Telemedicine virtual visits preferred by majority in Massachusetts General Hospital survey

The results are far better than parity with in-person visits for follow up. A group of 254 patients and 61 health care providers were the subject of a survey conducted by researchers at Massachusetts General Hospital, part of Partners HealthCare, and Johns Hopkins. It found that virtual video visits (VVVs) are perceived by the majority of patients as the same as or better than office visits in convenience and cost, at the same level of quality and personal connection. It measured responses from both patients and providers in the MGH TeleHealth (sic) program, in place since 2012, in follow up care from providers in psychiatry, neurology, cardiology, oncology and primary care (the last two added late in the survey).

The results were: 

  • The vast majority (94.5%) of patients preferred the travel time (minimal) and time convenience (79.5%) of the VVV
  • Most patients (62.6%) and clinicians (59.0%) reported “no difference” between VVV and office visits on “the overall quality of the visit.”
  • When rating “the personal connection felt during the visit”, over half–but more patients than clinicians–said that there was “no difference” with the VVV (patients, 59.1%; clinicians, 50.8%), although 32.7% of patients and 45.9% of clinicians reported that the “office visit is better”.
  • They were also willing to pay for it–and that increased with distance from the doctor. Among those who traveled more than 90 minutes to an office visit, 51.5% indicated they would pay a co-payment of more than $50 for a VVV compared with 30.4% of those who traveled less than 30 minutes.
  • Results graphs are here

The survey results were published in the American Journal of Managed Care. This month’s issue also examines gamification in healthcare, asynchronous communication between primary and specialty care practitioners at Geisinger, EHRs–and the relationship between data breaches and not surprisingly increased advertising expenditures after the fact to rebuild lost trust. According to this last article, breached hospitals were more likely to be large, teaching, and urban hospitals relative to the control group.

Also UPI and HealthDay.

Medicare Advantage model covering telehealth for certain in-person visits starting in 2020

Another small step for remote monitoring and visits. Late last week, the Center for Medicare & Medicaid Services (CMS) announced a limited expansion of telehealth (remote patient visits) coverage as part of the Value-Based Insurance Design (VBID) model. In 2020, plans can apply to use telehealth as part of their coverage. According to the CMS release, Medicare Advantage (MA) is testing a new series of service delivery approaches, including “increasing access to telehealth services by allowing plans to use access to telehealth services instead of in-person visits, as long as an in-person option remains, to meet a range of network requirements, including certain requirements that could not previously be fulfilled through telehealth.” Other MA additions under the VBID mode include expanded rewards and incentives for beneficiaries for health improvement, and reduced cost sharing and additional benefits to enrollees, including those around chronic conditions or socio-economic status, such as aid around social determinants of health. 

The VBID model is administered under CMS’ Center for Medicare and Medicaid Innovation (Innovation Center, also CMMI), which tests innovative payment and service delivery models to lower costs and improve the quality of care. It began in 2017. The CMS VBID page lists 14 participating plans concentrated in a few states; however, it was open to 25 states this year. The 2020 model expands to 50 states under the Bipartisan Budget Act of 2018 plus will accept other MA plan types such as Special Needs Plans and Regional PPOs. Applications will start later this year. CMS press releasemHealth Intelligence 

It’s not a bubble, really! Or developing? Analysis of Rock Health’s verdict on 2018’s digital health funding.

The doors were blown off funding last quarter, so whither the year? Our first take 10 January on Rock Health’s 2018 report was that digital health was a cheery, seltzery fizzy, not bubbly as in economic bubbles.  Total funding came in at $8.1 billion–a full $2.3 bn or 42 percent–over 2017’s $5.7 bn, as projected in Q3 [TTA 11 Oct]–which indicates confidence and movement in the right direction.

What’s of concern? A continued concentration in funding–and lack of exiting.

  • From Q3, the full year total added $1.3 bn ($6.8 bn YTD Q3, full year $8.1 bn) 
  • The deals continue to be bigger and fewer–368 versus 359 for 2017, barely a rounding error
  • Seed funding declined; A, B, C rounds grew healthily–and D+ ballooned to $59M from $28M in 2017, nearly twice as much as C rounds
  • Length of time between funding rounds is declining at all levels

Exits continue to be anemic, with no IPOs (none since 2016!) and only 110 acquisitions by Rock Health’s count. (Rock only counts US only deals over $2 million, so this does not reflect a global picture.)

