Shouldn’t we be concentrating on digital therapeutics rather than ‘health apps’?

Where the money and attention are going. The first generation of Quantified Self apps was all about viewing your data and storing it online in a vault or graphs…somewhere, usually proprietary. Your Pebble, Fitbit, or Jawbone tracked, you crunched the numbers and found the meaning. At the same time, there are wellness companies like Welltok, ShapeUp, Keas, Virgin HealthMiles, and RedBrick Health, usually working with companies or insurers, that use various methods (money, gamification, other rewards) to influence lifestyle and improve a person’s health in a quantified, verifiable, but general way. What’s happened? There are now apps that combine both data and behavior change, focusing on a specific but important (again) condition, coach to change behavior and verify results rigorously through clinical trials. Some, like Omada Health, prove through those clinical trials that their program successfully changes pre-diabetic indicators, such as weight loss, decrease cholesterol and improved glucose control–without medication. This results in big savings for insurance companies, one reason why a $50 million Series C was led by Cigna. Another model is to work with pharmaceutical companies to better guide treatment. Propeller Health with its asthma/COPD inhaler tracker is partnering with pharma GlaxoSmithKline on a digital platform to better manage lung patient usage, and surely this will go through a clinical trial. We will be seeing more of this type of convergence in medical apps. (The rebooted Jawbone Health Hub is moving in this exact direction.) The Forbes article, while short, is written by someone who knows the business of apps– the co-founder of the AppNext distribution/monetization platform. He does achieve his aim in making us think differently about the potential of ‘health apps’. 

Seeing into 2017: Fitness trackers’ chill, clinical and specialized wearables warm up

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2012/12/crystal-ball.jpg” thumb_width=”150″ /]The first in a series of brief projections for 2017. Fitness wearables aren’t even lukewarm anymore, and it’s visible in consolidation and the nay-saying articles. In late November, Fitbit bought one of the pioneers, Pebble, for a cut price of $40 million (TechCrunch). Fitbit shares are also cut price at below $7.50, whereas the 2015 IPO debuted at $50. Editor Charles’ favorite, Jawbone, is moribund; the springtime rumors of company sale and shutdown of the fitness band line have not been contradicted since [TTA 27 July]. Research/analytics company CB Insights calculated that 2015 wearable computing (a broader category) investment funding fell 63 percent from 2014 to a level comparable to 2012-13, in large part due to the cooling of the fitness segment.

A sure sign that fitness bands have chilled is negative play in the consumer press. ‘My fitness band has made me fat’, spun off the JAMA article [TTA 28 Sep], is now the theme of hilarious ‘dieters gone wild’ articles like this from the New York Post (warning, eye bleach photos!). But The Sun (UK) waves a warning flag that the information could be sold, sent to your employer or insurance company to profile and/or discriminate against you, or cyberhacked. All this can knock a pricey band off the Christmas shopping list. And no, it hasn’t shifted to smartwatches as most insiders predicted, as smartwatch sales have leveled off–as expected–until their functionality and appearance improve to justify their high price.

What’s in our crystal ball? Clinical-quality and specialized wearables will rise from these ashes.

  • Doctors are simply not interested in the current poor quality of data generated by current wearables–‘it’s worthless, Jim!’ ZDNet’s much-discussed article on this subject paradoxically stresses this, then focuses in on the clinical quality data generated by startup VivaLnk’s eSkin for temperature and stress. Clinical quality data is what is required for a health and wellness research partnership like the one recently announced by RTI and Validic.
  • Industry buzz is that Fitbit bought Pebble for its better IP, apps and stable of developers, not its smartwatch hardware, and that IP includes clinical quality measurement.  Other biosensor companies on the rise according to CB Insights are Thync, Thalmic Labs, YBrain and mCube.
  • In specialty wearables, there’s the recent funding success of Owlet, the High Cute Factor baby monitor sock. Lifebeam transfers multiple sensing technology to helmets and hats for richer data.

And if sensor patches develop with speed, in two to three years they may eliminate all of these!

The mixed picture of health tech investment: a potpourri

One picture is generally positive–plenty of opportunity in the aging and ill population, particularly in data integration from various sources, and value-based care. Everyone loves the excitement that a startup with a novel technology or way it can make knowledge more useful brings to the field.  Another picture is one of pitfalls aplenty, from overhyping technology (poster child, Theranos) to overestimating growth, overspending and especially picking the wrong (nervous, impatient) investors at the wrong time, which have left a general patina of mistrust around digital health. There’s also the fact that healthcare is a highly, confusingly regulated, long-cycle business that’s challenged money-wise, whether in the US, UK, Europe or Asia. Some advice to startups contained in these two articles, including from the principals of StartUp Health accelerator (who’ve seen it all), has to do with building trust, finding the right investors, the right advice/advisors, collaboration (though that is difficult with IP), finding proven (affordable) management and a sustainable (and resilient) culture. Underpromise, overdeliver.  TechCrunch, Healthcare Dive

No wonder that investment was flat in 2015, and that much of the news is around acquisitions that rearrange companies and/or offerings. The latest today is Allscripts‘ and GI Partners’ acquisition of behavioral EHR/care coordination company Netsmart for $950 million; Allscripts is moving its homecare business into Netsmart’s CareFabric suite. Kansas City Business Journal, Healthcare Dive  In addition we’ll cite our earlier Mo’ Money article on the $600 million in various digital health investments. UPMC, which had invested in Vivify Health’s telehealth/RPM platform, is spreading $3 million around partly in-house to six health tech projects developed under the Pittsburgh Health Data Alliance. And in an example of Wearables Confusion, investors put $16 million into LifeBeam to develop another DTC ‘holistic’ health wearable (LifeBeam’s origins are sensors for aerospace and defense) while early wrist fitness entrant Pebble has laid off 40 staff in an attempt to refocus on…fitness.

