The GreatCall Lively Mobile Plus Federal District Court lawsuit–and TTA

Eight emails and two comments later, your Editor wonders why the full court press on TTA. Our Readers may have noted that at the end of our last article on Best Buy [TTA 25 June] and their expansion into digital health, there was a brief reference to a recall of their subsidiary GreatCall’s Lively Mobile Plus and a related lawsuit:

This is not without pitfalls. Earlier this month, Best Buy was sued for a defect found in its GreatCall Lively MobilePlus mobile PERS that in action failed to detect falls as described, after GreatCall discontinued the device in mid-May in what a letter from their CEO David Inns described as an “important safety recall,” offering buyers a Jitterbug flip phone or a full refund. 

The link above was to a fairly comprehensive 3 June article in Mobihealthnews on a Federal District Court-Central District of California class action lawsuit filed by firm Bisnar Chase on 22 May on behalf of plaintiff Scott Barnes of San Luis Obispo, California (document via Mobihealthnews).

  • Mr. Barnes purchased the device on 21 April.
  • In early May, Mr. Barnes fell twice but the device did not detect the fall and automatically alert emergency services. Mr. Barnes is a disabled veteran and relied on the device to detect falls. The lawsuit states that he suffered unspecified damages as a result.
  • In a letter from David Inns as we noted above, GreatCall notified purchasers/subscribers dated 15 May (letter) that it was recalling all devices. It acknowledged fault in a quality issue. It also asked customers to stop using the device immediately and return it for a full refund plus additional considerations.

More on this is from a Morning Call (Allentown PA) article (picked up from the San Diego Union-Tribune) provided by Mr. Barnes to this Editor. It makes the cogent point that the device as a PERS did not require FDA 510(k) clearance. Fall detection does not fall under Class I or II medical device regulation as it does not monitor vital signs.

Mr. Barnes has written five separate emails to this Editor within less than ten minutes, with another three after our reply. Obviously, this matter is important to him. Moreover, our email is public and we welcome direct contact (including confidential contact) from our Readers with pertinent information. We also welcome comments on articles and don’t mind it being lively.

However, there were two comments at the end of our earlier article on Best Buy’s acquisition of Critical Signal Technologies that are, in the opinion of this Editor, marginal. One from ‘Scott’ implied that there was a relationship between this publication and Best Buy: “What is your companies relationship with the Recalled Great Call/Best Buy Mobile Lively Plus defective device that is now under a Federal Legal Action and Lawsuits.” (My answer was, of course, is that we report on these two companies, and other than that, have no relationship.) The other from ‘Kennie’ was phrased as ‘Be Warned’ and made certain assertions about the device and the company which have yet to be proved in court. This was published with some trepidation.

We ask commenters to be respectful of other Readers, of the facts, and understand that we report–and comment–as we see it.

Best Buy enlarges health tech footprint with Tyto Care expansion, connected fitness products (updated)

Best Buy is dramatically increasing its wellness profile with two announcements around digital health. The first is today’s announcement of a further rollout of retailing Tyto Care’s TytoHome device and platform in select Best Buy stores in California, Ohio, North Dakota, and South Dakota. This adds to the previously announced Minnesota locations [TTA 17 Apr] for a total of 30, as well as nationwide via BestBuy.com. In Minnesota, North and South Dakota, Tyto Care connects to Sanford Health doctors 24/7. In California and Ohio, as well as for online sales, Tyto Care partners with LiveHealth Online, part of American Well, except for users in Louisiana and Mississippi who will be covered by Ochsner Health System. Each visit is a maximum of $59, which may be less depending on the patient’s insurance plan or the type of visit. Tyto Care is also offering the plan through LiveHealth Online to select employers. Release.

Tyto Home is a handheld examination device with attachments that can examine the heart, lungs, skin, ears, throat, and abdomen, plus body temperature. The captured information can be sent or examined live by a primary care provider.

Best Buy is also betting that people also will flock to their stores to sample connected fitness, most with virtual classes and coaching. Last week they highlighted five: Flywheel Sports, an indoor cycle with online classes; Hydrow, a rowing machine with virtual classes on real-life bodies of water; NordicTrack, with a line of treadmills, bikes, rowers and strength training machines with virtual classes; NormaTec, a digital compression recovery system; and Hyperice, which produces a range of recovery tools like massagers. The digital fitness market is massive–estimated by Piper Jaffray at around $5 billion today, over double from 2016’s $2.1 billion. Mobihealthnews, CNN Business

This adds to a Best Buy digital health profile that includes the Big Buy of GreatCall last year and Critical Signal Technologies monitoring last month to add senior remote monitoring devices to their portfolio. This is not without pitfalls. Earlier this month, Best Buy was sued for a defect found in its GreatCall Lively MobilePlus mobile PERS that in action failed to detect falls as described, after GreatCall discontinued the device in mid-May in what a letter from their CEO David Inns described as an “important safety recall,” offering buyers a Jitterbug flip phone or a full refund. But Best Buy is hedging its bets on tech with higher price-point connected fitness exercise machines and wearables which will attract higher end buyers into stores and online.

