PharmaTech Innovations/Health 2.0 NYC Wed 19 July –speakers confirmed, reserve now!

Wednesday, 19 July, 6-8:30 pm at Cohn Resnick LLP, 1301 6th Avenue, NYC

Health 2.0 NYC‘s July event examines innovation in the pharmaceutical business. It’s changing radically, from companies like PillPack which disrupt traditional pharmacies to apps that monitor clinical trials or prescribed as adjuvant therapies. Presenters on Wednesday night include:

  • Dan Conely – Managing Director, NJ Angels, active investor in drug discovery automation
  • Grace Cordovano, PhD – Enlightening Results – CEO and private cancer patient advocate. She founded Enlightening Results, LLC in 2010 to foster private, personalized patient advocacy services.
  • Jodie Gillon – Achillion Pharmaceuticals, Senior Director, Patient Advocacy and Professional Affairs

Early stage companies presenting: ClearRx. Other speakers/presenters to come. 

For $25, you get engaging speakers, beverages, food, and plenty of networking time amongst the like-minded and leaders in health tech! More information and registration on the Health 2.0 NYC Meetup page. (Disclaimer: Editor Donna is an event host and TTA is a long-time sponsor and supporter of Health 2.0 NYC) 

“Crazy”: StartUp Health’s 2nd Q digital health funding breaks record

As predicted, a torrid start to the year. StartUp Health‘s 2nd quarter and first half funding estimate shattered records–$6.5 billion first half, $3.8 billion 2nd quarter compared to $8 bn and 500+ deals in full year 2016. StartUp Health takes a wider sample than Rock Health, tracking over 300 international company deals, including those below $2 million, in service and biotech/diagnostic companies. A change from last year is that there are more Series A than seed deals, concentrating on workflow, big data/analytics, wellness, medical device, and personalized health-Quantified Self companies. Series B deals are well-populated, but there is still a long bridge to C and above. San Francisco and the Bay Area continue to substantially lead in deals made, with Chicago at 39 percent and New York at 25 percent of deal value. They also trumpet the success of their funding family. Watch the video below or download the free report here.

‘Record-shattering’ Q2 for digital health deals: Rock Health’s volte-face

In a pirouette worthy of Nureyev in his prime, Rock Health’s latest Digital Health Funding review for Q2 and the first half of 2017 bangs the drum loudly. With $3.5 bn invested in 188 digital health companies, it’s a record in their tracking. (∗See below for their parameters, which focus on larger fundings and omit others by type.) Q2 reversed the muddling results of Q1 [TTA 11 April] and then some. If the torrid pace is maintained and the market doesn’t take a pratfall, this year will easily surpass 2016’s full year venture funding at $4.3 bn and 304 investments.

Looking at trends, the average deal size has ballooned to $18.7 million from the 2015-16 range of $14 million. Seven $100 million+ deals led the way: Outcome Health, Peloton, Modernizing Medicine, PatientPoint, Alignment Healthcare, PatientsLikeMe, and ShareCare. Of these, three are consumer health information (Outcome, PatientPoint, ShareCare), with PatientsLikeMe closely related with a patient community focus; as the lead category of investment overall, there’s now gold in consumer health. All seven businesses are located outside of Silicon Valley, a refreshing change. A surprise is Modernizing Medicine in the settled (we thought) EHR-clinical workflow category. There’s also an interesting analysis of the shift in top categories from last year to this, which takes out the $100 million+ deals (click to enlarge): click to enlarge

Other changes from the usual: no IPOs and a slowing pace of M&A: 58 this year versus first half 2016’s 87 and full year 146. Their public company index is brighter, with positive gains in first half led by Teladoc (up 110 percent YTD), Care.com (up 80 percent), and consulting favorite Evolent Health (up 70 percent–with United Healthcare’s acquisition of The Advisory Board’s healthcare practice, can an acquisition be far away?). Remaining in the doldrums are NantHealth, Fitbit, and Castlight Health. Rock Health Digital Funding Review First Half 2017

Soon up will be StartUp Health’s first half analysis, which takes a different cut at the companies and looks at the balance of deals by funding series.

∗ 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; healthcare services companies (Oscar), biotech/diagnostic companies (GRAIL), and software companies not solely focused on healthcare (Zenefits), but include fitness companies like Peloton. 

