Short takes: Livongo buys myStrength, Apple Watch cozies with insurers, Lively hears telehealth and $16 million

Livongo gets behaviorally stronger with myStrength. Extending from their base in diabetes and chronic disease management into behavioral health, Livongo made a logical extension with early-stage behavioral health company myStrength. A large percentage of those with chronic conditions are also struggling with a behavioral health issue–Livongo cites 20 percent but in this Editor’s opinion, the estimate is low. Both Livongo and myStrength have been very successful in the payment game, with both companies achieving payment and reimbursement by employers, insurers, health systems, and state/Federal payers. The other factor is that employers and payers want single, integrated platforms for wellness and disease management. Livongo last year bought Retrofit for its weight management program. Competitor Omada Health recently acquired the behavioral health technology of defunct Lantern. MedCityNews, Fortune, Livongo release

Apple Watch wastes no time in partnering with insurers. Or vice versa! Confirming that Apple Watch’s growth strategy hinges heavily on health via its new features are fresh agreements with Aetna/CVS Health and a rumored reach into three Medicare Advantage plans. The Aetna partnership is with an app called Attain, which blends Apple Watch activity tracking data with users’ health history to create personalized programs. The program is limited to about 250,000 slots plus additional slots for employer plans, and will debut this spring. Late last year, United HealthCare announced Apple Watches would be added to existing wellness program called Motion and their Rally platform. Both Aetna and United have tiered payment programs for the watches, with United adding a HSA reward. For Medicare Advantage plans, Apple is rumored that they will subsidize the watch for use as a health tracker and coach. FierceMobileHealthcare 30 Jan (Aetna), 14 Nov 18 (UHC), and 29 Jan (Medicare Advantage).

Lively adds telehealth to hearing assistance. Lively’s mobile-connected, direct to consumer hearing aids are adding more telehealth features such as remote tuning, virtual video consults with an audiologist, and an online hearing assessment/uploading audiogram for assessment. The NYC-based company also announced closing on a $16 million seed/Series A fundraising round led by Declaration Capital with participation from Tiger Management. There are an estimated 35 million Americans with hearing loss in a $10bn annual market. Hearing aids are rapidly adding digital and DTC features–others in the field are Eargo and ReSound. Lively releaseAlleyWatch, Mobihealthnews. (Lively is not to be confused with Lively!, acquired by GreatCall two years ago)

Weapons in the Perpetual Battle of Stalingrad that is diabetes management

A major area for both medicine and for healthcare technology is managing diabetes–Type 1, Type 2 and also pre-diabetes, which is the term used to describe those who are on the path to Type 2 diabetes. Type 1 diabetics, because they have had it for years, usually since youth, have one battle and are fighting that Perpetual Battle of Stalingrad. As this Editor has noted previously, technological tools such as closed-loop systems that combine glucose sensors with insulin pumps take much of the constant monitoring load off the Type 1 person. [TTA 20 Aug, 5 Oct]

But the panel at MedCityNews’ ENGAGE touched on a point that rankles most pre-diabetics and Type 2 diabetics–the lack of empathy both healthcare and most people they know, including family, have for their chronic condition. Many feel personal shame. And digital health ‘solutions’ (a tired term, let’s retire it!–Ed. Donna) either drown the patient in data or send out, as Frank Westermann of Austria’s mySugr said, a lot of negative messaging. Adam Brickman of Omada Health, whose ‘Prevent’ programs are mainly through payers and employers, noted it was a real challenge to get people to change their lifestyle, but also change their state of mind. Their model includes peer support and health coaching, specifically to include that empathy. Home support also makes all ther difference between those who successfully manage their condition and those who don’t, according to Susan Guzman of the Behavioral Diabetes Institute. The approach is certainly not one-size-fits-all.  MedCityNews  In September, Omada received a sizable approval on its approach via a Series C round of $48 million. Current clients include Humana and Costco. Forbes attributes the size of the round to Omada’s approach in tying participant outcomes to over 50 percent of its compensation.

 

Diabetes management: the Next Big Health Tech Thing?

