News roundup: with chronic conditions peaking, Twin Health’s metabolic AI gains $50M, Talkspace and Evernow partner for women’s mental health

December 15, 2023 | by

Chronic conditions on the rise, according to United Health Foundation. The non-profit philanthropic arm of UnitedHealth Group released its annual America’s Health Rankings 2023 report. The report considers 87 measures from 28 distinct data sources for 2022. Topline results in their summary are concerning. 

  • Eight chronic conditions reached their highest level in AHR’s tracking history: arthritis, depression, diabetes, asthma, cancer, cardiovascular diseases (CVDs), chronic obstructive pulmonary disease (COPD),  and chronic kidney disease (CKD).
  • 29.3 million adults, or 11.2% of the population, reported having three or more chronic conditions.
  • During 2021 and 2022, depression rates grew to 21.7% or 54.2 million people. Diabetes incidence rose to 11.5% or 31.9 million adults.
  • Disparities are pronounced between demographic groups. From the overview:
    • Hispanic adults were 2.1 times and black adults were 1.8 times more likely, respectively, to have uncontrolled A1C compared to multiracial adults.
    • In 2013-2016, asthma-related emergency room visits were 2.5 times higher among black compared with white adults with asthma.
    • White adults with hypertension were 1.5 times more likely to have their blood pressure “controlled” compared to black adults with hypertension.
  • Premature death increased 9% between 2020 and 2021: drug deaths increased 15%, firearm deaths 7%, and homicide increased 33%.

The report also ranked the healthiest states as New Hampshire, Massachusetts, Vermont, Connecticut, and Minnesota. Bottom-ranked: Louisiana, Mississippi, Arkansas, Oklahoma, and Alabama. The annual report includes sub-reports focusing on the health of women and children, mental and behavioral health, seniors, and Covid-19. FierceHealthcare

Twin Health’s AI approach to Type 2 diabetes as a metabolic disease gains a $50 million Series D. This late-year raise in a difficult funding market was led by Temasek with participation from existing investors ICONIQ Growth, Sofina, Peak XV, and Helena, adding to their October 2021 $140 million Series C. Twin Health’s main platform is the Whole Body Digital Twin which models an individual’s metabolism from data points collected daily via wearable sensors, clinical lab parameters, and self-reported preferences. The concept of a ‘digital twin’ to guide both the patient and the care team is a relatively new one, created on an app available to both the patient and their Twin Health licensed clinical care team. Their method is to provide individualized guidance on nutrition, sleep, stress, and activities to heal the metabolism and root causes of diabetes, intending to reverse Type 2 diabetes metrics and medication use within six months. Financially, they also have an attractive model–full risk with employers and health plans, being paid when their employees and members get results. According to their founder and CEO Jahangir Mohammed to Axios, “Twin is currently conducting two randomized controlled trials — one in India and one in the U.S. — analyzing whether people using its approach can successfully enter diabetes remission or “reversal.”  Mobihealthnews, Twin Health release

Addressing both mental and women’s health is an interesting partnership between Talkspace and Evernow. Evernow, which focuses on telemedicine treatment for women 40+ during perimenopause and menopause, is partnering with Talkspace to address mental health issues that are prevalent at that time. Evernorth’s survey using their records of over 100,000 patients found that 61.4% of women surveyed reported feeling symptoms of anxiety and/or depression.

  • Evernow members in multi-month plans will gain free access to Talkspace’s mental health resources in their self-guided program that has 400 self-guided therapy sessions plus on-demand workshops and classes. Virtual therapy offered by Talkspace has a $100 discount.
  • Talkspace members also have discounted access to Evernow programs, with a three-month plan for $129 or a 12-month plan for $348.
  • They are also bundling their programs together for enterprises and employers.

Evernow is also moving into AI capabilities through the Early Access Partnership with Hippocratic AI, a generative AI company developing safety-focused large language models for healthcare. Talkspace recently won a $26 million three-year contract with New York City’s Department of Health and Mental Hygiene for NYC Teenspace, a free therapy program for those aged 13 to 17. Release, Mobihealthnews, MedCityNews

Suddenly hot: chronic condition management in telehealth initiatives at University of Virginia and Doctor on Demand

February 28, 2019 | by

Chronic condition monitoring is suddenly hot. UVA has been a telehealth pioneer going back to the early oughts, with smart homes, sensor based monitoring, and remote patient monitoring. Their latest initiatives through the UVA Health System focus on preventing or managing chronic conditions. It will include remote monitoring for patients with diabetes, screenings for patients with diabetic retinopathy, home-based cardiac rehabilitation programs for heart failure patients and streamlined access by primary care physicians to specialists through electronic based consults. The program will also include specialized trainings for health care providers.

The programs are being funded by a $750,000 grant from the federal Centers for Disease Control and Prevention (CDC) and the Virginia Department of Health. UVA press release, Mobihealthnews

Mobihealthnews earlier noted that Doctor on Demand, a smaller commercial telehealth company, is also expanding in the management of chronic conditions through a new service, Synapse, that creates a digital medical home for personal data. This data can include everything from what is generated by fitness trackers to blood pressure monitors. The data can be directly shared with a provider or across health information exchanges and EMRs. Doctor on Demand plans to use this longitudinal data to identify gaps in care and increase access to healthcare services–and also integrate it into existing payer and employer networks.

This Editor recalls that this was a starting point for telehealth and remote patient monitoring as far back as 2003, but somehow got lost in the whiz-bang gadget, Quantified Self, and tablets for everything fog. Back to where we started, but with many more tools and a larger framework.

