Global HIT, digital health VC funding falls 35% in 1st Q 2015: Mercom Capital

Mercom Capital Group, a research and communications group, tracks global VC funding, mergers and acquisitions in the digital health area and notes a distinct slowing of activity, except for mobile health. They tracked $784 million in 142 deals in Q1 2015 compared to $1.2 billion in 134 deals in Q4 2014. Leading are consumer health companies with $437 million in 98 deals, then healthcare practice-centric companies, with $347 million in 44 deals–both dropping over $200 million each versus the previous quarter. Mobile health companies had $282 million in 56 deals; app companies accounted for $220 million. In transactions, mobile health led with $578 million, with UnderArmour’s acquisitions of MyFitnessPal and Endomondo. Since 2010, digital health companies have raised almost $10 billion. Mercom Capital release (the full study will run about $300-500). mHealthIntelligence notes that M&A activity is steadily rising in the healthcare sector. Also iHealthBeat.

Figure 1: an Instagram for medical professionals

Secure, free medical image sharing, access and collaboration is the idea behind Canadian startup Figure 1. It provides a platform for medical professionals, who are largely ‘verified’ with a blue tick (check)–a process the company is doing across 40 countries–to upload pictures into feeds, make comments and bookmark. While anyone can join, images are also put through a fairly strict vetting and access process to preserve patient privacy. They have to be deidentified, patient consent provided via signature (country-specific consent forms held by the doctor), and edited using their special software so that faces aren’t showing and identifying metadata deleted. Doctors have been using it for virtual consults and for teaching. The idea is not all that new–ClickCare has had a similar service for iPhone/iPad/iPod since 1995, but it is a paid subscription service. Available in the Apple Store and Google Play for North America, Australia, New Zealand, South Africa, and across Europe. What is the economic model, however? Guardian. Hat tip to Guy Dewsbury via Twitter.

When remote monitoring ends, what happens to patient outcomes?

They do not maintain improvement, just as we thought. A just-published study fills a significant gap in telehealth knowledge. The study published in the Journal of Medical Internet Research (JMIR) analyzed the long-running Partners HealthCare-Massachusetts General Hospital Connected Cardiac Care Program (CCCP) for patients with heart failure. They matched 174 patients participating in the 120-day program between January 2008 and August 2012 with an equal number of control patients, all with heart failure, previously hospitalized and receiving care at MGH. The program patients were provided with a ViTelNet monitoring hub plus devices–a digital weight scale, a blood pressure cuff and meter, and a pulse oximeter–as well as receiving patient education plus unscheduled education intervention from nurse care coordinators when results trended out of pre-set ranges.

During the 120 day program, the program patients (predictably) had consistently lower hospitalization rates versus the control group at the 30, 60, 90 and 120 day marks, though the differential narrowed over time. But after program completion, in the study’s follow up eight months after the end of the four-month program (see one year below), the program group’s hospitalization rates increased to exceed the control group’s. Mortality rates remained lower though not statistically significant:

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Medical apps & medication adherence: two key reports from the UK Academy of Medical Sciences

This editor was involved in the development of two events at the Academy of Medical Sciences that took place at the end of 2014, the reports of which have just been publicised.

The first, on medical apps, brought together a wide range of stakeholders to:

  • Explore the current and proposed regulatory frameworks for health apps;
  • Hear case studies of the development of health apps and of the regulation and oversight of software development in other medical, nuclear and automotive sectors;
  • Discuss the current and future challenges faced in the oversight of health apps and devise solutions to these issues.

Particular issues raised during the day included: (more…)

Politics, clinicians or demand holding back Australian digital health? The debate.

A familiar debate raged at the Connect Expo Future Health Summit in Melbourne this week [TTA 15 Apr]. Is lack of digital health adoption due to lack of political push, as Lyn Davies, managing director at Tunstall Healthcare, maintained? Australia continues to back the Personally Controlled EHR (PCEHR) to the tune of AU$1.1 billion so far, yet it is still not integrated into the healthcare system. Are clinicians allergic to technology qua technology projects, and need to be approached differently to adopt digital health, as Donna Markham, advisor to chief executive affairs at Monash Health, said? Is it people–the patients– not seeing any benefit to things like PCEHR, a lack of demand filtering down to the practice level, per Toby Hall, Group CEO of St Vincent’s Health Australia? There is a certain comfort in the issues not being much different in a smaller, centralized health system (as the US is not–and as we’ve learned from ISfTeH, in Germany telehealth adoption is low). What seems to be missing is a perspective on what individuals are doing with their own health management and tracking outside the system. TechRepublic Hat tip to David Trainor of Belfast’s Sentireal on David Doherty’s mHealth LinkedIn group (signup required).

A very important positive shift in attitude to digital health

Hat tip to Mike Clark for alerting this editor to a particularly important run of recent papers on digital health that suggests that we have at last turned the corner from the seemingly endless enquiries of the “does it work?” type, to asking instead “how can it be made best to work?”.

