| | | | | |  | | By Alexandra S. Levine | | | | NEW YEAR, NEW MILESTONES: The pandemic gadgetry that hit it big a year ago isn't going away with the turn of the calendar. Fast-spreading variants, test shortages and health care system stressors are already carrying over into 2022, so those smartwatches, at-home testing kits and other personal health tech that we've been turning to are here to stay. With little turnover in the technology itself, here are the biggest digital health questions that experts are weighing in 2022. What happens to telemedicine and digital health once rules relaxed during Covid are reinstated? Early in the pandemic, the Centers for Medicare and Medicaid Services waived certain requirements around licensing and providing telemedicine, and HIPAA regulations were loosened for some digital health tools. Many exceptions are still in place, but there are questions about how use of these products, services and innovations will change as the crisis subsides. | 
Mark Lennihan/AP Photo | "What kind of penetration are they going to have in the health care market? How is the health care system going to integrate all these new technology-enabled solutions within their practices, within their clinical workflows?" said René Quashie, the Consumer Technology Association's first-ever vice president of policy and regulatory affairs for digital health. Entrepreneurs, clinicians and other leaders in the space will begin to assess the state of play at CTA's Consumer Electronics Show, or CES, the huge exposition kicking off today in Las Vegas. A large number of health tech upstarts are attending the summit either remotely or in person. Can remote patient monitoring close the divide on health equity issues? Without the ability to remotely monitor chronic diseases, which tend to afflict medically underserved groups, "we're really not going to make a dent in the health equity conversation," Quashie told Future Pulse. "So remote patient monitoring tools that are geared for historically underserved communities — that take into account the digital literacy of the user, simplicity of use [and] broadband access … are going to be absolutely key to watch." This CES panel on Friday will explore health tech and health equity issues further, especially as they pertain to biases in artificial intelligence. And what will become of mental health tech as Americans enter the pandemic's third year? The shortage of clinicians in the mental health space — a longstanding issue exacerbated by the Covid crisis, as more people sought psychological support — means even more focus will be on how technologies like telemedicine, augmented and virtual reality and mindfulness apps can help bridge the gap, Quashie said. Check out a Thursday CES panel discussion — "Mental Health Innovation in Virtual Care: Stories of Success and Opportunity" — for more. For more on CES, subscribe to POLITICO's special edition newsletter , authored by tech reporters Alexandra S. Levine and John Hendel. Welcome back to Future Pulse, where we explore the convergence of health care and technology. Share your news and feedback: @dariustahir, @ali_lev, @abettel, @samsabin923 , @_BenLeonard_. | | | tylershultz [the Theranos whistleblower] @TylerShultz_ "This has been a long chapter of my life. I am happy that justice has been served and that this saga is finally in my rearview mirror. Proud of the impact that Erika and I had. Hope to inspire other young professionals to hold their leaders accountable." | | | PROJECTING OMICRON'S TOLL: The surge of Omicron cases is already shattering records for daily Covid-19 infections in the U.S. and signaling another grim winter. But what are public health models saying about the longer-term outlook? The University of Texas Covid-19 Modeling Consortium considered 18 possible scenarios when factoring variables like Omicron's transmission rate, the variant's ability to evade immune responses and the national rate of booster uptake. In a worst-case situation, Omicron would turn out to be as transmissible as the Delta variant but more capable of evading immunity, leading to a wave that peaks on Feb. 3 and results in 342,000 deaths between Dec. 1 and May 1 – or 1.2 times higher than the January 2021 pandemic peak. | 
Mario Tama/Getty Images | A more optimistic scenario assumes Omicron is 50 percent more transmissible than Delta but results in only a 10 percent reduction in protection against infection. That would mean a wave that crests on Jan. 18 and results in fewer deaths than in 2021. The researchers used a baseline scenario in which 57 percent of those eligible for booster shots would get the jabs by March 1. But they also simulated what increased vaccine uptake would mean. If 80 percent of those eligible got boosted, the models show there would be 39,000 fewer deaths, 168,000 fewer hospitalizations and 1.3 million cases averted between the December to May timeframe. The results haven't yet been peer reviewed, and consortium researchers say they'll update estimates as more information about the spread, vaccine evasiveness and severity of Omicron become available. PUBLIC HEALTH'S PATCHWORK DATA: Our public health system is largely a patchwork one, including the tech backbone, Johns Hopkins professors Megan Wallace and Joshua Sharfstein conclude in a new article in the New England Journal of Medicine. The authors surveyed health departments' tech capabilities in dealing with pandemics and foodborne