An Extraordinary Out-of-Body Journey

In her TEDMED 2014 talk, photographer Kitra Cahana shared a new visual language accompanying the extraordinary story of her father’s severe brainstem stroke, a catastrophe that they transformed into an inspiring and imaginative spiritual journey. She spoke with us via email about her talk and her father’s progress.

What motivated you to speak at TEDMED?

It’s very difficult to express the sublime and the surreal in words and photographs. I wanted to attempt to communicate all that my family had experienced in the summer of 2011 – my father’s brain stem stroke, and the profound spiritual awakening that followed – with others. When my father first had his stroke, I wrote down these words, and whispered them to him when I first came to his bedside: “We only ever needed one pair of hands, two legs, a respiratory system to keep the world afloat between us.” This became my mantra. We can sustain ourselves through each other. This is what my father taught us; he said that all who came into his room of healing should expect to be healed themselves. Healing has to be mutual.

Kitra Cahana at TEDMED 2014. Photo: TEDMED/Sandy Huffaker

Kitra Cahana at TEDMED 2014. Photo: TEDMED

The stroke ruptured my reality as well as his. In those initial months, so devoted to his limp body and to allowing him to communicate all that was bursting to come out from within, I saw sides of myself I never knew existed. I would have loved for him to have spoken at TEDMED himself. But as in the hospital, where my mother, sisters, brother and I acted as his mouthpiece, so too do we continue to act in that capacity, sharing his words and his Torah with others.

Why does this talk matter now? What impact do you hope the talk will have?

To me, this talk should be timeless. In fact, part of my father’s message is that he hopes others will step outside of the space-time hustle and bustle that many of us are so used to. He experiences life in a kind of slow-time (that’s what he’s called it), watching with curiosity as his body reawakens tingle by tingle, twitch by twitch. He spent and continues to spend hours alone with himself. That space of aloneness with his thoughts is not a place of anxiety, but a place of joy and introspection.

I hope that others get a sense of this slow-space-time, where you exist only with yourself, with those other humans that you are intimate with, and – my father would also say – with G-d. I tried to recreate this kind of in-betweenness (in between the inside and the outside, heaven and earth, body and mind) in the video series and photographs that I have been working on and that I presented in the TEDMED talk.

What kind of meaningful or surprising connections did you make at TEDMED?

I met a wonderful woman at TEDMED who runs a high-end rehabilitation center in Boca Raton, Dr. Lisa Corsa. Our chance encounter at the coat check turned into a half-hour consultation, wherein she reaffirmed our family’s sense of what intensive rehabilitation should look like. A body that has had every system affected as severely as my father’s needs hours of attention each day if there’s any intention for it to make functional progress. A body that doesn’t move hardens; it stiffens and withers away.

We have a wonderful circle of volunteers who give so much of themselves, but it’s not enough. Dr. Corsa helped me get a sense of how far we have to go to advocate and fundraise for my father to receive the minimum amount of proper care and attention. He’s currently living in an institution with limited human resources, and as a result we are only able to provide limited access to physiotherapists each week. She affirmed my resolve to fight for my father’s right to basic daily movement and to seek the funds for intensive physiotherapy, so that he can eventually move back home.

Please share anything else you wish you could have included in your talk.

Since my father’s stroke, I have become involved in a global community of people who have experienced brain stem strokes, either personally or on the part of a loved one. They are either still fully locked-in, or have since made great progress, including some partial to full recoveries. We share and compare our experiences online.

So many of those who have experienced being locked-in were written off too early. Their families were told to expect very little. As a result, they did not receive proper rehabilitation therapies, nor were their bodies moved on a daily basis to maintain a minimum quality of comfort and life. I’ve seen health care professionals refuse to address the locked-in patient directly, speaking about him or her in the third person, insensitive to the fact that the person is still completely conscious and able to communicate. We struggle every day to sensitize health care professionals and institutions.

Healing is taxing. But what is even more taxing is trying to heal in systems and institutions that drain the already low reserves of patients and their support systems. My father was able to have the spiritual experience that he had because he had a family and a congregation that preserved him in his role as father, husband and rabbi and advocated for him when he wasn’t able to.

