International acquisition roundup: Doro and Welbeing; Teladoc and Advance Medical

Two international telecare/telehealth/telemedicine M&A deals made the news this last week.

Sweden’s Doro AB acquired Welbeing, headquartered in Eastbourne UK. Welbeing (formally Wealden and Eastbourne Lifeline) is a telecare provider of home-based personal alarms which supports about 75,000 residents in local systems. Their revenue in last fiscal year (ending 9/17) was £7.6 million (SEK 90m). Doro operates in the UK and about 40 countries, with a core business in mobile phones specially designed for older adults. Their Doro Care solutions provide digital telecare and social services for older adults and the disabled in the home. Doro is paying SEK 130 million (£11.1 million) for the acquisition of Welbeing, equal to eight times estimated EBITDA for the financial year 2017/2018, with 85 percent cash and 15 percent in Doro shares with a bonus based on financial performance. Release 

Making a few headlines in the US is telemedicine leader Teladoc’s purchase of Barcelona’s Advance Medical for a hefty $352 million, giving Teladoc a major international footprint especially valuable for its corporate clients and major payers. Advance Medical provides complete telemedicine services in 125 countries in over 20 languages. Even more valuable is their knowledge of local healthcare delivery systems, global expert medical opinion, and chronic care. The acquisition also gives Teladoc an international network of offices and a significant entreé with international health insurance companies. Mobihealthnews, Seeking Alpha (Teladoc investor slideshow)

UK roundup: CCIO Simon Eccles warns against ‘shiny objects’, NHS Liverpool CCG award to Docobo, 87% concerned with NHS info security

click to enlargeNHS Digital CCIO doesn’t like ‘shiny objects’. Dr. Simon Eccles used his first NHS Digital board meeting as national CCIO to encourage delivering the current agenda first and not getting distracted by the ‘shiny objects’ of new innovations which also divert funding. “It is our collective challenge to make sure that doesn’t happen to things that are valued by the NHS – to do what we said we’d do and not be too distracted by new and shiny things.” This seems to be at odds with non-executive director Daniel Benton, who “suggested that NHS Digital needed to become more flexible as an organisation so that it was in a better position to roll with the punches in future.” Digital Health News

Docobo announced their win of the NHS Liverpool Clinical Commissioning Group‘s scale up of telehealth as part of the Healthy Liverpool program. The three to five-year contract has a maximum value of £11.5 million. The current Mi Programme (More Independent) partly funded by the Innovate UK dallas initiative and using Philips equipment is at 900 patients with 5,300 total patients since 2013. The plan is to scale up the program to 4-5,000 patients a year and support new clinical pathways and conditions including lung conditions, heart failure, and diabetes. Docobo’s platform is Doc@Home which uses patient information from the CarePortal device or their own digital devices. Docobo release. NHS Innovation Accelerator, Digital Health News

A survey of 500 British adults conducted by UK IT VAR Proband found that perceptions of public sector information security are poor. 87 percent were concerned about the security of their information with the NHS. Of that 87 percent, 34 percent were ‘very concerned’ about their cybersecurity. Taking this with a grain of salt, 80 percent distrusted security at the Driver and Vehicle Licensing Agency (DVLA) and 78 percent on data held by the police. The General Data Protection Regulation (GDPR) can’t come too soon [TTA 17 Feb] — but are you ready? More in Proband’s Online Security Audit (PDF).

The UTOPIA Project evaluation of telecare in social care report published (UK)

click to enlargeAn important and comprehensive evaluation of telecare in use in UK social care has been published this past week by King’s College London. The UTOPIA Project (Using Telecare for Older People In Adult social care) surveyed local authority telecare managers (114 valid responses or 75 percent of responders) November 2016-January 2017 to find out how telecare is being used by local authority adult social care departments in England to support older people.

This study springboards from the £80m Whole System Demonstrator (WSD) and its “curious neglect” by those engaged in UK telecare. The WSD’s findings contradicted earlier research in finding that telecare did not have long-term improvement of outcomes, gauged after only 12 months. It created, in the UTOPIA’s study’s terms, a ‘policy problem’ among major stakeholders. “The WSD remains an important study and its neglect is curious. The research team wondered why the findings had been overlooked and what, if any, consequences might have flowed from this.” The study thus looks at local authority aims, how local evidence is being collected, and how telecare is operationalized and delivered.

