First apps using Apple’s CareKit clinical care framework hit market

click to enlargeWell, that was fast! Apple’s CareKit framework, specifically for clinical care app developers, was only announced last month and opened its official doors yesterday, but three developers had early access. Their apps hit the market yesterday: One Drop (diabetes management), Iodine for Start (depression medication management), and Glow for Glow Nurture, an app for pregnant women, and Glow Baby, an app for new mothers. Four hospitals have also announced app development underway using CareKit modules: Beth Israel Deaconess (chronic condition management), the University of Rochester (Parkinson’s), Texas Medical Center (care coordination), and Cleveland Clinic (asthma and COPD).

There are four modules which developers can selectively use (pictured).

  • CareCard, which helps patients track care plans and action items
  • Symptom and Measurement Tracker, which helps patients keep a log of their experiences
  • Insights Dashboard which integrates the care plan data from CareCard with the symptom data from the Symptom and Measurement tracker to create insights about the effectiveness of treatments
  • Connect, which helps patients share data with their providers or other caregivers.

The three in market yesterday, for instance, all used Connect; Iodine and One Drop use Care Card and One Drop uses the Symptom Tracker.

The article’s comments from developers and hospitals highlight a move to a standardized framework for clinical apps, which may be wishful thinking as most of the world uses Android, but addresses the validation and certification conundrum that’s plagued health apps for years. We’ll wait and see if Apple sustains the lead here. Mobihealthnews. Apple ResearchKit/CareKit page. The Verge, Ars Technica, TechCrunch

ATA’s daily schedule now available online

click to enlargeAttending or interested in attending this year’s American Telemedicine Association annual meeting in Minneapolis 14-17 May? The daily Saturday-Tuesday schedule is now online here. Plenary session speakers include Nicholas Negroponte, founder of the groundbreaking MIT Media Lab and John Noseworthy, CEO of the Mayo Clinic. There are also Spotlight Sessions on Monday on ‘Consumer Stakeholders Confront Telehealth”, “Is a Prior Provider-Patient Relationship Still Required?” and “The Year in Review: Excellence in Telemedicine Research.” If you’re going, also check out their exposition floor which opens on Sunday with a late afternoon reception. Register by clicking the sidebar advert. TTA is a media partner of ATA2016.

Nokia’s healthcare repositioning confirmed with Withings $191 million acquisition (updated)

“We’re paying for the company, but in reality it’s Withings that’s going to be running the entire digital health business at Nokia.” –Nokia President Ramzi Haidamus

One of the more unusual corporate pivots has taken place over the past few years with Finnish former mobile phone leader Nokia. and has completed a circle with the seemingly friendly acquisition of digital health device and wearables developer Withings.

With the sale of its phone brand to Microsoft in 2013 and the majority acquisition of Alcatel-Lucent last year (finalized in January), Nokia seemed to reposition itself firmly in telecom networking. It retained an impressive brace of IP and international patents in the field managed by Nokia Technologies, plus licensing of its name. Nokia also introduced a successful iPad Mini clone in China, the N1 Android tablet, a virtual reality camera rig built for film studios and sold the HERE map app for $3 bn. But the company retained an interest in health tech over those years. In 2012, it started the annual Nokia Sensing XChallenge, a $2.25 million competition that is part of XPRIZE. Nokia Growth Partners (NGP) invests in the digital health sector.

We noted their below-the-radar health moves last October, and this confirms that true to the reports, Nokia had been been developing a digital health strategy called WellCare, centered on data and insights collected from wearables. WellCare will now apparently be integrated into Withings. The combination will also be competitive with Apple HealthKit and ResearchKit, which has had extensive takeup by both developers and clinical researchers–but there is plenty of room in the field. Withings retains a strong and uniquely quality design-driven identity, though perhaps not the most well known brand especially in the US, and has a small share in covetable, pricey fitness wearables. But it’s the integration and developments which will be of great interest after the expected closing in 3rd quarter this year. Two articles in Engadget (here, here) and The Verge

Updated: Mobihealthnews publishes an interview with Nokia’s president Mr Haidamus on why Withings, calling it a ‘reverse takeover’ where Withings will be in charge of expanding their health tech presence with no layoffs on either side. However, he’s a little disingenuous in implying that Nokia had no interest in digital health prior to selling their handset business to Microsoft in 2014–see the XChallenge above.

