Care Innovations sells off Validation Institute. But is there more to the story? And a side of Walmart Health action.

The Health Value Institute, part of Woburn, Massachusetts-based conference organizer World Congress, announced late last week the acquisition of the Validation Institute from Care Innovations. Terms were not disclosed. The Health Value Institute and the Validation Institute recently partnered to validate the outcomes for the Health Value Award finalists and awards this past April at the 15th Annual World Health Care Congress. According to both parties, the acquisition will help to expand the membership of validated companies, and the present offerings for HR, broker, and benefit executives. Release.

The Validation Institute was launched with fanfare back in June 2014, when GE still had a chunk of the company and during the 2 1/2 year repositioning (revival? resuscitation?) led by Sean Slovenski from the doldrums of the prior Louis Burns regime. Mr. Slovenski departed in early 2016 to be president of population health at Healthways/Sharecare, which lasted a little over a year. However, this week Mr. Slovenski made headlines as the new SVP Health & Wellness of Walmart, reporting directly to the head of their US business.  The hiring of a senior executive with a few years at Humana and a short time at Sharecare, another Walmart partner, coupled with several years in healthcare tech and provider-side is certainly indicative of Walmart’s serious focus on healthcare provision. It’s a fascinating race with Amazon and CVS-Aetna–with the mystery of what Walgreens Boots Alliance will do. Also Healthcare Dive.

But back to Care Innovations. Signs of a new direction–and a loss. The case can be made that the Validation Institute, the Jefferson College of Population Health, and validating individuals and companies was no longer core to their business which is centered around their RPM platform Health Harmony (with QuietCare still hanging in there!) However, this Editor notes the prominent addition of  ‘platform-as-a-service’ advisory services for those who are developing health apps, which appears to be a spinoff of their engineering/IT services. Vivify Health, a competitor, already does this. There is a vote of confidence; in June, Roche signed on with a strategic investment (undisclosed) as well as integration of the mySugr integrated diabetes management/app solution (release).

Looking around their recently refreshed website, there is an absence–that of the two or three pages previously dedicated to the Veterans Health Administration (VA) and the press release of the VA award. This tends to lend credence to the rumors that there was a second company that did not pass the Trade Adjustment Act (TAA) requirements that knocked out Iron Bow/Vivify Health from the VA, or for another undisclosed reason CI bowed out of a potentially $258 million five-year contract. If so, that leaves for the VA Medtronic and 1Vision/AMC Health. It’s certainly a limited menu for the supposedly growing numbers of veterans requiring telehealth and a limited choice for their care coordinators–and not quite as presented to the public or the 2015 competitors in the solicitation. Who benefits? Who loses? (Disclosure: This Editor worked for one of the finalists and a VA supplier from 2003, Viterion.)  Hat tip to one of our ‘Industry Insiders’, but the opinions expressed here are her own.

Rounding up the news: Babylon’s Samsung Health UK deal, smartphone urine test debuts, a VA Home Telehealth ‘announcement’, Aging 2.0’s NY Happy Hour

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2017/12/Lasso.jpg” thumb_width=”125″ /]Huge or Ho-Hum? Babylon’s ‘Ask an Expert’ feature is now available within the Samsung Health app as of the start of June. It will need to be activated at a cost of £50 per year, or £25 for a single consultation. Babylon’s service with over 200 GPs is now available on millions of Samsung Galaxy devices in the UK. Babylon now claims half a million users of its private GP services and 26,500 registered in London with its NHS-funded and controversial GP at Hand app.

Is it as our Editor Charles, quoting Niccolo Machiavelli writing in The Prince, “Nothing is more difficult to undertake, more perilous to conduct or more uncertain in its outcome than to take the lead in introducing a new order of things. For the innovator has for enemies all those who have done well under the old and lukewarm defenders who may do well under the new”. The debate rages–see the comments below the Pulse Today article. 

Healthy.io is introducing a test of its urinalysis by smartphone test with Salford Royal NHS Foundation Trust’s new Virtual Renal Clinic. 50 patients will received the Dip.io kit to test their urine. Dip.io uses the standard urine dipstick test combined with a smartphone application that guides the user through scanning in the results with a smartphone camera and sends the result to their doctor. Healthy.io claims this is a first-of-kind technology and system. According to Salford Royal, chronic kidney disease (CKD) costs the NHS £1.45 billion in England alone. The company is part of the NHS Innovation Accelerator Programme. Digital Health News

In what has been the worst kept secret in US telehealth, 1Vision LLC and AMC Health finally announced they were partners in 1Vision’s over $258 million Home Telehealth award by the Department of Veterans Affairs (VA) [TTA 6 Feb 17]. The news here is that the AMCH release states that they have an “Authority to Operate (ATO)”, which means they can provide Home Telehealth services using AMC Health’s CareConsole to VA-enrolled veterans and their families. This last step is very important because it is a common post-award point of failure for new awardees. Earlier this year, the Iron Bow/Vivify Health award failed on the country of origin of Vivify’s kit, dooming the implementation [TTA 16 Jan] and Iron Bow’s award. (Vivify Health has gone on.) Medtronic, as a long-term incumbent, has few worries in this regard, though any new equipment has to be cleared. The mystery is if Intel-GE Care Innovations, the last new awardee, has passed the ATO bar. AMC Health/1Vision release. 

