Is Babylon Health’s AI on par with a human diagnostician? Claim questioned in ‘The Lancet’.

In July, Babylon Health released the results of their testing against the MRCGP (Member of the Royal College of General Practitioners) exam based on publicly available questions. As we reported at the time, its AI system passed the exam with a score of 81 percent. A separate test where Babylon worked with 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. Babylon passed with an 80 score.

Now these results are being questioned in a letter to The Lancet. The authors–a medical doctor and two medical informatics academics–argue that the methodology used was questionable. ‘Safety of patient-facing digital symptom checkers’  shows there ‘is a possibility that it [Babylon’s service] might perform significantly worse’. The symptom checking methodology was questioned for not being real world–that the data in the latter test was entered by doctors only, not by patients or other clinicians. While the authors commended Babylon for being open about their research, they felt there was an “urgent need” for improvements in evaluation methods. “Such guidelines should form the basis of a regulatory framework, as there is currently minimal regulatory oversight of these technologies.” Babylon promises a response and additional improvements, presumably from its $100 million investment in AI announced in SeptemberDigitalHealth (UK), Mobihealthnews

Comings and goings: CVS-Aetna finalizing, Anthem sued over merger, top changes at IBM Watson Health

What better way to introduce this new feature than with a picture of a Raymond Loewy-designed 1947 Studebaker Starlight Coupe, where wags of the time joked that you couldn’t tell whether it was coming or going?

Is it the turkey or the stuffing? In any case, it will be the place you’ll be going for the Pepto. The CVS-Aetna merger, CVS says, will close by Thanksgiving. This is despite various objections floated by California’s insurance commissioner, New York’s financial services superintendent, and the advocacy group Consumers Union. CEO Larry Merlo is confident that all three can be dealt with rapidly, with thumbs up from 23 of the 28 states needed and is close to getting the remaining five including resolving California and NY. The Q3 earnings call was buoyant, with CVS exceeding their projected overall revenue with $47.3 billion. up 2.4% or $1.1 billion from the same quarter in 2017. The divestiture of Aetna’s Medicare Part D prescription drug plans to WellCare, helpful in speeding the approvals, will not take effect until 2020. Healthcare Dive speculates, as we did, that a merged CVS-Aetna will be expanding MinuteClinics to create urgent care facilities where it makes sense–it is not a big lift. And they will get into this far sooner than Amazon. which will split its ‘second headquarters’ among the warehouses and apartment buildings of Long Island City and the office towers of Crystal City VA.

Whatever happened to the Delaware Chancery Court battle between Anthem and Cigna? Surprisingly, no news from Wilmington, but that didn’t stop Anthem shareholder Henry Bittmann from suing both companies this week in Marion (Indiana) Superior Court. The basis of the suit is Anthem’s willfully going ahead with the attempted merger despite having member plans under the Blue Cross Blue Shield Association meant the merger was doomed to fail, and they intended all along for “Anthem to swallow, and then sideline, Cigna to eliminate a competitor, in violation of the antitrust laws.” On top of this, both companies hated each other. A match made in hell. Cigna has moved on with its money and bought Express Scripts.

IBM Watson Health division head Deborah DiSanzo departs, to no one’s surprise. Healthcare IT News received a confirmation from IBM that Ms. DiSanzo will be joining IBM Cognitive Solutions’ strategy team, though no capacity or title was stated. She was hired from Philips to lead the division through some high profile years, starting her tenure along with the splashy new Cambridge HQ in 2015, but setbacks mounted later as their massive data crunching and compilation was outflanked by machine learning, other AI methodologies, and blockchain. According to an article in STAT+ (subscription needed), they didn’t get the glitches in their patient record language processing software fixed in ‘Project Josephine’, and that was it for her. High profile partner departures in the past year such as MD Anderson Cancer Centers, troubles and lack of growth at acquired companies, topped by the damning IEEE Spectrum and Der Spiegel articles, made it not if, but when. No announcement yet of a successor.

Canary Care re-emerges as Canary Care Global Ltd, confirms continued operations

Canary Care, which entered administration in late August, has been reorganized and continues as Canary Care Global Ltd, remaining in Abingdon. The purchaser in the pre-packaged sale, as Readers learned here, is Lifecycle Software Ltd. Their marketing office sent a release last week confirming their operations. Stuart Butterfield, who answered our inquiries in September, is now managing and technical director. He is quoted in the release: “This is a really positive development for our company. We will continue to provide the Canary Care product and service that our existing customers know and love. Our new owner provides us with the stability and resources to further enhance the Canary Care offering and we’re very excited and optimistic about the future and the opportunity to bring Canary Care to a wider audience.”

