health. That time has come. 

And digital has become pervasive throughout healthcare. Even when we visit websites, we encounter chatbots to guide us through our visit, guiding us, asking questions, and directing us when we search for information, such as for clinical trials. Patients and healthcare workers use these tools every day to make our lives more efficient and I applaud the passion and efforts to make healthcare better. 

However, what if things don’t go as intended? What is the plan?

When things don’t work out as intended, no one is accountable. Not for lost productivity, money lost and for patients who experience the negative impacts of poorly functioning solutions. Most importantly patient safety issues caused by digital health solutions are not addressed. Healthcare’s bottom line can be affected by how digital health products perform in a clinical setting like this example, allegedly resulting in the financial breakdown of the institution. If this institution was the only hospital in the area, imagine how detrimental the effects would have been to the local community.

When we get the explanation of “It is an IT issue.” in healthcare, we wait till someone in the IT department resolves it. However, as we use many different products, establishing which one is causing the issue takes time. Different vendors point to other products for faults. In the meantime, we have to work around the issue while it’s addressed, often making the situation worse. Identifying which vendor is to blame doesn’t always resolve the problem either. Sometimes flagged issues get lost somewhere in the communication process, and no one follows up. Sometimes vendors wait until enough people complain about an issue before they apply a patch or a fix. 

Here are 3 recommendations I would like to voice as a healthcare professional and a patient advocate: 

1. Your end-users are ultimately patients, no matter who uses your product. 

Whether your product line targets businesses, clinicians, or customers including patients, if your product is for healthcare, the ultimate end user of your product are the patients. Let’s say your product’s users are doctors and nurses, or even nonclinical professionals in healthcare who support the clinical professionals. Your product is ultimately helping the institutions that are treating patients. Even though your product’s direct users are not the patients, your product needs to be designed “for” patients’ safety. Please remember that when your product breaks down or does not work as intended, you are ultimately compromising patient care and safety; the time and resources saved by your product are no longer enabling the direct users, which negatively impacts their ability to properly assist their patients. 

2. Healthcare is not binary, and your digital solutions shouldn’t be either.

Chris Dancy, “the most connected man on Earth,” says it so well in his book, Don’t Unplug.

Healthcare is not binary. 

The digital solutions you provide should not be either when integrated into practice settings. I know it is easier when things are all categorized with a yes or no. Data and A.I. like 1’s and 0’s but healthcare is far more nuanced. Not everything is easily categorized into predetermined boxes, as many issues are interconnected to each other. Consider “other” and “comment” as an option at all times. Digital healthcare works most efficiently when combined with a human touch that allows for the complexity of our species, in my humble opinion. Consider connecting the services you provide digitally with a person who can help that process as not everything is clearly yes or no, especially on the patients’ end. 

3. Please look ahead and consider empathy for “patients” and provide solid feedback loops for the “users.”

Notice “patients” and “users” are different here. I am a strong believer in empathy being the essential ingredient for all healthcare problems. Digital health is no exception. Again, your products exist essentially to help patients in the end, even though the direct users may not be patients. Consider asking questions like, 

“Are we providing our support staff with a broad enough brief, of how our products can not only help but also harm patients when things don’t work out?”

“How are we advocating for patients even though our direct users are not patients?”

“Are we regularly assessing feedback loops? Do our users have ways to properly bring their concerns to our attention? What is the pattern of communication breakdown? Do we have ways to collect this data?”

“Are our staff properly trained in how to resolve problems users bring to their attention? Are we training their listening skills and developing their empathy?”

Users’ concerns should always be seriously considered and never ignored. Healthcare is very detail-oriented. Continuous improvement and quality enhancement are must-haves, again, for patient safety. This is the difference between products that suffer poor adoption in the market and those that become indispensable. Great products work with and for the users and are flexible enough to change to address fluid workplaces.

Patient safety is a serious issue in digital health that does not enjoy enough attention. Not enough is being done about the problems users encounter on a daily basis. While the explosion of digital health is openly welcomed in the deeply flawed health system in the US, serious consideration of how the integration of digital technology into clinical settings and real lives occasionally compromises patient safety, which lags far behind. The digital health phenomenon is no longer based on “optional adoption’; it is intentionally and forcefully pushed to all of us. 

