AI news: GE HealthCare’s 510(k) for Precision DL (+ GE stake sale), Samsung adopts care.ai for in-facility patient monitoring, Mayo Clinic-Google Cloud generative AI, Wolters Kluwer buys Invistics for drug diversion detection

GEHC receives FDA clearance for Precision DL (deep learning) image processing software. It improves image quality on GEHC’s PET/CT, Omni Legend, which enables faster scanning time and improved small lesion detection. Deep learning as part of AI is a subset of machine learning (ML), which uses a neural network with three or more layers that simulates the human brain in processing and ‘learning’ from large amounts of data and drawing judgments from it. (See our recent Perspectives for a more nuanced explanation.)  According to GEHC’s presentation brochure on Precision DL, it is trained with thousands of PET images made using multiple reconstruction methods. Mobihealthnews

GEHC was spun off from parent General Electric (GE) in January. GE retained about 19% of its stock at the time with the remaining being distributed to GE shareholders, but on Monday announced that it would sell 25 million shares, or about $2 billion in value, in a debt-for-equity exchange. The debt is held by affiliates of Morgan Stanley which would then receive the stock, which has done well. This would reduce GE’s stake in the spinoff considerably.  Reuters, Yahoo Finance

Samsung partnering with care.ai for facility ‘smart care’. Orlando-based care.ai’s Smart Care Facility Platform monitors for conditions and learns from patient behaviors. It can be used for infection prevention and control, patient and protocol monitoring, workforce optimization, and virtual care. The AI-powered platform will be integrated into Samsung displays for clinician use, including virtual care. The system will be utilized in hospitals, nursing homes, and care facilities. care.ai release

Mayo Clinic is also jumping on the AI bandwagon with Google Cloud. Google Cloud’s Enterprise Search in Generative AI App Builder (Gen App Builder) will be used to make it easier for clinicians and researchers to find the information they need and improve the efficiency of clinical workflows to ultimately improve patient outcomes. According to the release, Enterprise Search in Gen App Builder unifies data across dispersed documents, databases, and intranets, making it easier to search, analyze, and identify the most relevant results. Mayo is an early adopter of the system. Google Cloud release  

Wolters Kluwer Health has acquired Atlanta-based Invistics. Invistics’ Flowlytics tracks medication in hospitals and other patient care settings through ML-based systems. The most critical ‘hot button’ use is for detecting drug diversion, which is when a healthcare worker illegally obtains or uses prescription drugs intended for a patient. This is done by reconciling drug transactions from purchase to patient, with their system being used to rapidly and accurately identify patterns of behavior consistent with drug diversion. More routine usage is for automating controlled substance compliance. This will fit in with Wolter Kluwer’s existing products Simplifi+ and Sentri7 in their Clinical Surveillance, Compliance & Data Solutions unit. Information on transaction cost and management transitions were not disclosed. Release

Hat tip to HIStalk’s new AI News feature 7 June for both Mayo-Google Cloud and WK-Invistics.

Amwell plans $100 million IPO, plus $100 million from Google as a kickoff

As expected [TTA 6 Aug], Amwell on Monday filed S-1 forms with the US Securities and Exchange Commission (SEC) registering them for an IPO to raise about $100 million. The number and amount of shares on the New York Stock Exchange, under ticker symbol AMWL, were not disclosed. Interestingly, and somewhat unexpectedly, Google’s cloud business is taking a private placement of $100 million in shares equal to the IPO price, to be executed on the IPO closing.

The partnership will mean that Amwell’s cloud services on Amazon Web Services (AWS) will be moving to Google Cloud. Amwell will also move some video performance capabilities to that platform, and will also cooperate on technology plus build out a dedicated sales effort to expand Amwell’s footprint in the sector.

Amwell’s telehealth business, like Teladoc’s, skyrocketed during the worst of the pandemic shutdown. According to the CNBC article on the IPO, Amwell told them in May that it’s seen a 1,000 percent increase in visits due to coronavirus and closer to 3,000 – 4,000 percent in some places (which without further data is meaningless). The IPO filing stated that revenue was up 77 percent January-June 2020 versus same period 2019, from $69 million to $122 million. Profits are not following, however. Its net loss nearly tripled over the same period, growing from $41 million in the first six months of 2019 to $111 million in the first half of this year. Seeking Alpha has the operating loss at a slightly higher $113.58 million.

