Nanowear’s ‘smart clothing’ in NY/NJ hospital trials to monitor patients for early-stage COVID. Is it the Year of the Sensor?

Nanowear, a NYC-based developer of cloth-based nanosensors and monitoring systems, has entered a clinical trial collaboration with two major NY/NJ-area hospital systems to test for vital signs which may be predictive of an advancing case of COVID-19. 

The goal of the investigative teams at Hackensack Meridian Health, the largest health system in north and central New Jersey with 17 hospitals plus 500 patient care sites, and Maimonides Medical Center of Brooklyn, affiliated with Northwell Health, is to determine and assess patients for early signs of the ‘cytokine storm’ in the heart and lungs which indicates inflammation within the circulatory system, often leading to severe complications and death in COVID patients. The clinical trial will monitor patients with confirmed or suspected COVID-19. The release is not specific as to whether the garment will be issued to patients monitored solely in the hospital or inclusive of patients still at home.

Nanowear’s SimpleSENSE adjustable undergarment continuously captures key physiological signs related to the onset of COVID–real-time ECG, systolic and diastolic blood pressure, blood flow hemodynamics, respiration, lung volume and fluid, and temperature. The vital signs are then transmitted via a mobile app to a physician portal for monitoring and interpretation.  

The garment test is also significant as it is a contactless monitoring system–highly applicable to contagious diseases.

Last July, SimpleSENSE launched in a heart failure management clinical trial with Penn State Hershey Medical Center in Pennsylvania and Hackensack Meridian. The patented cloth-based nanotechnology sensors can capture up to 120 million data points per patient per day. The HF management trial was designed to validate and provide a pathway to clear its own diagnostic algorithm generated from the garment. The SimpleSENSE device and mobile platform have been submitted to FDA for Class II 510(k) clearance.  Also mHealth Intelligence.

This may be the Year of the Sensor. Human contact is out, remote monitoring is in. Earlier this week, we covered Philips integrating BioIntelliSense‘s BioSticker into its RPM systems. During 2018-2019, we profiled Doncaster UK-based MediBioSense, which uses the VitalPatch from VitalConnect. They recently announced that an enhanced VitalPatch suitable for seven-day use and body temperature sensing received CE Class IIa medical certification as well as FDA clearance. We last covered them when MBS adopted the Blue Cedar app security system in 2018, but based on their website press section, much has happened since in extending their sensor-based technologies. This Editor will try to catch up with Simon Beniston of MBS.

Philips awarded by VA 10-year, $100 million remote ICU, telehealth contract; partners with BioIntelliSense for RPM

The US Department of Veterans Affairs (VA) awarded Philips a ten-year contract to build out their remote intensive care (ICU) service infrastructure to make it accessible to veterans from any location in the US. The VA currently manages 1,800 ICU beds nationwide in its approximately 1,700 sites. Based on the release, the Philips engagement in VA Tele-Critical Care will expand the VA’s current capabilities to encompass telehealth, tele-critical care (eICU), diagnostic imaging, sleep solutions, and patient monitoring. The agreement may total $100 million over the 10-year contract duration.

Philips has about 20 percent of the adult eICU market. They claim that 1 in 8 adult ICU patients are monitored 24/7 by their eICU Program, which combines audio/visual technology, predictive analytics, data visualization, and advanced reporting capabilities. Their proprietary research points to shorter ICU visits by eICU patients plus better outcomes. Healthcare IT News, Philips release (Photo: Philips)

By this Editor’s calculation, VA remains the single largest user of telehealth in the US. In their FY 2019, the first year of the ‘Anywhere to Anywhere’ initiative [TTA 24 May 2018], VA delivered more than 2.6 million telehealth episodes to 900,000 veterans. During the early part of the pandemic, they grew virtual home visits from an average of 10,000 to 120,000 per week. By the end of FY 2020, their goal is to deliver all primary care and mental health provider services, both in-person and via a mobile or web-based device. The VA release from November 2019 does not break out the different types of VA telehealth and usage.