Jawbone finally T-bones, founder starts Jawbone Health Hub (updated)

click to enlargeConfirming the decline of the fitness tracker/wearables business, Jawbone is finally over and done. Their liquidation this week was initially reported by The Information (subscription only) and that co-founder/CEO Hosain Rahman has started a new company, Jawbone Health Hub. JHH will work on medical software and hardware, as well as eventually servicing the buggy existing Jawbone products† which were sold off to a third party last September. JHH is also reportedly hiring many former Jawbone staff and on job boards such as Glassdoor. 

Jawbone’s demise comes after a troubled 18 months, starting with a $165 million private equity raise in January 2016 led by the Kuwait Investment Authority, rumors of financial problems, repositioning into clinical medical monitoring, and abandoning what was left of consumer market support. There is also the continuing saga of court actions with Fitbit over trade secrets, employee poachings, and IP–all additional reasons for the founder to walk away. The only value left in Jawbone is that IP which includes BodyMedia patents and anything left that wasn’t voided by a court. Fitbit shares are also sinking, currently trading at a near 52-week low of just above $5.

‘Death by overfunding’? Updated During its lifetime from wireless audio speaker innovator Aliphcom to wearables leader with the Jawbone UP, Jawbone raised $938 million (Crunchbase), and at one point was valued at $3 billion. An interesting take from a Reuters article was that one consensus among Silicon Valley tech funders was that the company would have been far easier to acquire had it raised less money. Jawbone ranks only behind solar tech Solyndra among largest failures among venture-backed companies. (The difference, of course, was that Jawbone didn’t take $500 million of public stimulus money, as Solyndra did before it failed.)

The words ‘Chapter 7’ have not been included in reports but Sherwood Partners, a busy Mountain View CA financial restructuring company that has wound down plenty of startups through unicorns, was reported to be in charge of the liquidation process plus any remaining legal actions with Fitbit. None of the usual sources have been able to obtain statements from Mr. Rahman and ‘the information’ remains limited. The Verge, TechCrunch, Business Insider 

†Editor Charles’ struggles with seven personal Jawbone UPs were often typical of the user experience.

Connected Health Summit 2017 — Engaging Consumers (San Diego)

29-31 August, The Omni Hotel, San Diego

click to enlargeTake a trip to Southern California for the end of the traditional summer season (sob!). This year’s Connected Health Summit, organized by research organization Parks Associates, spotlights health technologies as part of the Internet of Things (IoT) and the transformational impact of these connected solutions on the US healthcare system. Presentations are organized around:

  • Remote health monitoring for accountable care
  • Consumer-centric wellness and fitness solutions
  • Independent living technologies and services
  • Innovative virtual/convenience care models

Keynoters include 

  • Saquib Rahim MD, MBA, Chief Medical Officer, Aetna
  • Vidya Raman-Tangella, Senior Vice President, and Head, UHC Innovation Center of Excellence, UnitedHealth Group
  • Dale Rayman, Senior Vice President, Actuarial Consulting & Business Development, Sharecare
  • Chanin Wendling, AVP, Informatics, Geisinger Health System

For more information and to save 20 percent, click on the Connected Health Summit’s advert at the top of this page. Telehealth & Telecare Aware is pleased once again to be a media supporter of CHS 2017. Twitter at #CONNHealth17

Conference & Tender Alert: Perth & Kinross TEC event, Flintshire (Wales) tender (UK)

Susanne Woodman of BRE, our Eye on Tenders, alerts our Readers to a Scotland TEC conference and a Wales tender.

The Perth & Kinross Technology-Enabled Care Conference will take place on Tuesday 26 Sept at Perth Concert Hall. It’s expected to have an attendance of about 120 people from across the social and health care area. Sponsorship packages are available to about 20 organizations. See details on Public Contracts Scotland. Email TEC@pkc.gov.uk 

In Wales, the Flintshire County Council is seeking a telecare emergency alarm  system with 24-hour telephone support. Flintshire currently operates 70 sheltered housing developments with 2613 units, currently connected to a call handling system provided by Jontek. Tenders are due 4 August. Information on Sell2Wales. Contact dawn.kent@flintshire.gov.uk 

‘Let me die at home’. The human and financial cost of ending telehealth (Cornwall UK)-update

