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Evidence Supporting Three Interventions That Might Slow Cognitive Decline and the Onset of Dementia Is Encouraging but Insufficient to Justify a Public Health Campaign Focused on Their Adoption

Cognitive training, blood pressure management for people with hypertension, and increased physical activity all show modest but inconclusive evidence that they can help prevent cognitive decline and dementia, but there is insufficient evidence to support a public health campaign encouraging their adoption, says a new report from the National Academies of Sciences, Engineering, and Medicine.




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New NAM Special Publication Offers Opportunities for Improving Outcomes and Reducing Health Care Costs in ‘High-Needs Patients’

Nearly half of the nation’s spending on health care is driven by 5 percent of patients, and improving health outcomes and curbing spending in health care will require identifying who these high-needs patients are and providing coordinated services through successful care models that link medical, behavioral, and community resources, says a new National Academy of Medicine special publication.




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New Report Lays Out Strategy to Evaluate Evidence of Adverse Human Health Effects From Endocrine-Disrupting Chemicals at Low Doses

A new report by the National Academies of Sciences, Engineering, and Medicine proposes a strategy that the U.S. Environmental Protection Agency (EPA) should use to evaluate the evidence of adverse human health effects from low doses of exposure to chemicals that can disrupt the endocrine system.




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New Report Outlines Research Agenda to Better Understand the Relationship Among Microbiomes, Indoor Environments, and Human Health

New Report Outlines Research Agenda to Better Understand the Relationship Among Microbiomes, Indoor Environments, and Human Health




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Statement Regarding National Academies Study on Potential Health Risks of Living in Proximity to Surface Coal Mining Sites in Central Appalachia

In an August 18 letter, the U.S. Department of the Interior’s Office of Surface Mining Reclamation and Enforcement informed the National Academies of Sciences, Engineering, and Medicine that it should cease all work on a study of the potential health risks for people living near surface coal mine sites in Central Appalachia.




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National Academy of Medicine Releases New Special Publication Guide to Help Health Clinicians Counter the Opioid Epidemic

Halting the opioid epidemic requires aggressive action across multiple dimensions, including informed, active, and determined front-line leadership from health clinicians working in every setting throughout the nation, says a new National Academy of Medicine (NAM) special publication developed at the request of the National Governors Association to assist the nation’s governors as they work with clinicians to counter the opioid crisis.




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Consumer Access to Affordable Medicines Is a Public Health Imperative, Says New Report - Government Negotiation of Drug Prices, Prevention of ‘Pay-for-Delay’ Agreements, and Increased Financial Transparency Among Recommendations

Consumer access to effective and affordable medicines is an imperative for public health, social equity, and economic development, but this need is not being served adequately by the biopharmaceutical sector, says a new report from the National Academies of Sciences, Engineering, and Medicine.




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New Report One of Most Comprehensive Studies on Health Effects of E-Cigarettes - Finds That Using E-Cigarettes May Lead Youth to Start Smoking, Adults to Stop Smoking

A new congressionally mandated report from the National Academies of Sciences, Engineering, and Medicine takes a comprehensive look at evidence on the human health effects of e-cigarettes.




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VA Provides Mental Health Care to Veterans of Recent Iraq and Afghanistan Wars of Comparable or Superior Quality to Other Providers, Yet Substantial Unmet Need Remains

While the U.S. Department of Veterans Affairs (VA) provides mental health care of comparable or superior quality to care provided in private and non-VA public sectors, accessibility and quality of services vary across the VA health system, leaving a substantial unmet need for mental health services among veterans of the recent wars in Afghanistan and Iraq, says a new congressionally mandated report from the National Academies of Sciences, Engineering, and Medicine.




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National Academies Announce Initiative on Environmental Health - Appoint Advisory Committee

The National Academies of Sciences, Engineering, and Medicine are launching an Academies-wide initiative to transform how the nation addresses the complex issues associated with environmental health—a field that examines how the environment affects human health.




