TTA’s Week: Delays for Iron Bow, Babylon Health; CVS-Aetna’s experiential retail, NOLA/Miami startup events

 

A VA Home Telehealth supplier hits a Federal wall. Babylon Health wins in London, but NHS England rollout delayed. It may be all in the experience for CVS-Aetna. And experience New Orleans plus Miami find-and-fund startup events!

Iron Bow’s uncertain future with $258 million VA Home Telehealth contract (A Federal ruling against partner Vivify Health stops the program–can Iron Bow save it?)
Babylon Health’s ‘GP at hand’ not at hand for NHS England–yet. When will technology be? (Is there ‘Life on Mars’?)
CVS-Aetna: It’s not integrated healthcare, it’s experiential retail! (A different look at a complicated merger proposing another reason why it may set the pace)
Babylon’s ‘GP at hand’ has thousands of London patients in hand (A hit with Londoners indicates pent-up demand for virtual care)
Rounding up opportunities for showcasing–and funding–your health tech startup (US) (While NOLAHI is closed, there’s still time to apply in Miami)

January starts with a roar with big events and news out of SF and Las Vegas. Predicting falls–and falling right. And EU funding for health innovations gets its groove on!

€280m addition creates largest investment fund for European health tech (NL) (An upward trend in EU health tech funding at last)
Fall prevention: the technology–and Dutch–cures (Falling tech keeps seniors mobile…and learning to fall right)
January’s Crazy Week: JP Morgan, StartUp Health, Health 2.0 WinterTech…and CES takes the cake! (Following the money and the trends in rainy SF and dry Las Vegas)
Deals of the day: American Well partners with Philips for global telehealth apps, gains $59 million partnership with Allianz (Setting a torrid partnership pace–can Teladoc meet?)
EHR action: Allscripts acquires Practice Fusion, expands footprint in small/ambulatory practices (Buying market share to go the ‘last mile’–and against Cerner and Epic)

Our roundups start with 2017’s advances and some year-end surprises, then looking forward to 2018. Theranos makes a surprise reappearance riding a Trojan Horse. And we look for a new ‘Eye on Tenders’ for the UK. (Could it be you?)

Advances in 2017 which may set the digital health stage for 2018 (Alzheimer’s, Huntington’s treatments; All of Us, DeepMind Streams, and Telehealth in Outer Space!)
Rounding up the roundups in health tech and digital health for 2017; looking forward to 2018’s Nitty-Gritty (Dancing to the M&As, canaries, Babylon, KardiaBands on Apple Watches…)
The Theranos Story, ch. 45: a ‘Christmas present’ $100 million loan from Fortress averts bankruptcy (updated) (A Trojan Horse?)
Wanted: an Eye on Tenders (UK) (Looking for a contributor for this valued Reader service)
2017 wrapup: state telehealth reimbursement policies and progress made (Center for Connected Health Policy tracks 63 legislative actions in 34 states)

Reflecting on the CVS-Aetna merger and the FCC’s actions. A telemedicine survey points to an expectation gap. Franco-American health kiosks, a few more Tender Alerts, December deals, and CST’s tech advice to PM May round out our Year.

Far from a tipping point: only 18 percent of consumers using telemedicine (US) (How long, how long?)
One more Prior Information Notice–and Yes, Prime Minister, some Advice (UK) (Two more to consider before the holiday fruitcake)
End of year action: Vivify/InTouch, Medtronic, NYCEDC winners, ActiveProtective, Adidas exits wearables, Fitbit (The last minute deal rush)
FCC’s actions on Rural Health Care and Connect2Health for cancer–-relief from ‘net neut’ neurosis (A better concentration on what matters)
Tender Alert: Oxfordshire County Council, Housing & Care 21 Birmingham (Two more to be interested in–but hurry)
The ‘health kiosk’ idea is alive and kicking from New York to France (Not dead yet!)
Tender/PIN Alert: NHS North of England, Highlands & Islands Enterprise NHS Market Ready (A few more)
A basket of reflections, considerations on CVS-Aetna: Epic, Cerner, the model, and hospitals’ role (It’s not going to be simple or easy)

More on the ground-breaking CVS-Aetna merger–our canary is preparing. And of continued interest….

