TTA’s week: pop health en español, ATA’s choice, VA’s Cerner, de-retailing healthcare, more

August 16, 2017 | by | No Comments

Will the doctor’s office go the way of the retail store, even in NJ? Can we improve population health through telephone call centers? Will the UK get its mojo back in digital health innovation? Can the VA implement Cerner by 2019? And will ATA appoint a new CEO before then?

Only two weeks to go to Connected Health Summit 2017 in San Diego–save 20%. See below.

Beyond crowdfunding–startup funding through blockchain cryptocurrency, smart contracts (The Next Big Funding Thing?)
Commonwealth Fund case study on Spanish-speaking telemedicine services (MX, PH, US) (Population health south–and north–of the border)
Tender Alert: Torbay and South Devon NHS Foundation Trust for TECS (Looking for innovative telehealth)
VA’s Shulkin: Cerner rollout start by mid-2019? (The decision was a relief)
Innovate UK’s £35m Digital Health Technology Catalyst competition opens–apply now! (Another opportunity in UK healthcare)
Weekend Big Read: will telemedicine do to retail healthcare what Amazon did to retail? (Except there’s regulation…)
Tender Alerts: NHS Wales, Southend-on-Sea (More for innovative companies in UK)
Analyses of New Jersey’s new telemedicine regulations (Not quite parity, but a forward leap)
Some reflections on ATA and a future CEO–your ‘nominations’ wanted! (Name that CEO!)

Winners and losers…VA implements more telehealth, Israel gets its first aging services venture fund. Charterhouse loses equity in Tunstall, ATA’s Linkous leaves, Siemens delays the Healthineers and Theranos plays for time.

VA unveils several ‘anywhere’ new telehealth services for veterans (VA tech moves fast under Dr. Shulkin)
First aging services tech investment fund debuts in Israel (3rd Age tech)
Change at the top at ATA: CEO Jon Linkous departs after 24 years (Didn’t give notice either)
Charterhouse lost half its equity in Tunstall debt refinancing–Sunday Times report (updated) (Not unexpected)
Siemens plans IPO of Healthineers during 2018, possibly in US: reports (Expectations delayed)
The Theranos Story, ch. 44: Walgreens settles lawsuit, cash box empties further (The spiral to Flat Brokedom continues)

It’s an IoT Black Hat hackfest, Facebook bots learn argot, AI is debated after a fashion by ‘giants’, and Tunstall gets a partner that opens doors.

It’s all hackable by Black Hats: pacemakers, Amazon Echo, trains, heart monitors, prison cells! (Increasingly easy pickings)
AI good, AI bad (part 2): the Facebook bot dialect scare (Not all that…)
AI good, AI bad. Perhaps a little of both? (Top six effects) 
Tunstall pairing with Inhealthcare digital health for NHS remote monitoring (A shot of digital high-octane for the Big T?)

Connected Health Summit: Engaging Consumers analyzes the roles of connected health technologies and innovations in driving changes in consumer behaviors and business models. Now in its fourth year in beautiful San Diego, this event is focused on data-driven, human-centric patient experience and engagement. Keynoters include executives from Aetna, UnitedHealth, ShareCare and Geisinger. Readers save 20 percent! For more information, click on the advert or here.

Confirming football CTE, thinking ‘digital therapeutics’. Glass reboots, Fitbit and social robotics back up, TSA changes guard. Mindful (or mind your?) drinking, and catch up with The King’s Fund.

CTE found in 99% of former, deceased NFL players’ brains: JAMA study (News in both health and sports sections)
Shouldn’t we be concentrating on digital therapeutics rather than ‘health apps’? (A different look at the future of digital health)
The King’s Fund 2017 Digital Health Congress: videos, presentations now posted (Catch up!)
Fitbit’s smartwatch on track; Intel exits the game (Were they ever in?)
Can Google Glass’ enterprise iteration solve the patient documentation crisis? (Hands off help for hands-on workers)
Toyota’s $14 million bet on Intuition Robotics’ social companion robot (JP/IL/US) (ElliQ’s growing up)
Come along to London’s first mindful drinking festival! (Hic!)
TSA appoints new chair (Paul Shead takes the helm)

Recent articles of continued interest….

