The ‘health kiosk’ idea is alive and kicking from New York to France

click to enlarge[Photo: NYP] The $40 million+ failure of HealthSpot Station last year [TTA 14 June 16] might have signaled the demise of the health kiosk (telemedicine + multiple vital measurement devices) concept. Basic stations with consumer engagement/mobile tie-ins such as Higi have been gaining traction at retail locations [TTA 30 Mar] such as RiteAid (which bought the assets and IP of HealthSpot) and Publix supermarkets. CVS MinuteClinics in northeast Ohio and Florida have allied over the past two years with Cleveland Clinic and American Well to integrate records and telemedicine. But the kiosk model is gaining a second life with these recent iterations.

  • NewYork-Presbyterian, Walgreens (Duane Reade) and American Well: Kiosks located in private rooms at select Duane Reade drugstores (left above) connect to NYP OnDemand using American Well telemedicine and Weill Cornell Medicine emergency medicine physicians. In addition to the live consult, the patient can send select vital signs information to the doctor using a forehead thermometer, a blood pressure cuff, a pulse oximeter, and a dermascope for a high-resolution view of skin conditions. Pediatric emergency physicians are available through NYP OnDemand weekdays between 6 – 9pm. Prescriptions are e-prescribed to the patient’s preferred pharmacy. The first kiosk opened this week at 40 Wall Street with additional locations to open in 2018. NYP OnDemand telemedicine consults are also available to NY area residents through the Walgreens website. American Well release, Healthcare IT News, MedCityNews
  • H4D (Health for Development): French doctor Franck Baudino wanted to reach those who live in what the French term ‘health deserts’ in their rural areas. Over the past nine years, he developed a booth-type kiosk connecting to a live doctor and with vitals instrumentation. The Consult Station is fully equipped with a wide range of vitals instrumentation, including vision, audio, eye, and blood glucose, functioning almost as a remote doctor’s office. In France, to gain access, all users need do is pop in their carte vitale. Reportedly the kiosks can treat 90 percent of common illnesses. Prescriptions are printed out in the booth. Consult Stations are now in France, Italy, Portugal, Philippines, Canada, Belgium, UAE and were recently cleared by FDA as a Class II device. ZDNet  

Unhappy endings? HealthSpot’s remains to Rite Aid, Theranos’ story to Hollywood

HealthSpot Station’s assets to Rite Aid, minus the ‘froth’. On Monday, drug store chain Rite Aid won the US Bankruptcy Court in Columbus, Ohio’s mandated auction for the inventory, most assets and IP for its entry bid of $1.15 million. According to Columbus Business First (subscription only), a touted second bid by a central Ohio investor group was $1 million–and stayed right there with no second bid. This group had invested $650,000 before HealthSpot entered Chapter 7. A dark horse third bidder, which came in at the last minute, never put money on the line.

The Ohio business group leader, local assisted living facility owner Paul Gross, interestingly maintained his faith in the kiosk concept to Columbus Business First in an earlier interview, rapping the prior management for squandering approximately $47 million (more, given Xerox‘s never-disclosed investment) on office furniture, lavish executive salaries and misbegotten marketing (quoted in MedCityNews). 25 of the kiosks were in Rite Aid locations in Ohio and others with Cleveland Clinic, but there are 137 still ‘in the box’. Perhaps ‘misbegotten’ should be applied to the concept (kiosks too big, expensive) and not the marketing communications, which in this Editor’s professional judgment were strong and appealing, but ran into the ‘lipstick on a pig’ wall.

One wonders what Rite Aid, in the throes of its own difficult merger with Walgreen Boots Alliance, will do with the assets. TTA’s earlier stories on HealthSpot.