Avishek Choudhury and his colleagues studied research in digital health in the geriatric population and also studied artificial intelligence solutions in healthcare for patient safety. Their research highlighted

• machine learning and AI lack standardization, 
• lack of customization to clinical settings, 
• and lack of appropriateness of data being used in provided solutions

The most concerning issue for me, identified in the papers, was the inability of many systems to consider patients with comorbidities appropriately. While digital health solutions may provide help for patients, there are still huge limitations because, as stated above, healthcare is not binary. Are we assessing patients’ preferences even before the interactions start? How much time are we spending to find more about what is involved beyond the scope of the limitations of the systems and narrowly defined categories? How much benefit do patients get from replacing people with digital health solutions?

Focusing on patients, being aware that healthcare solutions should not be binary but be integrated with a personal touch, and having empathy for patients and providing solid feedback loops are what I ask you to please consider. 

I’ll leave you with a parting story for your consideration, as I am active as a patient advocate for patients with language barriers. I attended a continuing education committee conference for doctors as a patient advocate. When I brought up my concerns for patients with language barriers to one of the speakers, he shared an “unfortunate” story of a Japanese patient with limited English who died of pneumonia while trying to communicate with a doctor using a patient portal. 

The patient’s request to speak to a doctor was routed through a digital portal, and the doctor was not able to clearly assess the patient’s condition before it got out of hand. While it can be argued the breakdown in communication here was not simply due to technology, we have to be aware of how we use digital health and ensure that patients and users who are not tech-savvy, ready, or willing to use it because of barriers, still have other ways to communicate. 

Should a case like this remain an “unfortunate” case? I respectfully disagree. The assumption that all patients and providers be able to communicate via the electronic portal and the assumption that all should be able to communicate in English, well enough to describe symptoms electronically, is fundamentally flawed. I have to disagree, as one in five of the US population speaks a different language at home, This is not a percentage that healthcare can ignore in favor of technology. 

Thank you for your time, and please have “patient safety” in mind at all times. Let’s not forget that it is a prerequisite for “being” in any type of healthcare, whether it is digital or personal. I humbly ask you to learn from patients and constantly improve the patient experience with empathy. Covid-19 should have been an awakening opportunity for patient safety as we all were on the verge of being a patient, more so than at any time in our lives. 

We must improve patient safety together, digitally and in person. 

The post Dear “Digital Health Leaders And Healthcare Leaders,” You May Be Inadvertently Hurting Patients appeared first on Medika Life.

1. Poor Design

Without a doubt, the most commonly raised issue for existing solutions and new-to-market products that rely on user input, whether patient or provider input. The refrain “the system doesn’t allow me to do x, y, or z” can be heard across every field of healthcare in America. This speaks to one single cause. Poor design based on a limited understanding of the ecosystem you are engaging with and as it’s a frequent refrain, many companies, in fact, the large majority, are at fault here.

You are producing AI and data-driven software that, while efficient at performing its assigned tasks, lack the ability to perform accurately or meaningfully as your data capture is incomplete. You’re not asking the right questions and offering your user the breadth of input they require for their responses. The result is an incomplete picture and as you’re probably all too well aware, in healthcare that can prove fatal at worst, and at best, result in, you guessed it, terrible adoption.

You’ve chosen one of the most complex ecosystems to distribute a product into. Not only is the healthcare sector incredibly diverse with wide-ranging needs to address the most complex piece of machinery on the plant (the patient), this ecosystem is already filled with a multitude of products that you need to be able to communicate with seamlessly. There is no standardized Windows, Apple, or Android platform to base development on. Healthcare is the programmer’s version of data hell and you need to be ready to toss out all your preconceived ideas out the window.

To develop an effective AI or digitally driven software solution for healthcare(we’re not referring to cutting edge medical devices and tools here, but rather the software that drives much of the industry) it’s time to go back to med school 101 and that involves being able to draw on a full picture. One that includes both patient and provider views. Fail either and you’re doomed. This might sound patently obvious, it clearly isn’t and it this lack of a proper appreciation for the issues faced in the day-to-day practices of patients and providers that undoes most new solutions.

Startups need to spend time in their doctor’s and patients’ shoes. Live with them, shadow them and develop systems that solve their problems without creating new ones. Only once you can relate to their experiences can you arguably develop suited tools and solutions. You can’t provide the answers when you’re not even sure which questions to ask. Embed yourself and learn first. Then do what you do best. Build solutions.

2. Inbuilt Bias

I’ve broached this topic before and it’s a critical one that speaks directly to patient safety. Depending on which areas of the United States you’re pushing your services into, you’re addressing a multilingual, multiracial patient and provider landscape. The time for developing solutions for a white middle-class patient has died a well-deserved death and is now ascribed to history. The fact that so few platforms address equitable access to healthcare successfully is almost criminal, not only from an ethical perspective but when viewed from monetizing any solution.

