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City health commissioner backs sites for addicts to do drugs in battle against opioid crisis

Mayor de Blasio’s health commissioner said she thinks supervised sites for drug addicts to shoot up are an effective way to fight to opioid scourge.

“I think the public health literature is clear,” Health Commissioner Mary Bassett told the City Council Tuesday.

The controversial facilities — which have been opened in other countries, but not in the U.S. — allow drug users to inject themselves under watchful eyes, making it less likely they will overdose or get HIV from a dirty needle.

A long-awaited Health Department report on the issue is expected next month, as is a decision by de Blasio’s office.

De Blasio pumping another $22M to fight opioid crisis

Though Bassett is already sold on the effectiveness of the sites, there are legal obstacles to allowing New Yorkers to use illegal drugs at an officially sanctioned site.

“The legal [status] is a source of concern,” Bassett said. “I imagine that’s what the mayor is considering.”

City Councilman Mark Levine, chair of the health committee, said the city should forge ahead anyway.

NYC PAPERS OUT. Social media use restricted to low res file max 184 x 128 pixels and 72 dpi

The legal obstacles to allowing supervised sites are among the issues that pols are reviewing.

(Marcus Santos)

“We have a scientifically proven method to prevent fatalities,” he said. “Let’s battle forward — and if the federal government wants to sue us, we’ll take on that fight.”

Trump vows that some drug dealers will get death penalties

The health commissioner also reiterated her support for slapping a tax on sugary sodas — though she sees little chance it will be approved in Albany, which is required for the city to act.

“My favorite strategy would be a soda tax,” she said, adding that other cities have driven down soda drinking with a tax of a cent or two per ounce. “But as you’re aware, that is something our governor has been unwilling to entertain.”

A tax could only happen if Gov. Cuomo changed his mind, she said.

“It depends on what the feds do, maybe. Maybe the governor will change his position on taxes as our budget comes under attack from the federal government,” Bassett said.

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St. Joseph Health creating single board for Northern California hospitals

St. Joseph Health will soon institute a regional board to oversee key moves like capital planning, joint ventures and hiring and firing of chief executives for four Northern California hospitals that currently make such decisions in-house.

The four hospitals—Santa Rosa (Calif.) Memorial Hospital, Queen of the Valley Medical Center in Napa, St. Joseph Hospital in Eureka and Redwood Memorial Hospital in Fortuna—each will continue to operate community boards, but they will not have fiduciary oversight. St. Joseph Health teamed up with Providence Health Services to form the 50-hospital Providence St. Joseph Health in 2016.

“We’re actually behind the curve catching up,” said Vanessa deGier, a spokeswoman for St. Joseph Health. “We really have operated as four separate hospitals in Northern California, which doesn’t make a lot of sense in the healthcare industry today.”

St. Joseph Health executives have discussed the change since around 2015, deGier said. They studied roughly a dozen other health systems with similar governance structures before deciding on the regional model, she said.

The new board is slated to go into effect April 1. DeGier said St. Joseph Health must notify several regulatory bodies, including the CMS, but it does not need regulatory approval to make the change.

Hospital-level boards will retain certain responsibilities, such as medical staff credentialing and fundraising, deGier said. Some members of the forthcoming regional board will come from the community boards, she said.

Renton, Wash.-based Providence St. Joseph Health operates hospitals in seven states: Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. It uses similar regional governance models across its health system, although spokeswoman Nisha Morris declined to say whether all of its hospitals use regional boards.

“This new structure further facilitates the continuum of care in an integrated delivery network, provides greater clarity at each level of our governance, and enhances board efficiency and effectiveness,” Morris wrote in an email.

David Wildebrandt, a managing director with Berkeley Research Group, said while most health systems rely on regional boards like the one St. Joseph Health is creating, he would like to see the practice become even more of a standard. That’s because it helps the integration process after two health systems combine.

“From a fiduciary standpoint, we really feel that’s a critical piece—collapsing the governance to a single entity with multiple feeders for input,” he said.

That said, it can be tough for local board members to relinquish control over certain decisions affecting the hospital, he said. That’s why it’s still important that the hospital-level boards retain some level of control over governance, as well as a robust agenda and bylaws, so that local community members can still shape the organization, Wildebrandt said.

“But when you look at disbursement of capital and other types of resources, it’s not just one entity,” he said. “You have to look at the greater good of the organization and what’s going on in each market. It’s trying to get the best of both worlds so you can be more responsible.”

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Medicare Doesn’t Equal Dental Care. That Can Be a Big Problem.


Supported by

The New Health Care

Oral health cannot properly be considered apart from the health of the rest of the body.

