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<a href="https://www.businessinsider.com/category/future-of-healthcare"></a><div type="image" title="Blood sample" height="3398" width="4530" msid="87165102" hostid="261"></div><ul class="summary-list"><li>By 2022, there will be two <keyword id="12030295" type="UNKNOWN" weightage="60" keywordseo="blood-tests" source="Orion">blood tests</keyword> - made by <keyword id="12353013" type="UNKNOWN" weightage="60" keywordseo="exact-sciences" source="Orion">Exact Sciences</keyword> and <keyword id="12353012" type="UNKNOWN" weightage="60" keywordseo="illumina" source="Orion">Illumina</keyword> - available to detect cancer.</li><li>They have spent a combined $10.1 billion in M&amp;A in the hopes of diagnosing cancer earlier. </li><li>Experts say these tests still need to establish they can detect cancer and extend people's lives.</li></ul>Scarcely a day goes by when Kevin Conroy, the chief executive of cancer test manufacturer Exact Sciences, doesn't talk about colon cancer. But last month, it hit closer to home when Conroy's brother-in-law died of the disease. By the time the cancer was apparent, the treatment options were limited. Getting Americans to get routine screenings like colonoscopies has helped <a href="https://www.cancer.org/cancer/colon-rectal-cancer/about/key-statistics.html">cut down deaths from colon cancer</a> in the last couple of decades. The Cologuard test that Exact Sciences launched in 2014 has served as a next step, helping improve screening rates for Americans by four percentage points, according to Exact. But only 38% of colon cancer cases are caught when the cancer is in its earliest, less deadly stages, <a href="https://www.cancer.net/cancer-types/colorectal-cancer/statistics">according to the American Society of Clinical Oncology</a>.Two companies - Conroy's Exact Sciences and genetic sequencing giant Illumina - are hoping to make it easier to detect colon and around 50 other types of cancer, months or even years before doctors would see signs of the disease.The former head of Illumina's blood testing business, Hans Bishop, had <a href="https://collisionconf.com/schedule/cc21/timeslot/the-end-of-killer-cancer">previously said</a> these tests could help end deadly cancers. Exact and Illumina spent a <a href="https://markets.businessinsider.com/news/stocks/exact-sciences-stock-price-agrees-buy-thrive-earlier-detection-cancer-2020-10">combined $10.1 billion</a> <a href="https://markets.businessinsider.com/news/stocks/illumina-completes-grail-buyout-despite-uncertainty-in-regulatory-process-1030746156">over the last year</a> acquiring the two startups developing tests that seek out microscopic signs of cancer in a person's blood. Illumina's blood test launched commercially in June, and Exact plans to launch its test in the US next year. But the two firms behind the tests are still tweaking and testing their diagnostics, and experts say they need to prove that the tests can catch early cases of cancer and reduce death rates.<h2>Both tests need to improve their rates of identifying cancer</h2>Illumina and Exact's tests are part of a wave of "liquid biopsies'' informing cancer diagnosis and treatment.Companies like Guardant Health and Foundation Medicine have launched tests that pull together genetic information found in the blood to help physicians decide which cancer treatments to use. Now, biotechs are looking to introduce blood tests that could help diagnose cancer. Providence Cancer Center Institute in Oregon is one of the first medical centers in the country to begin using the Illumina's test, known as Galleri. It looks for signs of a biological process called methylation, which indicates whether cancer genes have been turned on. Testing of people who had already been diagnosed with cancer showed that the Galleri test has a <a href="https://www.annalsofoncology.org/article/S0923-7534%2821%2902046-9/fulltext">51.9% rate</a> of locating cancers at any stage of development. Early forms of Exact's CancerSEEK test, meanwhile, focused on finding traces of cancer DNA in the blood. A 2016 trial of CancerSEEK found that it <a href="https://www.evaluate.com/vantage/articles/events/conferences/aacr-2020-thrive-steals-march">had a 27.1% rate</a> of identifying any early stage cancer, before it had been caught by other screening tools. In another test of people with cancer, the test had a <a href="https://www.science.org/doi/10.1126/science.aar3247">62% rate of correctly identifying</a> the eight forms of the disease. Exact is currently in the process of adding a methylation component and machine learning tools, which Conroy expects will improve the test's performance.So, neither test is foolproof. Providence Cancer Center pathologist Dr. Carlo Bifulco said that both need to get better able to pick up on early signs of cancer and locate where it is in the body. Even if these tests can catch cancer earlier, we don't have strong data that starting treatment earlier allows people to live to older ages, Brigham and Women's Hospital's researcher Dr. H. Gilbert Welch <a href="https://www.statnews.com/2021/08/31/liquid-biopsy-misplaced-faith-in-early-cancer-detection/">wrote in an August op-ed in STAT</a>. <a href="https://www.cancer.gov/news-events/cancer-currents-blog/2020/cancerseek-blood-test-detect-early-cancer">Other physicians are looking for that data</a>, too.One theory Welch cites is that many cancers are thought to reflect the fact that the body's cells and immune system aren't working properly, making that person more susceptible to dying of any disease. But Bifulco said these liquid biopsies could change his job dramatically. Evidence has shown that patient outcomes depend on how advanced their cancer is. And if you can catch cancer earlier, you might be able to <a href="https://www.nytimes.com/2021/09/27/health/breast-cancer-chemotherapy-lung.html">avoid using chemotherapy</a>, which can kill cancer cells but also cause nausea, fatigue, hair loss and potentially permanent damage to the heart and nerves in the hands and feet. <h2>It could take more than a decade before these tests are available at your doctor's office and covered by insurers</h2>All evidence indicates that Exact and Illumina's tests won't immediately be embraced by the <keyword id="11897506" type="UNKNOWN" weightage="100" keywordseo="healthcare" source="Orion">healthcare</keyword> system. Cologuard is the perfect example of that. The test has been on the market for six years and has a <a href="https://www.mayoclinic.org/medical-professionals/digestive-diseases/news/cologuard-primed-to-change-landscape-of-crc-screening/mac-20429632">90% rate of correctly identifying cancer</a>, but is currently used by just 5% of the adults who could be routinely screened for colon cancer, according to an Exact Sciences investor call. Colonoscopies still <a href="https://www.reuters.com/article/us-health-colon-cancer-screening/colon-cancer-screening-rates-vary-widely-across-u-s-idUSKBN1H42YG">account for the lion's share of screening</a>.The Cologuard test is currently recommended for people over the age of 45. Getting 20-year-olds, 30-year-olds and 40-year-olds to start routinely checking for cancer - and for the healthcare system to pay for that - will require strong evidence that it improves survival, according to experts. Purchasing a Galleri test each year for every American over 50 alone could cost $100 billion, Welch wrote <a href="https://www.statnews.com/2021/08/31/liquid-biopsy-misplaced-faith-in-early-cancer-detection/">in the op-ed</a>. It can take upwards of 15 years for insurers, medical standard-bearers and everyday doctors to broadly embrace new ways of screening for cancer, Conroy noted. They want to see that it works, and results in people living longer and healthier lives, before upending the system. "There will be a tipping point, like there frequently is for new technologies," he said. "The data is going to power a new motivation to screen."