 

Theranos–the drama and examination continues

The latest chapters:

Theranos’ boards–the advisory board chock full of Blast From The Past political figures like George Shultz, Sam Nunn, Bill Frist and Henry Kissinger–and a governing board–are standing by CEO/founder Elizabeth Holmes. Of course, they have essentially no choice, because Ms Holmes utterly and completely controls the company in the Silicon Valley Manner. The governing board, split off from the advisory board after The Troubles started last October–consists of Ms. Holmes, COO Sunny Balwani, Riley Bechtel of the eponymous construction firm, retired Marine Corps General James “Warrior Monk” Mattis and David Boies, prominently featured in both articles below. Mr Boies is politically well wired and the kind of attorney you call in when you are facing Big Trouble and need Big Defense–or Offense. These boards of course bear responsibility for the governance of the company, including fiduciary, and the actions being taken by CMS, the US Attorney’s office in San Francisco and the Securities and Exchange Commission (SEC) may be making for some sleepless nights. New York Times, Vanity Fair (which overlaps the NYT article)

Trust But Verify is the extraordinarily apt ‘eyebrow’ on this ‘rise and fall’ Quartz article reviewing l’affaire Theranos by a professor of medicine at Dartmouth College. For the non-scientists among us, it gives a layman’s explanation on why venous blood for most tests is needed versus fingerpricks (the latter mixes blood and tissue fluid, and doesn’t accurately measure large molecules such as proteins and lipids–but fine for the smaller blood glucose molecules, as testing diabetics know). It also touches on the Icahn Institute/Mount Sinai study [TTA 26 April, see comment] and points to the Smoking Gun of boards largely not constituted of those with medical or biochemical expertise.

Update: Bloomberg explores a POV in an opinion piece that blood tests are inherently variable, and only one factor in a proper diagnosis. Theranos’ promises to run multiple blood tests on a tiny quantity of blood are not only suspect but also that the “assumption that succeeding in this quest would improve public health” is specious indeed. Theranos and the Blood Testing Delusion

The stakes are high, and getting higher, for Ms Holmes, indeed.

[Ed. Donna’s comment below our earlier article, Theranos’ triple whammy: CMS, DOJ and SEC, addresses some concerns our Readers may have about our coverage. While we are a website interpreting the news and the Editors generally refer to multiple published sources in an article to supply various points of view, we also express our opinions. We try our level best to be fair, to stay in good humor and buttress our points. When you the Reader has a point to add, differs with our interpretation, or believes that your Editors are hanging too far out on that swaying limb, please feel free to comment. We do have a Comments policy which isn’t onerous…it’s posted here.]

Blueprint Health graduates the Winter 2016 class

Tomorrow afternoon (April 27) is Graduation Day–Demo Day–for ten startup companies which address problems across the healthcare spectrum. They are:

● Blue Mesa Health – Helps employers reduce health costs through a digital diabetes prevention program
● HealthKick – Provides employers with curated perks for branded health and wellness services
● NexHealth – Provides a mobile-first appointment booking and reminder platform for doctor’s offices
● PatientPrep – Increases physician productivity and patient satisfaction by collecting data prior to a visit
● Rappora – Streamlines the coordination, management and time tracking of home care employees (more…)

BeVITAL: French telehealth, American multi-reading biosensor

click to enlargeParis-based telehealth company BePATIENT has partnered with Silicon Valley biosensor company Vital Connect for a remote patient monitoring system dubbed BeVITAL. The unusual part is that the Vital Connect sensor, HealthPatchMD, is about the size of a standard bandage–it adheres to the skin by the heart–and transmits multiple vital signs including single-lead ECG, heart rate, RR interval, heart rate variability, respiratory rate, skin temperature, body posture, fall detection and activity including steps. The BePATIENT PC/mobile telehealth platform has a patient facing mobile app (‘Fast Path’) app, currently available in the Apple App Store, with a clinician-facing reporting module. BeVITAL has been piloted already in Europe for post-discharge monitoring of over 80 surgical patients in clinical studies at five hospitals, with two more deployments this summer. In the Americas, the two post-discharge pilots will concentrate on heart failure, in the US at John Muir Medical Center in Walnut Creek and Concord, California and at the Hospital Infantile De Las Californias, Tijuana, Mexico. The latter study will be run by Scripps Translational Science Institute in San Diego.

