TTA’s Summer Unlockdown: Walgreens-VillageMD deal, digital health funding breaks record, Fitbit shines unflattering light on Google, Doctor on Demand’s rich Series D, KCC’s videophone initiative

 

 

Not many stories this week, but they were all eventful. US digital health funding broke last year’s record after a shaky start, not including Doctor on Demand’s Series D. It took a while, but Walgreens’ struck hard with VillageMD primary care deal. Google may be stumbling with little Fitbit. And KCC innovates with video’phone’ tablets. 

News Roundup: Doctor on Demand’s $75M Series D, Google’s Fitbit buy scrutinized, $5.4 bn digital health funding breaks record (Three big stories)
Kent County Council announces videophones for vulnerable residents in £1.5 million COVID response initiative (UK) (2,000 of them)
Walgreens Boots goes big with billion-dollar medical office deal with VillageMD (See the competition move–and raise ’em)

No fireworks near your Editor except illegal ones, but we have a few legal ones on hand. Ransomware is sending up mortars. COVID’s effect on telehealth is a flitter-glitter comet, but patient counts to date misfire. Samsung starbursts tele-genomics. We’re waving sparklers for the SURE Recovery app from King’s College London. And telehealth celebrated with some nifty Roman candles from the FCC, but Huawei and ZTE were sent the smoke bombs. Happy US Independence Day (a/k/a The Colonial Rebellion)–a day early!

News roundup: Teladoc closes InTouch, Samsung bets on tele-genomics, SURE Recovery app, Optimize.health’s seed round, Walgreens’ Microsoft boost
Hackermania runs wild, Required Reading Department: The Anatomy of a Ransomware Attack (Weekend reading for you and your IT department)
Do Huawei and ZTE present security threats to the US and global communications networks? The FCC says yes. (Recognizing geopolitical reality)
FCC approves 70 more COVID-19 telehealth funding applications for an additional $32 million (A major support for growth for small to large organizations)
Hackermania runs wild…all the way to the bank! Ransomware strikes Crozer-Keystone, UCSF med school, others (Hackers in their basements didn’t break for COVID)
COVID effect on US practices: in-person visits down 37%, telehealth peaks at 14%; ATA asks Congress to make expansion permanent (Patients still not visiting their doctors, virtual or not)
The TeleDentists now in 14 states with Anthem (Recognition of an oft-forgotten but key part of medicine)

On the First Day of Summer, there’s hot news with NHS finally giving up on its NHSX COVID tracing app and a few changes over at NHSX. Otherwise, we observe some semblance of a return to Business As Usual. A former unicorn goes bankrupt, a telecare company brings out a new product, the VA has more drama around its EHR. But still plenty of COVID related news, including its hopefully permanent telehealth stimulus, without any drugs!

Breaking: NHSX COVID contact tracing app exits stage left. Enter the Apple and Google dance team. (Not a surprise to anyone, and some changes made)

News Roundup (updated): Proteus files Ch. 11, VA’s EHR tests now fall–maybe, making US telehealth expansion permanent, Rennova’s rural telehealth bet, Oysta’s Lite, Fitbit’s Ready to Work jumps on the screening bandwagon
Where in the world is the NHS COVID contact tracing app? Apps rolling out globally, but will they roll out before it’s treatable?
(Apps have problems, but the protocols are getting better every day)

Despite other events, COVID still makes the news. Malcolm Fisk and his team studied how telehealth responded at the start of the pandemic in three countries. The ‘Thank And Praise’ virtual wall continues to accept thanks for healthcare workers. ATA’s now virtual conference may have been boosted by other cancellations. And finally, COVID struck the courts and held up the Cigna-Anthem breakup settlement–only three years in the making!

Another COVID casualty: a final decision on the Cigna-Anthem damages settlement (It’s only 3 years and billions at stake!)
ATA’s annual conference now 22-26 June–and fully virtual; announces three awards and Fellows (Plenty of names from US, UK, EU)
Thank and Praise’ to healthcare workers continues (UK) (A service that deserves notice for its graciousness)
Telehealth and the response to COVID-19 in Australia, UK, and US: the paper (Malcolm Fisk and team’s comparative study)

Gasping under our fabric masks, we are wheezing the Almost Summertime Blues. Is NHS a little blue with its unready contact tracing app and having to do things the Old Fashioned Way? Higi is not at all blue with a $30 million Series B infusion led by–Babylon Health–nor Propeller Health, 34 EU health tech startups, and Amazon. Google’s attorneys will roast in an Arizona summer. And finally, BMJ discovers that masks might make your breathing a lot more difficult–and concentrate whatever virus you’re exhaling.

Babylon Health leads a $30 million Series B for Higi health kiosks (An interesting series–of mutual interests in the US of A)
News roundup: LabCorp CRO boosts Medable, Propeller Health gains 510(k), EU’s 34 medtech startups, Amazon’s healthcare moves, Google’s Arizona privacy lawsuit
NHS’ COVID contact tracing service started today–but where’s the app? Australia?
(Looks like the old fashioned un-digital way)
Why ‘masking up’ isn’t such a great idea–more than a false sense of security (And 6 other reasons why)

Have a job to fill? Seeking a position? Free listings available to match our Readers with the right opportunities. Email Editor Donna.


Read Telehealth and Telecare Aware: http://telecareaware.com/  @telecareaware

Follow our pages on LinkedIn and on Facebook

We thank our present and past advertisers and supporters: Legrand/Tynetec, Eldercare, UK Telehealthcare, NYeC, PCHAlliance, ATA, The King’s Fund, DHACA, HIMSS, Health 2.0 NYC, MedStartr, Parks Associates, and HealthIMPACT.

Reach international leaders in health tech by advertising your company or event/conference in TTA–contact Donna for more information on how we help and who we reach. See our advert information here. 


