TTA’s week: pop health en español, ATA’s choice, VA’s Cerner, de-retailing healthcare, more

Will the doctor’s office go the way of the retail store, even in NJ? Can we improve population health through telephone call centers? Will the UK get its mojo back in digital health innovation? Can the VA implement Cerner by 2019? And will ATA appoint a new CEO before then?

Only two weeks to go to Connected Health Summit 2017 in San Diego–save 20%. See below.

Beyond crowdfunding–startup funding through blockchain cryptocurrency, smart contracts (The Next Big Funding Thing?)
Commonwealth Fund case study on Spanish-speaking telemedicine services (MX, PH, US) (Population health south–and north–of the border)
Tender Alert: Torbay and South Devon NHS Foundation Trust for TECS (Looking for innovative telehealth)
VA’s Shulkin: Cerner rollout start by mid-2019? (The decision was a relief)
Innovate UK’s £35m Digital Health Technology Catalyst competition opens–apply now! (Another opportunity in UK healthcare)
Weekend Big Read: will telemedicine do to retail healthcare what Amazon did to retail? (Except there’s regulation…)
Tender Alerts: NHS Wales, Southend-on-Sea (More for innovative companies in UK)
Analyses of New Jersey’s new telemedicine regulations (Not quite parity, but a forward leap)
Some reflections on ATA and a future CEO–your ‘nominations’ wanted! (Name that CEO!)

Winners and losers…VA implements more telehealth, Israel gets its first aging services venture fund. Charterhouse loses equity in Tunstall, ATA’s Linkous leaves, Siemens delays the Healthineers and Theranos plays for time.

VA unveils several ‘anywhere’ new telehealth services for veterans (VA tech moves fast under Dr. Shulkin)
First aging services tech investment fund debuts in Israel (3rd Age tech)
Change at the top at ATA: CEO Jon Linkous departs after 24 years (Didn’t give notice either)
Charterhouse lost half its equity in Tunstall debt refinancing–Sunday Times report (updated) (Not unexpected)
Siemens plans IPO of Healthineers during 2018, possibly in US: reports (Expectations delayed)
The Theranos Story, ch. 44: Walgreens settles lawsuit, cash box empties further (The spiral to Flat Brokedom continues)

It’s an IoT Black Hat hackfest, Facebook bots learn argot, AI is debated after a fashion by ‘giants’, and Tunstall gets a partner that opens doors.

It’s all hackable by Black Hats: pacemakers, Amazon Echo, trains, heart monitors, prison cells! (Increasingly easy pickings)
AI good, AI bad (part 2): the Facebook bot dialect scare (Not all that…)
AI good, AI bad. Perhaps a little of both? (Top six effects) 
Tunstall pairing with Inhealthcare digital health for NHS remote monitoring (A shot of digital high-octane for the Big T?)


Connected Health Summit: Engaging Consumers analyzes the roles of connected health technologies and innovations in driving changes in consumer behaviors and business models. Now in its fourth year in beautiful San Diego, this event is focused on data-driven, human-centric patient experience and engagement. Keynoters include executives from Aetna, UnitedHealth, ShareCare and Geisinger. Readers save 20 percent! For more information, click on the advert or here.


Confirming football CTE, thinking ‘digital therapeutics’. Glass reboots, Fitbit and social robotics back up, TSA changes guard. Mindful (or mind your?) drinking, and catch up with The King’s Fund.

CTE found in 99% of former, deceased NFL players’ brains: JAMA study (News in both health and sports sections)
Shouldn’t we be concentrating on digital therapeutics rather than ‘health apps’? (A different look at the future of digital health)
The King’s Fund 2017 Digital Health Congress: videos, presentations now posted (Catch up!)
Fitbit’s smartwatch on track; Intel exits the game (Were they ever in?)
Can Google Glass’ enterprise iteration solve the patient documentation crisis? (Hands off help for hands-on workers)
Toyota’s $14 million bet on Intuition Robotics’ social companion robot (JP/IL/US) (ElliQ’s growing up)
Come along to London’s first mindful drinking festival! (Hic!)
TSA appoints new chair (Paul Shead takes the helm)

Recent articles of continued interest….