Babylon Health: correcting earlier NW London CCG report; other concerns raised by CQC report (A deeper dive into The Rivers of Babylon and lessons to learn)
CVS-Aetna: the canary says that DOJ likely to review merger–plus further analysis and developments (It faces legal headwinds, may not make the most business sense–and has international repercussions affecting Walgreens Boots)

Analysis of the CVS-Aetna merger: a new era, a canary in a mine–or both? (Are US healthcare execs in shock?)
#MedMo17: the conference, winning startups, Bayer, blockchain, and more (A lively conference report!)

OnePerspective: VA shows how technology can improve mental health care (Telemental health’s expansion chronicled in our new section)

Mayo Clinic’s Victor Montori MD calls for a ‘patient revolt’ for ‘careful and kind care’ (Expanding minimally disruptive medicine concept)
HeyDoctor! Come and get your diagnosis via text here! (Intriguing, but we see the downside)

Have a job to fill? Seeking a position? Free listings available to match our Readers with the right opportunities. Email Editor Donna.


Read Telehealth and Telecare Aware: http://telecareaware.com/  @telecareaware

Follow our pages on LinkedIn and on Facebook

We thank our present and past advertisers and supporters: Tynetec, Eldercare, UK Telehealthcare, NYeC, PCHAlliance, ATA, The King’s Fund, HIMSS, Health 2.0 NYC, MedStartr, Parks Associates, and HealthIMPACT.

Reach international leaders in health tech by advertising your company or event/conference in TTA–contact Donna for more information on how we help and who we reach. See our advert information here. 


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

Subscribe here to receive this Alert as an email on Wednesdays with occasional Weekend Updates. It’s free–and we don’t lend out or sell our list–no spam here!

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

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Iron Bow’s uncertain future with $258 million VA Home Telehealth contract

Iron Bow Technologies’s setback with their VA contract confirmed. Iron Bow, which partnered last year with Vivify Health to provide telehealth services to the US Department of Veterans Affairs, received an unfavorable ruling on the US country of origin of the Vivify Health system that essentially stops the contract implementation.

Under Title III of the Trade Agreements Act of 1979, Federal suppliers must produce their products in the US or substantially transform the components in such a way that it becomes a product of the US. US Customs and Border Protection (CBP), Department of Homeland Security (DHS), makes this determination. Vivify Health contended that their Vietnam-produced tablet, because of their US-produced Vivify Health Pathways software and further US-based modifications to convert it into an FDA-regulated medical device, was transformed into a US product. In August, the CBP determined that the end product did not meet the transformation standard based on decades of precedent and the country of origin remained Vietnam. Transformation, yes, but not enough or the right kind for the CBP. Federal Register 8/22/17

An interesting Federal regulatory disconnect is that the FDA considers the Vivify tablet a regulated medical device. CBP considers it a communications device as the tablet transmits data from other medical devices but does not take those measurements itself. 

Vivify Health has publicly used in implementations with health organizations Samsung tablets. It is not known if the tablet reviewed by the CBP is manufactured by Samsung.

Both Iron Bow and Vivify Health were asked by this Editor for comments. Iron Bow’s response:

We have received an unfavorable ruling from United States Customs and Border Protection (“Customs”) regarding our proposed solution for the Home Telehealth contract. We respectfully disagree with the findings by Customs and have appealed the matter to the United States Court of International Trade. We are currently in discussions with our customer regarding the possible options for a path forward.

Vivify has not responded to date. 

Certainly, this is a sizable financial loss to both Iron Bow and Vivify if they cannot go forward with the VA, whether through a court decision or a different procurement process for the tablet to qualify it as US origin. Last February, we reported that the VA awarded the billion-dollar five-year Veterans Health Administration (VHA) Home Telehealth contract to four providers: incumbent Medtronic, Iron Bow, Intel Care Innovations, and service-disabled veteran-owned small business 1Vision. The award amount for each was $258 million over a five-year period, re-establishing the VHA as the largest telehealth customer in the US. All four awardees had in common that they were prior Federal contractors, either with the VA or with other Federal areas [TTA 1 Feb 17].

