Healthtech Security
Article | November 29, 2023
Do you have a difficult time explaining your mental health issues to your family and friends?
If so, here are six suggestions on how to discuss your mental health issues with your friends and relatives.
1. Talk to a counselor: The most important thing that you need to do is to talk to a counselor about your mental health problems. Seeking professional help will go a long way in overcoming your current issues. In addition, a counselor will be able to give you additional advice on how to deal with your friends and family members.
2. Don’t argue with others: It is important that you do not get into arguments with those who are giving you a hard time. Your number one priority is getting your life back on track. Your health is more important than what other people may think.
3. Watch who you hang out with: It is important to surround yourself with positive people. Try to keep your distance from those people who are giving you a difficult time. Remember that your goal is to remain positive and hopeful. Do not let the negative people in your life bring you down.
4. You are not alone: It can be very frustrating to deal with your mental health issues when your friends and relatives are on your case. Remember, you are not alone. There are millions of people around the world who struggle with their fears, anxieties, and depression. The key is to find those people who can relate to you.
5. Stand your ground: It is important to stand your ground when dealing with family members and friends who are giving you a hard time. Explain your situation and your feelings to the people in your life, however don’t let them hassle you. Your number one priority is to get better and not to please everyone that you know.
6. Join a support group: There are many mental health support groups in your area that can help you. Many hospitals, churches, and counselors in your area will be able to provide you with a list of groups. These mental health organizations will be supportive of your situation and they can give you additional advice regarding your problems.
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Digital Healthcare
Article | November 29, 2023
Virtual care and telehealth are no longer seen as merely an innovative method of delivering healthcare; technology is now indispensable to protecting patients, staff, and PPE resources amid the coronavirus pandemic. In a recent Harvard Medical School blog, Lee H. Schwamm, MD, shared that “telehealth, the virtual care platforms that allow health care professionals and patients to meet by phone or video chat, seems tailor-made for this moment in time… The current crisis makes virtual care solutions like telehealth an indispensable tool.” He believes that the role of telehealth is vital to our country as “it can help flatten the curve of infections and help us to deploy medical staff and lifesaving equipment wisely.”
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Health Technology, Digital Healthcare
Article | September 8, 2023
Throughout my professional carrier, I iused to visit many companies involved in drug discoveries and had seen the challenges they go through. Some are pleasant as the investigational molecules were moving forward in value chain whereas few faced bottlenecks at the end. The association with Pharma industry over the years had taught me about many new ideas and allowed me to see that how innovative ideas are impacting our social and scientific world to a great extent. The changes we see today, are the results of ideas came from various quarters globally and I feel digital innovation had shaped today’s world differently. The impact of digital platform in today’s Pharma world is a “Game-Changer".
Innovation is a continuous process which simplifies challenges into reality and plays a very important role in our society. Centuries ago, scientists used to spend years in laboratories to understand material science. The chemical science evolved around discovering elements, synthesis of compounds or even isolating products from natural resources. Today’s world is highly indebted to those discoveries and efforts and modern science has gradually moved towards digital platform. Last few decades, innovations based on new technology platforms has made huge impact in scientific discoveries and few such ideas and action I feel has brought significant changes. Our lifestyle and social environment have witnessed deep impact due to such innovation. The chemical science is evolved not around only chemists today but have huge influence of mathematicians and technologists for faster development.
Advancement of digital science, new algorithms to solve the problems has modified the way of drug discovery to a great extent. In the recent past, we were heavily depended on big machines, but innovation has brought the whole items in a small packet now. The technology platform is modified, speed has increased in identifying new drugs with artificial intelligence (AI) and machine learning is accelerating the drug discovery and development processes. Today’s Pharma industries for commercial supplies are now depended on automation, optimization of the manufacturing processes, as well as designing effective marketing and post-launch strategies. The process is aimed to have better control on the operation, improving safety and better predictability of quality. For conducting clinical trials, identifying patient’s profile, an eligibility criteria is crucial which has been made by the processes being faster and cost effective by introducing Artificial Intelligence (AI).
Earlier when focus was to identify the origin of life, finding new elements, compounds or building blocks, today’s world is heavily dependent on data or ‘Big Data’. The amount of information available throughout drug discovery and development process, analyzing, interpreting, and predicting right candidate require high-performance systems to analyze data properly and derive value from it. There is advancement of analytical techniques, which provides more accurate information about the clinical trial reports and the data across patient pool, zeroing down towards right candidate is a real challenge and there are several AI enabled tools available where the processing time is reduced significantly which might have taken several years. The exciting part is that innovation is not only limited to laboratory work but works in coordination of mathematical interpretations, data analysis and provide significant clues to develop new molecules and even provide approach towards therapeutic categories. Currently available advanced technologies enhance drug development process, making it less time-consuming and cost-effective process where AI can recognize hit and lead compounds, and provide a quicker validation of the drug target and optimization of the drug structure design. Data scientists play a very significant role in all these activities.
