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Inside Vida Health’s Move Into Musculoskeletal Care

By JESSICA DaMASSA, WTF HEALTH

In the ‘point solution versus platform’ debate, mark another score for integration as Vida Health jumps into the musculoskeletal (MSK) care space. This is a move we’ve seen before among the digital health chronic condition management set (remember when Omada acquired Physera, Dario Health acquired Upright, and everyone was waiting to see if Livongo would make a play for Sword or Hinge?) so why is Vida just jumping in now?

Dr. Patrick Carroll, Vida Health’s Chief Medical Officer, lets us in on the strategy behind the startup’s move into the MSK space and what it signals about how employers (and their employees) are starting to view digital health and virtual care within the larger scope of available care options out there.

As for Vida’s MSK program, it’s different than what you might expect. According to Pat, the program is strictly focused on lower back pain and helping members quickly find the physical therapy and, if needed, mental health care that can make a real difference to their overall health in a manner of weeks. If something more complex is discovered, Pat says Vida is working with partners – including those digital-first MSK clinics – to refer out. Is this the long-term play or will Vida eventually build out or buy its way further into MSK? We find out what’s ahead for the cardiometabolic care company as it launches yet another new offering to improve access to care.

Danger Ahead. Good

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BY KIM BELLARD

I saw a great quote by Alfred North Whitehead the other day: “It is the business of the future to be dangerous.”

Now, I was a math major many years ago, so I know who Alfred North Whitehead was: the coauthor (with Bertrand Russell) of the Principia Mathematica, a landmark, three-volume treatise that proved – in excruciating detail — that all of mathematics (and thus, arguably, all of science) can be reduced to mathematical logic.  I always thought Lord Russell was the eloquent one, but it turns out that Professor Whitehead had a way with words too.  

So, of course, I want to apply a few of his particularly pithy quotes to healthcare.

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Point-of-Care Ultrasound? How Butterfly Network’s Hand-Held Devices Make Scans On-Demand Diagnostics

BY JESSICA DaMASSA, WTF HEALTH

Butterfly Network (NYSE: $BFLY) is working to make its pocket-sized, smartphone-directed ultrasound as “ubiquitous as the stethoscope” – hoping to give docs and nurses at the point-of-care the ability to easily perform any type of scan and instantly see the results. Dr. John Martin, Butterfly’s Chief Medical Officer, talks us through the technology behind the $2,400 hand-held device and how the company is working with healthcare orgs to integrate ultrasound into their workflows — completely shifting the paradigm for where-and-when scans are performed and able to be utilized.

What does this paradigm shift toward on-demand, point-of-care ultrasound really mean for the practice of medicine? Is this over-medicalization and unnecessary, or the key to higher-quality care? And, what about the risk involved in taking ultrasound out of the specialized-and-certified arena of the radiology department and democratizing it for front-line practitioners?

John lets us ask all the tough questions, talks through what’s being learned as Butterfly scales-up and builds its body of use cases, and gives us some insight on how the business itself is doing after going public via SPAC last year. Fun fact on the diversity of those use cases: Beyond human healthcare and the very important work of helping improve maternal and fetal health in Africa via a $5 million dollar grant from the Bill & Melinda Gates Foundation, Butterfly is also being rolled-out across 200 Petco care centers to help veterinarians use point-of-care scans to treat our pets.

We Hold These Truths

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BY KIM BELLARD

It’s July 4th – Independence Day for those of you who remember your U.S. history.  There’s already too much talk about loss of rights, political tyranny, militias, even succession, and I don’t want to wade any further into those troubled waters.  But I thought I could at least try to reimagine what a Declaration of Independence might look like if it was aimed at the American healthcare system.  

I’m no Thomas Jefferson, or even a Roger Sherman, but here goes:

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Matthew’s health care tidbits: Texas is the present future of abortion care

Each week I’ve been adding a brief tidbits section to the THCB Reader, our weekly newsletter that summarizes the best of THCB that week (Sign up here!). Then I had the brainwave to add them to the blog. They’re short and usually not too sweet! –Matthew Holt

In this edition’s tidbits, I have to return to the stunning impact of the Dobbs ruling. We know will happen because it is already happening in Texas where the 6 week law was already being enforced in contravention of Roe v Wade.

Taxpayer money is going to “pregnancy crisis centers” that flat out lie to vulnerable patients about the impact of abortions on their health. Doctors are questioning women who have miscarried–at a moment that is already terrible for them, and women who have miscarried are being denied basic D&Cs–which can kill them.

Don’t get me started on the absolute nonsense being talked–and passed into law –about ectopic pregnancies, of which there are over 130,000 each year in the US, being carried to term. How unlikely is it that an ectopic pregnancy makes it to term with no ill effects? Let me tell you a story. My dad was an OBGYN. He and his anesthetist saved the life of a woman and her baby who somehow had made it to term while being ectopic. During the surgery she needed 12 pints of blood (a normal woman has 7-8 pints in her body) and he considered it the greatest piece of surgery he did in his entire career. He thought that he and the patients were very lucky. So I demand that crazy legislation saying ectopic pregnancies have to be carried to term also mandates that my dad is around to do every single C-Section. Unlikely, as he’s dead, but no crazier than the legislation in Indiana.