How sleep deep cleans your brain

Jeffrey Iliff at TEDMED 2014. Photo: TEDMED/Sandy Huffaker

Jeffrey Iliff at TEDMED 2014. Photo: TEDMED/Sandy Huffaker

 

In his TEDMED 2014 talk, neuroscientist Jeffrey Iliff illuminated a newly discovered, critical function of the brain during sleep: a natural cleansing system that keeps toxic proteins at bay.  We spoke to him via email about his talk.

What motivated you to speak at TEDMED?

TEDMED offered the unique opportunity to tell the story of our research – not just its facts, but also its story. As a neuroscientist, I go to the lab every day expecting to see something new within the brain, its pieces, processes, and the systems that comprise it that no one has ever seen before. What we find within the brain – its simplicity, minimalism, functionality, and its beauty – are a continuous source of wonder to me. In the methods, results, and careful interpretation of our findings, this wonder can easily be distilled. When the outside world looks in at our work, they may only see cells, blood, water, and so many solutes; not the beauty I see through the eyepieces of a microscope. TEDMED gave me the chance to tell the story of our work as we experience it, as the story that it is.

Why does this talk matter now? What impact do you hope the talk will have?

First, I think that it is a subject to which every person can relate. Each of us who is in school, works long hours at a job, or has kids to keep them up when they’re sick, deals with the inescapable fact that sleep is necessary for our brains to work correctly. Learning that parts of the way our brains work can make intuitive sense is comforting, and makes our brains seem a little less like these strange alien machines that no one can really understand.

I think that the research itself is timely, as well. An increasing number of clinical studies have begun to link such seemingly disparate processes as sleep, neurodegenerative disease, cardiovascular disease, brain injury and others. The science that we describe, and that is the subject of my talk, is fundamental to the basic function of the brain and may help to explain many of these puzzling associations. My hope is that my TEDMED talk will spur people’s imaginations and encourage them to dive headfirst into these questions and, in doing so, drive the field forward far beyond these small contributions that we’ve made.

What kind of meaningful or surprising connections did you make at TEDMED?

During the conference, I was approached by several people who were attending TEDMED for their own professional reasons, but who had also dealt – either personally or within their immediate families – with conditions that are likely impacted by the biology that we are studying. For those of us who are scientists, but not physicians, it is incredibly easy to view our work academically, to equate progress with papers and grants, and to view treatments as ideas and hypotheses to be tested. To an extent, this is completely appropriate. But, I was reminded that, when I talk about “Alzheimer’s patients” in a scientific talk, those words stand for millions of mothers and fathers, grandfathers and grandmothers who live with this disease every day – each loved and missed as they slip slowly away. In the face of this reality, the thin replies of “We don’t know yet,” “Here’s what we think is happening,” or “Here’s something we’re testing in our mice” seem hollow and inadequate. It was a stark reminder to focus not only on what, but also whom we are trying to cure with all of this amazing science.

A chorus of support for those struggling with mental illness

Entrepreneur Jen Hyatt, founder and CEO of Big White Wall, an online mental health support and treatment platform, talked to the TEDMED 2014 audience about how social networks can provide healing help to those who feel isolated in their struggles with mental illness. We spoke with her via email about her talk.

What motivated you to speak at TEDMED?

TEDMED’s global reach presents an unparalleled opportunity to “converse with the world.” TEDMED’s ethos, the ability to share knowledge and offbeat thinking that creates surprising sparks between innovators and disruptors from across the globe, is very dear to my heart. Focusing on the people who are creating new, or even strange or unusual, speaks to the greatest challenges facing health care offers the opportunity for transforming moribund systems. Being part of that, sharing knowledge and ideas, was a real privilege. So my message, as part of that, is that the economic and human cost of poor mental health is tragic in proportion, yet has a digital and human sized solution.

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Jen Hyatt at TEDMED 2014 Photo: TEDMED/Sandy Huffaker

Why does this talk matter now? What impact do you hope the talk will have?

Conventional methods of addressing poor mental health cannot meet the volume of need. We see this crisis in provision – lack of treatment, barriers to access, high costs and the pain caused by a lack of support for mental health – across the whole world. In my TEDMED talk, I showed that the human need for connection and community is thousands of years old. Yet it’s only now, with the growth of digital technology and online social networks, that we have the potential to truly transform mental health care with the support of online communities and a broad choice of support and recovery tools, so no one has to struggle alone. We need to shift the healthcare journey from one where people are passive and isolated to one where they are active and supported.

What is the legacy you want to leave?