The areas surveyed and some highlights of the findings are:

  • Use of research: 33 percent were informed by research and 47 percent were aware of but did not agree with the WSD’s findings which were negative on the long-term value of telecare.
  • Where does telecare fit in?:  “Telecare ‘fitted’ best if it was provided alongside social care (77%), to support reablement (77%), for people eligible for and funded by the adult social care department (75%) as well as for people who pay for their own care (75%).” Only 24 percent collaborated with the NHS or other partners. There was full (100 percent) agreement that telecare helps to reduce risk and promote safety and 81 percent agreement that it supports unpaid carers. 
  • Achieving strategic aims and monitoring of progress: Over half (53 percent) of respondents said their local authority was accredited to the Telecare Services Association (TSA) Codes of Practice for Telecare and Telehealth. 
  • Barriers and facilitators: Barriers mentioned were skill deficits among professionals and installers, as well as contract inflexibility with suppliers. There was also concern about the reduction of face-to-face contact and care. Access to telecare and availability of advice and support were good for both users and family carers, but levels of awareness about it were only average.
  • Financial commitment: Not surprisingly, funding is scarce and usually cobbled together from several sources including local authorities, CCGs, and users. 24 percent felt it saved money but many found it difficult to provide hard evidence.
  • What’s considered in telecare assessments?:  Nearly all (92 percent) agreed that a key assessment included the user’s ability to move around, their memory status, the person’s ability to communicate, and their daily routines. Flipping the script, “40% of respondents said that their local authority’s telecare assessment focused on what it was hoped would be achieved through using telecare.”
  • Who are the assessors, and is assessment always required?(more…)

Tender Alert: Oxfordshire County Council, Housing & Care 21 Birmingham

Our Tender Watcher, Susanne Woodman, has two more before we break for the holiday season–which may make your 2018 brighter!

  • Oxfordshire County Council: This is for a comprehensive telecare service for call monitoring of telecare alarms, a 24/7 emergency response service for telecare alarms, plus the installation, assessment and review of telecare and associated equipment. The Service Provider(s) will work closely with the Equipment Service Provider. This starts in April 2018 for five years with option to extend for two; value not correctly posted (£1?). Closing 15 January 2018. Gov.UK 
  • Housing and Care 21: This is an open future opportunity for providers to indicate interest in providing a new warden call supplier to maintain the existing stock of warden call products across the estate. The contract will be for one to five years with funding of £500k per year. This includes bridging equipment from analogue to digital. The approach to market date is 9 April 2018 with a start date of 1 July. More information at Gov.UK.

Tender/Prior Information Alerts: North Yorkshire, North Ayrshire

Susanne Woodman, our Eye on Tenders, has located more complete information on a North Yorkshire tender we listed on 7 Nov and a prior information notice by North Ayrshire for a contract to be published next month.

  • North Yorkshire: The North Yorkshire County Council has listed full information on the tender for Assistive Technology services for North Yorkshire. It is for technology, monitoring and support to extend healthier independent living in the home and reduce demand on social care services. It is a three-year contract (extension up to 24 additional months) valued at £4.85 m. Bids close on 17 January 2018. TED–Tenders Electronic Daily 
  • North Ayrshire (Scotland): This Prior Information Request by North Ayrshire Council is for a 24/7/365 call handling system which is fully compatible with alarm equipment and telecare peripherals installed or provided by the Council in the full North Ayrshire Council area which includes the islands of Arran and Cumbrae. There are about 4,200 services users of primarily Tunstall equipment with a volume of 21,000 to 28,500 calls per month. The contract will be from 01 September 2018 to 31 August 2019. The contract will be published on 4 Dec. Public Contracts Scotland and TED

Impact of IP telephony on UK telecare systems

The Telecare Services Association (TSA) in the UK has recently released a white paper addressing the impact of a fundamental change to the click to enlargeUK Public Switched Telephone Network (PSTN) that is now being contemplated. This change will eventually see the replacement of the current PSTN and Integrated Services Digital Network landline networks with IP telephony (the type of phone connectivity that has been commonly used in most modern office environments for some years).

Two years ago BT, who essentially owns practically the whole of the UK PSTN, proposed that the change of their network would be completed in 2025.

This has an impact on the telecare services to the extent that many telecare alarm devices in use connect to the call centres via the PSTN and hence such devices and/or the infrastructure used by suppliers of such services will need to be upgraded when the underlying network is changed. There are, according to the TSA paper, 1.7 million users of such devices in the UK.

