TTA Fall Follies Week 8: Amazon Pharmacy’s Big Week, Doro’s digital alarm, scoping data security needs, AI in Parkinson’s detection, Optum’s $, KOMPAI’s robots, more!

 

Amazon’s finally getting into the online pharmacy business–after a learning curve of two years with PillPack. News from all over including Doro’s digital social alarm, AI/biomarker early detection of Parkinson’s, GrandCare’s tech for the developmentally disabled, and a how-to guide to approaching your data security needs without tears (initially, at least).  

Short Takes 20 Nov: Doro Eliza social alarm in UK, R2G diabetes market study, KOMPAÏ Robotics update, Bluestream Health integrates LanguageLine translation, and Optum’s 18 (Optum spending big on health tech, KOMPAI’s story continues, Doro strikes again)
Weekend reading: HISTalk’s interview with Spirion’s CEO on healthcare data security (A Must Read on a logical approach to scoping your organization’s data security needs)
Early detection of Parkinson’s via AI (and a surprising medium); Ed Marx on the digital transformation (or not) of health systems and COVID treatment at home
News roundup: Amazon Pharmacy–retail, GoodRx threat, 81% of healthcare workers have remote IT issues, Epicor installs in Australia care homes, GrandCare for developmentally disabled adults

A crazy post-election week (EEK!) on this side of the Atlantic, and we haven’t moved to Brazil or Argentina. Yet. (Maybe Estonia?) COVID vaccine coming up–among 10–news from Vodafone and Doro in UK–Apixio acquired, and Karen Lynch will be CVS’ new CEO. And HIMSS says it will have an actual, real life, flesh and blood conference next August–but will it be worth the expense and attendance after all the restrictions?

News roundup: Pfizer’s COVID-19 vaccine on horizon, CVS’ new CEO, Vodafone UK 5G health survey, Centene acquires Apixio AI, Doro’s 24/7 Response
Shock news: a very muted HIMSS 2021 set for 9-13 August, Las Vegas (Will it happen? Is it worth it?)

A truly crazy Election Week on this side of the Atlantic, but your dauntless but distracted Editor rounded up some interesting COVID-19 early detection research (breathe, sleep, cough). Plus two UK Councils’ initiatives on remote monitoring and video calls to protect–and connect–isolated older people. (No legal comic relief from Theranos this week!)

Discovering ways to non-invasively early detect COVID-19 from heart rate, sleep, or a cough, even among the asymptomatic (Will they be rushed to market and be used before this is all over–or are they for the next Big Virus?)
Bexley, Wandsworth Councils onboarding remote monitoring, video calls with COVID-19 the spur (UK) (Protecting and connecting the most vulnerable their priority)

The Teladoc/Livongo merger closes fast, but Livongo veterans with spare $$$ form a SPAC. Will telehealth/telemedicine at 6% of office visits continue to be bubbly? More digging into the details of the Tunstall reorg. And we have a Perspective on how a communications provider connected in Pandemic Time.

Further information on Tunstall’s reorganization (A whole lot of shutdown and shuffling going on)
Breaking: Teladoc and Livongo close merger in $18.5 billion deal, staff/board changeovers (And a SPAC by Livongo vets in the works)
Perspectives: How Advanced Communications Technology Has Created A ‘New Normal’ In Healthcare (What Avaya has learned and done in connecting healthcare)
Telemedicine office visits versus in-person recede to 6%, concentrating in behavioral health. Will the gains hold? (The billion-dollar bubble bath question)

Kaiser extended its Medicare partnership with Best Buy’s Lively Mobile Plus. Review and approval of medical apps are revived in both the US and Germany. In the UK, Alcuris becomes a supplier to a DPS and Propel@YH brings in its 2020 cohort. For weekend reading, the ethics of contact tracing and ADL/safety trackers in senior care.

News roundup: Kaiser/Best Buy Lively partners; Teladoc’s mental telehealth, Livongo execs depart; approved apps make comeback in US, DE; United Airlines tests COVID CommonPass for international flying
Weekend reading: contact tracing in assisted living/LTC facilities via sensor-based ADL technology raises ethical issues (Older people value privacy too)
Alcuris appointed as supplier to Spark DPS (UK) (Innovation gains foothold in contracting)
Propel@YH digital health accelerator announces 2020 cohort of 10 companies (Bringing global digital health to Yorkshire & Humber)

Mostly a ‘redux’ of a week, with Doro acquiring another company, Teladoc suing Amwell, and Theranos’ judge telling them that nothing the defense threw at the wall stuck. Tunstall reminds us that the most vulnerable are at risk during the winter–you should too. And if you are seeking a sales manager position, see our UK highlights article–Buddi is hiring.

UK highlights: Doro acquires Connexus Careline, Tunstall warns on winter isolation and disconnected care, Buddi seeks Sales Account Manager  (Doro increases its second position, and happy to see more hiring!)
Teladoc sues Amwell on patent infringement–again (This time, much larger companies go head to head, creating bountiful Christmas bonuses for their lawyers)
The Theranos Story, ch. 67: the Holmes/Balwani indictments stay, Holmes’ defense strategy fails (Waiting for the Twinkie Defense II, or the money running out)

Leaves have started to turn and fall, but digital health just keeps rising with $9.4 bn in investment this year. Tunstall UK and Group Holdings report their financial status and preview their new ownership. And la scandale Theranos continues with a revelation of defense strategy.

Digital health investment smashes the ceiling: $9.4 bn invested through 3rd Q (It’s Bubble City!)
The Theranos Story, ch. 66: Walgreens and Safeway aren’t investors, they’re business partners! (Holmes’ defense strategy–erode her most serious charges)
Tunstall Healthcare (UK) and Group Holdings’ 2019 year end reports filed: highlights (The state of the company and a preview of new ownership) 

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: Legrand/Tynetec, Eldercare, UK Telehealthcare, NYeC, PCHAlliance, ATA, The King’s Fund, DHACA, 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

Thanks for asking for update emails. Please tell your colleagues about this news service and, if you have relevant information to share with the rest of the world, please let me know.