Innovation focusing personalized medicine is now a reality and companies involved in such basic research have made breakthrough to understand how the human body responds to drug. Software solution is also available for simulating effects of drugs in patient body based on individual characteristics, scientific data for real time prediction of efficacy and drug interaction on individual. These predictive models are shortening drug discovery pathways to a great extent. Small molecule drugs or even large molecules development are heavily depended today on such modelling and predictive approach. The aim to reduce cost of drug development, shortening discovery path, focus on clinical trial mechanism is more productive with a higher success rate. During the pandemic period, in a shortest possible manner, several companies started working to develop new drugs or vaccines using drug-specific exposure models for drugs under investigation for the treatment of Covid-19.
Similarly, discovery platform is also working on cutting edge technology ‘Organ-on-a-chip’ that can emulate the physiological environment and functionality of human organs on a chip for disease modeling, mimicking the impact and could be a game changer in future. I will be happy to see when technology platform can accurately predict human mind and with the help of AI, can find a probable solution to avoid any such complex conflicts. It would be interesting to see that AI is analyzing and predicting the chemical change in the bodies impacting human mind and analysisng it quickly to predict psychological behavior of the patient and guide physician for right therapy. This may lead to predicting problems one may face in old ages where the decays may be prevented at early stage. This is a challenge but understanding and predicting psychological behavior may improve patients’ life. Depression and its remedy may be based on understanding changes, patterns of physicochemical behavior and its impact during mood swing and predicting such things in advance by using the advanced AI tools could be a game changer.
Another path breaking development where technology involving both engineers and scientists to help drug design to obtain maximal therapeutic benefits for patients including designing drug delivery systems and biomedical devices is 3D-printing technology. This involves high end computer simulations making analysis faster and predictive than before. Influence of 3D printing in designing variety of dosage forms has simplified its preparation. Though further study is under progress but the technology implementation at late has reduced cost of drug development to a significant extent and will add value in future drug development. It is interesting to see how this 3D printing technology works on human brain mapping and predicting a right path for treatment for betterment of large patient pool. Today with advanced technology, we are now more dependent on machines, limited close interaction with our near and dear ones, but created more friends on social platform. Though life looks easy, but over dependent on machines is creating another complex environment and this growing complexity may change the disease pattern. It will be interesting to see that how these technology platforms improve further to ease out such complexities for a healthy future.
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Insurance
Article | November 2, 2021
The fall is a time of renewals and choices. It is also a time of so called “open enrolment” for health plans. It is the one time of year we can study and learn about the options offered through employers or government sponsored plans. Individuals and small business owners alike are also are faced with a myriad of choices with confusing and often contradictory language promising lower premiums with higher out of pocket costs for covered services subject to deductibles. What does it even mean anymore when your monthly premiums exceed your pay check and you still have to pay for your colonoscopy or your insulin? Where is it all going?
Let’s imagine you twist your ankle playing basketball. You might go to an urgent care, receive an X-ray, probably be examined by a non-physician, and then referred to your primary care, who can’t see you for a few weeks but eventually sends you to an orthopaedic who takes another X-ray and treats your injury. Weeks have passed, multiple visits, time out of work, and co-pays, not to mention the out-of-pocket fees associated with imaging and perhaps a $100 ace bandage. What stops you from going straight to the ankle specialist in the first place? First, we have become conditioned to follow the directions dictated by the insurance companies, even when restrictions are not in place, patients have been convinced that stepping out of line will make all insurance promises null and void resulting in catastrophic bills and financial ruin. Second, the doctors and their office staffs have been conditioned to deny entry to any patient who does not have the proper referral, authorization, or identification. There are dire consequences for both if the insurance rules are not followed and fear keeps both sides aligned.
The past two decades have seen an explosion of healthcare costs. Health insurance has become the single biggest line item second only to payroll for most businesses. It is no coincidence that as the government increased its role as payor with state subsidies, the prices have gone up. Much like college tuitions, when loans are easy to obtain and guaranteed by federal support, there is little to deter those in charge from increasing the price. After all, everyone is doing it, it must be OK, and even if students end up in debt, it will be repaid because they have received the value of a great education. Right? But unlike higher education, healthcare is a necessity. We cannot avoid it, and there needs to be a reliable mechanism in place to guarantee access.