The TSA is essentially the UK industry body for telecare and telehealth and as such it is understandably trying to raise awareness of the need for both the commissioners and suppliers of these services to prepare for the change. This paper is said to be a result of gathering views from “key stakeholders” related to this change.

The potential impact, however, seems to be somewhat exaggerated. It should be remembered that the UK very successfully underwent another major switch-over not that long ago in 2012 – from analogue to digital TV. It required every analogue TV in the country to be either fitted with a set top box or replaced with a digital TV.

TSA also suggest that this changeover be used as an opportunity to roll out more internet based digital health functionality to end users. Of course, such functionality is already widely appearing in the form of health monitors, exercise and medication reminders etc. and are not dependent on the switch over. So it is unfortunate that the paper flips between the two topics and asserts a dependence of internet based digital services on the PSTN switch-over.

The document feels more like marketing material than a white paper with about 1/3 of it taken up by irrelevant photographs of random happy smiling or laughing (mostly older) people. It reminded me of some of the material that came out the the 3 Million Lives project. If only our elderly people living alone or in our care homes were as happy as this!

The paper is available to download here.

BioSensics’ Huntington’s Disease remote monitor gains NIH grant

click to enlargeWatertown, Massachusetts-based BioSensics announced that the company has received a $2.5 million, two-year grant from the National Institutes of Health (NIH) to develop a continuous remote monitor for Huntington’s disease motor symptoms. The HDWear monitor uses BioSensics’ PAMSys sensor technology tested during pilot work performed with the University of Rochester Medical Center and Teva Pharmaceuticals. The study, published in the Journal of Huntington’s Disease (2016, Vol. 5, pp. 199-206), demonstrated a wearable sensor solution for remotely monitoring the severity of upper extremity chorea in Huntington’s disease.

The study will also use the HDWear monitor for a clinical study on patient response to anti-chorea medication or subtle motor abnormalities in the premanifest stage of Huntington’s disease.

It is interesting that the press release uses ‘telecare’ for HDWear, which is not much used in the US for behavioral monitoring though perfectly correct. HDWear’s use here builds on the company’s earlier sensors-based systems for telehealth, physical activity monitoring, fall risk assessment and detection. This Editor notes that BioSensics is one of the older telehealth companies still operating (2007), and now is primarily using its devices in research studies. Drug Discovery & Development,  Release.  Hat tip to Guy Dewsbury via LinkedIn (again)

Equivocal long term telemonitoring studies released by Telemonitoring NI, U. of Wisconsin

The HSC Public Health Agency for Northern Ireland and Queen’s University Belfast have released an evaluation of the six-year (2011 – 2017) Remote Telemonitoring Service for Northern Ireland (RTNI). The Centre for Connected Health and Social Care (CCHSC) launched the Telemonitoring NI project in 2011, which enrolled over 3,900 patients with COPD, diabetes, weight management, stroke, heart failure and kidney problems in both telehealth (vital sign) and telecare (behavioral) monitoring. The study period was through 2015, but the program continues to be implemented by all five NI Health and Social Care (HSC) Trusts across a range of chronic conditions. 

The Northern Ireland findings were at best equivocal. While the qualitative data gathered from patient, carer, and clinician focus groups and interviews were positive in terms of engagement and on reassurance–to be able to carry on with their lives as usual–the quantitative data did not confirm gains in effective care.

Although there were a number of testimonials from the participants in the patient focus groups regarding
reduced hospitalisations and a reduced need to attend outpatient clinics, this did not carry through to
the data obtained in the effectiveness aspect of the current evaluation. In general terms, the number
of hospitalisations, length of hospital stay and outpatient clinic attendance (and therefore overall cost
of healthcare provision) did not differ between the quasi-control ‘never installed’ group and any of the
groups who received some amount of telemonitoring. The results, where they were statistically
significant, were largely driven by an anomalous result for the heart failure ‘never installed’ group. (page 17)

The Executive Summary, Telehealth, and Telecare Reports are available for free download on the HSC R&D Division website. Many thanks to former TTA Ireland Editor Toni Bunting for the information, summary, and researching the previous TTA coverage below.