And on the social front for New Yorkers, raise a Pint 2.0 at Aging 2.0’s NYC Happy Hour, Tuesday 18 July at 310 Bowery Bar, 6pm. Aging 2.0 website, where you can check for a chapter and events near you.

Iron Bow’s uncertain future with $258 million VA Home Telehealth contract

Iron Bow Technologies’s setback with their VA contract confirmed. Iron Bow, which partnered last year with Vivify Health to provide telehealth services to the US Department of Veterans Affairs, received an unfavorable ruling on the US country of origin of the Vivify Health system that essentially stops the contract implementation.

Under Title III of the Trade Agreements Act of 1979, Federal suppliers must produce their products in the US or substantially transform the components in such a way that it becomes a product of the US. US Customs and Border Protection (CBP), Department of Homeland Security (DHS), makes this determination. Vivify Health contended that their Vietnam-produced tablet, because of their US-produced Vivify Health Pathways software and further US-based modifications to convert it into an FDA-regulated medical device, was transformed into a US product. In August, the CBP determined that the end product did not meet the transformation standard based on decades of precedent and the country of origin remained Vietnam. Transformation, yes, but not enough or the right kind for the CBP. Federal Register 8/22/17

An interesting Federal regulatory disconnect is that the FDA considers the Vivify tablet a regulated medical device. CBP considers it a communications device as the tablet transmits data from other medical devices but does not take those measurements itself. 

Vivify Health has publicly used in implementations with health organizations Samsung tablets. It is not known if the tablet reviewed by the CBP is manufactured by Samsung.

Both Iron Bow and Vivify Health were asked by this Editor for comments. Iron Bow’s response:

We have received an unfavorable ruling from United States Customs and Border Protection (“Customs”) regarding our proposed solution for the Home Telehealth contract. We respectfully disagree with the findings by Customs and have appealed the matter to the United States Court of International Trade. We are currently in discussions with our customer regarding the possible options for a path forward.

Vivify has not responded to date. 

Certainly, this is a sizable financial loss to both Iron Bow and Vivify if they cannot go forward with the VA, whether through a court decision or a different procurement process for the tablet to qualify it as US origin. Last February, we reported that the VA awarded the billion-dollar five-year Veterans Health Administration (VHA) Home Telehealth contract to four providers: incumbent Medtronic, Iron Bow, Intel Care Innovations, and service-disabled veteran-owned small business 1Vision. The award amount for each was $258 million over a five-year period, re-establishing the VHA as the largest telehealth customer in the US. All four awardees had in common that they were prior Federal contractors, either with the VA or with other Federal areas [TTA 1 Feb 17].

Medtronic and Care Innovations had long-established integrated telehealth systems but Iron Bow and 1Vision, as telemedicine and IT service providers respectively, did not have vital signs remote monitoring capability. In the solicitation, Iron Bow partnered with Vivify [TTA 15 Feb 17]. For 1Vision, it took nearly one year to announce that their telehealth partner was New York-based AMC Health, an existing provider of VA health services. It was also, for those in the field, a Poorly Kept Secret, as AMC Health had been staffing with VA telehealth veterans from the time of the award. (The joint release is on AMC Health’s site here.) The reason for the announcement delay is not known. AMC Health does not use a tablet system, instead transmitting data directly from devices or a mobile hub to a care management platform. They also provide IVR services.

Vivify has moved forward with other commercial partnerships, with the most significant being InTouch Health, which itself is on a tear with acquisitions such as TruClinic [TTA 19 Dec 17].

Hat tip to two alert Readers who assisted in the development of this article but who wish to remain anonymous.

End of year action: Vivify/InTouch, InTouch/TruClinic, Medtronic, NYCEDC winners, ActiveProtective, Adidas exits wearables, Fitbit (updated)

