News roundup: CVS-Aetna still on hold, blockchainers Change acquires PokitDoc, Teladoc’s COO resigns under insider cloud, Clapp joins Cricket

Federal Judge Richard Leon of the Washington, DC District Court is taking a consideration break on the integration of CVS and Aetna, after holding it up on 3 December. The Department of Justice (DOJ) originally recommended that the merger was legal under anti-trust law after Aetna divested its prescription drug plan to WellCare and both companies’ settlements with several states. Judge Leon, reviewing under the Tunney Act requirement that the merger meet the public interest, is waiting for the DOJ to respond to further steps that CVS has taken to keep the companies separate. According to Seeking Alpha, CVS will take “constructive measures on pricing and sensitive information” and that an outside monitor would be brought in to monitor the companies commitments. Hartford Courant

Health IT software company Change Healthcare acquired assets of San Mateo-based PokitDoc, a healthcare API and blockchain developer. PokitDoc has developed blockchain transaction networks for EHR and identity verification, automatic adjudication and smart contracts. Its APIs are used by Doctor on Demand, Zipnosis, PillPack, and available on Salesforce Health Cloud. Change’s own blockchain platform was developed in 2017. McKesson owns 70 percent of Change. PokitDoc had funding up to $55 million prior to purchase, the value of which was not disclosed. Mobihealthnews, Health Data Management

Teladoc cut loose its COO/CFO after insider trading and sexual misconduct allegations. Mark Hirschhorn resigned on 17 December from the telemedicine company after being instrumental in the company’s recent revenue and visit growth (albeit with a downward spiral on the share value). Mr. Hirschhorn was alleged to have not only have had a sexual relationship with a (much younger) subordinate while married, but also engaged in mutual insider trading…of Teladoc stock. The steamy details of the affair(s) and an equally seamy tale of a whistleblower’s fate are in the Southern Investigative Reporting Foundation’s ‘The Investigator’. For those more concerned about Teladoc’s financial future, a bullish analysis of their stock value and trends is over at Seeking Alpha. Adding to the fire: a class action lawsuit was also filed against Teladoc on behalf of the company’s shareholders, accusing the company of misleading or false statements. Also Mobihealthnews.

And it’s cheering to announce that a respected long-time telehealth executive has found a new perch. Geoff Clapp has joined Cricket Health, a provider of integrated technology around kidney health, as Chief Product Officer. Geoff is an authentic Grizzled Pioneer, having joined early telehealth RPM company HealthHero back in 1998, then their acquirer Bosch Healthcare. He was also founder of Better, which partnered with the Mayo Clinic on providing virtual care coordinators at popular prices for both consumers and health systems. Since then he has consulted for companies as diverse as Telcare (diabetes), Oration (sold to just-acquired PokitDoc), and in venture capital. Congratulations–and happy new year in the new job! Release

Ileana Welte

– Many readers will be deeply saddened to know that Ileana Welte died of a heart attack last Wednesday whilst travelling on the Tube in London.

Many will know her from her long time working in Bosch in the UK, where she was particularly associated with the NHS Direct telehealth service, and more recently her management of the UK side of Big White Wall where she was doing a brilliant job driving the uptake of digital health in the NHS to help treat people with mental health problems.

She will be very sorely missed; her untimely death has come as a huge shock to many.

We will shortly be publishing a larger article with contributions from Bosch, Big White Wall and from ex NHS Direct colleagues – other contributions will be gratefully received. We will also publish news of her funeral/memorial services when received.

 

Bosch, Remedy’s Health Buddy Web debuts at CES

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/01/Health-Buddy-Web-Image.jpg” thumb_width=”200″ /]Bosch Healthcare’s partnership with Remedy Health Media for a web-based version of Health Buddy for telehealth premiered today at International CES. It will be available on desktop, smartphone and tablet. The format seems to combine both the monitoring aspect of the hub-based Health Buddy with extras such as  an integrated reminder system, patient engagement and behavior modification tools such as brain games to improve memory and cognition, and patient educational content. The countries it will be available in were not disclosed. While Bosch has vigorously maintained that the Health Buddy hub will continue to be supported [TTA 24 Sept], Editors Charles and Donna have maintained that it will be relegated sooner, rather than later, to a secondary product line. Release.

Bosch Update (UK)

Further to our previous post on the topic, we have now heard from Bill Broderick, Acting Divisional Head of Bosch Healthcare in the UK, clarifying Bosch’s position re the UK market:

1. Bosch Healthcare is not exiting the UK market. Telecare is business as usual and we will continue to sell our entire line of telecare products in the foreseeable future. We have placed all new telehealth activities on hold for now as we spend the next few months re-evaluating the business strategy based on current market dynamics in the UK.

2. We are not exiting the Health Buddy device business. We will continue to offer Health Buddys to patients who need them. The Remedy partnership press release announced an expansion of our patient interface portfolio to more mobile and internet-based solutions, not a replacement of existing Health Buddy devices.

