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TTA’s Week: digital health funding flies to the moon, BlackBerry Sparking for health, Withings returns, e-triggers mine EHR data, and previewing Connected Health Boston

 

 

Digital health funding finally soars to the moon–in the home. BlackBerry is alive and Sparking, Withings is back. E-triggers to detect misdiagnosis. And are you going to Connected Health in Boston?

$6.8 bn in digital health funding through Q3 blows the doors off 2017: Rock Health (And the vote’s for in-home health)
It’s Alive! BlackBerry still Sparking with an ‘ultra-secure hyperconnectivity’ healthcare platform (Plugging the gap in EoT)
Diagnostic ‘e-triggers’ in EHRs to detect misdiagnosis, identify high-risk patients over time (Mining that data with machine learning and AI)
Withings returns to international markets with Steel HR Sport and a new Go (From Finland to France, and back to design heritage)
A preview of next week’s Connected Health Conference in Boston (Three days of immersion at the Seaport)

Lessons from Theranos for Silicon Valley? Are the new Apple Watch health features a mismatch to their market? Whither GEHC’s future within the Death Star? Will healthcare AI hype melt from a dash of cold water? Accreditation increasing provider burden?

The Theranos Story, ch. 57: was it Silicon Valley and Startup Culture bad practices pushed to the max? (The ‘hit to hope’ has two meanings)
Accrediting telehealth and remote patient monitoring providers (US) (Another try that may work this time, but increasing the training burden)
The Apple Watch, ECG and fall detection–a trend too far? (A market disconnect between those who buy and who actually need)
CEO change at GE may mean delay or cancellation of GE Healthcare spinoff–for good or ill (Time to destroy the Death Star?)
A sobering, mercifully hype-free view of AI in healthcare (A needed cold water bath)

Vital signs monitoring that reads people through walls and could revolutionize RPM.

No more smartwatches or connected tablets? Reading human vital signs through walls via a reverse Wi-Fi box and machine learning (A future without PERS, tablets, watches….)

Breaking news about 3rings and Canary Care. Babylon Health has no problem with funding–and spending. Cigna-Express Scripts clears DOJ. Two warnings about code running amuck if we don’t chill. More on Best Buy’s Assured Living. And more!

3rings assistive tech will be ringing off next March (UK) (Breaking news on yet another sad health tech closure)
Canary Care goes into administration, is acquired by Lifecycle Software (UK) (Breaking, but perhaps some hope)
AI promises, promises! Babylon Health to spend $100m, hire 1,000 to develop leading AI platform (Attracting funding like a magnet)
Cigna’s $69 million acquisition of Express Scripts clears US Department of Justice hurdle (But 50 hurdles lie ahead)
Weekend reading: the deadly consequences of unpredictable code (don’t be in a bike in front of a self-driving car)
IoT=Cyberdisaster, if we don’t chill innovation and secure it. It’s hip to be scared! (An argument for rational regulation)
Best Buy update: ‘Assured Living’ assuredly up and running. And was this Editor’s in-store experience not typical? (Should have the Geeks to the house for the TV)

It’s a busy start to September, including Apple and M&A Action, AliveCor’s FDA breakthrough, plus Tunstall’s Danish snack. Some thoughts on Best Buy and how not to serve the older adult market. Aging2.0 invites you to pitch. VistA EHR’s international future. And more!

Rounding up September’s start: AliveCor’s hyperkalemia detector, Apple’s ECG Watch, Tunstall Nordic’s EWII, steps towards a bionic eye, Philips licenses BATDOK, VistA’s international future
Apply to pitch your older adult health solution at the SOMPO Digital Lab Pitch Event (At Aging2.0’s OPTIMIZE)
Can Best Buy have an effective older adult strategy when they can’t sell a TV? (One Editor’s predictive visit)
CVS-Aetna, Cigna-Express Scripts reportedly on road to merger approval; Athenahealth in hostile takeover (M&A heats up, not always for the better)

Theranos runs out of cash and dissolves, but the litigation lingers on. Two more events for your fall calendar.

The Theranos Story, ch. 56: Bye, bye Theranos…but the litigation continues (Fortress collects the remains. Holmes and Balwani face the hard, cold DOJ with no company behind them)
Two more events for the calendar: ATA’s EDGE18 (Austin TX), SEHTA/Brunel MedTech Connects (London) (Is your calendar filled yet?)

