Highlights of The King’s Fund Digital Health and Care Congress 2018

click to enlargeAs The King’s Fund itself pointed to these two Digital Health articles, this Editor (who did not attend) will summarize their findings on the two days. Surely more to come!

Day One: digital transformation was not just about patient and clinician tools, but also about culture and partnerships

  • The King’s Fund’s researchers presented findings from their recently released report, ‘Digital change in health and social care’ where local organizations can speed change faster than nationally (more detail here)
    • Tight collaboration is necessary to bring change, not only within organizations, but also with providers and suppliers
    • The culture gap is significant between technology and clinical and must be overcome
    • Technology may be the only way “by which the NHS would be able to face “long-term pressures” facing the healthcare system”
  • What are lessons learned from national and regional NHS digital transformation projects?
    • How do you bring data together on a large scale?
    • Primary care practice is the obvious place to engage people with technology
  • No ‘post code lottery’–All patients should have access to digital services (the standard criticism of Babylon Health)

Day Two: build the technology around the patient

  • Put the patient first–some technology does not
  • The paramount importance of safeguarding the patient
  • Patients should be involved continuously with technology–and patients inspire technology

TTA is a media partner of The King’s Fund digital health conferences and was pleased to be a supporter this year.

Soapbox: JPM’s Dimon takes the 50,000 foot view on the JP Morgan Chase-Berkshire Hathaway-Amazon health joint venture

Mr. Jamie Dimon, the chairman and CEO of JP Morgan Chase, had a few thoughts about the JPM-Berkshire Hathaway-Amazon healthcare JV for all three companies. You’ll have to fill up the tea or coffee mug (make it a small pot) for it’s an exceedingly prolix Annual Shareholder Letter you’ll have to sled through to find those comments. Your Editor has taken her punishment to find them, towards the end of the letter in ‘Public Policy’. 

They demonstrate what this Editor suspected–an headache-inducing mix of generalities and overreach, versus starting modestly and over-delivering.

  • Point #1 sets up what has gone wrong. Among several, “Our nation’s healthcare costs are twice the amount per person compared with most developed nations.” Under point 2 on how poor public policy happened, an admission that Obamacare fixed little:

Here’s another example: We all know that the U.S. healthcare system needs to be reformed. Many have advocated getting on the path to universal healthcare for all Americans. The creation of Obamacare, while a step in the right moral direction, was not well done. America has 290 million people who have insurance — 180 million through private enterprise and 110 million through Medicare and Medicaid. Obamacare slightly expanded both and created exchanges that insure 10 million people. But it did very little to fix our broken healthcare system and has, in fact, torn up the body politic over 10 years — and this tumult may go on for another 10 years.

  • Point #7 is about fixing the deficit and the ill effects if we don’t. In Mr. Dimon’s view, healthcare is a major part of this through the uncontrolled growth of entitlements, with Medicare, Medicaid and Social Security leading the pack–skipping over the fact that nearly all Americans pay into Medicare and SSI well in advance of any entitlement collection. Healthcare is also an offender through unnecessary costs such as administrative and fraud (25-40 percent),  and six mainly chronic conditions accounting for 75 percent of spending.
  • The experts–specifically, their experts–will fix it! “While we don’t know the exact fix to this problem, we do know the process that will help us fix it. We need to form a bipartisan group of experts whose direct charge is to fix our healthcare system. I am convinced that this can be done, and if done properly, it will actually improve the outcomes and satisfaction of all American citizens.”
  • The generalities continue with
    • The JV “will help improve the satisfaction of our healthcare services for our employees (that could be in terms of costs and outcomes) and possibly help inform public policy for the country.” 
    • Aligning incentives systemwide ‘because we’re getting what we incentivize’
    • “Studying the extraordinary amount of money spent on waste, administration and fraud costs.”
    • “Empowering employees to make better choices and have the best options available by owning their own healthcare data with access to excellent telemedicine options, where more consumer-driven health initiatives can help.”
    • “Developing better wellness programs, particularly around obesity and smoking — they account for approximately 25% of chronic diseases (e.g., cancer, stroke, heart disease and depression).”
    • “Determining why costly and specialized medicine and pharmaceuticals are frequently over- and under-utilized.”
    • “Examining the extraordinary amount of money spent on end-of-life care, often unwanted.”
    • “To attack these issues, we will be using top management, big data, virtual technology, better customer engagement and the improved creation of customer choice (high deductibles have barely worked”).