This is the second discouraging study on the long term effectiveness of patient monitoring released in the past month. A five-year, 140,000 patient/90 provider study conducted by the University of Wisconsin found that giving patients the option of telemedicine, instead of being more convenient for the provider, created new issues. It increased office visits by six percent, added 45 minutes per month of additional visit time to practices, and reduced the number of new patients seen each month by 15 percent. For the patient, the researchers found “no observable improvement in patient health between those utilizing e-visits and those who did not. In fact, the additional office visits appear to crowd out some care to those not using e-visits.” The study suggested that the telemedicine visits could be made more effective by structured questions prior to the visit. (This approach has been taken by telemedicine provider Zipnosis with adaptive online interviews and patient triage.) Mobihealthnews

Previous commentary by TTA’s Editor Emeritus Steve Hards on the procurement of the NI Remote Telemonitoring Service:

http://archive1.telecareaware.com/the-long-and-winding-road-that-leads-to-your-doorin-northern-ireland/
http://archive1.telecareaware.com/african-elephant-ecch/
http://archive1.telecareaware.com/remote-telemonitoring-northern-ireland-service-tender-long-list-mystery/
http://archive1.telecareaware.com/short-listed-companies-rtni-service/
http://archive1.telecareaware.com/northern-ireland-remote-monitoring-servicegoes-to-tf3/

 

Tender Alert: NHS England–IAPT, Arden & GEM, Yorkshire and The Humber

Susanne Woodman, our Eye on Tenders, has three that cover a major initiative of NHS England, plus two regional telecare projects.

  • NHS England–IAPT (Improving Access to Psychological Therapies). NHS Shared Business Services is procuring ‘Digital Therapies for IAPT Assessment: Project Management Organisation’. The aim of the programme is to find good quality, evidence-based digital therapy packages for use in IAPT services. Up to 14 digital therapy products will be assessed for IAPT by 2020. This will help expand provision of psychological therapies, as well as improving access to digital services, both goals set out in the Five Year Forward View for Mental Health. Clarification questions are due by Wednesday 13 September at 10am. Bid deadline is Monday 18 September at noon. More information and contact here on Gov.UK Contracts Finder. Additional programme information on NICE and IAPT here.
  • Arden & Greater East Midlands: Bravo reference Project 851 is an Innovation and Technology Tariff. There are three parts (2-4): the closest related to health tech is #4, web-based applications for the self-management of COPD. Deadline is 2 October 2017 at 5pm. More information and application links on the Arden-GEM website here.
  • Yorkshire and The Humber: Kirklees Council is seeking a provider of assistive technology and telecare solutions aimed at supporting vulnerable people to live safely and independently in their own home. This also includes support for existing and future social care applications, lone workers, and building security. Value of the contract is £210,000. Deadline is 2 October 2017. There’s not a lot of information on the Gov.UK page and it directs questions to the Kirklees coordinator.

Tender Alerts: Warwickshire, Thurrock, and Hertfordshire

Susanne Woodman of BRE, our Eye on Tenders, alerts our Readers to two open and one probable new tenders:

  • Nuneaton and Bedworth Borough Council (NBBC) in Warwickshire is seeking a 24/7 ‘reactive repair service’ for Tunstall telecare equipment presently in 35 independent living accommodations. The contract is for an initial period of two years, with two optional one-year extensions. Closing is 4 August. Details here.
  • Thurrock Council in Essex is seeking “to appoint a Consultant who will work as Project Manager with Adult Social Care and Health staff to develop an Assistive Technology Strategy and support implementation of the strategy.” The contract is valued at £25-50,000. Interest must be registered by 28 July at the Council’s Delta eSourcing page. On the Council page there is additional information in a summary of the Council’s of the Careline service and a resolution to expand/upgrade assistive technology for local users. 

Not registered as a tender yet is a plan by Hertfordshire County Council to bring wearables such as activity trackers and software-enabled clothing into the homes of at-risk local adults, plus online systems for video-link calls, scheduling messages and reminders for people to take their medication and connect with families. This article in the Watford Observer tells some of the story but the page on the Hertfordshire blog is oddly missing–however, captured by the sharp-eyed Ms. Woodman here. They advise monitoring the Herts County Council on social media–right now they are burning up Twitter @hertscc on the alphabet countdown to potholes and fire safety tips from Reqs the Fire Dog!