This past May, Amwell also raised $194 million in a second Series C [TTA 23 May]. Their financing to date is over $700 million.

Amwell states that it provides telehealth solutions for over 2,000 hospitals and 55 health plan partners with over 36,000 employers, covering over 80 million lives, a higher metric than members. This is in comparison with Teladoc which claims 51.5 million members, 50 health plans, 70 global insurers, and 12,000 clients in 175 countries. Amwell is having to compete with a larger suite of services that a Teladoc-Livongo combination will eventually offer. Amwell’s by-contrast modest IPO and private placement corresponds to their relative size, but a contrarian would also look at Teladoc’s huge expenditures for InTouch Health ($1bn) and Livongo ($18.5bn) and rightly be concerned about their runway to ROI and profitability.

Digital health: why is it a luxury good in a world crying for health as a commodity?

Why digital health still struggles to find its stride. Those of us in the healthcare field, especially Grizzled Pioneers, have been wondering for the past decade why Digital Health’s Year is always Next Year. Or Next Decade. 

Looking back only to 2000, we’ve had 9-11, a dot-com bust, a few years in between when the economy thrived and the seed money started to pollinate young companies, a prolonged recession that killed off many, and now finally a few good economic years where money has flooded into the sector, to good companies and those walking the fine line of mismanagement or fraud. We’ve seen the rise/fall/rise of sensors, wearables, and remote monitoring, giants like Google and Microsoft out and back in, the establishment of EHRs, acceptance by government and private payers, quite a bit of integration, and more. All one has to look is at the investment trends breaking all records, with funding rounds of over $10 million raising barely a notice–enough to raise fears of a bubble. Then there’s another rising tide–that of cyberattack, ransomware, insider and outsider hacking.

Is it this year? It may not be. Despite the sunshine, interoperability holds it all back. Those giant EHRs–Cerner, Epic, Athenahealth, Allscripts–are largely walled gardens and so customized by provider application that they barely are able to talk to their like systems. There are regional health exchanges such as New York’s SHIN-NY, Maryland’s CRISP, and others, but they are limited in scope to their states. The VA’s VistA, the granddaddy of the integrated system, died of old age in its garden. Paul Markovich, CEO of Blue Shield of California cites the lack of interoperability and being able to access their personal health data as a major barrier to both patients and to the large companies who want to advance AI and need the data for modeling. (China and its companies, as we’ve noted, neatly solve this problem by force. [TTA 17 Apr]) Apple is back in with Health Records, but Mr. Markovich estimates it may take 10 years to gather the volume of data it needs to establish AI modeling. Some wags demand that Apple buy Epic, as if Epic was up for sale. BSC, like others, is testing interoperability workarounds like Notable, Ooda Health, and Manifest MedEx. Mr. Markovich cites interoperability and scaling as reasons why healthcare is expensive. CNBC

And what about those thriving startups? Hold on. During the Google Cloud/Rock Health 3 June event, one of the panelists–from Partners HealthCare, which works both side of the street with Pivot Labs–noted that hospitals have figured out their own revenue models, and co-development with hospitals is key. Even if validated, not every tech is commercially ready or lowers cost. And employers are far worse than hospitals at buying in because they ultimately look at financial value, even if initially they adopt for other reasons. In addition, the bar moved higher. The new validation standard is now provider-centric–workload, provider satisfaction, and implementation metrics, because meeting clinical outcomes is a given. Mobihealthnews

And still another barrier–data breaches and cyberattack–is still with us, and growing. Quest Diagnostics’ data breach affects nearly 12 million patients. It was traced to an individual at a vendor, American Medical Collection Agency, and it involved Optum360, a Quest contractor and part of healthcare giant Optum. The unauthorized person had access to the network for eight months – between 1 August 2018, and 30 March 2019–and involved both financial and some health records. Quest now is in the #2 slot behind the massive 79 million person Anthem breach, which, based on a Federal grand jury indictment in Indianapolis in May, was executed by a Chinese group in 2015 using spearfishing and backdoors that gathered data and sent it to China. There were three other US businesses in the indictment which are not identified. Securing health data is expensive — and another limitation on the cost-lowering effects of interoperability. Healthcare IT News

Digital Health’s Year, for now, will remain Next Year–and digital health for now will remain fractional, unable to do much to commoditize healthcare or lower major costs.