This Editor has observed from the vantage of the health tech, analytics, payer, and care model businesses that nearly every company has addressed or is addressing all these concerns. So what’s new here? Perhaps the scale, but will they tap into the knowledge base those businesses represent or reinvent the wheel? 

A bad sign is Mr. Dimon’s inclusion of ‘end of life care’. This last point is a prime example of overreach–how many of the JV’s employees are in this situation? The ‘attack’ tactics? We’ve seen, heard, and many of us have been part of similar efforts.

Prediction: This JV may be stuck at the 50,000 foot view. It will take a long time, if ever, to descend and produce the concrete, broadly applicable results that it eagerly promises to its million-plus employees, much less the polity. 

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

click to enlargeOur 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. 

click to enlargeLove 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…)

Japan’s workarounds for adult care shortage: robots, exoskeletons, sensors

click to enlargeThe problem of Japan’s aging population–the oldest worldwide with 32 percent aged 60+ (2013, RFE)–and shortage of care workers has led to a variety of ‘digital health solutions’ in the past few years, some of them smart, many of them gimmicky, expensive, or non-translatable to other cultures. There have been the comfort robot semi-toys (the PARO seal, the Chapit mouse), the humanoid exercise-leading robots (Palro), and IoT gizmos. Smarter are the functional robots which can transfer a patient to/from bed and wheelchair disguised as cuddly bears (Robear, developed by Riken and Sumitomo Riko) and Panasonic’s exoskeletons for lifting assistance.

Japan’s problem: how to support more older adults in homes with increasingly less care staff, and how to pay for it. The Financial Times quotes Japan government statistics that by 2025 there will be 2.5m skilled care workers but 380,000 more are needed. The working age population is shrinking by 1 percent per year and immigration to Japan is near-nonexistent. Japan is looking to technology to do more with fewer people, for instance transferring social contact or hard, dirty work to robots. The very real challenge is to produce and support the devices at a reasonable price for both domestic use and–where the real money is–export. 

The Abe government in 2012 budgeted ¥2.39bn ($21m) for development of nursing care robots, with the Ministry for Economy, Trade and Industry tasked to find and subsidize 24 companies–not a lot of money and parceled out thinly. Five years later, the Ministry of Health, Labour and Welfare determined that “deeper work is needed on machinery and software that can either replace human care workers or increase staff efficiency.” Even Panasonic concurred that robots cannot offset the loss of human carers on quality of services. At this point. Japan leads in robots under development with SoftBank’s Pepper and NAO, with Toshiba’s ChihiraAiko ‘geisha robot’ (Guardian) debuting at CES 2015 and Toyota’s ongoing work with their Human Support Robot (HSR)–a moving article on its use with US Army CWO Romy Camargo is here. (attribution correction and addition–Ed.)

The next generation of care aids by now has moved away from comfort pets to sensors and software that anticipate care needs. Projects under development include self-driving toilets (sic) that move to the patient; mattress sensor-supplied AI which can sense toileting needs (DFree) and other bed activity; improved ‘communication robots’ which understand and deploy stored knowledge. Japan’s businesses also realize the huge potential of the $16 trillion China market–if China doesn’t get there first–and other Asian countries such as Thailand, a favored retirement spot for well-off Japanese. In Japanese discussions, ‘aging in place’ seems to be absent as an alternative, perhaps due to small families.