It’s not a bubble. Really! Or is it a developing one? Most of the article delivers on conclusions why Rock Health and its advisors do not believe there is a bubble in funding by examining six key attributes of bubbles. Yet even on their Bubble Meter, three out of the six are rated ‘Moderately Bubbly’–#2, #3, and #5–my brief comments follow. 

  1. Hype supersedes business fundamentals (well, we passed this fun cocktail party chatter point about 2013)
  2. High cash burn rates (not out of line for early stage companies)
  3. Unclear exit pathways (no IPOs since ’16 which bring market scrutiny into play. Oddly, Best Buy‘s August acquisition of GreatCall, and the latter’s earlier acquisitions of Lively and Healthsense didn’t rate a mention)
  4. Surge of cash from new investors (rising valuations per #5–and a more prosperous environment for investments of all types)
  5. High valuations decoupled from fundamentals (Rock Health didn’t consider Verily’s billion, which was after all in January)
  6. Fraud or misuse of funds (Theranos, Outcome dismissed by Rock as ‘outliers’, but no mention of Zenefits or HealthTap)

Having observed bubbles since 1980 in three industries– post-deregulation airlines in the 1980s, internet (dot.com) in the 1990s, and healthcare today (Theranos/Outcome), ‘moderately’ doesn’t diminish–it builds to a peak, then bursts. Dot.com’s bursting bubble led to a recession, hand in hand with an event called 9/11.

This Editor is most concerned with the #5 rating as it represents the largest divergence from reality and is the least fixable. While Verily has basically functioned as a ‘skunk works’ (or shell game–see here) for other areas of Google like Google Health, it hardly justifies a billion-dollar investment on that basis alone. $2 bn unicorn Zocdoc reportedly lives on boiler-room style sales to doctors with high churn, still has not fulfilled its long-promised international expansion, and has ceased its endless promises of transforming healthcare. Peleton is a health tech company that plumps out Rock Health’s expansive view of Health Tech Reality–it’s a tricked out internet connected fitness device. (One may as well include every fitness watch made.)

What is the largest divergence from reality? The longer term faltering of health tech/telecare/telehealth companies with real books of business. Two failures readily come to mind: Viterion (founded in 2003–disclosure, a former employer of this Editor) and 3rings (2015). Healthsense (2001) and Lively were bought by GreatCall for their IP, though Healthsense had a LTC business. Withings was bought back by the founder after Nokia failed to make a go of it. Canary Care was sold out of administration and reorganized. Even with larger companies, the well-publicized financial and management problems of publicly traded, highly valued, and dominant US telemed company Teladoc (since 2015 losing $239 million) and worldwide, Tunstall Healthcare’s doldrums (and lack of sale by Charterhouse) feed into this. 

All too many companies apparently cannot get funding or the fresh business guidance to develop. It is rare to see an RPM survivor of the early ’00s like GrandCare (2005). There are other long-term companies reportedly on the verge–names which this Editor cannot mention.

The reasons why are many. Some have lurched back and forth from the abyss or have made strategic errors a/k/a bad bets. Others like 3rings fall into the ‘running out of road and time’ category in a constrained NHS healthcare system. Beyond the Rock Health list and the eternal optimism of new companies, business duration correlates negatively with success. Perhaps it is that healthcare technology acceptance and profitability largely rests on stony, arid ground, no matter what side of the Atlantic. All that money moves on to the next shiny object.(Babylon Health?) There are of course some exceptions like Legrand which has bought several strong UK companies such as Tynetec (a long-time TTA supporter) and Jontek.

Debate welcomed in Comments.