See below for ITV coverage. Jill Diggett, a resident of Bodmin in Cornwall, is one of undoubtedly many local people losing their telehealth monitoring next week. A business decision was made to abandon telehealth monitoring provided by NHS Kernow, whose statement is extensively cited by this article in Cornwall Live. NHS Kernow, which is £54 million in the red, cites “the service did not have significantly robust clinical evidence for effectiveness and did not demonstrate the desired outcomes that we would expect to see.” The Cornwall Partnership NHS Foundation Trust, which provides the service, will hand it off in advance to the telehealth user’s GP, and will provide community services or getting a helper to manage their condition.  

From this article, Mrs. Diggett is 1) an exception to their findings and 2) the handoff appears to have been dropped. Mrs. Diggett has five serious chronic conditions. She is on oxygen. Last December, she was in hospital for three weeks. Post-discharge, she was given telecare and telehealth monitoring of her vital signs (weight, blood oxygen, blood pressure), performed by her husband and sent to a care coordinator (a ‘medical expert’ in the article). There’s medical intervention if things trend poorly. However, she has stayed out of hospital since and is presented here as medically stable, though not doing handsprings. In the article, Mrs. Diggett expresses despair and real fear that she will be taken from her home and wind up back in hospital where she assumes she will die, an understandably emotional reaction. Worse, her husband gives no indication that his wife’s care has been transitioned. 

Readers of Cornwall Live are also pointed to the closure of a Bodmin treatment centre in March. So the Diggetts will be traveling much farther to receive care if they were using it.

Mr. Diggett was told that the average cost of a hospital bed is £1,000 a night. For 21 nights, that is £21,000. Let’s assume that the fully allocated cost (devices and monitoring) of the telehealth service is £100/month. That is 210 months–17.5 years–of monitoring for the cost of one hospital stay. If it is £250/month, that is 84 months or 7 years.

What is not cost-calculable but has consequences? Mrs. Diggett’s state of mind and her husband’s quality of life. Her predicament is shared by patients and caregivers who had telehealth or telecare withdrawn after a pilot or the ending of an at-home program. There is a feeling of abandonment, that they don’t have this help or support, no one is listening, the safety net’s been taken away, and they are all alone again. Anyone who has worked for telehealth and telecare companies, such as this Editor, knows this is an unavoidable consequence of service withdrawal unless that person is much better or is transitioned properly, which almost never happens. Readers on both sides of the Atlantic will surely be able to supply their own examples where the books don’t balance. Hat tip to Susanne Woodman, our Eye on Tenders.

Update: ITV last night (11 July) reported on this here, interviewing the Diggetts. Bravo!

Weekend reading: the life and spread of microbes in the average hospital room

We in healthcare and health tech know how deadly nosocomial or hospital-acquired infections are. Current CDC estimates are that in US hospitals, there are 1.7 million infections and 99,000 associated deaths each year (up from a previous estimate of 75,000) PatientCareLink. Most of us know that visiting a patient in a hospital room means also making sure hands are washed, clothes and shoes are clean, and that we bring a container of industrial strength bleach wipes for cleaning surfaces versus flowers.

However, it was news to this Editor that few studies have been done on the actual hospital room environment–the microbiome–and how the microbes in the room interact with the patient and the staff.  Sue Barnes, an RN who spent 30 years as the National Leader for Infection Prevention for Kaiser Permanente, reviews a newly published study in Science Translational Medicine (24 May, abstract available only). The study collected bacterial cultures from the ‘patient zone’ around the bed, every surface in the hospital room, and swabbed the hands and noses of patients and staff, along with the shoes, shirts, and cell phones of staff members. The problem is much more complex than simple cleaning.