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Eight Health Professionals Selected for Robert Wood Johnson Foundation Health Policy Fellows Program at the National Academy of Medicine

The National Academy of Medicine (NAM) and Robert Wood Johnson Foundation (RWJF) today named the 2018-2019 class of RWJF Health Policy Fellows.




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Permanent Supportive Housing Holds Potential for Improving Health of People Experiencing Homelessness, but Further Research on Effectiveness Is Needed, Including Studies On ‘Housing Sensitive’ Health Conditions

A new report from the National Academies of Sciences, Engineering, and Medicine examines evidence on whether providing permanent supportive housing (PSH) – a combination of stable housing and supportive services -- to individuals who are experiencing homelessness improves their health.




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National Academy of Medicine Announces Emerging Leaders in Health & Medicine

The National Academy of Medicine (NAM) today announced the Emerging Leaders in Health and Medicine.




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Up to 8 Million Deaths Occur in Low- and Middle-Income Countries Yearly Due to Poor-Quality Health Care, Says New Report

Recent gains against the burden of illness, injury, and disability and commitment to universal health coverage (UHC) are insufficient to close the enormous gaps that remain between what is achievable in human health and where global health stands today, says a new report from the National Academies of Sciences, Engineering, and Medicine.




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Kenneth Wells Receives National Academy of Medicine’s Sarnat Award for Outstanding Achievements in Improving Mental Health

The National Academy of Medicine today announced Kenneth Wells is the recipient of the 2018 Rhoda and Bernard Sarnat International Prize in Mental Health, for his work developing quality and outcomes approaches to psychiatry and mental health, fostering a generation of clinical investigators and mental health system leaders, and championing partnered, participatory research to advance equity for under-resourced populations.




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Stuart Altman Receives Lienhard Award From National Academy of Medicine for Leading Health Policy and Services Research in United States

For his pioneering role in national health policy and health services research, the National Academy of Medicine today announced Stuart Altman is the recipient of the 2018 Gustav O. Lienhard Award for Advancement of Health Care.




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National Academy of Medicine Publication Outlines Use of Procurement Requirements to Drive Interoperability in Health Care

While health care has made great strides in recent years with the proliferation of electronic health records (EHRs), establishment of regional health information exchanges, and development of data exchange standards and interfaces, interoperability among health care technologies remains very limited, says a new National Academy of Medicine (NAM) special publication.




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Three Health Professionals Named 2018 National Academy of Medicine Fellows

The National Academy of Medicine (NAM) has selected three outstanding health professionals for the class of 2018 NAM Fellowships.




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Team From University of Maryland, Baltimore, Wins Grand Prize in 2018 D.C. Public Health Case Challenge

The winners of the sixth annual D.C. Public Health Case Challenge were announced at this year’s National Academy of Medicine (NAM) Annual Meeting.




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National Academy of Medicine Announces Inaugural International Health Policy Fellow

The National Academy of Medicine (NAM) at its annual meeting announced its inaugural International Health Policy Fellow, Roger Chung, Ph.D., M.H.S., assistant professor in the School of Public Health and Primary Care at The Chinese University of Hong Kong (CUHK).




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New Report Calls for Health Monitoring and Research Program on Gulf War and Post-9/11 Veterans and Descendants

To help determine if the descendants of Gulf War and post-9/11 veterans are at risk for health effects resulting from the service members’ exposure to toxicants during deployment, a new report from the National Academies of Sciences, Engineering, and Medicine recommends the creation of a health monitoring and research program (HMRP).




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Reusable Respirators Are an Effective and Viable Option for Protecting Health Care Personnel During Routine Work and Public Health Emergency Response, Says New Report

Half-facepiece reusable elastomeric respirators are an effective and viable option for protecting health care workers from exposure to airborne transmissible contaminants or infectious agents — for example, influenza virus — during day-to-day work or with a sudden or rapid influx of patients, such as during a public health emergency, says a new report from the National Academies of Sciences, Engineering, and Medicine.