Best Buy buys Critical Signal Technologies, increasing telehealth footprint

Late last month, Best Buy with little fanfare bought Critical Signal Technologies (CST) of Novi, Michigan. CST is a device-agnostic telehealth monitoring and social work services platform through its Care Center, covering services such as PERS monitoring, medication management, and remote patient monitoring. Terms were not disclosed for this private company founded in 2006, but CST cares for 100,000 patients and has partnerships with 1,500 payers, including many Medicare Advantage plans. 

For those seeking the sunnier uplands of digital health, it’s surprising but gratifying to see Best Buy place another sizable bet in the home health area. The recent acquisition of GreatCall for $800 million is larger, but GreatCall is a turnkey, profitable company. The partnership with Tyto Care [TTA 17 April] to retail their system is relatively low risk, limited in scope, and follows their Midwest intro pattern (followed over 12 years ago with, believe it or not, QuietCare when owned by Living Independently).

Best Buy has gained kudos for moving into specialty areas in healthcare when its fellow retailers have been falling by the wayside. It covers both their bricks-and-mortar–where older adults still like to shop–and online, delivering a large slice of health tech directly to consumers. One asset, the tech-oriented Geek Squad, is a ready made unit for installing and walking older adults through using home tech. MedCityNews, MarketWatch

Tyto Care inks deal with Best Buy for retail sales of remote diagnostic device

Tyto Care’s long-planned retail debut of the TytoHome remote diagnostic device has arrived at Best Buy. The telehealth device which incorporates a camera, stethoscope, otoscope, tongue depressor, basal thermometer, and smartphone app can be bought online for $299.99. According to their release, TytoHome will be available at select Minnesota Best Buy stores and will roll out to North Dakota, South Dakota, California and Ohio.

TytoHome has been from the start (late 2016) pitched to parents as a 24/7 service for ill children in that middle-of-the-night sick call to the doctor, but more recently for adults as an adjunct to a virtual visit. The Israel-based company with US offices in NYC partnered with American Well early [TTA 2 Dec 2016]. For Best Buy customers outside of Minnesota, North and South Dakota, TytoHome will connect to doctors via LiveHealth Online, an American Well partner. In those three states, TytoHome will connect to Tyto Care health system partner Sanford Health and their medical providers. Each visit will be $59, possibly less if the service is covered by the person’s or family insurance plan.

Best Buy, of course, has made a large bet on retail health tech with its purchase of GreatCall, well-known for its Jitterbug phones targeted to older adults with its 5-Star PERS, but also prior to the acquisition with GreatCall’s purchases of Lively’s tech for consumer devices and HealthSense in LTC systems. Their current plans are outlined in a recent interview with CEO David Inns.

News roundup from all over: prescribing apps is back! Plus telemental health Down Under, GreatCall’s health tech strategy, Wessex’s diabetic sim, telehealth growth outpaces urgent care

Back to the future with prescribing apps! Early stage Xealth just gained a $11 million Series A from heavyweights such as Novartis, McKesson Ventures, UPMC, Philips, and ResMed. Clinicians can prescribe and monitor digital health care content, apps, devices, and services from within their EHR. Yet another thing to add to their 5+ hours a day in the system! Let’s hope that in staying away from certification, they are more successful than predecessors like the long-expired Happtique and the little-noticed but still in business Xcertia [TTA 6 Dec 15Release 

Telemental health startup Lysn working to spread mental health access in Australia. In two years, it has grown to over 265 psychologists and partners with 53 GP clinics, mainly regional and rural. The creator of the service is a Canadian-born surgeon, Dr. Jonathan King, who is 35–and bootstrapped it with his own earnings and house. In The Black

A good coffee break read is an interview with GreatCall’s CEO David Inns outlining their health tech strategy for older adults, including a reboot of Lively Home (without the exclamation point) with Senior Whole Health in Massachusetts for ADL monitoring (set up by Best Buy’s Geek Squad), the predictive analytics part of HealthSense in using connectivity and monitoring to predict falls, depression, and diseases, and back to wearables with smartphones. What is interesting is the stunning claim that they can back up the “soak up 20 percent of the healthcare costs of the population that we’re working with” through these predictive analytics and monitoring by reducing long-term care expenses. (Reminds me of some of the claims we made at Living Independently!) However, if any company has the muscle to make it happen, they do. BTW, not a peep about the retail Assured Living in Best Buy stores we tried to find last year, in vain. Mobihealthnews.

Oxford Medical Simulation is partnering with NHS England to trial its virtual reality training for diabetic emergencies. The pilot is being directed by Health Education England Wessex at the Portsmouth and Southampton Hospitals. Fifty doctors will use Oculus Rift headsets to walk through Oxford’s 100 or so scenarios. Mobihealthnews.