Philips and BioIntelliSense have also inked a partnership deal to integrate BioIntelliSense’s BioSticker sensors into their post-acute remote patient monitoring (RPM) systems. The BioSticker is a wearable FDA-cleared 510(k) Class II sensor that transmits passive monitoring of key vital signs, physiological biometrics, and symptomatic events up to 30 days. The first announced user of the RPM+BioSticker systems will be Healthcare Highways of Frisco, Texas, a provider of health plans, employer self-funded health plans,  pharmacy benefit management, population health management, and benefit plan administration. Healthcare Highways is participating in seven patient monitoring programs to assess patient health status with providers: COVID-19, CHF, hypertension, diabetes, total joint replacement, cancer, and asthma. Release (Photo: Philips)

The CES circus opens its largest tent yet in health tech, AI, 5G, and more

CES kicked off today in Las Vegas (7 Jan), taking over the town in multiple locations, and will be making news through Friday 10 January. Like the circus, there are three health tech ‘rings’ at CES this year: Accessibility, Digital Health (Digital Health Summit), and Fitness and Wearables.

  • Digital Health Summit over the two days of its conference has shifted focus from the gadgets and wearables of their past conferences to prevention, health data, voice tech, machine learning, AI, bioelectronics (low current devices for treatment), behavioral health, and passive monitoring. There’s also a soupçon of star power with Katie Couric and Dr. Mehmet Oz, and some Grizzled Pioneer speakers and moderators such as Laurie Orlov, Chris Otto, Sean Slovenski, and Jane Sarasohn-Kahn. The Digital Health Summit is itself a Grizzled Pioneer as it goes back at CES to 2013–and my, how the players have changed. (Whatever happened to Sonny Vu?)
  • The Wearables Tech Summit is about the form and function of wearables, plus VR, AR (augmented reality), and of course Peleton.
  • Accessibility is sadly a mismatch (mish-mash?) of home networks, 5G, IoT, and a pitch competition.

What’s big? 5G, AI anything, and autonomous vehicles. What’s faded in the stretch? Robots.

Back to health tech…here’s some highlights:

  • Philips has several new or tweaked products at CES this year
    • A smart version of the Sonicare toothbrush that collects and shares real-time toothbrushing data. The BrushSmart program works with Delta Dental of California to analyze the data for insights into oral care. Users get benefits such as exclusive dental care offers, the Philips Sonicare ExpertClean toothbrush and free brush heads when they brush regularly.
    • The Avent mother and childcare app adds a new feature called Baby+ to track baby’s growth and receive ongoing advice specific to each stage of their baby’s development.
    • The SmartSleep system adds the SmartSleep Deep Sleep Headband 2 to actively improve deep sleep with features such as Fall Asleep Sounds, SmartAlarm, and the SleepMapper app. Release
  • OMRON is adding to its heart monitoring services with HeartGuide, the first wearable blood pressure monitor, and Complete, the first wearable that combines a blood pressure monitor and EKG. The company is also launching this summer a heart health coaching and incentive app, OMRON Connect 2.0, that states it changes behavior, combining its two existing apps HeartAdvisor and OMRON Connect. Release
  • Withings’ newest is the ScanWatch which will be able to take an ECG and monitor for sleep apnea. The ECG has three leads on the watch on the side of the watch’s bezel and an SpO2 sensor to monitor apneic episodes and oxygen saturation. FDA and CE approval are pending, and when released later this year will cost $249 to $299 depending on size.  ZDNet
  • ZDNet and TechRepublic have a running special feature on CES’ big trends for business. The annoyance factor you’ll have to endure is the running CBS commercials for various programs.
  • Mobihealthnews rounds up interesting devices and software such as the Nanit baby sleeping bag that monitors an infant’s breathing, Reliefband’s low current anti-nausea band, Samsung’s Ballie rolling robot plus collaborations with Kaiser Permanente (cardiac rehab) and IrisVision (low vision/macular degeneration assistance), and more.
  • John Lynn, another Grizzled Pioneer, in Healthcare IT Today typically diverts from the mainstream coverage in spotlighting smaller companies in atypical areas. Examples are France’s Adok smart projector with the potential to be used collaboratively in practice offices, new connected apps for Neofect’s smart gloves for arm/hand rehab, two air filters to monitor both inside and outside air quality (as a social determinant of health!), Xenoma’s wired pajamas for fall detection, the Mateo bath mat which can measure weight and body mass, and a smart diaper from Smardii.

More to come in the next days!

News roundup: Philips allies with Humana for pop health, Dexcom’s outage outrage, Halamka ankles Lahey for Mayo, Google and NHS Wales changes, Agfa’s health sale, Victrix/WhatsApp, more

Insurer Humana is identifying high-acuity and chronic CHF Medicare Advantage members and deploying two support programs utilizing Philips PERS and remote patient monitoring (RPM) systems. The first program identifies at-risk older people with chronic conditions and offering them Philips Lifeline with AutoAlert, Lifeline’s fall detection technology, and their CareSage predictive analytics. Philips Lifeline is already offered in select Humana Medicare Advantage plans. The second is a pilot with telehealth RPM to monitor a select group of CHF patients. This will use a Philips interactive tablet and connected measurement devices for care teams to actively monitor congestive heart failure patients. The rationale in the press release is centered on population health management, quality of care, and positively influencing patient outcomes, with “more efficient resource utilization” a/k/a lowering cost of care. Philips release.