Dude, you just missed half your customers. Seriously. Do you know how many Asians, Hispanics, and other nationalities intentionally avoid using your solution because you’ve built bias into the system? What about the elderly? You’ve forgotten about half your market and that has two major consequences. Let’s examine both.

• You‘ve just cut your income stream in half and potentially rendered your product obsolete by not making it inclusive. It will suffer from poor adoption rates and as users discover its limitations you will hemorrhage clients. Trust me, go ahead and design for privilege, intentionally or otherwise, and let me know how that turns out.
• You‘ve developed a product that is in direct contradiction to healthcare’s much-vaunted goals of equitable and accessible care for all. We’re not there yet, but if your solution is part of the problem rather than seeking to address it, you can see where this is going right? EVERYONE, irrespective of race, color or creed should benefit or be able to benefit from your solution. If not, then it clearly isn’t fit for purpose.

Create products that are inclusive and allow for varying levels of access and when all else fails, still allow for human interaction. Do this well, and in the current market, you are ensured of spectacular success.

3. Flexibility

The ability to change and adapt to a fluid working dynamic like the one posed by healthcare is key to your product’s success. No matter how much homework you’ve done, how inclusive your system is, and how much money you’ve spent on testing, you’re dealing with human beings and ever-changing dynamics in terms of protocols and treatments. Build a rigid system that cannot be easily and rapidly fine-tuned and you will quickly find yourself in customer service hell.

IT companies often adopt an attitude of “fault tolerance levels”, waiting for the reports of glitches and flaws to mount up before they effect system-wide repairs. Healthcare is no different and if you want to really get a leg up on the competition, your ability to respond quickly and meaningfully is key. Not only will you reduce customer service loads, but your solution will also ingratiate itself with providers, who in turn, will ensure widescale adoption and brand loyalty. Win, Win.

Ignore issues, calls for updates, changes, and additions to a system and you’re committing brand suicide. At best, you’re alienating your customer and at worst, your inability to respond to requests for change can cost patients their lives. Neither outcome is desirable Build it so you can change it. Easily and quickly. This one aspect alone, coupled with simple and accessible customer service, will set your product light-years apart from competitors.

4. Understand the problem you’re addressing

This isn’t about poor design, although the two concepts overlap. it is about not correctly understanding the parameters of the problem you are seeking to address and this can have major ramifications when it comes to product adoption. One GP or a hospital that faces an issue is not reflective of the entire industry and problems can often be localized to an area or state. Do your homework. Understand the extent of the problem before you set about creating solutions.

Keep in mind that solutions don’t make users’ lives more complex. This is at odds with the whole idea of a solution and yet, the market is flooded with clever ideas that practitioners don’t need, much less have time for. Does your product address a widespread issue faced by healthcare workers, does the solution simplify their lives, and finally, is it simple to use. Tick all three or head back to the drawing board. Again, these are basics, but basics that are often lost sight of in our eagerness to bring our version of a solution to the marketplace. Any addition to a doctor’s workload that doesn’t translate into time saved and better patient outcomes is doomed to failure. Understand the problem you’re addressing and ensure the solution is appropriate.

Develop working models and consult with your users along every step of development. Changing tack is easily done when you’re in the development phase, less so when your distributing.

5. Accessibility

Possibly the most obvious of all, and yet, applications are still designed that will only function in the chrome browser, require the latest computers to run, and offer users complex and logic-defying UI’s. Dependence on a stable internet connection is another issue faced by many applications. kill the internet and you kill the application. While many solutions require an internet connection for functionality, many don’t, and making a system available offline increases reliability and access. 

Offering your solution across all platforms and browsers also greatly increases adoption and again, for a world that loves digital but doesn’t enjoy total coverage, don’t ignore your users that don’t as yet have access to smart devices. Integrate voice for people who don’t own a smartphone, who may not have internet, or who may simply not be familiar with our technical world. They also require access to medical help and the solutions you are creating. Be innovative and include them.

Ensure application UI’s are user-friendly, that visually impaired users can access the system and that font sizes can be adjusted. Inclusivity is your guiding principle for any healthcare application, particularly patient-facing solutions.

Going Commercial

There are fortunes to be made and lost in healthcare, especially in the trending arena of digital health. That hunger for profit and the need to generate turnover is often achieved at the expense of the patient and the provider. If your sole purpose is revenue, your experience with healthcare will most probably be singular and short-lived. The industry is unlike any other and while commercial interests do currently skew the medical landscape there are moves afoot to set the world to rights,

Idealists, purists, and ethical professionals want to ensure a return to patient-focused medicine, where the patient serves as both the motivation for and the final purpose behind the industry. Again, companies who are perceived as furthering the commercial exploitation of healthcare and patients will be spurned for their more ethical competitors. This patient-focused movement is alive, well, and growing within healthcare. Developers would be well placed to ensure their primary focus is improving the lot of the patient, even if that means occasionally forsaking profits and shareholders.