Take a number. A busy free dental clinic in Seattle in 2016. Medicare does not cover routine dental care.CreditJason Redmond/Agence France-Presse — Getty Images


March 19, 2018

Many people view Medicare as the gold standard of United States health coverage, and any attempt to cut it incurs the wrath of older Americans, a politically powerful group.

But there are substantial coverage gaps in traditional Medicare. One of them is care for your teeth.

Almost one in five adults of Medicare eligibility age (65 years old and older) have untreated cavities. The same proportion have lost all their teeth. Half of Medicare beneficiaries have some periodontal disease, or infection of structures around teeth, including the gums.

Bacteria from such infections can circulate elsewhere in the body, contributing to other health problems such as heart disease and strokes.

And yet traditional Medicare does not cover routine dental care, like checkups, cleanings, fillings, dentures and tooth extraction.

After I wrote a recent article about the lack of coverage for dental care in many state Medicaid programs, I received a lot of feedback from readers saying Medicare was no better.

I have not had dental coverage since I retired 25 years ago. Any problems and I have to go to a foreign country to get treatment that I can afford. It is incredible that there is no coverage available in America for one of the most important aspects of health and wellness care for seniors. — Tom, La Jolla

Several of my elderly relatives have just let teeth fall out without being cared for or replaced because of expense. This is no way to care for our senior citizens. — Bronxbee, Bronx

Paying for dental care out of pocket is hard for many Medicare beneficiaries. Half have annual incomes below $23,000 per year. Those who have the means, but are looking for a deal, might travel abroad for cheaper dental care. Tens of thousands of Americans go to Mexico every year for dental work at lower prices. Many others travel the globe for care.

Dental tourism in Mexico, in towns like Nuevo Progreso, is popular as Americans look for bargains. CreditGeorge Etheredge for The New York Times

Although low-income Medicare beneficiaries can also qualify for Medicaid, that’s of little help for those living in states with gaps in Medicaid dental coverage.

According to a study published in Health Affairs, in a given year, three-quarters of low-income Medicare beneficiaries do not receive any dental care at all. Among higher-income beneficiaries, the figure is about one-quarter.

“The separation of coverage for dental care from the rest of our health care has had dramatic effects on both,” said Amber Willink, the lead author of the study and a researcher at Johns Hopkins Bloomberg School of Public Health. “As a consequence of avoidable dental problems, the Medicare program bears the cost of expensive emergency department visits and avoidable hospitalizations. It’s lose-lose.”

Traditional Medicare will cover dental procedures that are integral to other covered services. So if your Medicare-covered hospital procedure involved dental structures in some way, important related dental care would be covered. But paying for any other care is up to the patient.

Lack of dental coverage by Medicare is among the top concerns of beneficiaries. The program also lacks coverage for hearing, vision or long-term care services. However, many Medicare Advantage plans — private alternatives to the traditional program — cover these services.

For example, 58 percent of Medicare Advantage enrollees have coverage for dental exams. In receiving these benefits through private plans, enrollees are also subject to plans’ efforts to limit use by, for example, requiring prior authorization or offering narrow networks of providers. These restrictions can be problematic for some beneficiaries, and about two-thirds of Medicare beneficiaries opt for the traditional program, not a private plan.

Adding a dental benefit to Medicare is popular. A Families USA survey of likely voters found that the vast majority (86 percent) of likely voters support doing so. The survey also found that when people do not see a dentist, the top reason is cost.

Ms. Willink’s study estimated that a Medicare dental benefit that covered three-quarters of the cost of care would increase Medicare premiums by $7 per month, or about 5 percent. The rest would need to be financed by taxes.

The cost of such a benefit might be offset — or partly offset — by reductions in other health care spending, reflecting the fact that poor oral health contributes to other health problems.

Making a case for this in the political arena would not be easy, though. The initial cost would be an inviting target for politicians who express concern about fiscal prudence, regardless of any potential long-term gain. But expanding Medicare has been done before.

In 2006, a prescription drug benefit was added to the program. The law for that program was enacted in 2003, and in that same year, the surgeon general released a report calling for dental care to be treated and covered like other health care. Whether by Medicaid or Medicare, that wish is still unfulfilled.


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Teen suicide is soaring. Do spotty mental health and addiction treatment share blame?


Crestview Hills mother Karen Ruf speaks about the loss of her son J.C. Ruf to teen suicide in October 2016.
Sam Greene/The Enquirer


J.C. Ruf, 16, was a Cincinnati-area pitcher who died by suicide in the laundry room of his house. Tayler Schmid, 17, was an avid pilot and hiker who chose the family garage in upstate New York. Josh Anderson, 17, of Vienna, Va., was a football player who killed himself the day before a school disciplinary hearing. 

The young men were as different as the areas of the country where they lived. But they shared one thing in common: A despair so deep they thought suicide was the only way out. 