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Biotechnology Holds Promise for Protecting Forest Health, But Investments in Research Are Needed, Along With Public Dialogue

Biotechnology has the potential to be a part of the solution in protecting forest trees against destructive pest and disease outbreaks




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National Academy of Medicine Announces 10 Emerging Leaders in Health and Medicine

The National Academy of Medicine (NAM) today announced the 2019 Emerging Leaders in Health and Medicine Scholars. These individuals are early- to mid-career professionals from a wide range of health-related fields, from microbiology and surgery to sociology and biomedical engineering.




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Paid Parental Leave, Increased Support for Caregivers, Improved Food and Economic Security Among Recommendations in New Report on Achieving Health Equity for All Children

The lack of supportive policies for families in the United States, such as paid parental leave, has serious implications for health equity, as it affects families’ overall health and financial stability, says a new report from the National Academies of Sciences, Engineering, and Medicine.




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National Academies Report Helps Inform Metrics for Healthy People 2030

The National Academies today released Criteria for Selecting the Leading Health Indicators for Healthy People 2030, the first of two reports that will help inform the development of Healthy People 2030 (HP2030).




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U.S. Should Create National Agenda to Improve Child and Youth Mental, Emotional, and Behavioral Health, Says Report

A new report from the National Academies of Sciences, Engineering, and Medicine calls for a comprehensive national agenda to improve mental, emotional, and behavioral (MEB) health in children and youth. Despite advances in research, rates of depression, suicide and self-harm among young people have been increasing.




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Patricia Gabow Receives Lienhard Award From National Academy of Medicine for Transforming Safety Net Hospital Into Nationally Recognized Health System

For her role in transforming a safety net hospital into a national model for high-quality, cost-efficient health care, the National Academy of Medicine today announced Patricia Gabow is the recipient of the 2019 Gustav O. Lienhard Award for Advancement of Health Care.




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Addressing Patients’ Social Needs Within Health Care Delivery Is Key to Improving Health Outcomes and Reducing Health Disparities, New Report Says

Whether a patient has a safe place to live or healthy food to eat has an important influence on their health, but such nonmedical social needs have not traditionally been addressed in routine health care visits.




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Team From University of Maryland, Baltimore, Wins Grand Prize in 2019 D.C. Public Health Case Challenge

The winners of the seventh annual D.C. Public Health Case Challenge were announced at this year’s National Academy of Medicine (NAM) Annual Meeting. The challenge aims to promote interdisciplinary, problem-based learning around a public health issue of importance to the Washington, D.C., community.




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To Ensure High-Quality Patient Care, the Health Care System Must Address Clinician Burnout Tied to Work and Learning Environments, Administrative Requirements

Between one-third and one-half of U.S. clinicians experience burnout and addressing the epidemic requires systemic changes by health care organizations, educational institutions, and all levels of government, says a new report from the National Academy of Medicine.




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Juvenile Justice – Moving From Punishment to Hope and Healing

Every year in the United States, nearly 250,000 youths are tried, sentenced, or incarcerated as adults.




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To Improve Public Health, Medicine Regulators Worldwide Should Collaborate, Remove Barriers to Sharing Information, Says New Report

Medicine regulatory authorities — including the U.S. Food and Drug Administration (FDA) — should strengthen cooperation with other countries’ regulators to ensure the quality, safety, and efficacy of medicines, says a new report from the National Academies of Sciences, Engineering, and Medicine.




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Report Offers Promising Approaches to Make HHS Adolescent Health Programs More Effective

The U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Health (OASH) should focus funding on holistic, evidence-based, population-wide adolescent health programs that consider adolescent risk-taking as normative, according to a new report from the National Academies of Sciences, Engineering, and Medicine.




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Healthy People 2030’s Leading Health Indicators Should Track Health Effects of Climate Change, Residential Segregation, Civic Engagement

Healthy People 2030 (HP2030) – which will set national objectives for improving the health of all Americans from 2020 to 2030 – should include in its Leading Health Indicators (LHIs) voting as a measure of civic engagement, the health effects of climate change, and indicators of racial and ethnic residential segregation, says a new report from the National Academies of Sciences, Engineering, and Medicine.