Big Data? Passé. Health IT security and hacking? At a peak. So what’s the Next Big Thing? If you’re tracking where the money’s going, it’s diabetes management. This week saw the joint venture Onduo formed by the controversial [TTA 6 Apr] life sciences-focused Verily (Google Alphabet) and Big Pharma Sanofi with a nest egg of $500 million. Onduo will be combining devices with services to help Type II diabetics. Based upon CEO Joshua Riff’s statements to MedCityNews, their platforms are yet to be developed, but “will be a digital platform that will involve software, hardware, and very importantly service” to change patient behaviors. Partnerships with Sutter Health in Northern California and Allegheny Health Network of western Pennsylvania will test their approaches in a clinical setting. Xconomy, Reuters

Verily’s other diabetes project include the £540 million bioelectronics partnership announced in August with UK-based GSK in Galvani Electronics [TTA 3 Aug] with a focus on inflammatory, metabolic and endocrine disorders, including Type II diabetes. With Dexcom, Verily is also building an inexpensive, smaller next-gen continuous glucose monitoring sensor; Mr Riff was coy about whether this sensor would be used but allowed that sensors might be used in Onduo’s approaches. Verily is also developing the well-known glucose-reading contact lens with Novartis [TTA 1 Sep 15].

Also this week, Glooko and Sweden’s Diasend announced their merger (more…)

‘Separating the wheat from the chaff’ in medical apps daunting: JAMA

Medical apps may not be strangers to doctors’ offices anymore but they also realize that apps are difficult to recommend responsibly to patients or even to find, because there is no real guidance or validation. This current article in JAMA online confirms the perception and the need for care integration that both Editors Charles especially and Donna have pointed out lo these many years. However this Editor is quite disillusioned at the attempts to date to ‘curate’ apps with the Happtique failure and the relatively low profile to date of IMS Health’s AppScript and professional review site iMedical Apps and the stated intentions of SocialWellth which purchased Happtique. The reality is that the numbers are against it–IMS Health in their study estimated 40,000 medical apps–in 2013. For apps that want to take the high road, it’s economically difficult, but could be rewarding in the long term. The WellDoc BlueStar diabetes tracking and management support app did with FDA clearance and prescription-only use, but few so far can see a revenue model there. Also MedCityNews.

Intended use determines degree of health app regulation–and also how you communicate your attributes and performance claims. Bradley Merrill Thompson, who performs an invaluable service by advising our field on regulation, compliance and interacting with FDA, demonstrates how a developer can determine where the intended use of an app might fall (more…)

$3,300 annual savings from diabetes monitoring: study

A study published in this month’s Endocrinology (US) demonstrated a $3,300 per person annual reduction in employee healthcare costs in a trial of the Telcare mHealthmonitoring system in conjunction with ActiveCare data analytics used for an employee diabetes management program (N=143). The amount was the average decrease in 12 month claims between 2011 and 2012 for those who enrolled and used the program, versus those who enrolled but did not use the program demonstrated a $282 per person increase. Telcare press release, TouchEndocrinology.com (abstract/text) Hat tip to Editor Toni

New diabetes telehealth trial in Mississippi (US)

A new telehealth trial for diabetes patients will be recruiting patients in Mississippi this spring. Known [grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/01/ummc_aerial.jpg” thumb_width=”150″ /]as the Diabetes Telehealth Network, the trial is planned to provide a classic telehealth service for up to 200 patients for a period of 18 months.

This trial is a result of a collaboration between several public and private organizations: the Mississippi Governor’s office, University of Mississippi, North Sunflower Medical Center, GE Healthcare, Intel-GE Care Innovations and C Spire.

The recruited trialists will be provided with a broadband connected tablet PC which will have software to enable daily medical measurements to be transmitted to a specialist team at the University of Mississippi Medical Center in Jackson. A press release states that the measurements will include weight, blood pressure, and glucose level and these will be monitored by the clinical staff at (more…)

WellDoc raises $20 million from Merck, others

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/01/BlueStar-promo-image-WD.jpg” thumb_width=”150″ /]WellDoc, developer of a prescribable Type 2 diabetes management smartphone app (BlueStar), announced today a $20 million Series A round from Merck Global Health Innovation Fund and Windham Venture Partners. The interest by Merck is understandable in several ways. Pharma companies are moving beyond the meds into other management models as blockbuster drugs become scarce (those cuts in R&D do hurt down the line), operating costs higher and profitable drugs go off patent. Because it is prescribable, BlueStar is reimbursable by US insurers (not disclosed by WellDoc); it is currently offered as a pharmacy benefit by Ford Motor and major drugstore chain RiteAid. In addition to these, WellDoc has developed strong partnerships (AT&T, Alere) since their founding in 2005 (see below). BlueStar also can be considered a strong fit for a Merck subsidiary, Vree Health.  (more…)