Facing September–and facing that we need to protect personal genomic data. What’s the difference between being embarrassed and indicted? (Mortal risk to patients?) Blending direct and telehealth for mental care. The US Army’s telehealth innovations in medical triage. Social determinants of health applied right can save acute care money. Why telehealth needs compliance folks. And you’ll ‘fall’ for our extended listing of international events.

Soapbox: Big Genomics and DNA testing–why we need a Genomic Data Bill of Rights

The Theranos Story, ch. 55: ‘Bad Blood’s’ altered reality on ‘Mad Money’; it was all Bad Blitzscaling (Fascinating Fraudsters Meet Mortal Risk )
Rounding up August’s end: ‘blended’ mental healthcare, Army’s telehealth innovation, Montefiore’s 300% ROI on social determinants, telehealth needs compliance (More short takes on articles in the hopper)
More events for your autumnal calendar, from Israel to Ireland to Santa Clara to NYC! (updated) (And there’s a Mediterranean Ventures winner!)

 


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Telehealth & Telecare Aware: covering the news on latest developments in telecare, telehealth, telemedicine and health tech, worldwide–thoughtfully and from the view of fellow professionals

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Donna Cusano, Editor In Chief, donna.cusano@telecareaware.com, @deetelecare

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$6.8 bn in digital health funding through Q3 blows the doors off 2017: Rock Health

And the money rolls in. All Rock Health had to do was wait a quarter to get breathless [TTA 4 July], because digital health funding through Q3 is now exceeding the full year 2017 by $1.1 bn. The average deal size has accelerated substantially–$23.6 million versus last year’s $16.4 million. The deals are bigger but fewer–290 so far versus 357 last year–and the length of time between funding rounds has consistently grown shorter. 

Another proportional shift is the growth of Series B and C startups, at long last, and a more than doubling of D+ deals.

A big shift in this quarter were that the stars lined up, perhaps for the first time, with at-home and on demand health. American Well of course at $291 M loaded these dice, but also benefiting from the throw were the similar Doctor on Demand, Honor (home care), and NowRx med delivery service. Faster meds at lower cost have become a major area of action (Amazon with PillPack, TelePharm, others). Digital therapeutics that help to monitor health at home followed from Pear Therapeutics, Click Therapeutics, Akili Interactive, Virta Health, Propeller Health, and Hinge Health. 

And where the money comes from? Independent venture funds still account for 63 percent, and corporate VCs for 15 percent.  Some of those CVCs are major names such as GSK, Abbott, and Cigna. Big tech is also moving into healthcare, with Amazon’s $1bn acquisition of PillPack, the Apple Watch 4, Google’s Nest.

Rock Health’s trend prediction is continued consolidation in digital health, with companies continuing to acquire each other. “With available capital and a desire to build out product lines, talent, and client bases, it’s not surprising to see a great deal of M&A activity within digital health.” One example given is Welltok, which plays in the consumer health ‘activation’ area, and their acquisitions from corporate health management programs to Wellpass, which has created such as Text4Baby, Text2Quit and Care4Life and whose largest customer is state Medicaid plans.

Keep in mind that Rock Health tracks deals over $2 million in value from venture capital, excluding government and grant funding. They omit non-US deals, even if heavily US funded.

Rock Health’s report. Healthcare Dive.  Mobilhealthnews‘ own top 17 M&As, which include Best Buy-GreatCall and Logisticare-Circulation in the burgeoning area of non-emergency medical transport (NEMT).