Related: Becker’s Hospital Review has a list of seven highly valued early stage companies that failed in 2018–including the Theranos fraud. Bubble photo by Marc Sendra martorell on Unsplash

It’s Official: CES is now a health tech event (updated)

CES is now, officially, a health tech event. It’s not just the timing before CES of the flashy but apparently cratering JP Morgan annual healthcare investment conference in the absurdly pricey venue of San Francisco (FierceBiotech on the #MoveJPM backlash; the general disillusion with it expressed well here). It’s the fact that whatever mainstreaming health tech has actually accomplished, it’s far better represented in Las Vegas. Always a place of beginnings, endings, fun, gambles taken, lack of sleep, and sore feet, health tech fits right in, big or small.

CES reported that 2019 boasted an increase of 25 percent health-related exhibitors and a 15 percent increase in the amount of floor space dedicated to health tech. One winner was a big gamble by a small company–Living in Digital Times, which organizes and stages the Digital Health SummitTen years later, it turned out to be right place, right time for the founders who work hard to keep it on trend. Lifestyle, robotics, self-care, assistive tech (even exoskeletons), wearables, cosmetic “wellness” devices like P&G’s Opté, and Alexa-type home assistants/robots all now fit into the CES purview. Trial balloons by young companies, AI-powered concept devices from big companies, watches (including the Apple-beater Move ECG from the revitalized Withings TTA 10 Oct 18 and Omron’s HeartGuide), and robots all appeared. Samsung again brought out a brace of concept robots. Last year’s Best of CES ElliQ is finally available for pre-order after three years at a measly $1,500. The humanoid Sophia brought a kid sister, the equally creepy Little Sophia, both of whom failed during this CNET video. Yes, Pepper from Softbank made its appearance and apparently didn’t wilt as it did last year.

Sleep tech was another hot item, with a spin on sleep diagnostics or improvement from many products. A brainwave product, Urgonight from France, claims to be able to train your brain to sleep better. (Send one to Rick Astley who was a poster child for not Sleeping.)  Mental health is a natural crossover into sleep tech and robots, with a $5,000 Japanese robot, Lovot, capable of responsive cuddling and comfort.

Best of the coverage:

  • CNET has probably the best coverage and articles on health which stick to the facts (slim in some cases as they are); anyone who wants to catch up with the feel and flavor of this three-ring circus can start and stay there. Their full show coverage is here.
  • Dr. Jayne at HISTalk also did an excellent health-related product roundup in her Curbside Consult column.
  • Mobihealthnews also has a very long running list of health tech pictures and announcements as part of its limited coverage, including the mea culpas and promised transparency of onetime health ed unicorn Outcome Health [TTA 29 Jan 18].

Beyond the plethora of products encouraging ever more to come forward, what ones will even make it to market, far more be winners? Aside from the Samsungs and P&Gs, which of these young companies planting their stake at CES will be there next year?  As in past CES, the wheel goes round and round, and where it stops, nobody knows–not even the JPM investors. 

News roundup: Walgreens Boots-Microsoft, TytoCare, CVS-Aetna moves along, Care Innovations exits Louisville

Walgreens Boots finally does something. Their teaming with Microsoft to migrate their IT infrastructure to the Azure platform will eventually lead to “more personalized care experiences from preventative self-care to chronic disease management. WBA will leverage the cloud for wellness and lifestyle management programs.” It was important enough to both companies to have a photo op with twin CEOs: Walgreens Boots’ Stefano Pessina and Microsoft’s Satya Nadella. The ‘consumerization of healthcare’ and ‘transforming healthcare delivery’ phrases liberally sprinkled throughout the article and the press release are today’s prevalent clichés, as ‘synergy’ was the buzzword of say, 1999. Healthcare IT News, CNBC  In the long run, this IT overhaul may actually mean more to their customers than, say, the Amazon-JP Morgan-Berkshire Hathaway hydra.

A vote of confidence in diagnostic telehealth pioneered by young Israeli company TytoCare. They added $9 million to their Series C from investors including Sanford Health, Itochu and Shenzhen Capital Group (and its affiliates). This adds to last year’s round led by Ping An Global Voyager Fund for a total Series C of $33.5 million. TechCrunch. TytoCare also was named one of Wired’s Best of CES (CBS TV video, at 1:35) and earlier this month announced the integration of Health Navigator’s symptom checker into their system.