Tender Alert: Scotland Excel, Leeds, London/Manchester, Thurrock

Our Eye on Tenders, Susanne Woodman of BRE, has a new batch for your telehealth business consideration. (Thank you, Susanne!)

  • Scotland Excel: A Prior Information Notice (PIN) for suppliers of “digital dispersed alarm units that communicate information digitally between alarm unit and alarm centre”. They are invited to note interest to Scotland Excel and to demonstrate what digital equipment they can currently offer, including any relevant peripherals, such as alarm triggers. The estimated date for the contract notice is February 2018. More information on Public Contracts Scotland.
  • Leeds City Council: A £400k contract for telecare equipment is on offer for North East, Yorkshire and The Humber. This includes alarm units, fall detection, pendants, multiple sensors, and more. It is a 12 month framework with approval obtained to re-procure for the following two subsequent years, expiring 31st March 2020. Submit by 17 July. More information on Gov.UK.
  • General Medical Council, North West (Manchester) and London: An unusual tender for research comparing UK health regulators to counterparts in overseas countries (i.e. Canada, US, Australia, New Zealand or European member states). This covers the regulation of doctors, other healthcare providers (e.g. pharmacists) and healthcare services. Submit by 17 July. More information on Gov.UK.
  • Thurrock Council: This is for community alarm telecare monitoring and administration platforms, with all associated hardware required. Value stated is £100k – £500k, and contract ends 31 July 2021. Submit by 17 July. More information on Gov.UK.

GreatCall’s acquisition: a big vote for older adult-centered healthcare tech

This midweek’s Big News has been the acquisition of the mobile phone/PERS company GreatCall by Chicago private equity firm GTCR. Cost of the acquisition is not disclosed. GTCR stated that they expect to make capital investments to GreatCall to fund future acquisitions and internal growth. GreatCall has over 800,000 subscribers in the US, generates about $250 million in profitable revenue annually, and employs about 1,000 people mainly in the San Diego area and Nevada. According to press sources, senior management led by CEO David Inns will remain in place and run the company independently. 

Our US Readers know of GreatCall’s long-standing (since 2006), bullseye-targeted appeal to older adults who desire a simple mobile flip phone, the Jitterbug, but has moved along with the age group to a simple smartphone with built-in health and safety apps. Along the way, GreatCall also developed and integrated the 5Star mPERS services on those phones, served by their own 24/7 emergency call center and developed an mPERS with fall detection. Their own acquisitions included the remnants of the Lively telecare home monitoring system in 2015 [TTA 5 Dec 15], adding the Lively Wearable mPERS/fitness tracker to their line; and senior community telecare service Healthsense last December. The original Lively home system and safety watch are sold in the UK (website) but apparently not the Jitterbug. In the UK and EU, the Jitterbug line would be competitive with established providers such as Doro.

What’s different here? GTCR is not a flashy, Silicon Valley PE investing in hot, young startups or a traditional senior health investor like Ziegler. Its portfolio is diversified into distinctly non-cocktail-chatter companies in financial services and technology; technology, media and telecommunications (including an outdoor ad company!); and growth businesses. It has real money, investing over $12 billion in 200 companies since 1980, and strategically prefers leadership companies. Their healthcare businesses have primarily been in life sciences, specialty pharma, dermatology, specialty services such as healthcare in correctional institutions, and device sterilization. Recent acquisitions have been San Diego-based XIFIN, a provider of cloud-based software to diagnostic service providers, RevSpring in billing and communications, and data analytics firm Cedar Gate Technologies. It also has partnered with newly formed medical device companies.

GreatCall crosses over into GTCR’s telecommunications sweet spot, but the older adult market and direct-to-consumer sell are different for them. Because it is unique in their portfolio, this Editor believes that GTCR sees ‘gold’ in the ‘silver’ market. Larry Fey, one of their managing directors, cited its growth and also GreatCall’s recent moves into senior communities with their products. GTCR also has expertise in the security alarm monitoring sector, which along with pharma clinical trials can bolster better utilization and broaden the utilization of GreatCall’s call centers.

However, this Editor would caution that the US senior community market has been having difficult times of late with overbuilding, declining occupancy, resident/labor turnover, and rising expenses–as well as recent coverage of security lapses and resident abuse. Telecare systems like Healthsense are major capital expenses, but the flip side is that communities can use technology to improve care, resident safety, and to differentiate themselves. To make the most of their Healthsense acquisition, GreatCall needs to bring innovation to the V1.0 monitoring/safety/care model that Healthsense is in its current state, and make the case for that innovation in cost/financials, usability and reliability. San Diego Union-Tribune, Mobihealthnews

Tender alert: London Hillingdon 24/7 telecare monitoring (due 5 May!)

