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…)

Xcertia takes another pass at app certification, but will it fly? (US)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/12/alp-mountains-peaks-in-winter.jpg” thumb_width=”150″ /]An app developer and a healthcare/digital health innovation lab get into the certification game. Can they fly over the treacherous peaks this time? Social Wellth made good on their promise (or threat?) to get into the app vetting business this past week through announcing a partnership with Columbia University-based HITLAB at the HITLAB Summit this week to develop a certification organization known as Xcertia. Last year, Social Wellth acquired the remains of Happtique from GNYHA Ventures [TTA 12 Dec 14]. The Xcertia principles center around privacy, security, operability and content–as Happtique’s did. The intent is to not only develop a program to certify apps based on established standards, but also form a Signature Steering Committee to ensure they maintain “their definitive set of criteria for evaluating mobile health apps.” MedCityNews, release

Possible conflict of interest. It all sounds positive, but the head of Xcertia, David Vinson, is also the CEO of Social Wellth, which despite its nonprofit-ish name makes its living by developing consumer apps and “dashboards” for insurance companies, a task grandly called (from their press release) “the curation of digital health experiences by leveraging mobile health technologies that allow for integration and aggregation of all digital assets.” Social Wellth also makes quite a bit of hay on its website about app curation for its clients. (more…)

IMS Health report: mainstream health app adoption remains elusive

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/09/Key-findings2-thumb-IMS1.jpg” thumb_width=”200″ /]Despite 165,000 apps (and counting). A followup to IMS Health’s report of 2013, Patient Adoption of mHealth demonstrates how far mHealth has to go. Over 50 percent of apps have a single functionality, but connectivity to external sensors (e.g. wearables) has improved to 10%. 36 apps account for nearly 50 percent of downloads and 40 percent of all health apps have 5,000 downloads or less. Providers give limited if any guidance to consumers on app choice despite greater interest; ‘curation’ efforts, including IMS Health’s own [15 Dec 13], have largely failed. Other barriers to adoption are reimbursement (though many are free), limited healthcare system integration, regulator and privacy unknowns.

Where’s the progress? Chronic condition monitoring (left), with clinical trials more than doubling in the past two years, and focusing on treatment/prevention largely for older adults. These clinical trails are looking at mental health, diabetes, cardiovascular disease, weight management and oncology. IMS Health also recommends that users and stakeholders, including clinical organizations such as the CDC, ASCO and the Cancer Support Community tap into their clinical resources to develop and promote patient-centered apps. Download report (information required.)  A decidedly less cheerful take on the report is Stephanie Baum’s at MedCityNews.

Ford disconnects research on heart attack-sensing car seat

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /]The Gimlet Eye returns and hopes that Ford has a better idea, because this wasn’t it. The automaker announced over the weekend that it is abandoning research on car seats that would detect cardiac anomalies such as a heart attack and then (presumably safely) bring the car to a halt (and also presumably, call for medical assistance). A corporate statement to the FT stated that Ford was ‘transitioning’ to other projects, based on advances in consumer wearables. No indication of spend out of a $5.5 billion budget. Undoubtedly, the potential for sensor problems in seats and the danger of shutting down a car while driving were insurmountable. No tears though…. (more…)

‘Separating the wheat from the chaff’ in medical apps daunting: JAMA

Medical apps may not be strangers to doctors’ offices anymore but they also realize that apps are difficult to recommend responsibly to patients or even to find, because there is no real guidance or validation. This current article in JAMA online confirms the perception and the need for care integration that both Editors Charles especially and Donna have pointed out lo these many years. However this Editor is quite disillusioned at the attempts to date to ‘curate’ apps with the Happtique failure and the relatively low profile to date of IMS Health’s AppScript and professional review site iMedical Apps and the stated intentions of SocialWellth which purchased Happtique. The reality is that the numbers are against it–IMS Health in their study estimated 40,000 medical apps–in 2013. For apps that want to take the high road, it’s economically difficult, but could be rewarding in the long term. The WellDoc BlueStar diabetes tracking and management support app did with FDA clearance and prescription-only use, but few so far can see a revenue model there. Also MedCityNews.

