Tyto Care inks deal with Best Buy for retail sales of remote diagnostic device

Tyto Care’s long-planned retail debut of the TytoHome remote diagnostic device has arrived at Best Buy. The telehealth device which incorporates a camera, stethoscope, otoscope, tongue depressor, basal thermometer, and smartphone app can be bought online for $299.99. According to their release, TytoHome will be available at select Minnesota Best Buy stores and will roll out to North Dakota, South Dakota, California and Ohio.

TytoHome has been from the start (late 2016) pitched to parents as a 24/7 service for ill children in that middle-of-the-night sick call to the doctor, but more recently for adults as an adjunct to a virtual visit. The Israel-based company with US offices in NYC partnered with American Well early [TTA 2 Dec 2016]. For Best Buy customers outside of Minnesota, North and South Dakota, TytoHome will connect to doctors via LiveHealth Online, an American Well partner. In those three states, TytoHome will connect to Tyto Care health system partner Sanford Health and their medical providers. Each visit will be $59, possibly less if the service is covered by the person’s or family insurance plan.

Best Buy, of course, has made a large bet on retail health tech with its purchase of GreatCall, well-known for its Jitterbug phones targeted to older adults with its 5-Star PERS, but also prior to the acquisition with GreatCall’s purchases of Lively’s tech for consumer devices and HealthSense in LTC systems. Their current plans are outlined in a recent interview with CEO David Inns.

What Best Buy’s $800 million cash purchase of GreatCall connected health/PERS really means

Have health and connectedness services for older people finally made it out of the pumpkin and to the ball? GreatCall’s market doesn’t make for great cocktail party buzz or TEDMED talks. It’s emergency response with Jeopardy’s Alex Trebek presenting 5 Star emergency service bundled in a Jitterbug flip or smartphone (made by others). It’s made intelligent acquisitions. taking some of the tech developed by Lively to develop wearables that are quite presentable and by Healthsense for the senior living market. It’s been a leader in how to make both traditional direct marketing (DRTV, print) and digital work for an older market. Somehow, it’s managed to accumulate over 900,000 paying customers, which proved to be very attractive to first PE firm GTCR and now Minneapolis-based Best Buy, which with GreatCall has made its Biggest Buy.

GreatCall will remain a separate division with the same CEO (David Inns, with them since their 2006 founding) and remain HQ’d in San Diego. The transaction is expected to close by end of the third quarter of Best Buy’s fiscal 2019, subject to regulatory approvals.

Best Buy in the US has remained the #1 electronics ‘big box’ store that, like most retail, has stumbled about and come back from the brink. Their purchase of GreatCall, a partner for many years, reinforces a strategy they’ve worked on for a while in featuring health and wellness-related products to what CNBC calls ‘an aging population’ as part of ‘solving technology problems and addressing key human needs across a range of areas.’ GreatCall, as noted above, has a superb track record in direct marketing to that group. (In this context, the former Healthsense B2B play is limited–some of the feedback that this Editor’s received is that GreatCall stumbled out of the gate with Healthsense customers with a lack of understanding of the LTC/senior housing market dynamics. Long term, it seems out of phase with Best Buy’s direction in a way that consumer-oriented Lively is not.)

Will that talent spill over to and influence the rest of Best Buy’s business? Will Best Buy successfully carve out a niche which is relatively resistant to the predations of Amazon (which also sells a lot of health tech) and other online retailers? Is this niche big enough to support this Big Box Retailer? Seeking Alpha, press release, Mobihealthnews

3rings goes Internet of Things with ‘Things That Care’ (UK)

3rings is launching another extension of its smart plug sensor that monitors daily use of a key appliance like a tea kettle or TV with a multi-sensor IoT system. [grow_thumb image=”http://telecareaware.com/wp-content/uploads/2017/10/3rings-IoT-hub-and-Sensors.jpeg” thumb_width=”250″ /]’Things That Care‘ uses proprietary ‘things’ (sensors) to monitor patterns of activity and the home environment to create a safety net for an older adult, perhaps growing frailer, usually living at home alone, so that family or caregivers can ‘look in’ to see if all is fine. It also integrates the Amazon Echo interactive personal assistant as announced in June [TTA 27 June].