Theranos the Movie, starring Jennifer Lawrence. Co-starring Walgreens? ‘Hunger Games’ star Jennifer Lawrence has reportedly agreed to star in ‘The Big Short’ director Adam McKay’s adaptation of the story. (Fortune) Certainly there is a resemblance to CEO Elizabeth Holmes Frogeyed Sprite (‘Bugeyed’ to us Yanks–Ed.) crossed with Steve Jobs. Ms Lawrence has already played a young, aggressive, come-from-nada inventor of household gadgets in ‘Joy’. The Theranos story is appearing to be the ‘Joy’ story in reverse. Suggested title: ‘The Royal Scam’? (credit Steely Dan, circa 1974). ‘Less Than Zero’ (Bret Easton Ellis) is taken, now describing Ms Holmes’ net worth according to Forbes.

Mr McKay will be ripping from the headlines in progress, should the movie actually be made. (more…)

Outsourcing of retail clinics–another reason for HealthSpot’s demise? (US)

Walgreens earlier this week announced another round of outsourcing their in-store health clinics to a local health system, this time in the Midwest US with Advocate Health Care. It affects 56 locations in the Chicago, Illinois area which will operate as Advocate Clinic at Walgreens in May 2016. It’s an interesting spin on the much-touted integration of healthcare services into retail pharmacies. It gives an integrated health system a prime location for community services–a clean, well-lighted place (to quote Hemingway, minus the daiquiris) with minimal overhead that provides one-stop-shopping for patient pharmacy and OTC products. It also solves part of the ‘fragmentation of care’ problem for Advocate patients as their records will go straight into their EHR. For Walgreens, it offloads the licensure and operating expenses of a clinic, gives a strong competitive advantage lent by the legitimacy of a leading provider, and attracts Advocate patients to their locations. Walgreens release  Last August, Walgreens turned over the keys of 25 Washington and Oregon clinics to Providence Health & Services in what now can be seen as a trial balloon.

What is surprising is how few Walgreens have clinic services–400 of over 8,100–over nine years of operations, starting with the acquisition of former travel industry executive Hal Rosenbluth’s 25 or so TakeCare Clinics around Philadelphia back in 2007. Yet further clinic expansion has been difficult as many locations have no physical space, there are restrictive state laws and the competition is everywhere between over 1,000 CVS Minute Clinics and local urgent care clinics. CVS also recently acquired 80 Target pharmacies and walk-in clinics. It’s reported that profitability has been a challenge for Walgreens in the clinic biz. Expect to see more of these arrangements to grow Walgreens’ clinic network.

Why might this be a contributor to HealthSpot Station’s end? A change of direction and a need for cost cutting that wasn’t there a year ago.  (more…)

HealthSpot closes the doors, shuts kiosks in Rite Aid, Cleveland Clinic (updated)

As we reported last July, HealthSpot, the Dublin, Ohio, based telemedicine health kiosk business which was click to enlargecarrying out a retail trial with Rite Aid since November 2014, started commercial operations in 25 locations in three Ohio areas.

In October reports emerged of a patent infringement claim that has been ongoing since April 2014 against HealthSpot by Nevada-based Computerized Screening. (More on this ongoing series of lawsuits in Ohio and Nevada is here.)

According to reports in Columbus Business First, HealthSpot has now informed Rite Aid that it would cease operations as of 31 December last year and its telemedicine kiosks are reported to have shut down in Rite Aid pharmacies. HealthSpot has also notified Cleveland Clinic that it has discontinued operations, which shuts its pilot with Cleveland Clinic in northeast Ohio.

HealthSpot’s website remains live but the last entry in the press releases section is from September 2015 and is on events at which HealthSpot was to participate in September and November. The blog page on its website is well out of date with the last update dated as far back as March 2015. (Links for locations and patient log in were inoperable–Ed. Donna)

One recent news report stated that attempts to contact CEO Steve Cashman went unanswered.

In November 2014, HealthSpot received a major investment from Xerox on top of a $18.3 million springtime round [TTA 13 Nov 14].