The suicide rate for white children and teens between 10 and 17 was up 70% between 2006 and 2016, the latest data analysis available from the Centers for Disease Control and Prevention. Although black children and teens kill themselves less often than white youth do, the rate of increase was higher — 77%. 


A study of pediatric hospitals released last May found admissions of patients ages 5 to 17 for suicidal thoughts and actions more than doubled from 2008 to 2015. The group at highest risk for suicide are white males between 14 and 21.

Experts and teens cite myriad reasons, including spotty mental health screening, poor access to mental health services and resistance among young men and people of color to admit they have a problem and seek care. Then there’s the host of well-documented and hard to solve societal issues, including opioid-addicted parents, a polarized political environment and poverty that persists in many areas despite a near-record-low unemployment rate.

And while some adults can tune out the constant scroll of depressing social media posts, it is the rare teen who even tries. 

Then there’s the simple fact they are teens. 

“With this population, it’s the perfect storm for life to be extra difficult,” says Lauren Anderson, executive director of the Josh Anderson Foundation in Vienna, Va., named after her 17-year-old brother who killed himself in 2009. ”Based on the development of the brain, they are more inclined to risky behavior, to decide in that moment.”

That’s very different from how even a depressed adult might weigh the downsides of a decision like suicide, especially how it will likely affect those left behind. And sometimes life is so traumatic, suicide just seems like the best option for a young person. 

Carmen Garner, 40, used to walk across busy streets near his home in Springfield, Mass. when he was a teen, hoping to get hit by a car to escape life with drug addicted parents. 

“Our students are dying because they are not equipped to handle situations created by adults —  situations that leave a child feeling abandoned and with a broken heart,” says Garner, now a Washington  elementary school art teacher and author. “Our students today face the same obstacles I faced 30 years ago.”

After the leaves fall

November is an especially difficult time in the Adirondack mountains resort town where her family lives, says Laurie Schmid, Tayler’s mother. As the seasons change, the trees are bare, it’s bitter cold and the small community has shrunk after summer residents leave their lakefront cottages.  

In the weeks before he took his life the day before Thanksgiving 2014, Tayler seemed sullen but his family chalked it up to “teenage angst and boredom and laziness.” It was likely “masking his depression he was dealing with the last few years of his life,” she says.

As her son moved through his teenage years, Schmid says she became less focused on getting her son in to see his pediatrician annually, because he didn’t need shots and wasn’t as comfortable with a female doctor. Besides, he got annual physicals at school to compete on the school soccer and track teams. Among the “what ifs” that plague her now is the question of whether the primary care doctor who had treated Tayler all his life would have picked up on cues about possible depression a new doctor missed. 

More: It’s Teen Health Week. Why I care and why you should too

She had even tried to get Tayler to see a mental health counselor, even though finding one in their area of upstate New York wasn’t easy. Once Schmid and husband Hans settled on one, Tayler refused to go.

One positive has risen out of the pain. There are far more resources and awareness about mental health and the need for counseling in her area now, thanks in part to the family’s advocacy through the “Eskimo Strong” group it started. A local counseling center even has an office at the high school now. 

Schmid speaks to schools and parents regarding signs of depression, to encourage counseling, and provide information for suicide hotlines and text lines. Her oft-repeated motto is “Say Something” and “Talk to Someone.” 

Mental illness also needs to be covered by insurance at the same level as physical illness, says psychiatrist Joe Parks, Missouri’s former medical director for mental health services.   

There need to be more psychiatrists and they also need to be part of primary care clinics, Parks said. At his community health center in Columbia, Mo., he screens those who may be suicidal and taught others to do it, too. Such “accountable care” was envisioned, but not fully realized, under the Affordable Care Act.

Children and teens who aren’t covered by their parents’ insurance can at least rely on Medicaid’s Children’s Health Insurance Program. That’s hampered by low reimbursement rates that mean few psychiatrists accept it, however.

So, even children who receive mental health treatment, Parks said, may be in environments dominated by family members with drug, alcohol or domestic abuse issues.

“Wouldn’t you expect that to increase depression in children?” he says.

Suicide chic?

If super skinny — or muscular — models aren’t enough to depress a teen, flipping through social media feeds can prove misery loves at least digital company. 

Teens regularly post about hating their lives and wanting to kill themselves, so much in fact that Parks says it’s almost like a competitive “race to the bottom.” 

On one hand social media provides a place to vent and get advice, but on the other hand, as Anderson said, “if everyone is commiserating over everyone, is it really helpful?”

Because teens are interacting in a way that isn’t face to face, there’s less of a connection, so it’s hard to understand what, if anything, to say when someone says they want to die. Teens say they will see a post about depression or suicide ideation and sometimes just pass it off as relatable dark humor.