Blood tests that can detect cancer are about to hit the market. But experts are still waiting to see if they can upend deadly disease.

<a href="https://www.businessinsider.com/category/future-of-healthcare"></a><div type="image" title="Computer with an Oscar virtual primary-care doctor on the screen" height="894" width="1600" msid="86820455" hostid="261"></div><ul class="summary-list"><li>Many insurers and <keyword id="12003791" type="UNKNOWN" weightage="60" keywordseo="telehealth" source="Orion">telehealth</keyword> companies launched virtual primary-care programs amid the pandemic.</li><li>Some say they're starting to see promising results, like improved health outcomes and lower costs.</li><li>They're betting that the future of primary care is virtual. </li></ul>Virtual primary care may be more than a pandemic-era fad.Over the past couple of years, health insurers like <keyword id="12258949" type="UNKNOWN" weightage="60" keywordseo="humana" source="Orion">Humana</keyword>, <keyword id="12258947" type="UNKNOWN" weightage="60" keywordseo="oscar-health" source="Orion">Oscar Health</keyword>, and UnitedHealthcare, and telehealth companies like <keyword id="12258948" type="UNKNOWN" weightage="60" keywordseo="doctor-on-demand" source="Orion">Doctor on Demand</keyword> and Teladoc, <a href="https://www.businessinsider.com/health-insurer-harvard-pilgrim-launches-virtual-primary-care-plan-2020-11">launched health plans and programs that encourage patients to see a primary-care doctor online.</a>In some cases, these programs were in the works before the COVID-19 pandemic, but the crisis spurred companies to roll them out faster to give patients a safe, convenient way to get care when in-person options were limited.Now, the companies that spearheaded virtual primary care say there are signs it will remain a fixture in <keyword id="11897506" type="UNKNOWN" weightage="100" keywordseo="healthcare" source="Orion">healthcare</keyword> going forward.Insurers and telehealth vendors are starting to see promising early results, like improved health outcomes and lower costs, that they say signals the future of primary care is virtual.<div type="image" title="Headshot of Marianna Spanos, vice president of virtual care at Oscar Health" height="1200" width="1200" msid="86820457" hostid="261"></div>"There's a new norm being established for what it means to have convenient access to high-quality care, and providers who are actually invested in your health and wellbeing long-term," Marianna Spanos, vice president of <keyword id="12258946" type="UNKNOWN" weightage="60" keywordseo="virtual-care" source="Orion">virtual care</keyword> at Oscar Health, said.Some data suggests that companies that provide health coverage to their workers are rapidly adopting health plans that encourage patients to seek virtual care.A September Credit Suisse survey of more than 400 health-benefit managers at companies across the country found that 15% of them plan to offer a virtual-first health plan to workers in 2022, and another 20% are interested in exploring the option. They said they expect virtual-first plans could save them about 6% in health-plan costs, the survey found.That's a pretty good acceptance rate for such a new option, considering many companies tend to wait for a new product to take hold in a market before offering it to their own employees, said Credit Suisse analyst AJ Rice.<h2>Oscar said virtual care accounts for up to 20% of all primary care in some markets</h2>New York-based <a href="https://www.businessinsider.com/how-insurance-startup-oscar-health-could-finally-turn-a-profit-2021-2">Oscar Health</a> piloted its virtual primary-care plans in 2019 and 2020 before launching them more broadly to commercially insured individuals and families in January 2021. The plans allow people to opt for primary care online at no cost.Spanos said she's encouraged by early results. Many of the people who have signed up for the program didn't have a primary-care doctor before or were looking for a new one, she said, and Oscar's data shows they are using it to establish ongoing relationships with a doctor - not for a second opinion or to supplement other care. The members opting to go virtual span all age groups, she said.In some of Oscar's markets, virtual providers represent 15% to 20% of all primary-care use among the health insurer's members, she said. She declined to give specific enrollment numbers.Early data also shows that emergency department spending among people using virtual primary care is about 13% lower than spending among other people enrolled in the plan who aren't using the program, after adjusting for age and severity of conditions, Spanos said.<h2>Doctor On Demand and Humana said virtual primary care is leading to lower costs</h2><div type="image" title="Doctor On Demand" height="3744" width="5616" msid="86820459" hostid="261"></div>Doctor On Demand, which partners with employers and health insurers like Humana to offer virtual primary care, has also found that it's resonating with patients and lowering their costs.Robin Glass, the president of the telehealth company, told Insider that the number of people served by the company's virtual primary-care practice has grown nine-fold since it launched in 2019, though she declined to say exactly how many people the practice serves.The company's data shows that members are seeing their virtual primary-care doctors more than two times each on average, and those repeat visits are translating to better outcomes and lower costs. For one of its health plan clients, unnecessary medical visits dropped 24% across the virtual primary-care membership, Glass said. For that health plan, the cost of care for members who had at least one visit with the virtual-care team dropped 35%, Glass said."We are feeling really bullish about how the model is working," Glass said.Humana, which launched its virtual primary-care plan with Doctor on Demand in 2019, said early results show members using the program have significantly lower costs than those who aren't engaged with it, a company spokesperson said. The spokesperson declined to provide more detail on how many people have enrolled in the plan or their costs. But Christopher Hunter, president of the insurer's group and military business, said at Humana's investor day in June that the plan is "really taking off."Humana first piloted the plan to small companies in Florida and Texas that provide health coverage to their employees. It's since expanded the program to a total 15 states and to larger companies, the spokesperson told Insider. It's planning to launch a version of the virtual primary-care plan for its own workers this month, the spokesperson said.<h2>More companies are launching virtual primary-care programs</h2>In another sign that the movement toward virtual primary care isn't going away, more health insurers, including Aetna and regional insurer CareFirst BlueCross BlueShield, have unveiled programs giving patients options to get their routine care online.Baltimore-based CareFirst unveiled a new virtual primary-care medical practice last month called CloseKnit aimed at commercial members who don't see a regular doctor for reasons like long wait times for appointments, or limited hours, said Mary Jane Favazza, CEO of CloseKnit.Favazza said the goal in opening the practice is that it leads to more rational use of the healthcare system among those patients that previously didn't have a primary-care doctor. People with primary-care doctors tend to get just the right amount of care at the right time, leading to higher quality and lower costs, she said.For virtual primary care to last, companies will need to deliver on lowering costs, said Jonathan Bush, executive chairman of <a href="https://www.businessinsider.com/firefly-health-wants-to-transform-healthcare-for-small-companies-2021-10">Firefly Health, a virtual-care startup that's expanding into health benefits</a> for small companies. The perk of convenience isn't enough. "The key is taking the big giant pretrial offer that everybody got thanks to COVID and turning it into something monetarily, spiritually, clinically, emotionally better," Bush said. "If you don't create economic value, it ain't gonna stick."

