TTA’s Spring Debut: CMS’ big telehealth expansion, conferences vaporize to virtual, Cera’s $70M raise, news from RxHealth, TeleDentists; Caravan buys Wellpepper, more

 

 

Did you forget it’s Spring? Your Editor finds a shiny silver tulip in in CMS’ major telehealth expansion versus C-19. We also caught up with Industry News that was largely (but not entirely) free of Virus News. (At this point, Theranos News would be comic relief….) Sadly, the entire spring season of conferences is gone either to virtual or vapor.

(Our Alert is a day late because your Editor’s Fios internet went on the fritz (C-19?) for the second time in 10 days. But it is now fully recovered–we hope!)

Virus-(almost) free news: Cera’s $70m raise, Rx.Health’s RxStitch, remote teledentistry to rescue, Alcuris responds, Caravan buys Wellpepper, and Teladoc’s heavy reading
Further ‘virtualization’ of industry meetings: DHACA Day, HITLAB, NAACOS, HXD, now ATA 2020 (updated) (Cabin fever strikes deep, but there is nowhere to creep…)
CMS clarifies telehealth policy expansion for Medicare in COVID-19 health emergency, including non-HIPAA compliant platforms (US) (BIG news in expanding telehealth)

It’s hard to move beyond the coronavirus talk permeating everything in healthcare to other news, but there is some. American Well’s rename, a Senate look at Project Nightingale, and a $16 million digital health Series A surfaced in the sea of spread and conference cancellations. And there’s more on how telehealth can be very useful in both diagnosis and treatment of the virus–even if the consulting doctor is quarantined or sick.

News roundup: Kompaï debuts, Aging Tech 2020 study, Project Nightingale may sing to the Senate, Amwell, b.well, Lyft’s SDOH, more on telehealth for COVID-19 
Update: healthcare/digital health conferences canceled/postponed due to COVID-19 include SXSW, Naidex, EPIC (updated 13 Mar). (The busiest season for meetings suddenly isn’t)

The only real news this week is around the effects of the coronavirus on the business of healthcare–HIMSS20 and other conferences are casualties–and on population health. The US is funding public health, NIH research, telehealth and more with an additional $8.3bn. Let’s hope that the last weeks of winter and (in US) springing forward on the clocks presage the end of its spread.

$8bn COVID-19 supplemental funding House bill waives telehealth restrictions for Medicare beneficiaries (US) (Passed and now to the Senate)
Breaking News: HIMSS20 canceled; Naidex update; what is the outlook for other major conferences? (updated) (The business effect of COVID-19 hits healthcare. Hard.)

How does one celebrate a Leap Year? Certainly not with a trip to China, as you may not have to go that far to have a coronavirus adventure. But digital health is going to the rescue in several significant ways, including treatment. Symptom checkers are much in the news, not only with COVID-19, but also with K Health’s big raise and Babylon’s profile on Newsnight with @DrMurphy11’s reveal. GGI and Legrand debut their study on digital tech’s potential to deliver more efficient health services. NYC events abound. And if you’re in London, leap to DHACA Day on 18 March! 

Digital health on the front lines of coronavirus checking, treatment, and prevention (What wasn’t around during the SARS and swine flu epidemics may make a big difference)
Symptom checker K Health gains $48 million Series C (NY/Tel Aviv) (A big bet made, and not on Babylon)
Babylon Health fires back at critic @DrMurphy11; Dr. Watkins–and Newsnight–return fire (UK) (Why can’t they just get along? Watch the video and find out.)
A potpourri of upcoming NYC events (HITLAB and Columbia University)
Unleashing the Digital Premium’ for health in the public sector (UK) (Good Governance Institute and Legrand study) 

The consumer DNA/genetics biz is frosty, IBM certainly isn’t feeling the love from 3M, and malware’s worse than rain you have to shovel. VA’s Cerner debut won’t be till the daffodils bloom. But Hollywood tech is helping stroke rehab, and it’s warming up around post-surgery telemedicine usage and physician telehealth use. Plus Yorkshire & Humber AHSN’s back with their Propel accelerator.