BePATIENT’s platforms and ‘digital health modules’ are largely used in France, Europe and Australia, and also integrate devices from iHealth, Withings and fitness tracker Fitbit. The Vital Connect Platform is FDA-cleared, CE-marked and Ninsho Certified (Japan). In addition to the HealthPatchMD biosensor, which is reusable up to 500 times, they developed the single-use VitalPatch biosensor marketed in the US and Europe, and being tested by Philips for at-risk hospital patients (ZDNet). Release, KTVU News

Theranos’ triple whammy: CMS, DOJ and SEC

click to enlarge Shocked, shocked! Theranos CEO Elizabeth Holmes is a bit more wide-eyed than ever. On the popular morning (breakfast=UK) program Today, interviewed by the oddly ‘browed Maria Shriver and sans the usual Steve Jobs-channeling black turtleneck, she stated she was ‘devastated’ that they didn’t catch the lab testing issues faster. On CNBC, she was mildly defiant and justifying:

“I know what we’ve built and I know what we’ve created and I know what it means to people and it is a change that needs to happen in the world”

(Yes, it does mean a lot to people when their test results are wrong or not reliable. And the disappointment of those of us who’d like simple, less expensive testing that works.)

Last week CMS proposed (but not yet imposed) sanctions that include banning Ms Holmes and president Sunny Balwani from running or owning labs for two years, and removing licenses from Theranos’ labs in Newark and Palo Alto California. Wall Street Journal. The effect would be to remove them from the company. Yesterday, Federal prosecutors started the process of discovery by subpoenaing Walgreens Boots Alliance, their former customer, and the New York State Department of Health seeking broad information on how Theranos described its technologies to gain Walgreens’ business and NYS licensure. That information may also have misled government officials.

The third whammy is the Securities and Exchange Commission (SEC) looking into a parallel claim–that deceptive claims were made to investors.  No one at the above organizations is commenting to the Wall Street Journal, which broke the story earlier this year. While the company has $700 million in the bank, the famed $9 billion Unicorn Valuation is moving towards $9.

Ed. note: If the WSJ articles are paywalled, search on the headlines “Regulators Propose Banning Theranos Founder Elizabeth Holmes for at Least Two Years” and “Theranos Is Subject of Criminal Probe by U.S.” to get around them. Alternatively, see TechCrunch and MedCityNews, which is playing the World’s Smallest Violin about this.

Two RSM events of interest on medicine’s future and Big Data/IoT (UK)

Make a place in your calendar for two Royal Society of Medicine full day events coming up in May and June. Both organized by the Telemedicine and eHealth Section. Hat tip to Charlotte Cordrey, Event Team Manager, RSM

The future of medicine – the role of doctors in 2025
Thursday 19 May 2016  (Chaired by our own Editor Charles Lowe)

Big data 2016 (Clouds and the Internet of Things)
Thursday 2 June 2016

 

Australia: Most of the benefit of NBN comes from Telehealth and Teleworking

A study has concluded that most of the benefit from the National Broadband Network in Australia comes from two sources, telehealth and teleworking. Economic Benefit of the National Broadband Network (NBN) is a report partially summarising a study by the Centre for Energy Efficient Telecommunications (CEET) at the University of Melbourne. The study analyses the potential economic impact of Australia’s NBN.

Assuming that eventual access speeds will reach 10-25 Mbps, the model used by CEET predicts long-term GDP increase of 1.8% and a 2% increase in real-term household consumption. Of six categories of services considered, cloud computing, e-commerce, online higher education, telehealth, teleworking and entertainment, it is telehealth and teleworking that have come up as the services that will generate the most benefit from the NBN.

The average annual household benefit is estimated to be around $3,800 by 2020. Recognising the significant investment being made in broadband in Australia, the paper attempts to describe how the NBN will influence the national economy through the adoption of new services and new ways of working.

The short summary report is in easily accessible language and well presented and is available here.

Insurer launches telemedicine for Australian travelers

An Australian health insurance underwriter has announced that it is offering a telemedicine service for its traveling and expatriate policyholders, according to today’s Insurance Business. click to enlarge Accident and Health International (AHI) is offering access to Australian-trained emergency physicians via video, phone call, email or text 24 hours a day for these customers.

The service is being offered through Docto, which describes itself as “Australia’s first on-line telemedicine hospital”. CEO of AHI, Peter Banks, is reported to have said “the policy holder simply clicks a button on the AHI App or the Docto website and they can see a doctor from the comfort of their home or hotel room. Often when you are travelling in an unfamiliar place, it is the simple questions you want answers to. They can simply text, email, video or voice call AHI’s TeleHealth for an immediate answer.”

