Healthcare tech investment gone wobbly?

Earlier this month, this Editor riffed on David Shaywitz’s Forbes article lamenting the paucity of life sciences VCs setting their sights and putting their money on the line for digital health. While David Doherty of mHealthInsight differed, pointing out his 16 billionaires making big bets in health tech, VC action in ‘hot’ digital health is underperforming. The ironically-named MoneyTree 2013 First Quarter report from PricewaterhouseCoopers (PWC) and the National Venture Capital Association (NVCA), tracks media, software, clean tech, biotech and medical devices. And the ‘Tree’ is not exactly ‘shaking’:

  • For all surveyed VC investment, 1st Quarter 2013 declined 12 percent in dollars and 15 percent in number of deals, compared to 4th Quarter 2012.
  • Medical devices and equipment are an ‘underperform’: down 20 percent to $509 million, deals dropping 10 percent to 71, 1st Quarter 2013 to the prior quarter.
  • In the prior year (2012) 1st Quarter, over $200 million more had been invested in medical device companies. Similar declines were tracked in biotech.
  • The Life Sciences sector (medical devices + biotech) declined to the fewest number of funding deals since 1st Quarter 2009. Even more shockingly, first time VC financings are at 2nd Quarter 1995 levels.
  • Software and media continued to dominate–and grow in funding.

According to investors queried by FierceMedicalDevices, reasons for weak investment in medical devices were: continued lack of transparency at the FDA about approval process, movement away from first round/early-stage to later-stage companies, a focus on companies with devices not needing FDA approval–or already having it. Unfortunate, but rational. One hopes a change of heart, or a change of cycle.  PwC/NVCA release (in FierceMedicalDevices)

Telemedicine breaking through with payers? (US)

Cigna, the tenth largest insurer in the US, jumped this week on the virtual consult wagon train with earlier pioneers UnitedHealthcare (#1), WellPoint (#2) and Aetna (#5).  Cigna is partnering with MDLive to offer online video, telephone or e-mail consultations with doctors for non-urgent care as an option for self-insured employers nationwide starting 1 July for plans effective 1 January 2014. MDLive will send, via Cigna, summaries of telehealth visits to patients’ physicians. Cigna’s present telemedicine partner, McKesson’s RelayHealth, will remain for virtual consults with the patient’s own physician. Among payers, the widest coverage appears to be UnitedHealthcare with NowClinic in 22 states; WellPoint offers American Well only in California and Ohio while Aetna is piloting with Teladoc in Texas and Florida. (Just in time to buzz through ATA 2013!) InformationWeek Healthcare

TBI drug in potential trial with former NFL players’ association

Breaking news in the US today on a topic we’ve been following. Maryland-based Neuralstem, a developer of neurogenic drugs, announced this morning that it is working with the National Football League Alumni Association (NFLAA) to develop a trial of their NSI-189 for treating NFL alumni members suffering from traumatic brain injuries (TBI). According to their release, NSI-189 (or NS1-189, both are used) is currently in a Phase Ib clinical trial to treat major depressive disorder. Because it appears to work by stimulating neurons in the hippocampus, a region of the brain that atrophies in depression, this could also apply to brain injury. While this announcement is perhaps more than it seems–a Phase I clinical trial is ‘early days’, to make it through all four phases (I-IV) may take a decade, and now the developer is switching around the treatment condition–the drug itself has received support from DARPA and NIH which are both closely concerned with TBI. In addition, working with the NFLAA will help Neuralstem find subjects for the trials. PR Newswire via Baltimore Business Journal 

Previously in TTA on TBI and the NFL: Further sad confirmation of CTE, Brain injury research study, NFL donates $30 million to NIH, Combating TBI on the battle and football fields.

Supporting People funding reductions – telecare panic (UK)

The situation described in the following article in the Liverpool Echo can be looked at in a number of ways and we wonder what other takes readers will have…

One has to wonder, given that the reduction in the Supporting People funding from April has been known about for a long time, what planning has been done between the council, the housing providers and the telecare service provider to prevent this situation arising. One could also wonder what alternative, less expensive, systems have been investigated and ponder the ethics of removing from people’s homes something which is potentially life saving (and cost saving further down the line). Ultimately, if substantial numbers of people are saying they will not pay an extra £2.99 per week [interesting number] then perhaps they are saying that the service and the much-trumpeted reassurance it provides is not, in reality, so important to them. Liverpool elderly could be at risk from loss of £500,000 funding for emergency care alarms. Check out the comments too.