The post 5 Key Pitfalls That Compromise or Sink Digital Health Startups appeared first on Medika Life.

Let’s start with Allyson’s work outside of her practice and the organizations and foundations, some of which she has co-founded, that focus on cancer patients, on care, aftercare, and support for a sector of the community that is so often left rudderless after the devastating and dreaded diagnosis of cancer. We’ve focused on two of the site she helped found and is prominently engaged with.

Michael’s Mission

Michael’s Mission was formed as a way to honor and remember Michael Soussa. Michael was a vibrant young man when he was diagnosed with colorectal cancer at the age of 30. He underwent multiple surgeries and almost 40 months of chemotherapy and radiation. After nearly three and a half years of fighting, Michael passed away at the age of 33. Here’s a brief summary of what Michael’s Mission is about.

Our mission is to improve the quality of life and treatment options for colorectal cancer patients, particularly young people like Michael. Michael always said that when he got better, he would give back to others diagnosed and living
with colorectal cancer. What Michael found most difficult to deal with was the lack of relevant and quality information about the disease, the inability to interact and share experiences with other patients, and the lack of funding for research trials and patient support services.

He was also incredibly frustrated with the lack of attention and information regarding the side effects and quality of life issues associated with colorectal cancer—the focus was on treating the disease and not on helping people live their lives.
One of our core values – enhancing quality of life – allows us to help patients regain some control in a very uncontrollable situation. Having observed Michael fighting for his life and knowing what was missing to support his struggle, our goals include creating programs and providing services that will help patients and families navigate this difficult journey.

You can visit Michaels Mission by clicking on the image above, or follow them here on Twitter @MMfightsCRC

Let’s Win! Pancreatic Cancer

Let’s Win! Pancreatic Cancer is an unprecedented platform that enables doctors, scientists, and patients to share fast-breaking information on potentially life-saving pancreatic cancer treatments and clinical trials. Our goal is to inform, enable, and educate patients and caregivers, providing easy-to-understand, actionable information. In this way we can help people find the best treatment options available.

In May 2014, Anne Glauber learned she had stage IV pancreatic cancer. She and her family were stunned and devastated, not knowing where to turn but knowing they had to do something urgently. That overwhelming fear and confusion became the genesis for Let’s Win.

Anne gathered a team to develop her idea: her oncologist, Dr. Allyson Ocean, her dear friend Willa Shalit, social entrepreneur and philanthropist; and Kerri Kaplan, President and CEO of the Lustgarten Foundation. Anne and her team imagined an online community sharing new science-driven treatments to help patients and families have a say in their treatment plans, uncovering new possibilities, and finding new treatment options. When Cindy Gavin joined the team as Founding Executive Director, the vision took wing.

In 2017, Anne passed away after living three times longer than originally predicted. Today, Let’s Win is Anne’s legacy, and it stands as a valued resource in the pancreatic cancer community. It is a living testimony to Anne Glauber’s commitment that no one would ever again need to face a diagnosis like hers without resources and hope.

You can follow Let’s Win by clicking on the image above or connecting with them on Twitter @letswinpc

Meet Allyson Ocean

Allyson Ocean is a medical oncologist and attending physician in gastrointestinal oncology at NewYork-Presbyterian Hospital/Weill Cornell Medical Center; Associate Professor of Medicine at the Weill Medical College of Cornell University; and medical oncologist at The Jay Monahan Center for Gastrointestinal Health.

She graduated cum laude from Tufts University and with honors from the Tufts University School of Medicine and completed residency in internal medicine at New York-Presbyterian/Weill Cornell Medical Center. Allyson was chief fellow during her fellowship in hematology and medical oncology at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

She is the author of numerous peer-reviewed articles and abstracts and is an active member of several professional societies, including the American Society of Clinical Oncology, American Society of Hematology, and American Association for Cancer Research.

Allyson Ocean is on a mission to educate the world about pancreatic and intestinal cancers, focusing on innovation and emerging treatments, both in the form of treatment and prevention, and she is all about patient support, throughout the entire process of diagnosis, treatment, and beyond. We cannot think of a finer example of real, ethics-driven compassionate healthcare in action.

It should come as no surprise that she’s racked up the following distinctions on top of her cancer advocacy.