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

– – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – –

Short Takes 20 Nov: Doro Eliza social alarm in UK, R2G diabetes market study, KOMPAÏ Robotics update, Bluestream Health integrates LanguageLine translation, and Optum’s 18

Why does this whole year feel like we are Pauline in Peril, all tied-up, with an Evil Man menacing us while the Train barrels down the tracks? Nonetheless, there are bites of news to be consumed, even though this year’s Thanksgiving in the US will be at best a muted one, and the Grinch may be stealing Christmas.

Doro remains ‘on a tear’ with new product introductions for the UK. The Doro Eliza (right) is a 4G/digital IP compatible social alarm/”smartcare” hub, with a modern design that connects to telecare accessories. The modern design has HD audio on the speaker for personal alarms, and also connects to smoke detectors, fall sensors, security cameras, and pill dispensers. Already introduced in Europe, its timing is part of the transition from analogue to digital telecare for 1.7 million UK telecare users as telecom moves to full digital by 2025. Release.

If your business is in diabetes care and the apps that assist them, Research2Guidance’s study and forecast, “The Global Digital Diabetes Care Market 2020: Going Beyond Diabetes Management” will be of interest. The 91-page report covers a global picture of growth from 2008 projecting out to 2024, as well as digital solutions, their segmentation, and competition. For instance, from 2019 to 2024, the number of diagnosed diabetics with access to smart devices is set to increase from 109 million to 180 million. It includes profiles of 10 countries. Priced from €3,290, so it will set you back a bit. More information here

We missed updating you on KOMPAÏ Robotics, which Editor Emeritus Steve Hards first covered in 2011. Their latest developments were earlier this year as their assistance/companion robot finally debuted for sale–right in the middle of the pandemic. This Pulse article recounts the road for CEO Vincent Dupourqué from 1975 to the third version of KOMPAÏ.

LanguageLine, which is a long-time provider of language translation services live to in-patient and acute care settings, announced an integration with Bluestream Health’s virtual visits. With a single click, a Bluestream user can access audio and video interpretation in 240 languages and over 13,000 interpreters. LanguageLine also assists with deaf and hard-of-hearing users. Bluestream provides whitelabeled telehealth services to approximately 50,000 providers. LanguageLine has headquarters in California, with offices in Taiwan and London.  Release

And finally, Optum’s 18. Optum Ventures, the funding arm of UnitedHealth Group’s Optum, has invested in a large number of healthcare ventures this year, nearly all with a health tech or AI spin. It’s neatly distributed internationally and between Series A through C, with UK companies like Oxford VR (VR used for therapies, no connection to Oxford Medical Simulations) as part of a $12.5 million Series A, Germany’s Kaia Health with a $26 million Series B tranche, and US companies like LetsGetChecked as part of a $71 million Series C. Not quite Ocean’s 11, but Optum’s bet a lot more than Danny Ocean got from those casinos in 1960. Becker’s Health IT.

Weekend reading: HISTalk’s interview with Spirion’s CEO on healthcare data security

A short but must-read if you care about data security and your customers/patients/residents. Where this HISTalk interview with Kevin Coppins, CEO of Spirion, excels is leading the reader through areas that are usually filled with fog and IT jargon. The view is from his company and a healthcare organization sitting in a conference room and scoping the problem without ‘paralysis by analysis’ or a turnkey ‘solution’ that may not be one. What’s different here is the clear, and few, logic steps, particularly the first three listed, that Mr. Coppins takes to get the ball rolling rather than befogging the discussion with too many factors or the punitive consequences of regulatory non-compliance.

“The concept of data and sensitive data is at the core of both security and privacy.”

  1. How much data do you have? (Nobody really knows, admit it)
  2. Of that data, what would you consider ‘sensitive’, and how do you define ‘sensitive’? Not only by regulation/compliance directives, but what your patients, clients and the board would consider ‘sensitive’.
  3. How much of that data is actually critical? 
  4. What’s the impact? How personal is it to your organization, not just in a compliance way but in your community, etc.
  5. How do I reduce the risk of loss?
  6. If I lost the data due to hacking or ransomware, what’s the backup? How fast can this happen?

This Editor notes that these points (quantity, definition, risk of loss and recovery, and community impact) can be applied to other situation analyses.

The litany of ransomware attacks that have ramped up during the pandemic waves has pushed data security issues to the ‘gotta tackle’ list. According to Emsisoft, a security company, there were 41 attacks on healthcare organizations in first half 2020. This didn’t stop during the summer, with a rash of them at end of October and a hit list of 400 hospitals, according to Becker’s.) Hacking attacks persist but aren’t getting the headlines.

And his conclusion is pertinent: “When it comes to security and privacy and all the drama and all the noise that you hear about it and read about it, just boil it down to this — am I doing everything I can today to protect what matters most to the constituents I serve?”

Early detection of Parkinson’s via AI (and a surprising medium); Ed Marx on the digital transformation (or not) of health systems and COVID treatment at home

Somewhat off our normal beat….but of interest.

Ardigen and The BioCollective are collaborating on early detection research for Parkinson’s Disease, based on a microbiome-based biomarker. Ardigen has developed an Artificial Intelligence (AI) Microbiome Translational Platform. The BioCollective has a bank of metagenomic and patient metadata generated from an unexpected source: Parkinson’s patients’ stool samples. Release

The BioCollective is headed by Martha Carlin, who came from well outside of healthcare and pulled together a research group to address her husband’s diagnosis. A visit to this website is worth an examination on how these samples are collected for microbiome extraction. An interesting twist is the marketing of a probiotic mix developed using their BioFlux metabolic model for ‘gut health’.

Ed Marx, the former CIO of the Cleveland Clinic, has written a new book, ‘Healthcare Digital Transformation: How Consumerism, Technology, and the Pandemic are Accelerating the Future’. It’s billed as a wake-up call for healthcare systems and hospitals under challenge by Big Retail, Big Pharma, and Big Tech. This Editor met Mr. Marx when he premiered his entertaining memoir, ‘Extraordinary Tales from a Rather Ordinary Guy’, a few years ago. On treatment for COVID patients, except for the very sickest, he advocates it being done from home. From the release: “When the pandemic hit, a lot of progressive organizations would send most of their Covid patients home with monitoring equipment hooked up to phones unless they needed a ventilator. It’s a lot cheaper than staying in the hospital.”