  • Patient skin and the microbial makeup of room surfaces became more similar over time. Non-ambulatory patients were less so, as they had less contact with external surfaces.
  • The longer patients were in the room, the more genetic resistance to antibiotics the organisms acquired. This is despite the lack of association with antibiotics save topicals. The author suggests that regular cleaning may be the reason–only the strongest survive.
  • The hospital room is most threating to the most vulnerable, such as babies in a neonatal ICU
  • “In the Lax study, several bacterial samples taken more than 71 days apart were identical,  (more…)

Cerner DoD deployment on time; Coast Guard EHR shopping; Air Force, VA sharing teleICU

The US Department of Defense announced that the deployment of Cerner’s EHR MHS Genesis at the Naval Hospital in Oak Harbor, Washington is on time for later this month. It’s a little unusual that anything this big and in the government is actually on time. It’s also meaningful for VA, as they are adopting MHS Genesis in an equally, if not longer, rollout [TTA 7 June]. Healthcare IT News

Less well known is the Coast Guard‘s dropping its costly six-year deployment of the Epic EHR last year and reverting to paper. They are not in the MHS Genesis rollout because the CG is part of the Department of Homeland Security, despite its service roots and structure similar to the US Navy. This has led to much speculation that their final choice will be DoD’s Cerner platform, although the OpenEMR Consortium has already answered their April RFI.

And even less noticed was the late June announcement that the US Air Force Medical Operations Agency and the VA are implementing a tele-ICU sharing arrangement, giving the USAF access to the VA’s capabilities at five AF locations: Las Vegas; Hampton, Virginia; Biloxi, Mississippi; Dayton, Ohio; and Anchorage, Alaska. The VA central tele-ICU facility is in Minneapolis. Doctors there can remotely consult, prescribe medications, order procedures and make diagnoses through live electronic monitoring. Becker’s Hospital Review, VA press release

Health tech arrivals (Philips, Roche, VRI, PushDoctor)…and departures (Pact, Jawbone)

click to enlargeThis popular vacation week has been filled with ‘money under the wire’ news of acquisitions, investments…and one high-profile owner shuttering a pioneering activity app.

Acquisitions:

Philips Healthcare added London-based pregnancy app developer Health & Parenting for an undisclosed sum. Its most popular app is Pregnancy + (and ++), with 12 million downloads via the Apple Store and Google Play, but others are Baby + for all things baby-rearing, and Baby Name Genius to Find That Ideal Name. It will fold into and diversify Philips’ existing uGrow digital parenting platform which includes the Avent smart baby monitor and smart ear thermometer and leverages the open infrastructure of Philips’ Health Suite Digital Platform. One wonders at the flood of data flowing from these apps to these devices and what Philips will do with all these points. Release, MedCityNews

Roche acquired Austrian partner mySugr, a management tool that promises to ‘make diabetes suck less’. Last year they added Roche’s Accu-Chek Connect blood glucose monitor to its chosen device connect and sync list. mySugr features an app for users to log their meals, exercise, glucose levels, and mood. It also captures pictures of user snacks and unleashes “a diabetes monster” avatar when the food choices are poor based on their glucose levels. Terms were not disclosed. MedCityNews

Telecare/monitoring company VRI quietly acquired Healthcom from Woodbridge International. Healthcom’s primary area is care transition management using medical alerts, telehealth, and medication management for payers, government agencies and care partners. Originally positioned as a partnership June 30 on VRI’s website, Globe Newswire confirmed the sale a week later. Terms (again) were not disclosed.

Mobihealthnews rounded up 24 major acquisitions, including GreatCall (by GTCR) and Best Doctors (Teladoc)–all by June 30!

Investments:

Manchester’s PushDoctor telemedicine app raised $26.1 million in Series B financing from Accelerated Digital Ventures and Draper Esprit plus Oxford Capital Partners, Partech Ventures, and Seventure Partners. This added to their $10.1 million Series A raise in January 2016. PushDoctor connects UK patients with NHS-registered GPs for virtual visits costing only £20. Unlike US-based tele-docs, Push Doctor issues prescriptions, makes doctor-led referrals to other health providers and specialists, and helps manage repeat prescriptions. Their founder also has an eye on managing long-term conditions, short-term illnesses, fitness, and nutrition. Their major UK competitors are Babylon Health (which recently raised £50 million for its triage app), Ada Health, and Your.MD. Crunchbase, TechCrunch, Mobihealthnews

And shutterings:

Pioneering fitness incentive app Pact (founded 2011) announced its closing by end of August. Originally a ‘get thee to the gym’ app, it branched out into healthy food (eat more vegetables!) and tracking meals with MyFitnessPal. Pact never truly emerged from seed funding. A rare stumble by Khosla Ventures, which led a 2014 bag-of-skittles round of $1.5 million. Mobihealthnews, Crunchbase

