Fitbit and Teladoc: big IPOs, big questions

This week’s big news (so far) of Fitbit’s $732 million initial public offering–the largest consumer electronics IPO ever–comes despite the Jawbone IP lawsuits [TTA 11 June]. Count us among those who question this ‘vote of confidence’ as raising unrealistic expectations for health tech by a fitness tracker not truly part of real digital health. Telemedicine provider Teladoc appears headed on the same track with an IPO estimated to come in at $137 million, probably by next week. This generous pricing (~$20/share) comes despite never being profitable in 13 years. Like Fitbit, Teladoc is facing lawsuits from its major competitor American Well on IP [TTA 9 June], with Teladoc asking the US Patent and Trademark Office to review the validity of several American Well patents. Both IPOs are on the New York Stock Exchange (NYSE). MedCityNews examines Fitbit and Teladoc.

Your Friday robot fix: the final DARPA Robotics Challenge

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/01/Overrun-by-Robots1-183×108.jpg” thumb_width=”150″ /]They’re Still Puppets! The final DARPA Robotics Challenge took place last week at the Fairplex racetrack in Pomona, California. 10,000 spectators viewed 24 teams’ robots going through their disaster-response paces to win a share of $3.5 million in prize money in this final stage of the DARPA three-year program. Many of the robots were custom, but several teams fielded adaptations of the Boston Dynamics Atlas robot as a common platform. The engineering teams were sequestered in a ‘garage’ offsite and linked to their robot charges by a deliberately degraded communication system (to simulate field conditions). The robots had no cords (unlike 2013) and were given eight tasks: driving a car down a dirt road, getting out of the car, opening a door and entering a building, turning a valve, cutting a hole in a wall with a drill, completing a surprise task (flipping a switch or unplugging a tube and plugging it into another hole), navigating a pile of rubble, (more…)

3rings smart plug fundraising on Kickstarter

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/06/3rings.gif” thumb_width=”150″ /]A note from founder and chairman Steve Purdham brings the news that the 3rings smart plug [TTA 11 Mar], which tracks an older one’s activity through everyday actions such as turning on an electric tea kettle or TV and radio on, is raising funds on Kickstarter through 13 July. Their goal is $30,709 (£20,000) of which $10,306 (£6,712) has been raised with 24 days to go. With product design and testing complete, the funds will go towards facilitating production. Pledges start at £2 and go up to £5,000 for practically everything listed in the lower donation levels, a special evening in Oxford for two and an autographed, personalized picture and autobiography of Manchester United and Scotland legend Willie Morgan. Note: the 3rings plug and service is only available in the UK, but if the service is available later in your country, any subscription pledges will be honored. Best of luck to Steve and the 3rings team! Release.

A ‘Game of Thrones’ analogy to potential health insurer mergers

The Wall Street Journal has likened the merger action pending among America’s largest insurers to the series ‘Game of Thrones’, said thrones occupied by Aetna, Cigna, Humana, UnitedHealthcare and Anthem. These more aptly remind this Editor of the final stages of airline deregulation, except that none are in a non-medieval bankruptcy court. Their actions reflects the payers’ urgent concerns that now is the time to reinforce a national presence, that revenues in a Obamacare environment (well, we’ll see the effect of that US Supreme Court subsidy decision due imminently) can do nothing but go down and that Medicare Advantage, commercial accounts, health system relationships (ACOs) and health IT systems are the place to be. What is missing: the fate of those independent, state and regional Blue Cross-Blue Shield (collectively, the ‘Blues’) which are not part of Anthem, many of which are ‘non-profit’ (note the quotes); the positive effect of competition on pricing and a fair consideration of the negative effects of monopoly. Ah, but there are no flung axes, regicide or poisonings to be found here. The real theme of ‘Game of Thrones’ is the effect of the powerful on the powerless (we the insured), which the WSJ writer doesn’t address…..Insurers Playing a Game of Thrones (if you hit a paywall, search on the title)

Telemedicine, telehealth follow up to reduce emergency room revisits

A great deal of importance has been placed on reducing same-cause hospital readmissions, but what about emergency room (ER, Emergency Department=A&E in UK) revisits? Sometimes they are needed–for increased pain, further testing or medication checks when the staff is doubtful the patient will follow up on their own–but often not. Two telemedicine/telehealth programs in Pennsylvania aims to cut these high rates of return–up to 20 percent in a month. Thomas Jefferson University Hospital is piloting video call follow up plus a call center to phone patients at risk of revisit to help with needed appointments. A group of insurers and providers, the HealthShare Exchange of Southeastern Pennsylvania, will also share patient information among local ERs when the insurance number is entered, a measure that may prevent unneeded testing. Modern Healthcare Hat tip to our readers at Practice Unite