Health tech is great, when it works–and Dexcom found out how serious it can get when it doesn’t. Dexcom, a continuous glucose monitoring system, experienced a server outage over the US Thanksgiving holiday weekend into Monday. It knocked out its updates in the Follow feature, frequently used by parents to monitor Type 1 diabetic children, and those with artificial pancreas devices that adjust insulin based on monitored BG levels. Dexcom was not only blasted by users on the server outage, which they attributed to ‘overload’, but also on its communications of the problem to users which depended on Facebook postings and not on real-time direct contacts or messaging. It was a ‘big surprise’ to their CEO, who also dismissed the possibility of a data breach, which seems a bit premature. Both Google and Microsoft provide cloud and tech services to Dexcom. CNBC 12/2, 12/3

Comings and goings: HIT pioneer, strategist, and general guru John Halamka is following the AI Star, leaving Boston’s Beth Israel Lahey Health to head up a machine learning/AI initiative at the Mayo Clinic in Minneapolis. Mayo this fall announced a 10-year high-level partnership with Google Cloud to store patient data and analysis. Modern Healthcare  According to the Healthcare IT News article, he’ll be returning on weekends to the Bay State to his 250-acre working farm….Also moving on to Google Health is Facebook’s Hema Budaraju, a product management director. Business Insider has annoyingly hid the news behind its paywall, leading to speculation in Mobihealthnews that she will be engaged in Google’s “social and environmental impact” efforts as she was at FB…And speaking of Google, founders Larry Page and Sergey Brin are stepping down at long last from active management. Google CEO Sundar Pichai will now be running Google and its corporate parent, Alphabet. See their letter on the GoogleBlog.DigitalHealth reports on changes at the NHS Wales Informatics Service. Helen Thomas is now interim director as NWIS director Andrew Griffiths is departing this month. NWIS is also transitioning to a new Special Health Authority….Agfa’s Healthcare Information Solutions and Integrated Care, plus their imaging division, are definitely going to Italy’s Dedalus Holdings S.p.A. for €975 million. It awaits approval from various authorities, their employee groups, and the usual closing conditions. Release, DigitalHealth.

UK healthcare analytics company Victrix Socsan has signed a licensing agreement last month with WhatsApp. Victrix will use Whats App for communications with beneficiaries as part of their furnishing proactive preventive care services and provide secure information. Release.

News roundup for Tuesday: room at the top at VA? (updated), Philips integrates teleradiology. 3rings Care premieres Amazon Echo service

Updated. Who’s the Leader? At the Veterans Administration, the soap opera plot accelerated on the continued tenure of Secretary David Shulkin who, after a strong start (and coming from within VA’s tech area), has stumbled over charges of inappropriate spending and staff turmoil since the beginning of the year. Journalist Christopher Ruddy, CEO of Newsmax, who speaks regularly with President Trump, indicated in an interview on ABC’s This Week on Sunday that Dr. Shulkin will likely be the next Cabinet departure. The fact that VA Choice 2.0 did not make it into the huge ‘omnibus’ budget bill indicated a disillusion with him on Capitol Hill. The lack of closure on replacing VistA with Cerner is also not in favor of a longer stay. The replacement may come from the VA House committee, the defense contractor community, or DoD. Why it’s important? VA is the largest purchaser of telemedicine and telehealth in the US, and has set the pace for everything from EHRs to info security. And there are those 9 million veterans they serve. Stay tuned. POLITICO Morning eHealth…..

By the next morning, a press secretary was saying “At this point in time though, he [President Trump] does have confidence in Dr. Shulkin. He is a secretary and he has done some great things at the VA. As you know, the president wants to put the right people in the right place at the right time and that could change.” But one of Dr. Shulkin’s biggest thorns-in-side at the VA, Darin Selnick, shuffled off last year to the Domestic Policy Council, will return to a post at the VA.

HIMSS continued to support VA’s and Dr. Shulkin’s efforts to increase veteran patient record sharing through changing the consent requirements authorizing the VA to release a patient’s confidential VA medical record to a Health Information Exchange (HIE) community partner. Letter.