  • Dallas-based Vivify Health is partnering with California’s InTouch Health to integrate their telehealth remote patient management with InTouch Health’s acute care video consult/device platform. For InTouch, it is a move into the home by using Vivify’s Managed Kit and BYOD and related APIs. For Vivify, this helps in their post-acute RPM sell to large healthcare organizations. (Is their VA partner Iron Bow somewhere in the mix?) Their VA Home Telehealth rival Medtronic announced their partnership with American Well a few months ago [TTA 21 Oct]. InTouch release via Telecom Reseller
  • Updated. InTouch also announced their agreement on Jan 4 to purchase DTC telehealth provider TruClinic furthering their move into home telehealth. TruClinic will be merged into InTouch. Heading it up will be recently appointed EVP of Marketing and Consumer Solutions Steve Cashman, who founded and headed pioneering but overly ambitious for the market health kiosk HealthSpot [TTA roundup here]. Release  (Our update on the state of health kiosks here)
  • Speaking of Medtronic Care Management Services, MCCM touted its VA Home Telehealth ties to Healthcare Analytics News. Intriguing claim: they’ve treated 310,000 veterans since 2011 (Cardiocom, the 2011 awardee, was purchased in 2013). VA itself credits only 156,000 patients to Home Telehealth in Federal FY 2014 (the last official count), 43,000 patients in 2010 and 144,000 in 2013. A very rough estimate by this Editor is that they were about 25 percent of the veterans in the program.
  • Announced at last week’s NYC Economic Development Commission (NYCEDC) Health 2.0 Digital Health Forum attended by this Editor were the winners of the third annual NYCEDC/HITLAB’s Digital Health Breakthrough Network accelerator program for pre-revenue startups: Altopax (VR behavioral health), Navimize (doctor/hospital scheduling), Tatch (sleep quality biometrics), and PainQX (pain level monitoring). The Forum also had Digital Health Marketplace matchmaking meetings for 65 NYC-based health tech companies with prospective clients. The Marketplace furnishes competitive grants to offset the cost of piloting between growth-stage tech companies and providers. Release, MedCityNews
  • ActiveProtective‘s controversial protective airbag to cushion hips from falls by high-risk older adults [TTA 10 Jan] gained $4.7 million in Series A funding led by Generator Ventures. Mobihealthnews
  • Adidas is shuttering its wearable device development unit and condensing its offerings, focusing on the Runtastic GPS-guided exercise offering and a shopping app. It follows similar moves at Nike and Under Armour proving that big names in sports fitness clothing couldn’t pull off wearables. Mobihealthnews
  • Meanwhile, Fitbit’s Ionic continues to develop with now an App Gallery with 60 apps–11 of which are health/fitness related–and more than 100 watch faces. (Wonder if any are Mickey Mouse?) What we termed a ‘Hail Mary’ pass may actually get past the goal line. Mobihealthnews

VA says goodbye to VistA, hello to Cerner for new EHR–and possible impacts (updated)

The new sheriff just turned the town upside down. Veterans Affairs’ new Secretary, Dr. David J. Shulkin, as expected moved quickly on the VA’s EHR modernization before the July 1 deadline, and moved to the same vendor that the Department of Defense (DoD) chose in 2015 for the Military Health System, Cerner. VA will adapt MHS GENESIS, based on Cerner Millenium. The rationale is seamless interoperability both with DoD and with private sector community providers and vendors, which base their services on commercial EHRs. The goal is to have one record for a service member through his or her lifetime and to eliminate the transition gap after discharge or retirement. (Transition gaps are also repeated when reservists or National Guard are called up for active duty then returned to their former status.) Another priority for VA is preventing the high rate of suicide among vulnerable veterans.

Updates: VA confirmed that Epic and Leidos will keep the development of the online medical appointment scheduling program, awarded in 2015 and currently in pilot, to be completed in 18 months. The contract is worth $624 million over five years. Wisconsin State Journal  The House Appropriations subcommittee on Veterans Affairs likes the Cerner EHR change. The Senate Veterans Affairs Committee is meeting Wednesday to discuss the VA budget sans the EHR transition. The EHR numbers are expected to be sooner rather than later. POLITICO Morning eHealth 

Dr. Shulkin is well acquainted with the extreme need for a modernized, interoperable system serving the Veterans Health Administration (VHA), having been on the US Senate Hot Grill for some years as Undersecretary of Health for VA. The foundation for the move from homegrown VistA to Cerner was laid last year during the prior Administration through an August RFI for a COTS (commercial off the shelf) EHR [TTA 12 Aug 16] and in later hearings. “Software development is not a core competency of VA” and it has been obvious in system breakdowns like scheduling, maintaining cybersecurity and the complex interoperability between two different systems. To move to Cerner immediately without a competition, which took DoD over two years, Dr. Shulkin used his authority to sign a “Determination and Findings” (D&F) which provides for a public health exception to the bidding process. The value of the Cerner contract will not be determined for several months.

For those sentimental about VistA, he acknowledged the pioneering role of the EHR back in the 1970s, but that calls for modernization started in 2000 with seven ‘blue ribbon’ commissions and innumerable Congressional hearings since. He understated the cost in the failed efforts on interoperability with DoD’s own AHLTA system, VA’s own effort at a new architecture, and modernizing the outpatient system. This Editor tallied these three alone at $3 billion in GAO’s reckoning [‘Pondering the Squandering’, TTA 27 July 13]. 

It is still going to take years to implement–no quick fixes in something this massive, despite the urgency.

  • Both MHS and VA will be running two systems at once for years (more…)