illness, concluding, "Much of state and local public health work remains on paper." "Only 3 percent of local health departments reported that their information systems are all interoperable, a limitation that hampers both daily prevention work and coordinated responses." The conclusion is no surprise, though the problem's depths might shock even longtime watchers of public health's tech and data struggles. As we've written previously, the feds are starting to put money into modernization — but as Wallace and Sharfstein suggest later in the piece, public health funding nationwide tends to be uneven, surging sometimes, staying flat at other times. That makes planning hard. | | | RX REVOLT: The FDA's recent decision to authorize two antiviral pill regimens to treat Covid-19 could be a game-changer for keeping patients at high risk for developing severe cases out of the hospital. But the fine print isn't sitting well with pharmacists. A coalition of national pharmacy groups sounded off on the way the emergency use authorizations block their members from writing prescriptions for the drugs, despite authority the government has already granted them to order and dispense oral treatments under a public health emergency law known as the PREP Act. The organizations — the American Pharmacists Association, the American Society of Consultant Pharmacists, the American Society of Health-System Pharmacists, the National Alliance of State Pharmacy Associations and the National Community Pharmacists Association — argue the restrictions will hinder their ability to help patients quickly access the pills, which are authorized to be taken early in infection. "Time is of the essence," they said in a statement. "Requiring patients to make an appointment with another prescriber just to get a prescription that their pharmacist will fill adds time, cost, and inconvenience but most concerning of all, it could cause hospitalizations and even deaths." The drugs, Paxlovid by Pfizer and molnupiravir by Merck and Ridgeback Biotherapeutics, should be taken within five days of symptom onset. But neither is a substitute for vaccines, and each comes with risks. The Pfizer drug can interact with several other medications and supplements, and the Merck pill can't be prescribed to children and isn't recommended for pregnant people, based on results seen in animal testing. | | | THE NEXT OMICRON?: Is yet another Covid-19 variant sickening people in the south of France and throwing a new wrinkle into the global pandemic response? Social media in recent days has been abuzz over the strain, designated as B.1.640.2, which researchers in Marseille last month reported has 46 mutations that could make it more transmissible. The discovery, contained in a preprint that hasn't been peer-reviewed, offered more evidence of how variants can hopscotch around the world and unexpectedly take root in a locale. The region in this instance was the Alpes de Haute Provence, where 12 people tested positive. The "index case" was reported to have recently returned from travel in Cameroon. The question is whether the French strain amounts to a real threat and poses more danger than the strains already in circulation. Tom Peacock, a virologist at Imperial College London, wrote on Twitter that the variant actually predates Omicron and "had a decent chance to cause trouble" but hasn't taken off — at least as far as he can tell. Francois Balloux, director of the University College London Genetics Institute and a professor of computational biology, noted the strain isn't responsible for a spike of recent cases in southern France or for sending hundreds of people to ICUs. "Feel free to Google "B.1.640.2" if you wished [sic]to be exposed to a lot of nonsense," Balloux tweeted. | | | How closely have you followed recent health tech headlines? (Answers below) 1) A bipartisan Senate bill known as the "Drugs Act" would: A) Encourage more online prescribing of abortion pills.
B) Crack down on websites that traffic in counterfeit or illegal drugs.
C) Authorize $2 billion for FDA evaluations of biologic medicines.
D) Create a new government agency to develop vaccines. 2) A recent poll from AP and the NORC Center for Public Affairs Research found this group is more likely to be skeptical about telehealth: A) Senior citizens.
B) People under age 18.
C) Non-white people.
D) Those with household incomes below $60,000. 3) President Joe Biden's pick to lead the Food and Drug Administration, Robert Califf, worked at this tech giant: A) Alphabet.
B) Microsoft.
C) Apple.
D) Meta. 4) Expansion-stage health tech funding approached this much in the first three-quarters of 2021, according to Deloitte: A) $5 billion.
B) $12 billion.
C) $24 billion.
D) $50 billion. 5) Private equity investment in hospitals is leading to more tech-driven services in all but which one of the following areas, per research in Health Affairs: A) Robotic surgery.
B) Digital mammography.
C) Freestanding emergency departments.
D) Birthing rooms. | | | The Wall Street Journal explains why the government's choice to give patients a small stage in the Theranos trial backfired. Stat reveals the problems when emergency techs are locked out of digital medical records. And NPR warns that the return of limits on telehealth prescriptions of addiction treatments might worsen the overdose crisis. Answers to Pop Quiz: 1) B. 2) C. 3) A. 4) C. 5) D. | | | | Follow us | | | | |
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