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What we’re expecting in 2021, and beyond…

From telehealth to digital trials, customer engagement to healthcare data, Healthware Group outlines the key trends that are
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From telehealth to digital trials, customer engagement to healthcare data, Healthware Group outlines the key trends that are expected to shake up digital health this year.

Well, it goes without saying, COVID-19 has resulted in a rapid adoption of digital technologies across all industries, most notably in healthcare. There are several important aspects to these shifts for pharma, biotech and medical device companies, so what can we expect to see over the next 12 months and beyond?

Telehealth keeps maturing and integrates into care pathways

The adoption of telehealth, which was already accelerating pre-pandemic, has been exponentially driven by COVID-19. It’s swept aside several historic barriers to uptake, such as the healthcare professional and patient desire to physically meet, medical guidelines that focus on in-person diagnosis and reimbursement models that discourage remote consultation.

2020 was a psychological and systemic tipping point for telehealth, adoption of which will accelerate in 2021 as it becomes the norm, in the process driving new self-service approaches to medicine and participation-based reimbursement models.

Mental health worsens – digital tools continue to fill the gap

The emotional and psychological wellbeing of the world’s population has been put under tremendous strain because of the COVID-19 pandemic, exacerbating an existing global mental health epidemic.

There is an opportunity to address this at scale with digital tools and techniques, and expand support into just about any therapeutic area through the holistic integration of mental and behavioural health solutions that improve patient care.

Mental health support is key to improving outcomes in chronic diseases and can also provide an invaluable empathetic and psychological component of support for people dealing with other complex medical situations.

When coupled with conversational interfaces and AI, digital mental health solutions are perceived as highly personal by users and open the door for a profound transformation in people’s relationships with digital health tools and how they integrate them into their daily lives.

Clinical trials get more and more digitalised

As study enrolment continues to lag drastically behind target, patient recruitment is set to rely even more on digital marketing to improve its speed and accuracy. These techniques will also need to be applied to screening, interviews and the actual studies themselves, particularly as more trials move towards a virtual, decentralised or hybrid model.

Digital screening of subjects makes their geographical location less relevant, which may make studies more attractive as there is less requirement to travel. And with the support of remote sampling, and growing tools for gathering real world evidence about improved quality of life, the clinical trials of the future can be done faster, with lower costs and on a more decentralised basis.

‘Aging in place’ becomes more commonplace

Aging in place will become more common as the baby boomer generation ages and feels more comfortable leveraging tools like remote monitoring, telehealth and disease management platforms. Living independently will be critical to this age group and digital health tools will be critical in supporting them in this endeavour. The adoption and growth of digital tools is expected to explode as a result. This is certainly evident in the amount of investment in the category.

The inevitable invisibility of digital health

Technology will begin to dematerialise, as has already been seen in other industries, and digital health will increasingly be woven into everyday objects. We’re starting to see this happen through the emergence of smart homes and smart cars (i.e., steering wheels that also measure the driver’s heart rate). As more data is collected passively, there will be more opportunities for integration.

No more ‘business as usual’ for pharma’s customer engagement

Life sciences companies need to rethink their customer engagement paradigms in light of changing customer preferences. Pharma should update the role of the rep from simply delivering a sales message to more of a concierge service model, providing access to – and facilitating the delivery of – meaningful content that physicians want and need. As such, reps will need to be reskilled.

Self-service models for HCPs are also needed in order to provide access to content when and how they want it – as already seen in other industries, the expectation will be for 24/7 access.

While digital-only product promotion was laughed at just a year ago, we’ve already seen the first digital-only blockbuster launch, and we expect this will become a growing trend. Pharma companies will need to continually rethink what works and not be afraid to experiment with solutions they’ve never tried before.

A growing need for digital health proficiency

While 2014 is often quoted as the first year where the majority of working healthcare professionals were digital natives, 2020 was the year when the remaining digital immigrants were forced to travel into the online world. Post-pandemic, online engagement will continue to be commonplace and 2021 will see much broader rollouts of ‘digital’ training for medics (young and old), and all medical societies will have to embrace online learning and digital publishing models. In addition, the subject matter for ongoing disease research will focus even further on COVID-19 comorbidities and the longer-term impact of the virus.