Tunstall Americas gets active with QMedic

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/07/Big-T-thumb-480×294-55535.gif” thumb_width=”150″ /]Tunstall Americas’ monitoring providers will have something new to distribute: the QMedic activity tracker. The QMedic bracelet (alternatively pendant) has an alert button and a base station like a conventional PERS, but also tracks sleep quality and activity levels. It has two way monitoring and also generates alerts and texts to loved ones if the bracelet isn’t worn or no wake-up is detected, plus recurring wellness reports on activity, sleep, and safety in the home. Fall detection presumably is inferred Tunstall’s reseller agreement includes all its local healthcare service providers. This Editor also observes that after a very long period of quiet, Tunstall in the US is demonstrating its own activity. Release. Earlier in TTA: Tunstall Goes Hawaiian with Kupuna Monitoring acquisition

London Health Technology Forum & the Cleveland Health challenge

The London Health Technology Forum (HTF), run by this editor, has its last event before the summer break on 17th June – Baker Botts, who have been kindly hosting our forums for a long time now will be presenting on An introduction to securing, protecting and maintaining your IPR. We’ve also news of a prize-giving event in our November meeting, and an exciting competition run by the Cleveland Clinic.

Failure to manage IPR effectively has been the cause of very many entrepreneurial failures so this free event to learn about the topic should be of real interest to very many people. Therefore, especially in view of the expertise of the presenters, it is highly recommended. There will be three presentations:

1) Starting out – a brief look at IPR relevant to new businesses

  • what IPR are you generating?
  • who creates the IP and who owns it?
  • how and where can you protect your IP?
  • how are IPR maintained?

(more…)

Telemedicine coordinators help improve user numbers in Queensland

The demand for telemedicine services in south western Queensland is reported to have tripled from 8 consultations a month [grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/06/Charleville-hospital.jpg” thumb_width=”150″ /]to about 35-40 following the appointment of coordinators who show patients how to use the service. The Queensland Government media statement issued last week quotes the coordinator at Charleville Hospital as saying 99% of people prefer the service to traveling to see a specialist face to face.

The video link service connects doctors with patients from 2 rural hospitals and one district hospital in south west Queensland. These are relatively small hospitals with 24 to 39 beds and use Flying Doctors to provide some of the facilities such as surgery. Alternative for patients, say in Charleville, could be a 7 hr 620 km drive to Toowoomba or a 8 1/2 hour 750km drive to Brisbane to see a specialist for a 10 minute appointment.

Georgia school telemedicine clinics to access EHRs

Georgia Partnership for Telehealth which has telemedicine programs at about 60 schools in Georgia, [grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/06/Georgia-Partnership-for-Telehealth.jpg” thumb_width=”150″ /]has joined the Georgia Health Information Network, the state-wide Health Information Exchange, according to a recent press release. This will enable participating schools to securely exchange healthcare information with more than 3600 Georgia healthcare providers and have access to an immunisation register.
“Our Rural School-Based Telehealth Center Initiative offers a number of benefits to students and families,” Sherrie Williams, Executive Director of GPT is quoted as saying.  “Students receive quality care without having to miss class.  Parents don’t have to leave work and lose wages to take their child to see the doctor. If a specialist visit is needed, it doesn’t require hours in the car to reach a large healthcare center; the child can be examined right from the school clinic.”

Tunstall Goes Hawaiian with Kupuna Monitoring acquisition

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/07/Big-T-thumb-480×294-55535.gif” thumb_width=”150″ /] Tunstall Americas is acquiring Kupuna Monitoring Systems of Aiea (northwest of Honolulu), Hawaii, a medical alarm and medication manager provider. In the press release, CEO Casey Pittock confirmed that Tunstall Americas’ strategy is to acquire regional monitoring services, as we noted in their Mountain Home (Denver) purchase last year. Locally owned (kama’aina) and serving the four major islands, Kupuna (‘elder’) is currently using Philips Lifeline monitors and Philips med dispensers. We hope they are welcomed with warmest aloha. (Hawaii as a market and culture is like no other in the US, and in this Editor’s experience in a totally different industry, can be fiercely local.)