Creepy data mining on medical conditions run wild: where’s the privacy? (Ethically dubious practices)
UDG Healthcare buys American, adds Vynamic, Cambridge BioMarketing for up to $67 million (Acquisition trend for healthcare consultancies and marketing)
“Crazy”: StartUp Health’s 2nd Q digital health funding breaks record (Another round of champs and roses! Can it last?)

‘Record-shattering’ Q2 for digital health deals: Rock Health’s volte-face (Suddenly it’s wine and roses!)
Conference & Tender Alert: Perth & Kinross TEC event, Flintshire (Wales) tender (UK) (TEC event Sept 26, tender Aug 4)
‘Let me die at home’. The human and financial cost of ending telehealth (Cornwall UK) (A familiar, no less wrenching story to those who’ve worked in telehealth–the books don’t balance)

The Nightingale-H2020 project for wireless acute care (UK/EU) (Major initiative, get on it before tender)

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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Shouldn’t we be concentrating on digital therapeutics rather than ‘health apps’?

July 26, 2017 | by | No Comments

Where the money and attention are going. The first generation of Quantified Self apps was all about viewing your data and storing it online in a vault or graphs…somewhere, usually proprietary. Your Pebble, Fitbit, or Jawbone tracked, you crunched the numbers and found the meaning. At the same time, there are wellness companies like Welltok, ShapeUp, Keas, Virgin HealthMiles, and RedBrick Health, usually working with companies or insurers, that use various methods (money, gamification, other rewards) to influence lifestyle and improve a person’s health in a quantified, verifiable, but general way. What’s happened? There are now apps that combine both data and behavior change, focusing on a specific but important (again) condition, coach to change behavior and verify results rigorously through clinical trials. Some, like Omada Health, prove through those clinical trials that their program successfully changes pre-diabetic indicators, such as weight loss, decrease cholesterol and improved glucose control–without medication. This results in big savings for insurance companies, one reason why a $50 million Series C was led by Cigna. Another model is to work with pharmaceutical companies to better guide treatment. Propeller Health with its asthma/COPD inhaler tracker is partnering with pharma GlaxoSmithKline on a digital platform to better manage lung patient usage, and surely this will go through a clinical trial. We will be seeing more of this type of convergence in medical apps. (The rebooted Jawbone Health Hub is moving in this exact direction.) The Forbes article, while short, is written by someone who knows the business of apps– the co-founder of the AppNext distribution/monetization platform. He does achieve his aim in making us think differently about the potential of ‘health apps’. 

Fitbit’s smartwatch on track; Intel exits the game

July 25, 2017 | by | No Comments

click to enlargeFitbit’s ‘Project Higgs’ in-house designed smartwatch is, by all reports, on schedule to hit the market later this year in time for the holidays, at least in Wall Street’s expectations. To the FT (may be paywalled) CEO James Park reassured, “The product is on track to meet our expectations and the expectations that we’ve set for investors. It’s going to be, in my opinion, our best product yet.” It will be waterproof, a battery that lasts several days, have mobile payment capability (from the Coin acquisition), simple health tracking,  heart rate monitor, sleep tracking, stream music (Spotify and Pandora are rumored), and its own app store. It will be either Wi-Fi or smartphone connected. TechRadar’s agglomeration of rumors include pricing ($199 to $299 –about £231), swappable bands, a full-color screen with 1,000 nits of brightness, an aluminum body and built-in GPS. The most interesting part is the proprietary operating system which uses Javascript. Also Pocket-Lint articles 18 July and 19 July. 