The other 3rings development is the system’s ability to analyze data for trends and insights (screenshots below). The introduction of self-learning algorithms to detect potential changes in activity that may be early signs of a change in health is a proactive care advance similar to capabilities in the far more complex and expensive QuietCare and Healthsense (now Lively) but affordable for families. It also puts the 3rings system into the professional space for councils and sheltered housing. According to 3rings CEO Steve Purdham, “our new platform gives professionals real time information to support efficient care planning and delivery, and provides a cost effective means of managing risks and providing tailored care to people to enable them to stay independent at home.” Again, we wish 3rings the best with these new developments. Release (PDF)  

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2017/10/patterns.jpg” thumb_width=”200″ /]   [grow_thumb image=”http://telecareaware.com/wp-content/uploads/2017/10/trend-analysis.jpg” thumb_width=”200″ /]

GreatCall’s acquisition: a big vote for older adult-centered healthcare tech

This midweek’s Big News has been the acquisition of the mobile phone/PERS company GreatCall by Chicago private equity firm GTCR. Cost of the acquisition is not disclosed. GTCR stated that they expect to make capital investments to GreatCall to fund future acquisitions and internal growth. GreatCall has over 800,000 subscribers in the US, generates about $250 million in profitable revenue annually, and employs about 1,000 people mainly in the San Diego area and Nevada. According to press sources, senior management led by CEO David Inns will remain in place and run the company independently. 

Our US Readers know of GreatCall’s long-standing (since 2006), bullseye-targeted appeal to older adults who desire a simple mobile flip phone, the Jitterbug, but has moved along with the age group to a simple smartphone with built-in health and safety apps. Along the way, GreatCall also developed and integrated the 5Star mPERS services on those phones, served by their own 24/7 emergency call center and developed an mPERS with fall detection. Their own acquisitions included the remnants of the Lively telecare home monitoring system in 2015 [TTA 5 Dec 15], adding the Lively Wearable mPERS/fitness tracker to their line; and senior community telecare service Healthsense last December. The original Lively home system and safety watch are sold in the UK (website) but apparently not the Jitterbug. In the UK and EU, the Jitterbug line would be competitive with established providers such as Doro.

What’s different here? GTCR is not a flashy, Silicon Valley PE investing in hot, young startups or a traditional senior health investor like Ziegler. Its portfolio is diversified into distinctly non-cocktail-chatter companies in financial services and technology; technology, media and telecommunications (including an outdoor ad company!); and growth businesses. It has real money, investing over $12 billion in 200 companies since 1980, and strategically prefers leadership companies. Their healthcare businesses have primarily been in life sciences, specialty pharma, dermatology, specialty services such as healthcare in correctional institutions, and device sterilization. Recent acquisitions have been San Diego-based XIFIN, a provider of cloud-based software to diagnostic service providers, RevSpring in billing and communications, and data analytics firm Cedar Gate Technologies. It also has partnered with newly formed medical device companies.

GreatCall crosses over into GTCR’s telecommunications sweet spot, but the older adult market and direct-to-consumer sell are different for them. Because it is unique in their portfolio, this Editor believes that GTCR sees ‘gold’ in the ‘silver’ market. Larry Fey, one of their managing directors, cited its growth and also GreatCall’s recent moves into senior communities with their products. GTCR also has expertise in the security alarm monitoring sector, which along with pharma clinical trials can bolster better utilization and broaden the utilization of GreatCall’s call centers.

However, this Editor would caution that the US senior community market has been having difficult times of late with overbuilding, declining occupancy, resident/labor turnover, and rising expenses–as well as recent coverage of security lapses and resident abuse. Telecare systems like Healthsense are major capital expenses, but the flip side is that communities can use technology to improve care, resident safety, and to differentiate themselves. To make the most of their Healthsense acquisition, GreatCall needs to bring innovation to the V1.0 monitoring/safety/care model that Healthsense is in its current state, and make the case for that innovation in cost/financials, usability and reliability. San Diego Union-Tribune, Mobihealthnews

In-home video monitoring acceptable to 90 percent of dementia carers: Age NI study

What used to be the ‘third rail’ of caring may no longer be. The idea of cameras in the home to view activity of an older family member was so abhorrent to caregiving relatives that it was a key in selling purely sensor-based monitoring systems from the early 2000s on, such as QuietCare, GrandCare, Alarm.com Wellness, Healthsense, Lively, Tynetec/Legrand and many others. Today, in the age of selfies and video on social networks, video surveillance doesn’t seem so foreign. Age NI‘s study conducted through Ulster University had the surprising finding that over 90 percent of participants in several focus groups supported it, with two important caveats; that there was initial consent from the older person being monitored, and that only family members could view the video. With that, they found it ‘useful’, ‘ethical’ and ‘moral’. It would support the person’s safety in aging at home longer, and provide peace of mind for carers. Hat tip to Toni Bunting of TASK Ltd. PharmaTimes, Ulster University News

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

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…)

GreatCall enlarges remote monitoring profile with Healthsense acquisition (US) (Updated)

Updated. GreatCall, the older adult-targeted mobile phone/PERS company, on 20 December announced the acquisition of telecare/RPM developer Healthsense. Terms were not disclosed. Healthsense was one of the earliest developers (close after Living Independently Group’s, now Intel Care Innovations’, QuietCare) of a sensor-based residential system, eNeighbor, to monitor ADLs for activity and safety. It has been primarily marketed to senior living communities after an early start in home sales, and currently monitors 20,000 lives according to the press release. Healthsense acquired a similar system, WellAWARE, in 2013.