Updated 13 Jan (Editor Donna)

The Columbus Business First articles that Editor Chrys has linked to, as of this point, are the most informative. Neil Versel and Stephanie Baum also have related articles in MedCityNews. They also chewed it over with HealthcareScene network’s John Lynn last Friday on video (starts at 26:30) with a surprising revelation that Mr Cashman had been in touch with Mr Lynn, to be published in one of their blogs (but not yet as of this update.) Thus the mystery remains.

Xerox has issued a statement of their continued interest and support of the healthcare sector which is covered in MedCityNews above. We also noted their diverse interests in healthcare quality management, data and analytics through through their Midas+ division here last year.

According to CrunchBase, HealthSpot received $43.81 million in financing since 2011, not including the undisclosed support from Xerox, with the most recent raise debt financing of $11.56 million in January 2015. One year ago, HealthSpot looked so promising. (more…)

Qualcomm Life, Cox Communications buy into integration–differently (US/FR) updated

Qualcomm Life, known for building partnerships with independent companies to form a continuum in transitional/chronic care management utilizing the HealthyCircles platform [TTA 19 Dec 14], yesterday announced not a partnership but an acquisition–Capsule Tech, a company that builds systems for healthcare facilities, mainly hospitals, to collect and integrate data from myriad medical devices. Their medical device information system (MDIS) is dubbed SmartLinx and is used by 1,930 hospital clients in 38 countries. Headquartered in Andover, Massachusetts, Capsule has international offices in France, Singapore, China, Australia, UAE and Brazil. Majority owner was Turenne Capital, a French PE company. Acquisition terms were not disclosed. Release. Also Forbes, Neil Versel in MedCityNews.

Update: Fortune is quite bullish on how this aids Qualcomm in narrowing the quality gap of data transmission between the home and the hospital setting.

Cox Communications, the third largest cable and internet company in the US with ad media and business data divisions, is dipping more than a tentative toe in healthcare with last week’s acquisition of Trapollo, a program design/supply chain/logistics provider that currently works with multiple telehealth, telecare and monitoring device companies. Cox is clearly seeking another type of integration of their data carriage capabilities with systems and programs; they have also invested in HealthSpot Station’s virtual visit/telehealth kiosk and formed a strategic alliance with Cleveland Clinic. Release.

Neil Versel’s columns also note IBM Watson‘s growth and development of its own Care Manager with Apple HealthKit/ResearchKit [TTA 10 Sep] and Salesforce’s entry into patient management with Health Cloud, with another big announcement rumored to be on the way.

Drawing a parallel between healthcare and … newspapers

…is the point that Dave Chase, who founded patient information/engagement portal Avado and sold it to WebMD in 2013 (and with them until last month), is making in this Forbes article. As newspapers found their readership leaving in droves for online websites that delivered ‘news they could use’ faster and more interestingly, healthcare systems are finding that their patients are finding healthcare services outside their bricks-and-mortar:

  • Onsite workplace clinics (including telehealth/telemedicine hybrids such as HealthSpot Station–Ed. Donna)
  • Direct primary care providers such as Iora Health, Qliance, DaVita’s Paladina Health
  • Retail clinics: MinuteClinic, TakeCare Health
  • Medicare Advantage-only programs such as CareMore [TTA 5 May] and Healthcare Partners
  • Domestic medical tourism by large, self-insured companies for elective surgeries

This Editor would argue that these forces are at work even in (and perhaps because of) centralized payment systems, and are worldwide, not just in the US. Certain communities such as Rochester, NY, Dubuque IA and Seattle are focusing on lower healthcare as attractions to business–and countries such as Costa Rica, Mexico, Brazil, Singapore, Hungary and India are capitalizing on US-quality facilities and doctors to gain medical tourism for elective and self-paid surgery.