Intel, however, is giving up the smartwatch and fitness tracking chase. In 2014 they acquired Basis in a well-publicized move and enlisted hip celebrities like 50 Cent to endorse their products versus the likes of Apple and Fitbit. In November about 80 percent of the group was let go, according to CNBC, and entirely eliminated this month. The New Technologies Group is now focusing on augmented reality. CNBC

‘Record-shattering’ Q2 for digital health deals: Rock Health’s volte-face

July 11, 2017 | by | No Comments

In a pirouette worthy of Nureyev in his prime, Rock Health’s latest Digital Health Funding review for Q2 and the first half of 2017 bangs the drum loudly. With $3.5 bn invested in 188 digital health companies, it’s a record in their tracking. (∗See below for their parameters, which focus on larger fundings and omit others by type.) Q2 reversed the muddling results of Q1 [TTA 11 April] and then some. If the torrid pace is maintained and the market doesn’t take a pratfall, this year will easily surpass 2016’s full year venture funding at $4.3 bn and 304 investments.

Looking at trends, the average deal size has ballooned to $18.7 million from the 2015-16 range of $14 million. Seven $100 million+ deals led the way: Outcome Health, Peloton, Modernizing Medicine, PatientPoint, Alignment Healthcare, PatientsLikeMe, and ShareCare. Of these, three are consumer health information (Outcome, PatientPoint, ShareCare), with PatientsLikeMe closely related with a patient community focus; as the lead category of investment overall, there’s now gold in consumer health. All seven businesses are located outside of Silicon Valley, a refreshing change. A surprise is Modernizing Medicine in the settled (we thought) EHR-clinical workflow category. There’s also an interesting analysis of the shift in top categories from last year to this, which takes out the $100 million+ deals (click to enlarge): click to enlarge

Other changes from the usual: no IPOs and a slowing pace of M&A: 58 this year versus first half 2016’s 87 and full year 146. Their public company index is brighter, with positive gains in first half led by Teladoc (up 110 percent YTD), Care.com (up 80 percent), and consulting favorite Evolent Health (up 70 percent–with United Healthcare’s acquisition of The Advisory Board’s healthcare practice, can an acquisition be far away?). Remaining in the doldrums are NantHealth, Fitbit, and Castlight Health. Rock Health Digital Funding Review First Half 2017

Soon up will be StartUp Health’s first half analysis, which takes a different cut at the companies and looks at the balance of deals by funding series.

∗ 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; healthcare services companies (Oscar), biotech/diagnostic companies (GRAIL), and software companies not solely focused on healthcare (Zenefits), but include fitness companies like Peloton. 

Jawbone finally T-bones, founder starts Jawbone Health Hub (updated)

July 7, 2017 | by | No Comments

click to enlargeConfirming the decline of the fitness tracker/wearables business, Jawbone is finally over and done. Their liquidation this week was initially reported by The Information (subscription only) and that co-founder/CEO Hosain Rahman has started a new company, Jawbone Health Hub. JHH will work on medical software and hardware, as well as eventually servicing the buggy existing Jawbone products† which were sold off to a third party last September. JHH is also reportedly hiring many former Jawbone staff and on job boards such as Glassdoor. 

Jawbone’s demise comes after a troubled 18 months, starting with a $165 million private equity raise in January 2016 led by the Kuwait Investment Authority, rumors of financial problems, repositioning into clinical medical monitoring, and abandoning what was left of consumer market support. There is also the continuing saga of court actions with Fitbit over trade secrets, employee poachings, and IP–all additional reasons for the founder to walk away. The only value left in Jawbone is that IP which includes BodyMedia patents and anything left that wasn’t voided by a court. Fitbit shares are also sinking, currently trading at a near 52-week low of just above $5.

‘Death by overfunding’? Updated During its lifetime from wireless audio speaker innovator Aliphcom to wearables leader with the Jawbone UP, Jawbone raised $938 million (Crunchbase), and at one point was valued at $3 billion. An interesting take from a Reuters article was that one consensus among Silicon Valley tech funders was that the company would have been far easier to acquire had it raised less money. Jawbone ranks only behind solar tech Solyndra among largest failures among venture-backed companies. (The difference, of course, was that Jawbone didn’t take $500 million of public stimulus money, as Solyndra did before it failed.)