Integration of telehealth strategy into commercial models

Amazon is making a serious global move into healthcare delivery with the acquisition of PillPack, and its recent launch of Amazon Pharmacy. With Amazon Care, it is starting to experiment with virtual health care services, offering them first to its own employees and with plans to expand them to health plans and other employers.

These moves are bringing Amazon closer and closer to a true end-to-end model, similar to the turnkey solutions offered by the likes of Hims, Ro and others in the category with an original focus on conditions with an associated stigma. We’re already starting to see some pharma build end-to-end solutions like this in birth control, and we’re expecting to see these efforts branch out into other disease areas. And beyond building end-to-end solutions like this to drive scripts, we expect pharma to begin approaching telehealth more generally as a potential marketing/sales channel, helping to remove barriers to care, improving online visits and even helping HCPs understand the benefits.

Consolidation of digital health platforms

Digital health platforms will likely see a wave of further consolidations, with a few leading platforms starting to stake out their respective positions across the healthcare spectrum. This trend can be seen as a net positive, in that it will enable digital therapeutic solution developers to concentrate on building the individual vertical products that will live on these platforms.

However, issues around data ownership and sharing will need to be addressed and resolved (by way of regulations) to avoid a situation where solutions that are competitive to platform owners’ own cannot find a way to be listed on them. Price controls will also need to be mandated to avoid the types of ‘access taxes’ currently seen, such as with Apple’s App Store fees on sales charged to app developers (upwards of 30% of sales collected), who have no way to sell their apps directly to iPhone users.

Services to manage and make sense of the health data explosion

We expect to see what we call Health Data as a Service (HDaS). As more solutions and devices generate increasing amounts of health data, there is a greater need to aggregate that data in a useful way for consumers. Consumers want and need tools to make sense of all that data. They also want to ensure they know who has access to that data, and control over where it can flow. So, we expect to see more tools supporting consumers in this way.

We look forward to continuing to contribute to the advancement of digital health and digital transformation across all aspects of the healthcare ecosystem and welcome your thoughts on the above.

About the authors

Roberto Ascione is Healthware Group’s CEO and founder, and a pioneer in digital health and a recognised thought leader, people-inspiring founder, serial entrepreneur and global manager.

 

Gerry Chillè is senior partner at Healthware Group, in charge of its digital therapeutics pipeline strategy and development.

 

Fulvio Fortini is Healthware’s managing director – Italy. With more than 20 years of experience, he is passionate about digital technology and an expert in the health and wellness sector.

 

Petteri Kolehmainen is managing director – Finland, leading Healthware’s Helsinki team, with focus the Nordic and Baltic countries, bringing strong experience in technology and business development.

 

Kristin Milburn is managing director at Healthware Labs, which was launched in New York in 2015 with a mission to accelerate digital health and therapeutic innovation.

 

Ariel Salmang is managing director at Intouch International, a unique joint venture between Healthware Group and the Intouch Group.

 

Paul Tunnah is Healthware’s chief content officer and managing director UK, and a recognised author, speaker and industry advisor with a passion for helping organisations tell authentic stories.

 

If you’d like to learn more about how we think please reach out to hello@healthwaregroup.com

About Healthware Group

Healthware is a next-generation integrated consulting group. For more than 20 years it has been offering large companies and start-ups in the life sciences and insurance sectors a unique set of services and expertise in strategic consulting, communication, technology and innovation to drive the digital transformation of health.

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Harvard Medical School Professor Was Fired Over Not Getting COVID Vaccine

Harvard Medical School Professor Was Fired Over Not Getting COVID Vaccine

Authored by Zachary Stieber via The Epoch Times (emphasis ours),

A…

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Harvard Medical School Professor Was Fired Over Not Getting COVID Vaccine

Authored by Zachary Stieber via The Epoch Times (emphasis ours),

A Harvard Medical School professor who refused to get a COVID-19 vaccine has been terminated, according to documents reviewed by The Epoch Times.