Philips has entered the integrated teleradiology field by combining Philips’ Lumify portable ultrasound system and Innovative Imaging Technologies‘ (IIT) Reacts collaborative platform. It combines a compatible smart device that enables a two-way video consult with live ultrasound streaming. How it works: “clinicians can begin their Reacts session with a face-to-face conversation on their Lumify ultrasound system. Users can switch to the front-facing camera on their smart device to show the position of the probe. They can then share the Lumify ultrasound stream, so both parties are simultaneously viewing the live ultrasound image and probe positioning, while discussing and interacting at the same time.” Release

Following up on 3rings and their integration into the Amazon Echo virtual assistant system [TTA 18 Oct], Mark Smith from their business development area has told us that they have formally launched this platform earlier this month. The person cared for at home can simply ask Alexa to alert family and caregivers that they need help via voice message, text or email. Care staff or family can also use Echo to check through the 3rings platform by simply asking Alexa if that person is safe and OK. 3rings is now actively seeking to partner with innovative health, housing, and social care organizations. Overview/release.

Rounding up what’s news: LindaCare, TytoCare funding; Medicare telehealth parity, Norway’s big cyberhack, Virta reversing diabetes, DARPA’s 60th birthday

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2017/12/Lasso.jpg” thumb_width=”100″ /]Your Editor’s been away and then largely out of pocket over the past two weeks. Here’s our roundup/catchup beyond the bombshells:

In remote patient monitoring for chronic disease, Philips, PMV, and other investors invested €7 million ($8.6 million) in Belgium’s/Hartford CT’s LindaCare. The Series B funding will accelerate its US expansion of OnePulse for remote monitoring of chronic heart failure and cardiac arrhythmia patients with Cardiac Implanted Electronic Devices (CIED). It is in use in major European hospitals and in US trials, though there is no mention in the release or on their website on CE Marking or FDA clearance/clinical trials. Previously from its 2013 founding, it had €1.6 million in funding. Also Mobihealthnews.

TytoCare, a remote monitoring telehealth/video consult platform which integrates peripherals for a virtual physical exam, raised $25 million in a Series C round led by large Chinese insurer Ping An via their Global Voyager Fund plus Walgreens, Fosun Group, OrbiMed, LionBird, and Cambia Health Solutions. Release. Their total raise is $45.6 million since 2012 (Crunchbase). Their most current partnership is with Long Island-based Allied Physicians Group which is featuring at-home telehealth visits at its pediatric practice in Plainview.

More favorable Medicare reimbursement for telehealth is the subject of four US Congressional bills. The one furthest along is the ‘Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act of 2017’ (S.870), which aims to improve at-home care, increases Medicare Advantage flexibility, gives ACOs more options and expands telehealth capabilities for stroke and dialysis patients. It passed the Senate in September and now goes to the House Subcommittee on Health of the Committee on Energy and Commerce. The effect of all four is on Medicare payment parity with in-office visits, which does not currently exist and is not affected by the various state parity bills on insurance for those below 65. American Well touts a 10-fold growth in revenue, but the likelihood of any of these four bills being signed into law is small, particularly with a pending report from the Medicare Payment Advisory Commission. Becker’s Hospital Review

Norway released at end of January news on an “advanced and persistent” 8 January cyberattack on Health South East RHF. This has both a health breach and military twist.

(more…)

Deals of the day: American Well partners with Philips for global telehealth apps, gains $59 million partnership with Allianz

The large partners with the large, adding a global dimension. Telemedicine provider American Well and Philips announced today a global alliance to integrate American Well’s patient-doctor video consults with a range of Philips’ healthcare monitoring program. First up will be adding American Well consults to the Philips Avent uGrow parenting app. This is an Apple/Android app that presently tracks baby feeding, weight, and sleeping patterns, tying into Philips baby monitoring products such as an ear thermometer and babycam. The second stage with American Well involves their mobile telehealth software development kit (SDK) to integrate video consults into other Philips’ digital health solutions and the Philips HealthSuite Digital Platform. Philips also announced that uGrow will include voice activation with the ever-trendy Amazon Echo and the Philips Avent smart feeding kit to automatically monitor the time, volume and duration of a baby’s feeds. Philips release

American Well’s second global deal of the day is with insurer Allianz’s digital investment fund, Allianz X.  The latter, funded with a $59 million investment, creates another partnership dedicated to developing a digital product that combines wearable sensors, remote monitoring, and virtual visits. The goal is to widen patient access, lower cost and improve healthcare quality. As part of the deal, Allianz X will be joining American Well’s Board of Directors. Allianz is not well known as a health insurer in the US, but is active in the international health insurance area for individual expats and employers with international employees.  Release, Mobihealthnews