We’ll start with perhaps one of the most unequivocal papers on the benefits of telehealth this editor can remember – a review by a team from the Mayo Clinic of controlled trials between 1990 and 2014 of digital health for managing cardiovascular disease. It is entitled “Digital Health Interventions for the Prevention of Cardiovascular Disease: A Systematic Review and Meta-analysis”. The results found were that “digital health interventions significantly reduced CVD outcomes”. It makes great reading. Another smaller academic study of an NHS Croydon implementation for both CHF & COPD also showed positive results, and strong patient appeal specifically, too.

Another paper, just published by Stephen Agboola of Partners Healthcare, and colleagues from Boston US, entitled “Heart Failure Remote Monitoring: Evidence From the Retrospective Evaluation of a Real-World Remote Monitoring Program”,  further supports the benefits of telehealth for managing CHF. However, benefits disappeared after the 120-day telehealth usage ended, as discussed by Jonah Comstock of mobihealthnews – important lessons to be learned there, relating perhaps to what follows in this post.

(Though not an academic study, it’s worth perhaps also recording en passant a Health Recovery Solutions (HRS) claim that they reduced the 30 day readmission rate for 130 congestive heart failure patients by 53%, from 8.0% to 3.8%, over a period from July 2014 to February 2015.)

Moving on then to a paper by Trisha Greenhalgh and colleagues entitled “What is quality in assisted living technology? The ARCHIE framework for effective telehealth and telecare services”. This paper concludes that (more…)

A good week for telehealth in Senate committee hearings (US)

In contrast to last week’s deletion of telemedicine by the House Energy and Commerce committee from  ’21st Century Cures’, this past Tuesday’s Senate Commerce subcommittee on Communications hearing was far more cheering for both telehealth and telemedicine advocates. More than twelve Senators spoke on behalf of telehealth expansion, especially Medicare reimbursement for telehealth in rural areas where there is limited care access. Holding this expansion back, according to iHealthBeat, are four factors: the limited cross-state licensing for physicians; the sluggishness of the Federal Communications Commission–despite initiatives such as Connect2HealthFCC [TTA 6 Mar 14], the FCC has blocked subsidies for nursing home broadband; reimbursement and limited broadband access in the same rural areas (more…)

‘Alarming deterioration in NHS finances': The King’s Fund April report

The King’s Fund has prepared since 2011 a Quarterly Monitoring Report on the performance of the NHS as seen by its finance directors. It is a ‘regular update on how the NHS is coping as it grapples with the evolving reform agenda and the more significant challenge of making radical improvements in productivity.’ Report #15 does not bring auspicious news as the challenges deepen. 7 of 10 NHS trust directors are concerned about balancing their books next year, and 60 percent have either drawn down reserves or relied on additional financial support. In healthcare delivery performance, over 440,000 patients in this quarter spent more than four hours in A&E (US=ER or ED), the poorest performance since 2003. (more…)

ATA announces award winners, Strategic Summit companies

ATA announced the six winners of their Annual Awards recognizing innovators in telemedicine and telehealth for significant contributions, along with six new members of the ATA College of Fellows. One of the more intriguing winners (Innovation in Remote Care) is the US/UK company Sentrian which has built intelligent predictive data models (‘Remote Patient Intelligence’) that can monitor disease and co-morbidity in thousands of patients with the goal of preventing hospitalization and readmissions. Release. ATA has also selected 30 emerging companies to participate in the Telemedicine Investor and Strategic Summit  (more…)

Women and eHealth on the international scale: JISfTeH explores

JISfTeH–the Journal of the International Society for Telemedicine and eHealth–published by the University of KwaZulu-Natal in South Africa, has an intriguing issue this quarter that focuses on the international role of women and eHealth, not only as recipients but also as developers, designers and integrators of what they term Information and Communication Technologies (ICTs). Encouraging a greater role for women in what we more commonly call HIT is the subject of various UN, academic and rural efforts. The articles here are about   programs designed by, implemented and largely for women: the ‘Zero Mothers Die’ global initiative using mHealth to reduce infant and maternal mortality, using video games in structured exercise to prevent depression and anxiety among new mothers in the rural Philippines, telehealth in the monitoring of gestational diabetes (more…)

Runup to UK General Election: where parties stand on health issues

The King’s Fund continues to perform a great public service in objectively following and compiling where the five major parties stand on health issues and drawing some clear lines. In the 7 May election, the future of the NHS has become one of the major issues facing Britain, to the point of ‘make-or-break’. Their latest digest presents Conservative, Labour, Liberal Democrat, Green and UKIP pledges in six areas in animated infographic style: NHS forward funding, mental health, integrated care (health and social care, national/local levels), GP access (US=primary care), public health and NHS reform. More detailed information is available in PDF form. The main website on their General Election coverage including the major parties’ manifestos as well as the independent National Health Action Party is here. Bottom line: the NHS needs £8 billion to maintain itself. The rest is debate. Kudos to The King’s Fund, and makes us even prouder to be again this year a supporter of the Digital Health and Care Congress (and to offer our readers a 10 percent discount on registration, see sidebar to right.) 

Our UK readers who want a stinging critique of the parties’ stances (concentrating on Conservative and Labour) would do well to read Roy Lilley’s latest in his NHSManagers newsletter here.

