TTA’s week: messy payer divorce, HIMSS17, NHS digital health’s future, VA, Theranos, ATA, more

 

More news on the VA award, the messy Anthem-Cigna divorce, HIMSS17, a preview of ATA 2017, social determinants of health, digital health’s future in the NHS, tenders are up, Theranos down and much more in our busy week.

HIMSS17 news flashes: Lenovo, Orbita, Tactio, Garmin, Parallax, Entra Health, Philips, IBM (Some setbacks for Watson Health)
The Theranos Story, ch. 36: Their money–and time–are running out (The start of the denouement)
Tender up: Durham Smart County on Social Isolation (It’s not just telehealth)
ATA 2017 Telehealth 2.0 Conference, Orlando (Special offer for TTA Readers)
Disrupting the pathways of Social Determinants of Health: the transportation solution (A focus on Veyo)
Utah Senate removes telehealth bill abortion restrictions (Editor Chrys profiles, wait to see if it’s approved)
Tender up: NHS Hammersmith and Fulham CCG (UK) seeking telemedicine for care homes (New opportunities)
What is the future of digital technology in NHS England for the haves and have-nots? (Local innovation, but the funding?)
Anthem to Cigna: That’s Sabotage! You’re staying, like it or not! (updated 21 Feb) (It’s a foolish War of the Payers in Divorce Court as they slug it out)
Iron Bow partners with Vivify Health for $258 million VA telehealth contract (A real competitor to Medtronic)

The wheels fall off the two Big Payer mergers. Big Tech’s moves on 2020 healthcare delivery. Two sales jobs at Buddi. Dementia therapy, telestroke response, and more.

Cigna to Anthem: we’re calling it off too–and we want $13 bn in damages! (The War of the Payers heads to Divorce Court)
Aetna’s Bertolini to Humana: Let’s call the whole thing off (updated) (The merger failed, but they’re still friends. For now.)
Updated–MedStartr’s Rise of the Healthy Machines 1 March (NYC) (On trend half-day event)
Tender/RFI up: two more from EU-Supply (UK, IRL)
Towards 2020: Big Tech developments predicted to impact healthcare delivery (AI, machine learning, blockchain)
Buddi looking for two dynamic Sales Account Managers (UK) (Opportunity)
Telestroke continues to expand (US) (Editor Chrys’ take on bringing fast stroke response to regional and rural areas)
NY’s Northwell Health Home Care partners with HRS for telehealth tablets (Largest NY system bets on digital health)
Robotic cats, parrot aid dementia patients at Lincolnshire Manthorpe Centre (UK) (Simple aids)
Jawbone still in business–with Fitbit in court (IP and trade secrets may be what’s left)
The Theranos Story, ch. 35: Arizona lab in violation, is there a biotech ‘Theranos effect’? (More strikes against Theranos)
Further clarification on telehealth tenders and the North Yorkshire County Council (We got the straight story, and it’s delayed)
Anthem-Cigna merger nixed, finally (US) (The DC District Court decided, and set into motion the rest)

See further comments and debate on the VA $1 billion award to four providers–US telehealth’s biggest client. Jawbone’s exit, UnaliWear’s entrance. AI beating Watson? Merger, product and meeting updates round out a busy week.

Humana-Omada Health diabetes prevention program could cut $3 bn in Medicare expense: study (Weight loss and programmed coaching work)
TytoCare remote diagnostics comparable to in-person exam results: study (A big plus for home diagnosis with telemedicine)
Tender up: NHS Shared Business Services (SBS) (UK) (Its worth a mystery)
VA awards over $1 billion in Home Telehealth contracts–at long last (updated) (Be careful of answered prayers)
Jawbone out of the consumer fitness tracker business, going to clinical model, raising funds: report (A last ditch effort to save a $980 million investment)
Updates on Anthem-Cigna, Aetna-Humana mergers (Best if they don’t happen)
UnaliWear’s Kanega PERS watch nears US launch (And stylish, too!)
Your temporary tattoo, now with vital signs monitoring! (Only reason to get a tat)
AI as diagnostician in ophthalmology, dermatology. Faster adoption than IBM Watson? (Faster, specialized, cheaper wins)
British Journal of Cardiology (BJC) Digital Healthcare Forum’s inaugural meeting (Put on your calendar for 28 April)
Analysis of an underserved market: only 0.2% of migraine sufferers use migraine apps (r2g study points to app opportunity)
(more…)