What’s news at the end of the week

Care Innovations harmonizes seniors, Panasonic adds diabetes, Jawbone and Fitbit bite, the first EHR/PHR Hack and Concussion in Cleveland. Converging its interests in remote patient monitoring with its long-time footprint in senior housing resident monitoring (QuietCare), Intel-GE Care Innovations is testing its Health Harmony remote patient monitoring system, partnering with two California-located Front Porch communities and the Front Porch Center for Innovation and Wellbeing. The residents selected have poor chronic condition management or have returned after a discharge from a skilled nursing facility. No disclosure on projected number or duration–and it doesn’t appear that QuietCare is part of the monitoring. Release….Panasonic just bought Bayer Healthcare’s diabetes/blood glucose monitoring device unit for $1.13 billion as Bayer continues to shed non-life science businesses. While old-school prick-and-bleed monitors are being eclipsed by continuous glucose monitors (CGMs) and mobile-based devices such as Telcare in the US and in Europe, there’s plenty of market remaining in the West, and new ones in Asia and the Middle East for simple devices. It joins Panasonic’s existing blood pressure monitors. MedCityNews….Jawbone and Fitbit continue to snap at each other in court, with the former on Wednesday filing a second lawsuit on patent infringement, specifically “a wellness application using data from a data-capable band”, with the added fillip of going to the International Trade Commission, which could ban the import of Fitbit products or component parts. The 28 May lawsuit was about Fitbit’s hiring of five former Jawbone employees who allegedly stole IP. The companies between them have hundreds of patents, and as this Editor has noted in previous IP and patent troll articles, the US Patent and Trademark Office (USPTO) is not especially rigorous in ensuring that patents are not overbroad. Wonderful for the IP attorneys, but not exactly what Fitbit wants as a runup to their expected IPO next week. Wall Street Journal….Now an EHR and PHR join Hackermania Running Wild. Medical Informatics Engineering reported Tuesday that in May their server was cyberattacked, exposing PHI of patients in five clients and separately information contained in the NoMoreClipboard PHR subsidiary. POLITICO reports that this is the first recorded instance of an EHR compromise. MIE ReleasePOLITICO Morning eHealth….If you are in the Cleveland, Ohio area and have an interest, Concussion: A National Challenge is a free, two-day event on detection and diagnosis sponsored by the National Academy of Engineering, the Institute of Medicine, Case Western Reserve University, Metro Health and Taipei Medical University. Advance registration required.

Health Datapalooza 2015: more data, better health

Guest columnist and data analytics whiz Sarianne Gruber (@subtleimpact) sat in on the Health Data Consortium’s 2015 edition of Health Datapalooza last week in Washington, DC. It was all about the data that Medicare has been diligently harvesting. Also see the US-UK connection on obesity.

Health Datapalooza 2015, now in its sixth year, welcomed more than 2,000 innovators, healthcare industry executives, policymakers, venture capitalists, startups, developers, researchers, providers, consumers and patient advocates. Health Datapalooza brings together stakeholders to discuss how best to work the advance health and healthcare,” said Susan Dentzer, senior policy adviser to the Robert Wood Johnson Foundation and a member of the Health Data Consortium. The Consortium promotes health data best practices and information sharing; and works with businesses, entrepreneurs, and academia to help them understand how to use data to develop new products, services, apps and research insights. This year’s conference was held on May 31 through June 3 in Washington, DC. And how best to celebrate is with the gift of more data!

New Medicare Data Means More Transparency
The Centers of Medicare and Medicaid Services (CMS) released its third annual update to the Medicare hospital inpatient and outpatient charge data on June 1, 2013. (more…)

Teladoc sued by American Well

American Well has launched a patent infringement case against Teladoc according to a news release yesterday.
[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/06/Teladoc-logo.jpg” thumb_width=”150″ /]The 10-page submission to the courts by American Well claims the infringements to be
– accessing a data repository that stores information pertaining to medical service providers including present availability of the medical service providers for participating in a consultation
– receiving in a computer, indications that members of a pool of  medical service providers have become presently available
– receiving in the computer, a request from a consumer of services to consult with a medical service provider
– identifying in the computer, an available member of the pool
– and establishing a real-time communication channel between the consumer of services and the identified member of the pool

This author is wondering who thought this was such a novel technology as to warrant a patent? What were they thinking? Having worked on developing unified messaging systems for a mobile phone operator at the turn of the century (now that’s a scary 15 years ago) I am just picking myself off the floor after reading this.
Surely all these functions are no more than what is in every instant messaging program, dating back to 1990s? Replace the words “medical service provider” by “friends” or “contacts” and “consultation” by “chat” or “call” it seems to me you get … Skype and Face Time and more! If I am missing something I’ll be happy to be put right.

It turns out that Teladoc also noticed something along these lines and told the patent office as much in March, according to Med City News. Not surprisingly American Well hasn’t taken too kindly to that and hence the law suit.

Let’s watch the outcome

Nurses, China, ageing, longevity, TV, mobile data, Magna Carta, even logarithms – something for everyone!

This editor has always felt that telehealth and allied technologies is a nurse’s friend, enabling them to treat more people, with less stress, in short delivering more care and driving less car. It’s therefore great to see the European Federation of Nurses so active in the mHealth event in Riga recently, and to see them making a strong case for nurse engagement in the mHealth care pathways.

However this editor could not restrain a small chuckle at presumably a wayward spellchecker resulting in the phrase “incorporating big data logarithms for clinical pathways” appearing in the Presidential Message in their June-July 2015 Update.