Telehealth & Telecare Aware: covering the news on latest developments in telecare, telehealth, telemedicine and health tech, worldwide–thoughtfully and from the view of fellow professionals

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

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

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Walgreens Boots goes big with billion-dollar medical office deal with VillageMD

Go big or go home. That seems to be Walgreens Boots Alliance’s’ theme in its 8 July announced deal with and investment in primary care provider VillageMD. They will set up 500 to 700 co-located full-service Village Medical offices in more than 30 markets over the next three to five years. The “Village Medical at Walgreens” offices will be staffed by a projected 3,600 primary care providers and fully integrated with Walgreens pharmacists for one-stop shopping. According to the release:

  • Most of the Village Medical medical offices will be approximately 3,330 square feet each, up to 9,000 square feet, and utilize existing store space. “80% will be used by VillageMD to fund the opening of the clinics and build the partnership.”
  • 24/7 care will be available via telehealth and at-home visits
  • Fees will be covered by insurance or for those without, on a sliding scale
  • Over 50 percent will be located in Health Professional Shortage Areas and Medically Underserved Areas/Populations, as designated by HHS. These would reach underserved “older, sicker, and poorer patients” without regular access to care, said VillageMD CEO Tim Barry in an interview with CNBC
  • Capacity would be 100 to 120 patients per day 

This follows on a pilot of five Village Medical clinics at Walgreens locations in Houston, and Village Medical’s eight-state expansion in the Find Care telehealth program announced in April.

Walgreens Boots Alliance will invest $1 billion in equity and convertible debt in VillageMD over the next three years, including a $250 million equity investment to be completed today which will culminate in about 30 percent ownership.

To this Editor, Walgreens is sitting at a giant poker table, stacking the $1,000 chips, and saying to its rivals, ‘see ya and raise ya’. These are full-service offices, not urgent care clinics, and they are investing in their provider. It could be transformative–or flop on executional niceties such as location, medical competition, or even COVID keeping down physical visits. The competition is also daunting on the retail side. Recently Walgreens has pared back hundreds of locations and faces the deep pockets CVS-Aetna, which plans to open 1,500 HealthHUBs which integrate stores, MinuteClinics with nurse-practitioners, pharmacies, and health data, Amazon with PillPack aimed at its pharmacy business, and Walmart with its toe in the water with clinics. 

Village Medical, formerly Village Family Health, is a multi-state primary care provider which is part of Chicago-based VillageMD. Both include more than 2,800 physicians across nine markets, so the Walgreens deal will more than double their size. Also Forbes (Photo: Walgreens)

TTA’s 4th of July Fireworks: sparklers and starbursts from Teladoc, King’s College London, ransomware, FCC, Samsung, Walgreens, more!

 

No fireworks near your Editor except illegal ones, but we have a few legal ones on hand. Ransomware is sending up mortars. COVID’s effect on telehealth is a flitter-glitter comet, but patient counts to date misfire. Samsung starbursts tele-genomics. We’re waving sparklers for the SURE Recovery app from King’s College London. And telehealth celebrated with some nifty Roman candles from the FCC, but Huawei and ZTE were sent the smoke bombs. 

Happy US Independence Day (a/k/a The Colonial Rebellion)–a day early!

News roundup: Teladoc closes InTouch, Samsung bets on tele-genomics, SURE Recovery app, Optimize.health’s seed round, Walgreens’ Microsoft boost
Hackermania runs wild, Required Reading Department: The Anatomy of a Ransomware Attack (Weekend reading for you and your IT department)
Do Huawei and ZTE present security threats to the US and global communications networks? The FCC says yes. (Recognizing geopolitical reality)
FCC approves 70 more COVID-19 telehealth funding applications for an additional $32 million (A major support for growth for small to large organizations)
Hackermania runs wild…all the way to the bank! Ransomware strikes Crozer-Keystone, UCSF med school, others (Hackers in their basements didn’t break for COVID)
COVID effect on US practices: in-person visits down 37%, telehealth peaks at 14%; ATA asks Congress to make expansion permanent (Patients still not visiting their doctors, virtual or not)
The TeleDentists now in 14 states with Anthem (Recognition of an oft-forgotten but key part of medicine)

On the First Day of Summer, there’s hot news with NHS finally giving up on its NHSX COVID tracing app and a few changes over at NHSX. Otherwise, we observe some semblance of a return to Business As Usual. A former unicorn goes bankrupt, a telecare company brings out a new product, the VA has more drama around its EHR. But still plenty of COVID related news, including its hopefully permanent telehealth stimulus, without any drugs!

Breaking: NHSX COVID contact tracing app exits stage left. Enter the Apple and Google dance team. (Not a surprise to anyone, and some changes made)

News Roundup (updated): Proteus files Ch. 11, VA’s EHR tests now fall–maybe, making US telehealth expansion permanent, Rennova’s rural telehealth bet, Oysta’s Lite, Fitbit’s Ready to Work jumps on the screening bandwagon
Where in the world is the NHS COVID contact tracing app? Apps rolling out globally, but will they roll out before it’s treatable?
(Apps have problems, but the protocols are getting better every day)

Despite other events, COVID still makes the news. Malcolm Fisk and his team studied how telehealth responded at the start of the pandemic in three countries. The ‘Thank And Praise’ virtual wall continues to accept thanks for healthcare workers. ATA’s now virtual conference may have been boosted by other cancellations. And finally, COVID struck the courts and held up the Cigna-Anthem breakup settlement–only three years in the making!

