Rounding up what’s news: LindaCare, TytoCare funding; Medicare telehealth parity, Norway’s big cyberhack, Virta reversing diabetes, DARPA’s 60th birthday

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2017/12/Lasso.jpg” thumb_width=”100″ /]Your Editor’s been away and then largely out of pocket over the past two weeks. Here’s our roundup/catchup beyond the bombshells:

In remote patient monitoring for chronic disease, Philips, PMV, and other investors invested €7 million ($8.6 million) in Belgium’s/Hartford CT’s LindaCare. The Series B funding will accelerate its US expansion of OnePulse for remote monitoring of chronic heart failure and cardiac arrhythmia patients with Cardiac Implanted Electronic Devices (CIED). It is in use in major European hospitals and in US trials, though there is no mention in the release or on their website on CE Marking or FDA clearance/clinical trials. Previously from its 2013 founding, it had €1.6 million in funding. Also Mobihealthnews.

TytoCare, a remote monitoring telehealth/video consult platform which integrates peripherals for a virtual physical exam, raised $25 million in a Series C round led by large Chinese insurer Ping An via their Global Voyager Fund plus Walgreens, Fosun Group, OrbiMed, LionBird, and Cambia Health Solutions. Release. Their total raise is $45.6 million since 2012 (Crunchbase). Their most current partnership is with Long Island-based Allied Physicians Group which is featuring at-home telehealth visits at its pediatric practice in Plainview.

More favorable Medicare reimbursement for telehealth is the subject of four US Congressional bills. The one furthest along is the ‘Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act of 2017’ (S.870), which aims to improve at-home care, increases Medicare Advantage flexibility, gives ACOs more options and expands telehealth capabilities for stroke and dialysis patients. It passed the Senate in September and now goes to the House Subcommittee on Health of the Committee on Energy and Commerce. The effect of all four is on Medicare payment parity with in-office visits, which does not currently exist and is not affected by the various state parity bills on insurance for those below 65. American Well touts a 10-fold growth in revenue, but the likelihood of any of these four bills being signed into law is small, particularly with a pending report from the Medicare Payment Advisory Commission. Becker’s Hospital Review

Norway released at end of January news on an “advanced and persistent” 8 January cyberattack on Health South East RHF. This has both a health breach and military twist.

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Japan as aging bellwether: experiential VR, claim that robots increase activity by 50 percent

Japan’s population is the oldest on average in the world, with over 27 percent of its population aged over 65 and the highest average life expectancy at 83.7 years. Writer Shiho Fukada spent a year researching aging tech supported by the Pulitzer Center. In STAT, he profiles innovation in two areas we’ve highlighted previously: VR experiences for those who are restricted in their mobility and the effect of robots in elder care.

Bringing experiences to the older person. A Tokyo therapist, Kenta Toshima, takes videos of his travels to 29 countries and 55 cities, then shares them with his patients on a smartphone mounted on an inexpensive cardboard viewer to simulate full VR. His concept, Virtually Able, has positive results and he is trying to develop a study. Yet in the US, Dr. Sonya Kim has been developing this in a commercial model via OneCaringTeam and Aloha VR.  [TTA 21 Nov 16 and 11 Nov 17These VR experiences for residents of long-term care are being researched for easing anxiety, increasing positive feelings, stimulation, and connectedness in older people with mobility difficulties or dementia, with Cedars-Sinai in LA evaluating VR for pain reduction with mixed results.

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2018/02/Pepper-daughter.jpg” thumb_width=”200″ /]Robotics in monitoring and connectedness. It’s another look at Palro and Pepper [TTA 24 Oct 17], this time in action at the Flos Higashi-kojiya Senior Care Facility in Tokyo, at a nursing home run by the Social Welfare Corporation of Tokyo Seishinkai, and in a home with an older couple. Robots, as we’ve noted, are stepping in the care and connectedness gap.

  • For older adults living at home by themselves, interactive robots like Pepper can aid with tasks but as you’ll see in the video, the wide-eyed Pepper becomes a ‘daughter-bot’ (left and above from the video) that remarkably increases engagement between this older couple in a typically crowded Japanese home.
  • In Japan, as in the West, there’s a shortage of care staff able to engage with residents in senior living. In the video, Palro struts across a table to the admiration of a group of older women in assisted living and leads them in an exercise routine.
  • In a Tokyo nursing home, a Guardian desktop robot not only monitors the well-being of patients in nursing care using audio and video, but also communicates interactively with the patient to give a feeling of personal attention and encouragement. Mr. Fukada at 06:14 quotes a study that residents living with robots are 50 percent more active and that 70 percent without robots are less active, but unfortunately this is not footnoted.

