TTA’s Spring Debut: CMS’ big telehealth expansion, conferences vaporize to virtual, Cera’s $70M raise, news from RxHealth, TeleDentists; Caravan buys Wellpepper, more

 

 

Did you forget it’s Spring? Your Editor finds a shiny silver tulip in in CMS’ major telehealth expansion versus C-19. We also caught up with Industry News that was largely (but not entirely) free of Virus News. (At this point, Theranos News would be comic relief….) Sadly, the entire spring season of conferences is gone either to virtual or vapor.

(Our Alert is a day late because your Editor’s Fios internet went on the fritz (C-19?) for the second time in 10 days. But it is now fully recovered–we hope!)

Virus-(almost) free news: Cera’s $70m raise, Rx.Health’s RxStitch, remote teledentistry to rescue, Alcuris responds, Caravan buys Wellpepper, and Teladoc’s heavy reading
Further ‘virtualization’ of industry meetings: DHACA Day, HITLAB, NAACOS, HXD, now ATA 2020 (updated) (Cabin fever strikes deep, but there is nowhere to creep…)
CMS clarifies telehealth policy expansion for Medicare in COVID-19 health emergency, including non-HIPAA compliant platforms (US) (BIG news in expanding telehealth)

It’s hard to move beyond the coronavirus talk permeating everything in healthcare to other news, but there is some. American Well’s rename, a Senate look at Project Nightingale, and a $16 million digital health Series A surfaced in the sea of spread and conference cancellations. And there’s more on how telehealth can be very useful in both diagnosis and treatment of the virus–even if the consulting doctor is quarantined or sick.

News roundup: Kompaï debuts, Aging Tech 2020 study, Project Nightingale may sing to the Senate, Amwell, b.well, Lyft’s SDOH, more on telehealth for COVID-19 
Update: healthcare/digital health conferences canceled/postponed due to COVID-19 include SXSW, Naidex, EPIC (updated 13 Mar). (The busiest season for meetings suddenly isn’t)

The only real news this week is around the effects of the coronavirus on the business of healthcare–HIMSS20 and other conferences are casualties–and on population health. The US is funding public health, NIH research, telehealth and more with an additional $8.3bn. Let’s hope that the last weeks of winter and (in US) springing forward on the clocks presage the end of its spread.

$8bn COVID-19 supplemental funding House bill waives telehealth restrictions for Medicare beneficiaries (US) (Passed and now to the Senate)
Breaking News: HIMSS20 canceled; Naidex update; what is the outlook for other major conferences? (updated) (The business effect of COVID-19 hits healthcare. Hard.)

How does one celebrate a Leap Year? Certainly not with a trip to China, as you may not have to go that far to have a coronavirus adventure. But digital health is going to the rescue in several significant ways, including treatment. Symptom checkers are much in the news, not only with COVID-19, but also with K Health’s big raise and Babylon’s profile on Newsnight with @DrMurphy11’s reveal. GGI and Legrand debut their study on digital tech’s potential to deliver more efficient health services. NYC events abound. And if you’re in London, leap to DHACA Day on 18 March! 

Digital health on the front lines of coronavirus checking, treatment, and prevention (What wasn’t around during the SARS and swine flu epidemics may make a big difference)
Symptom checker K Health gains $48 million Series C (NY/Tel Aviv) (A big bet made, and not on Babylon)
Babylon Health fires back at critic @DrMurphy11; Dr. Watkins–and Newsnight–return fire (UK) (Why can’t they just get along? Watch the video and find out.)
A potpourri of upcoming NYC events (HITLAB and Columbia University)
Unleashing the Digital Premium’ for health in the public sector (UK) (Good Governance Institute and Legrand study) 

The consumer DNA/genetics biz is frosty, IBM certainly isn’t feeling the love from 3M, and malware’s worse than rain you have to shovel. VA’s Cerner debut won’t be till the daffodils bloom. But Hollywood tech is helping stroke rehab, and it’s warming up around post-surgery telemedicine usage and physician telehealth use. Plus Yorkshire & Humber AHSN’s back with their Propel accelerator.

