Rounding up the news: Babylon’s Samsung Health UK deal, smartphone urine test debuts, a VA Home Telehealth ‘announcement’, Aging 2.0’s NY Happy Hour

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2017/12/Lasso.jpg” thumb_width=”125″ /]Huge or Ho-Hum? Babylon’s ‘Ask an Expert’ feature is now available within the Samsung Health app as of the start of June. It will need to be activated at a cost of £50 per year, or £25 for a single consultation. Babylon’s service with over 200 GPs is now available on millions of Samsung Galaxy devices in the UK. Babylon now claims half a million users of its private GP services and 26,500 registered in London with its NHS-funded and controversial GP at Hand app.

Is it as our Editor Charles, quoting Niccolo Machiavelli writing in The Prince, “Nothing is more difficult to undertake, more perilous to conduct or more uncertain in its outcome than to take the lead in introducing a new order of things. For the innovator has for enemies all those who have done well under the old and lukewarm defenders who may do well under the new”. The debate rages–see the comments below the Pulse Today article. 

Healthy.io is introducing a test of its urinalysis by smartphone test with Salford Royal NHS Foundation Trust’s new Virtual Renal Clinic. 50 patients will received the Dip.io kit to test their urine. Dip.io uses the standard urine dipstick test combined with a smartphone application that guides the user through scanning in the results with a smartphone camera and sends the result to their doctor. Healthy.io claims this is a first-of-kind technology and system. According to Salford Royal, chronic kidney disease (CKD) costs the NHS £1.45 billion in England alone. The company is part of the NHS Innovation Accelerator Programme. Digital Health News

In what has been the worst kept secret in US telehealth, 1Vision LLC and AMC Health finally announced they were partners in 1Vision’s over $258 million Home Telehealth award by the Department of Veterans Affairs (VA) [TTA 6 Feb 17]. The news here is that the AMCH release states that they have an “Authority to Operate (ATO)”, which means they can provide Home Telehealth services using AMC Health’s CareConsole to VA-enrolled veterans and their families. This last step is very important because it is a common post-award point of failure for new awardees. Earlier this year, the Iron Bow/Vivify Health award failed on the country of origin of Vivify’s kit, dooming the implementation [TTA 16 Jan] and Iron Bow’s award. (Vivify Health has gone on.) Medtronic, as a long-term incumbent, has few worries in this regard, though any new equipment has to be cleared. The mystery is if Intel-GE Care Innovations, the last new awardee, has passed the ATO bar. AMC Health/1Vision release. 

And on the social front for New Yorkers, raise a Pint 2.0 at Aging 2.0’s NYC Happy Hour, Tuesday 18 July at 310 Bowery Bar, 6pm. Aging 2.0 website, where you can check for a chapter and events near you.

End of year action: Vivify/InTouch, InTouch/TruClinic, Medtronic, NYCEDC winners, ActiveProtective, Adidas exits wearables, Fitbit (updated)

  • Dallas-based Vivify Health is partnering with California’s InTouch Health to integrate their telehealth remote patient management with InTouch Health’s acute care video consult/device platform. For InTouch, it is a move into the home by using Vivify’s Managed Kit and BYOD and related APIs. For Vivify, this helps in their post-acute RPM sell to large healthcare organizations. (Is their VA partner Iron Bow somewhere in the mix?) Their VA Home Telehealth rival Medtronic announced their partnership with American Well a few months ago [TTA 21 Oct]. InTouch release via Telecom Reseller
  • Updated. InTouch also announced their agreement on Jan 4 to purchase DTC telehealth provider TruClinic furthering their move into home telehealth. TruClinic will be merged into InTouch. Heading it up will be recently appointed EVP of Marketing and Consumer Solutions Steve Cashman, who founded and headed pioneering but overly ambitious for the market health kiosk HealthSpot [TTA roundup here]. Release  (Our update on the state of health kiosks here)
  • Speaking of Medtronic Care Management Services, MCCM touted its VA Home Telehealth ties to Healthcare Analytics News. Intriguing claim: they’ve treated 310,000 veterans since 2011 (Cardiocom, the 2011 awardee, was purchased in 2013). VA itself credits only 156,000 patients to Home Telehealth in Federal FY 2014 (the last official count), 43,000 patients in 2010 and 144,000 in 2013. A very rough estimate by this Editor is that they were about 25 percent of the veterans in the program.
  • Announced at last week’s NYC Economic Development Commission (NYCEDC) Health 2.0 Digital Health Forum attended by this Editor were the winners of the third annual NYCEDC/HITLAB’s Digital Health Breakthrough Network accelerator program for pre-revenue startups: Altopax (VR behavioral health), Navimize (doctor/hospital scheduling), Tatch (sleep quality biometrics), and PainQX (pain level monitoring). The Forum also had Digital Health Marketplace matchmaking meetings for 65 NYC-based health tech companies with prospective clients. The Marketplace furnishes competitive grants to offset the cost of piloting between growth-stage tech companies and providers. Release, MedCityNews
  • ActiveProtective‘s controversial protective airbag to cushion hips from falls by high-risk older adults [TTA 10 Jan] gained $4.7 million in Series A funding led by Generator Ventures. Mobihealthnews
  • Adidas is shuttering its wearable device development unit and condensing its offerings, focusing on the Runtastic GPS-guided exercise offering and a shopping app. It follows similar moves at Nike and Under Armour proving that big names in sports fitness clothing couldn’t pull off wearables. Mobihealthnews
  • Meanwhile, Fitbit’s Ionic continues to develop with now an App Gallery with 60 apps–11 of which are health/fitness related–and more than 100 watch faces. (Wonder if any are Mickey Mouse?) What we termed a ‘Hail Mary’ pass may actually get past the goal line. Mobihealthnews