News roundup: stroke rehab uses Hollywood technology, 3M sues IBM Watson Health on analytics software misuse, AI-based skin cancer detection apps fail, Dictum’s successful telemed use post-pediatric surgery, malware attacks Boston practice network 
Is the bloom off the consumer DNA business? It’s past time for a Genomic Bill of Rights. (Ancestry, 23andme’s declining fortunes)
100% increase in physician telehealth and virtual care usage in three years: AMA study (Progress in this market, especially for chronic care)
Propel@YH opens again for 2020 accelerator candidates (Yorkshire & Humber AHSN’s 2nd year)
VA running at least one month late on Cerner implementation launch (Not unexpected after last week’s turmoil)

February is here, can Spring be far away? It might be an early one for Mark Bertolini, booted from the board of the company he worked so hard to put together. Ashik Desai of Outcome Health may be looking at a Club Fed ‘vacation’. And James Byrne of the VA got an early furlough from Washington for that Florida holiday. So we can take a Mid-Winter’s nap courtesy of NHS, dream of digital health investments for 2020, and won’t buy into a company paying a $1 million monthly rent.

But do wake up in time for DHACA Day on 18 March! A good reason to be in London….

Considering 2019’s digital health investment picture: leveling off may be a Good Thing (Less froth, more quality)
Outcome Health’s Desai reaches settlement with DOJ, SEC (Another cautionary tale of Young Entrepreneurs Gone Wrong–somewhat like Theranos)
Comings and goings, wins and losses: VA’s revolving door spins again, NHS sleep pods for staff, Aetna’s Bertolini booted, Stanford Med takes over Theranos office

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News roundup: Kompaï debuts, Aging Tech 2020 study, Project Nightingale may sing to the Senate, Amwell, b.well, Lyft’s SDOH, more on telehealth for COVID-19

Believe it or not, there IS news beyond a virus!

France’s Kompaï assistance robot is finally for sale to health organizations, primarily nursing homes and hospitals. Its objective, according to its announcement release, is to help health professionals in repetitive daily tasks, and to help patients. It’s interesting that the discussion of appearance was to achieve a ‘slightly humanoid’ look, but not too human. The development process took over 10 years. (Here at TTA, Steve’s first ‘in person’ with the developers was in May 2011!) Kompaï usage mentioned is in mobility assistance and facility ‘tours’ and public guidance. Here’s Kompai in action on what looks like a tour. Press release (French/English)

Not much on robotics here. Laurie Orlov has issued her 2020 Market Overview Technology for Aging Market Overview on her Aging and Health Technology Watch, and everyone in the industry should download. Key points:

  • In 2020, aging technologies finally nudged into the mainstream
  • The older adult tech market has been recognized as an opportunity by such companies as Best Buy, Samsung, and Amazon. Medicare Advantage payers now cover some tech.
  • Advances plus smart marketing in hearing tech–one of the top needs in even younger demographics–is disrupting a formerly staid (and expensive)
  • The White House report “Emerging Technologies to Support an Aging Population” [TTA 7 March] first was an acknowledgment of its importance and two, would also serve as a great source document for entrepreneurs and developers.

The study covers the demographics of the older adult market, where they are living, caregiving, the effect of data breaches, optimizing design for this market, the impacts of voice-driven assistants, wearables, and hearables.