Martin Kulldorff, epidemiologist and statistician, at his home in Ashford, Conn., on Feb. 11, 2022. (Samira Bouaou/The Epoch Times)

Martin Kulldorff, an epidemiologist, was fired by Mass General Brigham in November 2021 over noncompliance with the hospital’s COVID-19 vaccine mandate after his requests for exemptions from the mandate were denied, according to one document. Mr. Kulldorff was also placed on leave by Harvard Medical School (HMS) because his appointment as professor of medicine there “depends upon” holding a position at the hospital, another document stated.

Mr. Kulldorff asked HMS in late 2023 how he could return to his position and was told he was being fired.

You would need to hold an eligible appointment with a Harvard-affiliated institution for your HMS academic appointment to continue,” Dr. Grace Huang, dean for faculty affairs, told the epidemiologist and biostatistician.

She said the lack of an appointment, combined with college rules that cap leaves of absence at two years, meant he was being terminated.

Mr. Kulldorff disclosed the firing for the first time this month.

“While I can’t comment on the specifics due to employment confidentiality protections that preclude us from doing so, I can confirm that his employment agreement was terminated November 10, 2021,” a spokesperson for Brigham and Women’s Hospital told The Epoch Times via email.

Mass General Brigham granted just 234 exemption requests out of 2,402 received, according to court filings in an ongoing case that alleges discrimination.

The hospital said previously, “We received a number of exemption requests, and each request was carefully considered by a knowledgeable team of reviewers.

A lot of other people received exemptions, but I did not,” Mr. Kulldorff told The Epoch Times.

Mr. Kulldorff was originally hired by HMS but switched departments in 2015 to work at the Department of Medicine at Brigham and Women’s Hospital, which is part of Mass General Brigham and affiliated with HMS.

Harvard Medical School has affiliation agreements with several Boston hospitals which it neither owns nor operationally controls,” an HMS spokesperson told The Epoch Times in an email. “Hospital-based faculty, such as Mr. Kulldorff, are employed by one of the affiliates, not by HMS, and require an active hospital appointment to maintain an academic appointment at Harvard Medical School.”

HMS confirmed that some faculty, who are tenured or on the tenure track, do not require hospital appointments.

Natural Immunity

Before the COVID-19 vaccines became available, Mr. Kulldorff contracted COVID-19. He was hospitalized but eventually recovered.

That gave him a form of protection known as natural immunity. According to a number of studies, including papers from the U.S. Centers for Disease Control and Prevention, natural immunity is better than the protection bestowed by vaccines.

Other studies have found that people with natural immunity face a higher risk of problems after vaccination.

Mr. Kulldorff expressed his concerns about receiving a vaccine in his request for a medical exemption, pointing out a lack of data for vaccinating people who suffer from the same issue he does.

I already had superior infection-acquired immunity; and it was risky to vaccinate me without proper efficacy and safety studies on patients with my type of immune deficiency,” Mr. Kulldorff wrote in an essay.

In his request for a religious exemption, he highlighted an Israel study that was among the first to compare protection after infection to protection after vaccination. Researchers found that the vaccinated had less protection than the naturally immune.

“Having had COVID disease, I have stronger longer lasting immunity than those vaccinated (Gazit et al). Lacking scientific rationale, vaccine mandates are religious dogma, and I request a religious exemption from COVID vaccination,” he wrote.

Both requests were denied.

Mr. Kulldorff is still unvaccinated.

“I had COVID. I had it badly. So I have infection-acquired immunity. So I don’t need the vaccine,” he told The Epoch Times.

Dissenting Voice

Mr. Kulldorff has been a prominent dissenting voice during the COVID-19 pandemic, countering messaging from the government and many doctors that the COVID-19 vaccines were needed, regardless of prior infection.

He spoke out in an op-ed in April 2021, for instance, against requiring people to provide proof of vaccination to attend shows, go to school, and visit restaurants.