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PEPFAR’s Investments in Rwanda Helped Boost Health Workforce, But Future Programs Should More Comprehensively Support Long-Term Capacity

Rwanda’s Human Resources for Health (HRH) Program – funded in part by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) from 2012 to 2017 – more than tripled the country’s physician specialist workforce and produced major increases in the numbers and qualifications of nurses and midwives, says a new report from the National Academies of Sciences, Engineering, and Medicine.




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Determining Whether There Is a Link Between Antimalarial Drugs and Persistent Health Effects Requires More Rigorous Studies

Although the immediate side effects of antimalarial drugs are widely recognized, few studies were designed specifically to examine health problems that might occur or persist months or years after people stopped taking them.




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Health Care System Underused in Addressing Social Isolation, Loneliness Among Seniors, Says New Report

Seniors who are experiencing social isolation or loneliness may face a higher risk of mortality, heart disease, and depression, says a new report from the National Academies of Sciences, Engineering, and Medicine. Despite the profound health consequences — and the associated costs — the health care system remains an underused partner in preventing, identifying, and intervening for social isolation and loneliness among adults over age 50.




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White House Requests National Academies Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats in Response to Spread of Coronavirus

WASHINGTON — In response to the COVID-19 outbreak, the White House Office of Science and Technology Policy has asked the National Academies of Sciences, Engineering, and Medicine to establish a Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats.




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U.S. Funding for World Health Organization Should Not Be Interrupted During COVID-19 Pandemic, Say Presidents of the NAS, NAE, and NAM

It is critical for the U.S. to continue its funding for the World Health Organization in the midst of the COVID-19 pandemic given the WHO’s lead role in coordinating an international response, especially in developing countries.




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Exploring the Importance of Pharmacies to Public Health

Research by NAM Pharmacy Fellow Dima M. Qato has shed light on “pharmacy deserts” and closures that reduce people’s access to medications.




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COVID-19 and Health Equity — Serving the Underserved, Poorly Served, and Never Served

The novel coronavirus has been called “the great equalizer,” when in reality, it has only exacerbated health inequities that racial and ethnic minorities have experienced for decades.




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Your Urban Drool (aka Polluted Runoff) Isn't Being Cleaned Up Quickly Enough, Says Heal The Bay

The engineered Dominguez Gap Wetlands in Long Beach filters stormwater and runoff from the Los Angeles River, then the water is siphoned under the river to a spreading ground to the west.; Credit: Sharon McNary/KPCC

Sharon McNary

Angelenos are used to looking up Heal the Bay's annual beach water quality report card each May as we search out the cleanest places to swim and surf.

Now, the environmental advocacy group is focusing on a new target — the often polluted water that flows into the ocean from the mountains and across the L.A. Basin.

In a first-ever report, it concludes the managers of 12 watersheds from Malibu to Long Beach are making too little progress toward cleaning up this major source of pollution in the Pacific.

This content is from Southern California Public Radio. View the original story at SCPR.org.




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Coronavirus Conundrum: How To Cover Millions Who Lost Their Jobs And Health Insurance

As millions of Americans have lost their jobs, Congress is trying to figure out what to do to help those who have also lost their health insurance.; Credit: South_agency/Getty Images

Dan Gorenstein and Leslie Walker | NPR

Mayra Jimenez had just lost the job she loved — and the health insurance that went along with it.

The 35-year-old San Francisco server needed coverage. Jimenez has ulcerative colitis, a chronic condition. Just one of her medications costs $18,000 per year.

"I was just in panic mode, scrambling to get coverage," Jimenez said.

A recent estimate suggests the pandemic has cost more than 9 million Americans both their jobs and their health insurance.

"Those numbers are just going to go up," MIT economist Jon Gruber said. "We've never seen such a dramatic increase in such a short period of time."

