After the COVID Deluge: a Topol-esque view of what (tele)medicine will look like

A typically cheery view by Eric Topol, MD of what medical practice will look like after COVID is over. With the full court press to go remote in hospitals and practices worldwide, telehealth and telemedicine has gone fast forward in a matter of under two months. But what will it look like after it’s over? Most of what the good doctor is prognosticating will be familiar to our Readers who’ve followed him for years–certainly he was right on mobile health overall and especially AliveCor/Kardia Mobile— but not so on point with mobile body scanners (anyone remember VScan?)

When the high tide recedes, what will the beach look like?

  • “Telemedicine will play the role of the first consultation, akin to the house-call of yore.” (Terminology note–interesting that Dr. T still uses ‘telemedicine’ versus ‘telehealth’–Ed.)
  • Chatbots will serve as screeners–once they are proven to be effective (a ways to go here, as the Babylon debate rages on)
  • Smartphones will be the hub, connecting with all sorts of monitoring devices (the ‘connected health’ Tyto Care and Vivify Health model–which makes the Editor’s former company, the late Viterion Digital Health, even more of a pioneer that died crossing the Donner Pass of 2016)
  • Smartwatches are also part of this hub (this Editor remains a skeptic) 
  • Now is the time to harness technology by both health systems and individual practices, but multiple barriers remain. (This Editor can speak to the difficulties for both primary care and specialty practices in not only practice but also reimbursement–and acceptance by patients.) Device expense is also a problem for the non-affluent.

As to the rest, it is pretty much what we’ve heard from Dr. T before.  The Economist

Your Editor will add:

  • Easy to use, secure platforms that don’t put users through multiple security steps remain a concern for users. This Editor’s concern is that easy to use = insecure. Skype and Zoom are inherently insecure–Skype’s user unfriendliness and insecurity outside enterprise platforms and Zoom’s major security problems on its platform and user flaws are well-known (ZDNet).
  • Reimbursement, again! CMS has done a creditable job in broadening reimbursement for telehealth a/v and telephonic services, but coding remains a nightmare for practices struggling to remain open and with some lights on. After COVID, will CMS and HHS get religion, or put it right back in its rural bottle? Covered in the CARES Act passed at the close of March, $200 million sounds like a lot from the FCC to bankroll telecom equipment for providers, but these funds will go quickly. At least they are not delayed in endless rule making, as the Connected Care Pilot Program has been for two years. Mobihealthnews 

News, events roundup: FDA clears AliveCor’s first 6 lead ECG, Jawbone Health rises from ashes, Let’s Get Checked’s $30M check, Health Wildcatters’ $35M ‘how to’ breakfast

AliveCor receives FDA clearance for KardiaMobile 6L, the first FDA-cleared personal 6-lead device. From the AliveCor release, the description: “In addition to the two electrodes on the top of the device, there is one additional electrode on the bottom. The user places her thumbs on each of the two top electrodes, and places the bottom electrode on her left knee or ankle. This formation, known in cardiology as the Einthoven Triangle, allows cardiologists to view electrical activity in the heart from six perspectives or “leads.”” The information is sent to the mobile device’s software including KardiaAI bradycardia and tachycardia detection features cleared recently for the single-lead KardiaBand, as well as deeper information into arrhythmias. The single-lead ECG space that AliveCor pioneered with first their snap-on then the KardiaBand is now crowded with the Apple Watch, Withings, and numerous others. It’s a big step forward for the company. AliveCor has opened pre-orders now at $149, to be delivered starting in June. Hat tip to co-founder Dr. Dave Albert. 9to5Mac, Biospace (release), Mobihealthnews

Save Your Jawbones, the Founder Rises Again. Yes, Jawbone founder Hosain Rahman just raised $64.5 million for a new company. The new outfit, dubbed Jawbone Health, will offer a “personalized subscription service where we take all of this continuous health data about you and we combine that with a lot of machine intelligence . . .” to prevent avoidable diseases. After having burnt to a crisp $1 billion over 10 years on wireless speakers and fitness bands, again Mr. Rahman goes into territory which isn’t exactly unique with the footprints of the aforementioned Apple Watches, Withings, Spry Health’s Loop, EarlySense, etc. But hey,  SignalFire and Refactor Capital in the Bay Area, Polymath Ventures and Meraas in Dubai like his style. Even TechCrunch is arching an eyebrow.

Let’s Get Checked checks in with $30 million raise. This NYC-based direct-to-home supplier and manufacturer of in-home test kits raised a $30 million Series B from Leerink Transformation Partners, Qiming Venture Partners USA, and Optum Ventures after last year’s $10 million Series A. Customers can order in-state physician-approved laboratory tests via LetsGetChecked.com or through partner retailers, including CVS, Walmart, Pharmaca, and McKesson online stores, with delivery in 1-2 days. Tests covering wellness, men’s and women’s health are processed by CLIA-certified reference labs with results sent to a secure online account in 2-5 days, with the customer referred to in-state physicians for interpretation of results and further action if needed. PrivaPath Diagnostics markets in the US, Canada, Ireland, and Europe. Release

Speaking of raising money, how about $35 million for your med device startup? Health Wildcatters is hosting one of their Pulse Health Startup Education Series breakfasts (7.30-9am) in Dallas on Tuesday 21 May with main speaker Ken Nelson from Bardy Diagnostics, which just had a $35.5 million Series B, presumably letting everyone in on the secret. Registration and more information here.