Amazon Alexa is luring health developers, but it will be a while before we use it to call a doctor

If you want to schedule a doctor’s appointment or check on the status of a medication without picking up the phone, Amazon Alexa can help. As of this week, the voice assistant is HIPAA compliant, which means Amazon can work with hospitals and other health providers that manage protective health data to share personal information on an Echo. Currently, Amazon is working with applications on an invite-only basis, and none of the initial six developers link patients with doctors. “It’s tricky,” sai


If you want to schedule a doctor’s appointment or check on the status of a medication without picking up the phone, Amazon Alexa can help. As of this week, the voice assistant is HIPAA compliant, which means Amazon can work with hospitals and other health providers that manage protective health data to share personal information on an Echo. Currently, Amazon is working with applications on an invite-only basis, and none of the initial six developers link patients with doctors. “It’s tricky,” sai
Amazon Alexa is luring health developers, but it will be a while before we use it to call a doctor Cached Page below :
Company: cnbc, Activity: cnbc, Date: 2019-04-14  Authors: christina farr, luke macgregor, bloomberg, getty images
Keywords: news, cnbc, companies, theres, health, wrong, amazon, developers, information, consults, working, luring, alexa, medical, doctor, week


Amazon Alexa is luring health developers, but it will be a while before we use it to call a doctor

If you want to schedule a doctor’s appointment or check on the status of a medication without picking up the phone, Amazon Alexa can help.

As of this week, the voice assistant is HIPAA compliant, which means Amazon can work with hospitals and other health providers that manage protective health data to share personal information on an Echo.

But what users can’t do yet is connect with a doctor or a therapist through the device, and it might be a few years before they can. Currently, Amazon is working with applications on an invite-only basis, and none of the initial six developers link patients with doctors.

Developers focused on digital health have concerns about using home speakers like the Echo and Google Home for medical consults because privacy issues continue to emerge and there’s too much risk in sensitive health information falling into the wrong hands. Earlier this week, Bloomberg reported that thousands of employees listen in to snippets of conversations on Alexa to supposedly improve the product experience.

“It’s tricky,” said Robbie Cape, CEO of 98point6, a Seattle-based company that provides virtual medical consults via smartphones and the web. “To uphold user trust, I can imagine that Amazon Alexa would need to confirm they’re talking to the right person, but also that there’s no one else in the room listening to the conversation.”


Company: cnbc, Activity: cnbc, Date: 2019-04-14  Authors: christina farr, luke macgregor, bloomberg, getty images
Keywords: news, cnbc, companies, theres, health, wrong, amazon, developers, information, consults, working, luring, alexa, medical, doctor, week


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‘Alexa, find me a doctor’: Amazon Alexa adds new medical skills

Amazon’s voice assistant can now manage people’s sensitive health information, which represents an important step for the company into the $3.5 trillion health care sector. As of Thursday, consumers will be able to use about half a dozen new Alexa health skills to ask questions such as “Alexa, pull up my blood glucose readings” or “Alexa, find me a doctor,” and receive a prompt response from the voice assistant. Amazon is able to add these skills because Amazon can now sign business associate ag


Amazon’s voice assistant can now manage people’s sensitive health information, which represents an important step for the company into the $3.5 trillion health care sector. As of Thursday, consumers will be able to use about half a dozen new Alexa health skills to ask questions such as “Alexa, pull up my blood glucose readings” or “Alexa, find me a doctor,” and receive a prompt response from the voice assistant. Amazon is able to add these skills because Amazon can now sign business associate ag
‘Alexa, find me a doctor’: Amazon Alexa adds new medical skills Cached Page below :
Company: cnbc, Activity: cnbc, Date: 2019-04-03  Authors: christina farr, todd haselton, daniel berman, bloomberg, getty images
Keywords: news, cnbc, companies, voice, amazon, alexa, skills, medical, jiang, care, adds, health, information, hipaa, team, manage, doctor


'Alexa, find me a doctor': Amazon Alexa adds new medical skills

Amazon’s voice assistant can now manage people’s sensitive health information, which represents an important step for the company into the $3.5 trillion health care sector.

As of Thursday, consumers will be able to use about half a dozen new Alexa health skills to ask questions such as “Alexa, pull up my blood glucose readings” or “Alexa, find me a doctor,” and receive a prompt response from the voice assistant.