Seeing a primary-care doctor online is getting easier, and health insurers say it's saving money

<a href="https://www.businessinsider.com/category/future-of-healthcare"></a><div type="image" title="Two scientists working in a laboratory" height="1285" width="1713" msid="86616895" hostid="261"></div><ul class="summary-list"><li>The pandemic's <keyword id="12003791" type="UNKNOWN" weightage="60" keywordseo="telehealth" source="Orion">telehealth</keyword> boost has spurred investments in startups making <keyword id="12204817" type="UNKNOWN" weightage="60" keywordseo="clinical-trials" source="Orion">clinical trials</keyword> virtual.</li><li>The goal is to open trials for experimental medicines to people who can't trek to a medical center. </li><li>These companies and experts agree it'll be years before decentralized clinical trials are the norm.</li></ul>Companies selling technology aiming to bring clinical trials online have raised more than $150 million in the past few months, but even they agree we're years away from widespread virtual clinical trials. Riding on the pandemic's rapid transition to virtual care, startups like Thread, Florence, Hawthorne Effect, and Castor are hawking tech they hope will decentralize clinical trials for vaccines, drugs, and treatments that have traditionally been concentrated near large academic medical centers in metropolitan areas. In a bid to open trials up to people who can't afford the trek, they offer services that vary from software to collates data from disparate sources to gig-economy clinicians who can go directly into homes to gather samples. <a href="https://hawthorne-effect.com/hawthorne-effect-raises-20-million-series-a-round-of-financing-to-decentralize-clinical-trials/">Their teams</a> and investors have pitched the technology as a means for diversifying clinical trials, which have <a href="https://www.thelancet.com/journals/langas/article/PIIS2468-1253(21)00228-4/fulltext">historically underrepresented racial minorities</a>. But these companies tell Insider that the technology required for widespread virtual clinical trials, including standards for gathering data from disparate data sources, is far from established. The rush to develop vaccines and treatments for <a href="https://www.pfizer.com/science/clinical-trials/diversity-clinical-trials">COVID-19 spotlighted the issue</a>, prompting the Food and Drug Administration to recommend <a href="https://www.fda.gov/regulatory-information/search-fda-guidance-documents/enhancing-diversity-clinical-trial-populations-eligibility-criteria-enrollment-practices-and-trial">researchers enroll underrepresented groups in their trials.</a>But "nobody in the industry has arrived," said John Reites, CEO of clinical-trial data company Thread. Lack of standards in the way the data is stored and reported makes it harder to link new sites up to clinical trials, Reites said. <a href="https://www.fda.gov/regulatory-information/search-fda-guidance-documents/enhancing-diversity-clinical-trial-populations-eligibility-criteria-enrollment-practices-and-trial"></a>Thread, <a href="https://www.businessinsider.com/reviews/out?u=https%3A%2F%2Fwww.wsj.com%2Farticles%2Fwater-street-and-jll-partners-add-50-million-to-thread-commitments-11597273200">which raised $50 million from private-equity backers in August</a>, sells a software platform that pharmaceutical companies and academic research centers use to gather data that's collected from sites across the country, whether they're retail pharmacies or commercial labs like Labcorp.<h2>Where the tech falls short</h2>Companies are raising millions to disrupt how clinical trials are conducted at a time when others are working at the beginning of the process to recruit underrepresented patients using sophisticated advertising. There, too, <a href="https://www.businessinsider.com/clinical-trials-have-a-diversity-problem-is-tech-the-solution-2021-8">equity experts agree that technology alone</a> won't address the social barriers keeping underserved patients out of clinical trials.<a href="https://www.fda.gov/regulatory-information/search-fda-guidance-documents/enhancing-diversity-clinical-trial-populations-eligibility-criteria-enrollment-practices-and-trial"></a>The software company Florence recruits patients, obtains their consent virtually, and aims to make the enrollment process easier. The startup <a href="https://florencehc.com/press-release/florence-supports-pfizers-covid-19-vaccine-clinical-trials/">worked with Pfizer</a> to gather data from patients across the country about COVID-19 vaccine response.But Blake Adams, Florence's marketing vice president, told Insider that the lack of data sharing even among the companies managing different parts of clinical trials makes it harder to expand them virtually."There's not really a lot of standards in the space right now," he said. Florence raised $80 million in a Series C round in May. Jodi Akin, who founded Hawthorne Effect, agreed that these types of services alone won't address larger systemic barriers keeping underserved patients out of clinical trials. Hawthorne Effect, which <a href="https://www.prnewswire.com/news-releases/hawthorne-effect-completes-20-million-series-a-round-of-financing-to-decentralize-clinical-trials-301309184.html">raised $20 million in June,</a> hires thousands of clinicians on a contract basis modeled after the gig economy to gather specimens directly from patients' homes. And though backers are eager to fund decentralized clinical-trial technology because of its potential to diversify research, some startups and investors are overhyping its ability to meaningfully change it in the short term, Akin said.