Staying, briefly, overseas – the UKTI and co want to take you to the Expo 2015 in Milan on 28 September to 1 October to find new export opportunities. Programme for the main day is here. Book for the whole event here. Looking further afield, there is more info about the China Healthcare & Life Sciences Roadshow 2015 taking place in London, Manchester, Belfast, Glasgow, Leeds, Cardiff between 29 June – 8 July here. For those interested in exporting to China, the roadshow will highlight the extensive work that has been done to identify and scope current opportunities in the healthcare sector there. Great stuff.

On a different tack, this editor has just been made aware that the University of Greenwich has established (more…)

Medtronic favoring early-stage acquisitions, diabetes; American Well and Teva

Medtronic plc, now firmly planted in the Auld Sod of Ireland, reported a tidy $7.304 bn in its 4th quarter global revenue closing 24 April versus a prior year of $7.257 bn, with a net loss of $1 million. Their report yesterday (2 June) was primarily centered around the integration of Covidien and the foreign currency loss. Results were especially strong in the US with an 8 percent gain in fourth quarter. Earlier speculation that the major Covidien acquisition in addition to Corventis, Zephyr Technologies (through Covidien) and telehealth provider Cardiocom would slow future investments seems to be the direction CEO Omar Ishrak is taking, based on his comments during the analyst call. The Covidien strategy of making early-stage company acquisitions is to his liking and with new revenues from Covidien (and a more favorable tax domicile) certainly there is not a lack of funds despite a small loss in fourth quarter revenues. Another change from being a cardiac-centric device company is apparent in the growth area of global diabetes, shifting from pumps to diabetes management. They have a minority investment in diabetes manager Glooko, a partnership with IBM Watson Health for diabetes management, and acquired a Dutch clinic and research center, Diabeter. Jonah Comstock at Mobihealthnews has more on that call.

In a surprising move, Israel’s Teva Pharmaceuticals is putting a reported ‘tens of millions of dollars’ into American Well and their telemedicine (virtual consult) platform. The pharma interest at once may be narrow in utilizing these consults in clinical trials, but as we have seen with Merck’s telemedicine clinics in Kenya, there’s also a focus on monitoring critical medication at long distances. Late last year American Well completed an $81 million Series C, but it is not clear whether Teva is a part of this and the news is just now catching up. MedCityNews, Globes (Israeli business website)

The leaky roof of healthcare data (in)security–DARPA to the rescue?

This week’s priceless quote:

“A lot of the response was, ‘We live in a cornfield in the middle of Minnesota,’” he said. “’Who wants to hurt us? Who can even find us here?’”–Jim Nelms, Mayo Clinic’s first chief information security officer, 

We know where you are and what you do! The precarious state of healthcare data security at facilities and with insurers, plus increased external threats from hacking has been getting noticed by Congress–when you see it in POLITICO, you know finally it’s made it into the Rotunda. It was over the horizon late last summer with the FBI alert and legislators in high dudgeon over the Community Health Systems China hack [TTA 22 Aug 14]. It’s a roof that leaks, that costs a lot to fix, doesn’t have immediate benefit (cost avoidance never does) but when it does leak it’s disastrous.

This article rounds up much of what these pages have pointed out for several years, including the Ponemon Institute/IBM study from earlier this week, the Chinese/Russian connections behind Big Hacks not only for selling data, but also IP [TTA 26 Aug 14] and how decidedly easy it is to hack devices and equipment [TTA 10 May 14]. Acknowledgement that healthcare data security is about 20 years behind finance and defense deserves a ‘hooray!’, but when you realize that on average only 3 percent of HIT spend is on security when it should be a minimum of 10 percent (HIMSS) or higher…yet the choice may be better security or uncompensated patient care particularly in rural areas, what will it be for many healthcare organizations?

The article also doesn’t go far enough in the devil’s dilemma–that the Federal Government with Medicare, HITECH, meaningful use, rural telehealth and programs like Medicare Shared Savings demand more and more data tracking, sharing and response mechanisms, stretching HIT 15 ways from sundown. At the cutely named Health Datapalooza presently going on in Washington DC, data sharing is It for Quality Care, or else. Yet the costs to smaller healthcare providers to prevent that ER readmission scenario through new care models such as PCMHs and ACOs is stunning. And the consequences may be more consolidated, less available healthcare. We are already seeing merger rumors in the insurer area and scaledowns/shutdowns/buyouts of community health organizations including smaller hospitals and clinics. Also iHealthBeat.

DARPA to the rescue? The folks who brought you the Internet may develop a solution, but it won’t be tomorrow or even the day after. The Brandeis Program is a several stage project over 4.5 years to determine how “to enable information systems that would allow individuals, enterprises and U.S. government agencies to keep personal and/or proprietary information private.” It discards the current methodology of filtering data (de-identification) or trusting third-parties to secure. Armed With Science  FedBizOpps has the broad agency announcement in addition to vendor solicitation information.