But Japan must move quickly, more so than the leisurely pace so far. Already Thailand is pioneering smart cities with Intel and Dell [TTA 16 Aug 16] and remote patient monitoring with Western companies such as Philips [TTA 30 Aug]. There’s the US and Western Europe, but incumbents are plentiful and the bumpy health tech ride tends not to suit Japanese companies’ deliberate style. Can they seize the day?  Financial Times (PDF here if paywalled) Hat tip to reader Susanne Woodman of BRE (Photo: Robear) 

Connected Health Conference 25-27 October, Boston–save $100! (updated)

Connected Health Conference, 25-27 October, Seaport World Trade Center, Boston Massachusetts

The eighth annual Connected Health Conference, is now presented by the Personal Connected Health Alliance (PCHAlliance) in partnership with Partners Connected Health, with a combined and rebooted annual meeting in Boston. The largest global conference in connected health has surfed many changes from the time it was started as the mHealth Summit (and Telecare Aware was one of the first media sponsors) in Washington, DC. This year’s theme, The Connected Life Journey: Shaping Health and Wellness for Every Generation, is centered around the future of technology-enabled health, wellness and what innovation means for over 2,000 providers, researchers, healthcare executives, and developers. CHC17’s location is now in Boston’s Innovation District versus a fairly remote part of Foggy Bottom–and early fall! (For more on CHC’s evolution, see here.)

Wednesday the 25th has a full day of pre-conference specialized sessions here, such as the Society for Participatory Medicine and Parks Associates‘ workshop, with the full conference and open exhibit hall on Thursday and Friday. Continua has a running Plugfest for those involved with Continua standards on Thursday and Friday. Also on those days is CHC’s own Health Tech StandOut! Competition featuring a group of ten finalists, free for conference registrants and the Connected Health Innovation Challenge (CHIC) (information here).

For the main website and for registration, click on the ad in the sidebar. TTA Readers save $100 on registration–use code CHC17TELE100. TTA is a media sponsor of CHC17. For updates, see on Twitter #Connect2Health and @PCHAlliance

Update: The PCHAlliance published today a research paper, Personal Connected Health: The State of the Evidence and a Call to Action. This is a meta-study of 53 studies and trials for setting an initial baseline for evidence in personal connected health. The key findings on the current state will come as no surprise–that better studies are needed that show evidence in clinical trials and real-world use. Release, study (download links)

September Health 2.0 NYC/MedStartr events–hurry!

If you are located in the NYC metro area, two Health 2.0 NYC/MedStartr meetings are coming up very soon!

Endless Summer Social–Friday 22 September, 6 pm, Spark Labs, 25 W. 39th Street, 14th Floor

Grab your surfboard and celebrate the end of summer next week at the MedStartr Labs Beta site embedded within Spark Labs’ new Bryant Park co-working space in midtown. Organizer Alex Fair promises good food, a great selection of beer and wine (courtesy of MedAux), a few presentations and awards, plenty of participation from members of the NYC health tech community, and tours of the new MedStartr beta site. Register at the Meetup site here.

Mental Health Innovations Summit–Thursday 28 September, 6-9pm, CohnReznick LLP, 1301 6th Avenue

One in every five adults in America experiences some form of a mental illness. Nearly one in 20, or 13.6 million, adults in America live with a serious mental illness. We aren’t replacing retiring psychiatrists. Mental health resources are maldistributed across the country. These problems call for new approaches. Panelists and presenters include leaders in the field and six early-stage companies presenting. Register at the Meetup site here.

TTA has been a MedStartr and Health 2.0 NYC supporter/media sponsor since 2010; Editor Donna is active as co-organizer/host and a MedStartr Mentor. 

Tender Alert: Scotland CAN DO Challenge, Bootle needs assistive tech

This Editor thought it would be quiet for the rest of the month, but our Eye on Tenders, Susanne Woodman, has alerted us to two freshly posted–and the first is major:

  • Scotland: The tender for the CAN DO Innovation Challenge Fund – Health & Social Care Challenges is so large it is in 10 lots which offer an initial market test, an evaluation by the fund, then a decision made on whether to pursue the potential project further with the public body. There are eight that directly involve healthcare technology:
    • Point of care lab testing
    • Adopting technology for care in the north of Scotland
    • Transforming nursing care processes for the 21st century
    • Creating and driving a clinically and cost effective pathway to improve recovery after critical illness enabled by data from hospital information systems
    • An IT system for care workers and patients for adherence to stroke management plans to enable real time monitoring
    • Transforming management of people with severe COPD to improve patient outcomes and quality of life and reduce healthcare costs
    • Glasgow TECS development to support care and digital cutover
    • Develop and integrate digital services that allow for consent-driven data sharing from patient records

There is no deadline listed. More information and required document links here on Public Contracts Scotland

  • Bootle (Merseyside) and Sovini Ltd are seeking assistive technology for about 1,000 residents of its local One Vision Housing with retirement and dispersed housing. Estimated value £180,000 over 24 months. Deadline is 18 Sept at noon. More information at Delta e-Sourcing and Tenders Electronic Daily.