Amazon is able to add these skills because Amazon can now sign business associate agreements with health providers under HIPAA, which means third-party health developers who follow certain guidelines can meet the rules and requirements that govern how sensitive health information is transmitted and received. HIPAA, or the Health Insurance Portability and Accountability Act, is designed to protect patients in cases where their personal health information is shared with a health care organization, like a hospital.

Voice technology has been heralded as a major breakthrough for the health field, particularly for seniors, kids and those with mobility problems. As a result, Amazon, and its rival Alphabet, have been increasingly focused on the needs of these populations, who view voice assistant devices as an important way to manage their medications, communicate with loved ones, and alert emergency services.

Amazon Alexa’s health and wellness team has been working for months on HIPAA compliance, and its team includes Missy Krasner, who previously ran Box’s health care efforts, and Rachel Jiang, who previously worked at Microsoft and Facebook. Jiang announced via the Alexa developer blog that six health partners have been selected for the invitation-only program, and it expects to grow that number in the coming months.

“These new skills are designed to help customers manage a variety of healthcare needs at home simply using voice – whether it’s booking a medical appointment, accessing hospital post-discharge instructions, checking on the status of a prescription delivery, and more,” Jiang wrote in the post.


Company: cnbc, Activity: cnbc, Date: 2019-04-03  Authors: christina farr, todd haselton, daniel berman, bloomberg, getty images
Keywords: news, cnbc, companies, voice, amazon, alexa, skills, medical, jiang, care, adds, health, information, hipaa, team, manage, doctor


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Time is running out to switch or ditch your Medicare Advantage Plan

For starters, because you only get one shot at this, make sure you know what you’re signing up for if you choose another plan. “When you call your doctor, ask specifically if they are in network for your particular plan,” she said. This often was included in your Advantage Plan, and life-long penalties can be applied if you go more than 63 days without coverage. Additionally, if you’re planning to get a supplemental Medicare plan — called Medigap — to pair with original Medicare, be aware of add


For starters, because you only get one shot at this, make sure you know what you’re signing up for if you choose another plan. “When you call your doctor, ask specifically if they are in network for your particular plan,” she said. This often was included in your Advantage Plan, and life-long penalties can be applied if you go more than 63 days without coverage. Additionally, if you’re planning to get a supplemental Medicare plan — called Medigap — to pair with original Medicare, be aware of add
Time is running out to switch or ditch your Medicare Advantage Plan Cached Page below :
Company: cnbc, Activity: cnbc, Date: 2019-03-14  Authors: sarah obrien, photo hero images via getty images, cnbc, jaden urbi, -danielle roberts, co-founder of boomer benefits
Keywords: news, cnbc, companies, coverage, original, medicare, medigap, doctor, ditch, planning, switch, advantage, running, youre, plan, insurance


Time is running out to switch or ditch your Medicare Advantage Plan

For starters, because you only get one shot at this, make sure you know what you’re signing up for if you choose another plan. That includes ensuring that your medications are covered and that your favorite doctors or other providers are in-network.

Roberts said that even if you see your doctor listed on a plan’s online directory, you should confirm that status directly with their office because those listings can be outdated or contain errors.

“When you call your doctor, ask specifically if they are in network for your particular plan,” she said. “Don’t just say the name of the insurance company.”

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If you’re planning to drop your Advantage Plan in favor of original Medicare — which consists of Part A hospital coverage and Part B outpatient coverage — you also likely need to get a standalone Part D prescription drug plan. This often was included in your Advantage Plan, and life-long penalties can be applied if you go more than 63 days without coverage.

Additionally, if you’re planning to get a supplemental Medicare plan — called Medigap — to pair with original Medicare, be aware of additional rules for applying. These policies help cover costs such as deductibles, co-pays and co-insurance.

When you first enroll in Medicare (typically at age 65), you get six months when you’re guaranteed Medigap coverage. That is, you can get a policy without the insurance company nosing through your health history and deciding whether to insure you.