Japan’s workarounds for adult care shortage: robots, exoskeletons, sensors

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2017/10/robear.jpg” thumb_width=”150″ /]The problem of Japan’s aging population–the oldest worldwide with 32 percent aged 60+ (2013, RFE)–and shortage of care workers has led to a variety of ‘digital health solutions’ in the past few years, some of them smart, many of them gimmicky, expensive, or non-translatable to other cultures. There have been the comfort robot semi-toys (the PARO seal, the Chapit mouse), the humanoid exercise-leading robots (Palro), and IoT gizmos. Smarter are the functional robots which can transfer a patient to/from bed and wheelchair disguised as cuddly bears (Robear, developed by Riken and Sumitomo Riko) and Panasonic’s exoskeletons for lifting assistance.

Japan’s problem: how to support more older adults in homes with increasingly less care staff, and how to pay for it. The Financial Times quotes Japan government statistics that by 2025 there will be 2.5m skilled care workers but 380,000 more are needed. The working age population is shrinking by 1 percent per year and immigration to Japan is near-nonexistent. Japan is looking to technology to do more with fewer people, for instance transferring social contact or hard, dirty work to robots. The very real challenge is to produce and support the devices at a reasonable price for both domestic use and–where the real money is–export. 

The Abe government in 2012 budgeted ¥2.39bn ($21m) for development of nursing care robots, with the Ministry for Economy, Trade and Industry tasked to find and subsidize 24 companies–not a lot of money and parceled out thinly. Five years later, the Ministry of Health, Labour and Welfare determined that “deeper work is needed on machinery and software that can either replace human care workers or increase staff efficiency.” Even Panasonic concurred that robots cannot offset the loss of human carers on quality of services. At this point. Japan leads in robots under development with SoftBank’s Pepper and NAO, with Toshiba’s ChihiraAiko ‘geisha robot’ (Guardian) debuting at CES 2015 and Toyota’s ongoing work with their Human Support Robot (HSR)–a moving article on its use with US Army CWO Romy Camargo is here. (attribution correction and addition–Ed.)

The next generation of care aids by now has moved away from comfort pets to sensors and software that anticipate care needs. Projects under development include self-driving toilets (sic) that move to the patient; mattress sensor-supplied AI which can sense toileting needs (DFree) and other bed activity; improved ‘communication robots’ which understand and deploy stored knowledge. Japan’s businesses also realize the huge potential of the $16 trillion China market–if China doesn’t get there first–and other Asian countries such as Thailand, a favored retirement spot for well-off Japanese. In Japanese discussions, ‘aging in place’ seems to be absent as an alternative, perhaps due to small families.

But Japan must move quickly, more so than the leisurely pace so far. Already Thailand is pioneering smart cities with Intel and Dell [TTA 16 Aug 16] and remote patient monitoring with Western companies such as Philips [TTA 30 Aug]. There’s the US and Western Europe, but incumbents are plentiful and the bumpy health tech ride tends not to suit Japanese companies’ deliberate style. Can they seize the day?  Financial Times (PDF here if paywalled) Hat tip to reader Susanne Woodman of BRE (Photo: Robear) 

Philips publishes second annual Future Health Index on access, integration and tech adoption

The Future Health Index–a blockbuster 100-page annual study from Philips with research conducted by IPSOS, Schlesinger, and Braun–reflects findings of over 29,000 consumers and 3,300 healthcare professionals in 19 countries. The survey includes analysis by country and aggregate of perception versus reality (both difficult measures) in access to healthcare, integration between healthcare systems, and adoption of healthcare technology. It is, needless to say, complex and hard to parse into a headline and finding or two or four. The UK press release helpfully discusses particulars of the UK findings which are hard to find in the main report. Overall, it’s positive, but nowhere near a tipping point where connected care is expected and routine.  

  • About half (48%) of (UK) HCPs have seen an increase in the use of connected care technologies by primary care doctors in last 12 months
  • About a third of the (UK) general population (31%) have used connected care technologies to monitor a health indicator in the last 12 months
  • Over half of the (UK) general population (57%) who have used connected care technology to track health indicators have shared their data with an HCP in the last 12 months
  • Six-in-ten (62%) of the (UK) general population think that integration of the health system would make the quality of healthcare better

The appendix with the UK summary results is available online here and the US here. The full study is available for download here. (All countries are in the appendix)

Out of the global results, there’s a disconnect between having the data and making it useful: “Only 23% of the general population surveyed who used connected care technology within the last 12 months claim to completely understand when to share data from connected care technology with a healthcare professional, or the easiest way to do so.” 

