Comings and goings: Cuts hit Athenahealth, IBM Watson’s Drug Discovery unit; Bain may sell Waystar RCM

Athenahealth has announced they are trimming 4 percent of their total workforce. With a large 900-person campus in Belfast, Maine that once belonged to MBNA credit cards, and a workforce of about 5,000 headquartered in Watertown, Massachusetts, there is considerable local concern in an area of Maine that offers few well-paying jobs. Reportedly dozens of jobs there will be lost. This caps a tumultuous period with the company. Athenahealth was acquired last November by Veritas Capital and Evergreen Coast Capital, then merged with a GE Healthcare spinoff they owned, Virence Health, in value-based care, under the Athenahealth name. Bangor Daily News

IBM Watson’s Drug Discovery product, which was targeted to pharmaceutical companies, is being cut back to work with only current partners and with clinical trials due to poor sales. According to The Register, a tart-tongued UK tech website which actually reached an IBM spokesperson, IBM’s Ed Barbini stated that “We are not discontinuing our Watson for Drug Discovery offering, and we remain committed to its continued success for our clients currently using the technology.” Also Seeking Alpha. IBM Watson and Watson Health, like Athenahealth, are moving through a rocky period of closing initiatives (Watson Workplace), layoffs, executive departures (head Deborah DeSanzo last November), bad publicity, and clients like MD Anderson who don’t part quietly. [TTA 8 Nov 18].

Another merged health infotech company may have a new owner soon. Waystar, which was formed by the acquisition of ZirMed and Navicure in 2017 and manages revenue cycles for 450,000 practices, is rumored to be up for sale by owner Bain Capital. Interested parties include Visa and OracleBloomberg

Babylon as AI diagnostician that is ’10 times more precise than a doctor’

The NHS announced at the top of this month that it would test Babylon Health‘s ‘chatbot’ app for the next six months to 1.2 million people in north London. During the call to the 111 medical hotline number, they will be prompted to try the app, which invites the user to text their symptoms. The app decides through the series of texts, through artificial intelligence, in minutes how urgent the situation is and will recommend action to the patient up to an appointment with their GP, or if acute to go to Accident & Emergency (US=emergency room or department) if the situation warrants. It will launch this month in NHS services covering Barnet, Camden, Enfield, Haringey, and Islington, London. TechCrunch.

The NHS’ reasons for “digitising” services through a pilot like Babylon’s app is to save money by reducing unnecessary doctor appointments and pressure on A&Es. It provides a quick diagnosis that usually directs the patient to self-care until the health situation resolves. If not resolved or obviously acute, it will direct to a GP or A&E. The numbers are fairly convincing: £45 for the visit to a GP, £13 to a nurse and £0 for the app use. According to The Telegraph, the trial is facing opposition by groups like Patient Concern, the British Medical Association’s GP committee, and Action Against Medical Accidents. There is little mention of wrong diagnoses here (see below). The NHS’ app track record, however, has not been good–the NHS Choices misstep on applying urgency classifications to a ‘symptom checker’ app–and there have been incidents on 111 response.

Babylon’s founder Ali Barsa, of course, is bullish on his app and what it can do. (more…)

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…)

IBM Watson being trialled for diagnosing rare and hard-to-diagnose diseases (DE)

The Centre for Rare and Undiagnosed Diseases in Marburg, Germany is known internationally as a healthcare resource for medical centers and physicians who suspect their patients have an unconventional and statistically rare medical condition. Often patient histories are inch-thick and replete with unstructured data such as X-rays, lab results, doctors’ notes and scans, reviewed by multiple medical professionals before reaching Marburg. How to review this data more promptly and better? The first step is to input this anonymized data into IBM Watson. The Marburg Centre will first ask patients to answer a 1,200-question digital questionnaire. This information will also include factors that may impact the diagnosis, from symptoms and family history to the environment they live in and their jobs. The data is also translated from German to English so that it can be cross-referenced to English-language medical information. For the 12-month pilot, Watson will provide Marburg’s staff with a differential diagnosis — a list of potential illnesses that fit the patient’s symptoms — which they then review. Watson can provide a percentage of possibility, which Marburg may skip as these are, after all, rare diseases. The Watson decision tool is being tested retrospectively on already-diagnosed patients. ZDNet

A brief history of robotics, including Turing and Asimov (weekend reading)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/06/robottoy-1.jpg” thumb_width=”150″ /]TechWorld gives us a short narrative on robotics history dating back to Asimov’s Three Rules of Robotics (1942), Turing’s Imitation Game (1950) and the pioneering work of several inventors in the late 1940s. There’s a brief tribute to Star Wars’ R2-D2 (Kenny Baker RIP) and C-3PO.  It finishes up with AI-driven IBM Watson and Deep Mind’s AlphaGo. Breezy but informative beach reading! Hat tip to Editor Emeritus and TTA founder Steve Hards; also read his acerbic comment on Dell and Intel’s involvement in Thailand’s Saensuk Smart City

Rounding up the funding rounds of 2015–and the deals some would like to see (?)