Company: cnbc, Activity: cnbc, Date: 2019-03-14  Authors: sarah obrien, photo hero images via getty images, cnbc, jaden urbi, -danielle roberts, co-founder of boomer benefits
Keywords: news, cnbc, companies, coverage, original, medicare, medigap, doctor, ditch, planning, switch, advantage, running, youre, plan, insurance


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Advisors take extra steps to protect elder clients from fraud or abuse

Matt Cooney, a 79-year-old retired television sportscaster, was informed that his financial decision-making capacity was in jeopardy. Dobe Cooney admitted that her husband had lost track of their bills a few times lately. McClanahan, a certified financial planner and a medical doctor, is the founder of Life Planning Partners in Jacksonville, Florida. At her recommendation, Matt went to his own physician with the findings. “Advisors tend to be very close to their [clients],” said Jim Wrona, vice


Matt Cooney, a 79-year-old retired television sportscaster, was informed that his financial decision-making capacity was in jeopardy. Dobe Cooney admitted that her husband had lost track of their bills a few times lately. McClanahan, a certified financial planner and a medical doctor, is the founder of Life Planning Partners in Jacksonville, Florida. At her recommendation, Matt went to his own physician with the findings. “Advisors tend to be very close to their [clients],” said Jim Wrona, vice
Advisors take extra steps to protect elder clients from fraud or abuse Cached Page below :
Company: cnbc, Activity: cnbc, Date: 2019-02-24  Authors: annie nova, source, carolyn mcclanahan, chris heye, gary vawter, -dobe cooney
Keywords: news, cnbc, companies, doctor, dobe, yearsmatt, protect, abuse, elder, steps, matt, cooney, wrona, went, extra, financial, industry, advisors, clients, fraud


Advisors take extra steps to protect elder clients from fraud or abuse

The Cooneys walked into the office to hear their test results.

Matt Cooney, a 79-year-old retired television sportscaster, was informed that his financial decision-making capacity was in jeopardy. Dobe Cooney admitted that her husband had lost track of their bills a few times lately.

“We don’t leave the teeth in the refrigerator or anything like that,” said the 75-year-old former nurse. “But as we get older, we seem to forget a lot.”

The exam had not been administered by their doctor but by their financial advisor, Carolyn McClanahan.

McClanahan, a certified financial planner and a medical doctor, is the founder of Life Planning Partners in Jacksonville, Florida. At her recommendation, Matt went to his own physician with the findings.

As it turned out, Matt indeed, had had a few silent strokes over the years.

Matt and Dobe Cooney

Such discoveries are coming to the surface in the offices of financial advisors across the country, as it becomes increasingly common for financial professionals to probe clients for signs that they are at risk of making poor decisions or turning into victims of fraud or abuse.

“Advisors tend to be very close to their [clients],” said Jim Wrona, vice president and associate general counsel at the Financial Industry Regulatory Authority, a self-funded regulator of the brokerage industry. “They’re in a fairly good position to know when something is out of the ordinary.”


Company: cnbc, Activity: cnbc, Date: 2019-02-24  Authors: annie nova, source, carolyn mcclanahan, chris heye, gary vawter, -dobe cooney
Keywords: news, cnbc, companies, doctor, dobe, yearsmatt, protect, abuse, elder, steps, matt, cooney, wrona, went, extra, financial, industry, advisors, clients, fraud


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By 2025, a lot more people will be tracking their blood sugar, predicts doctor — here’s why

Let’s start with a prediction: By 2025, everyone with diabetes will be tracking their blood sugar with devices called continuous glucose monitors, and it will be common for many people without diabetes to dabble in tracking, too. People with diabetes now have alternatives to pricking their fingers with a sharp needle to measure their blood glucose level multiple times per day. Anybody who has ever done a fingerstick blood glucose knows that it hurts. Accordingly, continuous glucose monitoring (C


Let’s start with a prediction: By 2025, everyone with diabetes will be tracking their blood sugar with devices called continuous glucose monitors, and it will be common for many people without diabetes to dabble in tracking, too. People with diabetes now have alternatives to pricking their fingers with a sharp needle to measure their blood glucose level multiple times per day. Anybody who has ever done a fingerstick blood glucose knows that it hurts. Accordingly, continuous glucose monitoring (C
By 2025, a lot more people will be tracking their blood sugar, predicts doctor — here’s why Cached Page below :
Company: cnbc, Activity: cnbc, Date: 2019-01-31  Authors: aaron neinstein, bsip, uig, getty images, cnbc, adam isaak
Keywords: news, cnbc, companies, heres, million, doctor, cgm, device, tracking, glucose, lot, devices, continuous, 2025, sugar, diabetes, type, fingerstick, blood, predicts


By 2025, a lot more people will be tracking their blood sugar, predicts doctor — here's why

Aaron Neinstein, MD, is Assistant Professor of Medicine at the University of California, San Francisco, and Director of Clinical Informatics at the UCSF Center for Digital Health Innovation. He’s also a practicing endocrinologist.