GreatCall is best known for its older adult-targeted mobile phone line, but in recent years they have expanded into mPERS services on phone and devices, including an emergency call center. The San Diego-based company acquired the remnants of the Lively in-home monitoring system a year ago and incorporated its watch-wearables into its medical alert product line.

This Editor speculates that one direction GreatCall may take is to expand into the senior community monitoring and home care business beyond mPERS. To date, GreatCall has been a highly successful, direct-to-consumer driven company which has popularized not only products to make technology simpler and more usable for older adults, but also led in a non-condescending approach to them. If the company decides to enter senior housing and home care, it presents a different and new marketing challenge, as both have been to date late technology adopters. Another concern is the cost/financial model, usability and reliability of Healthsense’s remote monitoring system.

The other direction is more conventional–GreatCall could incorporate the Healthsense technology and ADL algorithms into home monitoring, with a design resembling Lively’s original self-installed, attractively designed in-home telecare system.

Minnesota-based Healthsense in 15 years of operation raised what some would term a paltry $46 million of equity and debt financing in ten rounds (Crunchbase). Over this time, Healthsense’s investors were a small group, including New York-based Radius Ventures, Mansa Capital, West Health and Fallon Community Health Plan. After the $10 million venture round in 2014, the last investment was a small $2.6 million in February. Early investor Ziegler HealthVest Management, which purchased a significant interest in 2007, is not listed in Crunchbase’s roster, though one of their senior financial managers is on their board. This Editor senses (sic) that the investors were seeking to exit after a long time in.

The release has a summary of an earlier Healthsense study of interest to marketers of telehealth and telecare as a reference:

An independent 12-month study with Fallon Health (an investor–Ed.) found that using Healthsense remote monitoring in connection with Fallon’s model of care for seniors reduced total medical expenses by $687 per member per month — a nearly 16 percent reduction for pilot members as compared to a control group. The Fallon population using Healthsense demonstrated a 32.2 percent reduction in fees for inpatient hospital visits, a 39.4 percent reduction in emergency department costs and a 67.7 percent reduction in expenses for long term care vs. the control during the year-long study.

More in Mobihealthnews, MedCityNews, Minneapolis-St Paul Business Journal

(Updated with further information on early investor Ziegler and the senior housing market; hat tip to reader Andrea Swayne)

Tunstall Americas introducing Vi+ telecare home monitoring

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/07/Big-T-thumb-480×294-55535.gif” thumb_width=”150″ /]We don’t hear much from Tunstall Healthcare in the US other than their traditional/mobile PERS business (formerly AMAC‘s). That may be changing with their introduction (finally) of the Vi+ telecare home unit. It has medical alert, fall detection (via ‘intelligent pendant’) and integrates with home monitoring an array of what they call ‘Virtual Sensors’–motion and other sensors to monitor activity in the home, including wireless sensors for fire, flood and gas leaks. They do make a point of having an integral ambient temperature sensor which will alert their response center if an unsafe high or low temperature is detected.

Other than the press release, no information on Vi+ is on the Americas website yet, including pricing. (Vi without the sensor array has been sold for some time.) Vi+ is marketed in most Tunstall countries in Europe, Australia and New Zealand. The fact sheet from Ireland is representative of Vi+ in most markets.

It’s interesting that Tunstall Americas has chosen to enhance their PERS/call center services with sensors, versus entering the hotter telehealth area. Sensor-based activity/danger monitoring is hardly new. (more…)

‘Déjà vu all over again’ or critical mass? NYTimes looks at older adult care tech

“It’s like déjà vu all over again” as Yogi Berra, the fast-with-a-quip Baseball Hall of Fame catcher-coach-manager once said. About 2006-7, telecare broke through as a real-world technology and the tone of the articles then was much like how this New York Times article starts. But the article, in the context of events in the past two years, indicate that finally, finally there is a turning point in care tech, and we are on the Road to Critical Mass, where the build, even with a few hitches, is unstoppable.