The growth of telehealth is outpacing urgent care and retail clinics, according to FAIR Health. This healthcare nonprofit calculated a 53 percent growth rate for telehealth (defined as virtual visits) between 2016 and 2017. In contrast, urgent care use increased only 15 percent in urban areas but went flat in rural areas. Retail clinic use fell 28 percent in urban areas and with a small 3 percent increase in rural areas. The advantages of telehealth in rural areas (up 29 percent), of course, is not having to drive when you’re sick. For urban residents, the advantage is not having to leave the house. According to their analysis, the top three reasons for telehealth visits were acute respiratory infections, digestive issues and injuries, each representing 13 percent of telehealth diagnoses. Mental health, which led in 2016, dropped to fifth. Healthcare Dive

$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).

Best Buy update: ‘Assured Living’ assuredly up and running. And was this Editor’s in-store experience not typical?

Reader and Opinionator Laurie Orlov wrote this Editor to advise her that Assured Living was most definitely alive and well in Best Buy-land. The Assured Living page presents a variety of services, starting with a personal monitoring service (video) for an older adult that starts with a fairly standard pendant PERS (two way) and also creates an in-home network of motion sensors for doors, windows, and furniture installed by Geek Squad. These sensors send activity to a control panel which tracks activity and wellness patterns (sic!–as we know it’s algorithms and rules in the software). Within about a month, the system will send real-time automated alerts if something is out of the ordinary. The video then promises the usual ‘deeper insights’ into wellness and potential issues with the older person.

What doesn’t sound like QuietCare circa 2006, down to the need for installation, are the Wi-Fi camera in the doorbell and the automated remote door locks, the tie ins with the Mayo Clinic and UnitedHealthcare. 

We both speculated on the motion sensor set as being Lively Home (from GreatCall) –Laurie added possibly Alarm.com’s BeClose, which has supplied Best Buy in the past.

Assured Living is available only in limited markets (not listed) but you can get 10 percent off with AARP! But product packages go up to nearly $189.97 for a one time fee plus $29.99/month, not inclusive of that nifty doorbell camera and remote door locks.

One wonders if the reluctance of older adults to admit they need monitoring and consent to the installation is less than in 2006, when QuietCare’s and ADT’s sales people had difficulty overcoming the reluctance of a person living home on their own to be monitored by their (usually) child. Sometimes a sale would be made, the installer would come, and the installer would be shooed out after second thoughts. The genius of GreatCall was in making technology palatable to this market by assigning it a positive use, such as communicating with friends and direct personal safety, not someone minding her. Right now, the template is 2006 with a tech twist.

Drop in and visit Laurie Orlov on her Website We Like, Aging in Place Technology Watch. (She’s alarmed about chipping people too and frames it as more of a security and a moral issue than this Editor did, who prefers her chips to be chocolate and her cars to be driven by her alone.)

As to this Editor’s ghostly experience buying a TV in store, perhaps I should have invited a Best Buy rep over! Reader, former Marine flyboy, eldercare expert, and full time grandfather John Boden did and got a simple solution to an annoying problem. Read about it in comments on our prior article here.

Can Best Buy have an effective older adult strategy when they can’t sell a TV?

We noted last month that the acquisition of GreatCall by big box retailer Best Buy was the next step in a strategy targeting an older adult market niche, with goods and services promoting digital health and wellness, ‘solving technology problems and addressing key human needs across a range of areas.’ GreatCall will be managed as a separate division because, as their CEO admitted, ‘it is a different business’, presumably continuing to do what they do best–direct marketing. Longer term, what GreatCall was purchased for is to enable what they have touted to investors as “Best Buy 2020 that includes Assured Living, a program aimed at using the mobile web, sensors and other digital or smart-home healthcare technology to help adult children or caregivers remotely check in on the health and safety of aging residents at home.” The acquisition is expected to close this fall.  Digital Commerce 360/Internet Health Management  

But will this strategy, which requires a bit of personal service and problem solving, work in the field? The result of a simple search and transaction for a common electronic product wasn’t a promising predictor. This Editor went to a Best Buy in search of a new TV set to replace her aged and fritzing Panasonic (the kind with a cathode ray tube). It was a rainy Saturday night in Paramus NJ, the kind of night on which only Those Determined To Buy brave the traffic to shop. After a sweep of the aisles looking for that senior-oriented healthcare technology, finding none, she hit the TV displays, adjacent to the laundry dryers.

With space measurements and a tape measure in hand, she looked at smaller TVs. Having already determined that a 28″ would likely be best, but with no 28″ on display, she measured 32″ sets which maybe, maybe could fit the TV spot in the wall unit. Smart? Roku? What do these mean, and do I need them? 720 px? 1080 px?  This went on for about 30-40 minutes. In that time, not one blue-shirted salesperson stopped to assist a willing buyer who just needed a little help. So she went in search of one, finding exactly…none. Other shoppers looking at larger sets? Also non-assisted. After a few more sweeps of the aisles, stopping to marvel at an QLED’s resolution, feeling a bit ghostly and ghosted, she tapped out and left, vowing to buy a Samsung online–anywhere other than Best Buy.

If this can happen with a straight-forward electronic product with a relatively willing buyer…what will happen to a more complex sale with a lower level of understanding? Without a better level of customer service, all the corporate strategy talk will simply…flop.

Oh yes, that live link to Assured Living? It goes to a page that says “We’re sorry, something went wrong.” 

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