A recent post in one Baltimore teen’s Facebook feed: “Alright, so I will literally pay anyone to shoot me in the head. Who wants a go at it? Please.” 

She included a smiley face emoji. 

Blacks do kill themselves

Two African American preteen Washington charter school students killed themselves in the space of about two months recently, drawing attention to something not commonly thought of as a problem. 

“There’s been a lot of discussion about how suicide is potentially thought of as a white person’s issue,” says Craig Martin, global director of mental health and suicide prevention at the men’s health charity Movember Foundation. ”As a result of that, less is being done in black communities to look at the issue of depression.” 


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Why are so many of my teen patients cutting themselves? We need to fix this now.

There’s also a more pronounced stigma in the African American community surrounding mental health issues. African American men have fewer mental health issues but more serious types when they are present. And they are far less likely to seek treatment, says New York City psychiatrist Sidney Hankerson. 

Then there’s the trauma that comes with living amidst multi-generational poverty and addiction.

A version of the much-publicized opioid epidemic in often-rural white communities has plagued inner city black families since long before Garner was a boy. 

Garner thought “normal” meant watching his mother shoot heroin and his aunts and uncles smoke crack. “I lived with rapists, murderers and drug dealers and gangsters,” he said.

Now, his students are his motivation. They and his family remind “me I don’t have to try to kill myself anymore,” Garner says.

On a Monday night, Karen Ruf went to a Bible study and J.C. took his grandmother out for unlimited shrimp on a Red Lobster gift card. When he got home, he talked to some friends at about 7:30 p.m. No one heard anything different in J.C.’s voice. Karen returned around 9:15 p.m. to a quiet house. She called for her son, no answer. She came downstairs and found his body.

Ruf knew J.C’s death wasn’t an accident because her son left his phone unlocked so she could find his note: “Everything has a time. I decided not to wait for mine. They say we regret the things we do not do. I regret it a lot.”

Schmid’s son Tayler also left something on his phone. A video suicide note that talked about the depressive thoughts he was having. 

Hans and Hansen Schmid watched it. Laurie says she hasn’t been able to: “That’s not how I want to remember him.”

Contributing: Marquart Doty, Janiya Battle and Ashanea Parker of the Urban Health Media Project, which O’Donnell co-founded.  


HOPELINE offers emotional support and resources – via text message – in an effort to prevent suicide. Text “HOPELINE” to 741741.


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Cleveland Cavaliers coach Tyronn Lue stepping away from duties due to health-related reasons

Cleveland Cavaliers coach Tyronn Lue says needs to “step back from coaching for the time being” to deal with a persistent health issue.

TNT analyst David Aldridge reports Lue will be on a one-week plan to address his health issues and that the current plan is for him to return to the bench next week.

In a statement released by the team, Lue and Cavs general manager Koby Altman addressed Lue’s recent health issues. He spent the second half of Saturday’s Cavs-Bulls game in the locker room with an undisclosed illness.

Lue cited dealing with “chest pains and other troubling symptoms, compounded by a loss of sleep, thoughout the year. Despite a battery of tests, there have been no conclusions as to what the exact issue is.”

According to multiple reports, associate head coach Larry Drew will take over as coach.

Here’s Lue’s statement, via

“After many conversations with our doctors and Koby and much thought given to what is best for the team and my health, I need to step back from coaching for the time being and focus on trying to establish a stronger and healthier foundation from which to coach for the rest of the season.

I have had chest pains and other troubling symptoms, compounded by a loss of sleep, throughout the year. Despite a battery of tests, there have been no conclusions as to what the exact issue is.

While I have tried to work through it, the last thing I want is for it to affect the team. I am going to use this time to focus on a prescribed routine and medication, which has previously been difficult to start in the midst of a season. My goal is to come out of it a stronger and healthier version of myself so I can continue to lead this team to the Championship we are all working towards.

I greatly appreciate Dan Gilbert, Koby Altman, our medical team and the organization’s support throughout.”

From Koby Altman:

“We know how difficult these circumstances are for Coach Lue and we support him totally in this focused approach to addressing his health issues.”

ESPN’s Adrian Wojnarowski reports that Lue had been considering stepping way for several weeks but resisted doing so until now.

At Monday’s practice, Cavs star LeBron James said he knew Lue “was struggling, but was never not himself.”

LeBron James is concerned about the health issues coach Tyronn Lue is enduring.

“He was just dealing with it the best way he could, but he was never not himself when he was around. … He was the same every single day, even though he was going through what he was going through,” James said. 

Per’s Joe Vardon, Lue has had his conditioned checked numerous times by doctors with no diagnosis:

Lue has been examined repeatedly by Cleveland Clinic doctors for months and undergone a battery of tests, and there is no diagnosis. He’s missed all or parts of three games this season because of his symptoms, including the second half of the Cavs’ win over Chicago on Saturday.