TTA’s week: Big Mergers off, Big Tech on, Jawbone, Theranos, roboparrots, rural telestroke, more

 

The wheels fall off the two Big Payer mergers, and one winds up in Divorce Court. Big Tech’s moves on 2020 healthcare delivery. Two sales jobs at Buddi. Dementia therapy, telestroke response, and much more in our busy week.

Cigna to Anthem: we’re calling it off too–and we want $13 bn in damages! (The War of the Payers heads to Divorce Court)
Aetna’s Bertolini to Humana: Let’s call the whole thing off (updated) (The merger failed, but they’re still friends. For now.)
Updated–MedStartr’s Rise of the Healthy Machines 1 March (NYC) (On trend half-day event)
Tender/RFI up: two more from EU-Supply (UK, IRL)
Towards 2020: Big Tech developments predicted to impact healthcare delivery (AI, machine learning, blockchain)
Buddi looking for two dynamic Sales Account Managers (UK) (Opportunity)
Telestroke continues to expand (US) (Editor Chrys’ take on bringing fast stroke response to regional and rural areas)
NY’s Northwell Health Home Care partners with HRS for telehealth tablets (Largest NY system bets on digital health)
Robotic cats, parrot aid dementia patients at Lincolnshire Manthorpe Centre (UK) (Simple aids)
Jawbone still in business–with Fitbit in court (IP and trade secrets may be what’s left)
The Theranos Story, ch. 35: Arizona lab in violation, is there a biotech ‘Theranos effect’? (More strikes against Theranos)
Further clarification on telehealth tenders and the North Yorkshire County Council (We got the straight story, and it’s delayed)
Anthem-Cigna merger nixed, finally (US) (The DC District Court decided, and set into motion the rest)

US telehealth’s biggest client finally awards $1bn in contracts to four lucky (?) providers. Jawbone’s exit, UnaliWear’s entrance. AI beating Watson? Merger, product and meeting updates round out a busy week.

Humana-Omada Health diabetes prevention program could cut $3 bn in Medicare expense: study (Weight loss and programmed coaching work)
TytoCare remote diagnostics comparable to in-person exam results: study (A big plus for home diagnosis with telemedicine)
Tender up: NHS Shared Business Services (SBS) (UK) (Its worth a mystery)
VA awards over $1 billion in Home Telehealth contracts–at long last (updated) (Be careful of answered prayers)
Jawbone out of the consumer fitness tracker business, going to clinical model, raising funds: report (A last ditch effort to save a $980 million investment)
Updates on Anthem-Cigna, Aetna-Humana mergers (Best if they don’t happen)
UnaliWear’s Kanega PERS watch nears US launch (And stylish, too!)
Your temporary tattoo, now with vital signs monitoring! (Only reason to get a tat)
AI as diagnostician in ophthalmology, dermatology. Faster adoption than IBM Watson? (Faster, specialized, cheaper wins)
British Journal of Cardiology (BJC) Digital Healthcare Forum’s inaugural meeting (Put on your calendar for 28 April)
Analysis of an underserved market: only 0.2% of migraine sufferers use migraine apps (r2g study points to app opportunity)

US healthcare starts transforming–what are the opportunities? A ‘ripple’ of a Tunstall partnership, NHS CCGs forcing disabled into care homes, and tenders posted in Scotland and Wales.