VA says goodbye to VistA, hello to Cerner for new EHR–and possible impacts (updated)

The new sheriff just turned the town upside down. Veterans Affairs’ new Secretary, Dr. David J. Shulkin, as expected moved quickly on the VA’s EHR modernization before the July 1 deadline, and moved to the same vendor that the Department of Defense (DoD) chose in 2015 for the Military Health System, Cerner. VA will adapt MHS GENESIS, based on Cerner Millenium. The rationale is seamless interoperability both with DoD and with private sector community providers and vendors, which base their services on commercial EHRs. The goal is to have one record for a service member through his or her lifetime and to eliminate the transition gap after discharge or retirement. (Transition gaps are also repeated when reservists or National Guard are called up for active duty then returned to their former status.) Another priority for VA is preventing the high rate of suicide among vulnerable veterans.

Updates: VA confirmed that Epic and Leidos will keep the development of the online medical appointment scheduling program, awarded in 2015 and currently in pilot, to be completed in 18 months. The contract is worth $624 million over five years. Wisconsin State Journal  The House Appropriations subcommittee on Veterans Affairs likes the Cerner EHR change. The Senate Veterans Affairs Committee is meeting Wednesday to discuss the VA budget sans the EHR transition. The EHR numbers are expected to be sooner rather than later. POLITICO Morning eHealth 

Dr. Shulkin is well acquainted with the extreme need for a modernized, interoperable system serving the Veterans Health Administration (VHA), having been on the US Senate Hot Grill for some years as Undersecretary of Health for VA. The foundation for the move from homegrown VistA to Cerner was laid last year during the prior Administration through an August RFI for a COTS (commercial off the shelf) EHR [TTA 12 Aug 16] and in later hearings. “Software development is not a core competency of VA” and it has been obvious in system breakdowns like scheduling, maintaining cybersecurity and the complex interoperability between two different systems. To move to Cerner immediately without a competition, which took DoD over two years, Dr. Shulkin used his authority to sign a “Determination and Findings” (D&F) which provides for a public health exception to the bidding process. The value of the Cerner contract will not be determined for several months.

For those sentimental about VistA, he acknowledged the pioneering role of the EHR back in the 1970s, but that calls for modernization started in 2000 with seven ‘blue ribbon’ commissions and innumerable Congressional hearings since. He understated the cost in the failed efforts on interoperability with DoD’s own AHLTA system, VA’s own effort at a new architecture, and modernizing the outpatient system. This Editor tallied these three alone at $3 billion in GAO’s reckoning [‘Pondering the Squandering’, TTA 27 July 13]. 

It is still going to take years to implement–no quick fixes in something this massive, despite the urgency.

  • Both MHS and VA will be running two systems at once for years (more…)

VA awards over $1 billion in Home Telehealth contracts–at long last (updated)

Breaking News, Updated  The Department of Veterans Affairs (VA) on 1 Feb issued over $1 billion in awards to four companies to provide Home Telehealth vital signs monitoring technologies to veterans in home care and monitoring. The four companies are Medtronic, Care Innovations, Iron Bow Technologies, and 1Vision LLC. The $1 billion is split evenly between the four ($258 million for each company over the five-year duration). The contracts are for an initial year (31 Jan 2018 end date listed on GovTribe.com), renewable annually for five years total. The bid process started in 2015 and the award had originally been scheduled for early-to-mid 2016.