An emotionally literate world, in which there is no more mental health stigma, and no one left struggling without help. Every human being should have one-click access to support and recovery tools for improving how they are feeling, and I hope that will be Big White Wall (BWW)’s legacy, and mine. A world in which your emotion is known without needing to speak it provides support that is integral to our lives.

Please share anything else you wish you could have included in your talk.

I wish I could have shared the vibrant images that our community members use to show their journeys from darkness to light, from struggle to recovery, and all the moments in between. Big White Wall centers on a shared, anonymous digital social space, supported 24/7 by professional staff. This center draws much of its strength from the power of peers – not trained professionals, but people just like you and me. Not necessarily the people who see themselves as leaders or helpers, but the struggling, the lost, the unhappy and the confused. I wish I could have showed a bit of their struggle, their strength and the amazing support they offer.

Watch Jen Hyatt’s TEDMED 2014 talk here.

A medical school in Cuba trains doctors to serve the world’s neediest

American journalist and Havana resident Gail Reed spoke at TEDMED 2014 about a Cuban medical school that trains doctors from low-income countries who pledge to serve communities like their own all over the world. She talked with TEDMED about the Latin American Medical School and its contributions to global health.

Why does this talk matter now? What impact do you hope it will have?

Ridden by Ebola today, other emerging infections tomorrow, and always by chronic diseases—our world needs strong health systems, staffed by well-trained and dedicated people. And their education must be the result of enlightened decisions from policymakers who put health first, learning from the likes of the Latin American Medical School to make these new health professionals the rule, not the exception. Now is the time for medical educators to make the changes needed to give us the kind of physicians we need. And to bring the profession into the movement for universal health care, bringing doctors to the forefront with other health workers. To walk the walk.

Gail Reed at TEDMED 2014

Gail Reed at TEDMED 2014 Photo: TEDMED/Sandy Huffaker

I hope that people seeing the talk will be inspired to act to support the Latin American Medical School graduates through our organization, MEDICC. I hope policymakers will take the School’s courageous experiment to heart, and then take another look at their budgets and find more for health and medical school scholarships; and that governments will find a way to employ these new doctors in the public health sector, in places where they are most needed. I hope the graduates will never ever wonder about their importance to global health, for they and others like them are vital to turning around our global health crisis, in which one billion people still have no health care—millions, even, in the USA. And finally, I hope we will recognize Cuba’s contribution to global health, including the nearly 500 nurses and doctors on the front lines against Ebola in West Africa, as an example of what is possible and as a challenge to others to do more. Today, Cuba has over 50,000 health professionals serving in 66 countries, 65% of them women. Since 1963, 77,000 of them have given their services—and some their lives—in Africa.

What motivated you to speak at TEDMED?

As a journalist in Cuba, I realized I was witnessing an extraordinary experiment in health solidarity with the world’s poorest people: The thousands of scholarships offered by Havana’s Latin American Medical School to students from low-income families in 123 countries, who pledge to serve in communities poor like their own. I was struck by the fact that a country, an institution, believed these young people could themselves be the answer to the call for doctors where there were none. And I was astounded, too, that this audacious experiment has remained essentially an untold story. Audacity is right at home on TEDMED’s stage, so it seemed the perfect opportunity. I also thought the TEDMED audience would ‘get it,’ the urgency and responsibility we all have to support these new doctors, who represent the potential of imagination when commitment drives it into bold action.

What is the legacy you want to leave?

The talk’s legacy is in the hands of thousands of young doctors continuing to graduate from the School in Havana, who are bringing health care to some of the world’s most vulnerable people. Their school and their example should remind us that this is one world, with one fate and one humanity, and that the odds are there to beat: Health for all is possible.  

Want to learn more about Gail and her efforts? Visit her speaker page on TEDMED.com.

TMIcon

From the Internet of Things to the Internet of the Body

As Managing Director of Healthcare at GE Ventures, Leslie Bottorff invests in healthcare industry startup companies—with a preference for medical technologies and emerging business models. Her 15 years of venture capital investing experience includes her roles as managing director at ONSET Ventures, and investments and board seats at Sadra Medical, which was sold to Boston Scientific; Spinal Concepts, which was sold to Abbott Labs; Neuronetics; Relievant; and VisionCare Ophthalmic.

