#46 - Data, Data, Everywhere

Apple and Verily want your data, UHC won't share its data, and more...

Things That Happened

Data mine. UnitedHealth Care will stop sharing de-identified claims data with the Health Care Cost Institute, a research organization studying healthcare spending in America. Perhaps UHC decided that data was too valuable to give away for free. 

Blue suede sensors. Verily wants to walk a mile in your shoes. The company is trying to find someone to take them into the shoe business, specifically so they can load those shoes up with sensors that’ll gather health data. The company also recently got FDA clearance for EKG sensing on its study watch (currently in use as part of Project Baseline). More thoughts on what Verily is trying to accomplish below. 

500 million leaf clover. Clover Health announced $500m in new venture funding this week. Between this round, and the $500m recently raised by Devoted Health and Bright Health, that’s a billion dollars invested in just three insure-tech companies since… October. 

Watch your health. Aetna policyholders will be able to use an Apple Watch app - Attain - to track their activity and earn rewards (like getting reimbursed for the expense of the Apple Watch.) One key aspect of the deal: policyholders will be able to incorporate Aetna’s health records into their Apple health records. I suspect this is Apple’s main motivation in the deal, as it will allow them access to a rich trove of data that’ll provide a much more comprehensive experience for users. 

Selling candy and tooth fillings. CNBC reports that Walgreens and CVS are adding dental services to their roster of in-store offerings. While CVS is piloting integrations with SmileDirectClub, Walgreens is putting entire clinics inside their walls through a collaboration with Aspen Dental. 

Dental services is a huge market. It’s also one where both providers and consumers are accustomed to a standard retail experience (a much greater portion of dental is paid for with cash as compared with medical services). I wouldn’t be surprised if dental grows more quickly than medical services in terms of retail-integration. 

Things Worth Understanding

Comparing Verily to Apple, their shared ambition is to gather health data. Their strategies, however, are entirely different, and follow with their overall larger corporate genealogy. 

Apple, always optimizing for user experience, wants your health data as a way of enhancing the utility of their devices. Hardware is becoming less and less of a differentiation point for selling devices, and so they need to make the surrounding ecosystem of apple devices and services even stickier and more tightly integrated with your life. Knowing that your personal health data - both what you generate with your apple devices and your health records pulled via the health records API - is easily accessible in the apple ecosystem makes the decision to leave the ecosystem that much more complicated.

Verily on the other hand, doesn’t just want your health data; they want everyone’s health data. Much like their corporate progenitor Google, Verily is all about gathering as much data as possible and wringing insights out of it. They then take this data and insight to commercialization partnerships, like Onduo and Dexcom, where they can be put to use as a way to get products into the field that can collect even more data. 

If you were forced to sum up the comparative health strategies of Apple and Verily in a dangerously reductionist sentence, you could argue Apple is the full stack solution while Verily is the picks and shovels play. 

Things To Read

What’s your risk score? Mohana Ravindranath reports in ProPublica that companies have begun aggregating data to create “risk scores” that ostensibly tell physicians how likely you are to become addicted to opiates.

Ambrosia, the startup that promises to help you fight aging by infusing you with the blood of young people, has reportedly completed 150 infusions. I’m including the story here because it’s an interesting jumping off point into the big business of blood. If you’ve never considered how the blood donated by volunteers makes its way to the people who need it, start here in exploring this interesting and complex set of resource allocation, supply chain, and ethical problems. 

When non-profit insurers converted to being for profit, premiums increased. Here’s Leemore Dafny’s paper examining the role of insurance company ownership in health care costs. 

“Could the use of A.I. in medicine worsen health disparities?” Dr. Dhruv Khullar writes in the NY Times about how artificial intelligence is not a panacea for bias. This is abundantly evident once you understand the process by which machine learning models are created - they are imbued with the biases of their creators and the data on which they are trained. At their core, these models are no different than traditional programs - they produce the desired outcomes as dictated by the programmers.

“What's the actual evidence that M&A is an effective strategy?” David Willis unpacks and examines the reasons often cited for hospital mergers. Stripping away the various forms of operational “synergy” he finds the only reliable benefit to hospitals is increased market power when negotiating with payers. Given payers are consolidating as well, where does this spiral end? When you have effective monopolies among both payers and providers, who wins? Certainly not the patient.

Thanks for reading The Healthcare Handout, a bi-weekly update on tech and business in healthcare from Isaac Krasny. Criticize, praise, hire, or otherwise get in touch with Isaac via isaac@healthcarehandout.com, or on twitter @isaackrasny

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