First aging services tech investment fund debuts in Israel

Mediterranean Towers Ventures of Ganei Tikva, east of Tel Aviv, has launched an investment fund dedicated to supporting technologies that support quality of life–health, culture, and leisure–for older adults.  Co-CEO Dov Sugarman, via email to this Editor, confirmed that the venture fund is limiting itself for the time being to Israel-based companies in pre-seed and seed stages, although some later stage investments may be considered. They are “open to all opportunities in the aging tech space”. Interested companies should review their website and apply for funding here.

While Israel is statistically a young country, with only 11 percent or 900,000 aged 65 and over, this number is expected to increase to 1.3 million by 2025. At present, 25 percent of households have a member over 65, and because of this distribution, there is a substantial support network of supportive and adult housing. The venture fund grew out of Mediterranean Towers’ main business as a leading publicly traded provider of retirement housing. 

The venture capital group is headed by Dr. Yael Benvenisti, who is the chair of the SIG Technologies of Aging Well (Society of Electrical and Electronic Engineers in Israel), a member of the board of the Israel Association of Gerontology and an advisor to government bodies. Mr. Sugarman is the CEO of Aging2.0 Israel and founder of the third-generation technologies sector at JDC-Israel. (‘3rd generation’, ‘3rd tech’, and ‘third age’ are common expressions for aging and related tech in Israel.) ReleaseThe Marker (in Hebrew)

Health tech arrivals (Philips, Roche, VRI, PushDoctor)…and departures (Pact, Jawbone)

click to enlargeThis popular vacation week has been filled with ‘money under the wire’ news of acquisitions, investments…and one high-profile owner shuttering a pioneering activity app.

Acquisitions:

Philips Healthcare added London-based pregnancy app developer Health & Parenting for an undisclosed sum. Its most popular app is Pregnancy + (and ++), with 12 million downloads via the Apple Store and Google Play, but others are Baby + for all things baby-rearing, and Baby Name Genius to Find That Ideal Name. It will fold into and diversify Philips’ existing uGrow digital parenting platform which includes the Avent smart baby monitor and smart ear thermometer and leverages the open infrastructure of Philips’ Health Suite Digital Platform. One wonders at the flood of data flowing from these apps to these devices and what Philips will do with all these points. Release, MedCityNews

Roche acquired Austrian partner mySugr, a management tool that promises to ‘make diabetes suck less’. Last year they added Roche’s Accu-Chek Connect blood glucose monitor to its chosen device connect and sync list. mySugr features an app for users to log their meals, exercise, glucose levels, and mood. It also captures pictures of user snacks and unleashes “a diabetes monster” avatar when the food choices are poor based on their glucose levels. Terms were not disclosed. MedCityNews

Telecare/monitoring company VRI quietly acquired Healthcom from Woodbridge International. Healthcom’s primary area is care transition management using medical alerts, telehealth, and medication management for payers, government agencies and care partners. Originally positioned as a partnership June 30 on VRI’s website, Globe Newswire confirmed the sale a week later. Terms (again) were not disclosed.

Mobihealthnews rounded up 24 major acquisitions, including GreatCall (by GTCR) and Best Doctors (Teladoc)–all by June 30!