News roundup: Amazon Pharmacy–retail, GoodRx threat, 81% of healthcare workers have remote IT issues, Epicor installs in Australia care homes, GrandCare for developmentally disabled adults

Rounding up lots of dogies here!

Amazon, to no one’s surprise, has formally entered the US pharmacy business with Amazon Pharmacy which can fill prescriptions for most common medications. There is a whole process of course to sign up (at right), and a separate program for Amazon Prime customers with discounts on Amazon Pharmacy with two-day delivery, PillPack, and at 50,000 pharmacies in 45 states. The Prime program is administered by Inside Rx, a subsidiary of Evernorth/Cigna.

Mr. Market downgraded pharmacy retailers CVS and Walgreens Boots stocks, again unsurprisingly. It isn’t just brick ‘n’ mortars feeling the heat; heavily advertised drug price comparison platform (lumped into ‘digital health’) and recent IPO winner GoodRx took a 20 percent hit as Amazon Prime also discounts, comparable to GoodRx Gold. The GoodRx network is about 70,000 pharmacies, including the largest retailers. Fierce Healthcare. Big hat tip to Jailendra Singh at Credit Suisse Equity Research for these analyses on Amazon Pharmacy and GoodRx.

81 percent of healthcare workers experience issues with systems and technology used in external care, out visiting and caring for patients, according to a ‘State of Mobility in Healthcare’ multi-national study (email signup required) by business mobility development company SOTI. 64 percent of UK healthcare workers (63 percent overall) are ripping out what is left of their hair due to IT/technology glitches leading to system failures within a normal working week. Only a quarter of respondents said that their systems were able to cope with COVID-19. Based on the Healthcare IT News EMEA edition article, UK respondents apparently reported a higher level of IT problems affecting their work. The bright spot is that 68 percent of UK healthcare workers/55 percent overall agree that investment in new or better technology could help save lives. The study had respondents in the US, Canada, UK, Germany, Sweden, France, and Australia.

Speaking of software, Epicor, a US-based software company, is providing to two Australian care home groups their Community Care workflow and information platform: Finncare, which is associated with services to the Finnish and Scandinavian communities, and MannaCare in the Victoria area. Healthcare IT News Australia

One of the Ur-companies (2005!) in the senior health monitoring sector, GrandCare Systems, announced that they are working with LADD, a Cincinnati Ohio-based non-profit that supports adults with developmental disabilities. LADD’s project, the Heidt Smart Living Home, will incorporate GrandCare’s communication, cognitive assists, telehealth, and social engagement tools, as well as innovations in accessibility, lighting, and sensory control, for residents. Release Hat tip to CEO Laura Mitchell via LinkedIn.

TTA Fall Follies Week 7: a COVID-19 vaccine, CVS’ new CEO, HIMSS21 actual not virtual, Vodafone and Doro UK news, more

A crazy post-election week (EEK!) on this side of the Atlantic, and we haven’t moved to Brazil or Argentina. Yet. (Maybe Estonia?) COVID vaccine coming up–among 10–news from Vodafone and Doro in UK–Apixio acquired, and Karen Lynch will be CVS’ new CEO. And HIMSS says it will have an actual, real life, flesh and blood conference next August–but will it be worth the expense and attendance after all the restrictions?

News roundup: Pfizer’s COVID-19 vaccine on horizon, CVS’ new CEO, Vodafone UK 5G health survey, Centene acquires Apixio AI, Doro’s 24/7 Response
Shock news: a very muted HIMSS 2021 set for 9-13 August, Las Vegas (Will it happen? Is it worth it?)

A truly crazy Election Week on this side of the Atlantic, but your dauntless but distracted Editor rounded up some interesting COVID-19 early detection research (breathe, sleep, cough). Plus two UK Councils’ initiatives on remote monitoring and video calls to protect–and connect–isolated older people. (No legal comic relief from Theranos this week!)

Discovering ways to non-invasively early detect COVID-19 from heart rate, sleep, or a cough, even among the asymptomatic (Will they be rushed to market and be used before this is all over–or are they for the next Big Virus?)
Bexley, Wandsworth Councils onboarding remote monitoring, video calls with COVID-19 the spur (UK) (Protecting and connecting the most vulnerable their priority)

The Teladoc/Livongo merger closes fast, but Livongo veterans with spare $$$ form a SPAC. Will telehealth/telemedicine at 6% of office visits continue to be bubbly? More digging into the details of the Tunstall reorg. And we have a Perspective on how a communications provider connected in Pandemic Time.

Further information on Tunstall’s reorganization (A whole lot of shutdown and shuffling going on)
Breaking: Teladoc and Livongo close merger in $18.5 billion deal, staff/board changeovers (And a SPAC by Livongo vets in the works)
Perspectives: How Advanced Communications Technology Has Created A ‘New Normal’ In Healthcare (What Avaya has learned and done in connecting healthcare)
Telemedicine office visits versus in-person recede to 6%, concentrating in behavioral health. Will the gains hold? (The billion-dollar bubble bath question)

Kaiser extended its Medicare partnership with Best Buy’s Lively Mobile Plus. Review and approval of medical apps are revived in both the US and Germany. In the UK, Alcuris becomes a supplier to a DPS and Propel@YH brings in its 2020 cohort. For weekend reading, the ethics of contact tracing and ADL/safety trackers in senior care.