ATA 2015: Day 1 news

click to enlarge HealthSpot/Xerox, Sentrian/Scripps, American Well, Honeywell, vitaphone, more

HealthSpot unveiled the first results of its partnership with (and investment by) Xerox, leveraging their HIT cloud infrastructure and back-end for the HealthSpot Station. The telehealth/virtual consult walk-in kiosk has targeted over 30,000 retail pharmacies with a newly developed consumer retail pharmacy personal health record (PHR). Upgraded patient and portal interfaces process insurance claims through a payment data feed and integrates with EMRs. Release….The US/UK predictive data/remote patient intelligence company Sentrian, winner of this year’s ATA Innovation in Remote Care award, is a part of a year-long 1,000-patient COPD remote patient monitoring study by the Scripps Translational Science Institute (STSI) with members of Anthem’s CareMore health plan. The goal is to use the Sentrian platform data to accurately detect COPD patient decompensation in advance to reduce avoidable hospital readmissions, which on average in the US is 1 out of 11 within 30 days of discharge. Release….American Well launched a platform for individual physicians to connect with current patients (more…)

News highlights for Friday

AnthemHealth didn’t encrypt, Blueprint Health collects, HealthSpot funds again, Sense4Baby goes to Europe, Apple Health pilots in hospitals and buddi gets bigger still.

Another hack attack claimed major US health insurer AnthemHealth, the former WellPoint. It’s estimated that 80 million of its customers, former customers and employees had data breached: names, addresses, dates of birth, emails, employment information, income, medical IDs and SSIs. The Wall Street Journal reports that Anthem didn’t encrypt data for analytics reasons. It’s unconfirmed where the hackers originated but Bloomberg’s latest report tags the usual Chinese state-sponsored suspects. Unusually, it was reported within days of discovery; Anthem has called in Mandiant (FireEye) to beef up its cybersecurity. Other reports: WSJ, Modern Healthcare….The Blueprint Health accelerator has a new initiative, the Collective. It is designed to pair up major healthcare providers and payers with startups and early stage companies. So far signed up are Aetna, AstraZeneca, HP, Montefiore, North Shore LIJ, New York-Presbyterian, Samsung, EmblemHealth, Philips and Razorfish Healthware. More information here….The HealthSpot Station telehealth/telemedicine kiosk is readying a $11.6 million funding round from four investors soon, based on (more…)

Another Xerox healthcare move: reducing readmissions

About two months ago [TTA 13 Nov 14], we noted Xerox’s interesting investment in telehealth/virtual consult kiosk HealthSpot Station. We thought at that time that Xerox was not active in healthcare services and thus found the HealthSpot Station investment unusual. Right on the diagnostics, wrong on the data crunching. Notably, their Midas+ subsidiary concentrates on healthcare quality management, analytics and benchmarking solutions. Midas+ has entered into the readmissions fray by combining its proprietary database, compiled over 1,900 Xerox hospital clients, with five years of Medicare and claims data to help hospitals better predict 30-day same-cause readmissions. The Midas+ Readmission Penalty Forecaster uses the data to project in “near real-time” both patient patterns and reimbursement rates. Commenting to MedCityNews, Justin Lanning, SVP and managing director of Xerox Healthcare Provider Solutions, said the Forecaster has a 1.5 percent margin of error within the predictive model, with quarterly updates provided to participating hospitals. Midas+ also offers, beyond the model, onsite consulting. HealthSpot Station theoretically could throw off a lot of data on outpatient disease and treatment. Midas+ Forecaster white paper, eWeek.

We also note that MedCityNews, one of the livelier publications that covers a wide swath of the US healthcare scene,  is being acquired by Breaking Media, a New York City-based digital publisher. CEO Chris Seper will remain with the publication. Article.

A boffo week for telemedicine. Will 2015 be online visits’ Big Year?