Investments:

Manchester’s PushDoctor telemedicine app raised $26.1 million in Series B financing from Accelerated Digital Ventures and Draper Esprit plus Oxford Capital Partners, Partech Ventures, and Seventure Partners. This added to their $10.1 million Series A raise in January 2016. PushDoctor connects UK patients with NHS-registered GPs for virtual visits costing only £20. Unlike US-based tele-docs, Push Doctor issues prescriptions, makes doctor-led referrals to other health providers and specialists, and helps manage repeat prescriptions. Their founder also has an eye on managing long-term conditions, short-term illnesses, fitness, and nutrition. Their major UK competitors are Babylon Health (which recently raised £50 million for its triage app), Ada Health, and Your.MD. Crunchbase, TechCrunch, Mobihealthnews

And shutterings:

Pioneering fitness incentive app Pact (founded 2011) announced its closing by end of August. Originally a ‘get thee to the gym’ app, it branched out into healthy food (eat more vegetables!) and tracking meals with MyFitnessPal. Pact never truly emerged from seed funding. A rare stumble by Khosla Ventures, which led a 2014 bag-of-skittles round of $1.5 million. Mobihealthnews, Crunchbase

Jawbone closed out the week by liquidating and transubstantiating into Jawbone Health Hub. More on this here

Health 2.0 conferences acquired by HIMSS (updated)

The T-shirted revolutionaries converge with the corporate suits. HIMSS has acquired the ten-year-old Health 2.0 conference organization. It will be operated as a strategic business unit, retaining its name within HIMSS. Current CEO Indu Subayia, MD, will join HIMSS as EVP of the Health 2.0 business unit. Co-chairman Matthew Holt is taking a more freewheeling role as a ‘globe-trotting ambassador’, co-hosting and developing the international conferences currently held in India, Barcelona Spain, and Japan. He will also co-host the US annual and Wintertech meetings in the Bay Area. Transaction terms were not disclosed.

Health 2.0 was originally founded as a ‘bleeding edge’ networking community of misfit tech developers, IT gearheads, clinician renegades, startup newbies, and intense patient advocates, soon joined by marketers, communicators, funders, journalists, academics, and others who for various reasons wanted to be part of The Shock of the New. Over time, the small gatherings of the tribes (a/k/a chapters and annual meetings) grew ever larger, along with the startups growing up (or flaming out) and increased corporate interest, while Health 2.0 developed into a sizable conference, media, and innovation consulting company with a claimed 50,000 members. HIMSS has always represented, in their CEO Steve Lieber’s words, the “more established, fully adopted technology arena”. With the acquisition, HIMSS “now has much more of a portfolio to help drive better health through IT” and, of course, a deep well of resources including dues (and sponsor/exhibit) paying companies and members.

Health 2.0 will be expanding their conference schedule and into “additive products and services” such as MarketConnect, introduced at the 2016 annual meeting as a broker for startups/emerging tech to connect with larger customers and partners, and the Digital Health Marketplace with the NY Economic Development Commission (NYEDC). Developing these services will “lower barriers, increasing access and then being a conduit for larger established organizations to tap into that early stage technology community,” according to Dr Subayia. (Update: The Catalyst division, which runs sponsored challenges, code-a-thons, and pilot programs, is not part of this transaction but will work closely with the conference team, per a Health 2.0 email 20 April.)

By expanding to the early-stage health tech community, it refreshes HIMSS, in Mr Lieber’s words, with “new directions”. They also acquire two high-profile globally-known figures in the health tech field.

Those in the health tech community are asking:

  • Will this truly create an ecosystem that benefits startups and early to mid-stage health tech, fostering innovation investment–or will it accelerate the big company acquisition trend already present in the past three years?
  • Will the conferences, to date fairly freewheeling affairs, change to the buttoned-up HIMSS corporate model? Many categories of attendees (e.g. full-time physicians, caregivers, volunteers) have been admitted free or at greatly discounted rates. The meetings, speakers, and networking were the focus, with exhibits and sponsorships available but in the background. Or will some of these meetings merge?
  • And what of the over 75 worldwide Health 2.0 chapters, many of which charge minimal memberships and meeting fees, versus HIMSS chapters which require substantial national corporate/individual memberships to join? Will there be cooperation? What will the chapter relationship be with the now HIMSS-owned Health 2.0 in future?  (Disclosure: this Editor is active in the Health 2.0 NYC chapter as a volunteer co-organizer/host)

Will the t-shirts change the suits, or vice versa? We’ll see….  HIMSS press releaseHealth 2.0 member letter (The Health Care Blog), Health 2.0 TV video.  Also Healthcare IT News (HIMSS Media)

Technology for Aging in Place, 2017 edition preview

Industry analyst Laurie Orlov previews her annual review of ‘Technology for Aging In Place’ on LinkedIn with six insights into the changes roiling health tech in the US. We’ll start with a favorite point–terminology–and summarize/review each (in bold), not necessarily in order.