The administrator’s latest filing with Companies House is clearly a wrapup of the sale as the best possible outcome for the company. Shareholders included major investor Mercia Fund Management. A quick read of the administrator’s proposal is an object lesson how quickly an insolvency can happen. In section 2, the company went from seeking fresh funding to expand markets in May, having been turned down by Mercia due to their funding criteria, to having an interested buyer who ultimately was not approved by the shareholders by a hairsbreadth, to insolvency by August.

We do wish Canary Care luck with their new ownership and success in this very difficult time for acceptance of –and payment for–telecare and TECS services. Release (PDF) Hat tip to Nicola Hughes of Lifecycle Software

Upcoming UK telecare and telehealth events; SEHTA calls for Healthcare Business Awards nominees.

Winding up the year….

Managing digital change in health and care/The King’s Fund/Thursday 22 November/8.30am-4.30pm/The Met Hotel, King Street, Leeds, LS1 2HQ

This conference aims to support health and social care organisations that are looking to undertake large-scale digital change, no matter what their current level of technological advancement. Understand the factors that contribute to successful change by showcasing the experiences of different case study sites and Global Digital Exemplars that have already made significant progress. More information and registration here

UK Telehealthcare has several events coming up all over the country. For more information and registration, click here or the advert in the right sidebar and scroll down to ‘Members Events Coming Up’.

8th November 2018 – Suppliers’ Forum, Hammersmith Town Hall, King St. London W6 9JU
9th November 2018 – Providers’ Forum, Hammersmith Town Hall, King St. London W6 9JU
14th November 2018 – CECOPs Digital Health Masterclass, Carisbrooke Hall, Victory Services Club, 63-79 Seymour Street, London, W2 2HF
5th December 2018 – CECOPs Digital Health Masterclass, 2 Brewery Wharf, Kendell Street, Leeds, LS10 1JR.

UK HealthTech/4 December/Cardiff Park Plaza

At the UKHT conference, over 300 delegates will hear speakers discuss the major strategic issues and policy developments facing the life science and healthcare sectors. Showcases include the latest advances in R&D technologies and up and coming spinout companies. It closes with the 13th annual MediWales Innovation Awards, celebrating the achievements of the NHS, life science and health technology communities in Wales. More information and registration here.

SEHTA is calling for nominees for its 2018 Healthcare Business Awards through Friday 14 December. They are looking for the best achieving companies of 2018 in the following five categories: Export Achievement, Start-up, Innovation, Partnership with the NHS
MedTech, and the new category of Healthcare Investment of the Year (most significant/transformational public and/or private sector funding received in 2018). To download application forms, click here. Completed forms should be returned to Clare Ansett – clare.ansett@sehta.co.uk 

A critical take on Pepper’s Parliament Question Time (UK)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2018/10/103886629_mediaitem103886628.jpg” thumb_width=”150″ /]Perhaps this Editor should have been less credulous. Somewhere, this Editor failed to notice a mention in the press she picked up that Pepper’s Question Time before the Commons select committee on education had been fully prearranged and scripted. (Thank you and a Big Tip of The Hat to reader Alistair Appleby for pointing that out.) It made Pepper’s appearance a little less than All That Sensational–more like a pre-recording delivered by an automaton prompted through a Middlesex University student’s smartphone.

Mr. Appleby provided a link to a Wired UK article that bears close reading. It sharply critiques not only the presentation, but also the trivialization of what the select committee was really examining, which was the “Fourth Industrial Revolution” of large-scale automation and its disruptive effects on the work of the all-too-near future.

Wired‘s reporter Gian Volpicelli sat in the front row and acidulously observed that Pepper’s appearance was a PR stunt that detracted from the substantive (I think) conversation that preceded it.

