VA awards four remote patient monitoring companies to share in $1B Home Telehealth contract (updated)

The Department of Veterans Affairs awarded on 1 May the latest contract for veteran Home Telehealth (HT) remote patient monitoring systems to four companies. They are perennial and incumbent vendor Medtronic Care Management Services, with HT newcomers Cognosante, Valor Healthcare, and DrKumo.

The duration of the Remote Patient Monitoring-HT contract is for a base period of two years and six (6) option periods. Each vendor can receive a minimum of $100,000 and maximum of $250,000,000 for a total value of all vendors in the contract of $1.032 billion, which is about the same as the previous award setup. It covers 72,000 patients with chronic care, acute care, health promotion/disease prevention, and non-institutional care (NIC) needs, and was awarded through the Office of Connected Care. This contract provisions for systems and hardware/software tools for the connected care of veterans at home. The solicitation originally came out in September 2021 and the award for multiple reasons was delayed for nearly two years.

Cognosante is perhaps the most interesting one here as an IT services company that offers telehealth and RPM as part of a main suite of diversified business process outsourcing. It already does business with the VA and the government, most recently with the VA in 2022 for support of a system used to manage referral and authorization processes for community care services (GovConWire). Former Senator Thomas Daschle is on their board of directors.

Valor Healthcare also is a current VA provider in operating more than 50 community-based outpatient clinics (CBOCs). Valor as prime contractor partnered with GlobalMed on the contract, with GlobalMed as the technology provider for software integration and security services. GlobalMed already provides telemedicine carts to the VA and is a contractor for virtual health services for the Defense Health Agency’s (DHA) Medical Community of Interest network.

DrKumo is the upstart, founded in 2021 by CEO Kelly Nguyen, Pharm.D and CTO Duc Pham. Their main feature is RPM for disease and chronic care management. 

All four companies prominently feature their connections with the VA and veterans, featuring the latter prominently in their management. Medtronic is the long-time (since the ’00s) incumbent and a leading vendor to the VA and the MHS in multiple areas.

The VA is a tough client, which other companies with HT contracts (and the personal experience of this Editor while marketing director of Viterion two contracts ago) can testify to. While VA may award contracts with four companies, many things can happen in the execution, such as failure to satisfy government US-origin requirements on the hardware origins, as specified in the Trade Agreements Act (TAA). Your hardware will need to be “substantially transformed” in the US or in a signatory country designated by the TAA. More than one vendor has effectively lost their contract over this; it happened to Vivify Health (now part of Optum) in 2018 and they with Iron Bow walked away [TTA 16 Jan 2018]. Another major hurdle is acceptance by VA care teams, and here all three companies are up against incumbent Medtronic.

Update 1 Nov: Another incumbent, AMC Health, which in 2022 partnered with GE HealthCare on post-hospital monitoring, switched partnerships and moved to partner with Cognosante. Partnerships are near-impossible to discern from the award notices. This is per their chief operating officer, James Considine, to the Editor. 

Becker’s, GovConWire, Valor release, GlobalMed release, SAM.gov award notice-Medtronic, SAM.gov award notice-Valor, SAM.gov award notice-DrKumo, SAM.gov award notice-Cognosante

Rounding up July: Teladoc’s new name and earnings, Hitching a Lyft, GlobalMed with FCC, Proteus and HIV sensing, Parks Associates, Welbeing

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/12/Lasso.jpg” thumb_width=”125″ /] [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2018/08/teladochealth_logo_plumaqua_rgb.jpg” thumb_width=”150″ /]Telemedicine giant Teladoc today formally unveiled its name and logo change to Teladoc Health. Citing its worldwide reach and a broad portfolio of services, CEO Jason Gorevic stated “…we will further accelerate the adoption of virtual care and enhance our technology-enabled services to make high-quality healthcare a reality for more people and organizations around the world.” The name will officially change on 10 August but there is no change in their NYSE ticker symbol TDOC. Release on MarketWatch  Their earnings call on Wednesday reported a second quarter loss of $0.37 per share which was substantially less than the projected $0.43. Revenue was $94.56 million for the quarter ended June 2018, more than double that of CY 2017. Zacks.com