House Democrats introduced a bill in mid-April to help the millions of people, like Jimenez, who find themselves unsure of where to turn.

The Worker Health Coverage Protection Act would fully fund the cost of COBRA, a program that allows workers who leave or lose a job to stay on their former employer's insurance plan. COBRA currently requires workers to pay for their entire premium, including their employer's share.

The Worker Health Coverage Protection Act is one bill being considered as Congress tries to figure out what to do about the very real health care gap for those millions who have lost their jobs. Sponsors of the COBRA legislation say they hope their plan gets rolled into the next relief bill. But it's unclear when, how and whether the problem will get addressed in upcoming coronavirus relief measures.

Jimenez learned COBRA would run her $426 a month.

"I was kind of shocked to hear the number," she said. "That's almost half my rent."

The idea of allowing laid-off workers to stick with their coverage at no cost in a pandemic has clear appeal, says Gruber.

But he warns, "COBRA is expensive, and for many employees, it won't be there."

Only workers who get insurance through their employer are eligible for COBRA, leaving out more than half of the 26 million who have lost jobs in the last few weeks. Many of the industries hit hardest by COVID-19, including retail and hospitality, are among those least likely to offer employees insurance.

And even if someone had insurance through work, the person loses COBRA coverage if the former employer goes out of business.

Funding COBRA costs, federal dollars also wouldn't go as far as they could. Unpublished Urban Institute estimates show that an employer plan costs, on average, about 25% more than a Gold plan on the Affordable Care Act exchanges.

"We need to be all hands on deck, spending whatever we can to help people," Gruber said. "But that doesn't mean we shouldn't be thinking about efficient ways to do it."

Congress has tried this move before. In response to the Great Recession, lawmakers tucked a similar COBRA subsidy into the massive stimulus bill a decade ago. That legislation paid for 65% of COBRA premiums, leaving laid-off workers to cover the rest.

A federally commissioned study found that COBRA enrollment increased by just 15%. Mathematica senior researcher and study co-author Jill Berk said workers skipped the subsidy for two main reasons.

First, only about 30% of eligible workers even knew the subsidy existed.

"For those that were aware," Berk said, "their overwhelming response was that COBRA was still too expensive."

At that time, the average premium for a single worker — even with the subsidy — ran about $400 per month for a worker with family coverage.

"When you're actually facing those choices, choosing between rent and food and other bills," Berk said, "that COBRA bill looks quite high."

Berk's team also discovered that people who reported using the subsidy were four times more likely to have a college degree and a higher income than those who passed on it. In other words, Berk found that the COBRA subsidy was least helpful to those with the greatest need.

Several economists, including Gruber, and some Democrats in Washington are kicking around alternatives to COBRA. Among their ideas is a plan to have the federal government pick up more of a person's premium and other expenses on the Affordable Care Act exchanges. Another proposal would extend ACA subsidies to people who earn too much to qualify for any aid and to lower-income people who live in states yet to expand Medicaid.

Compared with funding COBRA, beefing up ACA subsidies could potentially help millions more people, including the pool of laid-off workers who did not get health insurance from their employer.

The ACA ties subsidies to people's income, giving more help to those at the bottom end of the wage scale and spending less on those who are better off. In contrast, the current COBRA plan would cover 100% of COBRA for everyone, regardless of the person's income.

There are some downsides to this approach. Making ACA subsidies more generous could end up costing the federal government more overall, because it gives more help to a lot more people.

Chris Holt from the American Action Forum, a conservative think tank, points out that the ACA already increases federal support when people's earnings fall and questions how much more of the tab Washington should pick up.

"If that subsidy would have been good enough for someone six months ago, why is it not good enough now?" he asked.

Maybe the biggest challenge to building on the ACA: The 10-year-old law remains a political football.

"There's just so much both emotion and, frankly, bitterness tied up in debates," Holt said, adding that this makes it hard to move anything forward.

Holt notes that COBRA is not free of political hang-ups either. He expects a fight over whether subsidy money can be spent on employer plans that cover abortion services, for example.