“Health Tech” replaces “Digital Health,” begins acknowledging aging. This started well before Brian Dolan’s acknowledgment in Mobihealthnews, as what was ‘digital health’ anyway? This Editor doesn’t relate it to a shift in investment money, more to the 2016 realization by companies and investors that care continuity, meaningful clinician workflow, access to key information, and predictive analytics were a lot more important–and fundable–than trying to figure out how to handle Data Generated by Gadgets.

Niche hardware will fade away – long live software and training. Purpose-built ‘senior tablets’ will likely fade away. The exception will be specialized applications in remote patient monitoring (RPM) for vital signs and in many cases, video, that require adaptation and physical security of standard tablets. These have device connectivity, HIPAA, and FDA (Class I/II) concerns. Other than those, assistive and telehealth apps on tablets, phablets and smartphones with ever-larger screens are enough to manage most needs. An impediment: cost (when will Medicare start assisting with payments for these?), two-year life, dependence on vision, and their occasionally befuddling ways.

Voice-first interfaces will dominate apps and devices. “Instead we will be experimenting with personal assistants or AI-enabled voice first technologies (Siri, Google Home, Amazon Alexa, Cortana) which can act as mini service provider interfaces – find an appointment, a ride, song, a restaurant, a hotel, an airplane seat.” In this Editor’s estimation, a Bridge Too Far for this year, maybe 2018. Considerations are cost, intrusiveness, and accuracy in interpreting voice commands. A strong whiff of the Over-Hyped pervades.

Internet of Things (IoT) replaces sensor-based categories. Sensors are part of IoT, so there’s not much of a distinction here, and this falls into ‘home controls’ which may be out of the box or require custom installation. Adoption again runs into the roadblocks of cost and intrusiveness with older people who may be quite reluctant to take on both. And of course there is the security concern, as many of these devices are insecure, eminently hackable, and has been well documented as such.

Tech-enabled home care pressures traditional homecare providers – or does it? ‘What exactly is tech-enabled care? And what will it be in the future?’ Agreed that there will be a lot of thinking in home care about what $200 million in investment in this area actually means. Is this being driven by compliance, or by uncertainty around what Medicare and state Medicaid will pay for in future?

Robotics and virtual reality will continue — as experiments. Sadly, yes, as widespread adoption means investment, and it’s not there on the senior housing level where there are other issues bubbling, such as real estate and resident safety. There are also liability issues around assistance robotics that have not yet been worked out. Exoskeletons–an assistance method this Editor has wanted to see for several years for older adults and the disabled–seems to be stalled at the functionality/expense/weight level.

Study release TBD

#MedMo16: finalists, winners, and what they tell us about the state of health tech

click to enlargeHaving attended two conferences in the past two weeks, and squinting to read the tea leaves in the cup, there are some trends that this Editor is picking up. They are quite different from what has been seen over the past year or two. They’ll be expanded on in articles to follow. From the top:

  • Successful companies fit into a bigger picture. Startups into early-stage companies, which were the focus at #MedMo16, are now playing the niches like genetics, patient-focused discovery, condition management and cost-effective specialized clinical innovations.
  • Anything that simplifies a process and saves money is attractive. Complex ‘big data’, analytics and ‘population health/integration’ solutions aren’t in the lead anymore because there are a lot of them and they all look alike.
  • Nothing is revolutionary. The idea that an app, device or software will ‘revolutionize healthcare as we know it’ is now recognized as absurd. (The cocktail/drinks party is ovah!) Cases must be proved first, usually on your self-funded or FFF (families, friends and fools) dime, if you want to partner with the Big Dogs.
  • Value-based care, this year’s darling, is already being seen as a vague ‘catch-all’ in a way that Triple Aim and ‘outcomes/evidence-based care’ were eventually found to be. As a meme, it’s turning out to have the life of a fruit fly.
  • It has to be easy to access, preferably on something the average patient or clinician already has or can acquire easily, like a laptop, tablet or smartphone. The idea of having to place a special purpose-built device in, let’s say, a home, is looking more and more ‘analogue’ indeed, a trend we are seeing in the traditional hub-based telehealth market and even slowly in telecare and traditional PERS.
  • Funding models are changing, with more bootstrapping, self-funding, expand you go and less emphasis on big investment and selling out fast. As funders on a NYeC DHC panel pointed out last Wednesday, don’t raise more – or less – than you need.