Jawbone closed out the week by liquidating and transubstantiating into Jawbone Health Hub. More on this here

KOMPAÏ seeks €250,000 to develop next gen assistive robot (FR/EU)

click to enlargeKOMPAÏ, which has been developing assistive robots under that name for older and frail people with their caregivers since 2009 (Founder Steve saw the KOMPAÏ-1 in 2011), has spun off as an independent company after acquiring the IP from the developer ROBOSOFT. They are marketing the current KOMPAÏ-2 (see left) which has been on the market since early 2016 [TTA 24 Sept 15]. KOMPAÏ CEO and founder Vincent Dupourqué announced in their press release they are seeking €250,000 to fund the development of the KOMPAÏ-3 as a scalable physical and cognitive assistive robot, primarily for the assisted living/nursing home market. The new iteration will include improvements from technologies which were unavailable or unaffordable only two to three years ago: cloud computing, artificial intelligence, conversational agents, and affective computing. The KOMPAÏ-2 had a ‘face’ which was far more ‘reactive’ than the original and an overall friendlier look, and that would be expected to continue with improvements in the last area.

The KOMPAÏ company and funding is profiled on the European crowdfunding site Hoolders. Investors can join them for as little as €250. They are located on the Basque Coast of France in Bidart in the Izarbel Technopole (la Technopole d’ Izarbel). Website and KOMPAÏ-2 product flyer (English) Hat tip to Founder Steve Hards

Free individual advice and guidance to SMEs wanting to sell to the NHS

Here is your opportunity as an SME to get advice on selling to the NHS. Specfically, DHACA and Kent Surrey & Sussex AHSN have joined forces to help you to prepare a more compelling and comprehensive value proposition as part of your market access strategy. (SMEs don’t need either to be in the KSS AHSN catchment areas, or members of DHACA, although the latter is free to join and has lots of useful digital health resources, so why wouldn’t you?) 

There will be two sessions, both of which you should be able to attend if you apply. These will be held at the Royal Society of Medicine (close to Oxford St and Bond St tubes). That on 20th July will be about 90 minutes. In that time you will hear and be able to discuss:

  • How current NHS finances and cash flow may impact on your service/product uptake
  • How to improve your value proposition for NHS audiences

This will help you prepare for the second stage, on 27th July, which will be an individual Innovation Surgery. These will last 1 hour and cover aspects from the market access briefing. They will be specific to your product as well as covering the technical and market potential of your product/service.

More details and how to apply are available in the DHACA Briefing and Surgery Flyer

Note that although the flyer says you need to email vivienne.gray3@nhs.net by the end of Thursday 6th July to apply, Vivienne will be happy to accept late applications, though do please get them in soon!

(Disclosure: this editor is Managing Director of DHACA)

 

LifeinaBox: portable refrigeration and monitoring for heat sensitive meds

click to enlargeOn this year’s trend–that the companies which look freshest and newest solve specific but important problems–is the debut later this year of LifeinaBox. It is a portable refrigerator/app combo for those who must travel with their medication at a stable, cool temperature, generally between 36 and 46°F (2 and 8°C).

According to CEO Uwe Diegel to this Editor, “There are about 3% of the population that are prisoners of their medication.” In France alone (where the company is), 1,5 million people are dependent on temperature-stable medication. The idea came from a critical situation experienced by his brother Olaf, when a hotel froze his insulin rendering it useless. Medications that must be kept cool are diabetes (insulin), some medications for arthritis and multiple sclerosis, plus growth hormones, but there are also topical steroidal creams that should not be at room temperature. 

The pre-ordering website (starting on 14 Sept) explains the app interface, which monitors the fridge temperature and battery life, also serving up medication reminders and health tips. The fridge itself is under two pounds (900 g) with a rechargeable battery and also directly powered by 110 or 220 v. current or car charger. It can hold refills and vials, for example with a capacity of eight regular medication pens. Other uses this Editor can envision are for disaster and crisis situations where rescue workers, EMTs, and military have to work quick, fast, and lean, throwing it into a backpack. Hat tip to Mr. Diegel via LinkedIn.