On the suppliers:

  • Medtronic is the incumbent as a supplier since 2011, dating back to Cardiocom’s 2011 award for its home monitoring units (Cardiocom was acquired in August 2013). Medtronic is a Dublin, Ireland HQ’d company with a US headquarters in Minnesota.
  • Care Innovations is well known to our Readers as the developer of Health Harmony and the acquirer of the QuietCare telecare/behavioral monitoring used in senior housing. Their parent is Intel.
  • Iron Bow Technologies is a supplier to VA in other healthcare areas (telemedicine and store-and-forward) and is a large, privately held IT company with multiple Federal contracts and deep Federal contractor roots. Their revenue has been reported at over $462 million (Washington Technology Top 100 2016).
  • 1Vision LLC is a new company formed as a joint venture between HMS Technologies, Inc. and MBL Technologies, Inc. Neither are previously engaged as home telehealth providers, but both are Federal contractors. According to their individual websites, HMS is an IT systems integrator and MBL is engaged primarily in cybersecurity.

The question for this Editor is how Iron Bow and 1Vision, which are not telehealth (vital signs) monitoring companies but telemedicine and IT service providers respectively, will execute Home Telehealth with the VA. Have they partnered with yet-to-be disclosed providers in providing home telehealth services to the VA? (Watch this space)

While the award is the largest in US telehealth, the VA is, by this Editor’s experience in her last position with Viterion Corporation, extremely demanding on its service providers and will be even more so in the future. The future reasons are clear: 1) President Trump has put a Klieg light on the VA and 2) he’s named a new VA secretary, Dr David Shulkin, who is currently VA Undersecretary for Health (confirmation hearing notes courtesy of POLITICO, nomination approved by the Senate committee Tuesday, and easily confirmed Monday night 13 Feb), who has been highly engaged with HIT issues, including both the VistA EHR modernization/replacement and initiatives such as the recently unveiled Digital Health Platform [TTA 12 Jan]. (more…)

ONC gets in study game in designing the Consumer Centered Telehealth Experience

ONC (the Office of National Coordinator for Health Information Technology, HHS) in the spring conducted a design session on creating a more consumer-centered telehealth experience, commissioning the engagedIN research firm to help select a panel, run it and produce the study. The white paper focuses on how telehealth can either further fracture or integrate PHR (study pages 7-11), and what’s needed to make telehealth and telemedicine more convenient and effective for consumers. The panel avoided the big telemedicine providers (a bone that Mobihealthnews picks with the study) which typically dominate these panels–to this Editor a positive action–but included other telehealth providers like Qualcomm Life, Care Innovations and Zipnosis, as well as the US’ largest user of telehealth, VA Home Telehealth. Among the key drivers of telehealth are HHS’ and private insurers (UHC) shift to value-based payments; CMS’ target of 50 percent of Medicare value-based care is cited (page 5). There are nine principles at the end (pgs 13-16) to guide the way forward. Designing the Consumer Centered Telehealth and e-Visit Experience (PDF) (Though it is confusing why e-Visit was used rather than ‘virtual visits’ or, in fact, telemedicine.)

Breaking news confirmed: Bosch exiting healthcare and telehealth in US–UPDATED

Breaking News–UPDATED with Bosch response

Bosch has confirmed they are closing their telehealth business in the US. Please see their statement at the end of this article.

A home care industry newsletter, along with our own reliable industry sources, have confirmed the recent industry discussion that Bosch Healthcare, since January a solely US operation, is winding down its business without a definite turnover to a buyer. This Editor, in calling various departments in their Palo Alto, California offices for confirmation on Thursday, was (when she reached a human being) forwarded to HR where she could leave only voice mail. An email to marketing also received no response. All sources indicate that staff layoffs took place last Monday.

Editor’s Note: Bosch’s official press response follows this article. We have also made certain corrections to this article (see in red).

  1. The Home Care Technology Report, published by industry consultant Tim Rowan, on Wednesday posted two articles stating that Bosch laid off nearly all of its staff on Monday (15 June) save for customer service and some key operating areas. His information indicated that Health Buddy sales–new and existing orders–have been terminated. This includes orders placed through its McKesson partnership. Non-VA service will be terminated in 60 to 90 days.
  2. Home Care Technology also reported that Bosch’s business with the Veterans Health Administration (VA) will be maintained through April 2016, which is near to the contract end in May, but no new units will be delivered. The original contract was with Health Buddy hub developer Health Hero Network, sold to Bosch in 2008With the later acquisition of ViTel Net, Bosch developed into one of the two leading VA Home Telehealth remote monitoring hub suppliers–the other being Cardiocom. VA Home Telehealth is the largest telehealth program in the US with over 156,000 patients (Federal Year 2014) (Ed. Note: VA has a third authorized and active VA supplier, Viterion).

As Mr Rowan did, this Editor will speculate on the reasons why there is this reported exit without a sale or spinoff, despite the substantial VA and other healthcare placements of Health Buddy. Our take is somewhat different than his: (more…)