Medtronic and Care Innovations had long-established integrated telehealth systems but Iron Bow and 1Vision, as telemedicine and IT service providers respectively, did not have vital signs remote monitoring capability. In the solicitation, Iron Bow partnered with Vivify [TTA 15 Feb 17]. For 1Vision, it took nearly one year to announce that their telehealth partner was New York-based AMC Health, an existing provider of VA health services. It was also, for those in the field, a Poorly Kept Secret, as AMC Health had been staffing with VA telehealth veterans from the time of the award. (The joint release is on AMC Health’s site here.) The reason for the announcement delay is not known. AMC Health does not use a tablet system, instead transmitting data directly from devices or a mobile hub to a care management platform. They also provide IVR services.

Vivify has moved forward with other commercial partnerships, with the most significant being InTouch Health, which itself is on a tear with acquisitions such as TruClinic [TTA 19 Dec 17].

Hat tip to two alert Readers who assisted in the development of this article but who wish to remain anonymous.

Babylon Health’s ‘GP at hand’ not at hand for NHS England–yet. When will technology be? Is Carillion’s collapse a spanner in the works?

NHS England won’t be rolling out the Babylon Health ‘GP at hand’ service anytime soon, despite some success in their London test with five GP practices [TTA 12 Jan]. Digital Health cites an October study by Hammersmith and Fulham CCG (Fulham being one of the test practices) that to this Editor expresses both excitement at an innovative approach but with the same easy-to-see drawback:

The GP at Hand service model represents an innovative approach to general practice that poses a number of challenges to existing NHS policy and legislation. The approach to patient registration – where a potentially large volume of patients are encouraged to register at a physical site that could be a significant distance from both their home and work address, arguably represents a distortion of the original intentions of the Choice of GP policy. (Page 12)

There are also concerns about complex needs plus other special needs patients (inequality of service), controlled drug policy, and the capacity of Babylon Health to expand the service. Since the October report, a Babylon spokesperson told Digital Health that “Commissioners have comprehensively signed off our roll-out plan and we look forward to working with them to expand GP at Hand across the country.” 

Re capitation, why ‘GP at hand’ use is tied into a mandatory change of GP practices has left this Editor puzzled. In the US, telemedicine visits, especially the ‘I’ve got the flu and can’t move’ type or to specialists (dermatology) are often (not always) separate from whomever your primary care physician is. Yes, centralizing the records winds up being mostly in the hands of US patients unless the PCP is copied or it is part of a payer/corporate health program, but this may be the only way that virtual visits can be rolled out in any volume. In the UK, is there a workaround where the patient’s electronic record can be accessed by a separate telemedicine doctor?

Another tech head-shaker: 45 percent of GPs want technology-enabled remote working. 48 percent expressed that flexible working and working from home would enable doctors to provide more personalized care. Allowing remote working to support out-of-hours care could not only free up time for thousands of patient appointments but also level out doctor capacity disparities between regions. The survey here of 100 GPs was conducted by a cloud-communications provider, Sesui. Digital Health. This is a special need that isn’t present in the US except in closed systems like the VA, which is finally addressing the problem. The wide use of clinical connectivity apps enables US doctors to split time from hospital to multiple practices–so much so on multiple devices, that app security is a concern. 

Another head-shaker. 48 percent of missed NHS hospital appointments are due to letter-related problems, such as the letter arriving too late (17 percent), not being received (17 percent) or being lost (8 percent). 68 percent prefer to manage their appointments online or via smartphone. This preference has real financial impact as the NHS estimates that 8 million appointments were missed in 2016-2017, at a cost of £1bn. Now this survey of 2,000 adults was sponsored by Healthcare Communications, a provider to 100 NHS trusts with patient communications technology, so there’s a dog in the hunt. However, they developed for Barnsley Hospital NHS Foundation Trust a digital letter technology that is claimed to reduce outpatient postal letters by 40 percent. Considering my dentist sends me three emails plus separate text messages before my twice-yearly exam…. Release (PDF).

Roy Lilley’s daily newsletter today also engages the Tech Question and the “IT desert” present in much of the daily life of the NHS. Trusts are addressing it, junior doctors are WhatsApping, and generally, clinicians are hot-wiring the system in order to get anything done. It is much like the US about five to seven years ago where US HHS had huge HIPAA concerns (more…)

CVS-Aetna: It’s not integrated healthcare, it’s experiential retail!

click to enlargeThis very interesting take on financial analysis site Seeking Alpha draws another insight from the CVS-Aetna merger–it’s actually part of the rising commercial real estate trend of experiential retail. Here’s the logic. CVS MinuteClinics increase traffic to CVS stores. If they are part of a shopping center, that means those patients might grab a meal, coffee, or shop. Reportedly CVS and Aetna will add nurses and nutritionists, which will further increase attraction, stickiness, and traffic. 