“For one hour before Pepper’s triumphal entrance, three experts from UCL, Nesta and Siemens engaged just in that kind of nuanced, data-based, academic conversation with the Committee’s MPs. They studiously tackled issue after unresolved issue, from AI bias, to education reform, to pure epistemology. “What is knowledge? Why should we believe something?,” asked UCL professor Rose Luckin at one point. “What a wonderful philosophical discourse,” committee member William Wragg MP would remark – under the austere blue gaze of Maggie Thatcher’s portrait. “

It does sound like the usual academic drift-off into La La Land, making it a discussion on Big Issues That Make Your Head Hurt because they have a thousand possible outcomes out of H.G. Wells and Aldous Huxley, but what is remarkable is that neither BBC News nor the Guardian saw fit to mention the experts’ testimony.

Mr. Volpicelli rightly labels Pepper’s appearance a media stunt that gained all the attention versus a real discussion about the societal effect of future robots. Will it be the Pepper-future of cute machines that can perform few tasks and are non-threatening? Will it be the Atlas-future, the one projected by Boston Dynamics’ humanoid athlete-robot that does parkour and skillfully leaps large boxes, funded by DARPA to be a search and rescue robot? Will the future belong to the weirdly humanoid Frubber-skinned Sophia, who fell into the ‘uncanny valley’ at CES last January [TTA 23 Jan] — the same CES where Pepper ‘fainted’ to a non-working slump (schlump?) More than likely, it will be the robotic arm that flips and bags the fast-food burger that is more of the immediate future–and displacing low-wage workers–than any of the above. We need to have a very serious chat about Pepper’s pointless parliamentary pantomime 

Pepper pays a first-ever robot visit to Commons on the future of AI and robotics on education, older adult care (UK)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2018/10/103886629_mediaitem103886628.jpg” thumb_width=”150″ /]Pepper paid a visit to a House of Commons select committee on education and became the very first robot to meet with MPs. Accompanied by students from Middlesex University, where Pepper is part of an initiative on teaching primary school-level children, he made a short presentation about the future of artificial intelligence in education and older adult care.

Certainly his introduction has some historic value. Pepper bowed and then said in his rather high-pitched and somewhat Japanese-inflected voice: “Good morning, chair [Robert Halfon]. Thank you for inviting me to give evidence today. My name is Pepper and I am a resident robot at Middlesex University.”

Pepper used voice, gesture, and his embedded front tablet to explain about the role robots like him will play in education and healthcare. At Middlesex, final year students in robotics, education, psychology, and biomedicine like Joana Miranda, one of his two escorts, work with Pepper on projects such as developing numeracy skills in primary school students. According to BBC News, Tory MP Lucy Allan dryly noted that Pepper was “better than some of the ministers we have had before us”.

In healthcare for older adults, the Pepper robot developed by Softbank is part of a major research project funded by the EU, the Japanese Government and UK’s Horizon 2020. The objective of the three-year CARESSES program is to develop a culturally aware robot to provide care suited to a wide variety of individuals and reduce loneliness. Another desired outcome is to relieve pressure in hospitals and care homes by promoting independent living at home with a care robot.

The education committee is examining the “fourth industrial revolution” which impacts STEM education, school curriculum, and workforce skills (and reskilling). Videos on BBC News and Gevul News (YouTube) A tart take on Pepper versus PM Theresa May from The Guardian. (And no fainting, as Pepper did at CES earlier this year.) Hat tip to The King’s Fund weekly newsletter.

Connected Health Conference highlights (so far): FCC’s $100 million telehealth pilot, NIH’s ‘All of Us’, MIT’s social robots integrating AI

Expanding FCC connected health programs. FCC Chairman Ajit Pai in his keynote reinforced the agency’s interest and support of connected health initiatives, from rural to opioids. Most of the programs have a rural focus to bring broadband and telehealth/RPM to the ‘end of the line’ in underserved communities, something close to Mr. Pai’s heart as his parents were both rural physicians in Kansas..

  • This summer, the Connected Care Pilot Program was proposed and approved unanimously in August [TTA 9 Aug]. Funding for this is proposed at $100 million.
  • The spending cap for the rural healthcare program, which has been around since 1997’s dial-up days and now includes telemedicine and remote monitoring, was increased for 2017-2018 from  $400 million to $571 million, a 43 percent increase. The FCC has pledged to fully fund 2018 programs.
  • New initiatives were announced covering new uses for telehealth and remote patient monitoring:
    • Connected care at home via RPM as part of the Connected Care Pilot Program
    • Cancer care in partnership with the National Cancer Institute. The Launch program for rural and underserved communities aims to bring high-quality cancer care to where patients work and live through bringing together government, academia and community health providers.
    • For opioids, there are two programs. One is expanding the mapping broadband health platform to include critical drug use data. This will allow users to rapidly visualize, overlay, and analyze broadband and opioid data together at the national, state, and county level. The second is to launch a chronic pain management and opioid use challenge as part of the pilot program.  Mobihealthnews