Let’s start with a prediction: By 2025, everyone with diabetes will be tracking their blood sugar with devices called continuous glucose monitors, and it will be common for many people without diabetes to dabble in tracking, too.

This may sound like a bold statement coming from an endocrinologist (we’re the specialists who manage diabetes), but hear me out. In my practice, I primarily treat people with diabetes, and over the years, technology to help manage the disease has made remarkable strides.

People with diabetes now have alternatives to pricking their fingers with a sharp needle to measure their blood glucose level multiple times per day. Early continuous glucose monitoring systems — the first was released in 1999 by the medical device maker Medtronic — while helpful in some cases, were not widely used because they were painful to insert, bulky, inaccurate, very expensive and still required many calibrations every day with fingersticks.

The technology has improved dramatically. Two of the newest devices, the Dexcom G6 and Abbott Freestyle Libre , no longer require fingerstick calibrations, are FDA-approved for people to make insulin-dosing decisions, and are much easier to insert.

Anybody who has ever done a fingerstick blood glucose knows that it hurts. Inserting a device instead is much less painful than a fingerstick, and the needlestick happens much less frequently. Both devices transmit glucose levels to a smartphone, either wirelessly and continuously, or with a wave of a smartphone over the sensor. Accordingly, continuous glucose monitoring (CGM) use has increased in Americans with type 1 diabetes, from 6 percent in 2011 to 38 percent in 2018. I expect these technologies to continue to get even better — they will get smaller, more accurate, and even smarter as better algorithms are developed and collaborations from between the device companies and tech companies like Alphabet or Apple.

This is a positive trend. For the approximately 1.5 million Americans with type 1 diabetes, CGM has moved far beyond novelty and should represent standard of care.

But, I believe CGM has much larger potential. That includes people with type 2 diabetes (approximately 30 million American adults), the even larger group with pre-diabetes (approximately 81 million American adults), and potentially almost anybody.


Company: cnbc, Activity: cnbc, Date: 2019-01-31  Authors: aaron neinstein, bsip, uig, getty images, cnbc, adam isaak
Keywords: news, cnbc, companies, heres, million, doctor, cgm, device, tracking, glucose, lot, devices, continuous, 2025, sugar, diabetes, type, fingerstick, blood, predicts


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Dr. David Chao is the NFL’s armchair injury doctor

Enter Dr. David Chao, aka @ProFootballDoc, a former team doctor for the San Diego Chargers. Just the past weekend, when Kansas City quarterback Patrick Mahomes appeared to suffer a knee injury, Dr. Chao tweeted he wasn’t concerned about the knee within minutes. Dr. Chao said his accuracy is over 90 percent. This is not a substitute for a hands-on exam or imaging studies,” Dr. Chao. As legalized sports gambling grows across the country state by state, look for more doctors like Dr. Chao to pop up


Enter Dr. David Chao, aka @ProFootballDoc, a former team doctor for the San Diego Chargers. Just the past weekend, when Kansas City quarterback Patrick Mahomes appeared to suffer a knee injury, Dr. Chao tweeted he wasn’t concerned about the knee within minutes. Dr. Chao said his accuracy is over 90 percent. This is not a substitute for a hands-on exam or imaging studies,” Dr. Chao. As legalized sports gambling grows across the country state by state, look for more doctors like Dr. Chao to pop up
Dr. David Chao is the NFL’s armchair injury doctor Cached Page below :
Company: cnbc, Activity: cnbc, Date: 2019-01-15  Authors: jessica golden, eric chemi
Keywords: news, cnbc, companies, david, injury, gamblers, knee, doctor, chao, state, think, medical, edge, video, nfls, armchair, dr


Dr. David Chao is the NFL's armchair injury doctor

Sports bettors have always looked for any edge they can find. As sports gambling gains legalization across the country, the next frontier for finding that edge is real-time medical information.

Enter Dr. David Chao, aka @ProFootballDoc, a former team doctor for the San Diego Chargers. Dr. Chao is now a force on Twitter, podcasts, newspapers and radio shows, quickly using game video to let audiences know his opinion of an injury’s severity.

“If you think about it, it makes sense,” said Chao about what he does. He compares himself to former referees who are now part of live game broadcasts. “You have all the Mike Pereiras of the world, the former officials deciphering what is or isn’t a touchdown or a what is a holding call. I am just doing a similar thing in the medical venue. I call it the medical Mike Pereira.”