News roundup: stroke rehab uses Hollywood technology, 3M sues IBM Watson Health on analytics software misuse, AI-based skin cancer detection apps fail, Dictum’s successful telemed use post-pediatric surgery, malware attacks Boston practice network 
Is the bloom off the consumer DNA business? It’s past time for a Genomic Bill of Rights. (Ancestry, 23andme’s declining fortunes)
100% increase in physician telehealth and virtual care usage in three years: AMA study (Progress in this market, especially for chronic care)
Propel@YH opens again for 2020 accelerator candidates (Yorkshire & Humber AHSN’s 2nd year)
VA running at least one month late on Cerner implementation launch (Not unexpected after last week’s turmoil)

February is here, can Spring be far away? It might be an early one for Mark Bertolini, booted from the board of the company he worked so hard to put together. Ashik Desai of Outcome Health may be looking at a Club Fed ‘vacation’. And James Byrne of the VA got an early furlough from Washington for that Florida holiday. So we can take a Mid-Winter’s nap courtesy of NHS, dream of digital health investments for 2020, and won’t buy into a company paying a $1 million monthly rent.

But do wake up in time for DHACA Day on 18 March! A good reason to be in London….

Considering 2019’s digital health investment picture: leveling off may be a Good Thing (Less froth, more quality)
Outcome Health’s Desai reaches settlement with DOJ, SEC (Another cautionary tale of Young Entrepreneurs Gone Wrong–somewhat like Theranos)
Comings and goings, wins and losses: VA’s revolving door spins again, NHS sleep pods for staff, Aetna’s Bertolini booted, Stanford Med takes over Theranos office

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


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Update: healthcare/digital health conferences canceled/postponed due to COVID-19 include SXSW, Naidex, EPIC (updated 13 Mar).

Your Editor has been offline since Monday to this afternoon (EDT) due to a Fios network outage, not a health outage due to COVID-19. Since last week and the HIMSS20 cancellation, major conference and meeting cancellations and reschedulings are multiplying like fig buttercups in the spring. And yes, WHO has declared it a pandemic as Italy closes down and the US bans travel and even trade from Europe for the next 30 days, but not the UK. (There are additional relief measures including a requested payroll tax reduction, tax deferrals and assistance to small businesses. Many schools and businesses are going remote and long-term care residences, a nexus of infection, are being strongly encouraged to defer non-medically necessary visitors.)

Below are some of the majors and of interest to Readers in the digital health area. Most are the largest conferences with international attendees:

What’s on? The DHACA Day on 18 March at Brown Rudnick in London. Agenda and registration hereUpdates at @DHACA_org.

Additional updates 13 March

Running lists are up at Forbes (including sporting events such as the NBA, Broadway, and every major St Patrick’s Day parade; happily the NY International Auto Show is moved to 28 August) and MedPage Today. Healthcare IT News has a list of government and academic information resources led by the CDC, the WHO, and the NHS. We’ll repeat the NHS pages from our earlier article:

The UK Department of Health and Social Care and Public Health England has provided the following links to coronavirus guidance (hat tip to DOHSC via LinkedIn):

👩‍⚕️ Health: http://bit.ly/37qkWaV
🚂 Transport: http://bit.ly/2HDOFBW
👩‍🎓 Education: http://bit.ly/38KT41O
👨‍💼 Employers: http://bit.ly/2TfwpUT
🏡 Social care: http://bit.ly/2VhBIG9

$8bn COVID-19 supplemental funding House bill waives telehealth restrictions for Medicare beneficiaries (US)

The House of Representatives, which controls appropriations, has passed H.R. 6074, the Coronavirus Preparedness and Response Supplemental Appropriations Act. The bill provides $8.3 billion in new funding that includes a significant telehealth waiver for Medicare. From the bill summary on Congress.gov:

Within the Department of Health and Human Services (HHS), the bill provides FY2020 supplemental appropriations for

the Food and Drug Administration,
the Centers for Diseases Control and Prevention,
the National Institutes of Health, and
the Public Health and Social Services Emergency Fund.