Sunday marked was the second time this season Lue left a game because he wasn’t feeling well, and he also sat one out against Chicago at home in December. Drew filled in for him in the second half vs. Chicago, where the Cavs saw their 17-point lead reduced to zero with 4:12 left before surging past the Bulls for a 114-109 win.

Injuries have been an issue for the Cavs in general of late, but some good news may be looming in that department. The Cavs host the Milwaukee Bucks (7 ET, ESPN) tonight and have Kyle Korver and Kevin Love both listed as questionable. Love has not played since Jan. 29 because of a broken left hand, but had been targeting a date this week as a potential comeback

Cedi Osman, Rodney Hood, Larry Nance Jr. and Tristan Thompson, however, will all be out for tonight’s game.

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Shock treatment case seems headed to South Carolina Supreme Court

Clair Craver Johnson suffered from bipolar disorder, depression and episodes of mania when doctors at the Medical University of South Carolina started treating her with what was once called “shock treatment” in 2003. 

During 86 sessions over five years, Johnson was put under general anesthesia as hospital staff induced an electrical seizure in her brain.

Long considered a last-ditch treatment for severe mental illness, electroconvulsive therapy — formerly known as “electroshock therapy” — is often used when other medical options have failed. 

As Johnson claims, she was forced to undergo the treatment against her will, refusing to give permission for ECT in 2003.

Her estranged husband gave the informed consent to her doctor, the suit says.

Fifteen years later, Johnson’s lawsuits against the Charleston hospital and the doctor who administered the therapeutic shocks are poised to reach the state’s highest court while opening a window into a world of treatment few people understand.

Johnson’s suit against MUSC dates to 2011, some eight years after her treatment began.

While she could not be reached for comment and her attorneys did not respond to questions from The Post and Courier, her complaint against MUSC contends the treatment made her worse, not better.

The repeated use of ECT caused her “excruciating, intractable pain and suffering, loss of memory, and exacerbation of preexisting mental impairments which … (Johnson) could have avoided had an adequate assessment of alternative medical options been made by” the hospital, the suit says.

While that may be the basis of her legal dispute, the crux of the fight now is that attorneys representing the doctor and hospital say Johnson didn’t file her suit in a timely manner.

They argue Johnson’s treatment began in 2003 and that by filing a lawsuit eight years later, in 2011, the legal deadline to sue had long since passed.

They cited the state’s ”statute of repose,” which sets a six-year limit beyond which patients may not sue medical providers for malpractice. 

In 2014, a circuit court granted summary judgment in favor of MUSC and Roberts. The cases were dismissed. 

But Johnson’s attorneys appealed that decision in 2015. The state Court of Appeals last month ruled that because her ECT treatment was administered over the course of several years and didn’t end until 2008, the deadline to file a lawsuit had not expired in 2011. 

“Because there is evidence that her injury occurred as a result of treatment within the six years prior to her lawsuit, the circuit court erred in finding as a matter of law her claim is barred by the statute of repose,” Court of Appeals Chief Judge James Lockemy wrote.

The circuit court order was reversed, but the issue of timeliness soon could be further appealed to the S.C. Supreme Court.

Few in South Carolina were willing to talk about the impact of the case. 

Jon Snipes, a psychiatrist at the Carolina Center for Behavioral Health in Greer, where ECT is administered, declined to discuss the treatment for fear of upsetting leaders at MUSC.

Jerry Chapman, the Carolina Center’s regional director of business development, called MUSC a “training ground” for ECT treatment, but also declined to answer questions for this article. 

MUSC spokeswoman Heather Woolwine said the hospital “respectfully declines to comment on any pending litigation.”

Likewise, the attorneys representing Dr. Roberts and the attorneys representing his former patient declined comment.

The National Alliance on Mental Illness said the use of ECT, which originated in the 1940s, continues to have negative connotations, even though the treatment methods have become more sophisticated. 

“The reality today is different. People are asleep during the procedure and wake up five to 10 minutes after it has finished. They are able to resume normal activity in about an hour,” NAMI’s website said.

“Most people have four to six treatments before major improvement is seen. This is followed by additional treatments and in some cases ‘maintenance ECT’ on a less frequent basis, such as once a month or once a year.”

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These Entrepreneurs are Addressing the Growing Need for Mental Health Counseling Platforms

You’re reading Entrepreneur India, an international franchise of Entrepreneur Media.

Before diving down to that, let’s touch upon on what’s driving the growing chorus for such counseling platforms. Apart from the obvious figures quoted by World Health Organisation last year – around 94 million Indians suffers from some or the other mental issues such as depression of various types and anxiety disorders – there is a lack of accessible treatment. That’s because first, hospitals are not interested in investing time and resources in the space as there is no in-patient revenue for them.