Petya/NotPetya compared to an armed attack by a ‘state actor’ by NATO, Ukraine

Aux armes, citoyens? Hold that Article 5. This US holiday weekend has been light on Petya news, but it seems that NATO has roused itself into the cyberdefense arena as a military arena for them, based on NATO Secretary General Jens Stoltenberg’s statement on Article 5’s collective defense, and a Friday brief that declared:

The global outbreak of NotPetya malware on 27 June 2017 hitting multiple organisations in Ukraine, Europe, US and possibly Russia can most likely be attributed to a state actor, concluded a group of NATO CCD COE researchers Bernhards Blumbergs, Tomáš Minárik, LTC Kris van der Meij and Lauri Lindström. Analysis of both recent large-scale campaigns WannaCry and NotPetya raises questions about possible response options of affected states and the international community.

and

Nevertheless, NotPetya was probably launched by a state actor or a non-state actor with support or approval from a state. Other options are unlikely. The operation was not too complex, but still complex and expensive enough to have been prepared and executed by unaffiliated hackers for the sake of practice. Cyber criminals are not behind this either, as the method for collecting the ransom was so poorly designed that the ransom would probably not even cover the cost of the operation.

NATO’s Secretary General reaffirmed on 28 June that a cyber operation with consequences comparable to an armed attack can trigger Article 5 of the North Atlantic Treaty and responses might be with military means. However, there are no reports of such effects, so according to Tallinn Manual 2.0 on the International Law Applicable to Cyber Operations, self-defence or collective defence of victim states are not available options.

Well, the cyber-tanks are not rolling as of yet. The brief notes three interesting factors: low estimated deployment cost ($100,000) means that a non-state or criminal actor could have developed it, but the lack of ransom counterbalances that; the kill switch was a simple one that could be used to limit spread; and it was targeted to spread via internal networks versus the wide spread of the internet.

The brief’s options for international response seem contradictory and incomplete to this Editor. 

The number of affected countries shows that attackers are not intimidated by a possible global level investigation in response to their attacks. This might be an opportunity for victim nations to demonstrate the contrary by launching a special joint investigation.

Ukraine’s speculation (of course) is that it’s Russia, though Russian organizations were also hacked. This is of a piece with earlier Russian attempts to disrupt, and Ukrainian spokesmen pointed out, as did NATO, that Petya was easy to limit if you knew how. ZDNet

And now Australia is going on the offensive. The Australian Signals Directorate (ASD) has been authorized to “disrupt, degrade, deny, and deter” bad cyber actors, placing a national emphasis on cybersecurity for “the mums and dads, the small businesses, large businesses, government departments and agencies” according to Dan Tehan, Australian Minister Assisting the Prime Minister for Cyber Security (whew!). Can we include healthcare? Leading the way! ZDNet

Petya no pet as it spreads: is it ransomware or a vicious design for data destruction? (updated)

Breaking–The ‘more and worse’ experts predicted after WannaCry is here.  In two days, the Petya or PetyaWrap (or NotPetya) ransomware has spread from Ukraine to affect organizations in 64 countries with 2,000+ attacks involving 12,000+ machines. On the hit list are mostly Eastern European and trans-national companies: Maersk shipping, Merck, Nuance cloud services, WPP advertising, Mars and Mondelez foods, Rosneft (Russia’s largest oil producer), Chernobyl, unnamed Norwegian firms, Beiersdorf and Reckitt Benckiser in India, Cadbury and law firm DLA Piper in Australia. One local US healthcare provider affected in a near-total shutdown of their computer systems, and resorting to backups, is Heritage Valley Health System in western Pennsylvania. There are no reports to this hour that the NHS, major US, Asia-Pacific, or European health systems being affected. Update: Trading in FedEx shares were halted 29 June due to the Petya attack on its TNT Express international division. Update 30 June: The Princeton Community Hospital in rural West Virginia is running on paper records as Petya forced a complete replacement of its EHR and computer hardware. Fox Business

Like WannaCry, the ransomware exploited the EternalBlue backdoor; a report from ArsTechnica UK adds an exploit touchingly dubbed EternalRomance. But unlike WannaCry, according to ZDNet, both “Symantec and Bitdefender have confirmed that it’s a Petya ransomware strain dubbed GoldenEye, which doesn’t just encrypt files — it also encrypts hard drives, rendering entire computers useless.” ArsTechnica goes deeper into methodology. Petya uses a hacking tool called MimiKatz to extract passwords and then uses legitimate Microsoft utilities and components to spread it. (Ed. note: if you have time for only one technical article, read ArsTechnica’s as the latest and most detailed.)