Another COVID casualty: a final decision on the Cigna-Anthem damages settlement (It’s only 3 years and billions at stake!)
ATA’s annual conference now 22-26 June–and fully virtual; announces three awards and Fellows (Plenty of names from US, UK, EU)
Thank and Praise’ to healthcare workers continues (UK) (A service that deserves notice for its graciousness)
Telehealth and the response to COVID-19 in Australia, UK, and US: the paper (Malcolm Fisk and team’s comparative study)

Gasping under our fabric masks, we are wheezing the Almost Summertime Blues. Is NHS a little blue with its unready contact tracing app and having to do things the Old Fashioned Way? Higi is not at all blue with a $30 million Series B infusion led by–Babylon Health–nor Propeller Health, 34 EU health tech startups, and Amazon. Google’s attorneys will roast in an Arizona summer. And finally, BMJ discovers that masks might make your breathing a lot more difficult–and concentrate whatever virus you’re exhaling.

Babylon Health leads a $30 million Series B for Higi health kiosks (An interesting series–of mutual interests in the US of A)
News roundup: LabCorp CRO boosts Medable, Propeller Health gains 510(k), EU’s 34 medtech startups, Amazon’s healthcare moves, Google’s Arizona privacy lawsuit
NHS’ COVID contact tracing service started today–but where’s the app? Australia?
(Looks like the old fashioned un-digital way)
Why ‘masking up’ isn’t such a great idea–more than a false sense of security (And 6 other reasons why)

Sloooowly emerging from our homes into the sunshine, and maybe back into our offices soon, we have a first-person participant view of TechForce19. Back in the office, there will be a whole lot of app tracking and separation going on, if we return. In other news, Optum continues its buying spree, Amwell raises a few dollars, and DHACA has a #WebinarWednesday coming up in June. 

Reflections of a TechForce19 Participant (What it’s like to be in the center of a tornado!)
Optum buys naviHealth for reported $1 billion; Amwell raises $194 million in Series C (More $ in analytics, telehealth)
DHACA home testing webinar 20th May 10am–next one 3 June (DHACA’s #WebinarWednesday)
Post-COVID back to work: for workplace screening, testing, contact tracing, there’s an app for that (You’ll be in a very different looking office with plenty of new rules–if you return there)

Have a job to fill? Seeking a position? Free listings available to match our Readers with the right opportunities. Email Editor Donna.


Read Telehealth and Telecare Aware: http://telecareaware.com/  @telecareaware

Follow our pages on LinkedIn and on Facebook

We thank our present and past advertisers and supporters: Legrand/Tynetec, Eldercare, UK Telehealthcare, NYeC, PCHAlliance, ATA, The King’s Fund, DHACA, HIMSS, Health 2.0 NYC, MedStartr, Parks Associates, and HealthIMPACT.

Reach international leaders in health tech by advertising your company or event/conference in TTA–contact Donna for more information on how we help and who we reach. See our advert information here. 


Telehealth & Telecare Aware: covering the news on latest developments in telecare, telehealth, telemedicine and health tech, worldwide–thoughtfully and from the view of fellow professionals

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

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

News roundup: Teladoc closes InTouch, Samsung bets on tele-genomics, SURE Recovery app, Optimize.health’s seed round, Walgreens’ Microsoft boost

Teladoc completed the acquisition of InTouch Health on 1 July. The purchase, announced at the JP Morgan soireé in January (and an eternity ago) took place just before the ’10 years in 2 months’ leap forward in telehealth services. InTouch’s telehealth offerings are primarily for hospitals and health systems, heavily based on multi-feature carts and camera setups. The purchase price of $150 million in cash and 4.6 million shares of Teladoc Health common stock, valued then at $600 million, may be a great bargain for Teladoc considering the rich prices that other telehealth-related companies commanded during the peak of the pandemic, and that Teladoc’s revenue boosted to almost $181 million in revenue in Q1 2020, up 41 percent versus Q1 2019. Release

Samsung makes a telemedicine bet with Genome Medical. Through its Catalyst Fund, Samsung is the lead among 15 investors in a $14 million Series B extension financing that includes LRVHealth, Revelation Partners, and Kaiser Permanente Fund. Genome Medical’s connection to telemedicine is on-demand, standard-of-care genetics and genomics through virtual health services, including counseling, patient drug response, and provider-to-provider consults through its platform. Release. CNet. Crunchbase.

Mindwave Ventures, which this Editor noted last December was opening up an office in the Leeds health tech hub, has continued its development and research with multiple platforms and apps in partnership with NHS and academic/research clients. One that came on our ever-whirling radar screen is the release of the SURE Recovery app, for those in recovery from alcohol and drug problems. It enables users to work with the SURE (Substance Use Recovery Evaluator) and SUSS (Substance Use Sleep Scale) measures, plus a personal diary, to track their recovery over time. Mindwave developed the app in conjunction with The King’s College London and theInstitute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London. The app is now available to download; search ‘SURE Recovery’ on the App Store or Google Play. The page on the Mindwave site is on their Clinical Research page–click the tab for SURE. Hat tip to Ellis Noble of KC Communications.

Connected to telehealth and RPM is provider reimbursement. Optimize.health is an early-stage company which provides a turnkey setup for practices for its remote patient monitoring platform, with the usual features such as patient engagement, integrated devices with the platform, and call center support. The apparent difference is the emphasis on sharing data and simplifying reimbursement, the hard part of any RPM or telehealth platform. Announced this week: a $3.5 million seed round led by Bonfire Ventures. A small boost to this part of the telehealth field which has not had the great success of virtual consults. Release.

Back in January 2019, Walgreens Boots announced a partnership with Microsoft to migrate their IT over to the Azure platform. It took a while for results to manifest to the public. When COVID happened, they rolled out a COVID-19 risk assessment tool on its website and mobile app based on Azure. Their Find Care platform doubled the number of virtual care providers and services available. Walgreens also provided a link to COVID-19 clinical trials through the Find My Clinical Trial program on its mobile app. This article in FierceHealthcare touts how they are maneuvering to stay even with CVS Aetna and Amazon, which is hardly waiting for its partners in the gone-pearshaped Haven.