Dr John Field, founder of Docto, offers another scenario: “it is preventing a mother from having to go to a foreign hospital in the middle of the night with sick kids. She can press a button and see a doctor in real time, without leaving the house.” Docto website claims that its “Emergency Department” is staffed 24-hours a day by fully trained Australian Emergency Physicians. Access to medical specialist covering a wide range of areas are arranged via Telemedicine consultations on the next business day.

If the traveler requires repatriation back to Australia that is arranged via Dynamiq, a global emergency management company.

Two events that should appeal to all commercially-minded UK readers

As some readers will be aware, this editor is involved in organising a range of low-cost, and free, digital health events. Two that should be of interest to all commercially-minded readers are:

On Friday 22nd April DHACA is holding its eighth members’ day at the Conference Centre at 1 Victoria St., this time focusing on customer mapping: how do you identify and contact the right person in the NHS to sell your digital health product or service to? We will have Siobhan Jones, a Deputy Directory in the Department of Health, John Currie a senior procurement manager in NHS England, and Karen Livingstone, National Director of SBRI Healthcare, NHS England, and Director of Partnerships & Industry, Eastern AHSN to help us. However the most important part of the day will be attendees sharing what works & what doesn’t. Membership of DHACA is free (though we do need to make a small charge for refreshments). Do come along – book here.

Then on the evening of the 28th April the London Health Technology Forum is holding an event kindly sponsored by Baker Botts on the assessment & regulation of medical apps. Confirmed for the evening is Julian Hitchcock, a partner in Denoon Legal, who gave a masterful presentation recently at the RSM medical apps event – this is particularly important considering the EU GDPR finalisation and changes expected as the Medical Devices & In Vitro Devices Directives are converted to regulations. Book here – attendance is completely free.

Telehealth Quality Group first conference Manchester 21 June 2016

The Telehealth Quality Group kicks off its campaign to stimulate new thinking around telehealth and telecare with a UK event in Manchester on June 21st. The focus of the event is on ‘Integrated Care’ – the route to which has been exercising strategists, policy-makers, commissioners and those tasked with delivery for some time.

The programme includes the likes of Malcolm Fisk, Kevin Doughty and this editor as well as Dr Laura Ryan of NHS24 … bringing news of the experience in Scotland, and Professor Andrew Sixsmith … bringing practice examples and insights from Canada.

Participants will also learn more about the TQG’s International Code of Practice for Telehealth Services – for which apparently three services are now seeking certification.

Other treats at the Manchester event include sessions that:

• look back and learn lessons from the Whole System Demonstrators;
• consider some of the technological developments and market trends around telehealth and telecare;
• check out developments in Rochdale as they pursue integrated care in the context of Manchester’s new devolved powers;
• draw on the telehealth experience of a West Yorkshire GP; and
• make sure the position of carers and service users is not overlooked.

A potpourri, maybe…and hopefully of interest to readers. Details are on the TQG website here

Charterhouse rejects buyout bid for Tunstall Healthcare, considers refinancing

click to enlargeBreaking News. Some long-awaited updates on the ongoing rumors regarding Tunstall Healthcare and a potential sale surfaced on Bloomberg late yesterday. Citing ‘people familiar with the matter’, Charterhouse Capital Partners, the owner and main investor, rejected a £300 million (US$425 million) buyout offer from private equity investment firm Triton Partners and reportedly will seek refinancing as an option if a buyout offer cannot be accomplished. However, the same sources state that talks are ongoing including with Triton and other potential investors and that no decisions have been made.

Triton is an investment firm registered in St Helier, Jersey and with locations through Europe, China and New York. It represents around 100 institutional investors and concentrates in investments in medium-sized businesses in northern Europe, Italy and Spain. In looking at their sector mix on their website, health is a small slice of their interests under consumer. This Editor speculates that they were seeking to expand this area, and perhaps sensed a bargain, because Tunstall by no stretch could be considered ‘medium-sized’.

Another interesting tidbit is that the cited sources indicated that before a refinancing, the company might need to be deleveraged. There is about £230 million in debt excluding shareholder loans and bank debt, which if included would bring the total to an eye-blinking net debt of £1.2 billion. Charterhouse purchased Tunstall in 2008 for £530 million. Current sales are £212 million for the fiscal year ending in September 2015, down from £215.2 million in 2014 according to a filing with Companies House (see 4 Dec 15 PDF in the filing history tab).

Tunstall’s statement: “Tunstall’s turnaround plan is well advanced and we are seeing improved performance,” the company said in an e-mailed statement. “Our focus is on delivering for our customers and helping them exploit the possibilities that new digital technologies present.”