Intended use determines degree of health app regulation–and also how you communicate your attributes and performance claims. Bradley Merrill Thompson, who performs an invaluable service by advising our field on regulation, compliance and interacting with FDA, demonstrates how a developer can determine where the intended use of an app might fall (more…)

HIMSS’ last full day highlights company partnerships

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/04/himss_chicago_2015-588×337.jpg” thumb_width=”150″ /]It’s almost time to Say Goodbye to Sinatra’s ‘My Kind of Town’, but there’s still news: Samsung+Partners Healthcare, IMS Health, AliveCor, Interoperability≠Humana, Panasonic+Cisco

  • Samsung and Partners HealthCare announced a direct-to-mobile partnership to develop chronic care management mobile software that monitors vital signs such as blood pressure, blood glucose and weight, as well as delivers mobile patient engagement, medication adherence and wellness self-management. Clinical trial is scheduled for June. Partners has always been a pioneer in the mHealth area, but playing with Samsung, Partners is flying at a slightly higher level than with Wellocracy and certainly the late Healthrageous. Partners release, Mobihealthnews (more…)

Looking back over Telehealth & Telecare Aware’s predictions for 2014, part II

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/01/magic-8-ball.jpg” thumb_width=”150″ /]Editor Charles has treated you to a look back on his 2014 predictions, daring Editor Donna to look back on hers. Were they ‘Decidedly so’, ‘Yes’, ‘Reply hazy, try again’ or ‘My sources say no’? Read on…

On New Year’s Day 2014, it looked like “the year of reckoning for the ‘better mousetraps’”? But the reckoning wasn’t quite as dramatic as this Editor thought.

We are whipping past the 2012-13 Peak of Inflated Expectations in health tech, diving into the Trough of Disillusionment in 2014.

There surely were companies which turned up ‘Insolvent with a great idea’ in Joe Hage’s (LinkedIn’s huge Medical Devices Group) terms, but it was more a year of Big Ideas Going Sideways than Crash and Burns.

Some formerly Great Ideas may have a future, just not the one originally envisioned. (more…)

ATA in the accreditation arena for online patient visits

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/12/ata-seal-of-accreditation.png” thumb_width=”150″ /]The American Telemedicine Association (ATA) has joined the gold rush of accreditation, in this case for online ‘virtual’ visits between doctor and patient only. US providers (only) can apply to ATA’s Accreditation Program for Online Patient Consultations through a multi-step process for vetting up to three years.

  • First round application clears a company for eligibility. Through 28 Feb 2015, it is also open to ATA members only: Institutional Members, Sustaining President’s Circle and President’s Circle. On 1 March it will open to all companies in the US. Canada accreditation will start at a date to be announced in 2015.
  • Once eligible, the second round application contains ATA Administrative Rules & Terms, Standards and Guidance, Application Form, Program Overview and Fee Schedule. Fees are annual, based on the numbers of providers of online, real-time patient consults in all service lines, which presumably means areas such as primary care, behavioral, pediatric etc.
  • The company provides an application and supporting documentation. ATA then conducts a survey to review the documentation, online resources and demonstration of online services. During the process, ATA says it will notify about areas which are not compliant and organizations will have the opportunity to “provide a plan of corrective action and present corrective materials to show compliance before a final decision regarding accreditation is rendered.”
  • The accreditation is valid for three years, contingent on submitting an Annual Accreditation Report at the beginning of year 2 and 3 of its accreditation cycle.

Of interest to your Editors and readers is how this accreditation was developed.  (more…)

Breaking news out of the mHealth Summit

mHealth Summit this year had an abundance of digital health company news announcements, not only from the conference but also timed to coincide with the heightened interest around it. Your Editor looks over the most interesting of them, briefly. Thanks to Ashley Gold of Politico’s Morning eHealth (@ashleygold, daily reports archived here), Stephanie Baum of MedCityNews (@stephlbaum) and Anne Zieger of Healthcare Dive for their coverage and their company in the press room!

Partners HealthCare researches, Validic expands, AliveCor and Omron ally, Happtique sells out, Doctor on Demand is telemental, Orange goes dental, VA Innovation Rocks