A status report on NIH’s All of Us. Back in January as part of setting the stage for 2018, this Editor briefly mentioned the National Institute of Health’s massive All of Us program, part of the Federal Precision Medicine Initiative (PMI). All of Us needs almost all of us–their goal is to collect data on at least one million Americans for a major leap forward on data supporting population health. Dr. Dara Richardson-Heron, All of Us’ chief engagement officer, confirmed that over 100,000 participants have registered since the launch in May, with over 65,000 completing the full protocol. She mentioned that 75 percent of signups are from groups often underrepresented in modern medical research, with 50 percent from racial and ethnic minorities. The Mobihealthnews article ends on a ‘Debbie Downer’ note of doubting whether the program will reach enrollment goals, the cost will be justified, and whether the data will be kept private as promised.

MIT’s social robots may be the future of emotional support for wellbeing. MIT associate professor Cynthia Breazeal heads up the Personal Robots Group and is working on how to integrate AI into emotional robots for pediatric patients at Boston Children’s Hospital. The robots serve as a go-between child life specialists and the patient. The initial results were positive, with higher verbal scores (as a measure of engagement) than with stuffed bears or digital avatars. Professor Breazeal wants to extend the technology to older adults for wellbeing and engagement. Running against the conventional wisdom, their research found that older adults were more open to technology than the children. Following MIT’s work are companies like Hasbro and Embodied. Mobihealthnews.

DNA-based personalized food choices to prevent Type 2 diabetes onset in test with Imperial College, London and Waitrose (UK)

Can DNA analysis and an app help prevent Type 2 diabetes onset in the pre-diabetic? The problem of preventing Type 2 diabetes in people determined to be pre-diabetic is multi-factorial, but one approach is diet to control 1) obesity and 2) improve glucose regulation. DnaNudge, which has developed a DNA analysis from a cheek swab, is being used in a clinical trial conducted by Imperial College London’s NIHR (National Institute for Health Research) Imperial Clinical Research Facility to determine whether DnaNudge’s scanner and app, used while shopping at Waitrose & Partners stores, can prevent the development of Type 2 diabetes in prone individuals.

To this Editor’s knowledge, this is the first time that personalized DNA testing and an app have been used in conjunction with retail food choices.

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2018/10/MyDNA-Report-Sample.png” thumb_width=”125″ /][grow_thumb image=”http://telecareaware.com/wp-content/uploads/2018/10/product-feedback-recommended.png” thumb_width=”150″ /]How it works is that the individual’s DNA is analyzed first and then used to match what food choices are best for that person via a simple thumbs up or down indicator on the app. 

  • Using a sterile cotton swab, users sweep the inside of their cheek to capture a sample of saliva.
  • The swab is inserted in a processing cartridge plugged into the DnaNudgeBox, a small instant DNA analyzer
  • The analysis of specific genetic traits related to nutrition is completed in minutes and uploaded to the DnaNudge app on the smartphone via a wearable ‘capsule’, the DnaBand (left #1)
  • The wearer then can scan individual food items as that person shops, receiving the ‘thumbs up’ for good choices and ‘thumbs down’ for ones not so good, with alternatives suggested for the latter (left #2)

The 12-month clinical trial was launched last week, with Waitrose contacting customers in the North London area with information on how to take part. Professor Nick Oliver from Imperial College London, who is leading the clinical study at the NIHR Imperial Clinical Research Facility, stated in the release: “This key trial with DnaNudge allows us – for the very first time – to study in detail the outcomes of DNA-personalised food choices for pre-diabetic individuals, and to explore whether this type of accessible technology can deliver a proactive and sustainable solution to managing nutrition, and preventing the development of Type 2 diabetes in people at highest risk of this long-term condition.” It is not clear from the release whether there’s further information provided on the food choices or other education.