• New York Magazine: Top Doctors: 2017, 2018, 2019, 2020
• Castle Connolly Regional Top Doctors: 1st Edition
• Top Doctors New York Metro Area (digital guide): 2017, 2018, 2019, 2021
• Exceptional Women In Medicine: 2019, 2020

If you’d like to reach out to Allyson, support her projects, or connect with here professionally, you can do so via the links provided below.

Getting in touch with Allyson

The post Allyson Ocean, MD, Associate Professor of Clinical Medicine at Weill Cornell Medicine appeared first on Medika Life.

Sam currently occupies the role of Chief Medical Strategy Officer at Numan, and is the founder and director of the Faculty of Future Health with Ulster University. Additionally, he holds the following roles,

• Chief Clinical Digital Advisor, ORCHA
• Editorial Board Member, International Journal Of Digital Health
• Advisor, Health Hero
• Advisory Board Member, Sesui Ltd
• Group Clinical Director, East Village Dental
• Clinical Director, The Ivory Clinic
• Chair Steering Committee, The HETT show

His opinions and expertise are sought after and he is frequently featured on webinars, podcasts, and talk shows. What quickly becomes apparent are his cutting insights into issues that surround the deployment of new digital healthcare solutions in both the local UK health market and further afield. His patient and provider-centered approach to outcomes are indicative of how he views medicine. In his own words.

I would like to see a shift in healthcare where both sets of users, the patients and clinicians, are the focus of digital change

He is about innovation delivering measurable benefits to both provider and patient and he believes the UK is very well positioned to provide digital solutions to a broader, global platform. You can read his views on a number of topics from the publications he writes for, such as Healthcare IT News and the Faculty of Future Health, or listen to recent podcasts at Anchor.fm and Apple Podcasts.

Medika also recently included Prof. Shah in our Top 50 List of Influential voices in Digital Healthcare.

On Digital Health

Sam was appointed as CMO for Numan in 2020. He was previously Director of Digital Development for NHS England and NHSX, where he was responsible for digital development of the ecosystem and leading on a number of national transformation programs. Sam has worked on a number of initiatives including the flagship project to digitize urgent care in the NHS. He headed up the national learning and development program for NHS England, which considered different channels to access healthcare using technology.

He has also been involved in the assessment of healthcare technology through a number of grant schemes and accelerator programs. Sam continues to work in the NHS within primary care and champions a range of agendas including improving diversity within the workforce; and reducing health inequalities. We’ve included a few of his key comments on digital health and innovation below, drawn from articles and interviews completed in the last year.

On Privacy and Healthcare data

There’s a strong argument that data should be shared more freely to allow better decision-making and enable more people in society to benefit. Some would even argue that health data is a public good. However, the challenge is that organizations have not yet demonstrated they can maintain privacy or safely handle data in a way that won’t lead to abuse.

On Digital Inequalities

Digital inequalities are unlikely ever to go away; this will probably always be a difference in society between access to technology, access to the internet and affordability. It’s doubtful that digital health services will meet everyone’s needs, which means health care providers, commissioners and technologists need to be realistic. Reducing inequalities is always multifaceted; it means those designing and implementing digital health services need to consider the wider social determinants and have a relentless focus on service and system design. For example, it’ll require investment in infrastructure, education, training and creating accessible digital services.

On Developers and Fundamental Values

I have worked with lots of healthcare and technology companies and prefer to work with those interested in promoting safety, security and privacy. Fundamentally, healthcare IT will impact on people’s lives often when they are most vulnerable. IT developers in healthcare need to be committed to sharing good practice, promoting clinical safety and inspiring trust and confidence through operating in a transparent way. The same values in healthcare around equity, equality, and availability need to be reflected in developers of IT solutions.

If your interests lie in digital healthcare, both in the UK and further afield, the opinions and insights of Sam Shah cannot be ignored. His intimate personal knowledge of the industry, coupled with a clear ethical vision for the industry’s future make him compulsory reading. Medika’s advice is that this is the one Professors’ classes you shouldn’t skip. Connect wih Sam below.

Getting in touch with Sam

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We can build software to do, quite literally, anything. The sky and the extent of our creative processes are literally the only limits. Facial recognition software is a great example. It has made spectacular advances in the last five years and not even a mask can help you evade its ever-present gaze. Unlimited budgets presented by eager backers from the NSA and almost every other intelligence and law enforcement agency on the planet have fostered and ensured a focused industry dedicated to the pursuit of perfecting the human version of “Where’s Wally”.