Bosch to can Health Buddy, withdraw from telehealth in UK – temporarily?

On September 6th, Bosch announced a tie up with Remedy Health Media  [TTA 10 Sep] “to launch remote patient monitoring products designed for tablets and smartphones”, which suggested that it would not be long before they stopped selling their purpose-built telehealth hardware.

Now TTA has heard from a reliable source that they are telling their customer organisations that they are going to withdraw (more…)

How startups are being damaged by patent trolls–and turning the tables

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2013/09/TROLLS-1992-008.jpg” thumb_width=”150″ /]In February and for a few months, this Editor was on a tear about the quaintly dubbed patent trolls–primarily (but not always) non-practicing entities (NPEs) which don’t create or market products, but buy up other people’s/companies’ patents and then seek out opportunities to license them. These NPEs target and challenge vulnerable startups and early-stage companies to defend their patents and systems; the suit for royalties, the financial threat, the papers filed, the attorneys called, the money spent and the eventual settlement (or licensing) is in reality just a form of what’s called in Latin America la mordida. It becomes cheaper to settle than to fight–and the cost can be six or seven figures. 

The shots over the bow were in 2012: Bosch’s February lawsuits against Waldo Health, ExpressMD/Authentidate and MedApps (now Alere Connect) [TTA 16 Feb 2012] and then the strange practice of PHR developer/patent accumulator MMRGlobal [TTA 23 Oct 2012] in sending hundreds, perhaps thousands, of letters out to EHR/EMR users to advise them of possible patent violations and demanding licensing. This Editor observed then and during the spring this year that it was only a matter of time that NPEs would pounce on healthcare tech as investment action accelerated. Yet discussions by this Editor with companies in some public venues indicated a certain level of obliviousness to the threat–that there were not enough assets to go after, thus healthcare startups made poor targets–though side conversations with IP specialist attorneys indicated otherwise.

Well, the trolls have reared their fuzzy heads again, uglier than ever, in this drama-laced article in Wired. (more…)

Doro 2.0 smartphone QSs with Withings (EU)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2013/09/Doro-Liberto-810.jpg” thumb_width=”100″ /]Doro’s unveiling of their second smartphone, the Doro Liberto 810,  along with its ‘privileged access’ to two Withings devices–the Smart Body Analyzer (weight, body fat, heart rate) and Pulse Smart Activity Tracker–continues their moves into older adult-appealing mobile telecare/telehealth offerings, as tracked by founding Editor Steve since at least 2009.  Doro’s assertive move into Quantified Selfing as part of what they call ‘the world’s most liberating smartphone’, is more fully featured and was predicted by David Doherty earlier this year [TTA 25 Feb]. It is also not Doro’s first big alliance; late last year, Bosch Healthcare announced that Doro would be the mobile platform for telecare offerings in Germany and Sweden [TTA 16 Nov 2012]. Both the release and Mobihealthnews indicate that this offering will roll out to select European markets initially, but the latter states that a similar offering will debut in the US by early 2014. (For US readers, Doro is equivalent to GreatCall’s Jitterbug line) According to Mobile, the Liberto will be available in the UK in October.

Engaging patients from the top down

Neil Versel’s first major national magazine story just appeared in US News & World Report on the always engaging topic of…patient engagement. He explains to a general audience how healthcare reform might not change individuals’ behavior right away, but surely it is changing providers’ behaviors in relating to and engaging their patients. It covers EHRs, PHRs, online communications, aging in place, social networking and even doctors speaking with patients in understandable language. Well, Neil certainly does get it….it’s a clear article which we hope will be one of many written by Neil for a general audience. He is also speaking Tuesday at ATA’s Fall Forum in Toronto. Helping Patients Stay Engaged in their Own Care

Engaging patients (sideways?) is a new partnership announced by Bosch Healthcare and New York-based Remedy Health Media to add web-based solutions to its current health management programs delivered through their Health Buddy and T400 devices. The release and coverage (Mass Device, mHealth News)  implies that monitoring will part of the patient engagement with “a suite of innovative web-based products for remote patient monitoring” available later this year. Does it mean that the hubs are on their way to the scrapheap? Hat tip to reader Bob Pyke.

Conflicting telehealth signals – is the VA or E Riding of Yorkshire CCG on the money?

Can there be two greater contrasts than the recent decisions by the Dept of Veteran Affairs in the US (VA) to award a five year $28.8m telehealth contract to AMC Health and that of the E Riding of Yorkshire CCG to “axe” its telehealth service?

The sheer size of the VA deal makes every recent deal in Europe seem very small in comparison. AMC’s CEO said: “AMC Health’s outcomes-based approach to telehealth and ability to actively engage patients to proactively self-manage their chronic conditions perfectly aligns (more…)

Well someone thinks telehealth is good news!