Action This Day in US healthcare: it’s coming in pharma, insurance, innovation (Pres. Trump’s ‘energy in the executive’)
A curious ‘Ripple’ of an announcement involving Tunstall Americas (A puzzler)
Two tenders up in Scotland and Wales (UK) (Alerting telecare companies)
What are the impacts of NHS CCGs forcing disabled and LTC patients into care homes? (UK) (Countering best practices and healthcare trends)

Aetna-Humana’s and Anthem-Cigna’s mergers on the (legal) rocks. Is there a conspiracy against Theranos? Get relief with NYeC’s conference videos and UK Telehealthcare’s upcoming schedule. And more of interest….

Breaking: Aetna-Humana merger blocked by Federal court (With Anthem-Cigna to follow)

The Theranos Story, ch. 34: It’s a conspiracy! It’s a vendetta! (Plus their CMS lab fail, and they add another governance board) (more…)

Robot-assisted ‘smart homes’ and AI: the boundary between supportive and intrusive?

click to enlargeSomething that has been bothersome to Deep Thinkers (and Not Such Deep Thinkers like this Editor) is the almost-forced loss of control inherent in discussion of AI-powered technology. There is a elitist Wagging of Fingers that generally accompanies the Inevitable Questions and Qualms.

  • If you don’t think 100 percent self-driving cars are an Unalloyed Wonder, like Elon Musk and Google tells you, you’re a Luddite
  • If you have concerns about nanny tech or smart homes which can spy on you, you’re paranoid
  • If you are concerned that robots will take the ‘social’ out of ‘social care’, likely replace human carers for people, or lose your neighbor their job, you are not with the program

I have likely led with the reason why: loss of control. Control does not motivate just Control Freaks. Think about the decisions you like versus the ones you don’t. Think about how helpless you felt as a child or teenager when big decisions were made without any of your input. It goes that deep.

In the smart home, robotic/AI world then, who has the control? Someone unknown, faceless, well meaning but with their own rationale? (Yes, those metrics–quality, cost, savings) Recall ‘Uninvited Guests’, the video which demonstrated that Dad Ain’t Gonna Take Nannying and is good at sabotage.

Let’s stop and consider: what are we doing? Where are we going? What fills the need for assistance and care, yet retains that person’s human autonomy and that old term…dignity? Maybe they might even like it? For your consideration:

How a robot could be grandma’s new carer (plastic dogs to the contrary in The Guardian)

AI Is Not out to Get Us (Scientific American)

Hat tip on both to reader Malcolm Fisk, Senior Research Fellow (CCSR) at De Montfort University via LinkedIn

Touch and feeling through a bionic prosthetic arm (DARPA-Univ. Pittsburgh)

click to enlargeA robotic arm with a neural interface that allows the user to experience touch has been developed by the University of Pittsburgh and University of Pittsburgh Medical Center, funded by the Defense Advanced Research Projects Agency (DARPA).  The Revolutionizing Prosthetics program since 2006 has been developing advanced upper-limb prosthetics. Their first was the Gen-3 Arm System by DEKA Integrated Solutions Corporation, submitted for 510(k) in 2012. The subject for the test of the touch interface, Nathan, has been a quadriplegic from the chest down since 2004. He permitted four microelectrode arrays, each about half the size of a shirt button, to be placed in his brain: two in the motor cortex and two in the sensory cortex regions that correspond to feeling in his fingers and palm. Wires run from the arrays to the robotic arm, which has torque sensors that detect when pressure is applied to its fingers. These physical “sensations” are converted into electrical signals back to the arrays in Nathan’s brain so that he has the sensation of feeling and touch.  The sensation of touch in the bionic arm is near 100 percent natural and accurate. This research has great potential both for prosthetics and for other neurological conditions. Armed With Science.  Video