“A hospital thrives on the revenue from operation theatre but for mental health treatment there is hardly any surgery involved,” says Davesh Manocha who launched Juno Clinic – online clinic for mental wellness along with Arun Kumar and Anuraag Srivastava. Second, almost 80 per cent of India’s top psychologists and psychiatrists are scattered across top five-six cities. This means no basic access to mental health therapists beyond these cities and hence, online treatment is the only alternative. Third, as families are getting nuclear, talking to the family members is getting improbable today. “Mental health issues could be taken care of by talking to someone in a joint family set up but now there is only so much that can be done,” says Dr Amit Malik, Founder and Chief Executive Officer, InnerHour and a trained psychiatrist since over a decade.

Value Game

So the demand for psychological wellness is taking shape. But is there value creation in such platforms and if yes, how that could be apparent to patients? That’s the first big problem since historically it has been significantly affiliated to social disgrace and conventionally the patient has been stamped as psychopath with abnormal or violent social behavior. Consequently, there has also been an issue of privacy as the patient or his/her family members or friends don’t want the problem to be disclosed to their social circle. But that attitude is fast changing with increased social acceptance.

“As the stigma attached is disappearing, mental health is now getting productized. So there are programs for depression, de-addiction, stress, anxiety etc.,” says Dr Vijay Raaghavan, Associate Director, Healthcare, PricewaterhouseCoopers India. Hence, instead of going to a therapist or a counselor offline, where there is a standard process to de-stress, separate programs allow patients and counselors for problem-specific sessions. Moreover, since the sessions are online-first, which includes chat and phone-based (audio and video) support, it solves the problem for lack of privacy.

For instance, counseling for de-addiction of drugs wherein the patient fears of being labeled as an addict socially, the online channel with better privacy control mitigates that issue. “This further reduces the overall cost for the program, even as it helps counselors deliver better value to the patient,” adds Raaghavan. It usually costs upwards of INR 1,000 for a session of 50-75 minutes offline versus INR 400 and above on the online platforms. For example, YourDost, another similar platform charges INR 1,000 per week for five-week program on marital relationship, whereas a regular relationship counselor charges over INR 1,500 per session. But much like in any healthcare business, the most important factor for success for these start-ups too is the clinical efficacy.

Since the delivery of treatment is taking place digitally, hence the workflow right from recording patient details, diagnosing the problem, counseling, and medication if required has to be seamless. This means that element of collaboration has to be deeply engrained in the process since there are multiple people involved in a single case – counselor or therapist, psychiatrist prescribing medication, psychologist doing the assessment etc. “Telemedicine in healthcare is just a delivery layer to connect the doctor and the patient but the business has to be built around telemedicine,” adds Manocha. For example, at Juno Clinic, the patients can begin with choosing the therapist and the time slot, pay for the session and start with the counseling. At the backend, the patient details are synced with the psychiatrist and psychologist for medication and further

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Harvard’s Nutty Idea: Cracking Into the Almond Market

In the Australian state of New South Wales, Harvard University is developing around 1,480 acres of former potato fields and other farmland, building a new dam and planting trees that will take about three years to bear their first edible crops.

It is part of a growing bet on almonds by the college’s endowment, which is adding to around 1,235 acres of almond plantations it already owns near a township called Hillston. Hundreds of miles away, Harvard is trying to sell an Australian sugar-cane plantation that it bought in 2016…

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Wired Health 2018: Old tech, new ideas

This week, we attended the Wired Health conference in London. As always, the event was jam-packed with innovators jostling for position in the race toward a brighter, healthier future.

This year’s Wired Health conference was as informative and insightful as ever.

Wired Health is held yearly in London, United Kingdom. It boasts a wide array of speakers from every corner of the health tech world, alongside forward-thinking companies who provide a glimpse of their latest offerings.

This year was as varied as ever, and the talks covered how technology could intervene in issues as diverse as HIV, bereavement in children, and cardiovascular surgery.

I spent the majority of my time at the EY WIRED Health Access Stage, which featured an annual showcase of start-up companies.

For me, the over-arching theme this year was one of consolidation. I saw less focus on newfangled technology and more emphasis on the use of recent innovations in more efficient ways.

Rather than designing solutions from the bottom up, it seems to be more about capitalizing on hard-won inventions of the recent past.

We have the data — now what?

Early on in the proceedings, Pamela Spence — the Global Life Science Leader at EY — reminded us that we are currently knee-deep in the fourth industrial revolution. And, key to this brave new dawn is that four letter word that promises so much: data.

Big data is here. What’s the next step?

Today, capturing data is easier than ever. There are more data available to us than we could have dreamt of just a decade ago. We have almost unlimited processing power at our fingertips.