A not surprising finding was that quick wins would be found in the home care area and in preventing avoidable readmissions:

  • Connected care was important to healthcare professionals in improving home care and for geriatric care–81 percent and 82 percent respectively  
  • 55 percent of professionals chose home care and related aspects in improving long-term management and tracking of medical issues

Looking forward into the future, the general population group was asked to speculate on artificial intelligence and on what AI technology would have the most impact on improving healthcare if available today. The two leaders were health tracking wearables/apps on smartphones and AI-assisted tools for guidance. Hologram doctors and robots cruised around 10 percent (!)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2017/08/AI-from-Philips-1.jpg” thumb_width=”250″ /]

Editor’s note: While incredibly comprehensive, this Editor will express a certain disappointment in the researchers’ selection of US and UK experts. This Editor could name five to ten experts and patient advocates in US and UK from personal contacts (including our UK-based Editors) without thinking particularly hard–and with a little homework UAE and Africa–who could have informed their study.

This Editor also had the pleasure to meet two of Philips’ connected health executives at this month’s Health 2.0 NYC/MedStartr meeting on population health and value-based care: Nick Padula, VP of Home Healthcare Monitoring, and Eduardo Da Silva, Strategic Sales Director of Philips Wellcentive. Mr. Padula was a panelist for the evening.

Health tech arrivals (Philips, Roche, VRI, PushDoctor)…and departures (Pact, Jawbone)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/03/Looney-Tunes-Were-in-the-Money.jpg” thumb_width=”150″ /]This popular vacation week has been filled with ‘money under the wire’ news of acquisitions, investments…and one high-profile owner shuttering a pioneering activity app.

Acquisitions:

Philips Healthcare added London-based pregnancy app developer Health & Parenting for an undisclosed sum. Its most popular app is Pregnancy + (and ++), with 12 million downloads via the Apple Store and Google Play, but others are Baby + for all things baby-rearing, and Baby Name Genius to Find That Ideal Name. It will fold into and diversify Philips’ existing uGrow digital parenting platform which includes the Avent smart baby monitor and smart ear thermometer and leverages the open infrastructure of Philips’ Health Suite Digital Platform. One wonders at the flood of data flowing from these apps to these devices and what Philips will do with all these points. Release, MedCityNews

Roche acquired Austrian partner mySugr, a management tool that promises to ‘make diabetes suck less’. Last year they added Roche’s Accu-Chek Connect blood glucose monitor to its chosen device connect and sync list. mySugr features an app for users to log their meals, exercise, glucose levels, and mood. It also captures pictures of user snacks and unleashes “a diabetes monster” avatar when the food choices are poor based on their glucose levels. Terms were not disclosed. MedCityNews

Telecare/monitoring company VRI quietly acquired Healthcom from Woodbridge International. Healthcom’s primary area is care transition management using medical alerts, telehealth, and medication management for payers, government agencies and care partners. Originally positioned as a partnership June 30 on VRI’s website, Globe Newswire confirmed the sale a week later. Terms (again) were not disclosed.

Mobihealthnews rounded up 24 major acquisitions, including GreatCall (by GTCR) and Best Doctors (Teladoc)–all by June 30!

Investments:

Manchester’s PushDoctor telemedicine app raised $26.1 million in Series B financing from Accelerated Digital Ventures and Draper Esprit plus Oxford Capital Partners, Partech Ventures, and Seventure Partners. This added to their $10.1 million Series A raise in January 2016. PushDoctor connects UK patients with NHS-registered GPs for virtual visits costing only £20. Unlike US-based tele-docs, Push Doctor issues prescriptions, makes doctor-led referrals to other health providers and specialists, and helps manage repeat prescriptions. Their founder also has an eye on managing long-term conditions, short-term illnesses, fitness, and nutrition. Their major UK competitors are Babylon Health (which recently raised £50 million for its triage app), Ada Health, and Your.MD. Crunchbase, TechCrunch, Mobihealthnews

And shutterings:

Pioneering fitness incentive app Pact (founded 2011) announced its closing by end of August. Originally a ‘get thee to the gym’ app, it branched out into healthy food (eat more vegetables!) and tracking meals with MyFitnessPal. Pact never truly emerged from seed funding. A rare stumble by Khosla Ventures, which led a 2014 bag-of-skittles round of $1.5 million. Mobihealthnews, Crunchbase