The words ‘Chapter 7’ have not been included in reports but Sherwood Partners, a busy Mountain View CA financial restructuring company that has wound down plenty of startups through unicorns, was reported to be in charge of the liquidation process plus any remaining legal actions with Fitbit. None of the usual sources have been able to obtain statements from Mr. Rahman and ‘the information’ remains limited. The Verge, TechCrunch, Business Insider 

†Editor Charles’ struggles with seven personal Jawbone UPs were often typical of the user experience.

Fitbit reaching out to NHS–but new smartwatch ‘a giant mess’ (updated)

May 4, 2017 | by | No Comments

There have been sketchy reports of Fitbit’s CEO James Park meeting with the NHS last month to get Fitbits into the ‘big moves’ in wearables and apps promised by Health Secretary Jeremy Hunt. Mr. Park’s interview with the Sunday Times (limited access) indicated that Fitbit’s NHS project, should it happen, would be for exercise and activity monitoring, similar to the partnership with UnitedHealthcare which reduces premiums based on policyholder exercise monitoring. This move towards payers is in line with reports starting last year of Fitbit’s seeking clinical markets and moving away from the fickle B2C market. City AM

click to enlargeGiven this week’s leak/reveal and scuttlebutt on the new Fitbit smartwatch, Mr. Park needs to gin up a big payer, quickly. The advance buzz is not positive nor kind. It’s delayed from spring to end of year–in competition with the latest iteration of the Apple Watch. This advance photo of codenamed ‘Higgs’ from Yahoo!Finance indicates a certain clunkiness (and derivation from the panned semi-smartwatch Blaze). It’s pricey, rumored to be priced at around $300. Features include a 1,000nit, built-in GPS, heart-rate monitoring, contactless payments, Pandora and four days of battery life along with connectivity to new Bluetooth headphones. Yet TechCrunch notes “complaints about design, production delays, antenna issues and software problems.” in what they dub “a giant mess”. Forbes notes problems in waterproofing and GPS signal. There are other Android-based smartwatches that do the same for the same price or less. Will this save Fitbit? To be determined….

Update: CEO Park denies delays in the new smartwatch, saying “all new product introductions are on track”, but then again–it hasn’t been officially announced! On the earnings call Thursday, Fitbit stated that new products are now accounting for 84 percent of 1stQ revenue. The company also reported better-than-expected earnings for the first quarter of 2017, reporting an adjusted loss of 15 cents per share on revenue of $299 million. Full year projected at $1.5 – 1.7 bn. Marketwatch, The Verge

A stride ahead in gait analysis for detecting potential health issues

May 4, 2017 | by | No Comments
click to enlargeReaders experienced in senior healthcare know that changes in gait can be predictors or a proxy for negative change in physical or mental status, for instance when walking becomes slow or unsteady and the risk of falling rises. We’re familiar with various remote monitoring approaches such as pads, sensor arrays, camera systems such as the VICON tracker, worn sensors, and Fitbits but none so far have proven workable, widespread, or particularly accurate. A research group at MIT’s Computer Science and Artificial Intelligence Laboratory (CSAIL) have designed a system using wireless signals which can measure the walking speed of multiple people with 95 to 99 percent accuracy, the same as clinical measurement and VICON. The WiGait device is the size of a small painting and emits signals at about the level of a smartphone. It analyzes reflected signals off the body and can differentiate through algorithms the type of movement, e.g. walking versus brushing teeth. It can also gauge stride length, since changes in that may indicate progression in diseases such as Parkinson’s. Since the WiGait can be used for longitudinal tracking, gait changes can be further correlated with disease state with the intent of avoiding hospitalization. The researchers built off of previous work on WiTrack, which used signals to track behaviors from breathing and falling to specific emotions.  MIT News, Paper: Extracting Gait Velocity and Stride Length from Surrounding Radio Signals

Q1 digital health investment: two perspectives from StartUp Health and Rock Health

April 11, 2017 | by | No Comments

StartUp Health’s and Rock Health’s investment/M&A roundups from Q1 2017 have just hit the deck. Before we dig into them, let’s start with the differences in methodology:

  • Rock Health tracks deals only over $2 million in value; StartUp Health seems to have no minimum or maximum; the latter includes early stage deals at a lower value.
  • StartUp Health gathers in international deals at all levels, whereas Rock Health includes only US-funded ventures.
  • Rock Health omits healthcare services companies (citing Forward, Oscar), biotech/diagnostic companies (GRAIL, Theranos), and software companies not solely focused on healthcare (Zenefits)
  • StartUp Health defines ‘digital health’ differently than Rock Health, with categories of ‘patient/consumer experience’, ‘wellness’, ‘personalized health/quantified self’, and ‘research’

StartUp Health is ‘over the moon’, breathlessly (appropriately as the home of the 25-year Health Moonshot) with Q1 trending, seeing the biggest investment quarter since 2010 at $2.5 bn. Topping up this number was GRAIL, which is developing a blood test for early cancer detection, with a massive Series B at $914 million. Far behind it in the $85-110 million range were (in descending order) Alignment Healthcare (population health), PatientsLikeMe (patient/consumer experience), Nuna (big data/analytics), and PointClickCare (EHR). Population health, patient/consumer experience, and research top their investment activity. Most deals are still seed and Series A (59 percent), but that is down five points from full year 2016; Series B’s share is up three points to 25 percent. But it remains a difficult bridge to cross to C+ rounds.

Rock Health splits the difference and calls it ‘business as usual’, surprised that there hasn’t been a tailspin. Its Q1 sandwiches between 2016 and 2015, well above 2015 but trending 23 percent below Q1 2016. Their biggest deals include the aforementioned Alignment, PatientsLikeMe and Nuna, omitting GRAIL and PointClickCare. Their top three investment categories are analytics/big data, care coordination, and telemedicine (over $50 million). Rock Health tracked almost 20 M&A, noting that many transactions are now ex-California. They also uniquely track public company performance. Here in 2016 is where Readers first noted weakness in NantHealth, but Fitbit and Castlight Health also had miserable quarters. Teladoc, Evolent Health (consulting), and Care.com had a good winter as well. Let’s see what Q2 brings.

Jawbone gets its day in California Superior Court versus Fitbit

March 25, 2017 | by | No Comments

It looks like the long-running Jawbone v. Fitbit trade secrets show will continue in California Superior Court. Judge Richard Ulmer on Friday (24 Mar) in San Francisco ruled that the scope of the Jawbone-initiated lawsuit, charging that Fitbit and five former Jawbone employees stole trade secrets, was far larger than the dismissal handed down last October by the US International Trade Commission (ITC) in Washington, DC, rejecting Fitbit’s claim. To Bloomberg Technology, a Jawbone spokesperson crowed, “We look forward now to focusing on presenting our case to a California jury, which will not be bound by the strict procedural limitations that we faced in the ITC. We will push the case to trial as quickly as possible and are confident that justice will be done.” Fitbit is expected to appeal, but this is not good news for them if this drags out–their share price is down 72 percent from a year ago (Marketwatch)–and threatens their IP which is key to a pivot to the clinical monitoring market.

A sidebar to this is Business Insider’s recent report that one of Jawbone’s law firms, Susman Godfrey LLP, has withdrawn from three pending cases citing ‘professional considerations’, remaining on two. This Editor cannot confirm whether Susman Godfrey is representing Jawbone in the above case, as Plainsite records indicate that Skadden Arps is their counsel. The California courts website has not been updated for the case (Aliphcom Inc. v. Fitbit Inc., CGC15-546004). Previous TTA coverage 9 Feb.

Wearables: it’s a journey, but is it really necessary?