News roundup: Kaiser/Best Buy Lively partners; Teladoc’s mental telehealth, Livongo execs depart; approved apps make comeback in US, DE; United Airlines tests COVID CommonPass for international flying
Weekend reading: contact tracing in assisted living/LTC facilities via sensor-based ADL technology raises ethical issues (Older people value privacy too)
Alcuris appointed as supplier to Spark DPS (UK) (Innovation gains foothold in contracting)
Propel@YH digital health accelerator announces 2020 cohort of 10 companies (Bringing global digital health to Yorkshire & Humber)

Mostly a ‘redux’ of a week, with Doro acquiring another company, Teladoc suing Amwell, and Theranos’ judge telling them that nothing the defense threw at the wall stuck. Tunstall reminds us that the most vulnerable are at risk during the winter–you should too. And if you are seeking a sales manager position, see our UK highlights article–Buddi is hiring.

UK highlights: Doro acquires Connexus Careline, Tunstall warns on winter isolation and disconnected care, Buddi seeks Sales Account Manager  (Doro increases its second position, and happy to see more hiring!)
Teladoc sues Amwell on patent infringement–again (This time, much larger companies go head to head, creating bountiful Christmas bonuses for their lawyers)
The Theranos Story, ch. 67: the Holmes/Balwani indictments stay, Holmes’ defense strategy fails (Waiting for the Twinkie Defense II, or the money running out)

Leaves have started to turn and fall, but digital health just keeps rising with $9.4 bn in investment this year. Tunstall UK and Group Holdings report their financial status and preview their new ownership. And la scandale Theranos continues with a revelation of defense strategy.

Digital health investment smashes the ceiling: $9.4 bn invested through 3rd Q (It’s Bubble City!)
The Theranos Story, ch. 66: Walgreens and Safeway aren’t investors, they’re business partners! (Holmes’ defense strategy–erode her most serious charges)
Tunstall Healthcare (UK) and Group Holdings’ 2019 year end reports filed: highlights (The state of the company and a preview of new ownership) 

We open October with the US DOJ’s blockbuster indictments of multiple ‘telemedicine’ companies reaping billions in fraudulent payments. Sweden’s Doro continues its acquisition tear with Victrix, adding data analytics and proactive intervention capability to monitoring. Clinical trials are another coronavirus casualty–but RPM and telehealth may be able to help.

DOJ ‘takedown’ charges 86 defendants with $4.5 bn in fraudulent telemedicine claims in largest ever action (‘Telemedicine’ enters the big leagues of Medicare fraud for DME, tests, and drugs)
COVID-19’s negative impact on clinical trials–can remote patient monitoring and telehealth companies help? (Arkivum’s extensive study has implications)
Doro adds Spain’s Victrix SocSan to its growing brand portfolio for £1.28 million plus shares (A small but big move in Doro’s data analytics capabilities)

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: Legrand/Tynetec, Eldercare, UK Telehealthcare, NYeC, PCHAlliance, ATA, The King’s Fund, DHACA, 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

Thanks for asking for update emails. Please tell your colleagues about this news service and, if you have relevant information to share with the rest of the world, please let me know.

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

– – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – –

News roundup: Pfizer’s COVID-19 vaccine on horizon, CVS’ new CEO, Vodafone UK 5G health survey, Centene acquires Apixio AI, Doro’s 24/7 Response

As infection rates continue to rise, Pfizer’s and German partner BioNTech SE’s COVID-19 vaccine was the top of the news this undecided post-US election week. It was found to be “more than 90 percent effective in preventing COVID-19 in participants without evidence of prior SARS-CoV-2 infection in the first interim efficacy analysis” of the Phase 3 clinical study. They exceeded their evaluable case count (total was 94). Protection was achieved 28 days after the initiation of the 2-dose vaccination. Pfizer release. Chain and independent pharmacies have already signed on for distribution at no cost to patients, covering about 60 percent of pharmacies through the US, Puerto Rico, and the USVI. It’s expected that FDA approval will be by end of year with availability early next year. HHS release. Work on 10 other vaccines goes on. The NHS is lining up for distribution with Health Secretary Matt Hancock promising that they’ll be ready from December as coronavirus diagnoses and deaths climb up from summer levels. BBC News

CVS’ CEO Larry Merlo announces 1 Feb 2021 retirement, Aetna head Karen Lynch to take the helm. Ms. Lynch will also join the board of directors. Mr. Merlo will depart after the shareholder meeting and serve as a strategic adviser until 31 May, which is typical of CEO phased departures. He leaves CVS in excellent shape having conducted during his 10-year tenure the acquisition of Aetna in 2018 and the growth of CVS to almost 10,000 store locations, initiating 1,500 HealthHUBs, and over $199 bn in earnings through Q3 this year. Ms. Lynch joined Aetna in 2012 from Magellan Health Services, a specialty/behavioral managed health company, and Cigna. She hit a home run with vitalizing Aetna’s Medicare Advantage business to 2.5 million members from under 1 million in 2013 and became Aetna’s president in 2015. Mark Bertolini, Aetna’s CEO during the merger in 2018 (but not Federally approved till September 2019), lost his spot on the board in an apparent spat/downsizing last February.  FierceHealthcare, Healthcare Dive, Fortune

Vodafone UK’s new survey on 5G and Internet of Things (IoT) devices in UK health and social care has been issued. A key finding is the comfort level of some telehealth consults well past 50 percent, and over 60 percent in the 18-34 and 35-54 age groups. There is 60-70+ agreement with Government investment in digital technology to ‘future proof the UK healthcare sector’ and to pay for care homes’ high-quality broadband and mobile. More in Vodafone’s study here.