The idea that everybody needs to be vaccinated is as scientifically baseless as the idea that nobody does. Covid vaccines are essential for older, high-risk people and their caretakers and advisable for many others. But those who’ve been infected are already immune,” he wrote at the time.

Mr. Kulldorff later co-authored the Great Barrington Declaration, which called for focused protection of people at high risk while removing restrictions for younger, healthy people.

Harsh restrictions such as school closures “will cause irreparable damage” if not lifted, the declaration stated.

The declaration drew criticism from Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, and Dr. Rochelle Walensky, who became the head of the CDC, among others.

In a competing document, Dr. Walensky and others said that “relying upon immunity from natural infections for COVID-19 is flawed” and that “uncontrolled transmission in younger people risks significant morbidity(3) and mortality across the whole population.”

“Those who are pushing these vaccine mandates and vaccine passports—vaccine fanatics, I would call them—to me they have done much more damage during this one year than the anti-vaxxers have done in two decades,” Mr. Kulldorff later said in an EpochTV interview. “I would even say that these vaccine fanatics, they are the biggest anti-vaxxers that we have right now. They’re doing so much more damage to vaccine confidence than anybody else.

Surveys indicate that people have less trust now in the CDC and other health institutions than before the pandemic, and data from the CDC and elsewhere show that fewer people are receiving the new COVID-19 vaccines and other shots.

Support

The disclosure that Mr. Kulldorff was fired drew criticism of Harvard and support for Mr. Kulldorff.

The termination “is a massive and incomprehensible injustice,” Dr. Aaron Kheriaty, an ethics expert who was fired from the University of California–Irvine School of Medicine for not getting a COVID-19 vaccine because he had natural immunity, said on X.

The academy is full of people who declined vaccines—mostly with dubious exemptions—and yet Harvard fires the one professor who happens to speak out against government policies.” Dr. Vinay Prasad, an epidemiologist at the University of California–San Francisco, wrote in a blog post. “It looks like Harvard has weaponized its policies and selectively enforces them.”

A petition to reinstate Mr. Kulldorff has garnered more than 1,800 signatures.

Some other doctors said the decision to let Mr. Kulldorff go was correct.

“Actions have consequence,” Dr. Alastair McAlpine, a Canadian doctor, wrote on X. He said Mr. Kulldorff had “publicly undermine[d] public health.”

Tyler Durden Sat, 03/16/2024 - 21:00

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“Extreme Events”: US Cancer Deaths Spiked In 2021 And 2022 In “Large Excess Over Trend”

"Extreme Events": US Cancer Deaths Spiked In 2021 And 2022 In "Large Excess Over Trend"

Cancer deaths in the United States spiked in 2021…

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"Extreme Events": US Cancer Deaths Spiked In 2021 And 2022 In "Large Excess Over Trend"

Cancer deaths in the United States spiked in 2021 and 2022 among 15-44 year-olds "in large excess over trend," marking jumps of 5.6% and 7.9% respectively vs. a rise of 1.7% in 2020, according to a new preprint study from deep-dive research firm, Phinance Technologies.

Algeria, Carlos et. al "US -Death Trends for Neoplasms ICD codes: C00-D48, Ages 15-44", ResearchGate, March. 2024 P. 7

Extreme Events

The report, which relies on data from the CDC, paints a troubling picture.

"We show a rise in excess mortality from neoplasms reported as underlying cause of death, which started in 2020 (1.7%) and accelerated substantially in 2021 (5.6%) and 2022 (7.9%). The increase in excess mortality in both 2021 (Z-score of 11.8) and 2022 (Z-score of 16.5) are highly statistically significant (extreme events)," according to the authors.

That said, co-author, David Wiseman, PhD (who has 86 publications to his name), leaves the cause an open question - suggesting it could either be a "novel phenomenon," Covid-19, or the Covid-19 vaccine.

"The results indicate that from 2021 a novel phenomenon leading to increased neoplasm deaths appears to be present in individuals aged 15 to 44 in the US," reads the report.