The burgeoning area of non-emergency medical transportation (NEMT) got a Lyft with the publishing of two studies indicating reductions in costs and no-shows. Lyft rideshare partner Hitch Health which integrates EHR data, to identify patients, worked over 12 months with the Hennepin Healthcare internal medicine clinic in Minneapolis. The no-show rate dropped from 31 percent to 22.5 percent, with an estimated increase in revenue of $270,000. In Camden, NJ, Rideshare worked with a branch of the MD Anderson Cancer Clinic to schedule on-demand transportation, reducing direct transportation costs by 30 percent with the service and no-show rate down to four percent. Mobihealthnews

GlobalMed, a previous Perspectives contributor, was represented by its CEO on a four-person panel discussing the FCC ‘s proposed Connected Care Pilot Program, a new $100 million program to support telehealth for low-income Americans, attended by  FCC Commissioner Brendan Carr. Here’s a video from the 24 July meeting. Hat tip to Marcia Rhodes of Amendola Communications

Proteus Digital Health’s sensor-equipped pills, transmitter patch, and app may have a new market with prophylaxis (PrEP) treatments for the prevention of HIV transmission. A study by University of California, San Diego researchers with Truvada (Gilead Sciences) found that the sensor-equipped drug was well-received by most users and pharmacokinetically equivalent to Truvada alone. Proteus is the first FDA-approved digital ingestion tracking system with Abilify MyCite [TTA 14 Nov 17]. Mobihealthnews

Parks Associates has two upcoming opportunities for speakers at their hosted events at two large conferences. Click on the links for more information:

CONNECTIONS Europe: Strategies for Smart Home & Consumer IoT – Deadline: 1 Sept
Amsterdam – 13-14 Nov 2018  Event website

CONNECTIONS Summit at CES – Deadline: 15 Sept 2018
Las Vegas – 8 Jan 2019  Call for papers and more information.  

Welbeing in the UK announced on Wednesday 1 Aug their Rehabilitation Project in Cumbria. The program is designed to help patients who have had a fall or similar trauma leading to a hospital stay. When they are discharged, patients can now receive Welbeing’s alarm service for up to 13 weeks, free of charge. The service is being funded by Eden District Council. Welbeing recently acquired Eden Housing Association’s alarm and response services in Eden and Carlisle. (Link to press release to come)

News roundup: First Stop, GlobalMed, American Well, Avizia, Medicity, Health Catalyst, Allscripts, Welbeing, BenevolentAI

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/12/Lasso.jpg” thumb_width=”125″ /]Announcements and acquisitions have been multiplying–here’s what’s most interesting.

In companies we’ve recently written about:

Our recent Contributor Bruce Judson, now with corporate telemedicine provider First Stop Health, wrote us enroute to the Government Finance Officials Association conference in St. Louis that FSH achieved triple-digit top-line revenue growth and also achieved an average utilization rate of 52 percent. The formal announcement was made earlier this week at the HLTH conference in Las Vegas (release), where another one of our Contributors, Sarianne Gruber, is attending for Answers Media Company.

GlobalMed, a prior contributor to Perspectives, is offering a lower cost telemedicine alternative to practices with a flat fee starting at $799 per month for three years. Startup costs remain at about $5,000. The starting kit includes a cart, a total exam camera, stethoscope and vitals linked to the organization’s network, and a nurse license. Additional compatible equipment is available at extra cost. We know that a number of comparable telemedicine cart-based kits run upwards of $8,000. It is one of the first public acknowledgments this Editor has seen (but has known for years) that high cost is a major impediment for implementing both telehealth and telemedicine in practices. Health Data Management.

In other news:

Telemedicine and telehealth consolidation continues with American Well’s acquisition of hospital-based telemed/workflow systems provider Avizia. Avizia has a product line of telemedicine carts and workflow software for 40 different specialties, including telestroke and telebehavioral health. The acquisition price was not disclosed. Prior investors in this 2013 Cisco spinoff include Northwell Health, NY-Presbyterian, HealthQuest, and other providers in seven rounds totaling over $23 million. Healthcare IT News