Early-stage companies are also alliancing and merging. Fresh out of Newark and the New Jersey Institute of Technology’s NJ Innovation Institute, the merger of Practice Unite (which knits together secure mobile clinician/patient communications into a customized platform) and Uniphy Health (physician engagement), is an example of complimentary enlargement. This expands care collaboration offerings and shades over into patient engagement if you look at the PHM quadrant here. According to Director/Chief Medical Officer Stuart Hochron, MD (who was a Practice Unite founder), “We’re really pleased with the outcome of this merger. It’s given us the capital and resources that we need to scale.” It’s also good to see that both the founders and the CTO are moving into the new Uniphy Health–and staying in Newark.  Release

Is wearable IoT really necessary–and dangerous to your privacy?

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/08/is-your-journey-neccessary_.jpg” thumb_width=”150″ /]But does the average person even care? This Editor senses a groundswell of concern among HIT and health tech regarding the highly touted Internet of Things (IoT) and the dangers it might present. Our previous article reviewed the possibilities of hacking, system vulnerabilities in IoT networks and software bugs ‘bricking’ everyday objects such as refrigerators and cars. But what about wearables and the unimaginable amount of data they generate? Is it as unidentifiable as wearables makers claim? Columbia University computer science student Matthew Piccolella focuses in his article on healthcare ‘things’, primarily fitness trackers like Editor Charles’ favorite, Jawbone, but also clothing and even headsets that measure brain waves (Imec). Their volumes of data are changing the definition of healthcare privacy, which in the US has been synonymous with HIPAA. The problem is that health metadata are increasingly identifiable in a ‘big data’ world. (more…)

Swoon or mourn? Smartwatch action: Misfit, MS HealthVault, Glance

The smartwatch is nowhere near dead (check the beautiful Withings Activité at CEWeek), but its future, along with pure fitness bands, is a complicated thing. Three moves by small to giant companies further add color to (or complicate) the picture, including an ‘aftermarket’ add on for your current watch:

  • Misfit joins up with the Pebble smartwatch. The Misfit Shine, which has enjoyed much appreciation by the D3H as the ‘elegant button’, announced it will distribute its tracking app and algorithm technology to smartwatch makers. Pebble is the first and not exclusive. Sonny Vu, not known for his subtlety, is quoted in VentureBeat: “If I kept making just fitness trackers, I would be out of business in 12 to 18 months.” Misfit will continue to sell Shine in the US and internationally for at least another few quarters to meet demand for a fitness-only tracker. It shows you how quickly the weather changes: with $23 million in hand, and a Series B last December of $15.2 million, they are pivoting–quickly. John Sculley and other bluechip investors like Khosla Ventures and Norwest Capital obviously see a boulder in the road.
  • Microsoft moving to get into the smartwatch biz. Their patent filing of 2012 was just the first move but both Forbes and VentureBeat have confirmed rumors the device is a go. And they have a core of techies (Xbox) to work on it and the perfect place for the data: Microsoft HealthVault. Nothing like a smartwatch to jolt some life into a moribund PHR!
  • Love your plain old watch but just want to soup it up? Slip Kiwi Wearables’ Glance under your watch instead and get fitness tracking plus smartwatch functions. Kiwi already has the app for the Kiwi Move but Glance seems to have more such as interaction with your phone calls. Think of it as an aftermarket accessory, especially if you’re a traditionalist in watch form factor and/or don’t have the long green for Withings. In Kickstarter funding now with a price point of $65, but they are less than halfway towards their $150,000 goal with only six days to go. Gizmag

The CES of Health (Thursday)

Beaucoup fitness bands and wearables, an ‘all-in-one’ glucose meter and finally, a lack of hype!

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/01/razer-nabu-main-banner.jpg” thumb_width=”150″ /]Mobihealthnews rounds up 18 mobile health launches in a slideshow format (a bit difficult to page through). It’s heavy on fitness monitor bands and wearables from well-known and startup companies at price points from the $100 range up well past $400:  Sony, LG, Garmin, Polar, Razer, Virgin Pulse (clipon), Lumo, iFit, Movea, Wellograph and Epson. (Also see Medgadget’s roundup if you can’t get enough!) Outside of fitness monitors: from China’s iHealth Lab (Andon Health), a blood pressure monitoring vest, an ambulatory ECG device that supposedly sticks to the wearer’s bare chest (no FDA approvals yet); Zensorium Tinke’s pulse oximeter plus for Android (seen by this Editor at New York CES in November 2012), the Qualcomm Life-backed YoFiMeter cellular glucose meter (more below) and the Medissimo Medipac GPS tracking pill box from France. Already covered here: Withings Aura, Qardio, Mother, Kolibree. (more…)

Smartwatches as the 2014 tablet, redux

Mobihealthnews does a very good roundup of smartwatchesboth familiar and not in this 10 page report. Most are in kickstarter mode, raising funds and some may never see daylight, but all a Pointer to the Near Future:  Pebble, AGENT, Kreyos Meteor (sounds like a sportscar), Sony Smartwatch, i’m Watch (from Italia), Motorola’s MotoActv, Androidly, Neptune Pine, the unfortunately named GEAK Watch, Toshiba, the Qualcomm Zola and the rumored Apple iWatch and Google Watch. If you want to watch smartwatches more, there is a website called The Smart Watch Review10 smartwatches that may take on fitness trackers

Previously in TTA: Smartwatches as the 2013-2014 tablet…and will they knock out fitness bands? at the end of the ‘Apple-ologist” article. A situation we spotted two weeks ago.