Medtronic has just announced a $200m takeover of Cardiocom, the telehealth device maker.  If you can get through the paywall, the WSJ article is here (updated link not paywalled–Ed. Donna)FierceMedical quotes Medtronic as saying that “At-home monitoring is a proven method of reducing the rates of hospital readmission…and that translates to savings for payers, providers and governments.” First area of joint working is expected to be heart failure. Recent US regulations on Medicare, and increasingly insurance payers, penalize hospitals for 30-day same-cause repeat admissions. Medtronic press release.

Editor Donna: The announcement of Medtronic’s (#4 in worldwide revenue) acquisition of Cardiocom (both Minnesota-based companies) created quite a stir in the US as Medtronic is a ‘traditional medical device’ company best known for its implantables: cardiac shunts, stents, heart valves, pacemakers, insulin pumps and interestingly, a wide range of neurostimulators for different conditions. Now with the acquisition of Cardiocom, Medtronic moves into the post-implant/post-discharge/post-diagnosis chronic condition management continuum– not only into telehealth via Cardiocom’s devices and hubs, but also their clinical and care management systems. $200 million in cold cash is a fair bet even though Medtronic’s market cap is north of $55 billion. Medtronic has to see the opportunity to make a bottom line difference to providers and payers. It is also reacting to a narrowing in its profitable core market–medical devices are now taxed, there have been recent product defect-related ‘scandals’ tarring the industry, and there is pressure to reduce pricey device costs to fit a cost-constrained environment, driven by the new healthcare ‘scheme’ (in both the British and American English senses!) Forbes‘ David Shaywitz has a smart take on it today (though he won’t hold his breath for the pharmas to follow), as well as VC TripleTree’s Chris Hoffman ‘connecting the dots’ and coming up with what we’ve been talking about for some time–integration making sense. It is also most definitely a shot over the bow for major competitors such as Alere, Bosch and Philips plus a raft of smaller companies which have been working with a scattering of hospital discharge areas, integrated delivery systems, ACOs and home health agencies, looking nervously over their shoulder–and other leading medical device companies such as Stryker, BD, Baxter and yes….GE. (Bosch also sued Cardiocom on patent infringement this time last year [TTA 7 Aug 2012]; presumably as this suit was not announced as settled or decided, Bosch is now dealing with a company its own size!)

It also should be noted that Medtronic’s CEO, Omar Ishrak, is well acquainted with home health. Mr. Ishrak was formerly the CEO and president of GE Healthcare through mid-2011–and the driver behind making what was an ultimately failed bet in getting GEHC into home health. That was in 2008-9 with a tiny company called Living Independently Group, developer of a telecare system called QuietCare, which ultimately went to the Care Innovations JV with Intel. (Disclosure: I was head of marketing at the time of the acquisition.) Like GEHC, Medtronic is acquiring a closely-held company in a very different line of business with drivers quite unlike its own; they are retaining the former CEO as a general manager of the division but whether other management or the brand name will survive is not disclosed.

Whilst on the subject of telehealth devices, Heartwire reports a meta-analysis of 52 studies that shows that just measuring your blood pressure regularly results in a significant reduction in both systolic and diastolic levels after six months. Sadly the paper itself in the latest issue of the Annals of Internal Medicine is behind a paywall so it’s not possible to try to understand how the final comment in the synopsis of the paper on the Annals website that: “Additional support enhances the BP-lowering effect.” fits with the comment in Heartwire that “Low-strength” evidence from 13 studies comparing self-monitoring plus additional support vs self-monitoring alone “failed to support a difference” between the two strategies.”

Meanwhile back in the UK, Medvivo has become the first company to be accredited to the telehealth elements of the TSA’s Integrated Code of Practice. Sadly the TSA website will only release the Code to members (TTA isn’t one) or those aspiring to achieve accreditation (TTA fails on that one too) so it’s not possible to make meaningful comment. However the prospect of a Battle of the Codes is looking up with word from Malcolm Fisk that the final version of the European Code of Practice for Telehealth Services will be available for all to read and download on the TeleSCoPE website within a month. There has been talk of a third code being developed too…

Doro launches mobile telecare phone (EU)

Doro has revealed its latest handset – the Doro Secure 681.” According to an item in Mobile Magazine, the phone will launch in the second quarter of this year and is “aimed at people who currently rely on the support of a fixed-line telecare services, allowing them greater mobility outside the home.” The 681 is said to be the first mobile phone to feature an embedded ‘class one’ telecare radio receiver that is compatible with Doro’s wearable wrist, neck and fall sensors. Alerts can be sent to monitoring services via the internet or SMS. To this editor, if the photo in the above item is to be believed, the clamshell design and screen/keyboard layout is going to be too complicated for many people in the target market. It also looks like big-boy Doro has been learning a few lessons about the need to check and report battery charge levels automatically from UK small-guy Carephone. However Doro will have the advantage of being part of Bosch’s offering to the public. It will be interesting to see which gets traction with the public first, the Doro/Bosch combination or O2’s Health at Hand.