DnaNudge was co-founded by Regius Professor Professor of Engineering at Imperial College London Chris Toumazou and published geneticist and leukemia researcher Dr. Maria Karvela. Waitrose has staked out a healthy food position with the introduction of 100 Healthy Eating Specialists, shop floor specialists who direct customers who ask towards healthier choices. This tie-in is interesting, and if it works, this Editor can see it in use in a CVS-Aetna test or Walgreens, as both have edged into food retailing in many locations, albeit with not many apparent healthy choices, unless one considers Milky Ways fine food.

Apple Watch, Zimmer Biomet in clinical trial for monitoring hip and knee replacements

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2018/10/apple-watch-series-4-elektrokardiogram.jpg” thumb_width=”150″ /]Zimmer Biomet, a musculoskeletal medical device company, is partnering with Apple to use the Apple Watch with an iPhone 6s and above in tracking the pre-surgery and post-operative recovery process for patients with hip and knee replacements. Zimmer is using the mymobility app developed with Apple to track patient-reported feedback, provide patient education and guidance, and share continuous health and activity sensor-based data with care teams. The aim is to improve the standard of care and patient outcomes after these surgeries.

The mymobility Clinical Study started on 15 October and may enroll up to 10,000 patients with 16 corresponding healthcare facilities including academic health systems, hospitals, and orthopedic surgery centers/practices. No length or end date for the study has been disclosed. 

A positive outcome leveraging patient engagement and providing continuous detailed clinical tracking data could have major significance. There are over 1 million hip and knee orthopedic replacements in the US annually, which is expected to increase to 3.5 million by 2035. The average cost of a hip or knee replacement is estimated at about $31,000, varying widely by region, based on a 2015 Blue Cross Blue Shield Association study. Post-surgery complications are common enough so that Medicare.gov tracks them through Hospital Compare.

According to Zimmer, “the mymobility app provides instruction and opportunities for enhanced engagement between the patient and healthcare provider. This mobile application is designed to work with the Apple Watch® wearable companion to remind patients to check their smartphone application daily, to read pre-planned and timed educational information, perform tasks, and complete assigned exercises; understanding their condition and care plan gives patients the ability to actively participate in optimizing their surgical outcome.” For the clinician, it is a communication tool between the patient and care team. “Surgeons use a clinician dashboard to monitor the threshold values and actively observe progress throughout each patient’s journey. Through the adoption of multifunctional sensor technology in the form of a wearable companion on the wrist, mymobility provides the potential to identify metrics that may permit further refinement of pre and postsurgical care.”

Healthcare Dive, Zimmer Biomet release, Zimmer mymobility study website

News roundup: Partners HealthCare Pivot Labs, TytoCare’s CE Mark, ISfTeH’s 2019 conference calls for presentations, three Smart Ageing Prizes awarded

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2017/12/Lasso.jpg” thumb_width=”120″ /]Partners HealthCare Pivot Labs announced before the Connected Health Conference. The 20-year-old Partners Connected Health Innovation is partnering (sic) with Pune, India-based Persistent Systems. Their joint project will create a center of excellence to develop patient-centered care delivery using digital tools. Release.

TytoCare gains CE Mark. TytoCare, a remote monitoring telehealth/video consult platform which integrates peripherals for a virtual physical exam, announced it received CE Mark approval and will be rolling out in the EU. In August, they gained Health Canada approval. For our European readers heading to MEDICA 12-15 November, they will be exhibiting and speaking (link here). This Editor also noted that Jeff Cutler, their US chief revenue officer for the past three years, has moved on to be chief commercial officer for Ada Health, an AI-powered health navigation platform and symptom checker.

The 24th ISfTeH International Conference will be 19-20 March 2019 in Lisbon, Portugal in conjunction with and hosted by the Portugal eHealth Summit. The International Society for Telemedicine & eHealth has extended its call for presentation proposals to 31 October–apply here. Multiple proposals are permitted. Submitters will be notified of acceptance 5-16 November.

Also in Portugal, €50,000 in Smart Ageing Prizes awarded at AAL Forum in Bilbao. This award recognizes companies that develop solutions that address social isolation and loneliness among older adults and facilitate real world interactions to improve quality of life. The lead winner was KOMP, a one-button computer for family communication. Other winners were PlaceCal, a partnership of community organizations, charities, social housing providers, government services, health providers, and citizens, plus Refresh by How Do I? to aid those with memory loss. The annual award is a collaboration between the Active and Assistive Living (AAL) Programme based in Belgium and Nesta’s Challenge Prize Centre. Nesta website, Release (PDF). Hat tip to Dimitra Gkivalou of OPUS for the notification.