The question is, which bits do we pay attention to, who gets to share it, and what shall we do with it?

Spence spoke of the problems with collating this new-found swarm of numbers. Healthcare data tend to be spread out and distributed into different silos.

If they could be combined more efficiently and analyzed effectively, they could be harnessed for the greater good.

She quipped that clinicians used to be supported by data scientists but, more and more, data scientists are being supported by clinicians.

This is the future of health tech. However, at the moment, you get the feeling that the data we are harnessing are nowhere near as useful as they promise to become.

One company bent on harnessing medicine’s new-found ocean of data is Heterogeneous. Though gene sequencing has been available for some time, Heterogeneous are offering whole-genome sequencing at rates cheaper than could have been imagined just a handful of years ago.

Anyone can sign up, and, once you have had your genome sequenced, you get full ownership of your data. You are then able to select which research projects you would like to make your data available to.

Heterogeneous pass your genome (anonymously) over for their study. The researchers receive good-quality data quickly, and you receive the warm satisfaction of advancing science passively from your armchair.

This is not a new idea; plenty of companies offer genomic information to consumers. However, most other companies sell these data to third parties without informing the customer. This is completely legal and above board, but Heterogeneous want to be part of a more open and collaborative future.

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Big data vs. personalization

Although many of the changes in healthcare are predicted to come from the rich tapestry of data that we collect, there are also changes at the other end of the spectrum: personalized medicine.

Bruce Levine — from the University of Pennsylvania in Philadelphia — spoke to an enthralled audience about his work with chimeric antigen receptors (CAR)-T cell therapy.

In this technology, cancer patients’ immune cells, or T cells, are removed, then genetically trained to target cancer cells and reintroduced into the patient.

Already tested in leukemia and lymphoma, CAR-T can save lives — a single infusion with the newly trained T cells can wipe out “kilograms” of tumor cells. Though the method cannot yet attack solid tumors, Levine and his colleagues are hot on their heels.

This intervention is very much tailored to the individual. In fact, he likened it to an organ transplant rather than a pharmacological intervention, calling it the “ultimate in personalized treatment.” The patients’ own cells are groomed to recognize and destroy the specific cancer that they carry.

Levine’s story also provides a little insight into how quickly a medical technique can move from the outskirts to the mainstream.

He recalled that, just a few years back, he and the other researchers investigating the potential of CAR-T were regarded as the “quaint” guys in the corner. Now, they’re the “hot thing,” Food and Drug Administration-approved, and, rightfully, the center of attention.

Generation App

Tech conferences the world over are awash with smartphones and apps. I had to stop myself from rolling my eyes when I saw the number of app-based solutions at Wired Health this year. But I shouldn’t roll my eyes.

Yes, I was disappointed that there weren’t more laser-wielding robots and X-ray-powered rocket shoes, but this was a science conference, not a science fiction conference (Medical News Today won’t pay for my Comic-Con ticket).

Apps are accessible to millions of people worldwide via a few taps on a device kept in their pocket. Their incredibly swift rise to ubiquity — let’s try to remember that Apple’s App Store only opened its digital doors in July 2008 — makes them a potentially powerful tool for the good of humanity’s health, if wielded in the right hands.

One such pair of safe hands belongs to Clinova, who have developed an app called Caidr.

Any health-focused conference in the U.K. is almost duty-bound to mention the struggling British National Health Service. Although the reasons for its troubles are largely political, finding ways to cut corners and save cash are of particular interest.

Caidr, which was designed by two pharmacists, helps users to “distinguish minor ailments from a more serious illness.” By answering a series of simple questions, the app’s algorithms assess whether they need to visit a doctor or if a pharmacist could offer effective over-the-counter medications.

Some examples of Caidr screenshots.

In the United States, where waiting times to see a doctor have sky-rocketed over recent years, this app could help to take the pressure off.

Another company who are offering an easier, mobile-based route to healthcare is Index Ventures, who have created an app called Kry. The app allows you to speak with a doctor directly via your cell phone.

This saves both the doctor’s and patient’s time and is significantly easier than having to take time off work or juggle other commitments to visit the doctor’s office. It is particularly useful for people who cannot visit the doctor easily or who live in isolated regions.

Kry is already part of Sweden’s health service, and 2 percent of all primary care appointments take place through the app. Again, this is a good example of technology that has been around for quite some time that is now being used in new and useful ways.

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Approaching obesity from new directions

A company called Modius have created a wearable device that stimulates the eighth cranial nerve, helping people to lose weight.

The Modius brain stimulation headset.

Yes, that might sound like the science fiction I was hoping for, but it is grounded in solid neuroscience.

As we evolved over thousands and thousands of years, we faced starvation at every turn.

Because a lack of food was a constant driving force in our development, our bodies adapted to make it very difficult for us to lose weight.