Creepy data mining on medical conditions run wild: where’s the privacy? (Ethically dubious practices)
UDG Healthcare buys American, adds Vynamic, Cambridge BioMarketing for up to $67 million (Acquisition trend for healthcare consultancies and marketing)
“Crazy”: StartUp Health’s 2nd Q digital health funding breaks record (Another round of champs and roses! Can it last?)

‘Record-shattering’ Q2 for digital health deals: Rock Health’s volte-face (Suddenly it’s wine and roses!)
Conference & Tender Alert: Perth & Kinross TEC event, Flintshire (Wales) tender (UK) (TEC event Sept 26, tender Aug 4)
‘Let me die at home’. The human and financial cost of ending telehealth (Cornwall UK) (A familiar, no less wrenching story to those who’ve worked in telehealth–the books don’t balance)

The Nightingale-H2020 project for wireless acute care (UK/EU) (Major initiative, get on it before tender)


Have a job to fill? Seeking a position? Free listings available to match our Readers with the right opportunities. Email Editor Donna.


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Donna Cusano, Editor In Chief, donna.cusano@telecareaware.com, @deetelecare

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Tender Alert: Torbay and South Devon NHS Foundation Trust for TECS

One more from our Eye on Tenders, Susanne Woodman, is from NHS South West which is reviewing their currently in-house delivery of TECS, including monitoring, in Torbay. The Torbay and South Devon NHS Foundation Trust is seeking a fresh look at innovative services from providers who are interested and able to provide the full service from equipment, installation and monitoring, as well as bench-marking information. To review their current services and equipment (Tunstall), they helpfully provided this linkThis was posted today (15 Aug) and closes 1 September, so there’s only a short window. Refer to the Gov.UK Contracts Finder page for contact information and (importantly) document attachments.

Tunstall pairing with Inhealthcare digital health for NHS remote monitoring

click to enlargeA digital link of hope for Tunstall’s future? Announced at The King’s Fund Digital Health & Care Conference but oddly not receiving much notice was the UK collaboration of Tunstall Healthcare and Inhealthcare. Inhealthcare builds infrastructure for digital health services, and currently works extensively with multiple NHS regions and programs, such as the North of England Regional Back Pain Programme, NHS England’s Sheffield City Region Test Bed and the Darlington Healthy New Town project. Their services include telehealth monitoring for INR, COPD, medication reminders, a smartphone app platform, chronic pain management, and a surprising one that addresses undernutrition in older adults. The Tunstall-Inhealthcare objective is to integrate health and social care with clinical care systems in six areas: LTC home monitoring, identifying vulnerable patients, involving family members, 24/7 clinical care coordination centers, post-discharge management, and digital health at home innovation. Also noted is that Inhealthcare has programming technology that can reduce the time to build out services and apps.

Inhealthcare Ltd is part of Intechnology plc, owned by Peter Wilkinson, who has developed several UK internet and technology companies at scale–Planet Online, Freeserve, and Sports Internet (now Sky Betting and Gaming). Tunstall release

Welbeing’s expansion on BBC Norfolk, Tunstall’s #MarysVIPHome Christmas (UK)

We start the New Year off we hope in the right way with some good news on telecare expansion and media coverage, traditional and social, versus the gloominess that dominated 2016.

Welbeing, which has become one of the larger telecare providers in the UK from its Eastbourne and Wealden Council roots, was the subject of a feature on Nick Conrad’s breakfast show on BBC Radio Norfolk. This focused on their East Anglia expansion to 4,500 new customers acquired from Flagship Home, with phone-ins by an operator from their new call center in Dereham, a local Welbeing customer and a representative from Norfolk County Council. Welbeing has been on a recent tear with acquisitions in East Sussex, Cumbria, Stonewater and with Muir Housing, cresting their total users to more than 70,000. Of late there’s been a lot of downbeat feelings about the fate of telecare in the UK, so it’s refreshing to hear an upbeat local story for a change. News release. Hat tip to Charlene Saunders, marketing manager of Welbeing. 

