Americans spend a lot on prescription drugs, more per capita than any other country by far. Pharmacy spending used to be about 5% of total medical spend, but today it can be as high as 25%. Today I speak with Tim Thomas from Crystal Clear Rx about what we can do to ensure that we’re not overpaying for already pricey meds. As a case study, Tim talks about how Caterpillar is dealing with this trend.

Juan Pablo founded Babyscripts in 2014 with the vision that internet - enabled medical devices would transform the delivery of pregnancy care. Since 2014, Juan Pablo has been named a Healthcare Transformer by the Startup Health Academy in New York and a Wireless Lifechanger by CTIA for his work in detecting problems in pregnancy faster. Juan Pablo is also the architect of the first "Prenatal Care Moonshot" focused on eliminating preterm birth by 2027 through mobile/digital technology and Babyscripts has been named Champions of Change in Precision Medicine by Barack Obama and the White House.

Juan Pablo has raised $8.6 million in venture/angel financing for furthering his vision of a data centric model in prenatal care which includes the recent closure of a Series A of $5.5 million. He has orchestrated large partnerships with General Electric and their Healthymagination initiative and the March of Dimes specifically targeting the elimination of premature birth. He has also led the Babyscripts sales team, closing large hospital deals with more than 13 health systems around the country and successfully signing a co-development deal to build an at-risk product with Aurora Health Care in Wisconsin.

Juan Pablo is a frequent speaker on the future of health care. He has spoken at the mHealth Summit on "How to Demonstrate Value in Digital/Mobile Health," at the national HIMSS conference on "Establishing ROI and Forming Partnerships: Digital Health Dating," and at the Bio+Tech conference on "Collaborating for Patient Engagement." He has pitched and won Startup Competitions at SXSW at their Barracuda Bowl and the 1776 Healthcare Challenge Cup. He has also been invited to share his thoughts on podcasts and write op-ed articles on startup fundraising and the future of health care. He was recently interviewed by Medistrategy and wrote "3 Musts for Raising Your First Round" and "Why Disruption in Health IT is like a Tiramisu Cake."

Juan Pablo founded Babyscripts in 2014 with the vision that internet - enabled medical devices would transform the delivery of pregnancy care. Since 2014, Juan Pablo has been named a Healthcare Transformer by the Startup Health Academy in New York and a Wireless Lifechanger by CTIA for his work in detecting problems in pregnancy faster. Juan Pablo is also the architect of the first "Prenatal Care Moonshot" focused on eliminating preterm birth by 2027 through mobile/digital technology and Babyscripts has been named Champions of Change in Precision Medicine by Barack Obama and the White House.

Juan Pablo has raised $8.6 million in venture/angel financing for furthering his vision of a data centric model in prenatal care which includes the recent closure of a Series A of $5.5 million. He has orchestrated large partnerships with General Electric and their Healthymagination initiative and the March of Dimes specifically targeting the elimination of premature birth. He has also led the Babyscripts sales team, closing large hospital deals with more than 13 health systems around the country and successfully signing a co-development deal to build an at-risk product with Aurora Health Care in Wisconsin.

Juan Pablo is a frequent speaker on the future of health care. He has spoken at the mHealth Summit on "How to Demonstrate Value in Digital/Mobile Health," at the national HIMSS conference on "Establishing ROI and Forming Partnerships: Digital Health Dating," and at the Bio+Tech conference on "Collaborating for Patient Engagement." He has pitched and won Startup Competitions at SXSW at their Barracuda Bowl and the 1776 Healthcare Challenge Cup. He has also been invited to share his thoughts on podcasts and write op-ed articles on startup fundraising and the future of health care. He was recently interviewed by Medistrategy and wrote "3 Musts for Raising Your First Round" and "Why Disruption in Health IT is like a Tiramisu Cake."

Jennifer E. Miller, PhD, is an Assistant Professor at the NYU School of Medicine and President of the nonprofit, Bioethics International. She is also the Creator of the Good Pharma Scorecard, an index that ranks all new drugs and large pharmaceutical companies on their ethics and public health performance to help recognize good practices in companies, improve trustworthiness, and incentivize change where needed. Prior to joining NYU, Dr. Miller was based at Harvard University.

Dr. Miller currently serves on NYU's Pharmacy and Therapeutics Committee and Stem Cell Research Oversight IRB, as well as the J&J-NYU Compassionate-Use Advisory Committee (monitor). Previously, she served on the Center for Disease Control and Prevention's (CDC) Task Force for Pediatric Emergency Mass Critical Care, the American Medical Association's (AMA) Advanced Disaster Life Support Education Consortium, as a consultant to the United Nations Economic and Social Council, and on the PCORI-NIH Collaboratory.

A prolific writer, Dr. Miller has authored over 35 articles in publications including Nature Medicine and Health Affairs. She was a Fox News pundit from 2009 to 2012 and remains a news commentator, frequently featured on CBS news, Wall Street Journal, Washington Post, Bloomberg News, Forbes, and NPR.

Dr. Miller's current work explores the ethics and governance of new drugs that are researched, developed, marketed, priced, and made accessible to patients globally. She also specializes in the ethics of data sharing.

00:00 EP148: Jennifer E. Miller, PhD, Bioethics International and Creator of the Good Pharma Scorecard. 01:00 The Good Pharma Scorecard rankings for 2017. 01:40 Two 100% transparent pharma companies. 02:20 Two stats that prove that Pharma companies are improving. 03:00 Industry improvements on patient trials. 03:25 Ninety-six percent of all patient trials are available to the public. 03:45 Where there wasn't a significant improvement in disclosure in pharma.