Jawbone closed out the week by liquidating and transubstantiating into Jawbone Health Hub. More on this here

HIMSS17 news flashes: Lenovo, Orbita, Tactio, Garmin, Parallax, Entra Health, Philips, IBM

Voice commands a new frontier in telehealth. Why not dispense with the pill dispenser, the smartphone, the tablet? Lenovo Health and Orbita have put together a solution that works via Amazon Alexa. The Orbita Voice is a voice-controlled speaker for the home that connects with the Lenovo Smart Assistant to “help patients with chronic and post-acute care needs be more fully engaged in their wellness at home. Enhancing a patient’s ability to access and share information with providers, caregivers, and family members contributes to improved care journey management, treatment adherence, and medication compliance.” The release isn’t informative as to how it will do this, but apparently it’s all in the programming. This is the second Lenovo Health initiative on view in the past few months. This Editor saw at NYeC Digital Health their Authoritative Identity Management Exchange establishing a universal, verifiable patient ID system [TTA 19 Jan video] and was impressed.

Canada’s Tactio telehealth platform is adding Garmin wearables to its compatible peripherals. TactioRPM is a mobile platform that combines mobile apps, hundreds of connected health integrations (Garmin, A&D, Fitbit, Roche, Nonin, Omron and Welch Allyn), patient questionnaires, digital coaching programs and HIPAA-compliant messaging. TactioRPM has FDA Class 1, CE and ANVISA (Brazil) clearances. Release via Yahoo Finance

Parallax Health Management (PHM) is presenting with Entra Health (mobile HIT) and Microsoft Cloud its remote patient monitoring systems. Based on the PHM website, they are tablet based with a raft of peripherals for the multiple-chronic condition patient. The release highlights their chief medical officer, Bob Arnot, MD who is well known in the US as an author and television presenter.

Philips announced US FDA 510(k) clearance of the IntelliVue Guardian software system, which pairs with the single-use, adhesive Philips Wearable Sensor for continuous clinical-grade monitoring of high-acuity patients. The software gained CE Mark certification last October. They also debuted a mobile app called Jovia Coach for healthcare systems to reach patients at risk for Type 2 diabetes. MedCityNews.  Philips’ ongoing Intensive Ambulatory Care (IAC) pilot program with Banner Health in Arizona so far has delivered impressive reductions in overall costs of care by 34.5 percent and hospitalizations by 49.5 percent. LeadingAge/CAST

IBM Watson heralds cognitive computing, or computers that learn, according to IBM CEO Ginni Rometty, and will profoundly change medicine as well as IBM, as they are betting the company on it. In the meantime, they have announced the Watson Platform for Health Cloud and a specialized Watson Health Consulting Services unit. Health Data Management. An elephant in the ointment is that the prestigious MD Anderson Cancer Center, part of the University of Texas, has put their Watson program, the Oncology Expert Advisor, on indefinite hold as it checks out other contractors after sinking $62 million into OEA over three years without a measurable result. Forbes

Babylon as AI diagnostician that is ’10 times more precise than a doctor’

The NHS announced at the top of this month that it would test Babylon Health‘s ‘chatbot’ app for the next six months to 1.2 million people in north London. During the call to the 111 medical hotline number, they will be prompted to try the app, which invites the user to text their symptoms. The app decides through the series of texts, through artificial intelligence, in minutes how urgent the situation is and will recommend action to the patient up to an appointment with their GP, or if acute to go to Accident & Emergency (US=emergency room or department) if the situation warrants. It will launch this month in NHS services covering Barnet, Camden, Enfield, Haringey, and Islington, London. TechCrunch.

The NHS’ reasons for “digitising” services through a pilot like Babylon’s app is to save money by reducing unnecessary doctor appointments and pressure on A&Es. It provides a quick diagnosis that usually directs the patient to self-care until the health situation resolves. If not resolved or obviously acute, it will direct to a GP or A&E. The numbers are fairly convincing: £45 for the visit to a GP, £13 to a nurse and £0 for the app use. According to The Telegraph, the trial is facing opposition by groups like Patient Concern, the British Medical Association’s GP committee, and Action Against Medical Accidents. There is little mention of wrong diagnoses here (see below). The NHS’ app track record, however, has not been good–the NHS Choices misstep on applying urgency classifications to a ‘symptom checker’ app–and there have been incidents on 111 response.