Tunstall in UK has also developed a smart home type test bed in a sheltered housing flat to showcase how existing TECS kit, Tunstall’s and others, can be combined in everyday living. Smart home demos to interested parties may be old news, but Tunstall is cleverly using social media marketing to build it up. It’s hashtagged #MarysVIPHome with updates on Twitter. There are also has five demo videos on YouTube which show how a family can observe activity/ADLs without intrusion, plus connect the resident to care, improve their socialization and remotely control the home environment. This Editor saw it on a LinkedIn post before the holidays from Tunstall’s Adrian Scaife thanking their visitors and wishing us a Mary Christmas. Now we hope to see more of a narrative about a real Mary living there and using all that TECS. It’s a nice start to what we hope is an innovative 2017.

Tunstall Americas’ Vi+ offers free temperature monitoring

click to enlargeLast week Tunstall Americas emerged from a long period of quiet with their introduction of Tunstall’s Vi+ telecare home unit [TTA 3 Aug]. We noted that Vi+ included an integral ambient temperature sensor which could alert their response center on extremes in home temperature and that the release highlighted it. This week, we learned the reason why, as on Tuesday they announced marketing that capability as free Temperature Extremes monitoring for subscribers of their medical alert monitoring service. When the ambient temperature sensor is activated, their call center will be alerted when the room temperature rises above 89°F or falls below 50°F. The subscriber and registered contacts are then notified so that the person can be checked and the situation corrected. Tunstall release (PRWeb)

Worthing MarketPlace Wednesday 8th June 2016 (UK)

click to enlargeFresh from last week’s National Telecare Awareness Day on 1 June, UK Telehealthcare is sponsoring a bonus MarketPlace today (8 June) in conjunction with the West Sussex County Council at the Charmandian in Worthing, West Sussex. 36 companies including Tynetec, CAIR, Doro, Tunstall and others we mention are listed for five hours of exhibition and activities starting at 10 am. UK Telehealthcare information and flyer at left above.

Is the clock at the funding pub pointing to ‘last call’? (Updated)

click to enlargeAnd we were having such a good time! UPDATED Having ridden a few hype curves (in health tech and out–remember airline deregulation?) and with the bruises to prove it, this Editor believes that she can spot a Cracking Market at forty paces. The hands on the clock appear to be near closing time, even as we party on. After all, DTC telehealth is forecast to be $25 bn in the US by 2025 (GrandView Research), if we make it that far!

Where are the sharp noises coming from?

  • The continuing fail of unicorns like Theranos [TTA 4 May and prior], now resorting to bullying the Wall Street Journal and negotiating with the alphabet (SEC, DOJ, FDA, CMS…), and the troubles of Zenefits. 
  • Another notable unicorn, the doctor booking site ZocDoc, being called out at last on their customer churn, low margins, and high customer acquisition costs. (As well as an irritant to doctors and office managers) New York Business Journal
  • Extremely high and perhaps insane rounds of funding to young companies with a lot of competition or a questionable niche. Higi is an odd little kiosk + consumer engagement program located in primarily Rite Aid drugstores–odd enough to score $40 million in its first venture round. (Ed. note: I shop at Rite Aid–and have never seen one.)This is after the failure of HealthSpot Station, which burned through approximately $43 million through its entire short but showy life. The low-cost, largely exchange plan insurer Oscar Health raised $400 million this February  ($727 million total) while UnitedHealth and others are dropping money-losing plans in most states. Over 50 percent of exchange co-ops went out of business in 2015, leaving doctors, health systems and patients holding their baggage. Again, low margins, high cost and high customer acquisition costs.
  • We’ve previously noted that funders are seeking ‘validation in similarity’–that a few targeted niches are piling up funding, such as doctor appointment setting, sleep trackers and wellness engagement [TTA 30 Dec 15]
  • Tunstall’s continuing difficulty in a sale or additional financing, which influence the UK and EU markets.
  • NEW More patent fights with the aim of draining or knocking out competition. We’re presently seeing it with American Well litigating Teladoc over patent infringement starting last year, which is only now (March) reaching court. It didn’t stop Teladoc’s IPO, but it publicly revealed the cost: $5 million in previously unplanned lobbying and legal costs, which include their fight with the Texas Medical Board on practicing telemedicine–which is beneficial for the entire industry. (But I would not want to be the one in the legal department explaining this budget line.) Politico, scroll down. But these lawsuits have unintended consequences–just ask the no-longer-extant Bosch Healthcare about the price of losing one. (more…)