The judge says ‘No Delay For You’! In the CVS-Aetna hearing, Federal Judge Richard Leon refused to give the Department of Justice any more time to submit comments in the CVS Health and Aetna merger case. The deadline remains 15 February despite the government shutdown furloughing much of the antitrust division. Judge Leon is reviewing the decree under the Tunney Act requirement that the merger meet the public interest. Healthcare Finance

Care Innovations ankles Louisville. A modest and mainly paywalled item in Louisville Business First may point to something larger at Care Innovations. After two years of operation and a much-touted expansion to one of Louisville’s better addresses, the telehealth/RPM company has quietly vacated its 7,200 square foot space at Brown & Williamson Tower and pulled its operations from the city. Reporters from the publication were unable to obtain a statement from Care Innovations, which is now in Folsom, California, closer to majority owner Intel. At the time of their Louisville expansion in April 2017 (still on their website), Care Innovations received a $500,000 KBI tax incentive to create 24 high-paying jobs, which now are departed. It is ironic as Louisville is a health hub dominated by insurer Humana but has successfully campaigned for health tech. Last July [TTA 17 July], CI sold its Validation Institute and their VA win disappeared from their website. Of late, there has been no news from the one-time Intel-GE partnership.

Verily, Google’s life sciences arm, gathers in another billion to go…where? (updated for Study Watch FDA clearance)

Biotech/device company Verily added to its 2016 $800 million stake from Singapore’s Temasek a fresh $1 bn from Silver Lake Partners. with reported participation from Ontario Teacher’s Pension Plan. Verily is majority-owned by Google parent Alphabet, which has added a new member to the Verily board, CFO Ruth Porat, and Egon Durbat from Silver Lake.

CEO Andrew Conrad, who is still there despite a brace of bad press two years ago [TTA 6 Apr 16], stated that “We are taking external funding to increase flexibility and optionality as we expand on our core strategic focus areas. Adding a well-rounded group of seasoned investors, led by Silver Lake, will further prepare us to execute as healthcare continues the shift towards evidence generation and value-based reimbursement models.”

One is tempted to say, ‘whatever that means’. They have had multiple ventures from contact lenses with Novartis’ subsidiary Alcon (reportedly discontinued but dating back with Google to 2014), diabetes with Sanofi, to sleep apnea with ResMed. VentureBeat reports they are cash-profitable and even venturing into areas such as small exploding needles that can extract blood through a wearable device–not precisely for the needle-phobic. There seem to be multiple projects in multiple directions that are primarily research. Certainly their finding at $1.8 bn is an outlier even at 2018’s big scale–but with Alphabet/Google as a parent and A-list partners, the risk is minimal. Mobihealthnews, Crunchbase

FDA clearance of Verily’s Study Watch. Late last week, Verily announced that their Study Watch was given a 510(k) FDA clearance. It records, stores, transfers and displays single-channel ECG. To date, there are no plans to use it beyond a handful of research studies primarily on cardiac disease. Mobihealthnews. Meanwhile, Google, not Verily, paid Fossil $40 million for a still under development smartwatch technology to fit into Google’s Ware OS area. It’s not known whether it is health related, but their CEO admitted that it was based on tech from the Misfit acquisition–and Misfit was focused on health tech. After the sale closing, it is predicted that some Fossil R&D staff will move over to Google. Back in 2015, Fossil paid $260 million for Misfit and their fitness tech but generally has stayed in the conventional smartwatch area. The story broke in Wareable. Also Mobihealthnews.

News roundup: CES’ early beat, CVS-Aetna pauses, digital health fizzes, Yorkshire & Humber Propels

The start of January can be a slow–or busy–time. There are, of course, the avalanche of announcements made at JPM and just starting CES, which has become a part-healthcare show with hundreds of health-related exhibitors. At this point, this Editor confesses that there is not much that has caught her attention or that she–and Readers–haven’t heard about before, but the bulk of the coverage will come out next week. A lot of what is on the floor are still gadgets–and they come and mostly go. In better news, there was a Hospital at Home panel kicking off the 10th year of the Digital Health Summit on till Friday which illustrates their maturing into issues such as AI, workplace wellness, and aging. All this may be moving forward and coming a lot closer to reality than say, in 2017. But Jake, it’s CES–this year, if it folds, rolls, is retro, has a healthcare spin, and 5G, it’s on trend at CES.