It may interest you to know that a deep learning company Megvii, in association with Huawei, has developed A.I. that can, with a reasonable degree of accuracy, determine the ethnicity of an Asian face. This machine learning model described in a recent paper successfully predicted Chinese Uyghur, Tibetan, and Korean ethnicity. Impressive you might say, and particularly helpful in a dystopian world where the Chinese allegedly seek to identify certain segments of their population.

Quite a few A.I. projects have focused recently on identifying race, gender, age, and facial features simply from the sound of your voice. The systems then generate a face they construct based on what the software has identified in your voice. These tools have created an ethical minefield made all the more complex by the inclusion of the gender debate and clearly defined sexes, parameters not addressed by the developers.

There is nowhere on the planet that you can escape the reach of A.I. It has infiltrated our lives, lives in our pocket via our smartphones, runs our cars, our homes, and is now making choices for us. It’s been doing that for a while. Think of the route Siri worked out for you this morning to avoid traffic. It’s a simple, but effective example of the impact of A.I. 

Did you decide how you reached your place of work or did A.I. deliver you, safe and gridlock free, to the office? Who just stocked your refrigerator, you or Alexa? Any music tracks you haven’t heard in a while from your music library? You do realize there’s nothing random about the random playlist option? A.I. doesn’t do random.

Ethics in Science

Medicine‘s raison d’etre’ is the care of human life. For this reason, and this reason alone, a carefully considered set of ethics developed alongside the profession, keeping everyone safe and ensuring medicine placed a premium on the value of human life. For generations, this ethical system of checks and balances has protected both the patient and the provider. That time is at an end and it is not only A.I. that reflects this change in the field of medicine.

Encroachment and overlapping technologies from other fields of science and commerce have become commonplace in modern medicine. Technologies with the potential and ability to revolutionize and reshape the healthcare profession are introduced to a shell-shocked medical industry on an almost daily basis. 

The scale of deployment of new technology is dizzying and unparalleled and we are simply not prepared for it. Not ethically, not morally, and not as a society.

Medicine can not rely on other fields of science or third-party agents to respect its code of ethics. Nonrelated fields, like the study and development of artificial intelligence, have until recently, only touched on the moral and ethical implications of their work in passing. New committees and bodies are gradually emerging from within these industries to address societal ethics and safety, but they remain in their infancy as they grapple with the larger debates centering on societal values.

Unlike medicine, scientific projects and papers generated by the computational sciences arent held up to rigid ethical scrutiny and it is easy to understand why. Until very recently, A.I. ethics only occupied the domain of philosophical discourse. Technology’s rapid rise caught everyone by surprise, including the technologists.

Take the example of the challenge of building a face simply from a voice sample. Any decent self-respecting coder is going to jump at the opportunity to develop it. The thrill of the challenge aside, the potential applications for systems like this are legion, and that’s exactly where the rub comes in.

Technology or A.I. is neither self-aware nor prescient. It can, currently, only perform tasks we ascribe it and A.I. does not provide flawless solutions. A.I. makes mistakes, simply because it is, for now, and the foreseeable future, reliant on human coding, on our biases, and the flawed models we provide it with. 

We are fallible and therefore A.I. is fallible. It is the one key hurdle A.I. may never overcome. To create itself, it requires systems. Systems we develop, reflecting our biases and flawed ethics. 

Recognizing the Limits of Technology

Humans are unethical and immoral creatures. We are all guilty of crossing lines we recognize and choose to ignore, from small daily transgressions to world-altering genocide. Our world is habituated by areas of gray, shades of right and wrong that we blend on a continual basis, most often for the benefit of self. Technology, in particular, A.I. is a tool, an extension of our interpretation of this world, and as always, the tool is not inherently evil. Its fate or intent rests in the hand that wields it.

This is why the field of ethics matters in medicine. It is also why the medical industry cannot rely on outside models to dictate the safety and implementation of its patient-centered view of the world. This is both irresponsible and naive and a failure to address immerging technology now will result in a dystopian future for medicine, possibly within the decade.

Tools do not, and cannot make decisions on our behalf or the behalf of the patient. They exist merely to serve both provider and patient alike.

Urgent rules of engagement are required that emanate from within medicine, rules that dictate the reach and limit of Artificial Intelligence in human-based care settings.

Let’s examine that statement in relation to care settings through the use of a simple example. We’ll return to our facial recognition software and the potential for this software to interpret intent and emotion. Assume it’s deployed into casualty wards across the country to improve patient assessment. The software analyses patient’s faces, picking up signs it interprets as distress, and places patients awaiting care into a queue, based on its assessment of their distress.