Earlier in her career, Bottorff spent 19 years in operating roles at large andventure- backed companies including Medtronic’s CardioRhythm division, Embolic Protection (acquired by Boston Scientific), Nellcor (now Covidien), Ventritex (now St. Jude), Menlo Care (acquired by J & J), and GE Healthcare. She has also served on advisory boards or as guest faculty at several universities including Purdue, Stanford, and UC Berkeley.

TEDMED: What’s the most remarkable innovation you are seeing in health tech or medicine, and what is driving it?

Bottorff: We’re seeing tremendous innovation in personal monitoring and in therapies for a wide variety of diseases. Combining therapies, diagnostics and digital communications is creating a more effective systems approach to patient care management. This means helping patients who are in the hospital or coming out of the hospital, living at home with chronic diseases as well as helping people who are not ill, but taking steps towards preventative care.

This is analogous to the emergence of the Industrial Internet, which GE is a major proponent of. This convergence of personal monitoring technology and advanced wireless communication is a pretty big opportunity for what I’ll call, the “Internet of the Body”. This convergence is going to be the driving force behind the advances we are seeing today.

In addition to personal monitoring, another area of remarkable innovation is noninvasive technologies to treat and diagnose conditions related to the nervous system. We’ll be able to take advantage of some of the electronics and connectivity that is now available. As one example, GE has a brain initiative being led by our Healthymagination unit.

TEDMED: What’s the most important factor for entrepreneurial success inhealth tech—and is that different from your own key to success?

Bottorff: It’s important for entrepreneurs to embrace innovation throughcollaboration and not think they have to be experts in everything to bring the many pieces of the puzzle together themselves. This is a multi-functional area. You have to recruit a strong multidisciplinary team and maintain focus. This industry is being re-invented as we speak; nobody’s got the formula. So it’s important to maintain focus and persevere to understand the needs of your target customer. Those factors are very synergistic to GE’s. We also need to stay focused, and we also need to innovate, which is why we stay close to the new thinkers and innovators. In a young and small company, you can be agile and you succeed or fail in much faster cycles than a large company. At GE, we think the best way to focus on what’s next and what’s coming is to partner with entrepreneurs and startups. We aim to help accelerate their growth and help them commercialize their ideas to really move the needle. At the same time, they may have the problem that they’re not able to scale, get big, or get reach. That’s the kind of thing we can help them with and one of the many reasons why we feel like it’s so important for us to collaborate.

TEDMED: For entrepreneurs with needle-moving ideas in global health, what are the keys to finding collaborators and supporters across specialties, industries, and geographies?

Bottorff: We’re an infrastructure company that has global reach and global distribution. We see ourselves partnering with all sorts of external partners, including startup companies with great ideas for products and business entities in many of the countries we’re based in. Having operations in 170 countries, we can take the innovations that are going to be most appropriate to the right markets and geographies and help an entrepreneur do that parsing—to ask if their product is a fit for the infrastructure of a given market. So we can say to entrepreneurs, “Let’s talk about how we can help you most, because you don’t have the scale to get all markets .”

TEDMED: In 2020, you’re asked to give a TEDMED talk about the biggest transformation you helped bring about in your field. What is it?

Bottorff: GE would love to play an important leadership role in coordinating what will be an end-to-end system that delivers on the promise, and not just the hype of  “Digital Health”.

A lot of people have grand visions of how Digital Health is going to transform and improve healthcare, and that is exciting. But, getting from point A (where we are  now) to point B (the ideal future vision) is trickier than coming up with a grand vision. It’s going to require a lot of cooperation with a lot of parties and GE intends  to be right in the middle of it to help make it happen. The transformation between now and 2020 or 2030 will be remarkable.

The Hive 2014: The Next 10 Startups

As promised, today we’re announcing 10 more breakthrough startups that will join the TEDMED Hive 2014. This September 10-12 in Washington, DC and San Francisco, each will share their products and ideas for progress in health and medicine with our Delegates. Visit TEDMED.com for fascinating background info on these newly announced entrepreneurs, and to revisit the 10 startups announced last week.

Screen Shot 2014-06-12 at 3.55.54 PMScreen Shot 2014-06-12 at 3.56.09 PMScreen Shot 2014-06-12 at 3.56.22 PMToday, we’re also getting to know Hive Curator Sumbal Desai, Associate Chief Medical Officer for Strategy and Innovation at Stanford Hospital and Clinics, via our weekly Q&A blog series. She shares insights on how healthcare is reshaping itself to fit consumers’ digital expectations.