Artificial intelligence with IBM Watson, robotics pondered on 60 Minutes

click to enlargeThis Sunday, the long-running TV magazine show 60 Minutes (CBS) had a long Charlie Rose-led segment on artificial intelligence. It concentrated mainly on the good with a little bit of ugly thrown in. The longest part of it was on IBM Watson massively crunching and applying oncology and genomics to diagnosis. In a study of 1,000 cancer patients reviewed by the University of North Carolina at Chapel Hill’s molecular tumor board, while 99 percent of the doctor diagnoses were confirmed by Watson as accurate, Watson found ‘something new’ in 30 percent. As a tool, it is still considered to be in adolescence. Watson and data analytics technology has been a $15 billion investment for IBM, which can afford it, but by licensing it and through various partnerships, IBM has been starting to recoup it. The ‘children of Watson’ are also starting to grow. Over at Carnegie Mellon, robotics is king and Google Glass is reading visual data to give clues on speeding up reaction time. At Imperial College, Maja Pantic is taking the early steps into artificial emotional intelligence with a huge database of facial expressions and interpretations. In Hong Kong, Hanson Robotics is developing humanoid robots, and that may be part of the ‘ugly’ along with the fears that AI may outsmart humans in the not-so-distant future. 60 Minutes video and transcript

Speaking of recouping, IBM Watson Health‘s latest partnership is with Siemens Healthineers to develop population health technology and services to help providers operate in value-based care. Neil Versel at MedCityNews looks at that as well as 60 Minutes. Added bonus: a few chuckles about the rebranded Siemens Healthcare’s Disney-lite rebranding.

A brief history of robotics, including Turing and Asimov (weekend reading)

click to enlargeTechWorld gives us a short narrative on robotics history dating back to Asimov’s Three Rules of Robotics (1942), Turing’s Imitation Game (1950) and the pioneering work of several inventors in the late 1940s. There’s a brief tribute to Star Wars’ R2-D2 (Kenny Baker RIP) and C-3PO.  It finishes up with AI-driven IBM Watson and Deep Mind’s AlphaGo. Breezy but informative beach reading! Hat tip to Editor Emeritus and TTA founder Steve Hards; also read his acerbic comment on Dell and Intel’s involvement in Thailand’s Saensuk Smart City

The healthcare future according to Britons before London Technology Week

click to enlargeMore robots than people, VR visits to the GP and 3D printed human organs were among the predictions in a survey of over 2,000 British adults. Also in their collective vision in the next 20 years (2036) were communications devices being embedded inside the human body (37 percent), a cloned human born by that year (50 percent), clothing connected to the internet (50 percent) and more driverless cars than conventional models. The study was conducted by SMG Insight and YouGov, commissioned by London & Partners, the Mayor of London’s promotional company, in the runup to London Technology Week through 26 June, highlighting London as a global technology hub. According to their release, an EY report ranked London as second only to Silicon Valley as the most likely place to produce the world’s next tech giant. The event also promotes Imperial College London’s Foresight team and their Tech Foresight 2036 on 24 June.  Also ITPro.

Robot greeter on the job at Ostend, Belgium hospital–and those killer robots

click to enlargeThis humanoid (but not Terminator-like, its developers are careful to say!) robot is currently on the job as a receptionist at Ostend, Belgium hospital AZ Damiaan. Equipped with healthcare-oriented software developed by local company Zora Robotics, the Aldebaran/SoftBank Robotics’ demure Pepper robot stands 1.2 meters (just under 4 feet), speaks 19 languages and works for about 20 hours on a single charge. Pepper communicates via its tablet interface but also is responsive to actions and emotions in what SoftBank calls a natural and intuitive way. The Pepper robot was first deployed in the hospital’s maternity area. The video has an awwwww…. illustration of a newborn grasping Pepper’s fingers. Previously, the toddler sized Nao robot worked with patients at AZ Damiaan for physical therapy. (Nao robots have also been featured in modern dance and as greeters at Japanese hotels and banks.) Reuters (video 1:51)

click to enlargeThis is a far more benign take on robots than the Daily Mail‘s recent screamer that “Killer robots are ‘quickly moving toward reality’ and humanity only has a YEAR to ban them” which conflates drone weaponry (human guided) with ground robots (human guided). As of now, They’re Still Puppets (more…)