CVS-Aetna grinds to halt. The partial government shutdown has affected the DOJ’s filings with DC Federal Court Judge Richard Leon on the consent decree from October. Judge Leon is reviewing the decree under the Tunney Act requirement that the merger meet the public interest. It turns out that the DOJ cannot supply documents as the Antitrust Division was furloughed–non-essential . This means little for the actual merger as it has already happened, but it slows down a fair amount of functional integration. Prediction: DOJ will not move forward with this until at least one month after the shutdown ends–our bet is April, with the cherry blossoms. Seeking Alpha

Fizzy, not bubbly. That’s Rock Health’s verdict on This Year In Digital Health Funding. No Bubble Here! While Rock only takes a piece of the picture (US only deals, over $2 million), it came in at $8.1 billion–a full $2.3 bn or 42 percent–over 2017, as projected in Q3 [TTA 11 Oct]. The deals continue to be bigger and fewer–368 versus 359 for 2017, which is barely a rounding error. More on this next week.

Propel@YH debuts. Returning to the UK, Yorkshire and Humber’s Academic Health Science Network’s (AHSN) first digital health accelerator program will be providing guidance and support services for pioneering developers with innovative digital and patient solutions. Eligible organizations will have either an existing presence in the region or are willing to establish one. Six organizations will be chosen to take part in a six-month program focused on human-related design, clinical safety by design and understanding NHS procurement. Announcement and AHSN website.

Events, Dear Friends, Events part 2: Newcastle and Texas accelerate, Aging2.0 NYC gets happy, AutoBlock’s Meetup, Wearable Tech, HealthImpact East

Short notice–Thursday 10 January in Newcastle, Aging2.0 is supporting the Innovation SuperNetwork on their Innovation in Ageing Accelerator Programme. This is a collaboration that includes the local National Innovation Centre for Ageing, Newcastle City Council and Northstar Ventures. They are offering £12,500 of investment and 6 months office space in the Biosphere building on Newcastle Helix. The Accelerator is holding a four-hour workshop tomorrow, 1-5 pm. If you can make it, register here.

Wednesday 30 Jan, NYC. Post-holiday, post-CES/JPM, and mid-winter blues have you down? Aging2.0 in NYC is hosting a Happy Hour (drinks are on you) down at Grey Bar in the trendy Flatiron District. It’s Wed 30 Jan 6-8pm at Grey Bar (26th between 6th and Broadway). RSVP here.

Friday-Saturday 8-9 February, Dallas. The Health Wildcatters are sponsoring a two-day Texas Healthcare Challenge. Format is a “hackathon-like” prize competition focused on creating team-based solutions to problems in healthcare. Teams can apply as well as solo fliers who will join a team that presents at the end of the event. Application by 24 January. More information here.

If you are in the Cambridge/Boston MA area, the former Health Innovators, now AutoBlock, hosts a weekly Thursday Meetup at the Cambridge Innovation Center on blockchain in healthcare. Hat tip to Kalyan Kalwa MD 

And on the other side of the country, the 10th Wearable Tech + Digital Health + Neurotech Silicon Valley conference will be 21-22 February at Stanford University, co-sponsored by ApplySci and the Stanford Wearable Electronics Initiative. More information here. 

And looking ahead to warmer weather…HealthImpact East will be up on 21-22 May at the Google offices in NYC. 

Events, Dear Friends, Events: Hancock at the RSM, MedStartr NOLA Challenge, RSM and The King’s Fund

HealthChat with Secretary of State for Health Matt Hancock. Monday 28 Jan at the RSM (starts at 8 for 8.30am).

Roy Lilley of NHS Managers will be asking the questions, so they won’t be a parade of powderpuffs. What is the long term look at health policy when the Government is gripped by Brexit? Promoting digital health won’t have an argument here and fax machines may have had their day, but what’s the 10 year plan all about? What about that social media blitz targeting the obese, smokers, and those who like their drink? Intriguingly, who is the real Matt Hancock? Is he That Man In A Portfolio? Tickets are a moderate £19.95 – £39.95 and likely will sell out soon. Book via Eventbrite here. Hat tip to Roy Lilley via NHS Managers.