(Boffo: extremely good or successful, sensational–Webster)

Adding to Monday’s news of ATA’s telemedicine accreditation program was American Well‘s near-simultaneous announcement of an $81 million Series C funding.  This brings total funding for the eight year-old Boston-based company to over $128 million, though it is not yet profitable. According to Modern Healthcare, “The capital injection will be used to serve a number of big projects the firm has underway, company co-CEO Dr. Ido Schoenberg said in an interview. Among those are campaigning to ease regulatory constraints, scaling its provider networks and customer outreach, working with insurers to secure more favorable reimbursement and working on its technology, he said.” The institutional, private equity, and corporate investors alluded to in the company release were not disclosed. Its mobile app, Amwell, claims over 1 million downloads with a year-to-year 1,000 percent increase. Major partners include payers Anthem Health, EmblemHealth, the Blue Cross Blue Shields of Massachusetts and Louisiana, Optum Health as well as corporate clients. American Well press release, BostonInno, SEC filing. (Note to American Well: you’re telemedicine, not telehealth)

If this round of funding represents a substantial bet on American Well’s future, another is the new relationship between Walgreens‘ and rival MDLIVE. (more…)

Follow up: Xerox invests in HealthSpot Station kiosks (US)

The day after this Editor posted on telehealth/virtual consult kiosk HealthSpot Station‘s new partnerships with Mayo Clinic and major drug retailer Rite Aid, Xerox announced their investment in the company. Xerox is not a business services organization one immediately associates with healthcare technology, but perhaps not anymore, based on this quote from Connie Harvey, Xerox’ chief operating officer of Commercial Healthcare: “HealthSpot is at the center of healthcare’s shift to a patient-centered model of care, and our investment in the company demonstrates Xerox’s commitment to transforming traditional healthcare into a high-value delivery system for patients, providers and payers.” Xerox will also be supplying BPO–business process outsourcing–services for cloud hosting, system integration, claims eligibility and claims submissions. But there’s more…. (more…)

Telehealth kiosk HealthSpot gains trials with Rite Aid, Mayo Clinic

click to enlarge HealthSpot Station, which was one of the higher points of this past May’s ATA, in the past month has announced two significant pilots. The retail pilot is with Rite Aid, the US’ third largest drug store chain (4,600 stores), with telehealth/telemedicine kiosks located in select Rite Aid locations in Ohio–Akron/Canton, Cleveland and Dayton/Springfield areas. The usage of the kiosks will be limited to common health conditions, such as cold, earaches, sore throat, sinus infections, upper respiratory infections, rashes, skin and eye conditions. HealthSpot Station kiosks are enclosed, free-standing units which use both video consults and real-time interaction with telehealth devices for remote diagnosis. They connect to a network of board-certified medical professionals at Cleveland Clinic and other major health systems across Ohio. Start date and duration were not disclosed.

This follows the October announcement with Mayo Clinic of an in-house pilot in Austin and Albert Lea, Minnesota with approximately 2,000 Mayo Clinic Health System employees (more…)

Funding, granting and executive moves

Summer hasn’t been beach holiday time for some of the companies we’ve been following….Genetic testing for the masses 23andMe, only last fall in much hot water with FDA (but recently making nice–TTA 2 July), received a two-year, $1.4 million grant from the National Institutes for Health (NIH). iHealthBeat….’Smart pill’ developer Proteus Digital Health received a Series G round of $52 million, adding to a June round of $120 million. Investors not disclosed, but Proteus currently has a blue-chip list including Novartis, Medtronic and Kaiser. BusinessWire….Pre/post-procedure education and recovery monitoring service VOX Telehealth received another $1.1 million round of angel financing primarily from original investors, preliminary to an institutional round of financing in 1st Quarter 2015. Release….HealthSpot Station is reinforcing its retail reach (more…)

A random walk through ATA 2014

click to enlarge Editor Donna attended ATA 2014 on Monday only. This article is a set of impressions (mainly) of the exhibit floor and visits to a number of select booths.

Donna, it’s Baltimore. You’re not in NYC or Las Vegas.

Arriving after a long trip to a city you used to visit regularly, but haven’t been to in over 30 years, is disorienting, especially when you are heading on a fair spring day to a section that didn’t exist then. The Inner Harbor and Camden Yards resemble Atlanta, not necessarily a bad thing since the parts of ‘Charm City’ they replaced were largely past ‘gentrification’. The Baltimore Convention Center was unexpectedly huge, the distance to registration made longer by a taxi driver who dropped me off at another entrance two blocks away. Any resolve I had to drop in on the many educational sessions was dissuaded by the sheer length of the halls. The thick Exhibit Guide confirmed that the show floor filled two city blocks–a challenge to cover and spend time with my appointments before the close of the day.