It’s Alive! BlackBerry still Sparking with an ‘ultra-secure hyperconnectivity’ healthcare platform

And this Editor thought that BlackBerry had long since hung up the ‘Out Of Business Sign’. In this era of BYOD in healthcare and software systems like Blue Cedar that secure apps from these BYODs from the device past the server, the image of the ‘Crackberry’ persists–tiny keyboard, tiny screen, and the corporate governed phone. All these loathsome features have now transitioned to iPhone 6s (tiny keyboard, tiny screen, corporate apps, locked down and trackable everything). (So much for that ‘tech will set you free’ world promised by Steve Jobs in the ‘1984’ spot, replaced by Big Brother–Ed. Donna)

BlackBerry, as a company based in Ontario, Canada, endures as a software platform minus the devices. Much like Nokia, they have taken on the world of IoT in areas demanding tight security. Their latest introduction is the BlackBerry Spark, a software platform they claim will lead the Enterprise of Things (EoT) to “ultra-secure hyperconnectivity from the kernel to the edge”. Hyperconnectivity, in their definition, will enable secure IoT equipment with consumer friendly interfaces, leverage AI and manage smart ‘things’ regardless of operating system and existing platforms, and making military-grade security easy and intuitive for users. Spark will be available to companies (thus EoT) by the end of 2018.

BlackBerry has evidently latched on to a messy need–the lamentable lack of security in most consumer IoT devices. They have also identified the yawning gaps in security in almost every healthcare enterprise in connected devices. In Mobihealthnews, their spokespeople expanded on the technology as they are applying it to healthcare via a quantum-resistant code signing server, a new system using blockchain to deliver medical data and an operating system for secure medical devices. More details on how these are being used so far were cited in their most recent release:

  • A blockchain digital ledger for the Global Commission, an organization focused on diagnostics for children with a rare disease. One of the pilots concentrates on BlackBerry’s powering real-time, actionable analysis to shorten time to diagnosis.  
  • A new OS for medical, QNX OS for Medical 2.0. This is described as a real-time operating system for the development of robotic surgical instruments, patient monitoring systems, infusion pumps, blood analysis systems, and other safety-critical products that must pass stringent regulatory approvals.
  • With the Mackenzie Innovation Institute (Mi2), participating in research around comprehensive security, patient privacy and intelligent connectivity in healthcare IoT.
  • Skin cancer research in Australia with the Melanoma Institute Australia.

Certainly BlackBerry is aiming for a certain sweet spot in healthcare and finding some partners all over the world, though the US seems to be absent. Will they be able to ‘crack’ it and the rest of the world? Time will tell.

Diagnostic ‘e-triggers’ in EHRs to detect misdiagnosis, identify high-risk patients over time

A just-published study in the BMJ Quality & Safety journal explores the potential of the information in EHRs to be used in new tools that detect errors in diagnosis and prescribing. The Safer Dx Trigger Tools Framework, proposed by the authors, would apply algorithms against the vast amounts of data stored in the EHR for data mining to prevent errors.

Current e-triggers detect prescription errors and procedure complications. This framework proposes tracking of patient events over time, such as patient-provider encounters, performance and interpretation of diagnostic tests, follow up and tracking of diagnostic information over time, and referral and/or patient-specific factors. It would detect errors such as initial misdiagnosis in office visit or hospital, abnormal test results, or delayed diagnosis from lack of specialty expertise.  

The model framework and seven steps they recommend for development and design of these tools are depicted here:

click to enlarge

Also POLITICO’s Morning E-Health.

Withings returns to international markets with Steel HR Sport and a new Go

Withings, bought back earlier this year from Nokia by founder Eric Carreel [TTA 3 May, release 31 May], reentered the market last month with most of the Nokia Health line and its new Steel HR Sport, a multisport hybrid smartwatch with heart rate monitoring, connected GPS tracking and fitness level analytics that analyzes VO2 max (release). Like Withings products before the acquisition, it is a pleasure to look at–well designed and more watch-like than smartwatchy–and surprisingly priced at $200. But on the budget side, reports indicate that Withings is reviving the Withings Go, famous for its eInk face. According to Wareable, they found a listing with the FCC for a successor model number to the previous Go (WAM03) containing information about a fresh design and new sensors for this basic fitness tracker. No price or release date is listed, but the 2016 model was about $70 retail.

Withings’ HQ has returned to Paris and is selling in the US, Canada, Mexico, Europe, Asia, and New Zealand.