We’ll release more Hive startups next week.  Until then, follow the latest news @TEDMED.

Q2 Checkup: What Is Shaping Digital Health Innovation in 2014?

By Aman Bhandari

With 2014 halfway behind us, it’s time for a bi-annual look back at digital health innovation so far.  What have been our major influencers?

Six months is a very short time span in which to say anything is shaping a sector, but it’s also a good time frame for a snapshot. It wasn’t until I started thinking about what’s happened recently that I realized how dizzying the activity has been across the spectrum and potentially at scale. This is critical. In this year alone we are seeing some of the biggest players make bets and shifts, from the Office of the National Coordinator for Health Information Technology (ONC) to Apple, which means the digital health ecosystem will be impacted, and it could happen at scale.

-1First, look at the activity and record levels of venture funding in the digital health space; $700M in Q1 2014 alone, an 87% year over year increase according to Rock Health. This recent Harvard Business Review piece nicely summarizes why the time to be in digital health is now. There has (finally) been some chatter that we are approaching bubble territory in digital health, and while that may be true, there are at least three areas of optimism thanks to the infrastructure and ecosystem evolving at all levels: Continued Federal activity, Fortune 500/Wall Street involvement, and diversified venture funding.

1. Federal Government: Continued Data Liquidity Push
The federal activity from this year is across the board. Some highlights that will challenge entrepreneurs to develop a continued drive for enhanced data and information liquidity with an improved consumer experience over the long run include the following:

  • ONC releases 10 year interoperability vision
  • ONC re-organizes and creates an API committee. This wouldn’t have happened as recently as two years ago.
  • Medicare announces an historic data release of physician payment data revises other data related guidelines, potentially opening more access to commercial entities
  • FDA Open Data releases millions of files to entrepreneuers in a more accessible format
  • Healthcare.gov helps enroll millions of people

2. Digital Health at Scale: Fortune 500 Involvement

Following on CMS data transparency efforts, some of the largest health insurers, including Aetna, United Health and Humana, announced they will release payment data to consumers. And speaking of consumers, technology companies including Intel, Samsung, and Apple have entered in a big way, and it’s clear that wearables have gone mainstream. The Fortune 500 are paying attention and are also forming collaborations across silos, such as the Apple Epic and Mayo partnership, including:

  • Intel’s $100M+ acquisition of Basis
  • Samsung’s $50M digital health fund + S Health launch
  • The Apple Health Kit
  • Health insurance giants making payment data public

3. Startup Diversification & Investment: New Entrants

The third signal flare from 2014 to watch is the increased diversity of players including some who haven’t been as involved previously. This includes investments this year from venture funds Social+Capital and Andreessen Horowitz (a16z). Some of the new entrants are driving record amounts of funding and are bringing greater assets to bear.  Here are some highlights of startup activity:

  • Flatiron Health had one of the largest series B rounds in the digital health space ($130M)
  • Omada Health gets $28M series B lead by a16z
  • Better raises $5M from Social+Capital
  • Nant Health receives $100M from the Kuwait Investment Authority
  • 16 digital health acquisitions to date

Digital health innovation is still the wild West, admittedly, and there are many hurdles. What’s clear is that these three areas have backing from actors who can scale and bring on the best talent in the world. They’re creating a robust ecosystem that is shaping innovation in digital health. Across the board, there is a larger theme taking shape of capturing, aggregating and democratizing access to data, which is spurring entrepreneurial activity and the consumerization of health. In addition, novel cross-silo partnerships are forming. Collaboration across the health and tech sectors is no longer an option; it is a necessity if we are going to drive meaningful change in healthcare.

Which three things would you point to as harbingers for 2014?   TMIcon

 

Aman Bhandari has worked in corporate, non-profit and government organizations. He formerly worked for Todd Park, the US CTO, at the White House, where he helped to launch a variety of global and national health policy initiatives at the intersection of health IT, data, and innovation. He also co-launched the Health2.0 code-a-thon and developer challenge series. Follow him @GHideas.

 

TEDMED COO, Shirley Bergin, says over-50 crowd are real winners at AARP @50+ LivePitch

Finalists at the AARP Health Innovation @50+ LivePitch in Boston last week included a lab-quality DIY diagnostic kit and a smart phone that can tell when it’s user is getting a bad case of the wobbles.

Clearly, this is not your mother’s health technology, said TEDMED COO Shirley Bergin, who was one of the judges for the event.