Project Nightingale may be singing to some US Senators. The 10 million Ascension Health identified patient records that were transferred in a BAA deal to Google [TTA 14 Nov 19], intended to build a search engine for Ascension’s EHR, continue to be looked into. They went to Google without patient or physician consent or knowledge, with major questions around its security and who had access to the data. A bipartisan group of senators is (finally) looking at this ‘maybe breach’, according to Becker’s. (Also WSJ, paywalled)

Short takes:  b.well scored a $16 million Series A for its software that integrates digital health applications for payers, providers, and employers. The round was led by UnityPoint Health Ventures….Lyft is partnering with Unite Us to provide non-emergency patient transportation to referred health appointments. Unite Us is a social determinants of health (SDOH) company which connects health and community-based social care providers….What happens if you’re a quarantined physician due to exposure to the COVID-19 virus? Use telehealth to connect to patients in EDs or in direct clinic or practice care, freeing up other doctors for hands-on care. 11 March New England Journal of Medicine….American Well is finally no more, long live Amwell. Complete with a little heart-check logo, American Well completed its long journey to a new name, to absolutely no one’s surprise. It was set to be a big reveal at HIMSS, but we know what happened there. Amwell blog, accompanied with the usual long-winded ‘marketing’ rationale They are also reporting a 10 to 20 percent increase in telehealth consults by patients (Becker’s)….Hospitals and health systems such as Spectrum Health (MI), Indiana University Health, Mount Sinai NY, St. Lukes in Bethlehem PA, and MUSC Health, are experimenting with COVID-19 virtual screenings and developing COVID-19 databases in their EHRs. The oddest: Hartford (CT) Healthcare’s drive-through screening center and virtual visit program. Is there an opportunity to cross-market with Wendy’s or Mickey D’s? After all, a burger and fries would be nice for a hungry, maybe sick, patient before they self-quarantine.

SNF emergency telehealth provider Call9 shuts down most operations, after $34M raise (updated)

Is it a symptom of a bubble’s downside? In an interview with CNBC, Dr. Timothy Peck, the CEO of Call9, profiled in TTA only a month ago, confirmed that his company will be shutting down operations. Call9 provided embedded emergency first responders in skilled nursing facilities (SNFs) on call to staff nurses. The first responders not only could provide immediate care to patients with over a dozen diagnostic tools, but also would connect via video to emergency doctors on call. 

Headquartered in Brooklyn, the shuttering of the four-year-old company has laid off over 100 employees as it winds down operations. They claimed 142,000 telemedicine visits and 11,000 patients who were treated via its services. In the past few months, Call9 had inked deals with Lyft for patient transportation and was expanding to Albany NY. They also operated a community paramedicine division utilizing their emergency doctor network.  

This Editor can now reveal that through a reliable industry source, I was informed of Call9’s difficulties earlier this month. Not wanting to ‘run with a rumor’, I contacted Dr. Peck. He confirmed to me information that later appeared in the CNBC article: that the company was refining its model in the face of a change in previous funders and working with some new partners to stay in a model with embedded clinical care specialists in nursing homes. While they would scale back, they still had current contracts. However, the changes in their model would mean that the company would be in a ‘bit of a stealth mode’. After we discussed the business situations that most early-stage health tech companies have faced with funding, we agreed to touch base in a few weeks when things developed.

CNBC, with a different source, had essentially the same information from Dr. Peck on the winding down of the company but in this case also confirmed layoffs, including a ‘pivot’ of the company into a different model around technology in nursing homes. They also confirmed that a part of the company, Call9 Medical, will remain in operations.

Update: Skilled Nursing News had additional detail on Call9’s partnerships which included SNF providers Centers Health Care, CareRite, and the Archdiocese of New York’s long-term care arm, ArchCare. Their first client was Central Island Healthcare, where Dr. Peck lived for three months testing the model. The article goes on with Central Island’s executive director explaining that he is now seeking a telemedicine provider, as they adjusted their services to Call9’s capabilities.

Payer providers included Anthem, Blue Cross Blue Shield, and Healthfirst, plus some Medicare Advantage plans, splitting the savings from avoiding unnecessary ER admissions. Another appeal made by the company for its services was to keep in place higher acuity–sicker–patients in SNFs who would otherwise have to go into the hospital.