A preview of next week’s Connected Health Conference in Boston

click to enlargeNext week’s Connected Health Conference at Boston’s Seaport World Trade Center is themed around ‘Balancing Technology and the Human Element’, and over the three days of the conference the organizers will be tackling subjects such as social determinants of health, research, rapid prototyping of devices, and the very timely subject of the Apple Watch‘s ‘fall call lite’. This year day 1 on Wednesday 17 October is an ‘Immersion Day’ with separate registration (and separately priced) mini-conferences sponsored by The Society for Participatory Medicine, ECHAlliance, the VOICE Health Summit, and PCHAlliance’s ‘deep dives’ including one from Parks Associates. Days 2 and 3 on Thursday and Friday 18-19 October are fairly standard conference fare on a variety of stages and of course with a small exhibitor floor, ending after 3pm on Friday (and a good way to segue into a fall weekend in Boston).

CHC is organized by PCHAlliance, a non-profit formed by HIMSS, and incorporates the Boston conference previously organized by Partners HealthCare. Mobihealthnews offers a preview in an interview with  Senior Director of Connected Health Innovation at Partners HealthCare Kamal Jethwani, and Tufts University School of Medicine Associate Professor and Recycle Health founder Lisa Gualtieri. There is still time to register here (though hotel rooms are, as usual, scarce). (Unfortunately, Editor Donna can’t attend as she did in previous years due to other commitments.)

The Theranos Story, ch. 57: was it Silicon Valley and Startup Culture bad practices pushed to the max?

click to enlargeTheranos is now formally in California insolvency proceedings (note on their website). Creditors may have enough awarded to them to go down to the local pizzeria to buy a slice or two. Hard lessons indeed for creditors and shareholders. But aside from the drama yet to come in the trial of Elizabeth Holmes and Sunny now Shady Balwani, a/k/a the Silicon Valley Trial of the Century, are there any further lessons to be learned?

For those of us who have not been closely following The Theranos Story, David Shaywitz’s kind-of-review of John Carreyrou’s Bad Blood coupled with a thought piece in Forbes is especially appealing. Even if you’ve been tracking it closely like your Editor, it’s a good read. He posits that in three key areas, Theranos exhibited Startup Culture and Silicon Valley Ethics (or lack thereof) at the very extreme in these areas:

  • Secrecy: extreme compartmentalization, siloing, stratification, and rigid definition of roles that prevent information sharing. No outsiders in, or peer-reviewed research out.
  • Promises, promises, promises: a rosy picture to the point of delusion that masks real flaws
  • I Want To Believe: for various personal reasons, investors, press, and supports need to believe

Secrecy can and should work for companies in keeping proprietary information and competitive advantage intact. All startup and early-stage companies have to paint a positive picture in the midst of pitched struggle. The glass is always half full not empty even when the bank account is, but when the old ‘fake it till you make it’ becomes too strong, papering over the truth is the thing and the institutional absence of tough self-scrutiny (or a professional kicker-of-holes) prevents companies from fixing obvious problems–you get a delusional organization like Theranos edging gradually, then very quickly, into outright fraud. Finally, Theranos’ supporters had their own reasons for wanting to believe the technology worked. 

He goes on to state that the fraud that Theranos perpetrated was not only financial and in harm to health, but also in the hope that change is possible in healthcare delivery, we can challenge the way it’s always been done and win, and that technology can be empowering.

Will we, as a result, in Mr. Shaywitz’s words, take the ‘hit to hope’ to heart and become ‘excessively chastened and overcautious”? This Editor tends to be on the overcautious side when it comes to technologies such as IoT and AI because the potential for hacking and bad use is proven despite the hype, but far less so in challenging incumbents–even it it resembles tilting at windmills till they buy you.   

Will l’affaire Theranos change the Silicon Valley and Startup Culture for the better? Here is my ‘hit to hope’–that this excessively aggressive, conformist, borderline irresponsible, and secretive culture could change. This Editor doubts it’s even entered their leaders’ ‘deep’ thoughts, despite this best-selling book.

A more typical review of ‘Bad Blood’ is by Eric Topol, MD (!) in Nature–who certainly borrowed ‘The Theranos Story’ from this series of articles!

Accrediting telehealth and remote patient monitoring providers (US)

Another organization has a go at it. ClearHealth Quality Institute (CHQI) of Annapolis, Maryland, an independent health care accrediting body, is developing two new telemedicine accreditation modules that cover Telemedicine Outcomes and Remote Patient Monitoring. The CHQI has formed a committee to develop standards in these areas to add them to current accreditation modules in telemedicine delivery: Consumer-to-Provider (C2P), Provider-to Consumer (P2C), and Provider-to-Provider (P2P). 