March 22, 2017 | by | No Comments
click to enlargeIncreasingly, not in the opinion of many. We’ve covered earlier [TTA 21 Dec, 6 Feb] the wearables ‘bust’ and consumer disenchantment affecting fitness-oriented wearables. While projections are still $19 bn by 2018 (Juniper Research), Jawbone is nearly out of business with one last stab at the clinical segment, with Fitbit missing its 2016 earnings targets–and planning to target the same segment. So this Washington Post article on a glam presentation at SXSW of a Google/Levi’s smart jeans jacket for those who bicycle to work (‘bike’ and ‘bikers’ connote Leather ‘n’ Harleys). It will enable wearers to take phone calls, get directions and check the time by tapping and swiping their sleeves, with audio information delivered via headphone. As with every wearable blouse, muumuu, and toque she’s seen, this Editor’s skepticism is fueled by the fact that the cyclist depicted has to raise at least one hand to tap/swipe said sleeves and to wear headphones. He is also sans helmet on a street, not even a bike path or country lane. All are safety Bad Doo-Bees. Yes, the jacket is washable as the two-day power source is removable. But while it’s supposed to hit the market by Fall, the cost estimate is missing. A significant ‘who needs it?’ factor.

Remember the Quantified Selfer’s fascination with sleep tracking and all those sleep-specific devices that went away, taking their investors’ millions with them? Fitbit and many smartwatches work with apps to give the wearer feedback on their sleep hygiene, but the devices and apps themselves can deliver faulty information. This is according to a study published in the Journal of Clinical Sleep Medicine called “Orthosomnia: Are Some Patients Taking the Quantified Self Too Far?” (abstract) by Kelly Glazer Baron, MD with researchers from the Feinberg School of Medicine at Northwestern University. “The patients’ inferred correlation between sleep tracker data and daytime fatigue may become a perfectionistic quest for the ideal sleep in order to optimize daytime function. To the patients, sleep tracker data often feels more consistent with their experience of sleep than validated techniques, such as polysomnography or actigraphy.” (more…)

Jawbone still in business–with Fitbit in court

February 9, 2017 | by | No Comments

While most industry observers are perceiving Jawbone’s abandoning the consumer fitness tracker market, repositioning into the clinical B2B2C vitals market, and seeking fresh financing as a last-ditch effort to save the company, Jawbone continues to be highly active in one place–court. Last week, Jawbone filed a lawsuit against Fitbit and five former employees in California state court for theft of trade secrets and has rebutted Fitbit’s motion to dismiss in a 27-page filing. According to Fortune’s account of the lawsuit, Jawbone’s filing states: “Each of the defendants has been, for more than five months, the subject of a criminal grand jury investigation regarding theft of Jawbone’s trade secrets that is being conducted by the Department of Justice and the Department of Homeland Security,” a charge that Fitbit calls ‘fictional’ and false. The court hearing in San Francisco is 15 February.

The legal skirmishing, which largely has gone Fitbit’s way [TTA 27 July] in the US International Trade Commission, indicates that Jawbone is still spending money to protect what is left of value in the company–its patents and intellectual property (whatever hasn’t been voided). Jawbone $100 million ‘gem’: the BodyMedia patents acquired in 2013 [TTA 30 Apr 13]. BodyMedia had FDA Class II clearance but a clunky form factor. This IP is a critical save if they want to go clinical. Fitbit’s shares continue to go down, an indicator that the mud is rising. Also Bloomberg with video.

Jawbone out of the consumer fitness tracker business, going to clinical model, raising funds: report

February 6, 2017 | by | No Comments

Confirming reports from various sources last year [TTA 21 Dec] and prior (July) is a report in TechCrunch confirming what we already guessed: Jawbone is out of the consumer fitness tracker market, is aiming at a B2B2C market of health providers, and needs to raise a lot more money.

Key points in the article:

  • It intends to market a “health product and accompanying set of services sold primarily to clinicians and health providers working with patients”
  • It’s seeking additional funding from investors. TechCrunch‘s sources claim that is at an advanced stage, but no closings as of yet.

We noted in December that research/analytics company CB Insights calculated that 2015 wearable computing (a broader category that includes smartwatches) investment funding fell 63 percent from 2014 to a level comparable to 2012-13, in large part due to the cooling of the fitness segment. TechCrunch’s end of year report from eMarketer and other sources also noted that 2016 sales growth of the wearables sector, forecast at 60 percent, only achieved 25 percent growth and will be equally weak in 2017. Lack of demand, lack of loyalty (most fitness bands are discarded after 3-6 months), unreliable (TechCrunch makes much of customer displeasure), their looks and generally useless (in a clinical sense) data and the greater versatility (and appearance) of smartwatches for those who want them, are all factors. There’s a disenchantment here (‘who needs ’em?’) that mass marketing can’t overcome.