  • Partners HealthCare/Center for Connected Health’s cHealth Compass will use panel and other research to help companies, device manufacturers, startups and investors determine what end users–consumer and provider–want out of personal health tech. Focus groups, interviews and usability testing will help to determine product design, evaluation, assess applications and feasibility as well as interim/final product testing. Partners is already organizing in Massachusetts a 2,000-patient database which rewards participants $50 on registration and $110 annually to be in a monthly survey panel. cHealth Compass website, BetaBoston (Boston Globe)
  • Health data connector/aggregator Validic demonstrates the attractiveness of Anything Big Data on with new clients including the Everyday Health consumer/professional website and the adidas Group’s sport and fitness apps. Recently they added WebMD, Pfizer, University of Pittsburgh Medical Center (UPMC), NexJ Health and MedHost to their client list. The company claims that their ‘ecosystem’–probably the most popular buzzword at this year’s conference–of healthcare companies and tech developers now reaches over 100 million people with devices such as Omron, Alere, Qardio, Telcare, Jawbone and Withings. Release
  • AliveCor accentuates the retail with Omron. AliveCor, which developed the first FDA-cleared ECG for smartphones and gained clearance for an atrial fibrillation algorithm in August, is collaborating with Japanese device manufacturer Omron on developing its retail presence. Omron’s devices are available in major drugstores such as Walgreens, RiteAid and Walmart so certainly AliveCor is due to benefit. AliveCor is also part of a revived QualcommLife (more on this in an upcoming article)  ReleaseMobihealthnews (Your Editor had the pleasure of meeting at last AliveCor’s CMO and founder Dr. Dave Albert.)
  • Happtique sold to SocialWellth. Last year’s floor talk was about Happtique’s first class of certified apps and a security expert’s untimely discovery of major flaws (more…)

Journal starts peer review process–at a price–for mHealth apps

If the rosy future of mHealth apps [study here] is to be achieved, some form of validation and review is needed, but is ‘pay to play’ the way to go?. The Journal of Medical Internet Research has come up with a peer review process which gives, in the words of mHealthNews, “developers a chance to have their products evaluated by “medical and mHealth experts from the JMIR peer-reviewer database (possibly complemented by consumers/patient experts) for a cool $2,500 per app.”  Aside from the price, (more…)

Getting sleepy behind the wheel? Your seat will tell (ES)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/07/heartbeat-sensor-seatbelt.jpg” thumb_width=”150″ /]Finally something useful in automotive biometrics! Researchers from Spain’s Instituto de Biomecánica de Valencia (IBV) have integrated sensors into a car seat and seat belt to continuously track the driver’s heart beat and respiration, with the aim of warning a drowsy driver. Data is gathered through a signal-processing unit (SPU) in real time, then sent to a computer program which through modeling patterns of fatigue in these two metrics, determines whether the driver is drowsy. It’s in working prototype save the proactive warning part, which does present a design challenge. (An electric shock? A VC10 at takeoff? Jimi Hendrix or Queen at 80 dB?) It’s appropriately dubbed The Harken Project. A potential life-saver far more useful than Ford SYNC/IMS’s Allergy AlertPress release. Medgadget  Hat tip to reader David Albert MD @DrDave01 via Twitter (!)  

Certifying health apps: is it at all possible?

This article in iMedicalApps takes a look back at the controversy that swirled around Happtique only four weeks ago–when Harold Smith III of Monckton Health and Fixmo went public on major data security flaws in two of their 19 certified apps–and moreover how Happtique did not respond to his concerns either in December or on the process in March [TTA 13 Dec]. It was the talk of the last big US gathering prior to International CES, the mHealth Summit.

Unfortunately, Satish Misra, MD, one of their editors, provides an argument best described as a ‘circular firing squad.’ Dr. Misra is absolutely correct on the enormity of curating and certifying tens of health/medical apps. But the point of the article seems to be that any kind of evaluation mechanism or certification is a fool’s errand.

The logic presented as this Editor interprets the article: Since Happtique’s certification process had standards which were complicated and arbitrary (plus, as it turned out, flawed), it proves that it’s useless to pursue standards and certification. In addition to being ‘resource intensive’ for reviewing tens of thousands of apps, standards cannot decide what app is the right choice, even if that was not the intent of the certification. So doctors and ‘end users’ have to become ‘app-literate’; hang the fact that the point of curation and certification is to do at least some of the heavy lifting (pre-screening) job for them beforehand! Back to the start: reading all the peer review stuff on thousands of medical apps, if it’s reviewed at all, as iMedicalApps does for some. (And will these reviews be 100% accurate? Will they subject every app to data security screening? What are their standards?) Back to Square One: DIY and Dodge City. Apps present too much (unpaid) work for docs to think about, patients use (then abandon) apps that can be privacy risks, because they don’t know any better and they aren’t white-hat hackers after all….

Remaining unconsidered by iMedicalApps is the plausibility of what Master Data Cruncher IMS Health is taking on with AppScript and AppNucleus [TTA 15 Dec]: a proprietary 25-point methodology (AppScore) that automates the classification and evaluation of health apps plus a hosting platform that uses IMS information to assist developers in creating secure, effective apps.