As our Readers know, these pages have covered the comings and goings of many health tech and app companies. Some succeed on their own, are acquired/combined with others and go on in different form, or are bought out at their peak, leaving their founders and some employees cheerful indeed. On the other hand, and far more common: the demise of some is understandable, others regrettable, and nearly none of them are cause for celebration in our field–Theranos and Outcome Health being exceptions. This Editor has been a marketing head of two of them (now deceased except for their technology, out there somewhere), and has discussed marketing, funding, and business models with more startups and early-stage companies than she can count.

If anything, investors have less patience than they did back in the Grizzled Pioneer period of the early 2000s, when a $5 million round put together from a few personally (more…)

Rounding up July: Teladoc’s new name and earnings, Hitching a Lyft, GlobalMed with FCC, Proteus and HIV sensing, Parks Associates, Welbeing

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2017/12/Lasso.jpg” thumb_width=”125″ /] [grow_thumb image=”http://telecareaware.com/wp-content/uploads/2018/08/teladochealth_logo_plumaqua_rgb.jpg” thumb_width=”150″ /]Telemedicine giant Teladoc today formally unveiled its name and logo change to Teladoc Health. Citing its worldwide reach and a broad portfolio of services, CEO Jason Gorevic stated “…we will further accelerate the adoption of virtual care and enhance our technology-enabled services to make high-quality healthcare a reality for more people and organizations around the world.” The name will officially change on 10 August but there is no change in their NYSE ticker symbol TDOC. Release on MarketWatch  Their earnings call on Wednesday reported a second quarter loss of $0.37 per share which was substantially less than the projected $0.43. Revenue was $94.56 million for the quarter ended June 2018, more than double that of CY 2017. Zacks.com

The burgeoning area of non-emergency medical transportation (NEMT) got a Lyft with the publishing of two studies indicating reductions in costs and no-shows. Lyft rideshare partner Hitch Health which integrates EHR data, to identify patients, worked over 12 months with the Hennepin Healthcare internal medicine clinic in Minneapolis. The no-show rate dropped from 31 percent to 22.5 percent, with an estimated increase in revenue of $270,000. In Camden, NJ, Rideshare worked with a branch of the MD Anderson Cancer Clinic to schedule on-demand transportation, reducing direct transportation costs by 30 percent with the service and no-show rate down to four percent. Mobihealthnews

GlobalMed, a previous Perspectives contributor, was represented by its CEO on a four-person panel discussing the FCC ‘s proposed Connected Care Pilot Program, a new $100 million program to support telehealth for low-income Americans, attended by  FCC Commissioner Brendan Carr. Here’s a video from the 24 July meeting. Hat tip to Marcia Rhodes of Amendola Communications

Proteus Digital Health’s sensor-equipped pills, transmitter patch, and app may have a new market with prophylaxis (PrEP) treatments for the prevention of HIV transmission. A study by University of California, San Diego researchers with Truvada (Gilead Sciences) found that the sensor-equipped drug was well-received by most users and pharmacokinetically equivalent to Truvada alone. Proteus is the first FDA-approved digital ingestion tracking system with Abilify MyCite [TTA 14 Nov 17]. Mobihealthnews

Parks Associates has two upcoming opportunities for speakers at their hosted events at two large conferences. Click on the links for more information:

CONNECTIONS Europe: Strategies for Smart Home & Consumer IoT – Deadline: 1 Sept
Amsterdam – 13-14 Nov 2018  Event website

CONNECTIONS Summit at CES – Deadline: 15 Sept 2018
Las Vegas – 8 Jan 2019  Call for papers and more information.  

Welbeing in the UK announced on Wednesday 1 Aug their Rehabilitation Project in Cumbria. The program is designed to help patients who have had a fall or similar trauma leading to a hospital stay. When they are discharged, patients can now receive Welbeing’s alarm service for up to 13 weeks, free of charge. The service is being funded by Eden District Council. Welbeing recently acquired Eden Housing Association’s alarm and response services in Eden and Carlisle. (Link to press release to come)

Is Uber fit to deliver healthcare transport? Healthcare organizations may want to check.