The authors suggest that the cause may be the result of "an unexpected rise in the incidence of rapidly growing fatal cancers," and/or "a reduction in survival in existing cancer cases."

They also address the possibility that "access to utilization of cancer screening and treatment" may be a factor - the notion that pandemic-era lockdowns resulted in fewer visits to the doctor. Also noted is that "Cancers tend to be slowly-developing diseases with remarkably stable death rates and only small variations over time," which makes "any temporal association between a possible explanatory factor (such as COVID-19, the novel COVID-19 vaccines, or other factor(s)) difficult to establish."

That said, a ZeroHedge review of the CDC data reveals that it does not provide information on duration of illness prior to death - so while it's not mentioned in the preprint, it can't rule out so-called 'turbo cancers' - reportedly rapidly developing cancers, the existence of which has been largely anecdotal (and widely refuted by the usual suspects).

While the Phinance report is extremely careful not to draw conclusions, researcher "Ethical Skeptic" kicked the barn door open in a Thursday post on X - showing a strong correlation between "cancer incidence & mortality" coinciding with the rollout of the Covid mRNA vaccine.

Phinance principal Ed Dowd commented on the post, noting that "Cancer is suddenly an accelerating growth industry!"

Continued:

Bottom line - hard data is showing alarming trends, which the CDC and other agencies have a requirement to explore and answer truthfully - and people are asking #WhereIsTheCDC.

We aren't holding our breath.

Wiseman, meanwhile, points out that Pfizer and several other companies are making "significant investments in cancer drugs, post COVID."

Phinance

We've featured several of Phinance's self-funded deep dives into pandemic data that nobody else is doing. If you'd like to support them, click here.

 

Tyler Durden Sat, 03/16/2024 - 16:55

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“I Can’t Even Save”: Americans Are Getting Absolutely Crushed Under Enormous Debt Load

"I Can’t Even Save": Americans Are Getting Absolutely Crushed Under Enormous Debt Load

While Joe Biden insists that Americans are doing great…

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"I Can't Even Save": Americans Are Getting Absolutely Crushed Under Enormous Debt Load

While Joe Biden insists that Americans are doing great - suggesting in his State of the Union Address last week that "our economy is the envy of the world," Americans are being absolutely crushed by inflation (which the Biden admin blames on 'shrinkflation' and 'corporate greed'), and of course - crippling debt.

The signs are obvious. Last week we noted that banks' charge-offs are accelerating, and are now above pre-pandemic levels.

...and leading this increase are credit card loans - with delinquencies that haven't been this high since Q3 2011.

On top of that, while credit cards and nonfarm, nonresidential commercial real estate loans drove the quarterly increase in the noncurrent rate, residential mortgages drove the quarterly increase in the share of loans 30-89 days past due.

And while Biden and crew can spin all they want, an average of polls from RealClear Politics shows that just 40% of people approve of Biden's handling of the economy.

Crushed

On Friday, Bloomberg dug deeper into the effects of Biden's "envious" economy on Americans - specifically, how massive debt loads (credit cards and auto loans especially) are absolutely crushing people.

Two years after the Federal Reserve began hiking interest rates to tame prices, delinquency rates on credit cards and auto loans are the highest in more than a decade. For the first time on record, interest payments on those and other non-mortgage debts are as big a financial burden for US households as mortgage interest payments.

According to the report, this presents a difficult reality for millions of consumers who drive the US economy - "The era of high borrowing costs — however necessary to slow price increases — has a sting of its own that many families may feel for years to come, especially the ones that haven’t locked in cheap home loans."

The Fed, meanwhile, doesn't appear poised to cut rates until later this year.

According to a February paper from IMF and Harvard, the recent high cost of borrowing - something which isn't reflected in inflation figures, is at the heart of lackluster consumer sentiment despite inflation having moderated and a job market which has recovered (thanks to job gains almost entirely enjoyed by immigrants).

In short, the debt burden has made life under President Biden a constant struggle throughout America.