Have telehealth, telecare, digital health or TECS (whatever you’d like to call it) turned the corner of acceptability? More than that, has it arrived at what industrial designer Raymond Loewy dubbed MAYA (Most Advanced Yet Acceptable) in keeping older adults safer and healthier at home? The DIY-installed Lively! system keeps an eye on a hale 78 year old (more…)

Breaking (holiday weekend) news: Aetna does the ‘deal deal’ with Humana

Crap Game (Don Rickles): Ya make a DEAL!
Big Joe (Telly Savalas): What kind of a deal?
Crap Game: A DEAL DEAL.

Kelly’s Heroes (1970), on getting the German Tiger tank and commander to help them in their bank heist

A $37 bn deal, that is. Announced on the Friday before the US Independence Day holiday (a day which may define media ‘black hole’), Aetna and Humana announced either their merger or the acquisition by the former of the latter, depending on what account you read. If approved by the Feds, the combination of #3 and #4 insurers (by revenue) respectively will exceed 33 million insured, making the combined entity #3 in insured individuals (after UHG and Anthem) and #2 in revenue. The announcement also stated that Louisville, Kentucky, Humana’s current headquarters, will continue to manage the Medicare, Medicaid and military Tricare businesses. Both are in Medicare Advantage, which is problematic due to market share and anti-trust considerations in at least four states, according to Reuters. (Humana has about 20 percent of national Medicare Advantage private policies.) We’ve previously noted the unfavorable comparison to the end stages of airline deregulation–consolidation reducing competition and consumer-favorable pricing. No word on the future of the Humana brand and marketing, which has always been executed well.

As to the outlook for digital health support–the prognosis by this Editor of this combination is, in the Magic 8 Ball’s answer, ‘reply hazy, ask later’.

  • Humana was known in the industry for being fairly open to opportunities and backed them with funding (Healthsense, Vitality, what remained of Healthrageous) under business such as Humana Cares. Humana at Home also owns a home care management company, SeniorBridge. Will this be of interest to Aetna in population health management, or an early ‘For Sale’?
  • Aetna, by contrast, has pivoted several times. CarePass consumer apps was a patient engagement experiment that proved the point that policyholders don’t want apps from insurers. Healthagen (an acquisition) was first positioned as an ’emerging businesses’ skunkworks of sorts umbrella-ing over iTriage (now integrated into the parent), ActiveHealth, Medicity and other digital health/analytics related businesses, then scaled back in early 2014 [TTA 28 Feb 14]. Repositioned as ‘population health management, the ACO business dominates.

Various reports: Daily Mail, Forbes (which likes it not at all and sees none of the touted ‘economies of scale’) and the WSJ.

Aetna may ‘buy into’ more analytics, digital health

Rumors now mainstreamed into press surround Aetna’s apparent interest in fellow insurers Humana and Cigna. Forbes last Friday started the ball rolling with an article last Friday focusing on the main event driving insurance payer consolidation: the transition of Medicare from fee-for-service to value-based bundled payments and accountable care organization (ACO) models. Humana has substantial Medicare business and a foot in home care (SeniorBridge), but has innovated in digital health: partnerships (Healthsense, TTA 20 Dec 13), purchases (what remained of Healthrageous, TTA 16 Oct 13), employee wellness (Vitality) and app development. Cigna is a major insurer with corporate business, but has struggled a bit in the digital health arena with the flashy-but-flopped patient engagement platform GoYou. It’s piloted telehealth to reduce readmissions with Care Innovations [TTA 7 Oct 14]  and Coach by Cigna, a mobile health platform in conjunction with Samsung for the Galaxy S5 and S6 phones.

Aetna has had some success with working with ACOs, with 62 contracts covering about 1 million lives, but this Editor counts over 400 practice-based ACOs in the Medicare Shared Savings incentive program alone. Their experiment in consumer app aggregation, CarePass, came to a quiet end last August and Healthagen, their ’emerging businesses’ unit, has had some swerves in rationale including iTriage and even ActiveHealth Management, their long-time population health analytics arm. While digital health is part of it (see Mobihealthnews), (more…)

Life expectancy up, but so is death from falls (US)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”175″ /]The Gimlet Eye falls outside the box, and is writing this from recovery. Our companion in curmudgeonliness, Laurie Orlov, whacks us upside the head with first the good news then the bad. US life expectancy is up: if you are 65 today, on average you will live to 83 (men) and 86 (women), even with the rise in chronic conditions that affect quality of life, such as diabetes and heart disease. But the bad is that death from falls is also up. This is despite all the systems and gizmos the Digital Health Industry has concocted to detect falls beyond 1970s PERS technology. Once upon a rose-colored Telecare Time we thought we could infer falls purely by sensors detecting lack of activity (the basis of QuietCare, GrandCare, Healthsense, the late WellAWARE). Then with accelerometers, fall detection would be automatic, (more…)