The Microsoft patch–and Microsoft has just issued an update for Win10, which this Editor heartily recommends you download and install–while defending against WannaCry, still isn’t preventing the spread. It’s speedier than WannaCry, and that says a great deal. Its aim appears not to be ransom, but data destruction. Updated: this POV is confirmed in today’s ZDNet article confirming that Comae Technologies and Kaspersky Lab strongly believe that Petya is a ‘wiper’ designed to destroy data by forever blocking it on your hard drive.

Another article in ZDNet (Danny Palmer) attempts to isolate why hackers remain one step ahead of us:

Law enforcement agencies and cybersecurity firms across the world are investigating the attack – and researchers have offered a temporary method of ‘vaccinating’ against it** – but how has this happened again, just six weeks on from a previous global ransomware outbreak?

One reason this new form of Petya is proving so effective is due to improved worm capabilities, allowing it to spread across infected networks, meaning that only one unpatched machine on a whole network needs to become infected in order for the whole operation to come crashing down.

Not only that, but cybersecurity researchers at Microsoft say the ransomware has multiple ‘lateral movement’ techniques, using file-shares to transfer the malware across the network, using legitimate functions to execute the payload and it even has trojan-like abilities to steal credentials.

**  The inclusion of this link in the quote does not imply any recommendation by TTA, this Editor, or testing of said fix.

What you can do right now is to ensure every computer, every system, you own or are responsible for is fully updated with Microsoft and security patches. If you’re in an enterprise, consult your security provider. Run backups. Remind employees to not click on links in suspicious messages or odd links even from known senders–and report them immediately. Based on reports, phishing emails and watering hole attacks are the main vectors of spread, like WannaCry. (A suggestion from this Editor–limit web search to reputable sites, and don’t click on those advert links which are buggy anyway!) Be judicious on updates for your software except by Microsoft and your security provider; there is growing but still being debated evidence that the initial Ukrainian spread was through a hacked update on a popular tax accounting software, MeDoc. More on this in ZDNet’s 6 Quick Facts. Another suggestion from Wired: run two anti-virus programs on every computer you have, one free and one paid.

And no matter what you do–don’t pay the ransom! The email provider within hours blocked the email so that the payment cannot go through. Updates to come. More reading from Bleeping ComputerHealthcare IT News, CNBC, HIStalk, US-CERT, Fortune, Guardian,

Telemedicine reduced hospital readmissions by 40% in rural Virginia: UVA study

In last week’s Senate subcommittee hearings on the Federal Communications Commission (FCC)’s Universal Broadband Fund and Rural Healthcare (RHC) program, the University of Virginia’s Center for Telehealth chalked up some substantial results confirming the effectiveness of telemedicine in rural areas. In advocating further funding for an expansion of the program, they presented the following:

  • A 40 percent reduction in 30-day same cause hospital readmissions for patients with heart failure, acute myocardial infarction, chronic obstructive pulmonary disease, pneumonia, stroke, and joint replacement
  • It enabled over 65,000 live interactive patient consultations and follow-up visits with high definition video within 60 different clinical subspecialties
  • Their home remote monitoring program included over 3,000 patients and screened more than 2,500 patients with diabetes for retinopathy
  • UVA delivered 100,000 teleradiology consults and provider-to-provider consults supported by the Epic EHR.

The UVA analysis also quantified travel savings in areas where medical and hospital care can be hours away–17 million miles of rural travel including 200,000 miles by high-risk pregnant mothers. For these mothers, NICU hospital days for the infants born to these patients were reduced by 39 percent compared to control patients and patient no-shows by 62 percent.

Karen Rheuban, MD, director and co-founder of the UVA Telehealth Center, recommended that the FCC continue to fund the RHC’s $400 million budget, with the caveat of exploring additional federal revenues should that budget be reduced. She also recommended that Medicaid and Medicare reimbursement for telehealth services be increased, the addition of wireless technologies, and including emergency providers and community paramedics in RHC funding. mHealth Intelligence, Subcommittee information and hearing video (archived webcast)