News roundup: LabCorp CRO boosts Medable, Propeller Health gains 510(k), EU’s 34 medtech startups, Amazon’s healthcare moves, Google’s Arizona privacy lawsuit

It does seem ages since our last one! One major winning category for digital health is clinical trials. LabCorp has one of the largest CROs (contract research organization), Covance. LabCorp has partnered with startup Medable, a Palo Alto-based company that decentralizes the gathering and analysis of clinical trial data from recruited participants through apps and telemedicine. Mobihealthnews  Confirming this trend: earlier this month, Medable cleared a $25 million venture round from GSR Ventures. Crunchbase  This does make rival CRO PRA Health Science’s pickup of Care Innovations from Intel late last year, for an undisclosed amount, look like a prescient (and likely a bargain) purchase.

Propeller Health, which specializes in digital respiratory health with sensors connected to inhalers and apps, gained 510(k) FDA clearance for a sensor/app for use with AstraZeneca’s Symbicort inhaler. This medication is used for asthma and COPD. It does not seem that long ago (2014) that the startup was at trade shows like NYeC and mHealth Summit with an exceedingly modest display of popups and brochures. Their 2019 acquisition by ResMed for the stunningly premium price of $225 million made news in late 2018. Mobihealthnews

In Europe, COVID-19 has boosted at least 34 medtech startups, including 11 in UK alone, followed by Switzerland and Sweden. This is based on a study by Oxford University data visualization spin-out Zegami. One of them happens to be Zegami on a project in using a limited dataset to distinguish between x-rays of COVID-19 infections and infections caused by viral or bacterial pneumonia, as well as images of healthy lungs. On the list are (naturally) Babylon Health and the slightly mysterious Medopad. Sweden’s Kry (LIVI in the UK) is also on the list. Kry/LIVI last made some news when Juliet Bauer of NHS Digital ankled to Kry in early 2019, Med-techInnovationNews, Mobihealthnews

Amazon’s latest stretches into healthcare are noted in a brief Becker’s Health IT article which notes AWS’ deals with Cerner and addition of healthcare-specific features with hospitals using AWS. Mayo Clinic has partnered with Alexa for voice responsive ‘Mayo Answers’. Some Amazon employees now have access to telehealth benefits (this Editor wonders why not all, beyond those Seattle warehouse workers). Industry research company CB Insights is projecting that Amazon’s next move will be a benefits marketplace for employers and payers. Meanwhile, their partnership with JP Morgan Chase and Berkshire Hathaway, Haven, has stumbled with its CEO Atul Gawande, MD, leaving the post to return to practice after less than two years. Executive turnover has been high, and the company has yet to announce a major initiative. FierceHealthcare 

Meanwhile, Arizona’s attorney general has sued Google for violating state privacy laws. Seems like Android users are trackable, even if they turn off location on their phones, through Google apps like Maps and Weather. The lawsuit also charges that Google changed its default tracking settings without informing users, using data for targeted ads. Becker’s Health IT 

Google’s ‘Project Nightingale’–a de facto breach of 10 million health records, off a bridge too far?

Breaking News. Has this finally blown the lid off Google’s quest for data on everyone? This week’s uncovering, whistleblowing, and general backlash on Google’s agreement with Ascension Health, the largest non-profit health system in the US and the largest Catholic health system on the Planet Earth, revealed by the Wall Street Journal (paywalled) has put a bright light exactly where Google (and Apple, Facebook, and Amazon), do not want it.

Why do these giants want your health data? It’s all about where it can be used and sold. For instance, it can be used in research studies. It can be sold for use in EHR integration. But their services and predictive data is ‘where it’s at’. With enough accumulated data on both your health records and personal life (e.g. not enough exercise, food consumption), their AI and machine learning modeling can predict your health progression (or deterioration), along with probable diagnosis, outcomes, treatment options, and your cost curve. Advertising clicks and merchandising products (baby monitors, PERS, exercise equipment) are only the beginning–health systems and insurers are the main chance. In a worst-case and misuse scenario, the data modeling can make you look like a liability to an employer or an insurer, making you both unemployable and expensively/uninsurable in a private insurance system.

In Google’s latest, their Project Nightingale business associate agreement (BAA) with Ascension Health, permissible under HIPAA, allowed them apparently to access in the initial phase at least 10 million identified health records which were transmitted to Google without patient or physician consent or knowledge, including patient name, lab results, diagnoses, hospital records, patient names and dates of birth. This transfer and the Google agreement were announced by Ascension on 11 November. Ultimately, 50 million records are planned to be transferred from Ascension in 21 states. According to a whistleblower on the project quoted in The Guardian, there are real concerns about individuals handling identified data, the depth of the records, how it’s being handled, and how Google will be using the data. Ascension doesn’t seem to share that concern, stating that their goal is to “optimize the health and wellness of individuals and communities, and deliver a comprehensive portfolio of digital capabilities that enhance the experience of Ascension consumers, patients and clinical providers across the continuum of care” which is a bit of word salad that leads right to Google’s Cloud and G Suite capabilities.

This was enough to kick off an inquiry by Health and Human Services (HHS). A spokesperson confirmed to Healthcare Dive that “HHS’ Office of Civil Rights is opening an investigation into “Project Nightingale.” The agency “would like to learn more information about this mass collection of individuals’ medical records with respect to the implications for patient privacy under HIPAA,” OCR Director Roger Severino said in an emailed statement.”