Healthcare-related organizations have codes of conduct pertaining to suppliers. Does Uber meet compliance standards? As we reported a few days ago in our article on the burgeoning area of non-emergency medical transport (NEMT) [TTA 9 Mar], Uber Health’s debut with a reputed 100 healthcare organizations has led this Editor to a further examination of Uber, the organization. Uber has had a hard time staying out of the headlines–and the courts–in the past two years, in matters which might give healthcare partners pause.

  • On 21 Nov, Uber reported that the personal data of 57 million users, including 600,000 US drivers, were breached and stolen in October 2016–a full year prior. Not only was the breach announcement delayed by over a year, but also in that year it was made to go away by Uber’s paying off the hacker. Reuters on 6 December: “A 20-year-old Florida man was responsible for the large data breach at Uber Technologies Inc [UBER.UL] last year and was paid by Uber to destroy the data through a so-called “bug bounty” program normally used to identify small code vulnerabilities, three people familiar with the events have told Reuters.” The payment was an extraordinary $100,000. “The sources said then-CEO Travis Kalanick was aware of the breach and bug bounty payment in November of last year.” The Reuters article goes further into the mechanism of the hack. It eventually led to the resignation of their chief security officer, former Facebook/eBay/PayPal security head Joe Sullivan, who ‘investigated’ it using encrypted, disappearing messaging apps. Atlantic.
  • CEO and co-founder Travis Kalanick was forced to resign last June after losing the confidence of the company’s investors, in contrails of financial mismanagement, sexual harassment, driver harassment, and ‘bro culture’. This included legal action over Uber’s 2016 acquisition of self-driving truck startup Otto, started by former Googlers who may or may not have lifted proprietary tech from Google before ankling. These are lavishly outlined in Bloomberg and in an over-the-top article in Engadget (with the usual slams at libertarianism). Mr. Kalanick remains on the board and is now a private investor.
  • The plain fact is that Uber is still burning through funds (2017: $1bn) after raising $21.1bn and its valuation has suffered. The new CEO Dara Khosrowshahi, who earlier righted travel site Expedia, has a tough pull with investors such as SoftBank and Saudi Arabia’s Public Investment Fund. Also Mashable.

Healthcare and NEMT, as noted in our earlier article, are a strong source of potential steady revenue through reimbursement in Medicare Advantage and state Medicaid programs, which is why both Uber and Lyft are targeting it. The benefits for all sides–patients, practices, these companies, sub-contractors, and drivers–can be substantial and positive in this social determinant of health (SDOH).  

Healthcare organizations, especially payers, have strict codes of compliance not only for employees and business practices but also for their suppliers’ practices. Payers in Medicare Advantage and Medicaid are Federal and state contractors. While Uber under its new CEO has shown contriteness in acknowledging an organization in need of righting its moral compass (CNBC), there remains the track record and the aftermath. Both deserve a closer look and review.

Lyft and Uber’s big tech twists on a Social Determinant of Health–medical-related transportation

Social determinants of health (SDOH), that widely-discussed concept often dismissed as the turf of social workers and small do-good companies such as Healthify, are receiving a substantial boost from two profit-oriented, on-demand transportation companies: Uber and Lyft. Several years ago, smaller companies such as Circulation and Veyo [TTA 21 Feb, 26 Apr 17] entered the non-emergency medical transportation (NEMT) field with their on-demand services. These proved to be valuable links in the continuum of care–valuable in helping patients make their appointments, at generally a lower cost than Access-a-Ride or taxis, while collecting a wealth of data on usage.

Uber and Lyft’s recent announcements take the NEMT concept further with integration into discharge planning, chronic care management in practices, and EHRs while keeping it simple for patients and caregivers.

