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…)
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
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…)
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…)
[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2017/01/2017-upgrade-HITN-survey.jpg” thumb_width=”200″ /]Healthcare 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)
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)
[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2017/01/UHC-Motion-Qualcomm-Infographic-Short-12-06-2016.jpg” thumb_width=”150″ /]Another 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…)
[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2012/12/crystal-ball.jpg” thumb_width=”150″ /]The 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!
Fitbit may succeed in blocking Jawbone from selling in US? The Jawbone wins [TTA 27 July] in the US International Trade Commission court was apparently reversed due to a judge’s error for two Fitbit patents, and this may open the way for Fitbit to further block Jawbone. An additional California court action on infringement and misappropriation on trade secrets by Jawbone is headed for court in 2017. Mobihealthnews…..Maybe texting is enough? Dr Joseph Kvedar seems to think so for simple medication adherence and reminders, with reasons like the easy scaling of text messaging in EHRs, but prefers installing an app to deliver them due to the downsides of plain text messaging such as HIPAA and security. Thus we return to the logic of the desktop unit days (e.g. Health Buddy, Viterion) but delivered via smartphone. CHealthBlog….550 US primary care docs say no reimbursement, no telehealth (actually telemedicine). Usage in the past year was a scant 15 percent, with higher usage in Federally designated ‘safety net’ clinics (FQHCs) and HMOs versus PCMHs and ACOs where reimbursement by Medicare, Medicaid and private payers is far chancier. The survey was conducted by their association, the American Association of Family Physicians (AAFP). mHealthIntelligence….iHealth Andon Group buys France’s eDevice for $106 million. The aim seems to be integration of eDevice’s backend infrastructure to iHealth’s RPM devices. Mobihealthnews….A analysis of what went wrong at HealthSpot is in the new publication Telehealth & Medicine Today. A summary is that they had a business model that started out on point quite a while ago (2010) but then competitors and fresh technology ate their lunch (Editor’s term). They didn’t pivot to fit, moved too slowly and were overly wedded to their business model. A big problem was scaling costly kiosks and not finding the right places for them. While initially impressive, there was something all too elephantine about HealthSpot from the start. Our Readers interested in a Trip Down Memory Lane may read our collection of articles from 2013 here which pointed out most of the above….In the industry moves department, Peter Radsliff, whom this Editor worked with briefly on AgeTek-The Aging Technology Alliance (apparently defunct), has joined Arrayent, an IoT developer, as VP Marketing. Now that tells us something! Congrats to Peter!
And finally for a good long, but not light, read, this article in The Atlantic will give you a chilling glimpse of front-line medicine attempting to heal the carnage in Syria, using WhatsApp, texts and the simplest forms of telemedicine. A dedicated group of primarily Syrian-American doctors on a WhatsApp volunteer group called Madaya Medical Consultants uses it to perform consults with the minimal medical resources available in Syria. And yes, they know what Aleppo is.
Mobihealthnews provides a recap of the past four years of patent actions pitting company against company in the hushed but deadly rings of the US Patent and Trademark Office (USPTO) and the US International Trade Commission. On the fight card: the never-ending American Well-Teladoc bout (Teladoc winning every decision so far by a knockout [TTA 18 June]–a second American Well patent being invalidated on 25 August); CardioNet vs MedTel, which the former won but has had to chase the latter out of the arena and down the street to collect; Fitbit-Jawbone which has gone both ways [TTA 27 July]; and the long trail of blood, sweat and Unintended Consequences around Bosch Healthcare’s heavyweight IP pursuit against mainly flyweight early-stage companies (not noting, as we did, their apparent ‘draws’ vs Philips and Viterion, then owned by Bayer).
The Reader will note our tracking Bosch’s activities go back to 2012 (here, here and here). Moreover, with Mr Tim Rowan of Home Care Technology, we broke the news of Bosch’s demise in June 2015, drawing the conclusion that their offense versus Cardiocom’s patents (now in Medtronic’s cardiac division) directly led to the invalidation of their key patents, IP–and the very basis of the company’s existence. See the 19 June 2015 article and our recap one year later in reviewing AW-Teladoc. (Any similar phrasing or conclusions within the Mobihealthnews article, we will leave to our Readers to decide!)
[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/02/Hackermania.jpg” thumb_width=”150″ /]Cybersecurity is the word, not the bird, from South Korea (see here) to the US. The week opened with an unusual healthcare plan supplier breach: 3.3 million payer records held by a card issuer, Newkirk Products of Albany, NY. The company issues ID cards for several Blue Cross and Blue Shield plans and provides management services to other commercial payers. Ironically, it was discovered five days after their $410 million acquisition by Broadridge Financial Solutions of Lake Success, Long Island. On July 6, Newkirk discovered ‘unauthorized access’ to a server with records containing the member’s name, mailing address, type of plan, member and group ID number, names of dependents enrolled in the plan, primary care provider, and in some cases, date of birth, premium invoice information and Medicaid ID number. “No health plans’ systems were accessed or affected in any way” according to the release. MedCityNews, Newkirk release on notice
Another supplier breach affected another estimated 3.7 million patients at Arizona’s Banner Health. This one was a bit closer to home, hacking computer systems used in payment processing on debit and credit cards used at their food and beverage outlets in four states between June 23 and July 7. A week later, the hackers gained unauthorized access to systems containing patient information, health plan member and beneficiary information, as well as information about physician and healthcare providers. MedCityNews, Banner Health release
But what’s secret anymore about your health data anyway? It’s all those apps that are sending data via your Apple Watch and your Fitbit which aren’t necessarily covered by HIPAA or secure. (more…)
Philips has made another substantial, if traditionally risky, move into the direct to consumer (DTC) health monitoring segment with a limited wearables ‘ecosystem’ under a new Personal Health Solutions division. It contains five FDA-cleared products for monitoring vital signs. Four peripherals download via a watch to iPhone/Android phone apps which run on version 2.0 of the Philips HealthSuite (with Salesforce1) mobile app. Earlier the apps were marketed in NL and BE.