Mobihealthnews rounded up 2015’s hot funding in the mobile health/health tech-related space, with helpful links to their articles. They cite as we have previously [TTA 16 Dec] Rock Health‘s flattish year-to-year 2015 total of $4.3 bn, but also StartUp Health’s bloom-off-rose 2015 digital health total of $5.8 bn–larger than Rock Health’s tote, but 17 percent off their 2014 total of $7 bn. If you consider the proportions: the top 10 deals raised $738 million–$130 million alone to the endlessly funded but yet to take over the world ZocDoc –the roster below $20m remains the longest, which is completely in accord with the lower part of Rock Health’s pyramid of angel-A-B rounds.

Yet Aditi Pai’s detailed summary strikes this Editor as useful in an unanticipated way. There is a certain sameness in the products and services of these companies, as if funders are seeking validation in similarity. ZocDoc, DoctoLib and Vitals–doctor profiles and appointment booking. Sharecare, Welltok, Novu, Noom, AbilTo, SocialWellth, Health Recovery Solutions, Jiff–health and wellness engagement programs/apps, many for corporate programs. Whoop, Sano, Sproutling, TuringSensor, Valencell, Moff and four others–wearables. Hello, Sleepace, Sproutling (baby)–sleep tracking. Klara, SkinVision, Spruce–dermatology apps. Beyond the gloomy forecast for unicorns (Theranos being the Child on the Milk Carton), how many of these corporate wellness programs, sleep trackers and wearables will be around in 2017? Mobihealthnews’ 2015 funding roundup.

MedCityNews takes a lighter-hearted (I think) look at 2016 deals. IBM would buy athenahealth mainly for its EHR and practice management data, plus data aggregator Validic, to beef up Watson; 23andMe, past its two years of troubles after stepping on FDA Superman’s cape, would buy PatientsLikeMe (endangering its community shaped credibility? 23PatientsLikeMe?) and the best–Theranos bought by Boston Heart Diagnostics/Eurofin (EU lab testing giant), which would reduce this unicorn to a pony…but one that might make it. Theranos also made VentureBeat’s list of Likely Carcasses in the Valley of Unicorn Death (to quote the article’s author). Chris Seper’s Deals He’d Like To See.

Taking our own transformation medicine: how to integrate digital health into healthcare

An antidote to Dan Munro’s top-down and pessimistic vision of healthcare transformation (having much in common with Ezekiel Emanuel’s, see below) are two parallel prescriptions on integrating digital health into our healthcare systems and maybe, just maybe, transforming it.

The first acknowledges basic reality: we have all the health tech and funding we need right now. We are way beyond the fictional one device, app or service that will deus ex machina and transform healthcare. What we in the field need to do is integrate them, measure (and integrate) the data, get these systems and services into the home and–interestingly–seek out atypical early adopters. Your users/patients may not be the sexiest market for cocktail party chatter–older adults, the developmentally or cognitively disabled–and you’ll have to think beyond smartphone apps, but here is an opportunity to make an impact on a real, large, high-need and open market which can improve care, outcomes and reduce/redistribute cost over time. How The Digital Health Revolution Will Become A Reality (TechCrunch) Hat tip to reader Paul Costello of Viterion Digital Health.

The second analyzes a key point often neglected in healthcare discussions but well-known to students of behavior, like marketers: the patient’s perception of value. (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.

US Department of Defense picks Cerner/Leidos/Accenture for $4.3 bn EHR

Breaking News Updated  The winner of the massive, potentially ten year contract for the Defense Healthcare Management System Modernization program is defense computer contractor Leidos, which brought in Cerner and Accenture Federal Systems.The DOD announcement mentions only lead contractor Leidos, interestingly under the US Navy Space and Naval Warfare Systems Command, San Diego, California. The announcement was released just after 5pm EDT today.