What is evident is that Japan continues to pioneer in robotics for care of older adults and in general (CES), but the takeup in other countries, with some exception for Europe, is not that great–yet. Previously in TTA: Japan’s workarounds for adult care shortage, Japan’s hard lessons on an aging population

 

Scary Monsters, Take 3: one week later, JPMorgan Chase takes heat, Amazon speculation, industry skepticism

It’s the Week After the Amazon/Berkshire Hathaway/JPMorgan Chase announcement of their partnership in a non-profit joint venture to lower healthcare costs for their 1.1 million employees, and there’s a bit of a hangover. Other than a few articles, there’s been relative quiet on this front. This could be attributed to the financial markets’ roller coaster over the past few days, at least in part due to this as healthcare stocks were hardest hit. In the US, healthcare is estimated to be 18 percent of the economy based on Centers for Medicare and Medicaid Services (CMS) actuarial statistics for 2015…and growing. 

Jamie Dimon, CEO of JPMC, had some ‘splainin’ to do with some of the bank’s healthcare clients, according to a report in the Wall Street Journal (paywalled) summarized on MarketWatch. He assured them that the JV would be to serve only the employees of the three companies. JPMC bankers handling the healthcare sector also needed some reassuring as they are “paid handsomely to help clients with mergers and other deals and worry the move could cost them business.”

Speculation on Amazon’s doings in healthcare remains feverish. A more sober look is provided by the Harvard Business Review which extrapolates how healthcare fits into Amazon’s established strength in delivery systems. Amazon could deliver routine healthcare via retail locations (Whole Foods, Amazon Go), same day prescription delivery, passive data capture developed for Amazon Go sold as a service to healthcare providers (on the model of Web Services), and data analytics.

Headlines may have trumpeted that the three-way partnership would ‘disrupt healthcare’, but our Readers in the business have heard this song before. While agreeing with their intent, this Editor differed almost immediately with the initial media cheering [TTA 31 Jan]. The Twitterverse Healthcare FlashMob in short order took it down and apart. STAT racks up some select tweets: in the ACO model, savings come when providers avoid low-value care; the contradiction of profitable companies avoiding profit; that the removal of healthy employees from existing plans will increase inequity and the actuarial burden upon the less insurable; the huge regulatory hurdle; and the dim view of investment advisory firm Piper Jaffray that it will not be a ‘meaningful disruptor’. 

In this Editor’s view, there will be considerable internal politicking, more unease from JPMC customers, and a long time before we find out what these three will be doing.

CVS-Aetna: DOJ requests additional information at deadline (updated for CVS earnings)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2017/12/canary-in-the-coal-mine.jpgw595.jpeg” thumb_width=”150″ /]The Canary Tweets. The sources [TTA 8 Dec] were correct that the Department of Justice (DOJ) would take the lead on reviewing the CVS-Aetna merger. Yesterday (1 Feb) they did, requesting additional information. This extends the waiting period for an additional 30 days or more.  The CVS Form 8-K (SEC), which reports the request for information, is here courtesy of Seeking Alpha.

The US law governing this is the Hart-Scott-Rodino Act Antitrust Improvements Act of 1976 (HSR). A pre-merger notification and report was filed with DOJ and the Federal Trade Commission (FTC) on 2 January. There’s a 30-day period for an additional information request and that was taken by the DOJ yesterday. The length of the compliance process may extend for 30 days but may be less if the request is satisfied or more if requested by the parties involved. 

CVS and Aetna still hope to complete the merger by the second half of 2018. The respective shareholder meetings are already scheduled for 20 March. Our previous coverage here.

Editor’s thoughts: CVS-Aetna, despite its size, is a relatively straightforward merger, but because of its nature and size, expect some political haymaking and delays to come. This will be a preview of the action around the Amazon-Berkshire Hathaway-JPMorgan Chase cooperative partnership, in whatever they decide to create, if they create: “there’s many a slip twixt cup and lip.”

Updated for 4th Quarter Financials: CVS is reasonably healthy and nimble. Their earnings report is positive in earnings, operating profit, and reinvestment versus prior year. Under US securities law, it’s silent on Aetna. Form 8-K and press release via Seeking Alpha.