Our Eye on Tenders, Susanne Woodman, has located a just-published telecare tender for the London Borough of Hillingdon UB8 1UW.

Description: The London Borough of Hillingdon (the Council) is inviting tenders from suitably experienced organisations capable of providing a Telecare emergency alarm system and 24- hour telephone support for the Council (the Services).

The specification is split across two service requirements;
A. Social Alarm and telecare 24/7 monitoring services;
B. Provision of an out of hours emergency answering service.

The London Borough of Hillingdon (the Council) currently operates 21 sheltered housing developments across the borough, consisting of 838 units. All sheltered housing accommodation is connected to the current Telecare call handling system provided by Jontek.

The current system is monitored by Council staff 24/7; this would switch 24/7 monitoring to an outside sole contractor. It is a three-year contract starting 1 September and ending 31 August 2020, with an extension of one year. The estimated value is £1.5m.

Application deadline is 5 May. More information is on the Gov.UK Contracts Finder page.

Here’s Howz: now electricity consumption as elder minder (UK)

click to enlargeIntelesant’s latest project, Howz, has added electricity consumption to the monitoring set of Activities of Daily Living. The Howz set of multiple sensors generally monitors activity in the home, home temperature, lights on/off, and exterior door opening/closing, depending on their placement, but one sensor monitors electricity consumption by directly going into the meter to determine whether appliances are being used as an indicator of activity. These activities are reported over a smartphone app to those who have permission for reports. After a trending baseline over a few days is established via algorithms, the Howz system tracks departures from that norm and alerts via the smartphone app. This bears resemblances to this Editor’s former company which developed the behavioral telecare (first and still in market) QuietCare system, but the ‘meter reader’ is a new and smart twist.

Intelesant is testing Howz in 100 Manchester homes and is scheduled to be in a pilot with dementia patients at home in partnership with the Surrey and Borders Partnership NHS Foundation Trust. In December, they also announced that they are a finalist with the EDF Energy Blue Lab Acceleration Programme.

Howz is more comprehensive (and expensive) than 3rings‘ single appliance plug which keys into specific activities (tea kettle, TV on) [TTA articles here] but the objective for family peace of mind for older adults, especially those living alone, is the same. Available consumer direct from their website in the UK only (unfortunately) from £199 for the starter kit. New Scientist, Howz video on YouTube Hat tip to former Northern Ireland Editor Toni Bunting

Tender/RFI up: two more from EU-Supply (UK, IRL)

Susanne Woodman, our Reader who is our Eye on Tenders, has located two new tenders available on the EU-Supply site:

(NHSSBS)Telemedicine Advice and Guidance Service Deadline is 8 March 2017. Documents are attached and available after registration and log in. Contact Greg Reide, phone: +44-161-2123701

(CTM) Pobal on behalf of the Department of the Housing, Planning, Community and Local Government invites responses from organisations for the purpose of market research. This is a Request for Information and not a tender process. This is a market sounding exercise to obtain market information in respect of Telecare Equipment in relation to the Seniors Alert Scheme. Please refer to the Request for Information document which is available via this notice. Submissions should be sent to procurement@pobal.ie on or before 3.00pm, on Thursday the 2nd March 2017. Registration and log in required for further information.

Two tenders up in Scotland and Wales (UK)

Susanne Woodman, our Reader who keeps an eye on telecare procurement tenders, has alerted our UK readers to two current postings:

Telecare IT Platform for East Lothian Council (Scotland).  This is for the purchase an integrated call handling facility and telecare asset management system to respond to alerts from telecare equipment in the homes of vulnerable people. Contract duration 60 months. Deadline 1 March. (Public Contracts Scotland)

NHS Wales Informatics Service–Velindre NHS Trust. The NHS in Cardiff, Wales is looking to appoint partners to develop solutions to engage citizens digitally in the proactive management of their health. It is anticipated that this could encompass a wide range of services from existing applications (Apps) to innovative joint developments. Contract notice will be published 4 April, but the notice as published does not have a deadline. (Tenders Electronic Daily)  See the Sell2Wales website for documentation.