Project Nightingale cannot help but aggravate existing antitrust concerns by Congress and state attorneys general on these companies and their safeguards on privacy. An example is the pushback around Google’s $2.1 bn acquisition of Fitbit, which one observer dubbed ‘extraordinary’ given Fitbit’s recent business challenges, and data analytics company Looker. DOJ’s antitrust division has been looking into how Google’s personalized advertising transactions work and increasingly there are calls from both ends of the US political spectrum to ‘break them up.’ Yahoo News

Google and Ascension Health may very well be the ‘bridge too far’ that curbs the relentless and largely hidden appetite for personal information by Google, Amazon, Apple, and Facebook that is making their very consumers very, very nervous. Transparency, which seems to be a theme in many of these articles, isn’t a solution. Scrutiny, oversight with teeth, and restrictions are.

Also STAT News , The Verge on Google’s real ambitions in healthcare, and a tart take on Google’s recent lack of success with acquisitions in ZDNet, ‘Why everything Google touches turns to garbage’. Healthcare IT News tries to be reassuring, but the devil may be in Google’s tools not being compliant with HIPAA standards.  Further down in the article, Readers will see that HIPAA states that the agreement covers access to the PHI of the covered entity (Ascension) only to have it carry out its healthcare functions, not for the business associate’s (Google’s) independent use or purposes. 

Short Takes: Amazon buys symptom checker Health Navigator; Ettain Group acquires EHR consultant Leidos Health (updated)

Amazon’s acquisition of startup Health Navigator, a developer of online symptom checking and triage tools sold to other digital companies to integrate into their digital health solutions, is another foray into healthcare. In this case, Health Navigator is a straightforward fit into their Amazon Care unit which provides enterprise virtual care benefits. No transaction amount, leadership, nor timing are mentioned. This is unlike their purchase earlier this year of online pharmacy PillPack for a stunning $700+ million. After roadblocks on getting the patient data they need [TTA 12 Sept], and other stumbles, PillPack has been folded into their consumables group and right now is not challenging CVS or Walgreens in any meaningful way. CNBC

Charlotte NC-based ettain group has purchased EHR consultancy Leidos Health. The divesting parent, Leidos Inc. is best known to our Readers for its contract with the US Department of Defense in the replacement of the ancient AHLTA EHR with a Cerner system. The acquisition will reinforce Ettain’s healthcare IT sector. Leidos Inc. remains in business in the government and private healthcare sectors for consulting and retains the MHS Genesis contract. Unfortunately, the announcement is dimmed by a poorly written and elliptical release.

Update: A spokesperson for ettain group (lower case correction) has clarified via email that they have “acquired Leidos Health LLC which is a commercial EHR staff augmentation services business. This is not to be confused with Leidos Inc, the original parent company that still maintains a health business that manages the DOD MHS Genesis program. Basically, the ettain group transaction doesn’t include MHS Genesis.”

News and event roundup: Amazon PillPack, Humana joins CTA, NH’s telemedicine go, Fitbit Lives Healthy in Singapore, supporting Helsinki’s older adults, events

Now that we are past the unofficial end of summer, it’s time to spin that lasso and rope us some news.

Amazon’s PillPack loses a critical data partner. Electronic prescriptions clearinghouse Surescripts terminated their data contract with ReMy Health, which supplied PillPack with information on patients’ prescriptions. Surescripts found fraud in several areas of their relationship with ReMy Health including medication history, drug pricing, and insurance billing. Now PillPack has to obtain it the old-fashioned way–by asking the patient. This can lead to errors and inaccuracies in things like dosages and whether a drug is brand-name or generic. Now PillPack, in the lurch, is seeking a direct relationship with Surescripts. Seeking Alpha, CNBC

Health plan Humana is the first payer to join the Consumer Technology Association (CTA). Humana has been building up his data analytics and digital health capabilities with new ‘studios’ in Boston and hiring USAA’s CTO.  It’s piloting an app for Medicare Advantage patients to connect them with pharmacists and medication management via Aspen RxHealth plus working on a virtual digital primary model with telemedicine provider Doctor on Demand. Fierce Healthcare

New Hampshire is joining the telemedicine reimbursement bandwagon, with its legislature and Gov. Sununu approving primary care providers and pediatricians to bill Medicaid and private insurance for telemedicine visits starting in January 2020. This also ties into rural telehealth. AP, Mobihealthnews

Internationally….Fitbit is partnering with Singapore’s Health Promotion Board (HPB) for the Live Healthy SG behavioral change program, based on the Fitbit Premium program, starting in late October. Mobihealthnews A-P   In Finland, Digital Service Center Helsinki is creating digital tools and virtual care systems to enable older adults to safely and independently live at home, including socialization to prevent loneliness. It’s a significant challenge as over 22 percent of Finland’s population is over 65. Mobihealthnews Europe-UK

Events:

The 9th International Digital Public Health Conference series (#DPH2019), 20-23 November, Marseille, France. This conference is billed as the digital health partner of the 12th European Public Health Conference and brings together the areas of public health, computer and data science, medtech, and NGOs. Conference information here.

Aging 2.0 New York Global Innovation Showcase 4 December, NYC. One of a series of global Aging 2.o events, startups will present aging-focused innovations. Want to pitch? It’s still open–apply here. Register to attend here. Additional information on this and on CREATE’s Design for Older Adults Workshop on 21-22 October at Weill Cornell is here.

 

CVS-Aetna merger closes, but hardly ‘rubber stamped’ in Federal court

The deal is done, but expect unhappy holidays. As expected, the $69 million CVS-Aetna merger closed the week after Thanksgiving, on Wednesday 26 November, and are proceeding with their integration. Later that week, a Federal judge in the Washington, DC District Court complained at a hearing that both companies had treated him as a “rubber stamp” for the agreement. He was “less convinced” than the Department of Justice that the merger was legal under US anti-trust law. Yesterday (Tuesday 3 Dec), Judge Richard Leon ordered both companies and the DOJ to file briefs by 14 December “to show why their integration should not be halted while he considers whether or not to approve the consent decree reached in October,” according to Reuters.