Ironically, as charges and prices have continued to escalate, payments to doctors have diminished. Why medicine is the only service industry where there is no transparency is truly astounding, especially since the there has been no increase in so called “reimbursements” for decades. As physicians, we have been complicit, being fully aware of the discrepancies between what is charged and what a patient’s insurance will pay. Even as patients began to have higher deductibles, and therefore higher out of pocket expenses, we continued to follow the rules, asking insurance permission to collect payment from the patient. It is not surprising that bad debt accounts for over 50% of most account receivables and why over 70% of doctors are now employed by hospital networks or private equity, who not only go after patients, but benefit from the repricing that occurs when insurers pay a negotiated amount as opposed to the charge. In other words, we pay more not just for less, but for nothing.
But what if we twisted our ankle and went directly to that specialist and paid out of pocket a transparent price? What would it take for that to happen? Not much, the cost of care is predictable, and because payments have always been decreasing, most physicians have learned to be economical. Plus, out of pocket costs are capped by federal law, so no patient is really responsible for catastrophic bills. Charges inflate to cover overhead, but if payments were guaranteed and immediate, then the cost of doing business goes down. Add technologies like telemedicine to a practice and you have increased patient access to a doctor without adding more personnel. Direct pay doctors are emerging all over the country and have consistently offered better access and more affordable care. The bar is also being set by independent surgery centers and imaging centers who offer better outcomes at lower costs. Perhaps motivated by prohibitive pricing, better options have emerged that have moved patients away from expensive operating rooms to safe, office-based procedures. Even cutting-edge cancer therapies can be delivered at home, preserving more of the healthcare dollar for medical care rather than the complex system built to manage it.
Competition and choice inevitably drive prices, but in a monolithic system the price is not negotiated, but instead it is set by only a few, in this case the big insurers. Small businesses cannot compete when bigger companies come to town. Eventually, the local hardware store gives way to a national brand, and the consumer is left with fewer choices and eventually higher prices. Amazon disrupted this equation by creating a marketplace for individual buyers and sellers. The convenience of finding a trusted brand, no longer available locally, is irresistible and the reason why we became loyal consumers. Healthcare is no different. Trust exists implicitly between a physician and patient, because it is an authentic, empathetic, and logical relationship. Trust does not exist between a patient and their insurer, on the contrary it is an unsympathetic business relationship without transparency or consistency. Few doubt the insurance company’s top priority is the premium, not the patient. Creating a direct relationship between the doctor and patient is a common-sense approach that serves both stakeholders well, and requires merely a fair and affordable price. But do doctors have the capability or the will to do it and if so, can the rest of the system follow?
Never in the history of modern medicine have physicians been more dissatisfied. US healthcare used to lead the world in innovation and outcomes, now we struggle to break the top thirty. We may have the most brilliant doctors and scientists with access to the best resources, but the need to maximize profits while catering to special interests, be they commercial or political, has led us to favour certain therapies over others despite marginal proven benefits. Doctors have little autonomy and less authority; prescribed treatments are routinely denied by insurance companies without a second thought or appropriate peer review. In fact, insurers even renamed us “providers”, a term used to by Nazis when referring to Jewish doctors to devalue them professionally. Over 56% of physicians are burned out, nearly all report moral injury and as hospitals have systematically replaced doctors with non-physicians with limited training, we have watched the standard of care deteriorate. It is no wonder we have witnessed the single biggest loss in life expectancy since WWII. The prognosis is grim, but there are solutions.
We need to reinvent healthcare by removing the middleman. We don’t have to set the price, but we can make it transparent so patients can decide for themselves if it is worth the inconvenience, the delay, and the co-pay to use insurance or just pay directly. Health savings accounts are tax deferred and can cover an out-of-pocket maximum in just a couple of years. Paying for care means there are no surprise bills or out of network costs, because there are essentially no networks and therefore no need to follow restrictions. You’d be hard pressed to find a doctor or hospital unwilling to accept an immediate cash payment, especially when it costs nothing more than the service provided. There are no billing cycles, or claims to prepare, no up coding, or authorizations. Doctors free to care for patients, patients treated individually and not subject to protocols designed to maximize charges. There are literally thousands of direct pay primary care and specialists now available all over the country and they are building alliances with likeminded people providing imaging, ancillary services, surgery centers, and prescriptions all at fair market prices. More and more employers are moving toward medical cost sharing plans that not only lower the cost of care but the cost of administration. Even the biggest payor, namely the government, sees the benefit of price transparency and is piloting models of direct contracting.
We will always need coverage for those unexpected events, emergencies, or hospital-based services, but all the rest - doctor visits, screening tests, and outpatient procedures - are easily affordable. After all, do we use our car insurance to pay for an oil change? If we did, the cost would be prohibitive and few of us would drive. But health insurers have lost our trust, they no longer cover necessary services and no longer honour contracts with physicians or patients. It is time to offer another option and let the patients and doctors get back to the real business of medicine.
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