Startups are raising tens of millions to make clinical trials virtual. But experts say we're still years away.

<a href="https://www.businessinsider.com/category/future-of-healthcare"></a><div type="image" title="A person in a light-blue protective suit and helmet with face mask near laboratory equipment." height="1614" width="2152" msid="86242006" hostid="261"></div><ul class="summary-list"><li>Drugmakers big and small are storming into messenger RNA research.</li><li>The technology behind the first COVID-19 vaccines could help fight other diseases, including cancer.</li><li>Early leaders in the <keyword id="11976522" type="UNKNOWN" weightage="60" keywordseo="mrna" source="Orion">mRNA</keyword> space include <keyword id="11901412" type="UNKNOWN" weightage="60" keywordseo="moderna" source="Orion">Moderna</keyword>, BioNTech, Pfizer, Sanofi, and GlaxoSmitKline.</li></ul>While the COVID-19 pandemic will be remembered as a scourge on humanity, there are silver linings. Perhaps the biggest success story has been coronavirus vaccines, which were developed in record time and have undoubtedly <a href="https://www.commonwealthfund.org/publications/issue-briefs/2021/jul/deaths-and-hospitalizations-averted-rapid-us-vaccination-rollout">saved millions of lives</a>. Looking beyond the pandemic, the underlying technology behind the leading COVID-19 shots could also be useful for many other diseases, potentially leading to dozens of new treatments and vaccines over time. The first vaccines, developed <a href="https://www.businessinsider.com/insider-pfizer-biontech-historic-coronavirus-vaccine-program-2020-11">by Pfizer-BioNTech</a> and <a href="https://www.businessinsider.com/moderna-startup-to-biotech-developing-coronavirus-vaccine-flagship-pioneering-2020-5">Moderna</a>, are based on a new technology platform called messenger RNA, or mRNA. While drug companies have been working on mRNA-based medicines for years, the COVID-19 vaccines are the first mRNA vaccines to be authorized and widely used. Now, scientists are eager <a href="https://www.businessinsider.com/vaccine-mrna-covid-drug-treatment-future-of-medicine-2021-5">to usher in a new era of medicine</a>, applying the learnings from COVID-19 to a range of illnesses, including cancer, HIV, and rare diseases.Only a few years ago, mRNA was seen as a promising but unproven idea in drug development. Now, the world's largest drugmakers - like Pfizer, GlaxoSmithKline, and Sanofi - are building their mRNA capabilities as the pandemic has vaulted relatively smaller biotechs like Moderna and BioNTech to record valuations.<h2>mRNA taps into genetic insights over the past decades </h2>Many vaccines aim to deliver a crucial protein to cells to teach them to fight off a certain pathogen. The mRNA approach uses genetics to go a step back in that process.Our cells convert DNA to RNA molecules. RNA tells cells how to produce proteins. mRNA vaccines deliver those genetic instructions to build a certain protein, rather than the protein itself. Drug engineers can design mRNA therapies to control which protein to make and how much. That mRNA sequence is then placed in a microscopic blob of fat, called a lipid nanoparticle, which carries the genetic payload into our cells. Because mRNA therapies can theoretically be designed in the lab, mRNA holds the promise of addressing a wide range of diseases. Moderna CEO Stephane Bancel often calls it "plug-and-play" technology, where scientists can design additional mRNA sequences with a higher-than-usual chance they'll work.<h2>The mRNA pipeline extends beyond COVID-19 </h2>The mRNA technology won't be limited to vaccines.Moderna <a href="https://www.businessinsider.com/modernas-5-biggest-vaccine-programs-after-covid-19-2021-4">is already testing in human studies potential vaccines</a> against the flu, cytomegalovirus, respiratory syncytial virus, and Zika. Vaccines against the mononucleosis-causing Epstein-Barr virus, the Nipah virus, and HIV are still in the earliest stages of research. The Massachusetts <keyword id="11908912" type="UNKNOWN" weightage="60" keywordseo="biotech" source="Orion">biotech</keyword> is also developing mRNA treatments for the Chikungunya virus and is exploring research into auto-immune disorders and cancer. The German biotech BioNTech originally focused on fighting cancer with mRNA. That's still reflected in its pipeline, where the bulk of the research is in oncology. The biotech is in the early stages of human studies testing its mRNA technology against a range of cancer types, including melanoma, prostate cancer, breast cancer, and ovarian cancer among others. BioNTech also has some additional vaccine research. In partnership with Pfizer, it's <a href="https://biontech.de/sites/default/files/2019-08/20180816_BioNTech-Signs-Collaboration-Agreement-with-Pfizer.pdf">working on a flu vaccine that has yet to start human testing</a>. BioNTech <a href="https://biontech.de/sites/default/files/2019-08/20181104_20181105_BioNTech-and-the-University-of-Pennsylvania.pdf">also partnered with the University of Pennsylvania</a> in 2018 to work on vaccines for infectious diseases.<h2>Capturing the attention of drug giants </h2>Moderna and BioNTech are far from alone.While Pfizer partnered with BioNTech to develop the COVID-19 vaccine, the pharma giant <a href="https://www.businessinsider.com/reviews/out?u=https%3A%2F%2Fwww.wsj.com%2Farticles%2Fpfizer-goes-it-alone-to-expand-vaccine-business-beyond-covid-19-pandemic-11616491800">is hiring its own mRNA team</a> that will work independently from BioNTech. Pfizer has mapped out three waves of mRNA research: more infectious-disease vaccines, expanding to rare disease and cancer, and potentially going into prevalent heart and inflammatory diseases if there's more evidence the approach will work. Meanwhile, in August, the French <keyword id="11908913" type="UNKNOWN" weightage="60" keywordseo="pharmaceutical" source="Orion">pharmaceutical</keyword> company Sanofi <a href="https://www.sanofi.com/en/media-room/press-releases/2021/2021-08-03-07-00-00-2273307">said it would buy Translate Bio</a>, a tiny Massachusetts biotech specializing in mRNA, for $3.2 billion. CEO Paul Hudson said the deal will allow Sanofi to work on mRNA in vaccines, immunology, oncology, and rare diseases.GlaxoSmithKline has also invested in its own mRNA program, <a href="https://www.businessinsider.com/gsk-vaccine-research-covid-departures-uncertain-future-2021-4">which is led by its Rockville, Maryland vaccine research unit</a>. The British pharma company hasn't specified its long-term plans in mRNA, but started an early stage human study testing its own potential mRNA COVID-19 vaccine earlier this year. The leader of its vaccine unit has pledged GSK will be a leader in mRNA and also has inked a partnership with CureVac, a German mRNA specialist, <a href="https://www.curevac.com/en/2021/08/16/second-generation-mrna-covid-19-vaccine-candidate-cv2cov-demonstrates-improved-immune-response-and-protection-in-preclinical-study/">to develop a next-generation COVID-19 vaccine</a>.