““There really is something to the idea that today’s 50-year-old is yesterday’s 40. The way this group thinks about technology is sophisticated, from invisible sensors to wearable technology. They’re definitely ready to participate in a productive way,” she said.

Photo: Christopher Sherman/AARP

Photo: Christopher Sherman/AARP

The judges chose Lift Labs as their winner, which makes a spoon that automatically and unobtrusively prevents those with tremors from spilling food, an advance very much geared toward life quality.

The audience choice was Careticker, a web based program that helps caregivers track activities to earn incentives and to connect with other caregivers.

“Careticker is very focused on what I thought was a big theme; we’re living longer and taking care of those we love for longer periods of time,” Bergin said, adding that health tech innovation for this crowd seemed to center on needs-based items for an audience that was very much on the move.

“The psychographics of a 50-plus today is one of a very active individual, not somebody who’s thinking they’re on the last journey of life. They want to take advantage of all the world has to offer, and look for technology that facilitates an active lifestyle and promotes a good quality of life,” she says.

Shirley Bergin Photo: Christopher Sherman/AARP

Shirley Bergin Photo: Christopher Sherman/AARP

In a couple of weeks, TEDMED will begin releasing the names of startups joining its own innovation showcase, the TEDMED Hive.  After reviewing the hundreds of Hiva applicants, the AARP contestants and those at SXSW, at which she was also a tech innovation judge, Bergin says the market seems to be shifting to a more mature phase of implementation and commercial viability.

For example, while you’re still seeing startups focused on big data, it’s more focused about how that data is going to enable you to take care of yourself, manage a chronic disease or facilitate some improved state of being.  How is all of that data going to improve our health?

Entrepreneurs are also coming to terms with a venture capital pool that is finite, she says, and are delivering more sophisticated business model presentations; still mission-based, but with an eye as to how the work will scale commercially. One thing that might help:  joining forces.

“Startups are trying to approach solutions from different angles, so I hope there will be more awareness that other people are addressing the same problems. My hope is that those are going to be more collaborations as well as innovations,” Bergin said.

A startup health incentives app shows users the money

The human brain is a marvel, but it does a pretty lousy job of weighing long-term hazard avoidance versus immediate gratification. C’mon, if we were really thinking clearly about consequences, would anyone start smoking? Finish the entire bucket of Kentucky?

But what if someone gave you money to put down the cigarette?  Ah, that might change things.

Achievemint is betting on it. The startup app, part of a platform developed by Activity Exchange Inc., awards points for behaviors like a gym workout or nutritious food choice that can translate directly into merchandise or even cash. The platform has some 170,000 users. Achievemint gains by aggregating data anonymously for customers.

The company’s end target, though, is insurers, who stand to gain from improving preventive behaviors now that the Affordable Care Act put an end to pre-existing condition restrictions. In this scenario, users accrue discounts on their insurance premiums of up to 30 percent.

Mikki Nasch, Achievemint’s CEO, says most insurer wellness programs as yet have a poor track record of inspiring behavior change over the long run, with little research as to what actually motivates an audience and a general lack of truly targeted messaging. Instead, Achievemint aims to push age- and language-appropriate information relevant to a user, marketing health as a product one might actually like to buy.

Nasch dismisses gadgets and group competitions as interventions one might flirt with, but rarely marry.

“The whole notion of gamification and health undermines the intelligence of the consumer, to be frank. We don’t all rush to a reward portal every day to see how we’re doing against our five friends,” she says.

Money in one’s pocket is a different story.

“The way the ACA is written is very smart, because it incentives the payers to incentivize their populations. Regardless of what you want to do as a payer you’ve got to give those discounts intelligently, because if you discount the wrong 30 percent you’re going to lose your shorts,” Nasch says.

Patricia Meisner, co-founder and CEO of ActualMeds, also bemoans the difficulties of engaging patients.

“Today, there’s not a strong payment model or market model where consumers are used to paying for their own healthcare. They’ll buy their own running shoes but they won’t buy their own healthcare management tool,” she says.

Care managers, though, have all sorts of reasons to look for help, from avoiding risks to better outcomes and reduce costs. To those ends, ActualMeds is a web-based platform that helps them collect patient data and manage medications for those with chronic diseases. It provides medication reconciliation on demand at point of care and seamlessly combines medication information from the electronic health records, prescription claims, and structured patient interviews.