Your weekly robot fix: ingestible robot fetches swallowed button batteries, more

click to enlargeA research team drawn from MIT, the University of Sheffield and the Tokyo Institute of Technology has developed an ‘origami’ robot to aid in the location and fetching the result of a common and potentially fatal incident–swallowed button batteries or other foreign objects. The robot is swallowed in a capsule which dissolves. It then unfolds its dried pig intestine appendages and is directed by external magnetic fields towards the battery, attaches to it and safely moves through the digestive system. Another potential use is to patch wounds or deliver medicine to a specific location. Unlike other robots, it is untethered and moves freely, propelling itself through a ‘stick-slip’ motion, and is resistant to acidic gastric fluids. Next steps for the team are to equip it with sensors and to perform animal and human in vivo testing. ZDNet

Nosocomial hospital infections may also get a good zapping by disinfecting robots. In an 18 month test at Lowell (Massachusetts) General Hospital, robots with pulsing xenon high-dose ultraviolet light from Xenex Disinfection Services disinfected the Lowell Hospital ORs nightly in addition to routine chemical disinfection. The study estimated that they avoided an estimated 23 infections at a cost savings of one life and $478,000. MedCityNews.

Robotics in healthcare will also be part of the five tracks centered on informatics available to attendees of HEALTHINFO 2016, August 21 – 25, 2016 in Rome’s H10 ROMA CITTA,  organized by IARIA (International Academy, Research, and Industry Association). More information here.

And if you wonder if humans will be able to find work when robots take over everything (maybe we just go to conferences and have a guaranteed income?), take comfort (or not) in this interview with one of the two authors of Only Humans Need Apply: Winners and Losers in the Age of Smart Machines, a new book by Thomas Hayes Davenport and Julia Kirby. “One is to work alongside smart machines, and complement their activity. The other is to dip into what smart machines are unlikely to be able to do any time soon.” The emphasis on STEM education may be misplaced as many of these jobs will be replaced by AI. In healthcare, they predict that automation will displace specialists and empower GPs, leaving room for ultra specialization in combinations not thought of today. Robots beware: Humans will still be bosses of machines (TechRepublic)

Drone ‘bots’ to help older adults in future

click to enlargeA Saturday Robot Fix! Short article in yesterday’s NY Times about development of tiny household drones to fetch medications and do other simple tasks around the house (like cleaning). These ‘Bibiddi Bobbidi Bots’ are under development at the University of Illinois. This Editor will take several to go clean. But do they do laundry? I’d rather take the new iteration of a 4′ Robby the Robot under development in Seattle by an ex-Microsofter who founded Hoaloha Robotics. Practical? Perhaps not, says Laurie Orlov of Age in Place Technology, who’s been up and down a few hype curves. And will it help older people stay connected, even though help around the house is always appreciated? The withering comment on the Jibo robot from a 91 year old at the end of the article does put a damper on it. Still, Robby could make me a dress of sapphires any old time (as did his namesake in Forbidden Planet). As Aging Population Grows, So Do Robotic Health Aides 

Is ‘pure’ robotic telesurgery nearing reality?

click to enlargeMoving beyond robot-assisted surgery (e.g. the well-accepted use of the daVinci system with prostate surgery), controlled by a surgeon present in the operating room, is telesurgery, where a remote surgeon uses a robot to fully perform surgery at a distant location. The Nicholson Center at Florida Hospital in Celebration, Florida, which specializes in training surgeons and technicians in leading (bleeding?-Ed.) edge techniques, is studying how internet latency (lag time to the non-techie) affects surgical effectiveness. Latency is defined in this case as “the amount of delay a surgeon can experience between the moment they perform an action to the moment video of the action being carried out at the surgery site reaches their eyes.” Their testing so far is that internet latency for surgery between hospitals has a threshold of 200-500 milliseconds before dexterity drops off dramatically (not desirable)–and that given the current state of the internet, it is achievable even at a mid-range distance tested (Florida to Texas). Making this a reality is highly desirable to military services worldwide, where expertise may be in, for example, Germany, and the casualty is in Afghanistan. It would also be a boon for organizations such as the Veterans Health Administration (VA) where resources are stretched thin, rural health and for relief agencies’ disaster recovery. ZDNet