It is worthwhile reflecting that Jawbone, which started off in 1997 as an audio technology company, has burned through over $980 million in 14 funding rounds, generously provided by various VC luminaries of Silicon Valley. (One wonders how much equity is even left in the company, a la ‘The Producers’) (more…)

Was 2016 a great or off year for digital health funding, M&A, IPOs? (updated)

January 10, 2017 | by | No Comments

It depends on the study you read and how jaundiced your view is. If you believe the StartUp Health Insights 2016 ‘Health Moonshots’ report, 2016 digital health funding has hit a zenith of $8.18 bn (up 38 percent from 2015), with 500 companies enjoying funding from over 900 individual investors. Yet over at fellow funder Rock Health, the forecast is far more circumspect. They tracked only half the funding–$4.2 bn in funding–with 296 deals and 451 investors, down from the $4.6 bn over 276 deals in 2015.

There are significant differences in methodology. Rock Health tracks deals only over $2 million in value, while StartUp Health seems to have no minimum or maximum; the latter includes early stage deals at a lower value (their cross-section of ~$1 million deals has 15). StartUp Health gathers in international deals at all levels (pages 11-12),  whereas Rock Health only includes US-funded ventures. Another observation is that StartUp Health defines ‘digital health’ differently than Rock Health, most notably in ‘patient/consumer experience’, ‘wellness’ and ‘personalized health’. This can be seen by comparing their top 10 categories and total funding: (more…)

Health execs’ wish list for 2017: security, analytics, pop health…and telehealth (US)

January 6, 2017 | by | No Comments

click to enlargeHealthcare IT News published the results of their October survey of 95 healthcare executives as to their forward plans (resolutions?) for 2017. It’s unsurprisingly centered on upgrades to the following areas:

  • Data security (52 percent)–definitely making up for lost time and spending due to the obvious threats from hacking and data breaches. In November alone, nearly two incidents a day (57) and over 458,000 records were reported by healthcare entities to HHS. (Protenus Breach Barometer)
  • Data analytics (51 percent)–figuring out what to do with all that patient data generated by….
  • Patient engagement and population health (44 percent each)–demanded by quality standards in CMS’ MACRA Quality Payment Program (QPP), including the Merit-Based Incentive Payment System (MIPS) and the Advanced Alternative Payment Models (APMs)
click to enlargeThe surprises come here–the technologies they expect to introduce or investigate. Analytics and workflow correspond to the last two points above, but what is compelling is an apparent tipping point for technology which links the patient to care monitoring and access: telehealth (44 percent), smart medical devices (41 percent) and remote patient monitoring (34 percent). These overlap (as in telehealth and RPM require smart medical devices), yet these are strong numbers if they accurately reflect these execs’ actual (or eventual) spending. (Does it point to more clinically validated use of trackers like Fitbit? The Magic 8 Ball does not tell here….)

The presence of 2016-17’s ‘It Girl’, precision medicine (21 percent), which applies both data analytics and genomics to improve patient outcomes, isn’t surprising with the emphasis on quality care.

One can quibble that the sample size is small N, and the report doesn’t confirm the selection details like title, location, and type of organization, but the direction has to be cheering on many fronts. HITN’s overview, survey results (16 slides)

Fitbit, Qualcomm Life get in step with UnitedHealthcare’s Motion

January 4, 2017 | by | No Comments

click to enlargeAnother step towards maturity in the fitness tracker and employee wellness business? Today’s news out of CES was the announcement by Qualcomm Life and UnitedHealthcare to expand the proprietary UHC employee wellness program, Motion. Qualcomm Life’s 2net is the platform that will eventually integrate with medical-grade connectivity multiple fitness trackers. The first will be Fitbit’s Charge 2.