Holt and Gruber agree that perhaps the easiest idea is to leave the ACA alone with one minor tweak: allow people to take the ACA subsidy they're already eligible for and use it on COBRA if they choose.

As for Jimenez, she did not have time to wait for Congress. She brought in too much from unemployment to qualify for Medicaid. And she couldn't afford COBRA, so she picked out a plan on the ACA exchange, where she's eligible for generous existing subsidies. It will cost her $79.17 per month, and she gets to keep her doctors. Not everyone does.

This is the first time she has ever purchased insurance on her own, rather than gotten it through work — and that has delivered one other unexpected benefit.

"Freedom," Jimenez said. "It feels so freeing to take charge of my health care and to know that no one can take this away from me. I don't have to rely on a job to give me what they want to give me. I can make my own choices."

Policymakers, providers, employers and health-industry executives have been fighting over whether the United States should tie insurance to work since the end of World War II.

Subsidizing COBRA preserves the status quo, while doubling down on the ACA might just start to drive a real wedge between work and health insurance.

As states begin reopening businesses, some laid-off workers will get back their jobs, as well as their insurance. But many will remain unemployed and uninsured. A decade ago, faced with the same challenge, Congress chose to subsidize COBRA. It proved to be a narrow solution with limited impact.

Lawmakers now have the ACA at their disposal, a tool that may be a better fit for this moment. Whether they choose to use it may be a choice grounded more in political realism than policy idealism.

Dan Gorenstein is the creator and co-host of the Tradeoffs podcast, and Leslie Walker is a producer on the show, which ran a version of this story on April 23.

Copyright 2020 Kaiser Health News. To see more, visit Kaiser Health News.

This content is from Southern California Public Radio. View the original story at SCPR.org.




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Checklist devised to diagnose seafloor health

Scientists have produced a list of seafloor characteristics to determine the health status of the ecosystem it supports. These indicators could improve the quality and consistency of marine conservation efforts across Europe, particularly where the impact of human activities is high.




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Stretchable wireless sensor could monitor healing of cerebral aneurysms




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Stretchable wireless sensor could monitor healing of cerebral aneurysms





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CloudMD Is My TeleHealth Stock

Source: Keith Schaefer for Streetwise Reports   04/28/2020

With telehealth becoming a rising star in the coronavirus era, Keith Schaefer discusses why one company rapidly expanding in Canada stands out.

An entirely new—and highly profitable—industry is being borne out in 2020—TeleHealth.

CloudMD Software & Services Inc. (DOC:CSE; DOCRF:OTCQB; 6PH:FSE) is my favorite way to play teleHealth. It's growing quickly with over 100,000 patients registered on its app and over 3000 doctors in 8 provinces in its Electronic Medical Records—EMR—system. It has MULTIPLE revenue streams and it just moved into Canada's largest market—Ontario—setting up an even faster growth rate.

The recent spread of coronavirus is only accelerating this. COVID-19 has forever changed how we all will think about visiting a hospital or seeing our doctor. We really don't want to do that at all, if possible. It will have a very positive and long lasting impact on teleHealth.

teleHealth companies in Canada are getting paid more money for services than bricks-and-mortar clinics, and have a fraction of the costs. Doctors want more of it, patients want more of it, government wants more of it—and the Market REALLY wants more of it. Everybody wins here; there is no downside.

The rapid scale-up and profitability is key for investors.

The stock market is now recognizing this trend—in spades. You can see it in the stock chart of the U.S. leader in teleHealth, Teladoc Health Inc. (TDOC:NYSE).

While the market plummeted Teladoc's business and share price soared.


Now that a firm trend is in place—and teleHealth is one that makes a lot of sense—I'm looking for the junior with the best leverage to this new long term trade.

CloudMD is established, growing quickly and trading at a fraction of its peers.

The average multiple of competitors in the sector trade at 5-7x revenue, and CloudMD is trading way below that at 2.5x per revenue. I'll have more on those comps in a moment.