At #MedMo16, Crowd Challenge participants were judged by a combination of the interested MedStartr/Health 2.0 NYC community through the MedStartr funding platform, and then by a panel of judges who have leading clinical, technological, patient advocate and funding experience. In short, a group that has seen a lot over the past decade plus, has been up and down the Hype Cycle, and is down to Brass Tacks.

The innovations that bubbled up through the finalists (more…)

UK HealthTech Conference, Cardiff, 6 December (UK)

6 December, Mercure House Hotel, Cardiff, Wales

Exploring critical strategic trends in both health tech and biotech is this full day conference in Cardiff that is expected to have 300 participants. This year’s conference theme is patient safety. Keynote speaker is John Wilkinson, Director of MHRA. Full information, speaker and programme information, registration and sponsorship starts here. Hat tip to Dr Malcolm Fisk (@malcolmjf) via Twitter.

Health tech’s disruptive power in pictures

click to enlarge

One of our Readers works for an agency that developed, under the direction of home care provider CEO Ryan McEniff, a digital health infographic which is packed with facts on how technology is changing healthcare processes, hopefully for the better. It’s a little lengthy but it covers how many tasks will be automated, workforce changes, global investment highlighting the US, Singapore, Canada and Australia, leading accelerators, startups and companies, how markets are accepting technology and the international challenges. What you need for your next meeting! Courtesy of Minute Women Home Care  (@MWhomecare) of Lexington, Massachusetts, Ryan and reader Veronika Gorina. Full infographic follows.

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Autumn/winter UK health tech events–Extra #1

SEHTA (South East Health Technologies Alliance), one of the largest healthcare networking organizations in the UK, has two upcoming digital health-related events of interest to those in London and the Southeast. Hat tip to Clare Ansett of SEHTA for the details.

London Innovation Surgeries 26 Sept at Queen Mary University, London. There are only two spots left so act quickly. More information here. SEHTA is in partnership with Kent Surrey Sussex Academic Health Science Network (KSS AHSN), GLA, MedCity, Digital Health.London and Enteric HTC.

How to Access Funding 12 October at City Hall, London. This is a ‘how to’ workshop on finding funding from crowdfunding to public/private sector. Partners are KSS AHSN, GLA, MedCity and Digital Health.London. More information here. Free but limited registration.

 

The difficulty in differentiating telemedicine and telehealth

Our Editors have always tried to cleanly define the differences between telemedicine, telehealth and telecare, even as they blur in industry use. (See our Definitions sidebar for the latter two.) But telemedicine, at least on this side of the Atlantic, has lost linguistic ground to telehealth, which has become the umbrella term that eHealth wanted to be only two or three years ago. Similarly, digital health, connected health and mHealth have lost ground to health tech, since most devices now connect and incorporate mobility. And there are sub-genres, such as wearables, fitness trackers and aging tech.

Poor telehealth grows ever fuzzier emanations and penumbra! Now bearing the burden of virtual visits between doctor and patient, doctor-to-doctor professional consults, video conferencing (synchronous and asynchronous), remote patient monitoring of vital signs and qualitative information (ditto), and distance health monitoring to treat patients, it also begins to embrace its data: outcome-based analytics, population health and care modeling. Eric Wicklund accumulates a pile of studies from initial-heavy organizations: WHO, HIMSS, HHS, Center for Connected Health Policy (CCHP), ATA, TRC Network. All of which shows, perhaps contrary to Mr Wicklund’s intentions, how confusing simple concepts have become. mHealth Intelligence