Babylon’s founder Ali Barsa, of course, is bullish on his app and what it can do. (more…)

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…)

Using telehealth to improve night-time ICU care

Intensive Care Units treat the most sick people in a hospital and requires round-the-clock staffing by doctors and nurses. 24-hour staffing, however, means shift working and an inevitable night shift. To make it fair on all staff the shifts are usually rotated so any doctor or nurse would do a period on one shift and then move to the next shift.

It is not surprising that the more senior staff manage to have less night work than newer, less experienced ones. On the other hand night shifts may have attractions such as extra pay and this may be more important to the lower paid less experienced staff than to the higher paid senior ones. Also, the cost of staffing nights with less experienced staff may prove cheaper for the hospital. Nevertheless, the patients’ needs are no less important at night than during the day. Another aspect of night-time care is the possibility that a doctor or nurse may not be as alert at night as they would be in the day-time.

Looking at these downsides of night-time ICU care staffing, an hospital in the US has come up with a novel idea – move the doctors and nurses to a zone where it is day-time when it is night-time at the hospital and use telehealth to connect them. This is counter intuitive and has its own drawbacks.

Georgia’s largest healthcare provider Emory Healthcare is sending some ICU doctors and nurses to Sydney, Australia, for tours of six to nine weeks at a time, in a trial to staff ICU at night with health staff in a daylight zone using telehealth. The six month trial in collaboration with Philips and Australia’s Maquarie Health has been underway for 3 months.

The reason this is counter-intuitive is that telehealth was invented to overcome the problems associated with healthcare professionals and patients not being at the same location and here the two are being artificially removed to two ends of the world. While telehealth is a good solution to the diagnosis and treatment from afar, most professionals are likey to agree that it is inferior to being face to face with the patient. So it will be good to see the conclusions reached by this trial on how any drawbacks of distance balances out with having more alert doctors and nurses.

See also mHealth Intelligence article here.

A review of digital health patent slugfests and Unintended Consequences

Mobihealthnews provides a recap of the past four years of patent actions pitting company against company in the hushed but deadly rings of the US Patent and Trademark Office (USPTO) and the US International Trade Commission. On the fight card: the never-ending American Well-Teladoc bout (Teladoc winning every decision so far by a knockout [TTA 18 June]–a second American Well patent being invalidated on 25 August); CardioNet vs MedTel, which the former won but has had to chase the latter out of the arena and down the street to collect; Fitbit-Jawbone which has gone both ways [TTA 27 July]; and the long trail of blood, sweat and Unintended Consequences around Bosch Healthcare’s heavyweight IP pursuit against mainly flyweight early-stage companies (not noting, as we did, their apparent ‘draws’ vs Philips and Viterion, then owned by Bayer).

The Reader will note our tracking Bosch’s activities go back to 2012 (here, here and here). Moreover, with Mr Tim Rowan of Home Care Technology, we broke the news of Bosch’s demise in June 2015, drawing the conclusion that their offense versus Cardiocom’s patents (now in Medtronic’s cardiac division) directly led to the invalidation of their key patents, IP–and the very basis of the company’s existence. See the 19 June 2015 article and our recap one year later in reviewing AW-Teladoc. (Any similar phrasing or conclusions within the Mobihealthnews article, we will leave to our Readers to decide!)

Philips dives into global consumer health tech with new wearables ‘ecosystem’

Philips has made another substantial, if traditionally risky, move into the direct to consumer (DTC) health monitoring segment with a limited wearables ‘ecosystem’ under a new Personal Health Solutions division. It contains five FDA-cleared products for monitoring vital signs. Four peripherals download via a watch to iPhone/Android phone apps which run on version 2.0 of the Philips HealthSuite (with Salesforce1) mobile app. Earlier the apps were marketed in NL and BE.

While the release states they are globally available, initially it appears they are being marketed direct to consumer for the US only. Purchase is direct on the site. All devices are Bluetooth LE and sync with the watch and smartphone app/dashboard (available on Google Play and the Apple Store). The watch/app also tracks exercise with activity recognition, calorie tracking and sleep patterning, with the app providing some education content.

  • Watch $249
  • Body Analysis Scale (weight, body fat, BMI) $100
  • BP/pulse (upper arm) $100, (wrist) $90
  • Ear Thermometer $60

Interestingly, their existing DTC PERS enterprise, Lifeline, is not linked to or mentioned.

Prices are mid-range to high, making this a prima facie tough sell. (more…)