NOLA Health Innovators Challenge. Over here in the US, we have a very big event (no, not CES in Las Vegas or the JP Morgan invitational conference this week in SF). It’s down in one of the homes of Real Jazz, New Orleans (NOLA), in March (date to come). Back for its second year, MedStartr Ventures has been running the Health Innovators Challenge jointly with the New Orleans Business Alliance. It’s very late to apply for one of the four Challenges (it closes on Sunday 13 Jan) but if you work hard and fast, see the link to apply to a program that is raising its second round of funding and helping previous crowd challenge winners raise their next rounds–plus get a wealth of guidance on how to package your idea for presentation to key healthcare stakeholders to get to market much faster. They also sponsor the #HCLDR Tweetchat every Tuesday at 8:30 PM EST, 5:30 PST, Wednesday 1.30 AM GMT.

Speaking of the RSM, their Digital Health (Telemedicine & eHealth) section is sponsoring upcoming events on Recent Developments in AI and Digital Health on Tuesday 26 Feb and Medical Apps–Mainstreaming Innovation on Thursday 18 April featuring a return appearance by Matt Hancock. 

Over at The King’s Fund, they will be hosting a full day session on Digital Health Explained: demystifying the tech revolution in health and care on Wednesday 27 March. The annual two-day Digital Health and Care Congress will be a little earlier this year, on 22-23 May; preliminary information and registration including sponsor packages are here. Follow developments at #KFdigital19.

Healthsites, eHealth Africa mapping health facility locations in West Africa to improve emergency care

News from an area not known for health tech. eHealth Africa is partnering with the Global Healthsites Mapping Project to create a dataset of health facility locations across West Africa. The goal of the global project is to improve outcomes in the medical and humanitarian sectors by establishing an accessible global baseline of health facility data. 

The project was initiated during the Ebola epidemic in March 2016 with support from the International Committee of the Red Cross (ICRC) and Kartoza. eHealth Africa’s expertise is in health facility data collection and presentation. eHealth Africa will be working with Healthsites using two platforms they developed: Gather, a human-mediated data collection and curation application that crowdsources and quality checks facility information; and Aether to facilitate interoperability over several systems, allowing for a large-scale data exchange between numerous organizations. The mapping app that Healthsites uses to establish the baseline of facility data is OpenStreetMap. 

Improving emergency care can lead to a 45% reduction in mortality rates and a 36% reduction in disability–The Lancet  The primary use cases center around epidemic preparedness, support for disaster response, immunization programs, and maternity care. Most of this involves responding to outbreaks more effectively, preparing for sudden influxes of patients, allocating resources and availability of resources, but also the health of women giving birth in remote areas.

Project partners include the International Committee of the Red Cross (ICRC), Doctors Without Borders (MSF), The Humanitarian OpenStreetMap Team (HOT), the International Hospital Federation, and CartONG. The eHealth Africa blog is a great spot to track health tech used in the field in Africa.

Is Babylon Health the next Theranos? Or just being made out to be by the press? (Soapbox)

There, it’s said. A recent investigative article by a Forbes staff writer, European-based Parmy Olson (as opposed to their innumerable guest writers), that dropped a week before Christmas Eve raised some uncomfortable questions about Babylon Health, certainly the star health tech company on the UK scene. These uncomfortable bits are not unknown to our Readers from these pages and for those in the UK independently following the company in their engagement with the NHS.

Most of the skepticism is around their chatbot symptom checker, which has been improved over time and tested, but even the testing has been doubted. The Royal College of Physicians, Stanford University and Yale New Haven Health subjected Babylon and seven primary care physicians to 100 independently-devised symptom sets in the MRCGP, with Babylon achieving a much-publicized 80 test score. A letter published in the Lancet (correspondence) questioned the study’s methodology and the results: the data was entered by doctors, not by the typical user of Babylon Health; there was no statistical significance testing and the letter claims that the poor performance of one doctor in the sample skewed results in Babylon’s favor.  [TTA 8 Nov]. 