Readers may want to compare that with the ongoing publicity in nearby Trafford which is encouraging people over 80 to take up a year’s free telecare trial. Events held to promote free telecare for Trafford’s over 80s.

Electronic paper and tactile robots

E Ink technology, popular on e-books like the Kindle and on displays, is now showing up as a highly readable, lightweight (80g), low power display (one week life) phone.  A prototype E Ink-only Android phone was demo’d at Mobile World Congress. The tradeoff is full color for great readability and simplicity in any light. Kind of like silent movies. Watches, anyone?  Springwise Hat tip to TANN Ireland’s Toni Bunting.

Robots with tactile sensors for pressure and adjustable gripping are necessary but at present don’t come cheap–sensors are about $16,000 for a robot hand. The cutely named TakkTile, developed by grad student Leif Jentoft and postdoctoral fellow Yaroslav Tenzer at the Harvard School of Engineering and Applied Sciences, may be the answer. “At the heart of the device is a tiny air pressure-sensitive digital barometer, of the type already commonly used in things like cell phones and GPS units. A layer of rubber is vacuum-sealed onto it.” Beyond robots, uses envisioned are toy animals that respond to being petted and medical devices that assist with surgery. New sensor designed to give robots a gentler touch – on a budget (Gizmag)

Helping the ‘beleaguered caregiver’

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2013/04/60344-1-lg.jpg” thumb_width=”150″ /]Medication organizing/sharing apps, geotracking, learning programs and texting are helping caregivers of those with Alzheimer’s, heart conditions and autism better cope with family conditions.   The National Alzheimer Center, a division of Hebrew Home at Riverdale in Bronx, NY, developed the Balance $3.99 app that has multiple features: Pill Box (med management), Learning (sharing info about the disease), Caregiving, Schedule (sharing calendars), Doctor Diary (tracking physical and emotional changes in the patient and sharing them with the doctor/s) and News (Arutz Sheva/Israel National News; release with photos). Available currently on iTunes; Android version to come. The Alzheimer’s Association offers Comfort Zone, which uses GPS to track the person with Alzheimer’s within a pre-set geographic area, for about $43 a month. For heart patients, Mended Hearts will be starting a program of texted tips for caregivers. Autism Speaks has collected learning websites and apps for tablets which families have used successfully with autistic children, and has given away over 800 to low-income families.  None are pricey, all serve growing populations–and none will generate buzz at industry cocktail parties. Beleaguered caregivers getting help from apps (SacBee/AP)

Mobile visits in the medical home

This presentation by William C. Thornbury, MD  summarizes his two-year research on ‘virtual patient visits’ in the primary care area. In patient-centered medical homes (PCMH), telemedicine virtual visits fit extremely well with an e-commerce minded, ‘gone mobile’ patient group and their needs for convenience and rapid response. It also fits with patient engagement, superior care delivery and cost efficiencies. This presentation is a lengthy 1 hour 28 minutes (including Q&A, which is also interesting) so you may want to bookmark for the weekend. It frames the essentials of disruptive innovation as it applies to mHealth telemedicine. From a webinar presented by MeVisit and the PCPCC’s Care Delivery and Integration Stakeholder Center via HealthShareTV.

[This video is no longer available on this site but may be findable via an internet search]

ATA 2013 announces three ‘practical’ keynotes

The American Telemedicine Association’s 2013 meeting, 5-7 May in Austin, Texas has three keynote speakers, and not a buzzy one among them. The large provider:  Lynn Britton, President & CEO, Mercy, a 31 hospital healthcare system in the Midwest and named 2012 “Most Wired” healthcare organization by the American Hospital Organization. The tech innovator: Jeffrey Henley, Chairman, Oracle Corporation. The payer side: Reed Tuckson, MD, the immediate past Chief of Medical Affairs for UnitedHealth, the largest US private insurer. Release. More information on ATA 2013. If you are attending ATA, and would like to contribute a summary of what you find interesting or your general observations (including video and photos), please email Editor Donna or comment below.