The company began life as NIH-funded research at the University of Connecticut, focusing on Medicare’s high-risk patients with seven or more medications to manage. Medicare’s way of helping ensure compliance involved matching patients with a random pharmacist for review, which brought in less than desirable results and low engagement rates.

“ActualMeds did not set out to disrupt that market model; we set out to change it entirely. You don’t need a clinical pharmacist to do all this. We can do a tool that aggregates the best possible medical history,” Meisner says.

ActualMeds also aims to provide a virtual safety net of reminders for areas that often escape attention, like over-the-counter meds.

“Acid inhibitors are powerful pharmacologic agents, as are antihistamines. And I want to go on records as saying statins will be next. People self medicate with these like crazy. Older patients will take things to help them sleep and they end up falling down. That’s the stuff no other claims database is going to give insight into,” Meisner says.

ActualMeds was part of the New York Digital Health Accelerator program (run by the New York eHealth Collaborative, another TEDMED 2013 Hive company), and recently won the 2014 Venture+Forum contest at the annual HIMSS conference. They’re currently working on a number of pilots on various facets of the platform, including testing its structured interviews for home visits and primary care, with results checked by case managers or clinical pharmacists.

Catalyst is an ongoing series about health innovation, focusing on companies from the TEDMED Hive.  For more information and to apply for the Hive 2014, click here.

Great American health startups, not from garages

Sure, a lot of great ideas came out of American garages, but with enough imagination, moxie and determination, they can be teased out of virtually every setting.

Take these products and projects from the TEDMED 2013 Hive companies, for example.

iMPaK Health makes an ultra low-energy Bluetooth enabled device, about the size of a credit card, supporting products that monitor medication adherence, pulmonary function, activity and sleep. Functions run the gamut from simple to complex – recording symptoms, measuring pulmonary function or analyzing a drop of blood. The company is an offshoot of Meridian Health, a not-for-profit hospital system based on New Jersey, which started developing the products after pondering how to help patients monitor their own conditions in ways that meshed with the workflow of the Meridian health system.

“We realized that the companies that were out there didn’t understand health care that well. They had no real idea of what health systems were looking for in terms of costs, return on investment, and ability to scale easily. They didn’t understand that patients don’t want to feel sick. A lot of the devices made to be placed in the home were modified hospital versions of existing technology,” says Meridian Health Director of Consumer Technology and Service Development, Sandra Elliott.

Screen Shot 2014-03-21 at 7.48.59 AMInstead, iMPak aims to increase patient engagement over time and to aid in prevention when possible with inexpensive, easy to use tools.

“How do we get people to own their health now, and at the same time take those patients who are at the ‘Oh, Crap’ moment in the hospitals, and put them back on a different track when they’re in the community? It’s not just about the tools and what the information is telling us; it’s about helping people change their behavior,” Elliott says.

Tiffany Wilson Karp, Executive Director of the non-profit Global Center for Medical Innovation (GCMI), works to help medical device innovations coming out of academic centers in the Southeast ramp up to market. Health devices are a tough field for a startup, not only with normal new business pressures but also with the mandates of prototypes and clearing FDA approvals.  A device can’t raise money until its proven clinically and commercially viable, and that can’t be proven until it’s manufactured in a cleanroom, an area designed to reduce environmental pollutants.

Project partners Georgia Tech, Piedmont Hospital, the Georgia Research Alliance and St. Joseph’s Translational Research Facility collaborated to open GCMI in 2012. It’s based in a 12,000-square-foot facility near Georgia Tech. The idea is to help innovators, from the Southeast at least initially, navigate what Karp calls the “little pockets and ecosystems” of the medical device commercialization process, and to gather the intelligence needed to see the process through.

“It takes a village to get something from a concept to the patient. It’s an intersection of science, engineering, business and law. Everybody speaks a different language, yet need to carefully coordinate to get something to market that’s safe,” Karp says.

The fine print is seen to by a network of intellectual property, regulatory and quality systems advisors, and the bottom line by investors already flocking to the center.

While products are of necessity hush-hush, Karp says results include supporting one company from going to a team of two to their FDA clearance and CE approval in about 18 months, a process that can take years.

“The medical device industry is hard, messy and expensive. The underlying reason that drives innovation is the patient. You ask anybody in this industry why they do it, and they say, ‘Every day when you go to work you’re working on something that’s going to affect somebody’s life and quality of care,” she says.