MedStartr Challenge at the AMIA Annual Symposium 5 November

Alex Fair, CEO of MedStartr, has posted this Editor on their latest Crowd Challenge, this time at the AMIA Annual Symposium in San Francisco, 3-7 November. There are over 40 companies competing for five presentation spots in the AMIA 2018 PitchIT Competition on 5 November. What’s at stake? AMIA’s Informatics Partnership Council (IPC) sponsoring PitchIt has a prize of up $12,500, plus MedStartr has $25,000 in grants and entry into the MedStartr Acceleration Program. The link to the eligible companies is here on MedStartr, the leading crowdfunding platform exclusively for healthcare. Review, vote, and fund! 

NYeC’s 2018 Gala & Awards on 27 November (US)

The influential New York eHealth Collaborative (NYeC) is honoring four highly influential leaders in improving healthcare through the use of technology on Tuesday 27 November in NYC: Michael Dowling, CEO of Northwell Health; Linda A. Lambert, CAE, Executive Director of the New York State Chapter of the American College of Physicians; and CEO/founders Ido and Roy Schoenberg, MD of American Well.

The gala will be at the Edison Ballroom, which this Editor can confirm was a top-notch venue last year. More information and registration is here.

If you are at all engaged with healthcare systems and technology in the New York metro area, it’s worth your time and fisc to attend this event to be the company of over 250 C-suite executives, leaders, and policymakers.

NYeC is a non-profit which works with the New York State Department of Health to improve healthcare by collaboratively leading, connecting, and integrating health information exchange (HIE) across the state. One of their major tasks is to advance the Statewide Health Information Network for New York (SHIN-NY), a network connecting healthcare professionals statewide. 

UK sets forth a Code of Practice for secure IoT for connected devices and smart homes

IoT security concerns moving forward. As IoT continues to move into homes, the UK Department for Digital, Culture, Media & Sport (DCMS), with the National Cyber Security Centre (NCSC), has published an updated guide on Gov.UK outlining a Code of Practice for consumer development of Internet of Things (IoT) products. It lays out 13 guidelines for IoT manufacturers, service providers, app developers, and retailers intended to improve the security of consumer IoT products and associated services. The aim is to protect consumer privacy and safety, plus mitigate the threat of Distributed Denial of Service (DDoS) hacking attacks which have vectored in on products from the simple–children’s toys–to the more complex systems in smart homes, home automation including security systems, and health trackers. Following the Code of Practice may also help with data compliance, notably the EU General Data Protection Regulation (GDPR).

The thirteen guidelines range from eliminating default passwords that have to be reset by the consumer (which usually doesn’t happen) to ensuring software integrity and system resilence.

DCMS has pledged to revisit the Code every two years. Comments may be made to securebydesign@culture.gov.uk. What’s missing, of course, are two things: an enforcement mechanism and a comparable code of practice for commercial use.

$6.8 bn in digital health funding through Q3 blows the doors off 2017: Rock Health

And the money rolls in. All Rock Health had to do was wait a quarter to get breathless [TTA 4 July], because digital health funding through Q3 is now exceeding the full year 2017 by $1.1 bn. The average deal size has accelerated substantially–$23.6 million versus last year’s $16.4 million. The deals are bigger but fewer–290 so far versus 357 last year–and the length of time between funding rounds has consistently grown shorter. 

Another proportional shift is the growth of Series B and C startups, at long last, and a more than doubling of D+ deals.

A big shift in this quarter were that the stars lined up, perhaps for the first time, with at-home and on demand health. American Well of course at $291 M loaded these dice, but also benefiting from the throw were the similar Doctor on Demand, Honor (home care), and NowRx med delivery service. Faster meds at lower cost have become a major area of action (Amazon with PillPack, TelePharm, others). Digital therapeutics that help to monitor health at home followed from Pear Therapeutics, Click Therapeutics, Akili Interactive, Virta Health, Propeller Health, and Hinge Health. 

And where the money comes from? Independent venture funds still account for 63 percent, and corporate VCs for 15 percent.  Some of those CVCs are major names such as GSK, Abbott, and Cigna. Big tech is also moving into healthcare, with Amazon’s $1bn acquisition of PillPack, the Apple Watch 4, Google’s Nest.