European remote patient monitoring to $800 million by 2018

Frost & Sullivan’s latest report on the European market posits remote patient monitoring (RPM)–including telemedicine (virtual consults and patient visits), telecare and telehealth–as achieving $616.4 million in 2012 and rising to $831 million by 2018 as European countries economize in healthcare delivery. It’s worthwhile noting that F&S has developed multiple studies in their Connected Health Growth Partnership Service program for Europe, APAC and the Americas. F&S release, HealthTechZone article.

MOBISERV and Kompaï (Video from Dutch TV)

A 5 minute clip of a Dutch TV programme for people over 50 where someone is talking about care robots and Kompaï in particular. (Also clips from the film Robot and Frank) Even if you do not speak Dutch you will probably get the gist. The interviewee, Corien Van Berlo of Smart Homes, appears to be dispelling some misconceptions about robots in the home. Video thanks to Vincent Dupourque of Robosoft.

[This video is no longer available on this site but may be findable via an internet search]

Telecare as entrepreneurial platform (US)

Telecare ‘grizzled pioneer’ GrandCare Systems, which extended some time ago into both telehealth and socialization, is profiled in this Milwaukee Journal-Sentinel article on local entrepreneurship and the relationship of intellectual capital to economic success. CEO Charles Hillman, COO Gaytha Traynor and VP Marketing Laura Mitchell are interviewed in the video (05:26).

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2013/04/Lively.jpg” thumb_width=”150″ /]But telecare has attracted a new entrant, Lively (or Live!y). It’s an in-home behavioral monitoring system which uses neatly-designed motion sensors and M2M connectivity. It strongly resembles to this Editor QuietCare as originally positioned for older adult independence and safety in the home, but developed out in a version 2.0 or 3.0. Activity information feeds over to a web/smartphone platform which generates alerts when something is off the routine (again, like QuietCare). Pricing is right with an equipment cost of $149 (same as the original QuietCare) but with a far lower per month subscription of $19.99–lower than PERS which averages around $35-45–and unlike QuietCare, it is fully self-install. The connectedness overlay is (hold the presses!) direct mail–a ‘LivelyGram’ every two weeks which turns friends and family photos, news and updates into a booklet. The sticking point may be the usual–the older person finding this intrusive and ‘I don’t need this.’ Their Kickstarter appeal has unfortunately started off slowly even with initial discount pricing of $99 for the system; as of 23 April, $11,534 pledged of a $100,000 goal with 21 days left. Neil Versel reviews at Mobihealthnews.

FCC very quietly names Director of Health Care Initiatives (US)

With no official announcement, the US Federal Communications Commission (FCC) has selected Matthew Quinn from the National Institute of Standards and Technology (NIST) for its first-ever Director of Health Care Initiatives, as reported in FierceMobileHealthcare (via Mobihealthnews). His maiden appearance was at a recent Care Continuum Alliance Capitol Caucus in Washington, D.C. This contrasts with the relative fanfare back in December of the new position and its big scope–administering the Health Care Connect Fund, the health care part of the National Broadband Plan, developing spectrum policy for Medical Body Area Networks (MBANs) and other medical devices as well as expanding broadband to skilled nursing facilities (SNFs). It’s all quite curious as it seems to be a muting of the FCC’s previous aggressive stance in cutting its slice of the pie in health care. FierceMobile’s editor Greg Slabodkin wonders what door the new Director will be using in Welcome, Mr. Quinn, I don’t believe we’ve been introduced.