This combination beat the Epic/IBM and the Allscripts/Computer Sciences/HP bids. According to the DOD announcement, “This contract has a two-year initial ordering period, with two 3-year option periods, and a potential two-year award term, which, if awarded, would bring the total ordering period to 10 years. Work will be performed at locations throughout the United States and overseas. If all options are exercised, work is expected to be completed by September 2025. Fiscal 2015 Defense Health Program Research, Development, Test and Evaluation funds in the amount of $35,000,000 will be obligated at the time of award.” Modern Healthcare attended the embargoed press conference this morning and adds in its article that only one-third is fixed cost, with the remainder as ‘cost plus’, which could conceivably run the contract to the $4.33 bn ceiling over the 10 years. The system will be used in 55 military hospitals and 600 clinics, with an initial operational test as early as 2016 (Washington Post) and full rollout by 2023.  Interoperability with private EHR systems was a key requirement (Healthcare IT News).Over the 18 year life cycle, the contract value could be up to $9 bn, according to the WaPo.

The race to replace DOD’s AHLTA accelerated with the final failure to launch a plan to create a joint DOD-VA EHR in March 2013 [TTA 27 July 13], though hopes revived in Congress occasionally during the past two years [TTA 31 Mar].

It is also widely interpreted as a blow to Epic, which has been defensive of late about its willingness to play in the HIT Interoperability sandbox with other EHRs; certainly it cannot make Big Blue, which would undoubtedly have found some way to sell Watson into this, happy.

POLITICO’s Morning eHealth had many tart observations today, mostly pertaining to the belief of some observers that Cerner will be strapped in meeting this Federal commitment and would find it increasingly difficult to innovate in the private sector.

Example–From Micky Tripathi, CEO of the Massachusetts eHealth Collaborative: “My biggest worry isn’t that Cerner won’t deliver, it’s that DOD will suck the lifeblood out of the company by running its management ragged with endless overhead and dulling the innovative edge of its development teams. There is a tremendous amount of innovation going on in health IT right now. We need a well-performing Cerner in the private sector to keep pushing the innovation frontier. It’s not a coincidence that defense contractors don’t compete well in the private sector, and companies who do both shield their commercial business from their defense business to protect the former from the latter.”

ATA’s hottest trend: advancing to Healthcare 2.0 via personalized healthcare

Guest columnist Dr Vikrum (Sunny) Malhotra attended ATA 2015 earlier this month. This is the third of three articles on his observations on trends and companies to watch.

For those who attended the American Telemedicine Association‘s meeting in Los Angeles, the overarching trend was how a personal healthcare system is taking shape. The three pillars include: care anywhere, care networking and care customization.

The ATA stage opened with a keynote speech by Dr Sanjay Gupta about celebrating new innovation and technology advancements. This is the year where healthcare models are being built around patients in the home to support patient autonomy.These three pillars of personalized healthcare are being made possible by disruptive technologies, wearables/implantables, social networks and analytic technologies to automate remote care. Wearables and biosensors allow patients to move anywhere without interfering with day to day schedules while allowing for optimized data collection.

Access to care anywhere has been a challenge and is becoming realized through providing cheaper wireless tools that takes it to far corners. Dr Gupta focused on the use of telemedicine for delivery of care and its utility for improving access. He endorsed it as a tool for providing care for those with limited healthcare accessibility and locally for more a mainstream solution to a larger healthcare problem. We have seen telemedicine become mainstream (more…)

IBM Watson Health adds 2 companies, three partners, moves to Boston and into the cloud

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/04/IBM-Watson-Announcement.jpg” thumb_width=”200″ /]A Day with a Big Exclamation Point for Healthcare Data and Analytics. In a series of press releases late NY time on Monday and a spectacular announcement at HIMSS (photo hat tip to Sandeep Pulim via Twitter), the recently quiet-on-the-healthcare-front IBM Watson has announced multiple major moves that re-position it squarely into the healthcare arena as the 90,000 lb. Elephant.

  • IBM Watson Health is now a separate business unit headquartered in Boston. The Watson New York headquarters will be expanded, but that may be for their other businesses: travel, retail, veterinary care, cognitive computing, and IT security and support. IBM claims that Watson Health will be hiring up to 2,000 healthcare consultants, clinicians and researchers, folding in existing units such as Smarter Care and Social Programs.
  • The IBM Watson Health Cloud is now their secure, open and HIPAA compliant platform for health-related data: physicians, researchers, insurers and health and wellness companies.
  • Three new partnerships were announced, designed to bolster IBM in different aspects of what is to be done with All That Data being generated from health and fitness devices. IBM Watson Health Cloud will be the secure platform, storage and analytics for Apple’s HealthKit and ResearchKitJohnson & Johnson will be working with Watson on pre/post-operative coaching and education and Medtronic on diabetes management using data from Medtronic devices. (more…)

Set that disease data free! A call to break down those data silos.