Rock Health’s trend prediction is continued consolidation in digital health, with companies continuing to acquire each other. “With available capital and a desire to build out product lines, talent, and client bases, it’s not surprising to see a great deal of M&A activity within digital health.” One example given is Welltok, which plays in the consumer health ‘activation’ area, and their acquisitions from corporate health management programs to Wellpass, which has created such as Text4Baby, Text2Quit and Care4Life and whose largest customer is state Medicaid plans.

Keep in mind that Rock Health tracks deals over $2 million in value from venture capital, excluding government and grant funding. They omit non-US deals, even if heavily US funded.

Rock Health’s report. Healthcare Dive.  Mobilhealthnews‘ own top 17 M&As, which include Best Buy-GreatCall and Logisticare-Circulation in the burgeoning area of non-emergency medical transport (NEMT).

It’s Alive! BlackBerry still Sparking with an ‘ultra-secure hyperconnectivity’ healthcare platform

And this Editor thought that BlackBerry had long since hung up the ‘Out Of Business Sign’. In this era of BYOD in healthcare and software systems like Blue Cedar that secure apps from these BYODs from the device past the server, the image of the ‘Crackberry’ persists–tiny keyboard, tiny screen, and the corporate governed phone. All these loathsome features have now transitioned to iPhone 6s (tiny keyboard, tiny screen, corporate apps, locked down and trackable everything). (So much for that ‘tech will set you free’ world promised by Steve Jobs in the ‘1984’ spot, replaced by Big Brother–Ed. Donna)

BlackBerry, as a company based in Ontario, Canada, endures as a software platform minus the devices. Much like Nokia, they have taken on the world of IoT in areas demanding tight security. Their latest introduction is the BlackBerry Spark, a software platform they claim will lead the Enterprise of Things (EoT) to “ultra-secure hyperconnectivity from the kernel to the edge”. Hyperconnectivity, in their definition, will enable secure IoT equipment with consumer friendly interfaces, leverage AI and manage smart ‘things’ regardless of operating system and existing platforms, and making military-grade security easy and intuitive for users. Spark will be available to companies (thus EoT) by the end of 2018.

BlackBerry has evidently latched on to a messy need–the lamentable lack of security in most consumer IoT devices. They have also identified the yawning gaps in security in almost every healthcare enterprise in connected devices. In Mobihealthnews, their spokespeople expanded on the technology as they are applying it to healthcare via a quantum-resistant code signing server, a new system using blockchain to deliver medical data and an operating system for secure medical devices. More details on how these are being used so far were cited in their most recent release:

  • A blockchain digital ledger for the Global Commission, an organization focused on diagnostics for children with a rare disease. One of the pilots concentrates on BlackBerry’s powering real-time, actionable analysis to shorten time to diagnosis.  
  • A new OS for medical, QNX OS for Medical 2.0. This is described as a real-time operating system for the development of robotic surgical instruments, patient monitoring systems, infusion pumps, blood analysis systems, and other safety-critical products that must pass stringent regulatory approvals.
  • With the Mackenzie Innovation Institute (Mi2), participating in research around comprehensive security, patient privacy and intelligent connectivity in healthcare IoT.
  • Skin cancer research in Australia with the Melanoma Institute Australia.

Certainly BlackBerry is aiming for a certain sweet spot in healthcare and finding some partners all over the world, though the US seems to be absent. Will they be able to ‘crack’ it and the rest of the world? Time will tell.

Creating EHR diagnostic ‘e-triggers’ to detect misdiagnosis, identify high-risk patients over time

A just-published study in the BMJ Quality & Safety journal explores the potential of the information in EHRs to be used in new tools that detect errors in diagnosis and prescribing. The Safer Dx Trigger Tools Framework, proposed by the authors, would apply algorithms against the vast amounts of data stored in the EHR for data mining to prevent errors.

Current e-triggers detect prescription errors and procedure complications. This framework proposes tracking of patient events over time, such as patient-provider encounters, performance and interpretation of diagnostic tests, follow up and tracking of diagnostic information over time, and referral and/or patient-specific factors. It would detect errors such as initial misdiagnosis in office visit or hospital, abnormal test results, or delayed diagnosis from lack of specialty expertise.  

The model framework and seven steps they recommend for development and design of these tools are depicted here:

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2018/10/bmjqs-2018-008086-F1.large_.jpg” thumb_width=”250″ /]

Also POLITICO’s Morning E-Health.