Was it a hardware show, a software show or somewhere in between?

You could make a case for both views. One observer I walked with at the start compared it to a radiology trade show–all hardware. Yet a closer look indicated that the hardware–the PCs, tablets and smartphones–was there to show software that integrated: systems to track patients, distribute information, workflows, store and forward images and reports. It was about enabling secure consults, platforms, interoperability, two-way data flows, mitigating readmissions and putting telehealth, telemedicine and education into provider and patient hands. It was also about making the business case. It was most definitely NOT about gadgets and single purpose peripherals, though the latter were still quite visible. The old picture of telehealth closed systems, of proprietary monitoring devices feeding data onto a proprietary PC platform where it’s seen by a care manager, is so 2011.

Noteworthy: the growth in specialized services like telepsychiatry, teleneurology, teleradiology and teledermatology. Contrast: despite VGo‘s ubiquitous telepresence robots accosting you on the floor, a tablet-faced robot following a nurse down the hospital hall and ‘consulting’ with patients will likely still be a rarity.

Patient engagement on top

Traditional telehealth device makers are connecting their devices and opening up their reporting platforms to be accessible to patients. But there are bumps along the way in this transition. A&D Medical has gone ‘Wellness Connected’ with a mobile app (more…)

A kudo for kiosks: HealthSpot Station adds $8 million funding

click to enlarge In a week of small funding announcements, HealthSpot announced an add of $8 million to its 2013 $10 million round, totaling $18.3 million of a $20 million offering (SEC filing). Investors are not disclosed. In three years, HealthSpot has raised an impressive total funding of $23 million (CrunchBase), although the company is still in pilot in a handful of locations around their Ohio HQ and reports minimal revenue. The company’s hosted, fully enclosed kiosks with both telehealth monitoring and virtual consult capabilities debuted at the end of 2012 at International CES New York. According to their website, their markets are facility waiting rooms, pharmacies, schools, military bases and prisons. Their partnerships have been notable: EHR Netsmart, telemedicine network Teladoc and a co-location arrangement with Canadian pharmacy kiosk MedAvail [TTA 23 Jan]. They are also on the board of the Alliance for Connected Care lobbying advocacy group [TTA 13 Feb], which will certainly aid their cause by plumping for increased telehealth coverage by Medicaid beyond the present 20 states and Medicare beyond rural special programs. Yes, they will be at ATA 2014, if you are attending. Mobihealthnews

‘Blue Blazes’ indeed: Wal-Mart’s clinic in a back room

click to enlarge The surprise here is not that Wal-Mart is teaming with Kaiser Permanente at two locations in California (Bakersfield, Palmdale) to trial a telemedicine/telehealth clinic. Nor is it that it’s confined to KP members and Wal-Mart employees–it is, after all, a pilot (albeit for two years). It’s that they’d let a photographer take a picture of the sheer crudity of the clinic setup (left, below, click to enlarge). It likely utilizes a disused storage area or back room, where the clinic, instead of soothing, clean white or blue, is institutional tan and crammed full of plug-ins–cameras, PC screens, equipment, exposed wires, plugs and outlets. Perfect for the claustrophobic! (s/o) The modish paint and signage at the entry area outside (see article photos) only serve to set up the potential user for disappointment. The question is, why didn’t they simply rent some ready-made kiosks from HealthSpot Station [TTA 29 Oct 13 + previous] or SoloHealth (already a Wal-Mart vendor)–or others? No wonder the nurse has to drag prospects off the floor. Truly a ‘What In Blue Blazes?’ moment that does not bode well for the success of this pilot–and a puzzle given the partners. Wal-Mart shoppers: The doctor will see you now (Bakersfield Californian)click to enlarge