Healthcare payer Centene Corporation is acquiring healthcare analytics company Apixio. Apixio’s AI platform analyzes large amounts of unstructured patient data in physician notes and medical charts. It then creates algorithms to extract high-quality insights to support payers’ and providers’ administrative activities. Acquisition cost is not disclosed and close is expected by end of year. It will be an ‘operationally independent entity’ in an Enterprise group, but complement other in-house technologies such as Interpreta. A bit of catch up here as larger plans Anthem, UnitedHealth/Optum, and Humana all have either substantial in-house AI analytics or have contracted with outside vendors (e.g. Microsoft) for this capability. Release. (Disclosure: This Editor was formerly with Centene, via their WellCare Health Plans acquisition)

Doro Mobile UK and Ireland is introducing ‘Response by Doro’, a touch button service to summon help if needed. The alert button is on the back of the phone versus on the screen, which differs it from most mobile systems. The standard level connects to family and friends, with the Response Premium level connecting to a 24/7 service. For BT Mobile and EE mobile customers with a Doro mobile phone, their first month’s access to Response Premium is free. Release (PDF)

Shock news: a very muted HIMSS 2021 set for 9-13 August, Las Vegas

Yes, Virginia, there will be a HIMSS21, of sorts, we think. The news of a HIMSS21 in Las Vegas next August (when it will be 110° in the shade) is like the forecast of rain for this parched-of-business convention city and the parched-of-contact health tech community. The basics, mostly from the FAQ:

  • Registration will open in January (date TBD). If you paid your registration for the canceled 2020 conference, your registration will automatically be carried over to the 2021 conference, with details to come. If you cannot attend, no refunds.
  • Programming, exhibits, and events will be held at the Venetian-Sands Expo Center, Caesars Forum Conference Center, and Wynn 
  • The program and topics are sketched in (see the website dropdowns).
  • Proposals for the education track are closed, but open till mid-January for the optional events.  

Exhibitor registrations and paid badges will be carried over (unless you don’t plan on exhibiting, then again, no refunds). For whatever reason, the exhibit floor will be worthy of a Woman’s Christian Temperance Union (WCTU) convention in Des Moines, based on the published rules:

  • NO SOLICITING OUTSIDE THE CONFINES OF YOUR BOOTH (replicating their capitals, including hotels–what fun is this?)
  • All demos and promo activities must be performed five feet set into your booth space. It’ll get cozy for the small, poor exhibitors in a 10 x 10! In fact, straying outside your booth for anything is apparently prohibited.
  • No megaphones, loudspeakers, or what is quaintly called ‘sideshow’ tactics, for instance, clowns, whistles, or high school marching bands in the aisle. Noise must be less than 75db. If there are speakers, they must face into the booth–and better be small.
  • Tchotchkes must have logos on them, so no running out for brand-name candy needed to fuel a looong floor day
  • You have to stay in your booth during exhibit AND non-exhibit hours. (I guess this means no food, event attendance, bathroom breaks–or scoping out/chatting up the competition, a key activity at any trade show.) And don’t wear lights or signage of any type on your clothes.
  • Speaking of clothes, they’re NOT optional–tops and bottoms required. At all times. Even though it’s HIMSS. And Las Vegas.
  • No cameras or video equipment on the floor. (I guess this means you can’t shoot reference pictures, booths you like, or cute videos to share on your blog, Twitter feed, and LinkedIn. Sounds like a closed shop for HIMSS Media.)
  • Exhibitors must use the official booker (onPeak), or you can lose your badges and booth. No economizing! Rough on the small, poor companies.
  • “Event Participants are expected to behave responsibly and to treat each other – and treat the community – with respect, kindness, and compassion.” If you don’t, you lose Exhibitor Points. (No comment!)

This Editor wonders that with all these restrictions and the mid-summer timing, how many exhibitors will simply walk away from HIMSS21 and its high expense? Or wait till March 2022 in Orlando? After all, 2020 booth expense was in last year’s budget and written off. Is going to HIMSS worth it to you?  Hat tip to HISTalk.

Discovering ways to non-invasively early detect COVID-19 from heart rate, sleep, or a cough sound, even among the asymptomatic

Heart rate, sleep quality, daily movement–cough sound frequency? Several studies in the US and UK are attempting to turn up ways to early diagnose mildly symptomatic, asymptomatic, or even pre-symptomatic COVID-19 cases, without the PCR swab or a blood test.

The more obvious of the two comes out of the Scripps Research Translational Institute. The DETECT study started in March (!) with 30,500 participants sending in data in the first six weeks of the study on heart rate, sleep quality, and daily movement. This information was then matched with self-reported symptoms and diagnostic tests taken if any. In this way, new infections and outbreaks could be detected at an earlier stage.  The study is attempting to confirm if changes in those metrics in an individual’s pattern can identify those even at a pre-symptomatic or asymptomatic stage. 3,811 reported symptoms, 54 reported testing positive, and 279 negative for COVID-19. The numbers seem small, but the analysis carries out that the combination of sensor and symptom data performed better in discriminating between positive and negative individuals than symptom reporting alone. The symptom data were taken from Fitbits and any device connected through Apple HealthKit or Google Fit data aggregators, then reported on the research app MyDataHelps. FierceBiotech, Nature Medicine (study)

Also using vital signs, back in August, Fitbit released early data on a 100,000+ study where changes in heart rate and breathing could detect about half of diagnosed cases at least one day to a week before diagnosis. Symptomatic cases were 1,100 in this sample. Heart rate and breathing were detected to become more frequent in the symptomatic, with the variability in time between each heartbeat dropping, resulting in a more steady pulse. The preferred tracking was at night during rest. However, there was a 30 percent false positive rate on the algorithm used, which is extremely high. FierceBiotech Related to this work, Fitbit was selected at the end of October by the US Army Medical Research and Development Command (USAMRDC) to receive nearly $2.5 million from the US Department of Defense through a Medical Technology Enterprise Consortium (MTEC) award to advance a wearable diagnostic capability for the early detection of a COVID-19 infection. Fitbit will be working with Northwell Health’s Feinstein Institutes for Medical Research to validate their early detection algorithm. Business Wire

And what about that ‘Covid Cough’? MIT is researching that this cough is different than other coughs, like from cold or allergy. Their research found that there’s a difference in the sound of an asymptomatic individual’s cough–and that sound frequency difference could not be heard by human ears. (Dog ears perhaps?) MIT researchers created “the largest audio COVID-19 cough balanced dataset reported to date with 5,320 subjects” out of 70,000 cough samples. The algorithm performed well. “When validated with subjects diagnosed using an official test, the model achieves COVID-19 sensitivity of 98.5% with a specificity of 94.2% (AUC: 0.97). For asymptomatic subjects it achieves sensitivity of 100% with a specificity of 83.2%.” This sure sounds like an AI screening tool that is inexpensive and convenient to use with multiple populations even daily. IEEE-EMB  BBC News reports that similar studies are taking place at Cambridge University, Carnegie Mellon University, and UK health start-up Novoic. The Cambridge study used a combination of breath and cough sounds and had an 80 percent success rate in identifying positive coronavirus cases from their base of 30,000 recordings.