This is despite various pounds of flesh:

  • The Department of Justice imposing the condition that Aetna sell its Medicare Part D drug plan business to far smaller WellCare Health Plans
  • New York State’s Department of Financial Services extracting concessions around their concerns: acquisition costs will not be passed onto consumers through increased premium rates or to affiliated insurers; maintaining current products for three years; privacy controls; cybersecurity compliance. Oh yes, a small $40 million commitment to support health insurance education and enrollment. (Healthcare Finance 26 Nov)
  •  But New York is a piker in its demands compared to California. The Department of Managed Health Care Director approved the merger based upon:
    • Minimal increases in premiums–and no increase due to acquisition costs
    • Investing $240 million in the state healthcare delivery system, including $166 million for state healthcare infrastructure and employment; $22.8 million to increase the number of healthcare providers in underrepresented areas like Fresno and Walnut Creek by funding scholarships and loan repayment programs; and $22.5 million to support joint ventures and accountable care organizations (ACOs) in value-based care (Healthcare Finance 15 Nov)

A CVS spokesman said in an email after the hearing: “CVS Health and Aetna are one company, and our focus is on transforming the consumer health experience.” (CNBC)  That transformation according to CVS president Larry Merlo involves expanding healthcare services beyond their present clinics to managing high-risk, chronic conditions, and transitions in care. Aetna’s expertise will be invaluable here as well as in an rumored expansion to urgent care (Seeking Alpha). All to out-maneuver Amazon, of course, which is promoting (on TV) PillPack and has applied for additional pharmacy licenses to ship drugs to customers in Washington, New Mexico and Indiana from their Phoenix facility (Healthcare Finance).

It appears that Judge Leon has his own serious reading of the 1974 Tunney Act, which requires a Federal court to ensure the agreement is in the public interest, despite the states and the DOJ.

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

imageWhat 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.

Cigna’s $69 million acquisition of Express Scripts clears US Department of Justice hurdle

As reported on 8 Sept, the DOJ announced on Monday that they have formally cleared the Cigna acquisition of pharmacy benefits manager Express Scripts. This puts together a major payer with a PBM manager, the latter area considered to be challenged for profitability as the PBM drug rebate model may be substantially less profitable in the future. Federal policy pressure is ramping up from Health & Human Services (HHS), with Secretary Alex Azar only last week promising disruptive change and more transparency in drug pricing.

CVS (PBM-Caremark) with Aetna is in the works and Anthem is creating its own PBM called IngenioRx. UnitedHealthcare has its own OptumRx for some years. 

Another point of pressure on the entire PBM category is the Amazon-Berkshire Hathaway-JP Morgan combine, sometime in the future when the hype and speculation on What Amazon Will Do turns into actual plans beyond their acquisition of tiny, specialized player PillPack for an exorbitant $1bn [TTA 4 July]. 

The DOJ investigation took six months, reviewed more than 2 million documents, and more than 100 industry people were interviewed.

Cigna and Express Scripts now must negotiate over 50 state departments of banking and insurance–over 50 because some states have two. Both companies already have shareholder approval, and the lack of overlap in their businesses limits the possibility of divestitures. Their advocacy website is here. But state DOBIs can be unpredictable, as Cigna found out with Anthem. (Their contentious breakup is still being contested in court–and Cigna could use the contractual breakup money to ease the Express Scripts debt estimated at $15 bn. Forbes.  Bloomberg, Healthcare Dive

What Best Buy’s $800 million cash purchase of GreatCall connected health/PERS really means

Have health and connectedness services for older people finally made it out of the pumpkin and to the ball? GreatCall’s market doesn’t make for great cocktail party buzz or TEDMED talks. It’s emergency response with Jeopardy’s Alex Trebek presenting 5 Star emergency service bundled in a Jitterbug flip or smartphone (made by others). It’s made intelligent acquisitions. taking some of the tech developed by Lively to develop wearables that are quite presentable and by Healthsense for the senior living market. It’s been a leader in how to make both traditional direct marketing (DRTV, print) and digital work for an older market. Somehow, it’s managed to accumulate over 900,000 paying customers, which proved to be very attractive to first PE firm GTCR and now Minneapolis-based Best Buy, which with GreatCall has made its Biggest Buy.

GreatCall will remain a separate division with the same CEO (David Inns, with them since their 2006 founding) and remain HQ’d in San Diego. The transaction is expected to close by end of the third quarter of Best Buy’s fiscal 2019, subject to regulatory approvals.

Best Buy in the US has remained the #1 electronics ‘big box’ store that, like most retail, has stumbled about and come back from the brink. Their purchase of GreatCall, a partner for many years, reinforces a strategy they’ve worked on for a while in featuring health and wellness-related products to what CNBC calls ‘an aging population’ as part of ‘solving technology problems and addressing key human needs across a range of areas.’ GreatCall, as noted above, has a superb track record in direct marketing to that group. (In this context, the former Healthsense B2B play is limited–some of the feedback that this Editor’s received is that GreatCall stumbled out of the gate with Healthsense customers with a lack of understanding of the LTC/senior housing market dynamics. Long term, it seems out of phase with Best Buy’s direction in a way that consumer-oriented Lively is not.)

Will that talent spill over to and influence the rest of Best Buy’s business? Will Best Buy successfully carve out a niche which is relatively resistant to the predations of Amazon (which also sells a lot of health tech) and other online retailers? Is this niche big enough to support this Big Box Retailer? Seeking Alpha, press release, Mobihealthnews

News roundup: Walmart and Microsoft AI, are derm apps endangering public with 88% skin cancer diagnosis?