Beyond COVID-19 vaccines, mRNA's pioneers have big plans for using the technology against a range of diseases

<a href="https://www.businessinsider.com/category/future-of-healthcare"></a><div type="image" title="Stanford's Michael Snyder holds up a monitor." height="901" width="1200" msid="85431215" hostid="261"></div><ul class="summary-list"><li>Health systems are exploring the clinical usefulness of consumer tools that can monitor heart rates.</li><li>Wearable devices can continuously measure vitals, as opposed to one-time measurements in the doctors' office. </li><li><keyword id="33081" type="ORGANIZATION" weightage="60" keywordseo="Stanford">Stanford</keyword> executives spoke with Insider about the medical center's approach to <keyword id="1616591" type="PERSON" weightage="60" keywordseo="Wearables">wearables</keyword>.</li></ul>Patients no longer have to trek to doctors' offices for detailed heart rate or blood pressure readings as <keyword id="3006231" type="ORGANIZATION" weightage="60" keywordseo="Consumer-Tech">consumer tech</keyword> giants churn out increasingly sophisticated smartwatches and high-tech rings that can measure vital signs and sleep patterns continuously. And as companies like Apple, <keyword id="6486191" type="UNKNOWN" weightage="60" keywordseo="fitbit">Fitbit</keyword>, and Samsung push to integrate these sleep trackers and heart rate monitors into medical visits - <a href="https://med.stanford.edu/appleheartstudy.html">including by funding large-scale clinical studies</a> <a href="https://clinicaltrials.gov/ct2/show/NCT03335800">in a bid for wider adoption</a> - large health centers like Stanford Medicine are taking note.Though the market for people to track their own vitals <a href="https://www.gartner.com/en/newsroom/press-releases/2021-01-11-gartner-forecasts-global-spending-on-wearable-devices-to-total-81-5-billion-in-2021">is growing</a>, getting buy-in from doctors and hospital systems could vastly increase their customer base. In turn, it's up to health systems to quickly figure out whether the data's useful to doctors and how to efficiently extract it from the devices, said Stanford's Michael Snyder, who leads many of the health systems' wearable projects. He added that Stanford likely spends millions researching these products.<div type="image" title="Stanford's Michael Snyder wears consumer devices the health system is researching." height="1484" width="1978" msid="85431219" hostid="261"></div><h2>Stanford's wearables experiment</h2>Stanford has been working <a href="https://med.stanford.edu/appleheartstudy.html">with Apple on a large-scale study</a> assessing whether the smartwatches can detect irregular heartbeats. It's also exploring whether other consumer devices like Oura Rings and Fitbits can give doctors better insight into patients' health by taking more accurate and more frequent measurements. For instance, researchers have developed a system using heart rate and temperature data to predict the onset of COVID-19 symptoms, which could eventually be used to alert patients to stay home. While Stanford's health record system can't currently pull wearable data into health records in real time, researchers have built a separate database that can group together medical records, data from wearable devices, and other information that patients contribute. The health system recently submitted the prototype for that system to a major research journal, Snyder said. It's not clear yet how the devices stack up to clinical-grade heart rate monitors, which doctors typically use to take snapshots of patients' heart activity while they're in the office, in detecting irregular heartbeats, Snyder said. But passively taking readings from smartwatches, which patients would already be wearing at home, could potentially help doctors establish a better baseline for heart activity. "There are circadian rhythms, there's just natural fluctuations during the day," Snyder said. At the doctor's office, he added, "they're literally measuring you for 15 seconds. It's just a very poor measurement, and the devices are measuring 24-7. Some of those measurements are so much more accurate, so much more reproducible."Some physicians still aren't sure the data's from consumer devices is valuable, Snyder said, but added that that's why the health system is proactively investigating whether the technology really can be useful. "Everybody sees it coming," Snyder said. "We're in this sort of twilight zone where some are very actively embracing it," he said, adding, "others are more dismissive."<h2>Making wearables more equitable</h2>There's also the challenge of ensuring that patients who can't afford the devices - Apple Watches, for example, retail for a few hundred dollars - aren't excluded from cutting-edge medical programs.Though most of its wearables programs are still in the clinical trial phase, Stanford is also examining how lower-cost options like the Fitbit compare to the higher-end devices, Sumit Shah, Stanford's director of clinical innovation and digital health, told Insider. "It's really important that we're able to use a device agnostic approach," Shah said.