In addition, the bill provides supplemental appropriations for

the Small Business Administration,
the Department of State, and
the U.S. Agency for International Development

The supplemental appropriations are designated as emergency spending, which is exempt from discretionary spending limits.

The programs funded by the bill address issues such as

developing, manufacturing, and procuring vaccines and other medical supplies;
grants for state, local, and tribal public health agencies and organizations;
loans for affected small businesses;
evacuations and emergency preparedness activities at U.S. embassies and other State Department facilities; and
humanitarian assistance and support for health systems in the affected countries.

The bill also allows HHS to temporarily waive certain Medicare restrictions and requirements regarding telehealth services during the coronavirus public health emergency.

Sponsored by retiring Rep. Nita Lowey (D-NY), it was introduced and passed in the House 415-2.

In the text of the bill, the telehealth-pertinent portion permitting CMS to waive restrictions on telehealth for Medicare beneficiaries during this emergency is Division B, Sections 101-102. This cost is estimated at $500 million by The Hill.

The bill went to the Senate yesterday (4 Mar) for final approval. There is already an amendment proposed by Senator Rand Paul (R-KY) to offset the $8 bn of the bill with unobligated, non-health related foreign aid funds (FreedomWorks). Whether this is the ‘offset’ for telehealth that is mentioned in The Hill as under negotiation is not revealed.

The American Telemedicine Association (ATA) approved of the waiver. Ann Mond Johnson, the ATA’s CEO, urged “CMS to implement its waiver authority as soon as possible to ensure health care providers understand any requirements and help speed the deployment of virtual services” and pledged “The ATA and its members will continue to work with federal and state authorities, including HHS and the CDC, to address the COVID-19 outbreak and ensure resources are appropriately deployed for those individuals in need of care and help keep health care workers safe.” ATA press release, Hat tip to Gina Cella for the ATA heads-up

Breaking News: HIMSS20 canceled; Naidex update; what is the outlook for other major conferences? (updated)

UPDATED 5 and 12 March

At 12.25 pm today, according to an email visible on HISTalk, HIMSS has canceled HIMSS20. This cancellation is the first in the 58-year history of the conference.

Quick facts are on HISTalk at the link above, on the HIMSS announcement, and on their FAQs.

The advisory panel recognized that industry understanding of the potential reach of the virus has changed significantly in the last 24 hours, which has made it impossible to accurately assess risk. Additionally, there are concerns about disproportionate risk to the healthcare system given the unique medical profile of Global Conference attendees and the consequences of potentially displacing healthcare workers during a critical time, as well as stressing the local health systems were there to be an adverse event.

Also from the announcement: “HIMSS20 exhibitors and attendees will be contacted with further information regarding booth contracts and registrations. Please contact exhibitors@himss.org for immediate booth concerns.”

The CHIME (College of Healthcare Information Management Executives)/HIMSS CIO Forum symposium on Sunday 8th-Monday 9th is also canceled, per a comment on HISTalk. The only indicator on their website as of now is a large ‘CANCELLED’ on their event list. Later this month is the 5G Executive Forum on 25-26 March in Plano, Texas; is that now being reevaluated?

Neither will be rescheduled for this year. Further chatter on the 3/6 HISTalk centers on what to do with all the promotional items and after-action assessments of losses to marketing and sales. There are companies which center their annual budget and marketing efforts on HIMSS, perhaps not the best ‘eggs in one basket’ strategy, but one that many follow. Hat tip to HISTalk and their ace staff

For our UK and European Readers, Naidex is one of the largest conferences for independent living and healthcare. So far, it is on at Birmingham NEC from 17–18 March, they are taking a long list of precautions based on guidelines set by the WHO and local authorities, but according to their site statement by the event director, it is a fast-moving situation and may change based on those advisories. POSTPONED 10 March–see 12 March update.