CVS and Walgreens‘ clinics have started, in the new model, to become significant, even anchor, tenants of shopping centers, filling up the empty storefronts left by traditional retail. Doctors’ offices, urgent cares like CityMD, and hospital-run outpatient clinics are filling retail spaces and anchoring new developments. Another part of the experience–fitness clubs, which are also converting vacant office spaces–a line extension increasingly popular with health systems. CVS also bought out department store Target’s drugstores and in-store clinics, which is another model (fill a prescription, buy socks or a TV). Another line extension is partnerships with urgent cares or outpatient clinics, not much of a stretch since CVS already has affiliations with health systems in many areas.

Add telemedicine (Aetna’s partnership with Teladoc) to the above: both MinuteClinics and in-home become 24/7 operations. Not mentioned here is that Aetna can add in-person or kiosk services in CVS stores to file claims, answer questions, or sell coverage.

As this model becomes clearer, big supermarket operators like Ahold (Stop & Shop, Giant), Wegmans, Publix, Shop Rite and others, which have pharmacies in most locations, may ally with or merge with insurers or health systems–or partner with CVS-Aetna. There is also the 9,000 lb. elephant called Walmart, which is 2/3 of the way to an experiential model including nutrition, diet, and fitness (ask any WalMartian). Further insights on how this merger is forcing retailers to adapt are in Drug Store News.

CVS-Aetna could very well be a major mover in experiential retail, which may save all those strip malls. But this article points out, as this Editor has already, that the full shape of what could be experiential healthcare will take years to work and shake out, assuming the merger is approved. Our prior coverage is here.

Babylon’s ‘GP at hand’ has thousands of London patients in hand

click to enlargeApparently Babylon Health’s ‘GP at hand’ is a hit with Londoners, despite the requirement to shift GP practices. The Evening Standard reports that the Lillie Road Surgery in Hammersmith, one of the five London practices in the program (plus Victoria, Poplar, Euston, and Fulham), increased its patient list by nearly 7,000 (4,970 in November to 11,867 last month). (Was it the Tube adverts?–Ed.) No information is available on increases at the other surgeries. 

Helping matters may be the UK flu epidemic, where the incentive to stay at home and have a video consult would be great (and helpful in stemming the spread). These consults on average are available 2 1/2 hours after booking, which to us Yanks used to independent services seems a great delay. One-third are reportedly out of office hours. Duration of the visit is about 10 minutes, which is standard for in-person. What is suspected is that many do not realize that the GP at hand signup also changes your GP to the program. The GP partner quoted in the article claims that homeless people, those with mental health and multiple chronic conditions–not just the young and mobile-savvy–have signed up. 

This Editor will concur with others that it’s time for telehealth to be integrated into the NHS, but the tying of it to specific practices which alters capitation is a large wrinkle which needs ironing out. Our earlier coverage here. Hat tip to Roy Lilley.

Rounding up opportunities for showcasing–and funding–your health tech startup (US)

click to enlargeAlex Fair, whom our Readers know as the head hombre of the MedStartr health innovation community and MedStartr Ventures, has several ex-NYC opportunities in New Orleans and Miami (where it’s a lot warmer than NYC!) for innovative early-stage healthcare companies. Deadlines are soon, so if you are interested, move quickly!

New Orleans

New Orleans Health Innovators Challenge (NOLAHI) – application deadline 1/15 (Expired)
In this Crowd Challenge, hospitals and hospital systems and insurance companies in the New Orleans area are looking for healthcare innovations to pilot plus startups to partner with and fund.  The finals are scheduled after Mardi Gras in late February or March. Full details at NOLAHI.com, with a summary of the individual challenges below:
The Diabetes Care Challenge – Create a digital tool that supports diabetic health maintenance. Presented by Blue Cross and Blue Shield of Louisiana and Ochsner Health System
The Navigator Challenge – Use technology to replicate the function of a navigator to enhance patient-centered care, without adding FTEs. Presented by Tulane Health System
The Inter-Operability Challenge – Eliminate errors, fraud, and misinterpretation plus increase inter-operability via the implementation of technologies such as blockchain. Presented by Lafayette General Foundation

Miami

MedMoMiami – application deadline 1/19
The first ever #MedMoMiami will be Jan 25th. This event is jointly organized with the Miami Health 2.0 Chapter. Apply to pitch in Miami here.