The need for clinical training and accreditation was recognized in August’s National Quality Forum report, Creating a Framework to Support Measure Development for Telehealth. Four domains of measurement were identified in the NQF report for telemedicine and telehealth organizations: 1) access to care, 2) cost effectiveness, 3) experience, and 4) effectiveness.

CHQI started in the insurance accreditation and compliance areas, expanding to telehealth recently. It is the only telemedicine accreditation program recognized by the American Telemedicine Association (ATA) and with major telemedicine providers such as American Well, Doctor On Demand, and MDLive.

Our Readers will remember that back in 2014, then Intel-GE Care Innovations in conjunction with the Jefferson College of Population Health had started the Validation Institute to accredit both individuals and companies. By last July, Care Innovations had sold it off to the Health Value Institute and had some time back concentrated on companies only. ClearHealth release, PatientEngagementHIT

The Apple Watch, ECG and fall detection–a trend too far?

click to enlargeMid-September’s Apple Fans kvelled about the Apple Watch Series 4 debut. Much was made in the health tech press of Apple’s rapid FDA clearance and the symbolism of their further moves into medical devices with the Series 4 addition of a built-in atrial fibrillation-detecting algorithm and an ECG, along with fall detection via the new accelerometer and gyroscope.

This latter feature is significant to our Readers, but judging from Apple’s marketing and the press, hardly an appealing Unique Selling Proposition to the Apple FanBoys’n’Girls who tend to be about 35 or wannabe. The website touts the ECG as a performance feature, a ‘guardian and guru’ topping all the activity, working out, and kickboxing you’re doing. It positions the fall detection and Emergency SOS in the context of safety during or after hard working out or an accident. It then calls 911 (cellular), notifies your emergency contacts, sends your current location, and displays your Medical ID badge on the screen for emergency personnel, which may not endear its users to fire and police departments. 

Laurie Orlov in her latest Age In Place Tech article points out the disconnect between the fall risk population of those aged 70+ and the disabled versus the actual propensity (and fisc) to buy an Apple Gizmo at $400+. PewInternet’s survey found that 46 percent of those over 65 actually own a smartphone, though this Editor believes that 1) much less than 50 percent are Apple and 2) most smartphone features beyond the basic remain a mystery to many. (Where store helpers, children, and grandchildren come in!)

Selling to older adults is obviously not the way that Apple is going, but there may be a subset of ‘young affluent old’ who want to sport an Apple Watch and also cover themselves for their cardiac or fall risk. (Or have children who buy it.) This is likely a sliver of a subset of the mobile PERS market, which is surprisingly small–only 20 percent of the total PERS market. But monitoring centers–doubtful, despite it being lucrative for GreatCall.

CEO change at GE may mean delay or cancellation of GE Healthcare spinoff–for good or ill

The well-publicized and unvarnished dumping of GE‘s CEO John Flannery after only 13 months has led a leading research analyst to predict that the planned GE Healthcare spinoff will be delayed or even halted. Analyst Jim Corridore of CFRA stated on CNBC that incoming CEO Lawrence Culp, a recent board member who was CEO of Danaher, a scientific, industrial and healthcare conglomerate, may decide that the division should stay. 

At $19 billion in revenue with a profit of $3.4 billion, 15.8 percent of GE’s total sales and 43.2 percent of its operating profit in 2017, the wisdom of a GEHC spinoff always seemed doubtful. The selloff was in line with Mr. Flannery’s strategy of refocusing on GE’s industrial and energy business. However, this was not going terrifically well, at least in the BOD’s view, with a sluggish turnaround, shares dropping off the S&P 500 and the Dow Jones Industrial Average, projections of missing year-end targets, activist investor Nelson Peltz hovering, and exacerbated by problems at GE Power with its new line of natural gas-fired power turbines. Perhaps a few were doubly offended by the selloff of the corporate jets (relative pennies) as well as the expensive and frankly hard-to-justify corporate HQ move from Connecticut to Boston.