Just the past weekend, when Kansas City quarterback Patrick Mahomes appeared to suffer a knee injury, Dr. Chao tweeted he wasn’t concerned about the knee within minutes.

The knee turned out to be fine and the Chiefs went on to beat the Colts without much of a challenge. Dr. Chao said his accuracy is over 90 percent. He’s also careful to note that what he does is very different from real medical analysis.

“This is not diagnosis. This is not a substitute for a hands-on exam or imaging studies,” Dr. Chao. “This is video impressions. This is no different than Tony Romo or any experienced QB in the NFL saying it’s going to go to the tight end based on the coverage. It’s just insider knowledge, not insider information.”

These insights are hard currency for gamblers who know how dramatically a game’s path can change based on one injury. There’s money to be made, even though it’s not life changing. “My main monetization is my practice still as an orthopedic surgeon,” Chao said. “This is a fun hobby that thankfully is becoming monetized. It was never the original goal to do this to make a living. There is monetization coming and I think it may grow with the legalization of gambling.”

The NFL league office did not respond to a CNBC inquiry for its opinion on this trend.

As legalized sports gambling grows across the country state by state, look for more doctors like Dr. Chao to pop up and offer their own instant injury opinions. Many top notch professional gamblers however will want to pay those doctors keep those opinions off the internet, so that the gamblers can maintain that extra edge.


Company: cnbc, Activity: cnbc, Date: 2019-01-15  Authors: jessica golden, eric chemi
Keywords: news, cnbc, companies, david, injury, gamblers, knee, doctor, chao, state, think, medical, edge, video, nfls, armchair, dr


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New year, new you: Fitness trends for 2019

New Year, New You: Fitness trends for 2019 3:32 PM ET Wed, 2 Jan 2019 | 26:23Wellness, fitness, nutrition – all of it is getting a makeover in this age of mobile tech. Now you can book doctor appointments on an app, get your blood drawn and the results back in 20 minutes. You can give your doctor access to your genetic code and get truly personalized service. To kick off the year, Jon Fortt sits down with CNBC reporters Chrissy Farr and Diana Olick. It’s the artist formerly known as Weight Watch


New Year, New You: Fitness trends for 2019 3:32 PM ET Wed, 2 Jan 2019 | 26:23Wellness, fitness, nutrition – all of it is getting a makeover in this age of mobile tech. Now you can book doctor appointments on an app, get your blood drawn and the results back in 20 minutes. You can give your doctor access to your genetic code and get truly personalized service. To kick off the year, Jon Fortt sits down with CNBC reporters Chrissy Farr and Diana Olick. It’s the artist formerly known as Weight Watch
New year, new you: Fitness trends for 2019 Cached Page below :
Company: cnbc, Activity: cnbc, Date: 2019-01-07  Authors: jonathan kim, jon fortt
Keywords: news, cnbc, companies, trends, 2019, watchers, ww, doctor, truly, fitness, whats, weight, youbut


New year, new you: Fitness trends for 2019

New Year, New You: Fitness trends for 2019 3:32 PM ET Wed, 2 Jan 2019 | 26:23

Wellness, fitness, nutrition – all of it is getting a makeover in this age of mobile tech.

Now you can book doctor appointments on an app, get your blood drawn and the results back in 20 minutes. You can give your doctor access to your genetic code and get truly personalized service.

Your stationary bike can connect to the Internet to motivate you.

But how much is too much? And what are the best services to check out?

To kick off the year, Jon Fortt sits down with CNBC reporters Chrissy Farr and Diana Olick. He is also joined by WW CEO Mindy Grossman. What’s WW? It’s the artist formerly known as Weight Watchers.


Company: cnbc, Activity: cnbc, Date: 2019-01-07  Authors: jonathan kim, jon fortt
Keywords: news, cnbc, companies, trends, 2019, watchers, ww, doctor, truly, fitness, whats, weight, youbut


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This doctor thinks medical schools should recruit more like Google and other tech companies

Dr. Stephen Klasko, the president of Thomas Jefferson University in Philadelphia and CEO of Jefferson Health, says that medical schools have the recruiting process all wrong. Klasko is pushing Thomas Jefferson along a different path, one that’s similarly being followed by Mount Sinai, Yale and Stanford. They’re all seeking ways to find candidates that may not be obvious targets for medical school by using techniques that are well known to tech companies. “We need to make medical students more hu