But realize that the Canadian use of telemedicine is still just a fraction of where it is in the U.S—so the quick, early upside is even bigger.

Literally the Canadian Version of Teladoc Health

The story with this stock is very simple. CloudMD is literally the Canadian version of Teladoc Health—just at an earlier stage in the growth curve.

The market desperately wants to own teleHealth right now (see also the stock charts of LVGO-NASD and CATS-NASD). I see CloudMD as the best way to do that in the junior sector (where the leverage is!).

For this stock to have a major run all that needs to happen is for institutional investors to wake up to the fact that the company exists. That's happening now with the company entering the province of Ontario—which has 14.5 million people, over one-third of Canada's population.

CloudMD is a fully integrated health care company—kind of like a hospital-in-the-sky. They do have five bricks-and-mortar clinics, but they also own their own EMR—Electronic Medical Records—system that operates in eight provinces and is used by over 3,000 doctors and is supported by an in-house 25 person development team. They have their own CloudMD app—which has over 100,000 registered patients already.

Folks, we really are in front of the institutions on this one. I don't have room in this article to even talk to you about the depth and credibility of CEO Dr. Essam Hamza, but after several conversations with him I can say that shareholders are in very good hands.

The EMR gives CloudMD a recurring monthly revenue stream, which The Street loves. The app gives them high margin fees from doctors, specialists and groups like massage therapists and counselors. These people are revenue, not costs. As I said, full hospital-in-the-sky. Multiple revenue sources with lower costs.

To schedule a virtual doctor's appointment all that a patient has to do is download the free CloudMD app and then arrange an appointment with one of the doctors. There is zero charge for the patient and they can see a doctor very quickly.

CloudMD can scale up the number of patients VERY quickly—and they are.

Every aspect of healthcare that's very fractured and disjointed will now be in the one CloudMD ecosystem.

Everyone wins with this system. Patients, doctors, the medical system, society, even investors. Everyone.

TeleHealth Is MUCH More Profitable Than Clinics

Doctors who have signed up with CloudMD work remotely from home or wherever they are (like their winter home down south). The rapid scale-up potential excites me. CloudMD can add in unlimited number of doctors and patients—so it has a virtually unlimited ability to scale quickly with little incremental cost.

Profit margins are wide and there is no cap on the number of customers that can be handled.

After a patient has an appointment, CloudMD bills the government directly just like every bricks-and-mortar clinic in Canada does. CloudMD records 100% of the revenue and gets to keep 30% of the billing for every patient that is seen through telemedicine, which is actually 10% more than what a bricks-and-mortar clinic receives. That is because the governments are trying to push teleHealth.

The doctor gets the other 70% and doesn't have to deal with any headaches of commuting or running a business.

Without the overhead of a bricks-and-mortar clinic, AND more revenue—CloudMD will be much more profitable than traditional health care stocks.

Faster scale, more cash flow. And they just entered Canada's largest market. This is the right stock in the right market at the right time.

When CloudMD goes from one doctor to 10 doctors to 100 doctors working at the same time, they don't have to build more clinics. They don't have to create more rooms for them or hire more staff. They just sign them on. That's it.

And we are not just talking about family doctors. They are also adding specialists and third party services like counseling and physiotherapists to the platform—and again, all these people are revenue, not costs.

That's the great thing about this business model. It's very scalable, very easy, and it grows very quickly.

CloudMD has been growing its recurring SAAS (Software-as-a-Service) revenue by 30% YoY with its EMR system. But this year the company is expecting that doctor growth to be much much higher—with a new full time sales team and the coronavirus pandemic. SaaS revenue is highly lucrative!

Consumer growth (patients) using the CloudMD app is growing even faster. And the recent COVID-19 situation will only turbocharge that.

Another Revenue Stream, Another Win-Win

There's another angle here—pharmacies. CloudMD says they will partner with more than 150 pharmacies in 2020 alone who are afraid of losing prescription business to Amazon (AMZN-NASD).