All of these will be useful, but still need to be validated–and that takes time, for which this Editor thinks is short as this virus, like others, will eventually 1) mutate out or 2) be effectively treated as we do with normal flus. But down the road, these will serve as a template for new ways for early screening or even diagnosis of other respiratory diseases.

Bexley, Wandsworth Councils onboarding remote monitoring, video calls with COVID-19 the spur (UK)

With Round 2 of the pandemic hitting the UK (and rising rates in EU and also parts of the US), it’s timely that borough councils have already stepped up their efforts to extend home monitoring and connectivity to the most vulnerable older adults and disabled. Here’s a short roundup:

  1. The London Borough of Bexley has been working with Docobo to install their DOC@HOME technology to connect residents with their GP to manage their health and well being at home. DOC@HOME connects with the patient via tablet (Android) tablet, computer, Docobo TV, or smartphone to their clinical teams to enroll, set up, and manage their patients using Docobo’s reporting platform. This version of DOC@HOME used two types of question sets: to set up a doctor consult requested by the resident or staff member and to conduct monthly wellness checks. The pilot was completed with one care home with these results (2019 vs 2018 same period): 71 percent fewer visits by GPs to the care home, and 36 percent fewer visits by residents to A&E. Bexley is now rolling out to 20 care homes using an NHS Digital pathfinder grant. Later plans will be rollout to individual homes.
  2. The Bexley Council is also piloting another Docobo product, ARTEMUS, a risk stratification platform, with the Bexley Clinical Commissioning Group (CCG) to create an analytics and decision support platform to support a more holistic approach to health and wellbeing at the individual level. Risk stratification at its most essential level uses data to classify residents or patients at their level of health risk (multiple chronic conditions) with the objective of mitigating long-term escalations in care needs and emergencies and integrate support, particularly to integrate support for those with dementia. 1 and 2 from NHS AI Lab Hat tip to Adrian Flowerday of Docobo for his LinkedIn post.
  3. Wandsworth Council is working with Alcove to provide the Carephone tablet to their residents who receive a care or support package. The Carephone enables them to make video calls with family, friends, care workers, and other approved service providers. Wandsworth Council article.

Further information on Tunstall’s reorganization

At the end of our 8 October article, we noted that Tunstall Group Holdings was purchased by a Jersey-based group. It is a registered private company listed as Tunstall Integrated Healthcare Holdings Limited, registered in St Helier on 31 July. Its previous name, which may be found in the Companies House reports, was Don Jersey Topco Limited. JFSC Companies Registry, OpenCorporates

Tunstall Healthcare Group Limited, which we noted had not filed a report by the 30 September deadline, now links to a new company name on Companies House, Exdon 1 Limited. The board voted for liquidation on 30 September, to be wound up by Cork Gully LLP at Snow Hill, London (PDF link). Liquidation will shift any assets or debts to other companies. The other pertinent document is a declaration of solvency (PDF link). There are several Exdons (CH link) with the Cork Gully address (not the ones in Devon) with Exdon 1-4 being liquidated. Balance sheets are included in the solvency declarations, with Exdon 3 having the most substantial list for redistribution.

Shareholder lists may be of interest to those in the industry. Barings is of course included on the shareholder votes for liquidation but so is the Bill and Melinda Gates Foundation (!). Once again, hat tip on the reports to a Reader in the UK industry who wishes to remain anonymous.

Breaking: Teladoc and Livongo close merger in $18.5 billion deal, staff/board changeovers

Breaking: Today (30 October) Teladoc announced the closing of its merger with Livongo. The release itself is pro forma. The acquisition is interesting in how rapidly it was completed: from ‘git to gone’ in under three months. By contrast, Teladoc’s close on much smaller InTouch Health took eight months. It is, of course, still positioned as a merger, but it is clearly a purchase based on the terms and their branding. (More of Editor Donna’s thoughts on this here and here.) 

Livongo shareholders will receive 0.5920 Teladoc shares plus cash of $11.33 for each Livongo share (including the special dividend declared by Livongo). The Motley Fool did the math and valued it at $18.5 million after the shareholder approval. Current Teladoc shareholders will own 58 percent, with Livongo investors holding 42 percent. Mr. Market continues to be cross, as the day started with TDOC above $215 with the current price (1pm Eastern time) at just above $197, though Teladoc’s 3rd Q earnings were excellent. TDOC’s share price just before the acquisition hovered in the $230s.

This Editor has already noted the reported exodus of many of Livongo’s top management, presumably to the bank: CEO Zane Burke, President Jennifer Schneider, MD, CFO Lee Shapiro (widely conceded as the merger engineer), and SVP of business development Steve Schwartz. David Sides, Livongo’s COO, and Arnnon Geshuri, Cheif (sic) Human Resources Officer, retain their same position as at Teladoc. According to their latest (29 Oct) 8-K, new members of the board effective 19 November will include Glen Tullman (formerly Livongo Executive Chair), Chris Bischoff (Kinnevic AB), Karen L. Daniel, Sandra Fenwick, and Hemant Taneja (General Catalyst, of which more follows).

MedCityNews detailed the above plus that R&D will be headed on an interim basis by Yulun Wang, PhD, who came over from InTouch. Also, a number of Livongo execs (Glen Tullman, Schneider, and three other managers) are putting their new wealth to work for their futures with General Catalyst’s Hemant Taneja, a Livongo backer. An S-1 was filed on 19 October to create a new special-purpose acquisition company with the goal of raising $500 million. Commonly dubbed a ‘blank-check’ company, a SPAC is a public company designed to quickly take a private company public versus the slower process of an IPO. Recent healthcare examples have been Hims Inc. and SOC Telemed

Livongo’s website as to management is already updated and cut over. The Teladoc site does not have a Livongo page other than on press releases and a landing page here. Much remains to be seen in this consolidation of telemedicine and monitoring/coaching, including whether the combined company can deliver on much-needed profits.