ATA 2015: keynotes, concurrent sessions and trade show

Now available on the ATA 2015 website are the full speaker lineup, including keynote speakers Sanjay Gupta, MD, CNN’s chief medical correspondent and Yulun Wang, CEO of InTouch Health, Patrick Soon-Shiong, healthcare investor extraordinaire and Chairman/CEO of NantHealth and Reed Tuckson, ATA’s president elect. Click here to investigate the concurrent sessions. Speaker abstracts are helpfully compiled in Telemedicine & e-Health (PDF).  There are also pre-meeting professional development certificate courses on Saturday and Sunday, a separate Telemedicine Investor & Strategic Summit on Monday and Industry Executive Sessions on Monday and Tuesday. TTA is a media partner of the 20th Annual Meeting ATA 2015.

The Future of Medicine – Technology and the Role of the Doctor in 2025: May 6th

Come to this RSM/IET jointly organised event on May 6th in London for a rare glimpse of what technology may do for the role of the doctor in ten years’ time. We have a fabulous line-up of academics, clinicians and entrepreneurs who are all working on really exciting breakthroughs that will profoundly change the way healthcare is provided over the next ten years.

First off is Prof Ian Kunkler (Consultant Clinical Oncologist & Professor in Clinical Oncology at the Edinburgh Cancer Research Centre) who will set the scene for the day. He will be followed by Prof Joachim Gross (Chair of Systems Neuroscience, Acting Director of  the Centre  for Cognitive Neuroimaging  and Wellcome Trust Senior Investigator, University of Glasgow) who will be discussing Magnetoencephalopathy (MEG) Signal AnalysisDr David Clifton (Lecturer, Department of Engineering Science & Computational Informatics Group, University of Oxford) will then give a talk on Real-time Patient Monitoring. Finally in this section on Signals, Prof Bill Sandham (Managing Director, Scotsig; Director, Diabetes Technology Research, HCi Viocare; Visiting Professor, University of Strathclyde & Javeriana University, Colombia) will talk on Biosignal Processing and Analysis.

After the break, the subject turns to Imaging, where there will be two speakers (more…)

A brief collation of important stuff

This editor has been so time starved of late that blogging has proved impossible. However the information has continued to come in so here is a selection of the most important:

CUHTec – effective Wednesday 1 April 2015, CUHTec is now being hosted by Coventry University Health Design & Technology Institute (HDTI). A new website is up and running where you can book courses online.

Telehealth Quality Group – the website for the International Code of Practice for Telehealth service, previously known as TeleSCoPE,  should go live on 22 April at midday, in synchrony with Malcolm Fisk starting his presentation on same at MedeTel.

Testbeds – there’s a most interesting NHS England initiative, whereby NHS units are being asked to put themselves up as trial sites for entrepreneurs to use as testbeds for innovative ways of providing care. The AHSNs will play a key role in brokering testbed and innovator.

Growth spaces for life sciences – an organisation calling itself (more…)

58 percent of health data breaches due to simple theft, not hacking: JAMA

click to enlarge Criminal activity is the cause of nearly 6 out of 10 data breaches, according to a study published in JAMA last week (subscription required). Cyberbreaches–the infamous hacking attacks–produce breaches in the millions, but the far more typical and frequent breach, if smaller, is caused by simple theft of records–electronic and paper. HealthLeaders We’ve reported previously that stolen records (over 500) have ranged from laptops to paper records as landfill and even old-style X-rays in dead storage sought after for mercury content. So if Hackermania is not always running wild, except when it is, how to keep those records secure? According to West Virginia United Health System’s assistant CIO interviewed by FierceHealthIT at HIMSS, it requires a policy change of staff education, expectations, understanding that protecting patient information is part of holistic care–and frequent audits. Trust, but verify. Encrypt–and keep passwords secure, multiple and frequently changed.

All about the fitness devices with Parks Associates, Juniper Research

Fitness trackers are hot, hot, hot.

So Parks Associates‘ latest study tells us, with 60 million US households expected to own at least one by 2019 (hey, only 4 years away!) with global revenues exceeding $5 billion. Of that, smartwatches will constitute 100 million units. Given that only 7 million Android-based watches have been sold to date, and that the Apple Watch is projected to be about 10 million (2.3 million sold to date, according to ZDNet which glows away), that may actually be–achievable. POLITICO Morning eHealth also reported from their interview that about one-fifth of smartphone and tablet owners use a health app on a monthly basis, and 19 percent of smartphone owners find a “master” health app that aggregates data from other health apps appealing. Parks release.

In the UK, of Juniper Research’s top five smart wireless devices, three have a relationship to health, with the Apple and Google-TAG Heuer smartwatches on the high end and GOQii Fitness using their or anyone’s watch or fitness band to keep you on track for the price of their subscription. Less karma than when we saw them last June at CEWeek, more coaching. The apps will be the primary generator of revenue in fitness-band land, with hardware margins declining in the next few years. (Speaking of revenue, Juniper’s full study will set you back a tidy £3970.)