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2017/12/Lasso.jpg” thumb_width=”150″ /]Walmart and Microsoft partner to change the retail experience via AI. The five-year agreement will switch over applications to the cloud and will affect shipping and supply chain. It’s projected in Healthcare Dive that the impact will be in healthcare as well. Microsoft announced last month that it is forming a unit to advance AI and cloud-based healthcare tools. The landscape is under extreme pressure in retail and healthcare delivery, and Walmart needs to ready for future moves which will certainly happen. Walmart is rumored to be interested in acquiring Humana and is currently working with Emory Healthcare in Atlanta. Then there is CVS-Aetna, Cigna-Express Scripts, Google, and (looming above all) Amazon. (Though you can tuck all the years of Amazon’s profits into one year of Walmart’s.)

The ITV News headline grabs attention — but are dermatology apps really endangering the public when teledermatology can help diagnose 88 percent of people with skin cancer and 97 percent of those with benign lesions? A University of Birmingham-led research team did a metastudy of the literature and found three failings: “a lack of rigorous published trials to show they work and are safe, a lack of input during the app development from specialists to identify which lesions are suspicious and flaws in how the technology analyses photos” particularly for scaly or non-pigmented melanomas. But did access to these apps encourage early diagnosis which can lead to up to 100 percent five-year survival? Of course review is required as recommended by the study, but this last factor was not really examined at the British Association of Dermatologists’ annual meeting in Edinburgh. University of Birmingham release with study abstract

Care Innovations sells off Validation Institute. But is there more to the story? And a side of Walmart Health action.

The Health Value Institute, part of Woburn, Massachusetts-based conference organizer World Congress, announced late last week the acquisition of the Validation Institute from Care Innovations. Terms were not disclosed. The Health Value Institute and the Validation Institute recently partnered to validate the outcomes for the Health Value Award finalists and awards this past April at the 15th Annual World Health Care Congress. According to both parties, the acquisition will help to expand the membership of validated companies, and the present offerings for HR, broker, and benefit executives. Release.

The Validation Institute was launched with fanfare back in June 2014, when GE still had a chunk of the company and during the 2 1/2 year repositioning (revival? resuscitation?) led by Sean Slovenski from the doldrums of the prior Louis Burns regime. Mr. Slovenski departed in early 2016 to be president of population health at Healthways/Sharecare, which lasted a little over a year. However, this week Mr. Slovenski made headlines as the new SVP Health & Wellness of Walmart, reporting directly to the head of their US business.  The hiring of a senior executive with a few years at Humana and a short time at Sharecare, another Walmart partner, coupled with several years in healthcare tech and provider-side is certainly indicative of Walmart’s serious focus on healthcare provision. It’s a fascinating race with Amazon and CVS-Aetna–with the mystery of what Walgreens Boots Alliance will do. Also Healthcare Dive.

But back to Care Innovations. Signs of a new direction–and a loss. The case can be made that the Validation Institute, the Jefferson College of Population Health, and validating individuals and companies was no longer core to their business which is centered around their RPM platform Health Harmony (with QuietCare still hanging in there!) However, this Editor notes the prominent addition of  ‘platform-as-a-service’ advisory services for those who are developing health apps, which appears to be a spinoff of their engineering/IT services. Vivify Health, a competitor, already does this. There is a vote of confidence; in June, Roche signed on with a strategic investment (undisclosed) as well as integration of the mySugr integrated diabetes management/app solution (release).

Looking around their recently refreshed website, there is an absence–that of the two or three pages previously dedicated to the Veterans Health Administration (VA) and the press release of the VA award. This tends to lend credence to the rumors that there was a second company that did not pass the Trade Adjustment Act (TAA) requirements that knocked out Iron Bow/Vivify Health from the VA, or for another undisclosed reason CI bowed out of a potentially $258 million five-year contract. If so, that leaves for the VA Medtronic and 1Vision/AMC Health. It’s certainly a limited menu for the supposedly growing numbers of veterans requiring telehealth and a limited choice for their care coordinators–and not quite as presented to the public or the 2015 competitors in the solicitation. Who benefits? Who loses? (Disclosure: This Editor worked for one of the finalists and a VA supplier from 2003, Viterion.)  Hat tip to one of our ‘Industry Insiders’, but the opinions expressed here are her own.

Rock Health’s ‘Another record-breaking first half’ in digital health funding is actually–flat. (With a Soapbox Extra!)

The Breathless Tone was the clue. “It’s déjà vu for digital health, with yet another record breaking half for venture funding.” It was déjà vu, but not of the good sort. This Editor hates to assume, so she checked the year-to-year numbers–and first half 2018 versus 2017 broke no records:

  • 2018:  $3.4 bn invested in 193 digital health deals 
  • 2017: $3.5 bn invested in 188 digital health companies [TTA 11 July 17]

But ‘flat’ doesn’t make for good headlines. Digging into it, there are trends we should be aware of — and Rock Health does a great job of parsing–but a certain wobbliness carried over from 2017 even though the $5.8 bn year finished 32 percent up over 2016, analyzed here [TTA 5 Apr 18]. Their projection for 2018 full year is $6.9 bn and 386 deals.