Docs tickling the computer keys a turnoff to patients: JAMA

December 2, 2015 | by | 5 Comments

Health tech as perceptual barrier. A study published Monday in JAMA Internal Medicine-Online First (limited content) found that patients were noticeably less satisfied their care when the physician used the computer (e.g. EHR) during the appointment. According to Reuters, only half of the 25 visits with high computer use were rated as “excellent care” by the patients, compared to more than 80 percent of the 19 encounters with low computer use. iHealthBeat cited that physicians who spent more time on the screen:

  • Spent less time making eye contact with patients
  • Tended to do more “negative rapport building,” such as correcting patients about their medical history or drugs taken in the past based on information in their EHR.

The researchers (primarily from the University of California–San Francisco) used data from two years of visits by 47 patients to 39 doctors at a public hospital. The patients had Type 2 diabetes, rheumatoid arthritis or congestive heart failure, with some having multiple chronic conditions. What is downplayed is that the patients were considered ‘safety net’ patients with communication barriers–limited health literacy and often limited English (primary Spanish speakers). But even this special population may be pointing to an overall problem (more…)

165,000 apps, 3 bn downloads and counting: global mHealth apps study

November 25, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/11/mHealth-Developer-Economics-2015.jpg” thumb_width=”200″ /]The results of the fifth annual mHealth App Economics survey are out. Our Readers were invited to participate back in March when it was sponsored by German research firm research2guidance in collaboration with mHealth Summit Europe and HIMSS and kicked off at the Riga meeting in May.

Major apps stores reported more than 165,000 mHealth apps published by 45,000 companies, and projected 3 billion downloads by close of 2015.  Some other key findings from R2G do surprise:

  • The target for apps is DTC–chronically ill patients–with their hospitals as #2. Physicians are important, but less so than last year’s survey.
  • App publishers aims appear altruistic. 53 percent of mHealth publishers claim that their main motivation is to help people improve their medical conditions. However, 60 percent aren’t reaching their goals yet mainly due to low reach. The vast majority of apps (62 percent) mark up less than 5,000 annual downloads. (See the chart below for some possible reasons why)
  • Diagnostic apps lead in anticipated business potential until 2020. And app publishers have added medical professionals to their team.
  • What app publishers find works to change behavior is not gamification. What does: integration of provider feedback or dialogue.
  • Yet providers, such as doctors and nurses, are seen as the most threatened group by mHealth solutions.
  • A scant 3 percent of mHealth publishers generate more than $1 million–and they are far more focused on sales and brand awareness than their brethren which make little. (chart)

(more…)

Drive to ACOs and value-based care may make 2016 The Year of Telehealth (US)

November 6, 2015 | by

An encouraging prediction? Two Foley & Lardner attorneys with evidently a great interest in healthcare predict that 2016 may very well be The Year of Telehealth. Why? They cite accountable care organizations (ACOs) and the coordinated care at the heart of their model as a protected activity under the Medicare fraud and abuse waivers. “Coordinating care, such as through the use of telehealth, remote patient monitoring, and other enabling technologies”is “an activity reasonably related to the purposes of the Medicare Shared Savings Program and therefore is eligible for protection under one or more of the fraud and abuse waivers”. National Law Review, mHealth News. While from the legal point of view this may be significant, there’s been a concatenation of other factors.

What are the drivers for telemedicine and telehealth in ACOs? In the Medicare Shared Savings Program (MSSP), which is one model, ACOs must leverage savings, and perhaps the largest is avoiding unnecessary hospitalization costs among ‘high-risk’ patients–those with chronic disease–and usually more than one. They are also over half of high ER/ED utilizers. The Federal agency behind Medicare, the Centers for Medicare and Medicaid Services (CMS) has since 2011 been signing up ACOs in risk and value-based payment models that offer incentives such as shared savings. In 2014, only 28 percent of ACOs in the MSSP program earned shared savings bonuses. (more…)

Patient groups most likely to use mobile phones for health: study

October 30, 2013 | by | 4 Comments

A new Manhattan Research study, which starts off rather pedestrian, contains a surprise. The trend of increased used of smartphones for health is not it, as it follows online use: 95 million Americans now use their mobile phones for health information or tools, up 27 percent from 75 million a year ago, and the Cybercitizen Health US 2013 study of over 8,600 Americans found that 38 percent of online smartphone users consider it “essential”. What sets the study apart from the usual enumeration and semi-puffery is the discovery of which patient groups find smartphones most useful and are most likely to use their phones for health reasons. It is closely linked to medical chronic conditions, but not the ones you think. (more…)

Medivizor patient info site goes public with additional information

August 24, 2013 | by

Medivizor, which was one of the better discoveries of our CE Week (NYC) coverage and the H20NYC/Healthcare Pioneers evening back in July [TTA 3 July], has moved out of what was a largely private beta to what they interestingly term a ‘public beta’. The site provides individualized content, understandable by the layman, for subscribers on a larger group of diseases which were on track for this fall: lung, colorectal, breast, and prostate cancer, as well as melanoma, diabetes, coronary artery disease, hypertension and stroke. The goal is to improve doctor-patient communications by better patient education. Another important feature is a “personalized system for matching individuals with specific clinical trials available worldwide.” Company release, Xconomy article.

A related New York Times article is an appreciation of how physicians are overwhelmed by information and that “doctors also need a skilled docent to help walk them through all that curated data.”  Healing the Overwhelmed Physician