During prehistory, keeping an extra layer of fat was an excellent way to survive. But, now that we have access to enough food to kill ourselves, holding on to fat is no longer such a beneficial adaptation.

The hypothalamus, deep within the brain, helps decide when and how to lay down fat. The Modius device is able to stimulate one of the cranial nerves that runs fairly close to the surface of the skin, sending a current through to the brainstem.

From there, the stimulation moves on to the hypothalamus, reducing appetite and encouraging the body to move toward a leaner state.

The eighth cranial nerve is also called the auditory vestibular nerve because it plays a role in our sense of balance. According to one of Wired Health’s staff members — who volunteered to try the brain stimulation device — it makes you feel a little dizzy. It’s not unlike the after effect of a glass of wine, apparently.

It can also make the user feel a little sleepy, in the same way that rocking a baby stimulates the vestibular system and makes them woozy.

This is not a miracle cure by any stretch, but for people who find it difficult to lose weight who are active and eating well, this may provide a much-needed edge.

Although the brain stimulation technology is, in this instance, cutting edge, the theory behind it was first uncovered by NASA in 1972, although they didn’t realize it at the time. It took another 30 years to understand that stimulating the vestibular system causes a reduction in body fat.

The take-home message for me this year is one of regrouping. In the past decade, there has been so much innovation that each strand of tech is still waiting to come to fruition.

Today, we see technology that has already been fine-tuned finally being used to benefit global health. It’s an interesting and app-heavy time for medical science.

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Amazon is hiring a former FDA official to work on its secretive health tech business

<!– –> founder and CEO Jeff Bezos.

Amazon’s Grand Challenge team, its equivalent of the Google X lab for moonshot technologies, has made its latest high-profile health care hire.

The company has quietly scooped up Taha Kass-Hout, the former U.S. Food and Drug Administration chief health informatics officer, according to a source with knowledge of the hire.

Kass-Hout will serve in a business development role focusing on health care projects. He will work alongside Amazon Grand Challenge chief Babak Parviz, a former director at Google X who joined Amazon in 2014 as a vice president.

Amazon has remained secretive about its health care ambitions, with a few exceptions.

It did announce a collaboration with J.P. Morgan and Berkshire Hathaway to bring down health care costs and improve quality for its own employees. But it hasn’t said much about how that will work, or who will run it.

Amazon’s Grand Challenge team has also been referred to internally as 1492. Like Google X, it is focused on very big bets that would potentially create a new category for the business. The multi-trillion dollar health sector is a major focus for the group.

Amazon did not immediately return a request for comment.

“Empowering consumers”

Kass-Hout left his previous role at Michigan’s Trinity Health in May of last year, and hasn’t updated his LinkedIn profile since then.

At Trinity, where he served as a senior vice president, his role involved “leadership and oversight over data, analytics and digital health initiatives,” according to his profile.

Prior than that, he worked in senior government roles at the Centers for Disease Control and Prevention and the FDA as its first executive focused on health informatics. He’s also a Harvard-trained physician.

His expertise is in health information technologies and digital health, as well as in navigating government regulation.

Most interestingly, he describes his mission on LinkedIn as “empowering consumers via sustainable health data ecosystems.”

That suggests Amazon might be looking to help consumers get easier access to health records. Both Apple and Alphabet have launched initiatives to help consumers gain access to their medical information, which is currently scattered across various health systems.

It’s a big problem — and a big opportunity for technology companies. More than 250,000 people die every year from medical errors, often resulting from a lack of available patient-data on hospital computer systems. Amazon hasn’t revealed its own ambitions in this space, but CNBC reported that it’s looking at opportunities to push and pull data from legacy electronic medical systems.

Medical experts say that it’s also possible that Kass-Hout will help Amazon through various facets of the regulatory process, especially if it brings new health hardware or software to market.

“It’s not clear either way, but it does at least give them the option,” said Stephen Buck, a former co-founder of GoodRx, which gives consumers a platform for cheaper medicines. Buck did not have any inside knowledge of the hire.

“It’s smart of Amazon to bring in people well versed in health care data and how connectivity is vital to improving results,” he added.

Amazon has various teams working internally on a wide variety different health projects, some of which may never reach production.

For instance, it has teams focused on bringing its Alexa voice assistant to health care, figuring out whether it can disrupt the drug supply chain, and selling medical supplies to hospitals. Amazon Web Services is working to serve its customers in the health care sector with cloud technology, and has a deal with Cerner to help better use their data to make health predictions about patient populations.

In addition to Kass-Hout, Amazon this year also scooped up Martin Levine, a prominent Seattle-based geriatrician with an expertise in innovative care delivery models.

WATCH: Amazon Prime could upend the health-care system

Jeff Bezos, Amazon


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