Your Friday robot fix: the final DARPA Robotics Challenge

click to enlargeThey’re Still Puppets! The final DARPA Robotics Challenge took place last week at the Fairplex racetrack in Pomona, California. 10,000 spectators viewed 24 teams’ robots going through their disaster-response paces to win a share of $3.5 million in prize money in this final stage of the DARPA three-year program. Many of the robots were custom, but several teams fielded adaptations of the Boston Dynamics Atlas robot as a common platform. The engineering teams were sequestered in a ‘garage’ offsite and linked to their robot charges by a deliberately degraded communication system (to simulate field conditions). The robots had no cords (unlike 2013) and were given eight tasks: driving a car down a dirt road, getting out of the car, opening a door and entering a building, turning a valve, cutting a hole in a wall with a drill, completing a surprise task (flipping a switch or unplugging a tube and plugging it into another hole), navigating a pile of rubble, (more…)

10th Anniversary Article 1: The Next Ten Years of Telecare

This year, on the 10th Anniversary of Telehealth and Telecare Aware, we have invited industry leaders nominated by our readers to reflect on the past ten years and, if they wish, to speculate about the next ten. Here is the first article, with a UK focus, by Dr Kevin Doughty.

Many of us are frustrated at how little progress there has been in the deployment and acceptability of telecare during the past decade. Yet, despite warnings that an ageing population was about to bankrupt the NHS (and health insurance schemes elsewhere in the world), and that access to social care for older people was being withdrawn at such a rate that it could only be afforded by the wealthiest in society, our health and social care systems have just about survived.

But this can’t go on, and in England over the past 12 months: (more…)

Your Friday superintelligent robot fix: the disturbing consequences of ultimate AI

click to enlargeOur own superintelligent humans–Elon Musk (Tesla), Steve Wozniak (Apple), Bill Gates (Microsoft) and Stephen Hawking–are converging on artificial intelligence, not just everyday, pedestrian robotics, but the kind of AI superintellect that could make pets out of people–if we are lucky. In his interview with Australian Financial Review, the Woz (now an Australian resident) quipped: ‘Will we be the gods? Will we be the family pets? Or will we be ants that get stepped on?’ (more…)

CES Unveiled New York

11 November, New York

The annual event that is CES Unveiled in New York City is meant to be a nanoparticle-scale preview of International CES in Las Vegas, 6-9 January.  It’s a smörgåsbord of what used to be called ‘consumer electronics’ and now is all about innovation–a taste of everything from ever-smarter video and audio to sensors, smarter homes with IoT (the cutely named Internet of Things), Big Data, robotics and (drum roll) Digital Health and the Quantified Self (QS). This Editor regrettably missed the opening briefing by Shawn DuBravac, CEA’s Chief Economist and Senior Director of Research which would likely touch on his areas of the innovation economy and disruption along with the other four 2015 trends to watch: big data analytics, immersive entertainment content, robotics and digital health. (CEA helpfully provides the 30-page white paper here.)

The exhibitors at the Metropolitan Pavilion did not fully represent the trends, however. (more…)

Humanoid robots and virtual humans in the ‘uncanny valley’

click to enlargeOne of the challenges that designers of both robots and ‘virtual humans’ in online simulation settings is to make them, in the dictum of pioneering industrial designer Raymond Loewy, MAYA–‘most advanced yet acceptable’. The MAYA of robotics appearance was stated about 40 years ago by Professor Masahiro Mori at the Tokyo Institute of Technology; the more human and less machine-like the appearance, the more positive a real human’s emotional response will be. But as simulated humans have progressed in commercial animation and in online settings to ‘almost human’, there is a ‘creepiness factor’ that emerges (more…)