Mr. Culp is apparently well-thought of, having retired after a highly successful 14-year run at Danaher, but he has his work cut out for him. He will also need to quickly judge whether to continue the GEHC spinoff process or bring the cattle back into the fold, as the drive was well underway down the trail. Somehow, spinning off 40 percent of your operating profit seems strategically foolish given a plummeting share price.

A jaundiced opinion. Perhaps as an outsider, Mr. Culp can change the ‘death star’ culture at GE. This Editor, in her brief encounter with GEHC as part of an acquired company (Living Independently Group, developer of QuietCare, circa 2008-9) found their business practices and many of their people to be both ruthless and self-referential to the point of stumbling blindness. The LIG acquisition was part of an ill-considered and perhaps ego-driven experiment by GEHC’s CEO at the time to get into home, remote monitoring, and assisted living health, a developmental, small-scale, early-stage area. It was obvious that GE’s vaunted methodology and hospital-based acute care experience were worse than useless when it came to understanding what is still a developmental area. The home health businesses were sold, closed, or (in the case of QuietCare), spun off into a joint venture. That CEO and a few other people leveraged it well; LIG’s employees, shareholders, and others at GEHC did not. 

As Star Wars fans know, Death Stars are destroyed in the final reel.

A sobering, mercifully hype-free view of AI in healthcare

Way up there on the Peak of Inflated Expectations in the Gartner Hype Cycle is that two-letter creature, AI. Artificial Intelligence has been invoked in multiple tech fields, and Microsoft in the US currently is running 30 second commercials about how AI is “making tomorrow today” but without much explanation as to how.

If AI’s current puffery makes you dizzy, long-time observer of the Healthcare Scene Anne Ziegler’s article in Hospital EMR and EHR might stabilize the whirlies. In direct and brief terms, she classifies the realities of healthcare AI adoption in three areas:

  1. Lack of Transparency. How does AI reach its conclusions in making ‘good decisions’? Sometimes the logic of the conclusion is obvious, but often it is not, and what you get is physician and clinician bypass–and suspicion.
  2. That Old Monkey Wrench Tossed into Existing Processes. It’s taken a long time for organizations to fully integrate their EHR inputs and documentation. Throwing in an AI implementation even in a limited sense may require more adjustments than the outcomes are worth.
  3. It’s Too, Tooooo Much Data. Healthcare organizations do not suffer from a paucity of data. AI feeds on data. Sounds like a good match, doesn’t it. Except that a lot of this data isn’t usable without filtering and mining, and that takes a lot of processing. The future may have more advanced data processing and indexing tech to do that, but right now even natural language processing to identify useful information is rare in the field.

Widespread AI use in healthcare is, despite the IBM Watson Health hype, a long way off. In healthcare, the rubber must meet the road of patient care and clinical practicality to be useful to us with Non-Artificial Intelligence. Problems We Need To Address Before Healthcare AI Becomes A Thing

No more smartwatches or connected tablets? Reading human vital signs through walls via a reverse Wi-Fi box and machine learning

A monitoring future without smartwatches, pendants, or transmitting readings through your tablet? A professor at MIT has developed a box, about the size of a Wi-Fi router, that can monitor a person’s vital signs throughout the house. Like Wi-Fi, the device emits a low-power wireless radio signal, but the device then measures the return on those radio signals from the bodies in the residence. The ‘neural network’ takes the data from the tiny changes in electromagnetic signals to track physiological signs as the person moves from room to room, even through walls, using machine learning to analyze those reflected signals and extract physiological data such as breathing, heart rate, posture, and gait. The device has also been tested on sleep patterns including sleep stages, which means it could replace the awkward and artificial electrodes in a lab which are usual for sleep testing.

Dina Katabi, a MIT professor of electrical engineering and computer science, built this box in her lab. So far it has been tested in over 200 homes around the US, tracking the baselines of healthy people and those with Parkinson’s, Alzheimer’s, depression, and pulmonary diseases. In the case of Parkinson’s, the data gathered by the device over eight weeks in the home of a patient indicated that his gait improved around 5 or 6 am, right around the time he took his medication. Data is encrypted and Professor Katabi has stated that the setup process requires a user to complete a series of specific movements before it’s possible to be tracked. She has also cofounded a startup, Emerald Innovations, to commercialize the technology. If it is workable beyond the test stage, it has the capability to revolutionize remote patient monitoring. Engadget, MIT Technology Review

3rings assistive tech will be ringing off next March (UK) (updated)

click to enlargeAnother assistive technology/TECS company decides that they have reached the end of the road.