‘Virtual visits’ win Singapore innovation award (AUS)

Australia’s Royal District Nursing Service (RDNS), which is testing a telehealth service (=telemedicine), won the Outstanding ICT Innovation award in the Asia Pacific Eldercare Innovation Awards 2013, part of the 4th Ageing Asia Investment Forum in Singapore.  Nurse virtual visits were demonstrated between ‘patient’ Singapore’s Senior Minister of State, Mr. Chan Chun Sing, and RDNS nurse Amanda Murray in Melbourne, checking his blood pressure and ‘medication’. The ‘Healthy, Happy and at Home’ project over the past two years was developed by the RDNS with the Victorian State Government under its Broadband Enabled Innovation Program (BEIP); participating partners are Telstra, Healthe Tech (using the original Intel Health Guide) and La Trobe UniversityRDNS telehealth wins international ICT award (ITWire),  Asia Today  Video (3:38) Hat tip to reader George Margelis of Care Innovations Australia.

Free whitepaper about the current smartphone app market

research2guidance is offering a free 27-page report on the current smartphone app market (the ninth edition). Entitled Building And Marketing A Mobile App Will Have Bigger Impact Than Commercialization Of Internet it highlights how:

  • App publishers and companies will be forced to keep track of at least the most important distribution channels for their most important target groups. Building and marketing an app is therefore becoming an important part of businesses. It will even have a bigger impact than the commercialization of the internet economy at the beginning of the century.
  • Diversity of mobile operating systems will increase, offering new opportunities, especially for 2nd tier device manufacturers.
  • App development will become more complex. For developers the pressure to reach out to new target groups who are demanding innovation is rising.

The Boston Marathon tragedy and health tech implications

The terrorist bombings at the end of Monday’s Boston Marathon has already stimulated some analysis on what tech did–and could have done–to save lives. MedCityNews’ article analyzes the handling of the casualties–well done in the coordination of multiple hospital ERs (EDs) in caring for over 100 moderately to severely wounded, but showing the present inability in Massachusetts for the state health information exchange (HIE) Mass HIway to exchange patient EHRs under emergency circumstances. “With HIEs that have this capability, emergency department personnel can search for a patient’s record immediately upon his arrival or even as he’s being transported to the hospital. In hospitals connected to the Indiana Health Information Exchange (IHIE), for example, the system searches for a patient’s record automatically when he’s registered to the ED.” mHIMSS focuses on emergency response, triage, mobile data collection–and Boston’s Center for Connected Health on how health tech could assist in victims’ recoveries and mental support. But in the short term, the Greatist health and fitness website offers links to ways to help, including blood and financial donations, showing support, finding people and keeping up with news. Also there’s the official email for the FBI on where to send photos of the Boylston Street/finish line area.

But what of the long-term–the recovery from both the physical and mental wounds, and managing long term care issues? Four entrants in the MassChallenge accelerator 2013 startup class  to be announced in early May have medical therapies directly applicable to the survivors:  Advanced Amputee Solutions (shock absorption for the lower limb, Benevolent Technology for Health (adjustable fit for prosthetics), Keradermlab (alternative to skin grafts for burn healing) and Lucirix (connectivity platform for all health providers. MedCityNews

StartUp Health adds AARP education on 50+ tech

Health tech accelerator StartUp Health is wisely pointing their entrepreneurs towards ‘the jobs to be done’ of the 50+ age group via a new partnership with AARP. AARP is sponsoring the development of educational content for entrepreneurs in the StartUp Health Academy as part of their Innovation@50+ initiative. They are also sponsoring StartUp Health’s quarterly industry research reports as well as trend data and intelligence. This is StartUp Health’s second high level partnership, after their joint program with GE Ventures Healthymagination [TTA 4 April]. StartUp Health/AARP release.

It’s good business and societal benefit sense. Lather, rinse, repeat: The 50+ market will comprise 45 percent of the US population by 2015. Extended thoughts on differentiating the needs of the ‘young old’ versus the 70-80+ group–and how individual older people have different takeups on tech; Stephanie Baum gives the example of her 80 year-old mom who just upgraded her iPhone and downloads apps, but finds it difficult to do online search. What do seniors need? (MedCityNews)

Related: The Oxitone wrist-worn blood oxygen meter is one of the StartUp Health/GE ‘Lucky Thirteen’ and is profiled in this Times of Israel article. [TTA 7 Sept 2012, 24 Feb 2012] Notably it’s one of only two non-US companies in the group–the other is Ireland’s GetHealth.