Other events are in planning stages for NYC, Austin, Maryland, San Diego, and Saratoga NY. #MedMo18 will be 29-30 November. TTA is a media sponsor and supporter of Health 2.0 NYC and MedStartr. Editor Donna is a co-organizer of NYC events.

TTA’s Big Week: crazy in SF and Vegas with JPM and CES, American Well, Philips, Allianz, Allscripts-Practice Fusion, falling tech, EU funding rises

 

January starts with a roar with big events and news out of SF and Las Vegas. Predicting falls–and falling right. And EU funding for health innovations gets its groove on!

€280m addition creates largest investment fund for European health tech (NL) (An upward trend in EU health tech funding at last)
Fall prevention: the technology–and Dutch–cures (Falling tech keeps seniors mobile…and learning to fall right)
January’s Crazy Week: JP Morgan, StartUp Health, Health 2.0 WinterTech…and CES takes the cake! (Following the money and the trends in rainy SF and dry Las Vegas)
Deals of the day: American Well partners with Philips for global telehealth apps, gains $59 million partnership with Allianz (Setting a torrid partnership pace–can Teladoc meet?)
EHR action: Allscripts acquires Practice Fusion, expands footprint in small/ambulatory practices (Buying market share to go the ‘last mile’–and against Cerner and Epic)

Our roundups start with 2017’s advances and some year-end surprises, then looking forward to 2018. Theranos makes a surprise reappearance riding a Trojan Horse. And we look for a new ‘Eye on Tenders’ for the UK. (Could it be you?)

Advances in 2017 which may set the digital health stage for 2018 (Alzheimer’s, Huntington’s treatments; All of Us, DeepMind Streams, and Telehealth in Outer Space!)
Rounding up the roundups in health tech and digital health for 2017; looking forward to 2018’s Nitty-Gritty (Dancing to the M&As, canaries, Babylon, KardiaBands on Apple Watches…)
The Theranos Story, ch. 45: a ‘Christmas present’ $100 million loan from Fortress averts bankruptcy (updated) (A Trojan Horse?)
Wanted: an Eye on Tenders (UK) (Looking for a contributor for this valued Reader service)
2017 wrapup: state telehealth reimbursement policies and progress made (Center for Connected Health Policy tracks 63 legislative actions in 34 states)

Reflecting on the CVS-Aetna merger and the FCC’s actions. A telemedicine survey points to an expectation gap. Franco-American health kiosks, a few more Tender Alerts, December deals, and CST’s tech advice to PM May round out our Year.

Far from a tipping point: only 18 percent of consumers using telemedicine (US) (How long, how long?)
One more Prior Information Notice–and Yes, Prime Minister, some Advice (UK) (Two more to consider before the holiday fruitcake)
End of year action: Vivify/InTouch, Medtronic, NYCEDC winners, ActiveProtective, Adidas exits wearables, Fitbit (The last minute deal rush)
FCC’s actions on Rural Health Care and Connect2Health for cancer–-relief from ‘net neut’ neurosis (A better concentration on what matters)
Tender Alert: Oxfordshire County Council, Housing & Care 21 Birmingham (Two more to be interested in–but hurry)
The ‘health kiosk’ idea is alive and kicking from New York to France (Not dead yet!)
Tender/PIN Alert: NHS North of England, Highlands & Islands Enterprise NHS Market Ready (A few more)
A basket of reflections, considerations on CVS-Aetna: Epic, Cerner, the model, and hospitals’ role (It’s not going to be simple or easy)

More on the ground-breaking CVS-Aetna merger–our canary is preparing. We wade into the rivers of Babylon Health’s pilots. A present of a large box of Tender Alerts for our UK companies.

Tender Alert: NHS England, London South Bank, Univ. of Leeds, NHS Digital, Halifax, Healthy New Towns (The last is big…really big)
Babylon Health: correcting earlier NW London CCG report; other concerns raised by CQC report (A deeper dive into The Rivers of Babylon and lessons to learn)
CVS-Aetna: the canary says that DOJ likely to review merger–plus further analysis and developments (It faces legal headwinds, may not make the most business sense–and has international repercussions affecting Walgreens Boots)

Of continued interest….