Mark Smith, one of our Readers and Business Development Director of 3rings, which has been featured more than a few times in these pages over the past six years from Kickstarter days, this morning passed along the sad news that 3rings is closing. From Steve Purdham, the founder and chairman (and updated by him today 19 September):

It is with great regret and sadness that we have to inform you that we will be bringing the 3rings Care plug and Internet of Things sensor service to a close. 

After a journey of 6 years we have taken this decision because the technology adoption within the Social care market is extremely slow moving, which means that we are not able to attain a sustainable business model that would give the quality, and daily operational support that we believe is the minimum we would expect to deliver, to look after you, our customers.

Our customers including individuals, regional council’s and housing association’s that use 3rings as a safety net of care, are very important to us and this is the reason why we haven’t waited until the last moment to notify you of our decision.

With this in mind, we will be maintaining support for the 3rings care service, including the Plug and IOT sensors platform until Friday 1st March 2019.

Given the extended notice period we feel that this provides enough time for you to make alternative arrangements.

The 3rings team strongly believe in the world of IoT sensors and true digital solutions to provide a safety net of care, 3rings has always evangelised this as our goal, we know that digital safety nets of care will change the face of social care in the future. With that in mind we are still exploring alternatives and should anything change we will inform you at the earliest opportunity.

We are truly sorry to have to deliver this message, but can I personally thank you for your support, we are immensely proud to have helped so many families and vulnerable people, and to have saved lives through the 3rings service.

Your support for the 3rings product range made a massive difference, and we thank you for your understanding and commitment to providing to the safety net of care for your loved ones or clients.

Should you wish to clarify anything or have any comments then please don’t hesitate to contact me directly either by email on steve@3rings.co.uk or call me on 01260-222853 or my mobile 07899 803555.

Yours sadly
Steve
Steve Purdham · Chairman

Steve, in his separate note to this Editor, explained that they chose this four-month-plus winding down in order to responsibly look after their customers so that they have enough time to transition to other monitoring systems. Individual users of 3rings will be separately notified as well.

It was, as Mark said, a shock, but as this Editor noted in the Canary Care article from earlier today, in many ways the TECS/AT/telehealth business has not progressed much since 2006. The funding, technology, and consumer acceptance are all better since the early 2000s, but there is a lot more competition with not enough market takeup to warrant it. Even 3rings’ integration with the very trendy Amazon Echo and the IoT space showed innovation, but not the reward.

The social care area is more developed in the UK than the US as a concept. In the US, we speak more about ‘social determinants of care’, with one determinant–transportation–getting most of the action and the money. When you look at the truly disproportionate amounts of investment in certain hot companies with sexy tech, for instance a few ‘unicorns’–the now expired Theranos being the Poster Child–where far smaller amounts funding tech that works in real companies with real customers would do immediate good and would change things in the long term (longer than 18 months, which is the usual VC horizon), one wonders if we haven’t gone a little bonkers.

Yet those of us in the industry remain hopeful. As Steve Purdham said to me in a separate note, “the market has all the tools to change face of social care but the families and the existing structures are so glacial in the acceptance of this change. It will come and it will make a massive difference when it does.” We’re all trying.

We wish Steve, Mark, and the 3rings team all the best–and perhaps a White Knight will Save the Plug. Hat tip to Gerry Allmark of UK Telehealthcare as well for the information.

Canary Care goes into administration, is acquired by Lifecycle Software (UK)

click to enlargeAbingdon-based Canary Care, a developer and marketer of wireless sensor-based home health monitoring systems, has gone both into administration (the closest US equivalent is Chapter 11 bankruptcy) and been acquired by Lifecycle Software Ltd., a developer of CRM and billing software for telecommunications, internet service providers, and utility companies. In US terms, this is basically a pre-packaged bankruptcy.

According to their listing on Companies House, the administration started on 31 August. At the end of August, Lifecycle acquired the company (5 September press release). The Lifecycle website now features that Canary Care will be ‘keeping your dearest nearest’.