Hyperbole, pets & apps: a brief romp around the digital health scene

In technology, over-use of the term “groundbreaking” is common. However it takes some nerve to use the term to describe “Home Assist”, a push-button pendant-based telecare service now being sold by Boots (provided by Tunstall). Whilst TTA can only applaud the arrival of another high street offering, we would counsel a more realistic service description for a telecare service already offered by many.

Research via Boots’ own website reveals that in addition to the advertised push-button pendant, a falls detector is available as well. This site gives price details too, which look quite competitive at the basic level with non-subsidised local authority telecare schemes, though of course without the linkages to local services, including response services in the event eg of a fall, that some of these schemes also offer. Downloading the in store leaflet gives yet further information, for example that the pricier ‘advanced’ package includes a smoke detector (surely for older people almost as important as a basic pendant, and ideally one/floor of your house?) and bogus call detector, as well as falls detector etc.

Meanwhile in a far off land (Los Angeles to be precise) Active4Pets are busy recruiting to accelerate the US rollout of their “innovative” telehealth communication platform for pets. The (admittedly far-fetched) thought of pets regularly reporting vital signs electronically conjures up all sorts of bad, (though unavoidable) puns such as: (more…)

Tunstall invests £100 m in ‘Connected Healthcare 2020’ strategy

Tunstall Healthcare Group in UK outlined today their five-year public, global strategic vision, along with a fresh investment of £100 million during this timeframe (~£20 m per year) to transition their connected care systems over to IP and cloud technology. The initiative, dubbed Connected Healthcare 2020, is centered on:

  1. Leading the switch to IP infrastructure–transitioning away from analogue (analog) services and devices to connected digital and mobile (cellular, Wi-Fi, Bluetooth)
  2. Extending managed services–offering a wide variety of services end-to-end including full outsourcing
  3. Developing new consumer propositions through innovation–tapping into demand, often private pay, for high quality home care not provided by carers (caregivers)
  4. Developing new models of care in the home through integration–coordination of social care and healthcare

The Yorkshire Post article also points out, through their separate comments with CEO Paul Stobart, that prospective markets include developing nations with aging populations such as Mexico, South Korea and Turkey. Tunstall claims market leadership in UK, Germany, France, Spain, the Netherlands, Belgium, Sweden, Denmark, Finland and Australia, as well as fourth position in the US. The TECS (technology enabled care services) initiative will create about a dozen jobs per year at the Whitley HQ, adding to their present 650 there and their total globally of 3,500. Tunstall release

We wonder if in the US we will see more of Tunstall at events like the mHealth Summit. Tunstall Americas has a refreshed website and communications as ‘The voice of connected health’, is more strongly promoting their call/contact services and its HQ location in New York City. We’ve previously noted their recent home care acquisitions and partnership with QMedic.