Then there’s the impact on telehealth. Most abortions are done using drugs but more and more of the pandemic-era exemptions to prescribing drugs and seeing patients over telehealth across state lines are being withdrawn. Clearly the state-based licensing of doctors is itself ridiculous in an age of online commerce, but despite the DOJ statements the legality of prescribing abortifacients across state lines is very unclear and, as Deven McGraw explained in this harrowing piece on THCB Gang, HIPAA doesn’t protect patient privacy from local law enforcement. So what happens to someone in a state where abortion is banned if they have to go to hospital because of a complication from taking an abortifacient? Trump thinks they should go to jail.

What is clear is that bans on abortion don’t stop abortions. But they do endanger women. And if the pregnancy crisis center stops a woman from getting an abortion, do they help afterwards? Why yes, if you mean by “helping”, they have a celebratory dinner and light a fricking candle.

We Have a Right to Privacy…Right?

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BY KIM BELLARD

Well, they did it.  We had a warning they were going to do it, from the leaked opinion in May, but it still was a blow to well over half the country when the Supreme Court struck down Roe v. Wade in its ruling on Dobbs v. Jackson Women’s Health Organization. It didn’t rule that abortion was unconstitutional – as Justice Kavanaugh wrote. “On the question of abortion, the Constitution is therefore neither pro-life nor pro-choice” – but, rather, left it to the “voters,” i.e., the states, to decide.  And, boy, the “pro-life” states have been deciding and are ready to do a lot more deciding.  

There has been lots of outrage, many protests, and calls for the Senate to pass a federal law explicitly granting a right to abortion (although that would require changing the filibuster rules).  Aside from the fact that the Democrats probably don’t have the votes to do that, even if they did, as soon as the Republicans retook Congress and the White House, they’d just repeal it and perhaps pass a law outlawing abortion everywhere.  So it goes.

There are going to be many fights about abortion in Congress and in the states, but I think it’s time for a new strategy.  It’s time to amend the Constitution.  

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American health care leaders are not blameless today

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By MATTHEW HOLT

It is a very sad day for America. Roughly 30% of our country is part of a quasi-religious cult. In general these people reject science and the enlightenment. This week the Jan 6th committee has shown they are prepared to use and support any tools or tactics–up to and including the overthrow of the government, in order to get what they want. 

The overturning of Roe vs Wade is the most visible artifact of a 40-year campaign. The campaign was funded by business leaders like the Koch brothers who want to revoke all environmental, labor and rational restrictions on their activities. Using dark money and the passion of religious zealots who want to control women’s bodies and discriminate against anybody who doesn’t believe what they believe, they have turned this nation back to the 18th century, using the Supreme Court as their vehicle.

The biggest of those dominos has now fallen and women’s right to control their own bodies has been taken away in most states. We can assume a nationwide ban (such as happened in Poland) will be coming here soon, maybe as soon as 2025 if the Republicans win the 2024 elections. And note that the rolling coup described by the witnesses at the Jan 6 hearings show that the Republicans are already blatantly taking over the supposedly neutral election process.

But the American health-care system is not blameless. Abortion and other reproductive health services are clearly part of health care. Yet uniquely in this country the provision of the services has not been from mainstream health care institutions. The leaders of our health care organizations, in particular our major hospital systems, have completely avoided delivering these services. They have been more than happy to allow Planned Parenthood and other specialist organizations to provide reproductive care, and have just looked the other way in the debate. 

Worse, many of our religiously affiliated institutions,  particularly those with a Catholic heritage which represent an enormous amount of hospitals in this country, have banned not only abortion but many other forms of reproductive health care such as female sterilization. The Hyde Amendment, ironically named after a religious bigot who was an appalling adulterer and hypocrite to boot, bans Federal funding for abortions. That means that private Medicaid plans which now cover most births in this country have never offered a full suite of reproductive health care.

Even in recent weeks when the fate of Roe became clear I have heard nothing from major leaders of hospital systems or health plans about this. Some of the newer provider organizations focusing on women, such as Maven and Tia, have been outspoken, as have many non health care-related employers. But the general silence from all major health care organizations in America on this topic has been deafening.

Today there is plenty of shame and blame to go around.

An Upside Down Future for Healthcare

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BY KIM BELLARD

I find myself thinking about the future a lot, in part because I’ve somehow accumulated so much past, and in part because thinking about the present usually depresses me.  I’m not so sure the future is going to be better, but I still have hopes that it can be better.  

Two articles recently provided some good insights into how to think about the future: Kevin Kelly’s How to Future and an except from Jane McGonigal’s new book Imaginable: How to See the Future Coming and Feel Ready for Anything―Even Things That Seem Impossible Today that was published in Fast Company.

I’ll briefly summarize each and then try to apply them to healthcare.

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