A far more detailed exploration of why at the very least an objective certification/evaluation process is needed is explored by Editor Charles in his continuing series Driving Up Medical App Usage in the UK, especially Part II (Part I here.) Watch for Part III shortly.

IMS Health files to raise $100 million in IPO

In news late yesterday, IMS Health has filed with the US Securities and Exchange Commission (SEC) to raise up to $100 million in an initial public offering of stock. The preliminary prospectus listed JP Morgan, Goldman Sachs, Morgan Stanley and BofA Merrill Lynch as the underwriters. We have noted IMS Health’s expansiveness on entering mHealth through app curation, prescribing and data security at the mHealth Summit [TTA 23 Dec] and their previous acquisition of Diversinet [TTA 15 Aug] in mobile app security; the latter was only a small part of their 2013 acquisitions in several areas totaling $105 million. Clearly there are some plans which may very well include health apps and data. Reuters, GeekWire.

2014: the year of reckoning for the ‘better mousetraps’

Or, the Incredible Immutability of the Gartner Hype Cycle

From Editor Donna, her take on the ‘mega-trend’ of 2014

This Editor expected that her ‘trends for next year’ article would be filled with Sensors, Wearables, Glasses, Smartwatches, 3D Printing, Tablets and Other Whiz-Bang Gizmos, with splashes of color from Continuing Crises like Healthcare.gov in the US, the NHS’ 3million lives plus ‘whither UK telecare’, various Corporate ‘Oops-ses’, IP/Patent Trolls and Assaults on Privacy. While these will continue to spread like storm debris on the beach, providing continuing fodder for your Editors (and The Gimlet Eye) to pick through, speculate and opine on, what in my view rises above–or is under it all–for 2014?

We are whipping past the 2012-13 Peak of Inflated Expectations in health tech…

…diving into the Trough of Disillusionment in 2014. Crystallizing this certainty (more…)

mHealth Summit 2013: The Velocity of Big

Lois Drapin, Founder & CEO of The Drapin Group, provides her post 2013 mHealth Summit insights on how IMS Health plans to move mHealth into a more ‘industrialized’ environment for mHealth apps. This is the second of her dispatches, courtesy of HIT Consultant.

The first time I heard Stefan Linn, Senior Vice President in Strategy & Global Pharma Solutions at IMS Health, pair the words industrial and mHealth in the first few minutes of his address in the Potomac Ballroom as part of the Executive Spotlights session on December 10th at the 2013 mHealth Summit, it made me sit up and listen more carefully. The words seemed to be odd companions, and oddly out of place in a healthcare conference. During the course of his speech, I heard those words three more times in some of its iterations— industrialized, industrializing, and industrialization with mHealth. It went something like this:

“What’s really needed here is to take on a large scale… to take mHealth forward into a kind of industrial world where we have standards, where we have safety and where we have adequate measurement of outcomes of mHealth applications.”

“So… there are a lot of folks taking on the world to a more industrialized environment, but certainly physicians [are] experimenting with this.”

“So… where does IMS fit in all of this? You may know that IMS Health is considered one of the best in the world around industrializing health informatics and analytics.”

“So…we think that this can make substantial contribution to the industrialization of mHealth.”

If you have ever seen Terry Gilliam’s 1986 film Brazil, (more…)

Is the ‘last mile’ of app certification efficacy metrics?

News and announcements around app certification definitely were hot topics in the past week or so, but are they more heat than light? Do these certifications adequately address efficacy? Stephanie Baum, in her follow-up to the Happtique kerfuffle in MedCityNews, opens up the discussion with the proposition: “It seems like there needs to be some way to prove that apps actually help people.” Bradley Merrill Thompson of Epstein Becker & Green points out “It’s certainly useful to know that an app works from a software perspective reliably, but it is even more valuable to know that the app can actually improve health.” While Happtique certification standards have a gap here, this Editor would point out that they were evolved nearly two years ago when the reporting/analysis needed for this was largely not available. Newer programs such as Johns Hopkins’ mHealth Evidence and the new IMS Health AppScript [TTA 15 Dec] can dip into the ‘big data’ pool far more effectively. Will Happtique be able to address this, or leave the ‘last mile’ to others? And what is the real and quantifiable demand for app certification anyway? Health app prescribing by physicians is a question mark in this Editor’s observation; the larger market may be health plans and programs such as Partners HealthCare’s Wellocracy, Cigna’s GoYou  and Aetna’s CarePass.