Let’s take a look at their trends:

  • “The future of healthcare startups is inextricably linked to the strategies of large, enterprise-scale healthcare players—as customers, partners, investors, and even potential acquirers.” It’s no mistake that the big news this week was Amazon acquiring tiny, chronic-conditions specializing prescription supplier PillPack after a bidding war with Walmart for an astounding $1bn, making its 32 year-0ld founder very rich indeed and gaining Amazon pharmacy licenses in 49 states. (Prediction: Walmart will be pleased it lost the war as it will find its own solutions and alliances.) 
    • Enterprise healthcare players are cautious, even by Rock Health’s admission, but the big money is going into deals that vertically integrate and complement, at least for a time–for example, Roche’s purchase of Flatiron Health. And when it doesn’t work, it tends to end in a whimper–this May’s quiet sale by Aetna of Medicity to Health Catalyst for an undisclosed sum. Back in 2011, Aetna bought it for $500 million. (Notably not included in the Rock Health analysis, even though they track Health Catalyst and the HIE/analytics sector.)
  • The market is dependent on big deals getting bigger. If you are well-developed, in the right sector, and mature (as early-stage companies go), you have a better shot at that $100 million B, D, E or Growth funding round. B rounds actually grew a bit, with seed and A rounds dipping below 50 percent for the first time since 2012. 
  • The Theranos Effect is real. Unvalidated, hyped up claims don’t get $900 million anymore. In fact, there’s real concern that there’s a reluctance to fund innovation versus integration. The wise part of this is that large fundings went to companies validating through clinical trial results, FDA clearance (or closing in on it), and CDC blessing.
  • The dabbling investor is rapidly disappearing. 62 percent of investors in first half had made prior investments in digital health including staying with companies in following rounds.
  • Digital health companies, like others, are staying private longer and avoiding public markets. Exits remain on par with 2017 at 60. Speculation is that Health Catalyst and Grand Rounds are the next IPOs, but there hasn’t been one since iRhythm in October 2016. The Digital Health public company index is showing a lot less pink these days as well, which may be an encouraging sign.
  • Behavioral health is finally getting its due. “Behavioral health startups received more funding this half than in any prior six-month period, with a cumulative $273M for 15 unique companies (nearly double the $137M closed in H1 2016, the previous record half for funding of behavioral health companies). Of these 15 companies, more than half have a virtual or on-demand component.”

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. 

Their projection for 2018 full year is $6.9 bn and 386 deals. Will their projection pan out? Only the full year will tell!

A Soapbox Extra!

Rock Health, like most Left Coast companies, believes that Vinod Khosla is a semi-deity. This Editor happens to not be convinced, based on predictions that won’t pan out, like machines replacing 80 percent of doctors; making statements such as VCs have less sexual harassment than other areas, and even banning surfers off his beach. He was at a Rock Health forum recently and made this eye-rolling (at least to this Editor) statement:

Is there one area in the last 30 years where the initial innovation was driven by an institution of any sort? I couldn’t think of a single area where innovation—large innovation—came from a big institution. Retailing wasn’t disrupted by Walmart, it was by Amazon. Media wasn’t changed by CBS or NBC, it was by YouTube and Twitter. Cars weren’t transformed by Volkswagen and GM—and people said you can’t do cars in startups—but then came Tesla.

Other than making a point that Clayton Christensen made a decade or more ago, the real nugget to be gained here is that formerly innovative companies that get big don’t grow innovation (though 3M tends to be an exception, and Motorola didn’t do too badly with the cell phone). They can buy it–and always have. 

Go back a few more decades and all of these companies were disrupters–and bought out (or bankrupted) other disrupters. CBS and NBC transformed entertainment through popularizing radio and then TV. VW created the small car market in the US and saved the German auto industry. GM innovated both horizontally (acquiring car companies, starting other brands) and integrated vertically (buying DELCO which created the first truly workable self-starting ignition system in 1912).

YouTube? Bought by innovator Google. Twitter? Waiting, wanting to be bought. Innovation? Khosla is off the beam again. Without Walmart, there would be no Amazon–and Amazon’s total lifetime profit fits nicely into one year of Walmart’s. Tesla is not innovative–it is a hyped up version of electric car technology in a styled package that occasionally blows up and remains on the borderline of financial disaster. (Model 3, where art thou?)

I’d argue that Geisinger, Mayo Clinic, and Intermountain Healthcare have been pretty innovative over the last 30 years. Mr. Khosla, read Mr. Christensen again!

Some more views on (and by) Atul Gawande on the JP Morgan-Berkshire-Amazon health combine

Often the best indicator of the success of a person in a new venture is to examine their own words. An interview with Dr. Gawande in STAT a few days after the Big Reveal of his new position as CEO of the JPM-BH-Amazon healthcare nonprofit indicates that he has an excellent grasp of the task before him. His main points:

  • Before accepting the position, he established that the healthcare company would be an independent entity and not part of the three companies
  • It is also non-profit and not expected to return money to those companies
  • He will be devoting 100 percent to the new job and have it be the number one priority, but he will be with patients and his surgery through at least the summer
  • “My job for them is to figure out ways that we’re going to drive better outcomes, better satisfaction with care, and better cost efficiency with new models that can be incubated for all. That is a tall fricking order. But what they’re saying to me is that resources won’t be the problem. Human behavior will be. And achieving scale will be.”

His speech at AHIP (America’s Health Insurance Plans) annual meeting a day after the announcement pointed out that unnecessary tests and treatments account for about 30 percent of healthcare spending, that our system fails the chronically ill in their needs to be asked about what they want to achieve through treatment, and for doctors to deliver the right and considerate treatment especially in end-of-life care. “Precision medicine has to be matched by precision delivery.”  Healthcare Finance

For the 1 million employees of the three companies, there may not be a lot of chronic illness or end-of-life consideration (people tend to fall out of the workforce under those circumstances). What kind of model will apply to them and save on the 25 percent of estimated healthcare spending which is wasted? The article in Forbes by another ‘big thinker’, Robert Pearl MD, sees a 5-10 year time frame for Dr. Gawande’s task: “…to fundamentally change how healthcare is structured, paid for and provided. He was hired to disrupt the industry, to make traditional health plans obsolete, and to create a bold new future for American healthcare.”

But in the meantime, how will those bank tellers, packers, IT workers, ice cream slingers, and railway workers fare with their health? What will they benefit from in two to three years time? And will the long-term backing and the promises to Dr. Gawande remain after Mr. Dimon, Mr. Buffett, and Mr. Munger (of BH, and possibly why Dr. Gawande is on board) are gone?