A further sign of consolidation, this time in the crowded health information business, is the Medicity acquisition by Health Catalyst. Health Catalyst is primarily a data analytics and warehousing company while Medicity focuses more on data interoperability and patient engagement for practices, health systems, and HIEs. Medicity was purchased by Aetna in 2011 with much fanfare for $500 million as one of its ‘Emerging Businesses’, rebranded as Healthagen in 2013 [TTA 28 Feb 14] which never quite took off. Out of that unit, what remains are Active Health Solutions and Aetna Accountable Care Solutions, a payer-driven value-based care management company. The amount of the sale was not disclosed but is expected to close in 90 days. Health Catalyst’s CEO Brent Dover served as president of Medicity up to 2013, and both companies are located in Salt Lake City. What is interesting about this sale is that CVS, which is buying Aetna, has no comparable in-house technology. It’s a probable shedding of peripheral or money-losing businesses prior to sale.  HISTalk, MedCityNews

Allscripts continues on its acquisition binge with patient communication and engagement platform HealthGrid. HealthGrid is a mobile app platform that delivers care and education materials traditionally distributed from practices to patients via paper. In January, Allscripts bought practice EHR Practice Fusion for $100 million (a loss to investors) and earlier McKesson’s HIT business for $185 million. It’s a noticeable shift to value-added care tools for this formerly EHR-centric company. Mobihealthnews. 

In UK news:

Welbeing has won Norwich City Council’s Norwich Community Alarm Service (NCAS). It provides a 24-hour, year-round monitoring and response service for over 6,500 adults who are vulnerable or at risk in this part of East Anglia. The press release is on UK Telehealthcare‘s news page. 

BenevolentAI, a UK company using artificial intelligence for drug development, raised $115 million in new funding, mostly from undisclosed investors in the United States, according to Mobihealthnews, for a total funding of over $200 million. The company uses AI to reduce drug discovery time and risk. It does not do its own drug discovery but sells the intellectual property discovered by their AI algorithms, claiming to cut drug development timelines by four years and improve efficiencies by 60 percent compared to pharma industry averages.

Rounding up the roundups in health tech and digital health for 2017; looking forward to 2018’s Nitty-Gritty

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/12/Lasso.jpg” thumb_width=”100″ /]Our Editors will be lassoing our thoughts for what happened in 2017 and looking forward to 2018 in several articles. So let’s get started! Happy Trails!

2017’s digital health M&A is well-covered by Jonah Comstock’s Mobihealthnews overview. In this aggregation, the M&A trends to be seen are 1) merging of services that are rather alike (e.g. two diabetes app/education or telehealth/telemedicine providers) to buy market share, 2) services that complement each other by being similar but with strengths in different markets or broaden capabilities (Teladoc and Best Doctors, GlobalMed and TreatMD), 3) fill a gap in a portfolio (Philips‘ various acquisitions), or 4) payers trying yet again to cement themselves into digital health, which has had a checkered record indeed. This consolidation is to be expected in a fluid and relatively early stage environment.

In this roundup, we miss the telecom moves of prior years, most of which have misfired. WebMD, once an acquirer, once on the ropes, is being acquired into a fully corporate info provider structure with its pending acquisition by KKR’s Internet Brands, an information SaaS/web hoster in multiple verticals. This points to the commodification of healthcare information. 

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/12/canary-in-the-coal-mine.jpgw595.jpeg” thumb_width=”150″ /]Love that canary! We have a paradigm breaker in the pending CVS-Aetna merger into the very structure of how healthcare can be made more convenient, delivered, billed, and paid for–if it is approved and not challenged, which is a very real possibility. Over the next two years, if this works, look for supermarkets to get into the healthcare business. Payers, drug stores, and retailers have few places to go. The worldwide wild card: Walgreens Boots. Start with our article here and move to our previous articles linked at the end.

US telehealth and telemedicine’s march towards reimbursement and parity payment continues. See our article on the CCHP roundup and policy paper (for the most stalwart of wonks only). Another major change in the US is payment for more services under Medicare, issued in early November by the Centers for Medicare and Medicaid Services (CMS) in its Final Rule for the 2018 Medicare Physician Fee Schedule. This also increases payment to nearly $60 per month for remote patient monitoring, which will help struggling RPM providers. Not quite a stride, but less of a stumble for the Grizzled Survivors. MedCityNews

In the UK, our friends at The King’s Fund have rounded up their most popular content of 2017 here. Newer models of telehealth and telemedicine such as Babylon Health and PushDoctor continue to struggle to find a place in the national structure. (Babylon’s challenge to the CQC was dropped before Christmas at their cost of £11,000 in High Court costs.) Judging from our Tender Alerts, compared to the US, telecare integration into housing is far ahead for those most in need especially in support at home. Yet there are glaring disparities due to funding–witness the national scandal of NHS Kernow withdrawing telehealth from local residents earlier this year [TTA coverage here]. This Editor is pleased to report that as of 5 December, NHS Kernow’s Governing Body has approved plans to retain and reconfigure Telehealth services, working in partnership with the provider Cornwall Partnership NHS Foundation Trust (CFT). Their notice is here.