The real questions raised by the Lancet correspondence and the article are around establishing standards, testing the app around existing standards, and accurate follow up–in other words, if Babylon were a drug or a medical device, close to a clinical trial:

  • Real-world evaluation is not being done, following a gradual escalation of steps testing usability, effectiveness, and safety.
  • How does the checker balance the probability of a disease with the risk of missing a critical diagnosis?
  • How do users interact with these symptom checkers? What do they do afterwards? What are the outcomes?

Former Babylon staffers, according to the Forbes article, claim there is no follow up. The article also states that “Babylon says its GP at Hand app sends a message to its users 24 hours after they engage with its chatbot. The notification asks about further symptoms, according to one user.” Where is the research on that followup?

Rectifying this is where Babylon gets sketchy and less than transparent. None of their testing or results have been published in peer-reviewed journals. Moreover, they are not helped by, in this Editor’s view, their chief medical officer stating that they will publish in journals when “when Babylon produces medical research.” This is a sad statement, given the crying need for triaging symptoms within the UK medical system to lessen wait times at GPs and hospitals. But even then, Babylon is referring patients to the ED 30 percent of the time, compared to NHS’ 111 line at 20 percent. Is no one there or at the NHS curious about the difference?

And the chatbot is evidently still missing things. (more…)

3rings’ well-handled transition to their March shutdown (updated)

In late summer [TTA 19 Sep] we learned that one of the most innovative UK companies in sensor-based assistive technology, 3rings, was ceasing operations as of March 2019’s end. We noted it was a planned shutdown that gave subscribers nearly six months to switch over to other technologies. Steve Purdham and his team have recommended three companies that in their estimation are good alternatives to 3rings in both their original electrical Plug (electric usage as a proxy for being up and around) and cloud-based IoT service. Three companies are recommended in detail based on needs. 3rings presents all three in detail with special offers, including a handy ‘how to’ on transitioning services.

  1. Clever Contact from Alertacall–a daily contact and reminder service
  2. Canary Care--motion sensor/IoT service which is fairly close to the way that 3rings developed. Canary Care has reorganized since last summer with new ownership [TTA 8 Nov].
  3. PPP Taking Care–pendant alarm

When asked to comment on Canary Care’s recent release (PDF) related to their service as a close fit to 3rings, Steve remarked that “As we plan our graceful close the key for us was to give all our customers significant notice of our intentions (almost 6 months) and where possible provide guidance as to ways forward. We also wanted to help as many of our customers to transition to technologies that would help them continue looking after their loved ones after March 1st 2019. Looking after all our customers means a lot to us so providing this help made sense. The team at Canary wanted to do a press release regarding their deal and I was happy to support it.”

The 3rings closing is regrettable, but the transition of their services to protect their customers deserves a ‘Well Done’. (Undoubtedly we will be hearing from Steve and the 3rings team in future.) Hat tip to Steve, Nicola Hughes of Canary Care/Lifecycle Software, and James Batchelor of Alertacall.

Happy Holidays and a most Festive Season!

The Editors of TTA wish our Readers and Friends, as well as their families, the best for this festive season! Hanukkah has passed, but we have a Merry Christmas to come. (And don’t forget Boxing Day!)

Even if you do not celebrate Christmas, these words of Charles Dickens speak to us all:

“I will honour Christmas in my heart, and try to keep it all the year. I will live in the Past, the Present, and the Future. The Spirits of all Three shall strive within me. I will not shut out the lessons that they teach!”
― A Christmas Carol

The next Alert will be on Friday, 4 January, and resume on Thursdays the following week.

Our best wishes for a happy, healthy, and prosperous New Year!

Ultrasound to break up brain amyloid plaques moving to human trials in 2019

Somewhat outside of telecare, but inside our concern with the health of older people, is the exciting news of a novel ultrasound treatment to break up the amyloid plaques in the brain that may be the cause of many dementias and Alzheimer’s Disease. Initially developed at the University of Queensland in 2015, the original objective was to open the blood-brain barrier to facilitate antibody treatment for dementia. Researchers found that in tests on mice, the ultrasound ablation cleared the plaques without any further drugs. Later tests found that the treatment clears both “toxic proteins and restores memory function safely in several different rodent models, including an older mouse model designed to resemble human brains of 80 to 90 years old.” 