Dr. Stephen Klasko, the president of Thomas Jefferson University in Philadelphia and CEO of Jefferson Health, says that medical schools have the recruiting process all wrong. Klasko is pushing Thomas Jefferson along a different path, one that’s similarly being followed by Mount Sinai, Yale and Stanford. They’re all seeking ways to find candidates that may not be obvious targets for medical school by using techniques that are well known to tech companies. “We need to make medical students more hu
This doctor thinks medical schools should recruit more like Google and other tech companies Cached Page below :
Company: cnbc, Activity: cnbc, Date: 2019-01-04  Authors: christina farr, jefferson health
Keywords: news, cnbc, companies, doctor, jefferson, yale, medical, tech, thinks, companies, university, schools, students, thinking, google, thomas, klasko, theyre, recruit


This doctor thinks medical schools should recruit more like Google and other tech companies

Dr. Stephen Klasko, the president of Thomas Jefferson University in Philadelphia and CEO of Jefferson Health, says that medical schools have the recruiting process all wrong.

In an age of advanced technology, they’re still choosing students who can reel off organic chemistry compounds, rather than screening for qualities like critical thinking, entrepreneurship and empathy. Once students arrive, they’re being asked to spend years on rote memorization.

It’s a system designed to “suck the creativity out of physicians,” Klasko said, while encouraging them to compete with each other, rather than collaborate.

Klasko is pushing Thomas Jefferson along a different path, one that’s similarly being followed by Mount Sinai, Yale and Stanford. They’re all seeking ways to find candidates that may not be obvious targets for medical school by using techniques that are well known to tech companies. Klasko’s son once interviewed for a job at Google, and “they didn’t want to see a transcript,” he said. Recruiters asked him a series of questions to see whether he could come up with creative solutions on the fly.

Klasko has worked with a firm called Teleos Leaders, which has clients ranging from Cisco to IBM, to develop a program to select medical students on the basis of their emotional intelligence.

“We need to make medical students more human,” Klasko said in an interview. “The way things are today is that you can be the most antisocial person in the room, but if we train you to pass a multiple choice test you can go and treat sick patients.”

Jefferson is tapping humanities departments, design universities and drama schools to convince young graduates to consider a career in medicine. It has a partnership with Princeton University that allows about a dozen Princeton undergraduates each year to take the minimum number of science courses and study any other subjects they wish before attending medical school at Jefferson.

It also has a program that trains students in design thinking under Bon Ku, an emergency room physician who was described by a local publication as “one of the coolest docs in Philadelphia.” Ku graduated with a degree in classics and was terrible at math.

FlexMed at New York’s Mount Sinai allows college sophomores in any major to apply for early acceptance. Students in humanities have proven to be just as successful as those with a science background, and they’re more likely to choose primary care or psychiatry as a specialty, which are both areas facing shortages. Other med schools like Yale and Stanford are offering art appreciation courses alongside traditional subjects like pathology and microbiology.


Company: cnbc, Activity: cnbc, Date: 2019-01-04  Authors: christina farr, jefferson health
Keywords: news, cnbc, companies, doctor, jefferson, yale, medical, tech, thinks, companies, university, schools, students, thinking, google, thomas, klasko, theyre, recruit


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A heart doctor explains why he’s wary of the new Apple Watch

Apple’s new watch sounds like a win for anyone interested in their heart health. It will notify wearers of a slow or irregular heart rhythm, and it can take a basic electrocardiogram (ECG), a recording of the electrical activity of the heart. As a heart doctor, my opinion is that if you think an Apple Watch is nifty, buy one. Even if the Apple Watch identifies true AF, we can’t be sure the treatment will do more good than harm. I worry that the Apple Watch will discover lots of short-duration AF


Apple’s new watch sounds like a win for anyone interested in their heart health. It will notify wearers of a slow or irregular heart rhythm, and it can take a basic electrocardiogram (ECG), a recording of the electrical activity of the heart. As a heart doctor, my opinion is that if you think an Apple Watch is nifty, buy one. Even if the Apple Watch identifies true AF, we can’t be sure the treatment will do more good than harm. I worry that the Apple Watch will discover lots of short-duration AF
A heart doctor explains why he’s wary of the new Apple Watch Cached Page below :
Company: cnbc, Activity: cnbc, Date: 2018-11-06  Authors: john mandrola, marcio jose sanchez
Keywords: news, cnbc, companies, ecg, stroke, patients, apple, heart, health, rhythm, explains, risk, af, wary, watch, hes, doctor


A heart doctor explains why he's wary of the new Apple Watch

This column originally ran on Medium on Sept. 17, 2018.

