[TT 039] subjective healthcare, microdose studies, telehealth trajectory, mental health tech, quantum sculptures
Hi again Thrivers,
This past week has been clarifying as I'm starting to get a clearer sense of the edge of digital healthcare and mental healthcare technologies. I'm also gaining respect and empathy for the absurd complexity of creating change in the US healthcare system. Oy.
I've also clarified the direction and scope of my independent research project in the psychedelic industry that I'll be doing next quarter. Some really interesting pieces coming together there.
With a humble bow to the mystery, let's swirl into this week's Thriving Thursday
On the complexity of patient-centered healthcare
In all the time I've spent studying healthcare this quarter, it's surprising that not once has anyone brought up "What does healthy mean to the patient?". In fact, the structure of western healthcare is to a) prevent death and b) decrease illness. What if your tolerance for health or illness is different from my own?
A 2003 article by Mark Sullivan on "subjective medicine" draws a distinction between objective biological fact and deeply personal concepts of subjective health and perceived quality of life.
Patient-centered healthcare has become more of a topic in the last decade as patient satisfaction scores have phased into Medicare compensation structures. Scary and uncomfortable as it may be, the logical conclusion of patient-centered healthcare means allowing the patient to define healthy for themselves.
It also means targeting messaging and delivery of any intervention to the specific patient's place on an acceptance-control curve. If Cambridge Analytica can use psychographics to prompt certain voting behavior change, why not use similar behavioral modeling techniques to prompt health behavior change? To the best of my knowledge, this is currently a frontier in health data science.
On a studying the effects of microdosing
Famed comedian and podcaster Joe Rogan collaborated with Quantified Citizen to create this decentralized microdosing study. There are over 13,000 participants and they need folks that microdose as well as a control that doesn't. If microdosing, or potentially microdosing at some point later, interests you this may be worth contributing to.
A more qualitative microdosing study (n=41) from Third Wave highlighted the distinction between microdosing LSD and psilocybin (from magic mushrooms). The results found that psilocybin triggered more collaborative creativity and empathy relative to LSD.
Both are completely valid, and they are simply distinct tools to be used for different purposes.
On the future of telehealth and virtual-first care delivery
5 years ago, a telehealth industry group published this list of future research questions. After COVID and the rush to online care, these telehealth questions feel more urgent and relevant than ever.
For the first time, insurance giant UnitedHealthcare launched a virtual-first insurance plan. That's an understandable approach from an economic standpoint, but it's not clear that patients want to be serviced digitally. A McKinsey study found that telehealth visits peaked around 32% of office and outpatient visits and has dropped closer to 13% today. Notably, there are significant cons to telehealth (like, say, less effective care). And, according to the FairHealth telehealth regional claims tracker, the substantial majority of these are for mental health services.
It makes sense that mental health, usually delivered as a conversation, can go online relatively seamlessly. Of course, something is lost when we're not face-to-face, but much more is lost when a physician actually needs to put hands on a patient.
Only time will tell how this stabilizes, but telehealth triage and delivery is definitely a systematic and strategic shift in the healthcare landscape.
On novel ways technology can improve mental health
Most mental health "technology" companies I've found so far boil down to some combination of self-serve coaching, care triage, matching platforms, or putting the office experience into a telehealth format. Effectively, translating existing therapy professionals and content into a new context.
There are a select few companies that are using tech in completely novel ways. BehaVR is using virtual reality for immersive experiences that achieve mental health objectives. The most interesting program I saw was related to maternal health with "NurtureVR". Also worth noting that the founder is the former CTO of Humana - one of the largest insurers in the US.
Another nifty company is Apollo - a wearable that uses haptic feedback (gentle vibrations) to nudge certain behaviors based on biomarkers. I like the framing of a "wearable hug" and definitely curious to try this sometime.
On quantum science-inspired disappearing sculptures
Portland, Oregon-based artist Julian Voss-Andreae makes incredible human form sculptures that play with our visual spatial orientations. This interview video gives a pretty good insight in Julian's thought process and workflow. Always loves seeing an artist's shop!
One of the things I cherish about the sculpture form is the ability to gain different perspectives as I walk around the piece. Having a sculpture play with that visual shift from solid to disappearing form feels inviting of the mystery of our human essence.
Dropping a picture in here won't do it justice, so watch the video above to see the full effect.
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And with a wisp of perspective shift, I disappear into thin air ... until next week.
Hocus Pocus & happy upcoming Halloween!
~Henry