Analysis of the CVS-Aetna merger: a new era, a canary in a mine–or both? (Are US healthcare execs in shock?)
#MedMo17: the conference, winning startups, Bayer, blockchain, and more (A lively conference report!)

OnePerspective: VA shows how technology can improve mental health care (Telemental health’s expansion chronicled in our new section)

Mayo Clinic’s Victor Montori MD calls for a ‘patient revolt’ for ‘careful and kind care’ (Expanding minimally disruptive medicine concept)
HeyDoctor! Come and get your diagnosis via text here! (Intriguing, but we see the downside)

NHS ‘GP at hand’ via Babylon Health tests in London–and generates controversy (Hits a GP brick wall)
Breaking: FDA approves the first drug with a digital ingestion tracking system (Proteus only took 16 years)

Have a job to fill? Seeking a position? Free listings available to match our Readers with the right opportunities. Email Editor Donna.


Read Telehealth and Telecare Aware: http://telecareaware.com/  @telecareaware

Follow our pages on LinkedIn and on Facebook

We thank our present and past advertisers and supporters: Tynetec, Eldercare, UK Telehealthcare, NYeC, PCHAlliance, ATA, The King’s Fund, HIMSS, Health 2.0 NYC, MedStartr, Parks Associates, and HealthIMPACT.

Reach international leaders in health tech by advertising your company or event/conference in TTA–contact Donna for more information on how we help and who we reach. See our advert information here. 


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

Subscribe here to receive this Alert as an email on Wednesdays with occasional Weekend Updates. It’s free–and we don’t lend out or sell our list–no spam here!

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

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€280m addition creates largest investment fund for European health tech (NL)

Amsterdam-based Life Sciences Partners LSP announced that the LSP Health Economics Fund 2 is now the largest European investment fund dedicated to healthcare innovation. An additional €280m was raised from the European Investment Fund, health insurance companies, and institutional investors.

Reportedly, the fund will look to invest in around 15 private companies with innovative products “on the market or very close to market introduction”. Rudy Dekeyser, LSP partner, said to Digital Health News that their focus areas are in drug compliance, remote monitoring, big data analytics and clinical software. Further caveats: companies must  “convince us that there is a clear path towards the integration of their innovative product in the complicated healthcare ecosystem, has to know who will pay for their product or services and should have access to the necessary partners for broad implementation of their product in the market.”

This adds to end-of-year UK and European announcements of early-stage life sciences and healthcare innovation funding. As reported in Digital Health News: the UK government’s life sciences industry partnership to advance medical technology in Britain (Digital Health News); Wayra UK (Telefónica) and Merck Sharp & Dohme’s Velocity Health £68,000 healthcare accelerator program for machine learning/AI start-ups. LSP release

Fall prevention: the technology–and Dutch–cures

The ‘Holy Grail’ of fall detection is, of course, fall prevention. The CDC statistics for the US are well known: One in four Americans aged 65+ falls each year. Every 19 minutes, an older adult dies from a fall. Falls are the leading cause of fatal injury and the most common cause of nonfatal trauma-related hospital admissions among older adults–2.8 million injuries treated in emergency departments annually, including over 800,000 hospitalizations and more than 27,000 deaths. In 2014, the total cost of fall injuries was $31 billion. In the UK, AgeUK‘s stats are that falls represent the most frequent and serious type of accident in people aged 65 and over, the main cause of disability and the leading cause of death from injury among those aged 75+. 

The technology ‘cures’ as noted in this NextAvenue/Forbes article centers around predicting if and when a person will fall.

  • The ‘overall’ approach, which is constant monitoring of ADLs through activity sensing and modeling/machine learning to detect early signs of decline or health change. Companies in this area are Care Innovations’ QuietCare (sensor arrays) and CarePredict (wrist worn).
  • Gait detection. Relatively small changes in gait and walking speed are an accurate, fast, and straightforward indicator of fall risk. Ten years of research performed at TigerPlace in Missouri showed that people whose gait slowed by 5 centimeters per second within a week had an 86% probability of falling during the next three weeks. Shortening of stride had a 50 percent probability of fall within three weeks.
  • Read the brain. Research at Albert Einstein School of Medicine in NYC indicates that in otherwise high-functioning older people, high levels of frontal brain activity while walking and talking can predict higher long term fall risk, up to 32 percent.
  • Balance impairment. Tests using VR to simulate falling in healthy subjects and tracking their muscular response also could be used to roadmap a person’s balance impairments and future fall risk–along with training and targeted physical rehabilitation.