I can almost guarantee you that a system similar to this is currently under development. Software used by the DOD to analyze faces for perceived threats would be an excellent starting point and it would make sense to incorporate this into a diagnostic system to prioritize triage. 

The problem arises when we empower A.I. with the ability to make its own decisions, rather than using its output to make our own decisions. When A.I. decides who gets to see the surgeon next, we have a problem. That is unacceptable.

The true purpose of A.I. is to supplement the human brain, to allow for millions of variables we cannot process, to consider everything, and to increase or expand the options for human-based choice. The ways in which we choose to implement these digital gifts in the practice of healthcare are where the issues arise.

Redefining Medical Ethics for a Technological Future

A.I. exists to augment, not dictate. This one simple rule should form the basis for a new arm of medical ethics, one that engages specifically with technology. At the heart of this supplemental code of ethics, as ever, are the patients, their safety, their health, and their access to care.

It isn’t simply the care patients receive, but their access to it, and the spider of technology has spun an all-encompassing digital web that envelops all of modern healthcare. A.I. is everywhere. It controls data and mines patient information on behalf of third parties, health insurers, drug developers, and federal agencies. 

Each A.I. system functions independently and is subject to the biases and preferences hardcoded by developers, instructed accordingly in their pursuits and design.

Patients are punished in a myriad of ways. Refusal to care, higher insurance premiums, medications prescribed based on algorithms rather than clinical evidence, flawed diagnoses, the list is endless. A.I.-based diagnoses of scans, for instance, pick up early signs of disease not visible to the trained human eye, leading to preemptive treatment for conditions that may or may not, eventuate over time. 

Evaluative software is another example, as it analyses provider efficiency. Do you think for an instant that healthcare chains, hospitals, and large clinics deploy this software for the benefit of the patient? Results and rankings are based on profit and efficiency, not patient-oriented outcomes. This is the inevitable cost of developing health care solutions in commercial isolation.

The issue is broad, complex, and impacts all aspects of healthcare. Telehealth is another perfect example. What do we know of the companies that offer remote platforms for mental health care providers? Has it occurred to the proponents of these systems that unbeknown to you or your patient, the A.I. running the system is under instruction?

It is more than likely analyzing voice patterns and facial signals to decide what the most appropriate services would be to offer to both you and your patient the next time either of you opens a browser? 

You aren’t alone in that virtual consultation. There is a third party present and it’s called A.I. To assume otherwise is to be naive.

Who checks? Who validates the software we have so willingly accepted into the lives of providers and patients as being beyond reproach? It’s time to wake up from our self-indulgent siesta, before commercial interests completely replace the inefficient and naive humans that inhabit healthcare. A.I. won’t be to blame, it is simply a tool in the hands of unethical forces who would have their way with the highly profitable platform of healthcare.

It is up to the industry to look out for itself and now would be a really good time to start. The clock has been running for a while. A.I. was never, and never will be the enemy. It is an essential and integral part of healthcare’s future. We simply need to manage it responsibly, for the sake of our patients.

The post The Ethics of A.I. in Healthcare Must Be Urgently Addressed appeared first on Medika Life.

If you’re involved in digital health then you’ve heard the name John Nosta, in fact, most in the healthcare field are familiar with his name. He is a leading light in the digital healthcare sector, a thought leader who challenges the status quo and disrupts for change. Very few voices are as respected and if you don’t believe us, see what these industry icons have to say about a man that has arguably become an icon in his own right.

John Nosta combines passion with knowledge and delivers more than a speech, he provides an engaged conversation that informs and moves his audience. John’s domain knowledge of medicine, technology, and marketing makes him a keen observer of digital health and only one of a handful of thought-leaders that can clearly articulate the importance of this movement in human history.

− John Sculley, Former CEO, Apple Computers and Pepsi

John Nosta provides a comprehensive perspective on the digital health movement. With unique sensitivities to science, consumer engagement, and brand marketing, he tells a story that helps drive mindshare and market share. 

− Eric Topol, MD, Cardiologist, Editor-in-Chief, Medscape, Scripps Health Chief Academic Officer

John founded NOSTALAB in 2013, an  “innovation think tank” that focuses on the emergence of technology and the implications to health, wellness, medicine, and the pharmaceutical industry.  The extent of his influence was recognized by the World Health Organization and in 2019 he was appointed as a founding member to their Digital Health Roster of Experts, a position he still occupies

.In 2014 Google appointed him to their Health Advisory Board, created to acquire a better understanding of the problems consumers and providers face every day and offer feedback on product ideas and development. He continues to contribute to this Board and is also an active contributor to Forbes Magazine.