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/03/BlueSiloCollapsing-41.jpg” thumb_width=”175″ /]Awash in a rising sea of data generated by devices and analytics–around treatments, population health, costs–there’s a struggle to make sense of it. We’ve noted the high value and merchandisability of 23andme‘s genomic data (gained by individual user consent) [TTA 5 Mar], but our healthcare institutions which should be codifying and sharing disease and treatment data, largely do not. Those with rare or ‘orphan’ diseases struggle to find information, diagnosis, fellow patients, treatments. They sometimes win breakthroughs by, believe it or not, blogging, and having their articles widely disseminated. Reasons why? According to David Shaywitz in Forbes, they are:

  • Hospitals, even research based centers, struggle to codify their genotype and phenotype data of their patients in a meaningful way that would be usable for clinical decision making. We’ve also noted (oddly not Mr Shaywitz) the long implementation process of IBM Watson cognitive processing/decision making tools in healthcare, the concentration on single diseases and their spread into other industries plus third-party integration outside of healthcare [TTA 9 Oct 14].  (more…)

VA calls IBM Watson for decision making, PTSD assistance (US)

The US Department of Veterans Affairs (VA) Veterans Health Administration (VHA) area is working with IBM Watson to develop and pilot a Clinical Reasoning System to assist and accelerate decision making by primary care physicians. The $6.8 million, two-year project will concentrate on acquiring and analyzing the data generated by hundreds of thousands of VHA documents, medical records, EMRs and research papers. The second focus of the VA-Watson relationship will also include mental health–supporting veterans with PTSD who constitute 12-20 percent of US veterans from Vietnam to present. The pilot phase, interestingly, will use simulated, not real, patients.

(more…)

NYeC Digital Health: two diverging visions of a connected future (Part 1)

The New York eHealth Collaborative’s fourth annual Digital Health Conference is increasingly notable for combining both local concerns (NYeC is one of the key coordinators of health IT for the state) and nationally significant content. A major focus of the individual sessions was data in all flavors: big, international, private, shared and ethically used. Another was using this data in coordinating care and empowering patients. Your Editor will focus on this as reflected in sessions she attended, along with thoughts by our two guest contributors, in Part 2 of this roundup.

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/12/Topol-Compressed.jpg” thumb_width=”150″ /]The NYeC Conference was unique in presenting two divergent views of ‘Future IT’ and how it will affect healthcare delivery. One is a heady, optimistic one of powerful patients taking control of their healthcare, personalized ‘democratized medicine” and innovative, genetically-powered ‘on demand medicine’. The other is a future of top-down, regulated, cost-controlled, analyzed and constrained healthcare from top to bottom, with emphasis on standardizing procedures for doctors and hospitals, plus patient compliance.

 

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/12/Topol-tech-adoption-compressed.jpg” thumb_width=”150″ /]First to Dr Topol in Monday’s keynote. The good side of people ‘wired’ to their phones is that it is symptomatic, not of Short Attention Span Theatre, but of Moore’s Law–the time technology is now taking for adoption by at least 25 percent of the US population is declining by about 50 percent. That means comfort with the eight drivers he itemizes for democratizing medicine and empowering the patient: sensors, labs, imaging, physical examination, records, costs, meds and ‘Uber Doc’.

(more…)

IBM Watson decision tools expand, lands at NYC HQ

Confirming that New York metro’s once-devastated (post-dot.com bust) ‘Silicon Alley’ is increasingly attractive to healthcare and tech firms, IBM this past Monday opened its new NYC downtown headquarters at Astor Place for the IBM Watson Group. Our readers have been following the development of Watson in the healthcare decision-making process since 2012 [TTA’s article index here], primarily in oncology (breast and lung cancer), in the UK (via the RSM’s 5 June ‘Big Data’ conference) as well as the US. IBM Watson has smartly created Ecosystem Partners where third parties integrate Watson. The spread is fairly wide: travel (your Editor’s former industry), retail, veterinary care, IT security and support, cognitive computing and of course healthcare. Spotlighted were three companies: @PointofCare, Welltok and GenieMD. (more…)

Data mining health records: the good, bad and ugly

Take your time this weekend and read this article from the Washington Post on the ‘brave new world’ of data mining health records. While those with experience analyzing real-world health data snicker at Larry Page of Google’s inflated claims of ‘saving 10,000 lives in the first year’ if only he could get his hands on that identified data (of course, then there’s the opportunity to make $£€¥, which is what Larry and Sergey are really interested in–count your Editor as a cynic!), the Health Data Analytics Express rolls on. The promise lies in more precision in treatment areas such as brain tumor radiology where sizing is critical (BraTumIA) and individualized genomics for disease. Yet the author does not touch on healthcare decision support systems best exemplified by IBM Watson, (more…)