Original article follows:

There is a growing list of exhibitor and attendee cancellations for HIMSS20 in Orlando, Florida, starting next Monday the 9th. HIMSS is one of the largest global healthcare conferences, and is a ‘must attend’ for a wide swath of healthcare-related companies, including clinical and monitoring technologies, software from the giants (Microsoft, Cisco) to the startups, hospital systems, payers, telecoms, and all sorts of governmental entities like CMS. (When the opening keynote speaker is President Trump, you know it’s important.)

Health IT website HISTalk, a regular exhibitor at HIMSS, has been tracking the cancellations as of today, doing their own research and following reader leads and public announcements, with a follow up article dated tomorrow. It’s well above 50, with major companies like Humana, Siemens, IBM, and the aforementioned Cisco and Microsoft, on the list. Modern Healthcare has an update.

Based on the comments and HIMSS’ own advisory, HIMSS is accepting cancellations from the CDC’s Level 3 or 4 alert countries, but other cancellations are not being refunded (likely pushed to 2021). Hotels/airlines may not be refundable based upon policies and the clout of travel bookers. Onsite, HIMSS is preparing onsite medical offices for care and screening, as well as promoting the HIMSS elbow bump in lieu of the handshake. It’s regrettable as there are hundreds of staff involved year to year who are responsible for all the planning, marketing, logistics, and security for HIMSS and any conference of this size.

The major reason? Many companies, including healthcare companies, have indefinitely canceled non-essential travel across the board for the next 30 to 60 days as a matter of institutional policy. The large destination conferences taking place March-June are the most affected by this. Consider that for the immunocompromised, attending any large conference is dicey, but COVID-19 is one large red flag.

IBM has canceled Think 2020 in May, which regularly attracts 30,000 attendees to San Francisco. Mobile World Congress Barcelona, the largest in the telecom sector which crosses over to mobile-based healthcare, canceled two weeks before starting on 24 February. The American Physical Society (physics) canceled this week’s conference in Denver the day before it started. The LA Times has a roll call of canceled conferences including Facebook and Google I/O. Others remain on, but monitoring the situation:  the American College of Healthcare Executives Congress on 23 March and EPIC 2020 in Croatia 19-21 March [TTA 16 Jan].

Small, local conferences and meetings are the least affected, so you’re probably safe in London and NYC. The King’s Fund has a full roster of London meetings, including the Digital Health and Care Congress 2020 on 20-21 May. Upcoming are also DHACA Day on 18 March and the NYC meetings listed last week. (Don’t go if you’re sick, steer clear of the inconsiderate, avoid buffets, and wash your hands!)

HISTalk’s 5 March article (scroll down) reports on the findings from the leader of the WHO team which spent two weeks in China studying their COVID-19 response. China is moving patients from their best hospitals to ‘routine care’ to accommodate COVID-19 patients. Children do not seem to become infected or be carriers. The trend in infection there is trending down. Overall, it seems to be a series of global outbreaks, not a global pandemic. And they came away with a fatality rate in China of 1-2 percent, which seems low based on other reports.

Digital health on the front lines of coronavirus checking, treatment and prevention (updated 2 Mar)

Coronavirus (COVID-19), which originated in Wuhan, China and has spread to at least 40 countries and 80,000 victims, with 2,700 fatalities, has been roiling both financial and healthcare markets. The stock price of payers in the US have been hit hard due to an anticipated uptick in illness, but interestingly, Teladoc has been up quite smartly in the past few days. Teladoc reported that one of eight virtual visits in January was due to flu, which isn’t atypical–but half had not used Teladoc before. Analysts do expect that there’s an opportunity for telehealth and telemedicine providers to attract new users due to what this Editor has dubbed ‘conscious contact’–that if you even feel remotely sick, you’re going to turn to a virtual visit.