The Motion program was tested in 12 states with select employers. It will expand to UnitedHealthcare’s self-funded employer health plans covering five or more eligible employees, plus companies with fully insured health plans with 101 or more eligible employees, in 40 states.

Employee incentives are up to $1,500 per year or $4 per day, but requirements are strict, based on Frequency, Intensity and Tenacity, or FIT.  The frequency requirement is six times per day with 300 steps within five minutes at least one hour apart; intensity of 3,000 steps within 30 minutes and tenacity of 10,000 total steps each day. The employers receive premium savings based on combined FIT results. Infographic above and left.

Through a Gimlet Eye…It gives a head start to Fitbit in a BYOD program, and a testing platform for a more clinical use of a new tracker, moving beyond the casual athlete who discards it in a few months and another sign confirming our 2017 View. For Qualcomm Life, it’s yet another pivot to stay in the Healthcare Game as apparently, their much-touted HealthyCircles care coordination platform has faded to black. For UHC, it’s a value-add for employers to sell a health plan. But employee wellness programs have yet to prove real health outcomes and real savings. The problem with all wellness programs, especially at the ‘frequency and intensity’ that UHC wants employees to achieve before they earn anything, is that they concentrate on making the well weller. How would it help the marginally fit or heaven forbid, those trying to regain their fitness with a chronic condition? One last point for employers: to get FIT, it involves a lot of employee time away from a desk or a station! ZDNet, UHC/Qualcomm release

Another bit(e) from Fitbit: Quietly at the end of year, Fitbit moved to terminate one of its multiple patent infringement-related suits against the now moribund Jawbone. (more…)

Seeing into 2017: Fitness trackers’ chill, clinical and specialized wearables warm up

December 21, 2016 | by | No Comments

click to enlargeThe first in a series of brief projections for 2017. Fitness wearables aren’t even lukewarm anymore, and it’s visible in consolidation and the nay-saying articles. In late November, Fitbit bought one of the pioneers, Pebble, for a cut price of $40 million (TechCrunch). Fitbit shares are also cut price at below $7.50, whereas the 2015 IPO debuted at $50. Editor Charles’ favorite, Jawbone, is moribund; the springtime rumors of company sale and shutdown of the fitness band line have not been contradicted since [TTA 27 July]. Research/analytics company CB Insights calculated that 2015 wearable computing (a broader category) investment funding fell 63 percent from 2014 to a level comparable to 2012-13, in large part due to the cooling of the fitness segment.

A sure sign that fitness bands have chilled is negative play in the consumer press. ‘My fitness band has made me fat’, spun off the JAMA article [TTA 28 Sep], is now the theme of hilarious ‘dieters gone wild’ articles like this from the New York Post (warning, eye bleach photos!). But The Sun (UK) waves a warning flag that the information could be sold, sent to your employer or insurance company to profile and/or discriminate against you, or cyberhacked. All this can knock a pricey band off the Christmas shopping list. And no, it hasn’t shifted to smartwatches as most insiders predicted, as smartwatch sales have leveled off–as expected–until their functionality and appearance improve to justify their high price.

What’s in our crystal ball? Clinical-quality and specialized wearables will rise from these ashes.

  • Doctors are simply not interested in the current poor quality of data generated by current wearables–‘it’s worthless, Jim!’ ZDNet’s much-discussed article on this subject paradoxically stresses this, then focuses in on the clinical quality data generated by startup VivaLnk’s eSkin for temperature and stress. Clinical quality data is what is required for a health and wellness research partnership like the one recently announced by RTI and Validic.
  • Industry buzz is that Fitbit bought Pebble for its better IP, apps and stable of developers, not its smartwatch hardware, and that IP includes clinical quality measurement.  Other biosensor companies on the rise according to CB Insights are Thync, Thalmic Labs, YBrain and mCube.
  • In specialty wearables, there’s the recent funding success of Owlet, the High Cute Factor baby monitor sock. Lifebeam transfers multiple sensing technology to helmets and hats for richer data.

And if sensor patches develop with speed, in two to three years they may eliminate all of these!