Stuart Butterfield, a Canary Care director as well as interim managing and technical director, was kind enough to answer my inquiry about the company’s status with a message that expressed a great deal of hope:

So, we’re still very much alive, and will continue to provide the Canary Care product and service that our existing customers know and love. As you will be aware, adoption of TECS is painfully slow. However, our new owner provides us with the stability and resources to continue to develop the Canary Care offering and we’re very excited and optimistic about the future and the opportunity to bring Canary Care to a wider audience.

Innovative assistive technology/TECS, despite the investments by major players, remains a difficult area for funding and adoption not only in the UK but also in the far larger market of the US and Canada. While we see a Best Buy acquiring GreatCall, we’re also reminded that GreatCall picked up the remnants of Lively for the IP and Healthsense for their assisted living customers and for the technology. The “name” health tech companies of the early ’00s are largely gone or no longer independent (Viterion, Living Independently, HealthSpot, Cardiocom, WellAware…)

In many ways, we have not progressed much from, say, 2007, in the field, except for tech advances and the number of players.

We wish Canary Care and Lifecycle success–and the patience they will need with this market. Hat tips first to a UK industry insider who alerted this Editor, as well as Gerry Allmark, managing director of UK Telehealthcare for help in sourcing Companies House.

AI promises, promises! Babylon Health to spend $100m, hire 1,000 to develop leading AI platform

Babylon Health’s CEO Ali Parsa announced at their headquarters last week that the company would be spending $100 million to develop the ‘world’s leading AI healthcare platform’. In the company of Health Secretary Matt Hancock, an admitted GP at hand fan (nothing goes better after poring over your red boxes), Mr. Parsa confirmed that the 1,000 data scientists, programmers, and clinicians would be based in London after a global search of suitable cities. They will be helping to design the next generation of health AI for diagnosis and to support patients with long-term conditions. 

The report in Digital Health noted that the audience included key figures such as Malcolm Grant, chairman of NHS England; Dr Simon Eccles, NHS England CCIO; and Juliette Bauer, head of digital experience. This is despite Babylon challenging the Care Quality Commission (CQC) over an unfavorable report [TTA 11 Dec] and being put on hold by Birmingham as well as Hammersmith and Fulham CCGs [TTA 23 Aug].

Babylon is well able to afford this as Prudential Asia (Prudential plc) has licensed Babylon’s software for its own apps across 12 countries in Asia for an estimated $100 million over several years. Forbes  It also inked a deal in June to provide insurer Bupa’s Instant GP to corporate clients [TTA 21 June]. Will this include a foray into the US? No clues so far!

Cigna’s $69 million acquisition of Express Scripts clears US Department of Justice hurdle

As reported on 8 Sept, the DOJ announced on Monday that they have formally cleared the Cigna acquisition of pharmacy benefits manager Express Scripts. This puts together a major payer with a PBM manager, the latter area considered to be challenged for profitability as the PBM drug rebate model may be substantially less profitable in the future. Federal policy pressure is ramping up from Health & Human Services (HHS), with Secretary Alex Azar only last week promising disruptive change and more transparency in drug pricing.

CVS (PBM-Caremark) with Aetna is in the works and Anthem is creating its own PBM called IngenioRx. UnitedHealthcare has its own OptumRx for some years. 

Another point of pressure on the entire PBM category is the Amazon-Berkshire Hathaway-JP Morgan combine, sometime in the future when the hype and speculation on What Amazon Will Do turns into actual plans beyond their acquisition of tiny, specialized player PillPack for an exorbitant $1bn [TTA 4 July]. 

The DOJ investigation took six months, reviewed more than 2 million documents, and more than 100 industry people were interviewed.

Cigna and Express Scripts now must negotiate over 50 state departments of banking and insurance–over 50 because some states have two. Both companies already have shareholder approval, and the lack of overlap in their businesses limits the possibility of divestitures. Their advocacy website is here. But state DOBIs can be unpredictable, as Cigna found out with Anthem. (Their contentious breakup is still being contested in court–and Cigna could use the contractual breakup money to ease the Express Scripts debt estimated at $15 bn. Forbes.  Bloomberg, Healthcare Dive