More UK roundups are available on Digital Health News: 2017 review, most read stories, and cybersecurity predictions for 2018. David Doherty’s compiled a group of the major international health tech events for 2018 over at 3G Doctor. Which reminds this Editor to tell him to list #MedMo18 November 29-30 in NYC and that he might want to consider updating the name to 5G Doctor to mark the transition over to 5G wireless service advancing in 2018.

Data breaches continue to be a worry. The Protenus/DataBreaches.net roundup for November continues the breach a day trend. The largest breach they detected was of over 16,000 patient records at the Hackensack Sleep and Pulmonary Center in New Jersey. The monthly total was almost 84,000 records, a low compared to the prior few months, but there may be some reporting shifting into December. Protenus blog, MedCityNews

And perhaps there’s a future for wearables, in the watch form. The Apple Watch’s disconnecting from the phone (and the slowness of older models) has led to companies like AliveCor’s KardiaBand EKG (ECG) providing add-ons to the watch. Apple is trying to develop its own non-invasive blood glucose monitor, with Alphabet’s (Google) Verily Study Watch in test having sensors that can collect data on heart rate, gait and skin temperature. More here from CNBC on Big Tech and healthcare, Apple’s wearables.

Telehealth saves lives, as an Australian nurse at an isolated Coral Bay clinic found out. He hooked himself up to the ECG machine and dialed into the Emergency Telehealth Service (ETS). With assistance from volunteers, he was able to medicate himself with clotbusters until the Royal Flying Doctor Service transferred him to a Perth hospital. Now if he had a KardiaBand….WAToday.com.au  Hat tip to Mike Clark

This Editor’s parting words for 2017 will be right down to the Real Nitty-Gritty, so read on!: (more…)

OnePerspective: VA shows how technology can improve mental health care

Editor’s note: This inaugurates our new series of ‘OnePerspective’ articles. These are written by industry contributors on issues of importance to our Readers and are archived under ‘Perspectives’. For more information on contributing an article to our OnePerspective program, email Editor Donna.

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/11/Gigi-Sorenson-GlobalMed.jpg” thumb_width=”150″ /]By: Gigi Sorenson

The shortage of mental health professionals in the U.S. is becoming more acute for two reasons: 1) more health professionals are encouraging their patients to seek treatment, and 2) more people now have health insurance due to the Affordable Care Act.  A December 2016 assessment showed that over 106 million Americans live in areas where there are not enough mental health providers to meet the need. Because of this provider shortage, as well as the stigma attached to behavioral health treatment, roughly half of mental illness cases go undiagnosed or unaddressed.

However, telehealth could fill much of this gap, and the beginnings of this trend are already evident. A growing number of psychiatrists and psychologists are using video and audio teleconferencing to treat patients remotely. Patients have access to this “telemental health” either in clinics and medical centers or, in some cases, through their Internet-connected personal devices. Studies of telemental health have found that it is effective for diagnosis and assessment in many care settings, that it improves access and outcomes, that it represents a portable, low-cost option, and that it is well-accepted by patients.

VA Program Sets the Pace

The Department of Veterans Affairs (VA) began to deploy telemental health in the early 2000s, and the VA now has the largest and most sophisticated such program in the U.S. In 2016, about 700,000 of American’s 22 million veterans used VA telehealth services. In 2013, 80,000 veterans used telemental health services, and over 650,000 veterans took advantage of those services in the previous decade.

The VA system has trained more than 4,000 mental health providers in evidence-based psychotherapies for post-traumatic stress disorder (PTSD) and other mental health conditions.  It has expanded the use of telemedicine at its 150 medical centers and its 800 outpatient clinics.  It is relying increasingly on telemental health to serve its beneficiaries, partly because nearly half of the veterans of Iraq and Afghanistan live in rural areas. Mental health professionals are often unavailable in these regions, and it can be difficult for these veterans to travel to metropolitan areas where VA clinics and medical centers are located.

Telemental health can address these issues.

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