Those pharmacies are paying $500 a month for CloudMD kiosks to be in their pharmacies—where customers can get a prescription from a doctor on demand.

This keeps the customer in the pharmacy for their prescription—not out to see a doctor and then off to Costco to get it filled.

Pharmacies that don't see the writing on the wall will become the blockbusters of the industry and get left behind.

With the kiosk in the pharmacy, a person can just see a doctor right away, within 10 minutes, and walk the prescription back to the pharmacist.

Buy-outs Are Happening at High Valuations

We know that these businesses are worth.

Grocery giant Loblaws purchased QHR—another Canadian based EMR company—for $3.10/share or 7.5X revenue. Note that QHR's former Chairman Mark Kohler recently joined CloudMD's Board of Directors.

Teladoc bought a company out of Quebec just two months ago called InTouch for about US$600 million, which again is about 7.5X revenue. Teladoc itself trades at more than 10X revenue.

CloudMD trades at 2.5X revenue, less than a third of recent transactions. Meanwhile the company is poised to grow revenues at a high double digit rate for the foreseeable future.

TeleHealth is the future of how our healthcare is delivered.

Everyone has always expected that the growth would be just like what Netflix experienced with streaming, shaped like a hockey stick. The hockey stick shape is slow at the start as early adopters move and then straight up as the mainstream catches up with plot.

The demand for teleHealth from COVID-19 just took the flat part of that hockey stick out of the equation and instead took the industry directly to the exponential growth curve.

The jumping off point for teleHealth is here and I think CloudMD is the best pure-play teleHealth stock right now.

TeleHealth is to healthcare what streaming was to video rentals, and what Amazon was to retail. IT IS THE FUTURE.

Now is the time for investors to get on board, especially in Canada where virtual healthcare only accounts for 0.15% of the market and the growth curve will be much steeper.

And for me, that's CloudMD. It's the new normal. I'm long.

Keith Schaefer is editor and publisher of the Oil & Gas Investments Bulletin. He has a degree in journalism and has worked for several Canadian dailies but has spent over 15 years assisting public resource companies in raising exploration and expansion capital.

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Disclosure:
1) Keith Schaefer: I, or members of my immediate household or family, own shares of the following companies mentioned in this article: CloudMD. I personally am, or members of my immediate household or family are, paid by the following companies mentioned in this article: CloudMD. My company has a financial relationship with the following companies mentioned in this article: None. Additional disclosures are listed below.
2) The following companies mentioned in this article are billboard sponsors of Streetwise Reports: None. Click here for important disclosures about sponsor fees. As of the date of this article, an affiliate of Streetwise Reports has a consulting relationship with CloudMD. Please click here for more information.
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Keith Schaefer Disclosures:

CloudMD has reviewed and sponsored this article. The information in this newsletter does not constitute an offer to sell or a solicitation of an offer to buy any securities of a corporation or entity, including U.S. Traded Securities or U.S. Quoted Securities, in the United States or to U.S. Persons. Securities may not be offered or sold in the United States except in compliance with the registration requirements of the Securities Act and applicable U.S. state securities laws or pursuant to an exemption therefrom. Any public offering of securities in the United States may only be made by means of a prospectus containing detailed information about the corporation or entity and its management as well as financial statements. No securities regulatory authority in the United States has either approved or disapproved of the contents of any newsletter.

Keith Schaefer is not registered with the United States Securities and Exchange Commission (the "SEC"): as a "broker-dealer" under the Exchange Act, as an "investment adviser" under the Investment Advisers Act of 1940, or in any other capacity. He is also not registered with any state securities commission or authority as a broker-dealer or investment advisor or in any other capacity.

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Contaminated vegetables from polluted gardens may pose health risk

City dwellers who grow their own fruit and vegetables may be consuming high levels of pollutants. In a recent study, researchers found that vegetables grown on plots in Berlin, Germany, often contained higher concentrations of some heavy metals than shop-bought vegetables, with those grown close to busy roads containing the greatest quantities.