This Editor’s reflection is that Tunstall is in the situation that nearly every company in telehealth and in health tech is in–a confusing market with segments as fine as a garlic clove sliced with a razor, too many players, too many segments with too many names, all chasing not enough money whether private or government.

Certainly more to come. Hat tip re the article to a Reader with long-standing experience in the telehealth field.

 

Calling all health start-ups: get some free pitching practice from KPMG!

How can founders and early stakeholders get the experience they need to present their ideas in the best light?

KPMG’s Graduate Development Network (GDN) and KPMG Tech Growth are organising an event to help answer that question. Start-ups will be invited to KPMG’s presentation suite to present their pitch in a friendly but constructive environment.

In addition to the brightest young minds in KPMG today, the audience will also include members of KPMG Tech Growth. These individuals’ sole purpose is to support and engage with early stage and high growth technology companies. Senior management from KPMG’s core business and industry experts in Healthcare will also be invited to provide input and augment the audience’s experience. Speakers can benefit from the constructive feedback on offer, form valuable connections and enjoy themselves in a friendly atmosphere.

The event takes place on May 13th – if you’re interested, contact Ian.McRae@kpmg.co.uk

Eric Dishman departs Intel for NIH’s Precision Medicine Initiative Program

click to enlargeLate breaking news….Reported in Aging in Place Technology Watch from the Oregonian is that Eric Dishman, one of Oregon’s more famous sons (and certainly a star in health tech), is leaving Intel after 17 years. Currently an Intel Fellow and general manager of the Health and Life Sciences for the Data Center Group (profile), he is joining the National Institutes for Health (NIH) in their Precision Medicine Initiative (PMI) Cohort program as a director. According to the Oregonian, Mr Dishman “will lead an effort to study more than 1 million volunteers to study the impact of “precision medicine” – the practice of studying an individual’s specific genetic makeup and lifestyle to produce targeted treatments. It had been a key focus of Dishman’s work at Intel, and he had helped design the study he will now oversee.” Mr Dishman had his own extreme experience with precision medicine to treat his recurrent cancer in 2012, which made him eligible for a life-saving kidney transplant later that year [TTA 27 Feb 14 and 12 Apr 2013]. He had recently been a key part of the PMI Network working group in this ‘audacious’ study as NIH, in announcing his appointment, termed it. His last day at Intel will be 29 April, according to Intel’s data center chief. Replacing him (at least in the organization) on an interim basis will be Steve Agritelley. NIH release, USNews interview

Laurie Orlov (hat tip re this article–Ed.) commented to this Editor that Mr Dishman could be considered the ‘father of Care Innovations‘; certainly he was crucial to the development of the original Intel Health Guide out of Intel’s Digital Health Group, and was prominently in the leadership of the early Louis Burns days of the company. His work during Intel spanned over LeadingAge’s CAST, Ireland’s Technology Research for Independent Living (TRIL) Centre, Everyday Technologies for Alzheimer’s Care (ETAC) and the Oregon Center for Aging & Technology (ORCATECH). Mr Dishman’s work is marked by a singular focus on delivering health into the home, changing aging and hospitals as we know them. Now he will be more focused on genomic medicine and changing disease treatments as we know them.

Your Editors wish him good fortune and hope that his experiences with NIH and in Washington will be fruitful and all that he intends it to be.

Webcast: practical telementoring…for surgery

Watch a live interactive webcast, free, with international surgical experts as they show and discuss actual cases using the currently available methods for surgical telementoring.  Utilising VisitOR1, off-the-shelf software services, and Google Glass, these studies will show the comparative strengths of each platform; real-world tips will be shared.  You and your institution will learn methods to improve skills and teach new procedures by remote presence. Watch the various “budget-friendly” ways to accomplish this goal.

The event will be broadcast live at 7pm BST on 18th May – a perfect warm-up for those attending the Royal Society of Medicine – and the Institution of Engineering & Technology’s – premier telemedicine event of the year the following day: the Future of Medicine: the role of Doctors in 2025.

This event was planned by The American Medical Foundation for Peer Review and Education, a leader in the organisation and support of surgical telementoring initiatives. There is more information on the most current approaches already implemented in their publication “Surgical Telementoring News” edited by Evelyn Baram-Clothier, PhG, JD

Register for the webcast here.

(Disclosure this editor participated in the planning for this event on behalf of the Royal Society of Medicine.)