Ding! Telecare developer Healthsense raises $10 million in 8th round

Sensor-based remote monitoring company and certified Grizzled Pioneer Healthsense has completed a raise of $10 million, its eighth round of funding since its founding in 2003. This round was led by new investor Mansa Capital with previous investors Radius Ventures and Merck Global Health Innovation Fund. Mansa has current investments in only two other companies–smartphone med adherence platform HealthPrize Technologies ($3 million from Mansa just yesterday) and employer behavioral health risk manager E4 Health (CrunchBase) with a third, Independent Living Systems, listed on its website, but was a prior investor in well-known Athenahealth. Earlier investors Ziegler HealthVest Management (2007) and West Health did not join in this round. The VentureBeat article alludes to home monitoring pilots with home health providers Humana Cares/Senior Bridge and Fallon Health–odd since Healthsense has always had units in home health. Last year Healthsense bought rival telecare company WellAWARE [TTA 2 July 2013] after the latter experienced difficulty (more…)

The CES of Health (Monday)

A managing director of Accenture, writing in Forbes, looks at the health tech trends as ZDNet did (TTA 5 Jan) and lobs a few surprises. He checks the boxes for wearables and real-time monitoring (what ZDNet called The Internet of Things), but also added in–happily for us–aging in place technologies, giving as examples household robots, med dispensers, video calling, easy navigation screens and interfaces (Bosch Health Buddy Web, GrandCare?). Surprisingly on the list: telecare–“motion sensors that can tell if a person has fallen”. Could it be QuietCare’s and Healthsense’s time–or will these be in a watch form factor? And how about proactive fall detection to help prevent them in the first place?

Withings gets into the Z-Z-Z-Z market: the Aura Smart Sleep System monitors noise, room temperature and light level. It also has an under-mattress sleep sensor to monitor breathing, body movements and heart rate. The app on your mobile device makes sense of the data so you can understand your sleeping patterns and make needed changes for better rest. It’s one of ZDNet’s top 10 products (so far) today.

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2013/10/blue-blazes.jpg” thumb_width=”100″ /]Our Blue Blazes award (so far) goes to the Kolibree Bluetooth Toothbrush. It connects with an app which somehow sizes up how well you–and other members of your family–are polishing their pearlies. Crowdfunding this summer, available either in July or 3rd Quarter (depending on reports) for iPhone and Android (Samsung Galaxy III and S4). It sounds like a good fit for the Hammacher Schlemmer catalogue. MacRumors The Guardian takes an even more dim view by including it in its ‘Day Zero vapourware at CES’ list but Engadget likes it (the job to be done by the inventor related to the kids).

And if you are already there, accelerator/investor RockHealth has a guide to where they will be participating at CES through 9 January here, if you’re interested.

Telecare-assisted AL resident monitoring: study

Research on telecare in the US has been rare of late. Thus this qualitative analysis of focus groups with twelve housing managers from twelve different Evangelical Lutheran Good Samaritan Society (GSS) assisted living communities in the LivingWell@Home (LW@H) program should be looked at carefully for both benefits of and issues with sensor-based monitoring of residents’ significant activities of daily living (ADLs). On the ten most prevalent themes, the most positive were:

  • Benefits: marketing in bridging home to AL and enhanced quality of care; validation of information helping with resident medical status and overall safety; proactive detection of health events
  • Sleep patterns: quality of sleep was perceived as important, and disturbance as an advance indicator of a change in resident health
  • Family member assurance: family members understand the value of technology-assisted care in advanced alerting to potential health problems. In fact using the system at home was possibly more attractive to them than in AL.

However, issues with the LW@H program ranged from perceptual ones (resident privacy)  (more…)

ABI Research surveys…telecare

It is refreshing to note a commercial research study that concentrates on straightforward home monitoring for the senior care market, a segment that doesn’t get the cocktail party chatter or anything resembling buzz.  ABI Research looks at eight home monitoring companies–BeClose, Care Innovations, GrandCare Systems, Healthsense, independa, Philips, pomDevices (Sonamba) and Tunstall Healthcare–and judges them on several analyses. On the Competitive Assessment, measuring product innovation as well as implementation, the three leaders were (in rank order) Healthsense, pomdevices (Sonamba), and GrandCare Systems. Both Healthsense and GrandCare are prominent ‘grizzled pioneers’ evolving their model considerably over the years; Sonamba is a tablet-based relative newcomer so low profile that we haven’t heard about them since their 2011 debut at CES. Whither Philips and Tunstall? (more…)