Rounding up the roundups in health tech and digital health for 2017; looking forward to 2018’s Nitty-Gritty

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2017/12/Lasso.jpg” thumb_width=”100″ /]Our Editors will be lassoing our thoughts for what happened in 2017 and looking forward to 2018 in several articles. So let’s get started! Happy Trails!

2017’s digital health M&A is well-covered by Jonah Comstock’s Mobihealthnews overview. In this aggregation, the M&A trends to be seen are 1) merging of services that are rather alike (e.g. two diabetes app/education or telehealth/telemedicine providers) to buy market share, 2) services that complement each other by being similar but with strengths in different markets or broaden capabilities (Teladoc and Best Doctors, GlobalMed and TreatMD), 3) fill a gap in a portfolio (Philips‘ various acquisitions), or 4) payers trying yet again to cement themselves into digital health, which has had a checkered record indeed. This consolidation is to be expected in a fluid and relatively early stage environment.

In this roundup, we miss the telecom moves of prior years, most of which have misfired. WebMD, once an acquirer, once on the ropes, is being acquired into a fully corporate info provider structure with its pending acquisition by KKR’s Internet Brands, an information SaaS/web hoster in multiple verticals. This points to the commodification of healthcare information. 

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2017/12/canary-in-the-coal-mine.jpgw595.jpeg” thumb_width=”150″ /]Love that canary! We have a paradigm breaker in the pending CVS-Aetna merger into the very structure of how healthcare can be made more convenient, delivered, billed, and paid for–if it is approved and not challenged, which is a very real possibility. Over the next two years, if this works, look for supermarkets to get into the healthcare business. Payers, drug stores, and retailers have few places to go. The worldwide wild card: Walgreens Boots. Start with our article here and move to our previous articles linked at the end.

US telehealth and telemedicine’s march towards reimbursement and parity payment continues. See our article on the CCHP roundup and policy paper (for the most stalwart of wonks only). Another major change in the US is payment for more services under Medicare, issued in early November by the Centers for Medicare and Medicaid Services (CMS) in its Final Rule for the 2018 Medicare Physician Fee Schedule. This also increases payment to nearly $60 per month for remote patient monitoring, which will help struggling RPM providers. Not quite a stride, but less of a stumble for the Grizzled Survivors. MedCityNews

In the UK, our friends at The King’s Fund have rounded up their most popular content of 2017 here. Newer models of telehealth and telemedicine such as Babylon Health and PushDoctor continue to struggle to find a place in the national structure. (Babylon’s challenge to the CQC was dropped before Christmas at their cost of £11,000 in High Court costs.) Judging from our Tender Alerts, compared to the US, telecare integration into housing is far ahead for those most in need especially in support at home. Yet there are glaring disparities due to funding–witness the national scandal of NHS Kernow withdrawing telehealth from local residents earlier this year [TTA coverage here]. This Editor is pleased to report that as of 5 December, NHS Kernow’s Governing Body has approved plans to retain and reconfigure Telehealth services, working in partnership with the provider Cornwall Partnership NHS Foundation Trust (CFT). Their notice is here.

More UK roundups are available on Digital Health News: 2017 review, most read stories, and cybersecurity predictions for 2018. David Doherty’s compiled a group of the major international health tech events for 2018 over at 3G Doctor. Which reminds this Editor to tell him to list #MedMo18 November 29-30 in NYC and that he might want to consider updating the name to 5G Doctor to mark the transition over to 5G wireless service advancing in 2018.

Data breaches continue to be a worry. The Protenus/DataBreaches.net roundup for November continues the breach a day trend. The largest breach they detected was of over 16,000 patient records at the Hackensack Sleep and Pulmonary Center in New Jersey. The monthly total was almost 84,000 records, a low compared to the prior few months, but there may be some reporting shifting into December. Protenus blog, MedCityNews

And perhaps there’s a future for wearables, in the watch form. The Apple Watch’s disconnecting from the phone (and the slowness of older models) has led to companies like AliveCor’s KardiaBand EKG (ECG) providing add-ons to the watch. Apple is trying to develop its own non-invasive blood glucose monitor, with Alphabet’s (Google) Verily Study Watch in test having sensors that can collect data on heart rate, gait and skin temperature. More here from CNBC on Big Tech and healthcare, Apple’s wearables.

Telehealth saves lives, as an Australian nurse at an isolated Coral Bay clinic found out. He hooked himself up to the ECG machine and dialed into the Emergency Telehealth Service (ETS). With assistance from volunteers, he was able to medicate himself with clotbusters until the Royal Flying Doctor Service transferred him to a Perth hospital. Now if he had a KardiaBand….WAToday.com.au  Hat tip to Mike Clark

This Editor’s parting words for 2017 will be right down to the Real Nitty-Gritty, so read on!: (more…)

The evolution of Facebook: implications for social health

The Telegraph’s recent retrospective on Facebook and its evolution from 2004’s ‘Thefacebook’ of Harvard University students to the Facebook that many of us use now, with Chat, timeline and a converged mobile and desktop design, led reader Mike Clark to drop Editor Charles a line about how healthcare isn’t maximizing social media and internet-based innovation. Recent studies have indicated that these social patient communities benefit their members. Agreed, but there are increasing qualifications–and qualms.