Tunstall Americas gets active with QMedic

click to enlargeTunstall Americas’ monitoring providers will have something new to distribute: the QMedic activity tracker. The QMedic bracelet (alternatively pendant) has an alert button and a base station like a conventional PERS, but also tracks sleep quality and activity levels. It has two way monitoring and also generates alerts and texts to loved ones if the bracelet isn’t worn or no wake-up is detected, plus recurring wellness reports on activity, sleep, and safety in the home. Fall detection presumably is inferred Tunstall’s reseller agreement includes all its local healthcare service providers. This Editor also observes that after a very long period of quiet, Tunstall in the US is demonstrating its own activity. Release. Earlier in TTA: Tunstall Goes Hawaiian with Kupuna Monitoring acquisition

Tunstall to demo mHealth Down Under at Connect Expo

click to enlargeBreaking from our HIMSS coverage, Australia takes its turn in technology mega-events with the Connect Expo next week, 21-22 April, in Melbourne. It features one expo and 11 conferences, including the Future Health Summit covering telehealth, big data, analytics, wearables and robotics. Featured are speakers Tim Kelsey from NHS England and Dr George Margelis. Reports indicate that sponsor Tunstall will be debuting its mymobile telehealth app, which ties into their Integrated Care Platform, and the myCareTrack app, a mobile safety solution meant for lone workers, including health professionals on in-home patient care visits. The Tunstall website in its release also has presentation times.  Pulse+IT (Australasia) (Returning to the US, we note that Tunstall was absent from HIMSS, and will also be from ATA2015 where they have been a major sponsor in the past. And we wonder how things are developing with mHealth platform designer Tactio.) Hat tip to Guy Dewsbury via Twitter

Looking back over Telehealth & Telecare Aware’s predictions for 2014, part II

click to enlargeEditor Charles has treated you to a look back on his 2014 predictions, daring Editor Donna to look back on hers. Were they ‘Decidedly so’, ‘Yes’, ‘Reply hazy, try again’ or ‘My sources say no’? Read on…

On New Year’s Day 2014, it looked like “the year of reckoning for the ‘better mousetraps’”? But the reckoning wasn’t quite as dramatic as this Editor thought.

We are whipping past the 2012-13 Peak of Inflated Expectations in health tech, diving into the Trough of Disillusionment in 2014.

There surely were companies which turned up ‘Insolvent with a great idea’ in Joe Hage’s (LinkedIn’s huge Medical Devices Group) terms, but it was more a year of Big Ideas Going Sideways than Crash and Burns.

Some formerly Great Ideas may have a future, just not the one originally envisioned. (more…)

Tunstall’s challenging year: results reported

click to enlargeBreaking News. The topline of Tunstall Healthcare Group’s 2014 results (through 30 Sept 14) is now (partly) public thanks to the Yorkshire Post, Tunstall’s ‘hometown paper’. (We do note that it was published on 23 Dec, in the ‘dead of night’ rolling up to the Christmas holiday.) Notably, there is no report on the Tunstall website and it is too early to show on standard corporate reporting sites such as DueDil and CompanyCheck. The YP article appears to be written partly in press release-speak, which we do not fault them for on limited news available. In summary:

  • In the 2014 FY ended 30 September, revenues were £215 million. FY2013 was £221 million, a decrease of £6 million (2.7 percent).
  • A corresponding but greater EBITDA (earnings before interest taxation depreciation and amortization) drop to £43.0 million. FY 2013 was £52.7 million, a decrease of £9.7 million (18.4 percent).
  • The good news: revenues up 6.8 percent in the Nordics, Southern Europe, Central Europe, and Australasia; Spain’s Televida as a market leader also a bright spot [TTA 19 Dec].
  • No such good news in UK and the US  (more…)

Qualcomm (Second) Life: a conversation with Jim Mault

One of the surprises for this Editor, and for others attending the mHealth Summit, was to see the sizable presence of Qualcomm Life on both the exposition floor and during the sessions. From a near-nil presence at ATA 2014 and gone dark on news, the floodlights snapped on last week with new partners and a new emphasis: coordination of chronic and transitional (hospital to home) care management (CCM/TCM).