Why Stanford is spending millions to incorporate Apple Watches and Fitbits into medical care

<a href="https://www.businessinsider.com/category/future-of-healthcare"></a><div type="image" title="GettyImages 1294850275" height="2652" width="3536" msid="85039912" hostid="261"></div><ul class="summary-list"><li>An increasing number of startups are creating health video games.</li><li>Video games can help treat conditions and acquire patient data.</li><li>But skepticism about how well they work may prevent doctors from using them.</li></ul>A new wave of startups is using video gaming to change how we treat mental and physical health conditions.These games vary from a virtual reality game to help children with autism learn life skills to a mobile adventure game to monitor chronic eye conditions.In June 2020, <a href="https://www.businessinsider.com/akili-endeavorrx-video-game-treatment-for-adhd-cleared-by-fda-2020-6">the US Food and Drug Administration approved</a> Akili Interactive's ADHD treatment EndeavorRx as the first ever prescribable <keyword id="13835" type="PERSON" weightage="60" keywordseo="video-game">video game</keyword>. In December, <a href="https://www.businesswire.com/news/home/20201208005617/en/Tilak-Healthcare-Inks-New-Partnership-Agreement-in-Ophthalmology-With-Novartis-to-Expand-Internationally">Novartis inked a deal</a> with Tilak <keyword id="6354525" type="UNKNOWN" weightage="100" keywordseo="healthcare">Healthcare</keyword> to distribute its eyesight monitoring game globally.In recent years, health game companies have raised millions of dollars to bring video game therapeutics to patients. The emerging field has the potential to help harder-to-reach patients stay engaged with their treatment and to give practitioners who prescribe games access to increased data on their patients. However, there are still lingering questions about how well the treatments work and whether medical professionals are willing to use them."The key is going to be hard research that shows that these games or experiences are actually leading to real-world skill development and that they are worth the time that families spend with those experiences," Vijay Ravindran, founder of autism therapy VR game Floreo, said.<h2>Why video games could transform how we treat conditions like anxiety</h2>Most video game therapeutics focus on mental- and behavioral-health conditions.Clinical psychologist, game designer, and American University adjunct professor Kelli Dunlap said video games lend themselves particularly well to treating conditions like anxiety."Games offer us multiple, infinite opportunities to try something and try it again and then get feedback and try it again and get feedback," Dunlap said. "And that kind of feedback loop is not something that's inherent in real life. If you screw up in your daily life, you might get in trouble, and who knows when you'll have the opportunity to try that again? But in a game, you really can't fail unless you quit."The way that video games help people learn lessons is especially useful with kids.Jason Kahn is the cofounder and chief scientific officer of Mightier, a video game that helps children with emotional regulation. He compared the way medical professionals usually try to talk kids through behavioral health treatment through psychotherapy to trying to teach someone how to ride a bike with a lecture and then expecting them to be able to ride it.Video games offer a chance to teach these skills more naturally."What video games do is they give us this environment where it's fun. So that's a huge advantage. Number one, like kids want to be there, the motivations are there, it's engaging, it's engrossing," Kahn said. "But also you get to use the skills inside of video games."<h2>Games provide data that could help doctors</h2>Video game therapeutics also may offer clinicians access to more data on their patients.Paris-based Tilak Healthcare made OdySight, a mobile game that tracks changes in patients' eyesight. Tilak has rolled OdySight out to ophthalmologists across France and is currently running trials in the US.Its founder, Edouard Gasser, said the sheer amount of data a mobile eyesight game can give to providers is the most promising things about OdySight. Though the average OdySight user is around 72 years old, they've found that patients were able to regularly engage with the game. Because of this engagement, OdySight is able to provide opthalmologists with much more data than they'd get from regular visits."With that in mind, it was a cool story for us to say, 'Listen it is a video game, but the result is that we get extremely good engagement and retention rate,'" said Gasser. "So in the end, you get 10 to 15 times more medical data than the regular healthcare process."<h2>Keeping games engaging</h2>Although there is a lot of promise within video game therapeutics, it's unclear whether they'll be effective in the long run.Daehyoung Lee, an assistant professor of adapted physical education at the University of Minnesota Duluth, developed PuzzleWalk, a mobile game to help people on the autism spectrum get more exercise.<a href="https://journals.sagepub.com/doi/full/10.1177/1460458220952909">His research</a> on the app's effectiveness found that after some time, the effects of the app waned, which he says is to be expected.Lee said this is the "novelty effect."People are fascinated by new technology, but if it doesn't change, they eventually get bored. Video game therapeutics can rise to this challenge or they could fall victim to it. He pointed to Pokemon Go as an example."They tend to be into these new intervention tools, but after that, it gets tedious, so people get bored," Lee said. "People need some kind of constantly changing new stimuli for this to be sustainable in terms of the information, but the available interventions are quite stereotypical."