Jennifer E. Miller, PhD, is an Assistant Professor at the NYU School of Medicine and President of the nonprofit, Bioethics International. She is also the Creator of the Good Pharma Scorecard, an index that ranks all new drugs and large pharmaceutical companies on their ethics and public health performance to help recognize good practices in companies, improve trustworthiness, and incentivize change where needed.  Prior to joining NYU, Dr. Miller was based at Harvard University.

Dr. Miller currently serves on NYU’s Pharmacy and Therapeutics Committee and Stem Cell Research Oversight IRB, as well as the J&J-NYU Compassionate-Use Advisory Committee (monitor). Previously, she served on the Center for Disease Control and Prevention’s (CDC) Task Force for Pediatric Emergency Mass Critical Care, the American Medical Association’s (AMA) Advanced Disaster Life Support Education Consortium, as a consultant to the United Nations Economic and Social Council, and on the PCORI-NIH Collaboratory.

A prolific writer, Dr. Miller has authored over 35 articles in publications including Nature Medicine and Health Affairs. She was a Fox News pundit from 2009 to 2012 and remains a news commentator, frequently featured on CBS news, Wall Street Journal, Washington Post, Bloomberg News, Forbes, and NPR.

Dr. Miller’s current work explores the ethics and governance of new drugs that are researched, developed, marketed, priced, and made accessible to patients globally. She also specializes in the ethics of data sharing.

00:00 EP148: Jennifer E. Miller, PhD, Bioethics International and Creator of the Good Pharma Scorecard. 01:00 The Good Pharma Scorecard rankings for 2017. 01:40 Two 100% transparent pharma companies. 02:20 Two stats that prove that Pharma companies are improving. 03:00 Industry improvements on patient trials. 03:25 Ninety-six percent of all patient trials are available to the public. 03:45 Where there wasn’t a significant improvement in disclosure in pharma.

Dr. Kyra Bobinet has five words of advice on engaging people in health: be caring, authentic, and useful.

As a national speaker, bestselling author and CEO-founder of engagedIN, a neuroscience behavior design firm, Kyra devotes her life to cracking the code of WHY we engage in our health. Everyday, she and her team use neuroscience to make products and communications more engaging.

For this work, Kyra received the 2015 Innovator Award from Harvard where she received her Masters in Public Health. She earned her medical degree at UCSF School of Medicine.

Dr. Bobinet is the author of Well Designed Life: 10 Lessons in Brain Science and Design Thinking for a Mindful, Healthy, and Purposeful Life. She has been featured by the Wall Street Journal, New York Times, Huffington Post, ExperienceLife and NPR.

She has created health start-ups, blockbuster products, health apps, big data algorithms, and evidence-based programs in mind-body & metabolic medicine. A former executive at a large payer, she has designed large-scale population health management and wellness interventions that yielded ROI for Fortune 500 companies.

Dr. Bobinet co-teaches patient engagement and health design with Dr. Larry Chu at Stanford School of Medicine, and studied in BJ Fogg's behavior design lab.

When she's not geeking out on neuroscience, you can find her engaged in her 160-acre training center in the Santa Cruz Mountains.

You can learn more at engagedin.com and changetrainingcenter.com.

What do physician burnout and sub-par patient portal usage have in common? It’s forgetting about how the user will react to the technology. To get what we hope to get out of a technology, we have to consider how to fulfill positive engagement and behavior change and build that right into the use case and workflow. Today I speak with Dr. Kyra Bobinet, MD MPH and CEO of EngagedIn, a neuroscience behavior design firm.

Stacey is co-president of Aventria Health Group, specializing in helping employer, pharmaceutical, device, and pharmacy clients by creating partnerships with other health care organizations. For 20 years, Stacey has innovated better-coordinated health solutions benefiting all stakeholders, and most of all, the patient.

00:00 The state of health care is fragile. 00:45 Antifragile: Things That Gain from Disorder by Nassim Nicholas 02:20 How easy it is for healthcare systems to break down. 02:40 "You can't domesticate disorder, volatility, or uncertainty." 03:15 The requirements of being an antifragile organization. 03:30 "Does everyone on the team understand the end game?" 04:45 Balancing people and processes. 05:25 "There is always judgement involved." 06:30 Overlap and quality control. 09:10 Allow for small mistakes. 11:45 The need for a feedback group. 14:15 Iatrogenic - relating to an illness caused by medical examination or treatment. 15:20 How rapid scaling slows down the ability to become antifragile. 17:10 Testing if you're doing something for the wrong reasons. 18:00 "What does the healthy business look like?" 18:20 How oligopolies make health care more fragile.

Healthcare industry in 2017: It’s fragile. I’m defining fragile as the opposite of “antifragile” coined by Nassim Nicholas Taleb in his book "Antifragile," recommended to me by Don Lee, the host of the HCBiz podcast which you should listen to.

In the English language there’s no opposite of fragile. Most people would say robust, solid, or resilient, but these terms mean less fragile. You have to hit harder to break it. The opposite of fragile would be something that actually strengthens the more

Ross Bjella, MBA is the founder and CEO of Alithias, a patient advocacy and population health analytics company serving self-insured employers, insurance companies, networks, and third party administrators. "Alithias" means "the truth" in Greek and currently has >60,000 lives with access to the platform. Ross has held senior management positions in the health care industry, including pharmaceuticals, biotech, and medical devices. Prior to Alithias, Ross served as the CEO of DDN, a leading business process outsourcer for pharma and biotech companies. Ross still consults with pharma companies about 3PL selection and resolving and supply chain issues from time to time. He has a degree in Biology from the University of Minnesota and a MBA from the University of Southern California.

You can learn more at alithias.com or by emailing Ross at [email protected], or following Ross on twitter @rossbjella.