The Netherlands has taken this last point and gone ‘low tech’ with physical training courses that teach older adults both not to fall and to fall correctly if they do. Students negotiate obstacle courses and uneven surfaces, then learn to fall properly on thick inflated mats. Many of those attending use walkers or canes, but complete the courses which reduce the fear of falling or getting up–and provide both fun and socialization. The courses have become popular enough that they are government rated with insurance often defraying the cost. New York Times

January’s Crazy Week: JP Morgan, StartUp Health, Health 2.0 WinterTech…and CES takes the cake!

This week is Crazy Week for healthcare and technology folk, with multiple major events centered in San Francisco and Las Vegas.

JP Morgan’s 36th annual healthcare conference started today 8 Jan through Thursday 11 Jan in San Francisco. It annually hosts 450 companies presenting to 9,000 attendees. It attracts hundreds of investors and is A Very Big Deal for both investors and companies angling for same. It kicked off with Medtronic‘s Omar Ishrak touting their success with Tyrx, an anti-microbial resorbable envelope for their cardiac devices to prevent post-surgical infection. In value-based care, it may not be in itself reimbursable, but improves outcomes (MedCityNews). The official hashtag for the conference is #JPMHC18 but there’s also #JPM18.

Of interest to Readers will be Teladoc’s presentation at JPM, provided by Seeking Alpha

CNBC’s tip sheet on the action. Genalyte‘s lab-on-a-chip demos their blood sampling in 15 minutes technique to MedCityNews writer. And Vive La Biotech–why American investors should be looking at French companies.

Within the event is the invite-only StartUp Health Festival Monday and Tuesday which hashtags at #startuphealth. Separately, but with many of the usual suspects, is Health 2.0’s one-day WinterTech conference in San Francisco the following day on Wednesday 10 Jan, also with an investment focus. (You can imagine the investor and company hopping between conference locations!) Alex Fair is also leading a Meetup tweetup for the week–more information here. You may also want to check out #pinksockspinksocks is an ad hoc group dedicated to health and wellness innovation and doctor-patient connectedness.

Further south, the sprawl of Las Vegas has been taken over by the sprawl of CES (aptly dubbed ‘Whoa!’) starting Tuesday 9 Jan through Friday 12 Jan. The substantial health tech focus (more…)

Deals of the day: American Well partners with Philips for global telehealth apps, gains $59 million partnership with Allianz

The large partners with the large, adding a global dimension. Telemedicine provider American Well and Philips announced today a global alliance to integrate American Well’s patient-doctor video consults with a range of Philips’ healthcare monitoring program. First up will be adding American Well consults to the Philips Avent uGrow parenting app. This is an Apple/Android app that presently tracks baby feeding, weight, and sleeping patterns, tying into Philips baby monitoring products such as an ear thermometer and babycam. The second stage with American Well involves their mobile telehealth software development kit (SDK) to integrate video consults into other Philips’ digital health solutions and the Philips HealthSuite Digital Platform. Philips also announced that uGrow will include voice activation with the ever-trendy Amazon Echo and the Philips Avent smart feeding kit to automatically monitor the time, volume and duration of a baby’s feeds. Philips release

American Well’s second global deal of the day is with insurer Allianz’s digital investment fund, Allianz X.  The latter, funded with a $59 million investment, creates another partnership dedicated to developing a digital product that combines wearable sensors, remote monitoring, and virtual visits. The goal is to widen patient access, lower cost and improve healthcare quality. As part of the deal, Allianz X will be joining American Well’s Board of Directors. Allianz is not well known as a health insurer in the US, but is active in the international health insurance area for individual expats and employers with international employees.  Release, Mobihealthnews

EHR action: Allscripts acquires Practice Fusion, expands footprint in small/ambulatory practices

A significant EHR acquisition kicks off an action-packed week. Announced today by leading EHR Allscripts is their acquisition for $100 million of independent practice EHR Practice Fusion. Allscripts, which has been usually in the top five US EHRs (Kalorama April 2017 survey), vastly expanded its hospital market share with August’s acquisition of #2 McKesson‘s health IT business and with this would be ranked just behind EHR leader Cerner. In acute care settings, Epic and Cerner dominate with 25 percent of the market each with Allscripts/McKesson far behind #3 Meditech (KLAS April 2017). 