Health video games could change how we treat patients - but doctors still need to be convinced

<a href="https://www.businessinsider.com/category/future-of-healthcare"></a><div type="image" title="Pear Therapeutics reSET-O digital therapeutics app" height="2160" width="3840" msid="84617555" hostid="261"></div><ul class="summary-list"><li>Apps and video games that can treat health conditions nabbed $1.2 billion in VC dollars in 2019. </li><li>Only a few commercial products have been launched so far, and they're struggling to penetrate the <keyword id="6354525" type="UNKNOWN" weightage="100" keywordseo="healthcare">healthcare</keyword> system. </li><li>Experts say this field is primed for consolidation and could be a great target for <keyword id="1477984" type="PERSON" weightage="60" keywordseo="telehealth">telehealth</keyword> firms.</li></ul>Pear Therapeutics is a leader in its field. But the announcement last month that it would <a href="https://www.businessinsider.com/digital-therapeutics-company-pear-to-go-public-in-16-billion-spac-ipo-2021-6">go public in a $1.6 billion deal</a> with a <a href="https://www.businessinsider.com/how-do-spacs-work-get-created-costs-guide">special purpose acquisition company, or SPAC</a>, raised eyebrows. Pear sells three apps designed to treat opioid abuse, substance abuse, and chronic insomnia. But it's only expecting to make $4 million in revenue this year. It's emblematic of where the young field of <keyword id="6262195" type="UNKNOWN" weightage="60" keywordseo="Digital-Therapeutics">digital therapeutics</keyword> stands today. The technology is theoretically promising, but the business model is completely up in the air. <a href="https://www.businessinsider.com/prescription-video-game-maker-akili-raises-160m-series-d-2021-5">Most health insurers don't</a> <a href="https://www.bizjournals.com/boston/news/2020/09/11/level-up-digital-therapeutics-have-won-over-regul.html">cover these products</a>, nor are many physicians prescribing them. Digital therapeutics are technologies like cell phone apps or virtual reality games that are designed to treat different diseases. In many cases, they target underserved mental health or neurological conditions like post-traumatic stress disorder and schizophrenia. The plethora of small, young digital therapeutics companies needs a savvy business partner. Pharmaceutical and telehealth companies each stand out as prime options. But, it's not clear which will truly engage with this new healthcare technology."Digital therapeutics, despite being around for a number of years now, it's still in an early stage of market development. I think the next few years are going to be about what kinds of businesses are best to shepherd through any special clinical benefits," Jeff Liesch, a consultant at Blue Matter Consulting, told Insider.As this gets worked out, the digital therapeutics field is likely to see a wave of M&amp;A. "Consolidation will come, and we're seeing it coming," Liesch said. <h2><keyword id="6363818" type="UNKNOWN" weightage="60" keywordseo="Pharma">Pharma</keyword> giants like Novartis, Roche, and Sanofi have been exploring prescription apps</h2>Digital therapeutics startups are getting their fair share of the investment dollars flowing into the healthcare industry. The amount of venture capital investment in digital therapeutics grew from $134.3 million in 2015 to $1.2 billion in 2019, according to Pitchbook. Another $709 million was invested in the first nine months of 2020, the most recent data available. Pharma giants like Novartis, Roche, and Sanofi have expressed an interest in the field. Novartis partnered with Pear to launch a schizophrenia therapy, but dropped that project in 2019. It later <a href="https://medcitynews.com/2020/04/novartis-to-acquire-digital-therapeutics-maker-amblyotech/?rf=1">acquired a digital therapeutics startup</a> developing a 3-D video game to address lazy eye. <div type="image" title="FILE PHOTO: The company's logo is seen at the new cell and gene therapy factory of Swiss drugmaker Novartis in Stein, Switzerland, November 28, 2019. REUTERS/Arnd Wiegmann" height="3087" width="4117" msid="84617559" hostid="261"></div>Digital therapeutics, particularly those that are prescribed by a physician instead of released directly to consumers, play to pharma's regulatory strengths while cutting down on the 10-plus years it can take to develop a chemical drug. The prescription route is where the money is: the annual US revenue expectations for digital therapeutics range between $100 million and $300 million, according to a Blue Matter report. Before agreeing to pay for them, insurers want to see long-term data showing how the benefits of these prescription apps or video games last. But, multi-year clinical trials are expensive and there's a chance that at the end of it all, the technology will be outdated, ZS Associates Principal Pete Masloski said. Even if the companies can get insurers to pay for their products, there's still the barrier of getting physicians to prescribe them.Eddie Martucci, the chief executive of digital therapeutics company Akili Interactive, said that thousands of doctors have reached out since the company got Food and Drug Administration clearance last year for an app to treat attention deficit and hyperactivity disorder. But its <a href="https://www.businessinsider.com/prescription-video-game-maker-akili-raises-160m-series-d-2021-5">commercial sales to date are small</a>. <div type="image" title="Akili Interactive" height="3840" width="5119" msid="84617561" hostid="261"></div>At this point, less than 5% of physicians in the US are exploring and prescribing digital therapeutics, according to Masloski. <h2>The next generation of digital therapeutics startups are building in telehealth options</h2>As a young digital health company, is it even worthwhile to try to educate and convince thousands of physicians to prescribe your app? Masloski estimates that time may be better spent by teaming up with a telehealth company with a specialized focus - be it mental health, chronic diseases, or something else - and a pool of medical specialists at hand. One telehealth firm, UpScript, has already begun offering consultations for Pear's prescription digital therapeutic. Meanwhile, the next generation of digital therapeutics companies like Happify Health and <a href="https://www.businessinsider.com/kaia-health-digital-health-startup-raises-second-vc-round-year-2021-4">Kaia Health</a> are building healthcare support staffs around their products. <div type="image" title="Kaia Health" height="1125" width="1500" msid="84617564" hostid="261"></div>A <a href="https://www.businessinsider.com/rock-health-on-whats-driving-digital-healths-consolidation-wave-2021-6">wave of M&amp;A</a> is just now hitting the telehealth and digital health space, with big names like Teladoc, <a href="https://www.businessinsider.com/ros-modern-health-acquisition-signals-consolidation-in-digital-health-2021-5">Ro, and others acquiring smaller players</a>. The digital therapeutics field may also get swept up in that, Masloski said. "Digital health companies are looking more broadly at ways to expand their impact across different parts of the patient journey. They're thinking in a platform way, how can I offer employers, for example, diabetes management, mental health services, all of these things?" he said. "They don't want to work with 1,000 individual different providers. They want to work with platform companies, simplifying their world."

Apps and video games are changing the way we treat diseases. Experts say they're prime M&A targets for telehealth firms.