Perspectives: How Advanced Communications Technology Has Created A ‘New Normal’ In Healthcare

TTA has an open invitation to industry leaders to contribute to our Perspectives non-promotional opinion area. Today, we have a contribution from Dave O’Shaughnessy, Avaya’s Healthcare Leader for EMEA and APAC, with a brief discussion of how AI and advanced communications technology can help healthcare in the long term. (It’s hard to say ‘a post-COVID world as France and Germany are experiencing second round lockdowns, and UK may not be far behind.) Interested contributors should contact Editor Donna. (We like pictures and graphs too)

Across industries, we see working patterns being transformed to create the ‘new normal’ as a result of COVID-19 and our reactions to the pandemic. The healthcare sector has been no different. The pandemic and its restrictions have brought a great number of new challenges to healthcare systems. And as has been the case across so many other sectors, communications technology has stepped in to plug the gaps caused by the pandemic.

The good news is that, not only have communications solutions successfully plugged the gaps, but they’ve also provided a blueprint for the future of healthcare. As we’ve found in other industries, we’ve actually seen the intelligent adoption of this technology lead to better experiences for patients, and better outcomes for providers, than were present before.

The most important (and immediate) area where this is most obvious is in contact tracing – tracking the physical, interpersonal interactions of those who have tested positive for COVID-19. This helps identify people who may need to be quarantined more quickly, therefore reducing the spread of the virus.

Helping government and healthcare organizations across the world with their contact tracing efforts, what we’ve found is that the most effective contact tracing efforts make use of artificial intelligence and automation. After all, the effort involves mountains of meticulous information gathering and analysis—all required to meet standards set by global health and government agencies. Acting upon that data manually just isn’t feasible, given the immediate needs at hand.

Therefore, the best systems employ AI virtual agents for initial patient contact, as well as for the simple data collection interactions – only falling back to live agents when the interaction becomes more complex. AI is also employed to deliver cloud-based, proactive notifications to automatically reach out to individuals or groups with optional response tracking, text interaction, and auto-forms to capture critical information.

Patients benefit from a smoother experience while providing the tracing information required, while healthcare providers and governments are able to collect more information with the resources they have.

Even without these focused AI technologies, however, our customers are putting their advanced contact centers to good use in combating the pandemic. In Saudi Arabia, for instance, one medical facility adopted a multi-experience approach, making it easy for patients to get the COVID-19-related information they need through a wide range of communications channels. This provided demonstrated results for improved knowledge on coronavirus safety measures in the community.

Going forward, we see tremendous use cases for extending this technology to make it easier for patients to directly engage with their doctors through asynchronous messaging. Such capabilities are of particular interest to mental health providers, who have found themselves unable to conduct in-person therapy sessions in the face of increased demand.

All of these solutions were implemented because of specific, pandemic-related challenges. But once the pandemic subsides, they’ll continue providing value, making it easier for patients to consume healthcare services, while delivering increased efficiency for providers.

Hat tip to Mary Burtt of AxiCom UK

Telemedicine office visits versus in-person recede to 6%, concentrating in behavioral health. Will the gains hold?

Has the telehealth wave receded to a ‘new normal’ tide? An updated Commonwealth Fund/Phreesia/Harvard University study, including data through 4 October, confirms that we are far past the point of telemedicine dominance of the office visit. Office visits to providers have largely returned to the 1-7 March baseline and even slightly above for ages 6 and above. But telemedicine visits, from their high in this study of 13.9 percent on 18 April during the peak of the COVID-19 pandemic, have continuously dropped and have leveled off to 6.3 percent. (Telemedicine here includes both video and telephonic visits; the sample is 50,000 providers that are Phreesia clients.)

To put this in proper perspective, the pre-pandemic baseline of telemedicine in practice use was an infinitesimal .1 percent.

Larger organizations use more telemedicine than smaller ones. Primary care practices with 6 or more physicians in the group account for 9.4 percent of telemedicine visits, while practices of 1 to 5 physicians account for 4.3 percent.

Even so, by September, only 9 percent of practices were heavy users (20 percent +) of telehealth, compared to 35 percent in April. Minimal use (5 percent or less) moved up to 39 percent. One-third never used telemedicine at all–did they shut down completely?

For those seeking to segment the overall telehealth market, the chart detailing telemedicine in visits to medical specialists is of interest. It confirms the anecdotal information this Editor has heard that telehealth remains highly popular and used in behavioral health (psychiatry)–41 percent of visits. By comparison, the next most popular are rheumatology and endocrinology at 14 percent of visits. The pandemic apparently has forever changed the mental health visit and acceptance of non-face-to-face delivery, with interesting (isolating?) consequences for both patients and doctors.

crystal-ballCan telehealth hold this gain, and develop from this base? What will it look like for the average practice? Pay the lady with the crystal ball! CMS will eventually roll back the waivers on usage of non-HIPAA platforms such as Facetime (appropriately so for security and privacy reasons). Reimbursement by Medicare and commercial plans will be a major hot button. A recent survey of health system executives presented at the HLTH virtual conference indicated yawning uncertainty at the top level:

  • 30 percent of respondents said they were unsure what their plans are if telehealth reimbursements return to pre-COVID levels
  • 13 percent said they’d return to face-to-face visits
  • 20 percent said they’d continue doing virtual visits regardless
  • 17 percent said they’d analyze the financial viability of continued use

(Nokia-UPMC Center for Connected Medicine and Klas Research, Healthcare Dive)

More on this: The hazy post-pandemic future of telehealth and From back-to-work to telehealth to retail rebranding: HLTH 2020 takeaways   

Previously: As practices reopen, telemedicine visits continue to plunge from 69% to 21%: Epic (September), COVID effect on US practices: in-person visits down 37%, telehealth peaks at 14% (Commonwealth Fund through July)

News roundup: Kaiser/Best Buy Lively partners; Teladoc’s mental telehealth, Livongo execs depart; approved apps make comeback in US, DE; United Airlines tests COVID CommonPass for international flying

Kaiser Permanente is adding to its existing partnership with Best Buy Health. The joint program will develop remote patient-monitoring tools for older adults centered on Lively Mobile Plus. By pressing a button on the phone, users can connect with individuals trained to triage emergency and nonemergency situations, from car trouble, home lockouts, or medical emergency. Kaiser Permanente has rolled it out to their Medicare members as part of its Medicare Affinity Program for independent living at home. In 2019, the Kaiser system piloted Lively Mobile Plus after Best Buy’s acquisition of GreatCall. Becker’s Hospital Review 6 October and 22 October. Photo from Best Buy via Kaiser on Twitter, @aboutKP.