  • The launch of Uber Health, targeted to healthcare organizations (and just in time for HIMSS). The ride booking for both patients and caregivers uses a HIPAA-compliant dashboard for the health manager to book the ride, and text messaging to the patient for confirmations and pickup. Over 100 healthcare organizations are piloting the service. MedCityNews
  • Lyft Business inked a deal with Allscripts to integrate booking transportation into appointment setting. The Allscripts EHR is in 45,000 physician practices and 2,500 hospitals (which doesn’t include newly-acquired Practice Fusion’s 30,000 small ambulatory sites). Besides its own driver base, Lyft also has used its Concierge API to facilitate partnerships with NEMT brokers working with providers such as Circulation, National MedTrans (the NEMT provider for Anthem’s CareMore Health Plan HMO), and American Medical Response for drivers and more specialized vehicles. Hitch Health works with Lyft and independently integrates into Epic and Athenahealth. MedCityNews, POLITICO Morning eHealth (scroll down).

But does providing transport for appointments save money? The logic behind it is that missed appointments can exacerbate existing conditions; a direct example is dialysis, where missing an appointment could result in a hospital admission. Another area is patient avoidance of making appointments. The CareMore Health Plan study reduced waiting times and ride cost, increasing patient satisfaction–great for HEDIS and ACO quality scores, but the longer-term cost saving is still to be determined.

Another attraction for Lyft and Uber: steady revenue. In Medicare Advantage, 70 percent of members are covered and all state Medicaid programs reimburse their members for qualifying transportation.

Themes and trends at Aging2.0 OPTIMIZE 2017

Aging2.0 OPTIMIZE, in San Francisco on Tuesday and Wednesday 14-15 November, annually attracts the top thinkers and doers in innovation and aging services. It brings together academia, designers, developers, investors, and senior care executives from all over the world to rethink the aging experience in both immediately practical and long-term visionary ways.

Looking at OPTIMIZE’s agenda, there are major themes that are on point for major industry trends.

Reinventing aging with an AI twist

What will aging be like during the next decades of the 21st Century? What must be done to support quality of life, active lives, and more independence? From nursing homes with more home-like environments (Green House Project) to Bill Thomas’ latest project–‘tiny houses’ that support independent living (Minkas)—there are many developments which will affect the perception and reality of aging.

Designers like Yves Béhar of fuseproject are rethinking home design as a continuum that supports all ages and abilities in what they want and need. Beyond physical design, these new homes are powered by artificial intelligence (AI) and machine learning technology that support wellness, engagement, and safety. Advances that are already here include voice-activated devices such as Amazon Alexa, virtual reality (VR), and IoT-enabled remote care (telehealth and telecare).

For attendees at Aging2.0, there will be substantial discussion on AI’s impact and implications, highlighted at Tuesday afternoon’s general session ‘AI-ging Into the Future’ and in Wednesday’s AI/IoT-related breakouts. AI is powering breakthroughs in social robotics and predictive health, the latter using sensor-based ADL and vital signs information for wellness, fall prevention, and dementia care. Some companies part of this conversation are CarePredict, EarlySense, SafelyYou, and Intuition Robotics.

Thriving, not surviving

Thriving in later age, not simply ‘aging in place’ or compensating for the loss of ability, must engage the community, the individual, and providers. There’s new interest in addressing interrelated social factors such as isolation, life purpose, food, healthcare quality, safety, and transportation. Business models and connected living technologies can combine to redesign post-acute care for better recovery, to prevent unnecessary readmissions, and provide more proactive care for chronic diseases as well as support wellness.

In this area, OPTIMIZE has many sessions on cities and localities reorganizing to support older adults in social determinants of health, transportation innovations, and wearables for passive communications between the older person and caregivers/providers. Some organizations and companies contributing to the conversation are grandPad, Village to Village Network, Lyft, and Milken Institute.

Technology and best practices positively affect the bottom line

How can senior housing and communities put innovation into action today? How can developers make it easier for them to adopt innovation? Innovations that ‘activate’ staff and caregivers create a multiplier for a positive effect on care. Successful rollouts create a positive impact on both the operations and financial health of senior living communities.

(more…)