COVID-19 is not remotely near a pandemic outside of China. The three hallmarks of a pandemic are cross-seasonal outbreaks (so far only in China), cross-geography (done), and most importantly, attacking the well. The fatalities have been among those with compromised immune systems, not among the young and healthy who do get it. It’s alarming, like SARS, because of the origination in animals, and the ease of person-to-person transmission via travel, as the outbreaks in Iran, South Korea, Italy, and on cruise ships visiting Asia have confirmed. In the US, the CDC is reporting that it is not currently spreading in the community, but is preparing for that scenario including containment, and has been since January.

But beyond the virtual visit, there are other areas where digital health is part of dealing with COVID-19:

  • Preventing the spread to the patient’s family members. Avaya has been working in China since January to provide enterprise customers with home agents to prevent the spread of the virus. For hospitals, they have donated equipment to enable remote consultation services and remote visiting video at the hospitals, including observation of isolation wards. They have provided a case study of their work with the Tongxiang Hospital at the Tongxiang Branch of Zhejiang Province People’s Hospital. (Photo at left courtesy of Avaya.) 
  • Another is remote patient monitoring. Sheba Medical Center in Tel Hashomer, Israel, is using Tyto Care to monitor the 12 Israeli returnees from the Diamond Princess cruise ship, who continue to be in isolation. The patients will perform the tests on themselves, especially respiratory tests. Jerusalem Post 
    • Update 2 Mar: A representative from Sheba, the largest hospital system in the Middle East, was kind enough to contact me with additional information on their RPM program for COVID-19. For patients requiring isolation in that stage of treatment, Sheba has implemented a modular ‘field hospital’ setup, similar to what the Israeli (and US) military use, which can be set up in any open area. This isolation is to protect immunosuppressed patients from disease spread in the main hospitals. Telehealth being used in addition to Tyto are the Vici telemedicine robot and the Datos Health app for home treated patients. This Editor believes that both European and US public health systems are looking at the Sheba and Israeli approach.
  • Robots–actually a telehealth cart–are being tested for patient self-testing, much like Tyto Care’s use at Sheba. Robots could also deliver food (although they could also carry germs) and sweep streets.
  • Other monitoring can be done via symptom checkers (Babylon, K, and others). 98point6 released a coronavirus screening chatbot app as early as January, but what they’ve turned up so far is more cases of the flu. STAT
  • Data analytics can pinpoint outbreaks. The Epic, Athenahealth, and Meditech EHRs have released new guidance, testing orders and screening questions (e.g. around travel and contacts) that will help to identify outbreaks.

Update 28 Feb: This Editor would like to know more about UV disinfection being used versus coronavirus for large spaces such as in hospitals and aircraft. If you have information on technologies such as PurpleSun which have been tested against hospital pathogens also being used against coronavirus, please contact Editor Donna.

Healthcare technologies which weren’t around during the SARS and swine flu epidemics may make a big difference in the spread, treatment and mortality rate of COVID-19. Healthcare Dive, HealthTechMagazine

UPDATE 28 FEB

As a service to our Readers, we are providing the following health service update links:

The UK Department of Health and Social Care and Public Health England has provided the following links to coronavirus guidance (hat tip to DOHSC via LinkedIn):

👩‍⚕️ Health: http://bit.ly/37qkWaV
🚂 Transport: http://bit.ly/2HDOFBW
👩‍🎓 Education: http://bit.ly/38KT41O
👨‍💼 Employers: http://bit.ly/2TfwpUT
🏡 Social care: http://bit.ly/2VhBIG9

US Centers for Disease Control (CDC)

World Health Organization (WHO) main website on coronavirus:https://www.who.int/health-topics/coronavirus

Health Canada’s main page: http://ow.ly/bLtF50yfJb7