Apple’s new watch sounds like a win for anyone interested in their heart health. It will notify wearers of a slow or irregular heart rhythm, and it can take a basic electrocardiogram (ECG), a recording of the electrical activity of the heart.

During Apple’s presentation of the new watch on Sept. 12, the company boasted of its FDA clearance and basked in praise from American Heart Association president Dr. Ivor Benjamin.

As a heart doctor, my opinion is that if you think an Apple Watch is nifty, buy one. But do not buy it for your health. It will not improve your health, and it could even bring you harm.

In particular, I’m concerned about the problems that arise when we screen healthy people.

I concede that early detection seems like a good idea, especially for atrial fibrillation (AF). AF can increase a person’s risk of stroke, and many people who have AF don’t know it. We also have effective ways to treat it, including drugs that block clotting—called anticoagulants—that can reduce the risk of stroke in patients with AF and other risk factors, such as high blood pressure or diabetes.

The first obstacle when it comes to AF screening is understanding that the vast majority of people do not have AF, but most people do have normal variation of their heart rhythm, which can mimic AF. Benign premature beats, for instance, can make your rhythm irregular.

This makes ECG accuracy a problem. Recently, I co-wrote an editorial in JAMA-Internal Medicine, where my co-authors and I reviewed studies of AF screening with medical-grade 12-lead ECGs, which are more accurate than the one-lead ECG used in the Apple Watch.

The specificity of an ECG (its ability to correctly identify people who don’t have AF) is around 90 percent. That may sound good, but the 10 percent of the time that an irregular rhythm is falsely labeled as AF will exert a massive effect in large populations—like the millions of people who may soon own the new Apple Watch.

To put this into perspective, let’s use a round number of 1 million watch owners. We know that about 1 percent, or 10,000 people, will have AF, and 990,000 will not have AF. If the watch is wrong 10 percent of the time, that means nearly 100,000 people will be falsely diagnosed with AF.

Sending hundreds of thousands of wrongly diagnosed people to the doctor scares me. In addition to needless anxiety and costs, this is hazardous because while some doctors will simply reassure the patient, many other doctors will order tests. Since all medical interventions come with risks, many people will suffer harm from unnecessary tests and procedures.

Another snag in heart rhythm screening stems from a poor understanding of AF. Despite decades of research, doctors still argue about the causes of AF and its treatments.

In 2017, Harvard researchers published a paper exposing a core deficit in AF knowledge. In their review of 34 studies of hundreds of thousands of patients with AF who were not treated with clot-blocking drugs, they found wide variation in the rate of stroke, which means we don’t really know the stroke risk of having an AF diagnosis.

Even if the Apple Watch identifies true AF, we can’t be sure the treatment will do more good than harm. While anticoagulants reduce the rate of stroke when used in patients with multiple risk factors—like high blood pressure, diabetes, and older age—these patients are typically diagnosed with AF using ECGs done in doctor’s offices, usually because they are experiencing symptoms.

I worry that the Apple Watch will discover lots of short-duration AF or AF occurring in younger people with fewer risk factors. Given their lower risk of stroke, it’s unlikely that anticoagulant drugs will deliver similar benefits. But anticoagulants do increase the risk of bleeding.

The truth is that preventive health is far more complicated than identifying irregular rhythms from a watch. When you endeavor to make healthy people healthier, you always risk making them worse.

John Mandrola is a cardiac electrophysiologist at Baptist Health Louisville.


Company: cnbc, Activity: cnbc, Date: 2018-11-06  Authors: john mandrola, marcio jose sanchez
Keywords: news, cnbc, companies, ecg, stroke, patients, apple, heart, health, rhythm, explains, risk, af, wary, watch, hes, doctor


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UnitedHealthcare warns hospitals it may drop major ER doctor network from plans

UnitedHealthcare’s negotiations with the nation’s largest provider of emergency room doctors has reached an impasse. A spokesperson for Envision Healthcare says the firm has been negotiating in good faith with UnitedHealth and criticized the insurer for reaching out to hospitals. Out-of-Network Billing for Emergency Care in the United States,” says it’s a difficult pricing problem to correct, because emergency room doctors have an incentive to charge high out-of-network rates. “One of the issues