Teladoc launches mental telehealth to Canadian employers. Four Livongo C-levels will depart after closing. The Teladoc Mental Health Care program is available to employees of Canadian companies and provides access to psychiatrists, psychologists, and therapists via phone, web or mobile app. It is in addition to Teladoc’s Mental Health Navigator and disability products in Canada. Press release, Becker’s Hospital Review  Becker’s has also been keeping a close eye on Teladoc’s SEC filings. The letter, filed 15 October, stated that Livongo CEO Zane Burke, President Jennifer Schneider, MD, CFO Lee Shapiro (widely conceded as the merger engineer), and SVP of business development Steve Schwartz will leave the company after the closing. Livongo’s Executive Chair Glen Tullman will keep his seat on the combined company’s board of directors. Look for more changes that won’t make Livongo employees happy. Our previous Skeptical Takes on the merger here.

Approved Apps Revive! The American Telemedicine Association (ATA) announced a new partnership with the UK’s ORCHA–the Organisation for the Review of Care and Health Apps–to develop an approval procedure for health apps. Announced at the virtual HLTH conference, the objective is to create a review process to vet safe and effective health apps out of various app stores. ORCHA’s automated, intelligent review engine can assess thousands of apps against more than 300 measures in order for a healthcare organization to build and manage a health app program. Both are trying to solve the same problem faced by Happtique and IMS Health (now IQVIA) in those long-ago days of 2014. ATA release, Healthcare IT News 

For Readers with long memories, iMedical Apps is still with us and their team is still reviewing health apps both personal and professional. They’ve extended their reach to reviewing apps to prescribe with iPrescribeApps.

Meanwhile, in Germany, the Digital Healthcare Act (DVG) now finally permits doctors to officially prescribe apps to patients. The Federal Institute for Drugs and Medical Devices (BfArM) certified Kalmeda for tinnitus and Velibra, a therapy program for anxiety disorders as Germany’s first two insured health apps. Germany also is kick-starting prescribed health apps through fast-tracking medical apps that are CE-marked as Class 1 and 2a low-risk medical devices. Healthcare IT News

United Airlines is testing an app-based ‘health pass’ to speed safer global travel. CommonPass, created by the Commons Project Foundation and the World Economic Forum to enable travelers to securely share their COVID-19 test status, taken 72 hours before flight, across borders. The app will also facilitate a health declaration that may be required by the destination country and generates a quick response (QR) code scannable by airline staff and border officials. UAL’s London-Newark test follows on a test with Cathay Pacific between Hong Kong and Singapore. FierceHealthcare, MarketWatch

Weekend reading: contact tracing in assisted living/LTC facilities via sensor-based ADL technology raises ethical issues

Contact tracing for COVID-19 is still ‘not quite there’ in many countries, especially those countries like the UK which had created centralized models and were slow to move to the decentralized systems based on Apple and Google’s APIs, the (Gapple? AppGoo?) Exposure Notification system now in use in Ireland and Germany. For the most vulnerable in assisted living, who aren’t using smartphones that ping adjacency to other smartphones and are moving around most of the time within the residence, other approaches have been developed. Already in place in many communities are sensor-based trackers for activities of daily living (ADLs) for both safety and predictive health analytics, as well as provide conveniences such as apartment entry for residents.

As we noted in July, a number of ADL and location trackers have repurposed themselves into highly accurate contact tracers since they retain the history of resident and staff movement. Profiled are CarePredict (ADLs), ZulaFly (location tracking), and CenTrak (location tracking). Residents in many facilities with these systems are early adopters of contact tracing, even if they don’t know it.

While the article is detailed and fairly laudatory about how these systems can assist residents and staff in arresting the spread of COVID-19 which has ripped through nursing homes and senior living, it then diverges into other issues, some worth considering even if some of the verbiage is over the top:

  • These location monitoring systems haven’t been used for infectious disease outbreaks before, but the article admits that the pandemic has presented extraordinary circumstances
  • Use of these systems cannot substitute for effective infection control: staff and resident handwashing, mask wearing, and staff PPE. (Something like wearing a used mask and not washing your hands for the rest of us)
  • These systems are dependent on facility-wide internet/Wi-Fi. Many LTCPAC facilities do not have it, thus creating a digital divide in care even in residences proven to have high-quality care.
  • Resident rights and privacy. Residents apparently have only limited choices in using these technologies, even if they are restricted to their rooms. Not all see the need for monitoring technology for their safety and intrusive ‘alarms’ that bring in staff. There is a real issue around older adults’ autonomy and privacy rights which tends to be forgotten in the balance of privacy and safety, with prediction of illness based on behavior a step further.

Interviewed for this article, Laurie Orlov of Aging in Place Technology Watch, believes “It’s pretty darn useful if you’re in independent living, and you decide to go for a walk. If it’s night, and there’s ice, having a full detection capability that knows where you are is really useful. I think with fall detection, and anything that can help when you’re alone, the benefits exceed the cost of the privacy — assuming that you’re with it enough to opt in.”  Senior Sensors (The Verge)  (Disclosure: Editor Donna consulted for CarePredict in 2017-18)

A counterpoint to this article is also by Laurie Orlov and published on her website, reviewing the future of remote care technology and older adults in 2020. It’s a preview of a to-be-released later this year report.