"I’m making the most money I've ever made, and I’m still living paycheck to paycheck," 40-year-old Denver resident Nikki Cimino told Bloomberg. Cimino is carrying a monthly mortgage of $1,650, and has $4,000 in credit card debt following a 2020 divorce.

Nikki CiminoPhotographer: Rachel Woolf/Bloomberg

"There's this wild disconnect between what people are experiencing and what economists are experiencing."

What's more, according to Wells Fargo, families have taken on debt at a comparatively fast rate - no doubt to sustain the same lifestyle as low rates and pandemic-era stimmies provided. In fact, it only took four years for households to set a record new debt level after paying down borrowings in 2021 when interest rates were near zero. 

Meanwhile, that increased debt load is exacerbated by credit card interest rates that have climbed to a record 22%, according to the Fed.

[P]art of the reason some Americans were able to take on a substantial load of non-mortgage debt is because they’d locked in home loans at ultra-low rates, leaving room on their balance sheets for other types of borrowing. The effective rate of interest on US mortgage debt was just 3.8% at the end of last year.

Yet the loans and interest payments can be a significant strain that shapes families’ spending choices. -Bloomberg

And of course, the highest-interest debt (credit cards) is hurting lower-income households the most, as tends to be the case.

The lowest earners also understandably had the biggest increase in credit card delinquencies.

"Many consumers are levered to the hilt — maxed out on debt and barely keeping their heads above water," Allan Schweitzer, a portfolio manager at credit-focused investment firm Beach Point Capital Management told Bloomberg. "They can dog paddle, if you will, but any uptick in unemployment or worsening of the economy could drive a pretty significant spike in defaults."

"We had more money when Trump was president," said Denise Nierzwicki, 69. She and her 72-year-old husband Paul have around $20,000 in debt spread across multiple cards - all of which have interest rates above 20%.

Denise and Paul Nierzwicki blame Biden for what they see as a gloomy economy and plan to vote for the Republican candidate in November.
Photographer: Jon Cherry/Bloomberg

During the pandemic, Denise lost her job and a business deal for a bar they owned in their hometown of Lexington, Kentucky. While they applied for Social Security to ease the pain, Denise is now working 50 hours a week at a restaurant. Despite this, they're barely scraping enough money together to service their debt.

The couple blames Biden for what they see as a gloomy economy and plans to vote for the Republican candidate in November. Denise routinely voted for Democrats up until about 2010, when she grew dissatisfied with Barack Obama’s economic stances, she said. Now, she supports Donald Trump because he lowered taxes and because of his policies on immigration. -Bloomberg

Meanwhile there's student loans - which are not able to be discharged in bankruptcy.

"I can't even save, I don't have a savings account," said 29-year-old in Columbus, Ohio resident Brittany Walling - who has around $80,000 in federal student loans, $20,000 in private debt from her undergraduate and graduate degrees, and $6,000 in credit card debt she accumulated over a six-month stretch in 2022 while she was unemployed.

"I just know that a lot of people are struggling, and things need to change," she told the outlet.

The only silver lining of note, according to Bloomberg, is that broad wage gains resulting in large paychecks has made it easier for people to throw money at credit card bills.

Yet, according to Wells Fargo economist Shannon Grein, "As rates rose in 2023, we avoided a slowdown due to spending that was very much tied to easy access to credit ... Now, credit has become harder to come by and more expensive."

According to Grein, the change has posed "a significant headwind to consumption."

Then there's the election

"Maybe the Fed is done hiking, but as long as rates stay on hold, you still have a passive tightening effect flowing down to the consumer and being exerted on the economy," she continued. "Those household dynamics are going to be a factor in the election this year."

Meanwhile, swing-state voters in a February Bloomberg/Morning Consult poll said they trust Trump more than Biden on interest rates and personal debt.

Reverberations

These 'headwinds' have M3 Partners' Moshin Meghji concerned.

"Any tightening there immediately hits the top line of companies," he said, noting that for heavily indebted companies that took on debt during years of easy borrowing, "there's no easy fix."

Tyler Durden Fri, 03/15/2024 - 18:00

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