While the release states they are globally available, initially it appears they are being marketed direct to consumer for the US only. Purchase is direct on the site. All devices are Bluetooth LE and sync with the watch and smartphone app/dashboard (available on Google Play and the Apple Store). The watch/app also tracks exercise with activity recognition, calorie tracking and sleep patterning, with the app providing some education content.
- Watch $249
- Body Analysis Scale (weight, body fat, BMI) $100
- BP/pulse (upper arm) $100, (wrist) $90
- Ear Thermometer $60
Interestingly, their existing DTC PERS enterprise, Lifeline, is not linked to or mentioned.
Prices are mid-range to high, making this a prima facie tough sell. (more…)
The wearables war continues, and the Law of Unintended Consequences seems unbreakable. This one was decided in a US International Trade Commission court, with the judge ruling that the three patents in question “don’t cover ideas eligible for protection” and dismissed the August trial between Fitbit and Jawbone. This is a reversal of fortune for the two competitors as a similar patent challenge to Jawbone was won by Fitbit back in April in the same court. In the new ruling, the judge said that Fitbit “seek(s) a monopoly on the abstract ideas of collecting and monitoring sleep and other health-related data.”
The skirmishing has a deeper context. Jawbone has accused Fitbit of hiring former employees and purloining trade secrets like product design and marketing plans, and alleges that the suits were “brought improperly by Fitbit in an attempt to burden Jawbone with having to defend invalid patents in multiple venues.” Fitbit reportedly has 300 patents, so that is a lot of defending for a company that has issues of its own. Jawbone has struggled in past months with its products, with various (and contradictory) reports indicating it’s exiting the wearable business, working on a new wearable and selling its audio business (which has also been crushed by competition.) Undoubtedly this will continue as Fitbit plans to challenge the ruling. Your Editor suspects that their legal and IP offense/defense activity is a substantial budget line for them. Bloomberg (20 July and April), The Verge
Update: Jawbone is rumored to be up for sale, with reports that they have approached at least one hardware manufacturer about a purchase. Reportedly they missed an August payment to a business partner. Investor BlackRock has marked down their shares, formerly valued at $5.97 a share, to less than a single penny. Since 1999, Jawbone has had funding of over $900 million. 9to5Mac, The Verge Even the much-publicized hiring of high-profile exec Adam Pellegrini from Walgreens to Fitbit to lead digital health has a Jawbone twist, as both the former and latter were partners. MedCityNews
The ‘silly money’ is packing its bags and taking the next flight from the Coast. An exceedingly tart take out of Fast Company confirms what your Editors have noticed in Rock Health and other year-end reports. Funding for digital health may have surpassed $4.2 billion in 2015, but it barely eked over 2014’s total of $2.3 billion despite rising geometrically since 2011 [TTA 16 Dec 15, revised by Rock Health since then]. Since then, we’ve had the Trouble Every Day of ‘unicorns’ (overreaching) Theranos and (ludicrously) Zenefits [TTA 17 Feb]; EHR Practice Fusion stalled out and cutting 25 percent of its staff, hoping to be acquired by athenahealth–or anyone (Healthcare Dive); shaky Fitbit shares [TTA 20 Feb]. Perhaps the high point was last year’s ‘Corvette Summer’ with yet another big round to a company yet to fulfill its promise, ZocDoc [TTA 15 Aug 15]. Even Castlight Health with decent revenue (still at a loss) has been dubbed an ‘absolute horror show’ when it comes to its share prices, if you were foolish enough to buy it at or near its IPO.
Fortunately a large dose of sanity may prevail among VCs with a sobering realization–no different than five or ten years ago–that investment has to be strategic and far longer than the usual 18 month-and-out time frame. Too many companies have systems which work the same niche–you don’t need 50 companies doing these things: data analytics for care management, patient engagement platforms, med reminders or diabetes management. [We’ve already noted the ‘sameness’ in companies getting funded in 2015, almost as if investors were seeking reassurance in similarity, a sure sign of a coming fail–TTA 30 Dec 15.]
Developers must fill a need–uniquely. And have a superb business plan, squeeze the nickels till they squeak and forget about the party culture. Investors: Dumb Money For Digital Health Will Vanish As Quickly As It Came In
Does this signal a new ‘trough of disillusionment’? The lead in this story is one of the major practice EHRs in the US–Practice Fusion. From a high valuation in 2013 of $635 million as a healthcare darling (free to doctors, ad supported), it burned through $4 million cash per month while revenue missed targets by 10 percent, chased after rainbows such as telemedicine, overhired, overperked and overpartied in the office. Now with a quarter of their staff pink-slipped, a new CEO is trying to bail them out. Most of the other examples aren’t healthcare, but huge deals by VCs are slowing, companies are discounting the price of their shares, taking on debt to not dilute shares, laying off employees and subletting their space. Adding to this is the glut in wearables and a slowdown in demand for single-purpose devices, leading to a 20 percent loss today in value in shares of Fitbit (MarketWatch). Like the ‘oil patch’ in the upper Midwest, the San Francisco area is feeling the chill that never really left the rest of the country. And ‘unicorns’ may become an endangered species. Wall Street Journal