Meet John Nosta

Perhaps the best way to gain insight into what drives John Nosta is to examine the ethos of NOSTLAB Here is how the website describes the ThinkTank.

On their Mind

“Thinking is what we do best. We apply our thinking to solve creative and strategic problems that seem either insurmountable or unthinkable. At times, we’ve even discovered new problems and challenges and proactively sought out solutions as preemptive strikes against second-rate thinking.”

On their Soul

“We are digital. We are health. We are also defiant, bold, and closely connected to imaginative thinkers and risk–takers who define digital health. Our philosophy is grounded in brilliance yet our methodology has often pushed us over the “practical ledge” and forced us to build wings on the way down. We like to fly.”

NOSTALAB exists to empower innovation with outlandish thinking. They connect the dots of genius and help drive the digital health revolution and behind the company sits the driving force that is John Nosta, questioning conventional and accepted wisdom and pushing the boundaries of modern health.

Despite his status in the industry, John remains approachable and exudes a thoughtful humility that has served him well. He is the one person you cannot choose to ignore in the field of digital health and your network has to include his thoughts and opinions. You can connect with him below.

Getting in touch with John Nosta

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If you’re the patriotic type, and I suspect many of the American-based innovation hubs are, then that may motivate your company to try and negotiate the minefield. Expect most of your development capital to be spent on agencies and consultants. Experts who know how to negotiate the hurdles your business will face. Go it alone, and I can almost guarantee failure. In fact, even success is sometimes failure, as a colleague points out in this telling article on the stifling influence of payer power.

While I appreciate that particular applications, software platforms, and patient solutions are developed specifically to address homegrown problems, many aren’t. Medical devices and wearables are an excellent example in point. We share the same physiology globally and experience disease in exactly the same way, allowing new medical devices to cherry-pick their markets.

Wearables are moving us closer to global industry standards for health care, driven by devices from companies like Apple and Samsung, worn around the globe and utilizing the same core software, no matter the market. Developers addressing and interfacing with these devices benefit from this uniformity.

Healthcare truly is one of the few “transplantable industries” and we live in a world where geographic borders no longer pose obstacles to development and deployment. Perhaps the first question innovators should be asking themselves is not “what” but “where”.

The lure of foreign markets

We’ve recently written up an article on a technology-based healthcare development hub in Asia, in Singapore to be specific. Here is the list of benefits their market offers to digital health and tech innovators in the healthcare sector. Humor me, and cast an eye over them.

Strong regulatory guidelines for health tech
Singapore’s National Telemedicine Guidelines and other similar frameworks have set clear principles around areas such as AI and data governance, medical devices, and telemedicine. This fosters high levels of consumer and practitioner trust and enables the smooth test-bedding and commercialization of new products and services.

Seamless access to health information
Singapore’s health information infrastructure is digitized and centralized. From as early as 2011, the National Electronic Health Record (NEHR) system has consolidated patient records on a shared database to enable holistic assessments and interventions across service providers.

Assurance of data security
Patient data security is taken seriously, with the Personal Data Protection Act introduced in 2012 and advisory guidelines for healthcare were issued to address the sector’s unique circumstances.

Public-private collaboration on patient-centered digital innovation
Public health agencies are partnering with the private sector on solutions that place the patient at its heart.

As a simple example, Singapore’s Health Promotion Board and Apple’s first-of-its-kind LumiHealth program employs behavioral insights from the Apple Watch to encourage user adoption of healthier lifestyles over a longer period of time. With such a conducive environment, 

Singapore has been unofficially dubbed “ASEAN’s sandbox for digital innovation,” producing a growing range of solutions.

Why the disparity?

Asian economies long ago realized the benefit of an effective and functional healthcare system, regulated by one central agency, the government. Witness Covid-19 and the differences in response. Strict controls, sensible regulation, effective funded services, and personnel and exceptional management of cohesive data streams. For America’s part, they could only observe in envy from afar, as the country fell to pieces in the face of the pandemic. Only the caliber of their provers saved them. The government and healthcare systems failed and failed spectacularly.

It will be no different under Biden’s watch as he contemplates a political appointment for the top post in the country. Only healthcare can effectively manage healthcare and Asia gets it. It’s what makes their systems so functional and patient-centered. It is also what positions them as a real threat to America’s tech talent in the coming years.

I’m not about to develop the next big thing in catheters, but if I was, I have a pretty good idea where I’d be headed. If American healthcare does not start cleaning house, it will pay the price, and inevitably, the patient will, as always, be the real victim.

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