Practice Fusion, one of the pioneers in the small practice/ambulatory EHR starting with a basic free, ad-paid model in 2005, has 30,000 ambulatory sites serving about 5 million patients each month. In the Allscripts view, they will now be able to offer “last mile” reach to the under-served clinicians in small and individual practices” and close gaps in care. Allscripts President Rick Poulton noted in the statement that “We believe this transaction will directly benefit Practice Fusion clients, who will now have access to Allscripts solutions and services. We look forward to welcoming Practice Fusion team members to our family.” which leads one to believe that the Practice Fusion name will be sunsetted. Allscripts release and Healthcare IT News

From being the leader in small practice EHRs, Practice Fusion found the last few years difficult as competition expanded into their segment, from eClinical Works, drchrono, athenahealth, and NextGen to small practice packages from Epic and Cerner.

It should be noted that Practice Fusion in 12 years went through 13 funding rounds, raising almost $158 million from a long list of VC luminaries such as Kleiner Perkins, Artis Ventures, Founders Fund, and Qualcomm Ventures (Crunchbase). However, it disappointed its investors and Wall Street, which expected two years ago a $1.5 billion IPO. The $100 million from Allscripts is all cash and the price is “subject to adjustment for working capital and net debt”–an exit which was surely not the sugarplum in the eyes of its 2014 and prior  investors. CNBC

Advances in 2017 which may set the digital health stage for 2018

click to enlargeOur second Roundup takes us to the Lone Prairie, where we spot some promising young Health Tech Advances that may grow up to be Something Big in 2018 and beyond. 

From Lancaster University, just published in Brain Research (academic/professional access) is their study of an experimental ‘triple agonist’ drug developed for type 2 diabetes that shows promise in reversing the memory loss of Alzheimer’s disease. The treatment in APP/PS1 mice with human mutated genes used a combination of GLP-1, GIP, and Glucagon that “enhanced levels of a brain growth factor which protects nerve cell functioning, reduced the amount of amyloid plaques in the brain linked with Alzheimer’s, reduced both chronic inflammation and oxidative stress, and slowed down the rate of nerve cell loss.” This treatment explores a known link between type 2 diabetes as a risk factor and the implications of both impaired insulin, linked to cerebral degenerative processes in type 2 diabetes and Alzheimer’s disease, and insulin desensitization. Other type 2 diabetes drugs such as liraglutide have shown promising results versus the long trail of failed ‘amyloid busters‘. For an estimated 5.5 million in the US and 850,000 in the UK with Alzheimer’s and other dementias, and for those whose lives have been touched by it, this research is the first sign of hope in a long time. AAAS EurekAlertLancaster University release, video

At University College London (UCL), a drug treatment for Huntington’s Disease in its first human trial has for the first time safely lowered levels of toxic huntingtin protein in the brain. The group of 46 patients drawn from the UK, Canada, and Germany were given IONIS (the pharmaceutical company)-HTTRx or placebo, injected into spinal fluid in ascending doses to enable it to reach the brain starting in 2015 after over a decade in pre-development. The research comes from a partnership between UCL and University College London Hospitals NHS Foundation Trust. UCL News releaseUCL Huntington’s Research page, BBC News

Meanwhile, The National Institutes of Health (NIH)’s All of Us programpart of the Federal Precision Medicine Initiative (PMI), seeks to track a million+ Americans through their medical history, behavior, exercise, blood, and urine samples. It’s all voluntary, of course, the recruitment’s barely begun for a medical research resource that may dwarf anything else in the world. This is the NIH program that lured Eric Dishman from Intel. And of course, it’s controversial–that gigantic quantities of biometric data, genomic and otherwise, on non-genetic related diseases, will simply have diminishing returns and divert money/attention from diseases with clear genomic causes–such as Huntington’s. Oregon Public Broadcasting.

Let’s not forget Google DeepMind Health’s Streams app in test at the Royal Free NHS Foundation Trust Hospital in north London, where alerts on patients at risk of developing acute kidney infection (AKI) are pushed to clinicians’ mobile phones, (more…)