Back in 2014, Facebook made some noises on forming its own online health communities, a move that was widely derided as Facebook monetizing yet another slice of personal (health) data from users. While Charles has made the excellent point that “almost all good health apps are essentially the tailored interface to an internet service that sits behind it, a fact often forgotten by commentators”, Editor Donna on her side of the Atlantic has seen concerns mount on privacy, security and the stealthy commercialization/monetization of many popular online patient support groups (OSGs) which Carolyn Thomas (‘The Heart Sister’) skewers here, excepting those with solid non-profit firewalling (academic, government, clinical). Example she gives: Patients Like Me, which markets health data gathered from members to companies developing products to sell to patients. How many members, with a disease or chronic condition on their mind, will browse through to this page that says in part: “Except for the restricted personal information you entered when registering for the site, you should expect that every piece of information you submit (even if it is not currently displayed) may be shared with our partners and any member of PatientsLikeMe, including other patients.”

We’ve also noted that genomics data may not be sufficiently de-identified so that it can’t be matched through inference [TTA 31 Oct 15], with the potential for sale. And of course Hackermania Running Wild continues (see here).

For now general information sites like WebMD and personalized reference sites such as Medivisor feel more secure to users, as well as small non-commercialized OSGs and ‘closed’ telehealth/telemedicine systems.

CVS Caremark’s employee wellness ‘stick’ revisited–in court (US)

Exactly a year ago, retail drug store/onsite clinic/PBM giant CVS Caremark unveiled its ‘big stick’ approach to employee wellness–if you are in their health plan, you must participate in their ‘voluntary’ health screenings and management program or be charged $50 per month. One employee is now suing about this in Alameda County (Oakland/San Francisco, California area) Court.

According to the Courthouse News Service, the complaint states that “During the ‘Wellness Exam,’ a doctor performs blood work, which, upon information and belief, is utilized by defendants to ‘flag’ employees who are at risk for a variety of medical conditions.” Also from CNS, “In addition to the exam, which Watterson says she had to pay for, CVS made her fill out a survey that asked personal questions such as weight, body fat percentage, whether she drinks or smokes and is sexually active. The survey was “required in lieu of a $600 fine,” according to the lawsuit.” (Editor’s emphasis) If she had the exam in-house–at a CVS MinuteClinic–it also would have cost her $125 out of pocket, so she went to a private physician who charged her the co-pay, $25. She’s seeking compensation for “class certification and damages for failure to pay hourly and overtime wages, failure to indemnify, illegal wage deductions, failure to provide accurate wage statements and unfair competition.” 

All of which was easily predictable that CVS Caremark would be asking these questions, as they are fairly standard in a health workup –but is the ‘cross the line’ part (and what most of the dither may be about) the last item noted?  (more…)

The lack of evidence in health IT and patient engagement

In health economist/consultant Jane Sarasohn-Kahn’s lengthy analysis of the IMS Research report, Patient Apps for Improved Healthcare: From Novelty to Mainstream, ‘mainstream’ does not necessarily mean that apps deliver value–in health outcomes, health support or behavior change–which is why doctors have largely ignored them. For the 43,000+ ‘health apps’ so categorized in the Apple iTunes store, only 23,000 met IMS’ criteria of a ‘genuine health app.’ Few apps manage chronic disease for the highest health spenders or assist seniors, amazingly 5 apps =15 percent of all downloads with most apps having less than 500 downloads. Most apps provide information only and only 20 percent capture/track user data. Not dissimilar to the Manhattan Research smartphone study [TTA 30 Oct], the bulk of apps address behavioral health, eyes and hearing, endocrine and nutrition, heart/circulatory, musculoskeletal, and cancer. In IMS’ view, (more…)

WebMD’s Avado acquisition and meaning (US)

Early-stage company Avado’s acquisition by content Goliath WebMD has rocked the small world of New York health tech, with both companies being located (or co-located) here. First is the acquisition price estimated by TechCrunch in the $20-30 million range. Co-founded by Dave Chase (whose Forbes articles we’ve occasionally commented on here), Avado developed its patient portal PRM (Patient Relationship Management) system, including direct messaging and the highly touted Blue Button, on relatively limited funding with a $1 million raise in March plus an earlier $300,000 from New York Digital Health Accelerator in addition to angel funding. Second, for WebMD, it is their first foray into anything that bridges from the patient to their physicians for messaging, reminders, and appointment scheduling. (more…)

Qualcomm Life ‘circles’ to care coordination

Qualcomm Life, which to date has been more involved in device connectivity, interoperability and data management through its 2net Platform, has acquired care coordination platform HealthyCircles. Announced at ATA2013, the HealthyCircles service-as-a-software adds a front end to 2net’s biometric data that will aid in post-discharge and chronic care management from the hospital to home care providers to family caregivers. Qualcomm is clearly going after  the hospital ACO (accountable care organization) market in areas such as reductions in 30-day same cause readmissions; the fit with WebMD in integrating 2net biometric data with the former’s reference information, as announced at mHIMSS, is a little less apparent [TTA 5 March]. MedCityNews, HealthcareITNews, Qualcomm’s (jargon-laden, nearly unreadable) release.