On the show floor, the spotlight was on the partner companies which mixed the established with (mostly) the early and mid-stage. Readers will recognize names such as AliveCor, Telcare, OMRON, Nonin and Airstrip; not so well known are Vaica, Orion Health, Monitored Therapeutics, IMPak Health, Vital Connect, Care Connectors, toSense (CoVa), Dexcom, InteliChart, TruClinic, ForaCare, VOXX, vitaphone (outside of Europe), Propeller Health and Noom Health (a NYeC Digital Health Accelerator 2014 graduate). The partners occupy different parts of the management continuum, integrating communications, record sharing, population health management, sensor-based monitoring, traditional and non-traditional vital signs monitoring, medication management, behavioral change methodologies and PHRs. The 2net Hub is still present for data transmission, sharing and storage, but more prominent is Qualcomm Life’s HealthyCircles platform which provides the clinical management ‘glue’: secure communications, record sharing and care team coordination. HealthyCircles was purchased in mid-2013. Founder James Mault, MD, FACS joined Qualcomm Life as VP/Chief Medical Officer.

We had some post-mHealth Summit reflection time by telephone this Wednesday while Dr Mault was in Boston. (more…)

Free telecare event in Eccles (UK)

If you are in the Eccles/Greater Manchester area on 11 September (and not attending the Kings Fund International Digital Health and Care Congress or Medical Engineering Centres Annual Meeting and Bioengineering14, both in London), Contour Homes is sponsoring a free, full day North West Telecare Event at AJ Bell Stadium. It will give an overview and showcase latest technologies in telecare for professionals involved in supporting independent at home living. There are talks including Alyson Bell, Managing Director of the TSA, Dawn Thomber of Contour Homes and Tahir Idris of TeleMagenta plus an exhibition. This Editor notes the Tunstall logo (but no speakers); Contour Homes is one of the ‘my world’ introductory sites. PDF with complete information and registration.

Tunstall launches Advisory Service for ‘telehealthcare’

click to enlargeTunstall Healthcare UK last week announced the addition of an advisory service to help commissioners (CCGs, borough councils) and providers better understand, design, deliver and deploy what they’ve coined ‘telehealthcare’, which is plain ol’ telehealth to The Rest of Us. The Advisory Service will be managed by a team of specialists with clinical, technology, training, implementation and business intelligence expertise. The illustration to the left indicates their ‘swirl of disciplines.’ An interesting quote from the release: “According to NHS England, nearly a third of patients aged 75 or over have two or more long-term conditions; the overall cost of care for a person with multiple conditions is £2,500 per year.” (In US terms, that seems vanishingly small, except when you start multiplying…Ed.D.) In the UK system, commissioners are supposed to stay vendor-neutral so to this Editor there is a question on the objectivity of the advice given. On the clinical side, how many doctors and nurses will be engaged by the Advisory Service? The release also implies that the service will be available internationally, but materials are UK only. Website, release, brochure.

Another indication that Tunstall is trying to broaden itself beyond frameworks, fees and NHS funding is their organization of a European Symposium in Barcelona a few weeks ago.  Hot topics were integrating services, enabling self-care and self-management for people with long-term health and care needs, increasing awareness of these service among carers, and of course cost management. Tunstall blog.

According to this GP article, GPs are not impressed by telehealth. They “have expressed doubts over the potential of telehealth to improve patient care, and studies have questioned whether the health-tracking technologies are value for money for the NHS.” Thus the Department of Health will encourage commissioners to use telehealth by surveying telehealth and telecare users, as well as developing a set of metrics for commissioners which will demonstrate their impact on health outcomes. The Telehealth Service Association (TSA) estimates are that 1.37m people in 2011 used telehealth, telecare and telecoaching services in England. Certainly Tunstall’s move in this area is designed to take advantage of Government action in this area and commissioners’ increased accountability.