<a href="https://www.businessinsider.com/category/future-of-healthcare"></a><div type="image" title="Spill video therapy" height="1502" width="2000" msid="83780253" hostid="261"></div><ul class="summary-list"><li>Startups are using technology to expand access to basic <keyword id="6354774" type="ORGANIZATION" weightage="60" keywordseo="Mental-health">mental health</keyword> services and preventive care.</li><li>Despite limitations, <keyword id="2147060" type="PERSON" weightage="60" keywordseo="digital-health">digital health</keyword> apps are still helping to chip away at the mental health crisis.</li><li>By even just taking therapy online, these companies are forging a brighter future for mental health.</li></ul>When it comes to treating mental illness within the broken US <keyword id="6354525" type="UNKNOWN" weightage="100" keywordseo="healthcare">healthcare</keyword> system, few good solutions that suit most people's healthcare needs and budget exist. Despite a push to destigmatize common conditions like depression and anxiety, the vast majority of Americans still face systemic barriers in treating their mental health conditions. For those priced out of mental health services covered by Medicaid, even the cost and hassle of private or insurance-backed therapy translates into fewer people getting the care that could help them manage their conditions.This combined need for mental health services is dizzying in its scale and scope. While the existing healthcare system is nowhere near a major overhaul, a new crop of technology-enabled options targeting milder conditions and prevention hope to chip away at the larger problem. Through online therapy for both groups and individuals, startups like <keyword id="9020936" type="LOCATION" weightage="60" keywordseo="talkspace">Talkspace</keyword> and Real are taking a direct-to-consumer approach to facilitating basic, digitally accessible talk therapy."We're building for preventative care," Real's founder, Ariela Safira, previously <a href="https://www.businessinsider.com/real-raised-10-million-for-a-preventive-mental-health-app-2021-4">told Insider</a>. <h2>There's 'definitely a place' for teletherapy in solving the nation's mental health crisis</h2>Clinical psychologist Adrian Aguilera, the director of University of California, Berkeley's Digital Health Equity and Access Lab, said the bottom line of most digital health companies is to make the most money, using the scalable aspect of technology to achieve that.That doesn't always overlap with addressing the country's mental health crisis."The system is totally bifurcated and screwed up," Aguilera said, particularly for Medicare and Medicaid patients. At the same time, Aguilera said there's "definitely a place" for teletherapy options. However, just increasing access to mental health providers, even via mobile app, is not enough. Although the pandemic's relaxed regulations provided "the perfect pressure" test for digital mental health options, a recent TIME/Harris Poll nationwide survey found that although overall telehealth usage doubled, <a href="https://time.com/6071580/teletheraphy-mental-health/">only 5% of respondents got mental healthcare</a> for the first time during the height of COVID-19. This suggests that telehealth expansion didn't necessarily help patients new to mental healthcare into treatment."Something my mentor drilled into me is that we currently do not have the ability to meet the need of everyone who wants one-on-one therapy - we simply do not," Aguilera said. "So if we tried to help everybody who needed it, we just could not do that."What excites Aguilera most are less flashy aspects of digitally enabled mental health services.For example, in a recent depression study, Aguilera paired <a href="https://www.jmir.org/2017/5/e148/">texting with in-person group therapy,</a> measuring if an automated text reminder improved attendance and thus treatment adherence. Aguilera and his team found that patients who received the reminder stayed in therapy significantly longer than those who didn't receive a text message, supporting the initial hypothesis of the study.<h2>How mental health startups want to integrate data science and AI into treating depression and anxiety</h2>To what extent venture-funded mental health startups can tackle the worst of the nation's mental health crisis is remains to be seen.Talkspace, for instance, tends to limit itself to "those with lower acuity," compared to more severe diagnoses like bipolar disorder and schizophrenia, according to a Talkspace spokesperson. However, it does have clients with those conditions. "We define lower acuity as patients who are able to manage care on their own," the spokesperson said. "For example, they are patients who, outside of occasional episodes, can take care of their family and go to work most of the time."Others, like Ginger, have a system of mental health services that encompasses behavioral health coaching as well as therapy from a fully licensed practitioner. Ginger in April <a href="https://www.businessinsider.com/cigna-taps-startup-ginger-for-virtual-mental-healthcare-coverage-2021-4">partnered with Cigna</a>, extending its reach to the major insurer's 14 million members.Startups are already using advancements in predictive data science and AI to try to better match their patient-users with their offered mental health services. Brightside, a mental health startup that <a href="https://www.businessinsider.com/see-mental-health-startup-brightside-series-a-pitch-deck-2021-5">recently raised $24 million</a>, takes teletherapy one step further by adding medication management and diet and mood tracking components within their app. It also uses past patient treatment and outcomes to recommend new users' best course of treatment. Others, like Wysa, are aiming to remove humans entirely from lower level mental health services. Its AI-powered chatbot interface, which just raised $5.5 million in May, has 3 million users, <a href="https://techcrunch.com/2021/05/21/mental-health-app-wysa-raises-5-5m-for-emotionally-intelligent-ai/">TechCrunch reports</a>.Largely aimed at people who "just want to vent," founder Jo Aggarwal told TechCrunch that Wysa's goal is not to diagnose or treat formal mental health conditions. Instead, it's meant to serve as an additional tool for managing stress around sleep, anxiety, and relationships. If a user's conversations in Wysa correlate with higher scores on traditional depression and anxiety questionnaires, the chatbot will suggest traditional therapy. Aggarwal said many of Wysa's predictions are the product of over 100 million conversations it's hosted since she started working on it in 2016. <h2>A better future in mental healthcare depends on whatever forms prevention can take</h2>Most of these mental health startups largely work within the existing system, often with large insurers or by using a consumer-first approach that prices out low-income patients. As a result, they ignore the healthcare needs of those unable to pay for their services.Still, by creating a variety of online options for tech-literate US consumers, the startups are furthering the development of a mental health system that prioritizes preventing, rather than treating, mental health diagnoses.With the nation's increasing mental health burden, it's a step in the right direction.

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