Australian government funding is key in helping accelerate development. The first stage in human trials is a phase 1 safety trial, kicking off later in 2019. 

While at least a decade in the future if all goes well in clinical trials, one of the researchers, Jürgen Götz, is thinking larger, towards future personal ultrasound devices which could be used for personal treatment or prevention. New Atlas

An earlier study referenced in MedPageToday summarized results and concerns with a Canadian study. 

News roundup: CVS-Aetna still on hold, blockchainers Change acquires PokitDoc, Teladoc’s COO resigns under insider cloud, Clapp joins Cricket

Federal Judge Richard Leon of the Washington, DC District Court is taking a consideration break on the integration of CVS and Aetna, after holding it up on 3 December. The Department of Justice (DOJ) originally recommended that the merger was legal under anti-trust law after Aetna divested its prescription drug plan to WellCare and both companies’ settlements with several states. Judge Leon, reviewing under the Tunney Act requirement that the merger meet the public interest, is waiting for the DOJ to respond to further steps that CVS has taken to keep the companies separate. According to Seeking Alpha, CVS will take “constructive measures on pricing and sensitive information” and that an outside monitor would be brought in to monitor the companies commitments. Hartford Courant

Health IT software company Change Healthcare acquired assets of San Mateo-based PokitDoc, a healthcare API and blockchain developer. PokitDoc has developed blockchain transaction networks for EHR and identity verification, automatic adjudication and smart contracts. Its APIs are used by Doctor on Demand, Zipnosis, PillPack, and available on Salesforce Health Cloud. Change’s own blockchain platform was developed in 2017. McKesson owns 70 percent of Change. PokitDoc had funding up to $55 million prior to purchase, the value of which was not disclosed. Mobihealthnews, Health Data Management

Teladoc cut loose its COO/CFO after insider trading and sexual misconduct allegations. Mark Hirschhorn resigned on 17 December from the telemedicine company after being instrumental in the company’s recent revenue and visit growth (albeit with a downward spiral on the share value). Mr. Hirschhorn was alleged to have not only have had a sexual relationship with a (much younger) subordinate while married, but also engaged in mutual insider trading…of Teladoc stock. The steamy details of the affair(s) and an equally seamy tale of a whistleblower’s fate are in the Southern Investigative Reporting Foundation’s ‘The Investigator’. For those more concerned about Teladoc’s financial future, a bullish analysis of their stock value and trends is over at Seeking Alpha. Adding to the fire: a class action lawsuit was also filed against Teladoc on behalf of the company’s shareholders, accusing the company of misleading or false statements. Also Mobihealthnews.

And it’s cheering to announce that a respected long-time telehealth executive has found a new perch. Geoff Clapp has joined Cricket Health, a provider of integrated technology around kidney health, as Chief Product Officer. Geoff is an authentic Grizzled Pioneer, having joined early telehealth RPM company HealthHero back in 1998, then their acquirer Bosch Healthcare. He was also founder of Better, which partnered with the Mayo Clinic on providing virtual care coordinators at popular prices for both consumers and health systems. Since then he has consulted for companies as diverse as Telcare (diabetes), Oration (sold to just-acquired PokitDoc), and in venture capital. Congratulations–and happy new year in the new job! Release

Kompaï robotics gets FABULOS in EU Horizon 2020 automated minibus competition

France’s Kompaï robotics, which Editor Steve first profiled in May 2011 (!), is still developing assistive robots for older adults, the disabled, and their caregivers. In another instance of technology integration and crossover into an area other than healthcare, they are a finalist in one of 5 consortia of 16 companies competing in the European FABULOS challenge to develop an automated minibus. Kompaï is partnering with Actia Automobile as the Kompai-Actia Consortium. Phase 1 of FABULOS starts 1 January with a feasibility study with conclusions for the start of prototype development. In autumn, the consortia will move to lab testing prototypes with real-world testing of the final three starting March 2020 in Estonia, Finland, Greece, the Netherlands, Norway, and Portugal. The R&D is being financed by the European Horizon 2020 Research and Innovation Programme with a total fund of over €5,5 million. FABULOS release.