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Brainstorm Health Daily: March 20, 2017

Good morning, readers. This is Sy. As Cliff mentioned last week, I'll be taking over for him until next Tuesday, March 28, when he gets back from vacation.

It's no surprise that digital health startups are often staffed with tech experts who have the savvy to build out complex IT infrastructure. But in many cases, the end-users - in this case, the medical providers and doctors who will ultimately use these technologies - are left out of the process. And that needs to change if we're truly going to realize the potential of the digital health revolution, according to anesthesiologist and tenured Northwestern University professor Dr. M. Christine Stock.

Stock is out with an op-ed in Venture Beat which she dubs an "open letter health tech startups." In it, she lists the ongoing hurdles to effectively folding groundbreaking tech into the medical sector, including a lack of physician input during the development phase.

"While many new technologies work well after the period of adaptation, leaving end-users (physicians) out of the product development process leads to unanticipated problems such as unintuitive and frustrating workflow, taxing documentation requirements, and nonsensical and inaccurate cut-and-paste progress notes," she writes.

And what happens when the doctor's perspective is incorporated from the get-go? Good things, according to Stock. Her own practice performed an experiment wherein one of her doctors was given time to collaborate (and wrangle) with health IT developers to create an electronic medical records system that would be effective for the practice's specific workflow. And, lo-and-behold, the strategy resulted in a tool that now serves as a prototype for Stock's type of clinical environment.

Stock goes on to issue a number of specific recommendations for the digital health industry that she believes would go a long way toward improving outcomes and results, including: technology tailored to smartphones; open platform electronic medical records that allow systems to talk to each other; and, strikingly, a "common medical identification number for every person starting at birth," among other suggestions.

"The tech community must be willing to engage early and to listen. And we physicians must be willing to meet the developmental challenges and share," she concludes.

Read on for the day's news.

Sy Mukherjee
@the_sy_guy
sayak.mukherjee@fortune.com

DIGITAL HEALTH

SpaceX capsule returns with science-heavy cargo. SpaceX capsule Dragon safely returned to Earth on Sunday - and it came back with a host of medical goodies. A number of ongoing initiatives, including the Microgravity Expanded Stem Cells project and the Tissue Regeneration-Bone Defect study, involved conducting life sciences experiments in the realm of microgravity. Test samples from those studies were part of Dragon's cargo. A number of biopharma companies and medical institutions, including pharma giant Merck and the Mayo Clinic, have been using the advent of microgravity to research drug development. For instance, the stem cells project is seeking to understand how cells may grow and propagate differently in microgravity compared to Earth's gravity, and whether this has an effect on gene expression. (Fortune)

Can electronic prescriptions help fight the opioid epidemic? Surgeon-journalist Dr. Atul Gawande has some advice for physicians: start using electronic prescription systems when giving a patient addictive opioid painkillers. Gawande notes that using these technologies "prevent duplicate and forged prescriptions by using 2-factor authentication; reduce dosing errors; cross-reference prescription monitoring program databases; and simplify the prescription process for doctors and patients." Furthermore, he notes, electronic prescribing "would make it far easier for surgeons to write smaller prescriptions that meet the needs of 80% of patients, or even 50%, knowing they could remotely order an additional supply if a patient needed it." But the trend has yet to catch on. In fact, just 8% of doctors serve in practices that allow for the use of this technology to prescribe controlled substances like opioids.

INDICATIONS

CytomX spikes on Bristol-Myers collaboration expansion. Shares of biotech CytomX Therapeutics soared more than 25% in early Monday trading after pharma giant Bristol-Myers Squibb announced that its expanding its cancer drug partnership with the smaller firm. CytomX will receive a $200 million upfront payment as part of the deal, which lands Bristol-Myers access to a number of investigational tumor-fighting drugs being developed by the biotech. The company's therapeutic platform aims to make cancer treatment safer by softening the effect that chemotherapy has on healthy tissue and targeting it more directly toward tumors. (TheStreet)

The battle of the blood thinners may have produced a winner. Speaking of Bristol-Myers Squibb - the drug maker, alongside partner Pfizer, is rejoicing thanks to new study results showing that its next-generation blood thinner Eliquis is safer and considerably more cost-effective than rivals Xarelto (from Johnson & Johnson) and Pradaxa (from Boehringer Ingelheim). Data analysis of U.S. Medicare patients found that all three of these treatments were safer in one way or another than the more old-school blood thinner warfarin (which still controls the majority of the market). But Eliquis was the only one which simultaneously reduced the risk of stroke and major bleeding events in patients while also saving more than $250 in costs (compared to warfarin) per patient who had a significant bleed during treatment.

THE BIG PICTURE

Meals on Wheels sees donation surge following Trump budget. President Donald Trump's budget could potentially end federal funding (or at the very least significantly roll it back) for Meals on Wheels, the safety net program which feeds millions of elderly Americans every year. But the proposed cuts have led to an explosion in donations to the program, with the average amount of daily donations spiking 50-fold after the budget's release. Volunteer registration also rose by 500%, according to Meals on Wheels. (Fortune)

The Flint pipe replacement project is off to a slow start. Years after the lead water crisis in Flint, Michigan, progress is still slow to come on replacing the city's dilapidated water infrastructure. "So far, I'd say it's been going slow," said retired National Guard Brig. Gen. Michael McDaniel, who oversees the FAST Start initiative. "We wanted to replace 1,000 service lines in the city of Flint in 2016 and we are still working on that contract even today because we've had a fairly warm winter." The current goal is to finish the pipe replacements by 2019, which would require about 6,000 homes to be addressed per year. (Fortune)

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