UnitedHealthcare’s negotiations with the nation’s largest provider of emergency room doctors has reached an impasse. A spokesperson for Envision Healthcare says the firm has been negotiating in good faith with UnitedHealth and criticized the insurer for reaching out to hospitals. Out-of-Network Billing for Emergency Care in the United States,” says it’s a difficult pricing problem to correct, because emergency room doctors have an incentive to charge high out-of-network rates. “One of the issues
UnitedHealthcare warns hospitals it may drop major ER doctor network from plans Cached Page below :
Company: cnbc, Activity: cnbc, Date: 2018-09-24  Authors: bertha coombs, sam edwards, caiaimage, getty images
Keywords: news, cnbc, companies, patients, innetwork, outofnetwork, network, room, insurer, unitedhealthcare, er, surprise, major, drop, plans, warns, envision, united, rates, emergency, doctor, hospitals


UnitedHealthcare warns hospitals it may drop major ER doctor network from plans

UnitedHealthcare’s negotiations with the nation’s largest provider of emergency room doctors has reached an impasse.

The insurer is warning hospitals it may drop Envision Healthcare from its network starting in January if the two can’t reach an agreement before then, according to a letter sent to more than 250 hospitals Friday.

“You know better than most how Envision’s rates are driving up the cost of health care for the people we all serve,” Dan Rosenthal, president of UnitedHealthcare Networks, said in the letter, which was obtained by CNBC. UnitedHealthcare has been in negotiations with Envision for a year without success, he said.

A spokesperson for Envision Healthcare says the firm has been negotiating in good faith with UnitedHealth and criticized the insurer for reaching out to hospitals.

“There were never any problems until now, when United demanded massive cuts to allow us to stay in-network. We have offered United a solution that helps with the affordability of healthcare, and yet United is making egregious demands that will force all of our physicians out of network,” said Kim Warth, vice president for communications at Envision, in a statement.

“Unfortunately, United has been sending aggressive letters to our hospital partners filled with half-truths and inaccuracies. They’ve elected to use data for one group in one market and have presented it as the single source of truth. This is misleading and designed to fit their narrative rather than the reality,” Warth said.

UnitedHealth Group’s insurance division first threatened to cut Envision from its network services last spring over what the insurer said were overly high rates. If no agreement is reached, the move would impact more than 1 million of United’s members across the nation.

Because emergency room physicians and other specialists contract with health insurers separately from hospitals, the result can be that the doctors at an in-network hospital are actually out-of-network on an insurer plan.

UnitedHealthcare spokesman Stephen Shivinsky said Envision was a “dominant player” among emergency physician networks and that the insurer would like to continue working with them to find a compromise.

Citing a study from Yale University researchers, UnitedHealthcare said Envision’s emergency room rates were twice as high as those of other emergency physician staffing providers, and in some cases when the staffing firm took over emergency care from in-network hospital physicians costs tripled.

One of the authors of the study, titled “Surprise! Out-of-Network Billing for Emergency Care in the United States,” says it’s a difficult pricing problem to correct, because emergency room doctors have an incentive to charge high out-of-network rates.

“This is actually a pretty fundamental market failure,” said Zachary Cooper, an associate professor of health and economics at Yale University. “One of the issues is that if you go to an emergency room you’re choosing a hospital and you’re not choosing a physician.”

Sky-high prices on surprise out-of-network ER bills have become a hot-button issue for consumers and for legislators. A number of states have taken aim to end the practice. Last week, a bipartisan group of U.S. senators drafted legislation to make sure patients are not forced to pay higher out-of-network rates when they go to an in-network hospital.

UnitedHealth said if it fails to renew its contract with Envision it will set up a hotline to help patients deal with potential out-of-network charges from the ER providers. A spokesperson said negotiations will continue until year-end. But in the meantime, the notice could put hospitals in the middle — having to decide whether to maintain their own contracts with Envision or explore other providers who would be covered in-network.

Envision agreed to be acquired by private equity investors at KKR for $5.6 billion, not including debt. Shareholders voted to approve the deal earlier this month.

“Our goal is to have in-network relationships with all of our payor partners, so that patients don’t have to worry about surprise bills caused by surprise gaps in coverage,” said Warth, “and we believe United should share that common goal instead of forcing a situation where patients may be required to pay more.”


Company: cnbc, Activity: cnbc, Date: 2018-09-24  Authors: bertha coombs, sam edwards, caiaimage, getty images
Keywords: news, cnbc, companies, patients, innetwork, outofnetwork, network, room, insurer, unitedhealthcare, er, surprise, major, drop, plans, warns, envision, united, rates, emergency, doctor, hospitals


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